bluuebunny/crossref_metadata_2025 huggingface dataset:
Rural or urban living and Parkinson's disease
Authors: Ferraz Henrique B. , Andrade Luiz A. F. , Tumas Vítor , Calia Leandro C. , Borges Vanderci
Published: December 2010

Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.
Local IgG synthesis in three pediatric patients with cuban epidemic neuropathy
Authors: Dorta-Contreras Alberto , Torres Eric Martínez , Dotres-Martínez Carlos
Published: December 2010

Three pediatric patients with Cuban epidemic neuropathy were studied. Cerebrospinal fluid and sera were simultaneously obtained. Albumin and IgG were quantified by immunodifusion. Albumin quotient and local synthesis of IgG were calculated by Reiber/Felgenhauer formula. A patient with optic neuritis had a dysfunction of the blood-cerebrospinal fluid barrier. All the group had local synthesis of IgG.
Metástase de adenocarcinoma mamário para a hipófise: relato de caso
Authors: Zambelli Heller J. L , Brito José Nazareno P.O. , Assumpção Ligia V. M. , Araújo Alessandra A. Q. , Zambelli Eliane R. L. , Parmigiani Alessandro M.
Published: December 2010

Relato de caso de metástase de adenocarcinoma mamário para a hipófise, referente a uma paciente de 57 anos de idade, apresentando imagem de tomografia computadorizada sugestiva de adenoma primário de hipófise. É mencionada pelos autores a importância da cirurgia no diagnóstico definitivo da lesão para determinar o tratamento apropriado.
Efeito de substratos, luz e sobreposição de papel de filtro na esporulação de Corynespora cassiicola
Authors: Melo Márcia Muliterno de , Reis Erlei Melo
Published: December 2010

O experimento foi realizado no Laboratório de Fitopatologia - Micologia, na Faculdade de Agronomia e Medicina Veterinária da Universidade de Passo Fundo, com a finalidade de avaliar a esporulação de Corynespora cassiicola em diferentes substratos. Para isso foram usadas placas de petri com seis diferentes meio de cultura - Batata Dextrose Ágar (BDA), Solução Czapek Ágar, Alimento infantil, Malte Ágar, Farinha de aveia e suco V8 Ágar e quatro combinações (com luz alternada e sobreposição de papel filtro, com luz alternada e sem sobreposição de papel filtro, sem luz com sobreposição de papel filtro e sem luz e sem sobreposição de papel filtro). O delineamento experimental usado foi fatorial triplo (substrato, luz/escuro, com ou sem sobreposição de papel filtro). Na avaliação de esporulação do fungo, foram cortados dois discos de 0,241cm² em cada placa dos diferentes substratos e colocados em tubos de ensaio contendo 10mL de água destilada. Esses tubos foram agitados e de cada um foram retiradas três alíquotas de 10mL para contagem de conídios no microscópio óptico. Os dados foram transformados em número de esporos.cm². A maior esporulação do fungo foi obtida com o substrato Solução Czapek-Ágar, com fotoperíodo de 12 horas e sobreposição de papel filtro.
Geração de seqüências viáveis para montagem automatizada
Authors: Guimarães Gilcina , Netto P.O Boaventura , Naveiro Ricardo M.
Published: December 2010

Este trabalho consiste numa aplicação das técnicas de modelagem por grafos à geração de seqüências de montagem de um produto discreto (composto de uma série de peças). Utilizamos como referência para o trabalho método desenvolvido por A. Bourjault [5] e T. Fazio e D. Whitney [6].
The European Medicines Agency Review of Ofatumumab (Arzerra®) for the Treatment of Chronic Lymphocytic Leukemia in Patients Refractory to Fludarabine and Alemtuzumab: Summary of the Scientific Assessment of the European Medicines Agency Committee for Medicinal Products for Human Use
Authors: Gravanis Iordanis , Ersbøll Jens , Skovlund Eva , Abadie Eric , Marty Michel , Pignatti Francesco
Published: December 2010

Learning Objectives

After completing this course, the reader will be able to: Evaluate the evolving risk-benefit profile of ofatumumab when considering treatment in patients with CLL.Identify patients with CLL who may be appropriate candidates for treatment with ofatumumab.

This article is available for continuing medical education credit at CME.TheOncologist.com.

On April 19, 2010, the European Commission issued a conditional marketing authorization valid throughout the European Union (EU) for ofatumumab (Arzerra®; Glaxo Group Ltd, Greenford, Middlesex, U.K.). The decision was based on the favorable opinion of the Committee for Medicinal Products for Human Use recommending a conditional marketing authorization for ofatumumab for the treatment of chronic lymphocytic leukemia (CLL) in patients refractory to fludarabine and alemtuzumab. A conditional marketing authorization means that additional data to confirm the benefit–risk balance of ofatumumab are awaited. The active substance of Arzerra® is ofatumumab, a monoclonal antibody medicinal product (ATC code L01XC10). The recommended dose is 300 mg of atumumab for the first infusion and 2,000 mg of atumumab for all subsequent infusions. The infusion schedule is eight consecutive weekly infusions, followed 4–5 weeks later by four consecutive monthly (i.e., every 4 weeks) infusions. Ofatumumab targets CD20, a cell surface marker of B lymphocytes, which is followed by cell lysis via complement-dependent cytotoxicity and antibody-dependent cell-mediated cytotoxicity. The benefit of ofatumumab is the control of CLL in patients who are refractory to both fludarabine and alemtuzumab, which was indicated by a high response rate. The most common side effects are infections and infusion reactions. The objective of this paper is to summarize the scientific review of the application leading to approval in the EU. The detailed scientific assessment report and product information, including the summary of product characteristics, are available on the EMA website (http://www.ema.europa.eu).
Subject Index
Authors: Xu De
Published: December 2010

Full text available
Chemical Enhancers
Authors: Lopez-Castellano Alicia , Merino Virginia
Published: December 2010

The transdermal administration of drugs is an effe ctive alternative to conve ntional methods such as
oral or subcutaneous injections, as it overcomes the difficulties associated with these routes. Several
methodologies have been developed in order to enhance drug transdermal absorption. Chemical percutaneous
enhancers have long been used to incr ease the range of drugs that can be effectively delivered through the skin.
To date, a vast array of chemicals has been evaluated as enhancers. This chapter reviews the principal chemical
percutaneous enhancers and their mechanisms of acti on. The techniques to determine permeation enhancement
and their uses in topical/transdermal formulations are also discussed.
Efficacy of sublingual administration of detomidine gel for sedation of horses undergoing veterinary and husbandry procedures under field conditions
Authors: Gardner Rachel B. , White Gary W. , Ramsey Deborah S. , Boucher Joseph F. , Kilgore W. Randal , Huhtinen Mirja K.
Published: December 2010

Objective—To determine whether sublingual detomidine gel administration to horses would be effective in providing an appropriate degree of sedation and restraint to facilitate completion of veterinary and husbandry procedures under field conditions.

Design—Multicenter, prospective, randomized, blinded, placebo-controlled clinical study.

Animals—270 client-owned horses known to require sedation or strong restraint to enable veterinary and husbandry procedures to be performed.

Procedures—Horses randomly received a single dose of detomidine gel (0.04 mg/kg [0.018 mg/lb]) or placebo gel administered sublingually. Horses were sedated to facilitate cleaning the prepuce, cutting of hair with electric clippers, hoof trimming or application of shoes, manual dental floating (ie, rasping or filing of the teeth to remove irregularities), nasogastric passage of a stomach tube or endoscope, and radiography. The primary determinant of efficacy was an assessment by a veterinarian on the ability or inability to successfully conduct the procedure.

Results—171 horses met all the study protocol criteria. One hundred twenty-nine horses were treated with detomidine. The procedure was completed successfully for 76% (98/129) of the detomidine-treated horses, while the procedure was completed successfully for only 7% (3/42) of the placebo-treated horses. The percentage of horses in which the procedure was successfully completed was significantly different between detomidine-treated horses and placebo-treated horses. No serious adverse effects were reported.

Conclusions and Clinical Relevance—Detomidine gel administered to horses sublingually at a dose of 0.04 mg/kg provided an appropriate degree of sedation and restraint to facilitate completion of veterinary and husbandry procedures in horses known to require sedation for such procedures.
Stability-indicating derivative spectrophotometry method for the determination of biapenem in the presence of its degradation products
Authors: Cielecka-Piontek Judyta , Lunzer Aran , Jelińska Anna
Published: December 2010

A first-derivative UV spectrophotometric method, with or without the subtraction technique, was developed for the determination of biapenem in pharmaceutical dosage form in the presence of its degradation products. The method was based on the measurement of first-derivative amplitudes at zero crossing point (λ = 312 nm) and the peak-to-zero technique and validated with regard to linearity, limits of detection and quantitation, selectivity and precision. The observed rate constants for the degradation of biapenem were comparable to those obtained in the stability-indicating HPLC method.
The bifunctionality of silica gel modified with Congo red
Authors: Kurczewska Joanna , Schroeder Grzegorz
Published: December 2010

Silica gel was chemically modified with Congo red and characterized by Fourier transform infrared spectroscopy, elemental and thermogravimetric analysis. The pH-sensitive immobilized Congo red retains the same properties as its solution counterpart and could be applied as solid indicator. The functionalized silica gel was also employed to extract different cations from water solutions. The concentration of cations extracted was determined by inductively coupled plasma optical emission spectrometry. The solid support is able to selectively extract silver and copper from water solutions and retains its properties after treatment with different organic and inorganic solvents.
The Functional Polymorphism 844 A>G in FcαRI (CD89) Does Not Contribute to Systemic Sclerosis or Rheumatoid Arthritis Susceptibility
Authors: BROEN JASPER C.A. , COENEN MARIEKE J.H. , RUEDA BLANCA , WITTE TORSTEN , PADYUKOV LEONID , KLARESKOG LARS , HESSELSTRAND ROGER , WUTTGE DIRK M. , SIMEON CARMEN , ORTEGO-CENTENO NORBERTO , GONZÁLEZ-GAY MIGUEL A. , PROS ANNA , HUNZELMAN NICHOLAS , RIEMEKASTEN GABRIELA , KREUTER ALEXANDER , VONK MADELON , SCORZA RAFAELLA , BERETTA LORENZO , AIRÒ PAULO , van RIEL PIET L.C.M. , KIMBERLY ROBERT , MARTIN JAVIER , EDBERG JEFFREY , RADSTAKE TIMOTHY R.D.J.
Published: December 2010

Objective.

To investigate the role of the FcαRI 844 A>G functional polymorphism in the genetic predisposition to rheumatoid arthritis (RA) and systemic sclerosis (SSc) susceptibility.

Methods.

The study population was composed of 1401 patients with SSc, 642 patients with RA, and 1317 healthy controls. The FcαRI (CD89) single-nucleotide polymorphism rs16986050 was genotyped by pyrosequencing.

Results.

We observed no significant deviation of the genotype and allele frequencies in RA and SSc compared to controls. A metaanalysis and a recessive and dominant model yielded similar negative results.

Conclusion.

Our data show that the FcαRI 844 A>G polymorphism is not associated with SSc or RA susceptibility.
Healthcare Cost and Loss of Productivity in a Canadian Population of Patients with and without Lupus Nephritis
Authors: AGHDASSI ELAHEH , ZHANG WENDY , ST-PIERRE YVAN , CLARKE ANN E. , MORRISON STACEY , PEEVA VALENTINA , LANDOLT-MARTICORENA CAROLINA , SU JIANDONG , REICH HEATHER , SCHOLEY JAMES , HERZENBERG ANDREW , POPE JANET E. , PESCHKEN CHRISTINE ,   LuNNET CaNIOS Investigators, WITHER JOAN E. , FORTIN PAUL R.
Published: December 2010

Objective.

To compare the healthcare cost and loss of productivity in patients with systemic lupus erythematosus (SLE) with (LN) and without lupus nephritis (lupus nephritis-negative, LNN).

Method.

Patients were classified into those with active (ALN and ALNN) and inactive disease (ILN and ILNN). Patients reported on visits to healthcare professionals and use of diagnostic tests, medications, assistive devices, alternative treatments, hospital emergency visits, surgical procedures, and hospitalizations as well as loss of productivity in the 4 weeks preceding enrollment.

Results.

Enrollment was 141 patients, 79 with LN and 62 LNN. Patients with LN were more likely to visit rheumatologists and nephrologists, undergo diagnostic tests, and had higher costs for medications than patients who were LNN. The annual healthcare cost averaged $CAN 12,597 ± 9946 for patients with LN and $10,585 ± 13,149 for patients who were LNN, a difference of $2012 (95% CI –$2075, $6100). Patients with ALN had more diagnostic tests and surgical procedures, contributing to a significantly higher annual direct cost ($14,224 ± 10,265) compared to patients with ILN ($9142 ± 8419) and a difference of $5082 (95% CI $591, $9573). The healthcare cost was not different between patients with ALNN and patients with ILNN. In patients with LN and patients who were LNN, < 50% were employed and on average missed 6.5–9 days of work per month. The loss of productivity was significantly higher for caregivers of patients with LN than caregivers of patients who were LNN.

Conclusion.

Healthcare cost and loss of productivity were similar between patients with LN and patients who were LNN; the loss of productivity for caregivers is higher for patients with LN; and the healthcare cost is greater in ALN than in ILN.
Anti-Interleukin 1 Treatment for Patients with Familial Mediterranean Fever Resistant to Colchicine: Table 1.
Authors: ÖZEN SEZA , BILGINER YELDA , AKTAY AYAZ NURAY , CALGUNERI MERAL
Published: December 2010

Objective.

Familial Mediterranean fever (FMF) is a recessively inherited autoinflammatory disorder characterized by recurrent attacks of fever and serositis. Although colchicine is the standard therapy for preventing attacks and suppressing inflammation, 5%–10% of compliant patients are colchicine-resistant. We report the effect of anti-tumor necrosis factor therapy (etanercept) and anti-interleukin 1 (IL-1) treatment (anakinra) in 6 cases resistant to colchicine therapy.

Methods.

Five children and an adult patient (3 female, 3 male) who were experiencing at least 2 attacks per month and had consistently elevated C-reactive protein levels despite regular colchicine therapy were given either etanercept or anakinra.

Results.

Although etanercept lowered the number of attacks (from 3–4 attacks per month to 2 attacks per month), attacks still recurred and acute-phase reactants remained high in 2 patients; thus etanercept was considered ineffective. All 4 patients were switched to anakinra. In 2 patients anakinra completely resolved clinical and laboratory findings. The other 4 patients have been switched to anakinra recently; to date anakinra has reduced the number of attacks (to < 1 per month) and lowered the levels of acute-phase reactants.

Conclusion.

In this small series, anakinra was succesful in suppressing inflammation and decreasing the number of attacks in FMF. This may be explained by the role of pyrin in the regulation of IL-1ß activation.
Probiotic modulation of dendritic cells and T cell responses in the intestine
Authors: Meijerink M. , Wells J.
Published: December 2010

Over the past decade it has become clear that probiotic and commensal interactions with mucosal dendritic
cells in the lamina propria or epithelial cells lining the mucosa can modulate specific functions of the mucosal
immune system. Innate pattern-recognition receptors such as TLRs, NLRs and CLRs play a crucial role in the host
recognition of probiotics and other microorganism. Signalling via these receptors directly influences the chemokine
and cytokine response of dendritic cells as well as the crosstalk between the epithelium and the immune cells in the
lamina propria. This can influence the population of effector and regulatory T cell subsets in the mucosa. Immune
assays with probiotics have shown that the in vitro immune response is both species and strain-specific. Such
assays may be useful for the selection of probiotic strains that have beneficial effects on the regulation of intestinal
inflammation but more comparative studies are needed to confirm recent findings. A better understanding of the
molecular mechanisms of probiotics, the effect of dose, and frequency of administration on microbial sampling by
mucosal APC will also help to clarify the value of immune assays as selection criteria for probiotics.
Mechanisms of Oxidative Damage in Multiple Sclerosis and a Cell Therapy Approach to Treatment
Authors: Witherick Jonathan , Wilkins Alastair , Scolding Neil , Kemp Kevin
Published: December 2010

Although significant advances have recently been made in the understanding and treatment of multiple sclerosis, reduction of long-term disability remains a key goal. Evidence suggests that inflammation and oxidative stress within the central nervous system are major causes of ongoing tissue damage in the disease. Invading inflammatory cells, as well as resident central nervous system cells, release a number of reactive oxygen and nitrogen species which cause demyelination and axonal destruction, the pathological hallmarks of multiple sclerosis. Reduction in oxidative damage is an important therapeutic strategy to slow or halt disease processes. Many drugs in clinical practice or currently in trial target this mechanism. Cell-based therapies offer an alternative source of antioxidant capability. Classically thought of as being important for myelin or cell replacement in multiple sclerosis, stem cells may, however, have a more important role as providers of supporting factors or direct attenuators of the disease. In this paper we focus on the antioxidant properties of mesenchymal stem cells and discuss their potential importance as a cell-based therapy for multiple sclerosis.
Selenium Deficiency and HIV Infection
Authors: Di Bella Stefano , Grilli Elisabetta , Cataldo Maria Adriana , Petrosillo Nicola
Published: December 2010

Selenium is a non-metallic chemical element of great important to human health. Low selenium levels in humans are associated with several pathological conditions and are a common finding in HIV infected individuals. We conducted a review of the literature to assess if selenium deficiency or selenium supplementation could play a role in modifying the clinical course of HIV disease. Several studies investigated the role of selenium in disease progression, morbidity and mortality in HIV infected individuals. Larger studies were conducted in countries with poor economic resources and limited access to HAART. According to the majority of published studies low selenium levels appear to have an association with mortality, and selenium supplementation appears to play a beneficial role on survival or on slowing disease progression among HIV infected individuals. The role of selenium supplementation on preventing hospital admission among HIV outpatients was also noticed. The literature suggests an association between selenium deficiency and development of HIV associated cardiomyopathy and furthermore, selenium supplementation appears to improve the cardiac function in HIV infected individuals with cardiomyopathy. However, there is conflicting evidence regarding the role selenium in modifying HIV viral load and immune status in HIV infection.
Aerobic and Facultative Microorganisms Isolated from Corroded Metallic Structures in a Hydroeletric Power Unit in the Amazon Region of Brazil
Authors: Correia Amabel F. , Segovia Jorge F.O. , Bezerra Roberto M. , Gonçalves Magda C.A. , Ornelas Sócrates S. , Silveira Damaris , Carvalho Josέ C.T. , Diniz Sέrgio P.S.S. , Kanzaki Luis I.B.
Published: December 2010

Aerobic and facultative bacteria belonging to the Enterobacteriaceae, Pseudomonadaceae, Bacillaceae, Corynebacteriaceae and Streptococcaceae families have been isolated from corroded metallic structures of a hydroelectric power unit in the Amazon region of Brazil. In addition to anamorphic dematiaceous and moniliaceous fungi, members of the archeobacteria kingdom were also detected in the same samples. Scanning electron micrographs of metal bars cultivated with consortia of the isolated microorganisms depicted suggestive images of biofilm formation and corroded metallic structures questioning the possible role of these microorganisms in the corrosion activity. We also found Amazonian medicinal plants exhibiting inhibitory activity against some of the isolated microorganisms. Our new findings need additional studies to confirm the participation of some isolated microorganisms in the process of metallic degradation despite our main question if are there particular microorganisms involved in the corrosion process? or if physicochemical conditions would favor the development of a particular microbiota and consequently the corrosion process would result from its metabolism? Therefore we hypothesize that any microorganism could be potentially involved in the genesis of corrosion process. This is the first report in the literature dealing with microbiologically induced corrosion in the Amazon region which is especially characterized by its high humidity and elevated temperature all year round.
Phytohemagglutinin-Induced Mitotic Index in Blood Lymphocytes: A Potential Biomarker for Breast Cancer Risk
Authors: Kosti Ourania , Byrne Celia , Cocilovo Costanza , Willey Shawna C. , Zheng Yun-Ling
Published: December 2010

Background

Cell proliferation is associated with the pathogenesis of cancer because it provides opportunities for accumulating genetic mutations. However, biomarkers of cell proliferation in response to environmental stimuli have not been adequately explored for breast cancer risk.

Methods

In a case-control study of 200 breast cancer patients and 360 healthy controls, we investigated the association between phytohemagglutinin (PHA)-induced mitotic index in blood lymphocyte and breast cancer risk.

Results

Having high mitotic index (>3.19%) was associated with an increased risk of breast cancer, with adjusted odds ratios (95% confidence interval) of 1.54 (1.03–2.30) and 2.03 (1.18–3.57) for all women and post-menopausal women, respectively. Mitotic index was correlated with some reproductive factors and body mass index in controls.

Conclusions

Our data suggest increased PHA-induced mitotic index in blood lymphocytes is associated with an increased breast cancer risk and that this association may be modulated by reproductive and other hormones.
Coffee-induced Hypokalaemia
Authors: Tajima Yutaka
Published: December 2010

Taking an excess amount of caffeine (e.g. overdrinking caffeinated beverages) sometimes causes hypokalaemia. Although the detailed mechanism has not been clarified yet, an increased loss of potassium via the urine stream caused by the diuretic action of caffeine is proposed as one of the possibilities. We report the case of a 50-year-old female outpatient who rapidly developed severe generalized muscle weakness and fatigue. Her symptoms were considered to be principally due to hypokalaemia. Since her blood urea nitrogen concentration decreased greatly, it was suggested that she had massive polyuria due to overhydration (i.e. dilution of her body fluids). Initially, we considered that a urinary tract infection might have caused her illness. However, we found that she was a heavy coffee drinker and had constantly experienced massive diuresis. After a course of oral antibiotics, potassium replacement and stopping coffee (caffeine) ingestion, her symptoms resolved quickly. In conclusion, it was considered that overdrinking coffee (caffeine) induced her hypokalaemia. Probably, loss of potassium via the urine stream with secondary aldosteronism was the main cause of the hypokalaemia.
Neurologic Manifestation as Initial Presentation in a Case of Hereditary Haemorrhagic Telangiectasia
Authors: Teo Yeow Kwan , Kor Ai Ching
Published: December 2010

Hereditary Haemorrhagic Telangiectasia (HHT), or Osler-Weber-Rendu syndrome is an uncommon autosomal dominant multi-organ condition of vascular dysplasias. We describe a 19 year old Indian female who presented with cerebral abscess secondary to paradoxical emboli from pulmonary arteriovenous malformations (PAVMs) associated with HHT. Cerebral, pulmonary, hepatic and gastrointestinal involvement can be life-threatening and it is important to have lifelong follow-ups on these patients.
Hepatitis B Screening Compliance and Non-compliance among Chinese, Koreans, Vietnamese and Cambodians
Authors: Ma Grace X. , Tan Yin , Wang Min Qi , Yuan Ying , Chae Wang Gyu
Published: December 2010

Objective

The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency.

Methods

A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and women.

Results

Overall, 71.4% of the sample reported having never been screened and 28.6% reported being screened for HBV Demographic, acculturation, and barrier factors were differentially associated with screening rates among the subgroups. Demographic factors associated with never-screened were: lower education, younger age, being male, and no insurance for Chinese; lower education, lower income and no insurance for Cambodians; younger age and unmarried for Koreans; and no health insurance for Vietnamese; Acculturation factors associated with never-screened were: not speaking English for Chinese; not speaking English, not reading newspapers in English, and watching TV in one's native language for Cambodians; not speaking English for Koreans; while no significant factors were found for Vietnamese. All barriers were associated with never-screened for Cambodians and Chinese. Those who lacked knowledge about HBV and had language and transportation barrier were more likely to be never-screened for Koreans. There were no significant relationships between the barriers and the screening status for Vietnamese.

Conclusions

High incidence of HBV and liver cancer in Asian Americans mandates a more vigorous and more culturally and linguistically appropriate educational effort to increase screening and vaccination for HBV in these underserved and mostly uninsured populations.
Intractable Chronic Low-Back Pain Caused by Ligamentopathia Treated Using a Spinous Process Plate (S-plate)
Authors: Iwatsuki Koichi , Yoshimine Toshiki , Yoshimura Kazuhiro , Ishihara Masahiro , Ohnishi Yu-Ichiro , Goto Yuko
Published: December 2010

We report a case of intractable chronic low-back pain in a gymnast that was caused by ligamentopathia in the interspinous region of the lumbar vertebrae. Sprained interspinous ligaments are a common mechanical cause of acute low-back pain in athletes. Although conservative therapy is generally effective in such cases, in this case it was not. The patient experienced severe low-back pain during lumbar flexion with tension between the L5/S interspinous ligaments. We performed interspinous fixation by using a spinous process plate system, which has been developed for short in situ fusions, and following which the low-back pain resolved. Conservative therapy for low-back pain caused by ligamentopathia is first-line choice, but interspinous fixation with instrumentation might be recommended in intractable cases with conservative therapy.
Autonomic Dysfunction Predicts Early Cardiac Affection in Patients with Systemic Sclerosis
Authors: Othman Khaled M. , Assaf Naglaa Youssef , Farouk Hanan Mohamed , Hassan Iman M. Aly
Published: December 2010

Objective

To detect the early preclinical alterations in cardiac autonomic control as well as altered cardiac function in systemic sclerosis (SSc) patients and their relevance to the clinical features of the disease using noninvasive methods.

Methods

30 SSc patients and 15 healthy controls matched for age and sex underwent clinical examination, serological analysis, and echocardiographic assessment including Doppler flow imaging to evaluate cardiac function, and 24-hour Holter monitoring analyzed for arrhythmia and heart rate variability (HRV) in the time and frequency domains.

Results

The trans-mitral Doppler of early to atrial wave (E/A) ratio was reversed in five patients (16.6%) and the tricuspid E/A ratio was reversed in 10 patients (33.3%). Holter analysis for SSc patients revealed an increased prevalence of premature ventricular contractions (PVC) ≥ 10/h ( P = 0.02), supra-ventricular tachycardias (SVTs) ( P = 0.2), and total PVC count ( P = 0.0000). Highly significant ( P = 0.000) impairment in all HRV parameters was demonstrated in the SSc patients. Total skin thickness score (TSS), Raynaud's phenomenon and anti-scleroderma 70 (anti-SCL70) showed significant positive correlations with all arrhythmia parameters, while showing a significant negative correlation with the impaired ventricular diastolic function and various HRV parameters. No correlation was found between arrhythmia and HRV parameters and disease duration, disease type, or presence of anti-centromere antibodies.

Conclusion

Low heart rate variability, increased TSS and the presence of anti-SCL70 are correlated with preclinical cardiac involvement in SSc patients and may predict the likelihood of malignant arrhythmia and sudden cardiac death. Therefore, noninvasive HRV evaluation before clinical cardiac involvement in these patients might be beneficial when added to the clinical and laboratory assessments in detecting high-risk patients, and may allow for implementation of preventive measures and initiation of appropriate therapy early in the course of the disease.
Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts
Authors: Wehrschuetz M. , Wehrschuetz E. , Schuchlenz H. , Schaffler G.
Published: December 2010

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses.

Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43.

Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.
Ventricular Tachycardia in Pregnant Patients
Authors: Kotchetkov Rouslan , Patel Ameen , Salehian Omid
Published: December 2010

Ventricular tachycardia although not common, can occasionally complicate pregnancy. Its presence may indicate an underlying cardiac structural abnormality, or undiagnosed congenital arrhythmic disease. However, some pregnant patients with ventricular tachycardia have structurally normal hearts. Two cases of ventricular tachycardia in pregnant patients with structurally normal hearts are presented and an approach to diagnosis and management of such patients are discussed.
An Investigation of Hair Cortisol Concentration across Body Sites and within Hair shaft
Authors: Sharpley Christopher F. , Kauter Kathleen G. , Mcfarlane James R.
Published: December 2010

Cortisol concentrations in hair collected from young male and female adults were assayed and compared for differences along shaft length and between body sites. No significant differences were found between hair shaft sites, supporting a model of the hair shaft as “alive” and responsive to environmental demand in terms of cortisol production. Hair taken from forearms had significantly higher concentrations of cortisol than hair from lower legs, suggesting a localized hair cortisol response and verifying previous findings. Issues of the link between central and peripheral HPA axes are raised for discussion and further investigation.
Nanobacteria: An Infectious Cause for Salivary Stone Formation and Recurrence
Authors: Badry Amr A El , Mokbel Mahmoud A.M. , Mofty Ismail El , Mohamed Amira H
Published: December 2010

Nanobacteria (NB) contribute to pathological calcification in the human and animal body. It has been isolated from salivary stones and suggested that it may act as a nucleus for the initiation of these stones. In the present study, we examined its role in the recurrent salivary gland stones using immunodetection with NB-specific monoclonal antibodies and scanning electron microscopy (SEM) hoping to provide a method for preventing the recurrence of these stones in the patient that has suffered from salivary stones. Our study comprised 30 patients with recurrent salivary gland stones (group I) and 30 patients with salivary gland stones for the first time (group II), in addition to 30 normal controls (group III). We could detect 100–500 nm nanoparticles in 24/30 (80%) cases in group I with significant difference <0.05 and <0.01 when compared with group II and group III in which they were detected in 19/30 (63.3%) and 6/30 (20%) respectively. Also there was a significant difference <0.05 between group II and group III. We proposed that salivary stone formation is a nanobacterial disease initiated by bacterial infection. This bacteria may play an important role in the recurrence of salivary stone. So the use of calcium chelator, ethylene diamine tetra acetic acid (EDTA), before or in combination with the suitable antibiotic that is given in an amount effective to inhibit or prevent the growth and development of nanobacteria may eradicate these stones and prevent their recurrence.
Treatment Options in Metastatic Renal Cell Carcinoma: Focus on mTOR Inhibitors
Authors: Pal Sumanta Kumar , Figlin Robert A.
Published: December 2010

The agents currently approved for use in metastatic renal cell carcinoma (mRCC) can be divided broadly into two categories: (1) vascular endothelial growth factor receptor (VEGFR)-directed therapies or (2) inhibitors of the mammalian target of rapamycin (mTOR). The latter category includes everolimus and temsirolimus, both approved for distinct indications in mRCC. Everolimus gained its approval on the basis of phase III data showing a benefit in progression-free survival relative to placebo in patients previously treated with sunitinib and/or sorafenib. In contrast, temsirolimus was approved on the basis of a phase III trial in treatment-naïve patients with poor-risk mRCC, demonstrating an improvement in overall survival relative to interferon-alfa. While these pivotal trials have created unique positions for everolimus and temsirolimus in current clinical algorithms, the role of mTOR inhibitors in mRCC is being steadily revised and expanded through ongoing trials testing novel sequences and combinations. The clinical development of mTOR inhibitors is outlined herein.
Pazopanib for the Treatment of Patients with Advanced Renal Cell Carcinoma
Authors: Lang Joshua M. , Harrison Michael R.
Published: December 2010

Dramatic advances in the care of patients with advanced renal cell carcinoma have occurred over the last ten years, including insights into the molecular pathogenesis of this disease, that have now been translated into paradigm-changing therapeutic strategies. Elucidating the importance of signaling cascades related to angiogenesis is notable among these achievements. Pazopanib is a novel small molecule tyrosine kinase inhibitor that targets VEGFR-1, -2, and -3; PDGFR-α, PDGFR-β; and c-kit tyrosine kinases. This agent exhibits a distinct pharmacokinetic profile as well as toxicity profile compared to other agents in the class of VEGF signaling pathway inhibitors. This review will discuss the scientific rationale for the development of pazopanib, as well as preclinical and clinical trials that led to approval of pazopanib for patients with advanced renal cell carcinoma. The most recent information, including data from 2010 national meeting of the American Society of Clinical Oncology, and the design of ongoing Phase III trials, will be discussed. Finally, an algorithm utilizing Level I evidence for the treatment of patients with this disease will be proposed.
Hemorrhagic Cystitis in a Patient Receiving Docetaxel for Prostate Cancer
Authors: Ntekim A.I. , Ajekigbe A.
Published: December 2010

A case is reported in which docetaxel was used to treat a patient with hormone refractory metastatic prostate cancer. The treatment was terminated at the third course of docetaxel following the development of hemorrhagic cystitis. This reaction was unexpected, as it is not a known reaction to docetaxel. Hemorrhagic cystitis has been associated with cyclophosphamide, where the metabolite acrolein has been implicated. The mechanism of this reaction from docetaxel is not yet known.
Validity of Caregivers’ Reports on Head Trauma Due to Falls in Young Children Aged Less than 2 Years
Authors: Fujiwara Takeo , Nagase Hiroaki , Okuyama Makiko , Hoshino Takahiro , Aoki Kazunori , Nagashima Tastuya , Nakamura Hajime
Published: December 2010

Objective

The clinical presentations of head trauma due to falls among young children aged less than 2 years are controversial, particularly in Japan, as the history of trauma recounted by a caretaker is not always reliable. The purpose of this study was to assess the validity of caregiver's reports on head trauma due to falls in young children aged less than 2 years in Japan.

Methods

All patients <2 years of age presenting with head trauma resulting from a fall who were admitted to 3 children's hospitals in Japan from January 2001 to December 2005 were retrospectively reviewed (N = 58). The clinical presentations were compared among groups categorized by the heights from which the patient fell (short (≤ 120 cm) or long (>120 cm)) and the surface on which the patient landed (carpet, tatami (Japanese mattress), hardwood floor, or concrete).

Results

Patients who suffered short falls were more likely to present with subdural hemorrhage (SDH) than those who suffered long falls (74% and 40%, respectively, P = 0.027). More specifically, 62% of short falls showed SDH indicative of shaken baby syndrome (e.g. multilayer SDH). Neurological symptoms, cyanosis, and SDH were more commonly observed inpatients who landed on carpeted or tatami surfaces than in those who landed on hardwood or concrete floors.

Conclusions

Short falls and landing on soft surfaces resulted in the presentation of severer clinical symptoms than did long falls and landing on hard surfaces, suggesting that the validity of caretakers’ reports on infant or young children's head trauma due to falls is low. Further research is warranted to investigate the cause of infant head trauma due to falls.
Hysterectomy for Uterine Disease in 2010: From past to Future
Authors: Mettler Liselotte , Sammur Wael , Schollmeyer Thoralf
Published: December 2010

Hysterectomies were unknown in the field of obstetrics and gynaecology until the 19th century. In the 20th century they were perhaps too frequently performed whereas the 21st century has witnessed a steep decline in hysterectomy numbers. It is therefore an opportune time to review the indications for hysterectomies, hysterectomy techniques and the present and future status of this surgical procedure. There is a widespread consensus that hysterectomies are primarily to be performed in cancer cases and obstetrical chaos situations even though minimal invasive surgical technologies (MIS) have made the procedure more patient friendly than the classical abdominal opening. Today, minimally invasive hysterectomies are performed as frequently as vaginal hysterectomies and the vaginal approach is the first choice if the correct indications are given. It is no longer necessary to open the abdomen; this procedure has been replaced by laparoscopic surgery. Laparoscopic and robotic-assisted laparoscopic surgery can also be indicated for hysterectomies in selected patients with gynaecological cancers. For women of reproductive age, laparoscopic myomectomies and numerous other uterine- preserving techniques are applied in a first treatment step of meno-metrorrhagia, uterine adenomyosis and submucous myoma. These interventions are only followed by a hysterectomy if the pathology prevails.
A study of Gonadal Arteries in 30 Adult Human cadavers
Authors: Wadhwa Ambica , Soni Sandeep
Published: December 2010

The gonadal arteries normally arise from the abdominal aorta. There are reports about the variant origin of these arteries. In the present study, we investigated the origin and course of the gonadal arteries and clinical implications of variant gonadal arteries are discussed. Out of 60 dissections, in 55 cases the gonadal artery was seen arising from abdominal aorta. In the remaining 5 cases, gonadal artery of renal origin was present in 3 cases, two on right and one on left side and of middle suprarenal origin was present in 2 cases on the left side. The present study agreed with the text book account i.e. right testicular artery passing anterior to inferior vena cava in majority of the cases i.e. 27 (90%). In the remaining 3 cases (10%), the right testicular artery was posterior to inferior vena cava. In our study, out of a total of 60 dissections, 57 dissections confirmed to type I pattern (95%). In 2 cases (3.3%) (11 M, 16 M) a type II pattern was seen on the right side. In 1 case (1.7%) (20 M), the left testicular artery arose directly from the aorta and arched over the renal vein giving a type III pattern. Awareness of variations of the testicular arteries such as those presented here becomes important during surgical procedures like varicocele and undescended testes. The variations described here are unique and provide significant information to surgeons dissecting the abdominal cavity.
Cardiovascular Disease and its Association with Histological Changes of the Left stellate Ganglion
Authors: Wood Adam , Docimo Salvatore , Elkowitz David E.
Published: December 2010

Mounting evidence has demonstrated that the autonomic system plays a role in the morbidity and mortality of certain cardiovascular disease states. Ventricular arrhythmias have been associated with the level of sympathetic activation. We attempted to determine if the presence of fibrosis, a marker for previous ischemic events, correlates with an increase in the number of left stellate ganglion nerve cell bodies which is indicative of hypersympathetic stimulation to the myocardial tissue. Left stellate ganglia were removed, sectioned and prepared using hematoxylin and eosin and Masson's trichrome stain. The interventricular septum of the heart corresponding to the stellate ganglion samples were removed, serially sectioned, and stained with hematoxylin and eosin and Masson's trichrome stain. The samples were described using a grading scale to quantify the percentage of fibrosis. Ganglion nerve cell bodies were then individually counted in three separate high-powered fields. A student's T-test was used to statistically evaluate the data. Stellate ganglions were sampled from 32 cadavers. Fibrosis was present within 72% (23/32) of the interventricular septums that were sampled. Nine interventricular septums were found to be free of fibrosis. For those interventricular septums that were positive for the presence of fibrosis, the mean left stellate ganglion nerve cell bodies was 39.8 (Range: 26-51). For those interventricular septums that were negative for the presence of fibrosis, the mean left stellate ganglion nerve cell bodies was 34.3 (Range: 27-46). The difference between the mean nerve cell bodies for interventricular septums with fibrosis and without fibrosis was found to be statistically significant ( P = 0.048). Histological changes in terms of the number of left stellate ganglion nerve cell bodies seem to be dependent upon the presence of fibrosis within the interventricular septum. Considering fibrosis of the interventricular septum is a marker for previous ischemic events, an increase in the number of nerve cell bodies of the left stellate ganglion in the presence of fibrosis suggests an association does exist between hypersympathetic stimulation to the myocardial tissue and myocardial infarction. Further research into this association is warranted in order to determine if left stellate ganglion blockade is a viable treatment option for arrhythmias following myocardial infarctions.
Intussusception Caused by Yersinia enterocolitica Enterocolitis in a Patient with Sickle Cell Anemia
Authors: Gupta Geetanjali , Kumar Shailesh , Singh Reecha , Shanmugasamy Kathirvelu
Published: December 2010

Yersinia enterocolitica intussusception is rarely encountered in patients without an underlying susceptibility and is most frequently reported in iron-overloaded patients. This is thought to be related to the unusual use of iron by this microorganism. We present a case of a 5-year old child with intussusception of the terminal ileum caused by Y. enterocolitica whose past medical history was significant for sickle cell disease. This type of presentation is extremely rare. His monthly blood transfusions may have put him at risk for Y. enterocolitica enterocolitis. The pathogenesis of this disease relates to the role of iron as an essential growth factor for Y. enterocolitica, and this patient's transfusions left him in an iron overloaded state despite treatment with Deferoxamine. Our patient's unusual presentation of intusssuception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied Peyer's patches in the ileum caused by the Y. enterocolitica infection. We believe that our case demonstrates that Y. enterocolitica should be considered a possible pathogen in patients with sickle cell disease, especially if symptoms occur shortly after blood transfusion.