bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palynological Investigation of Neogene (Early Miocene) Sediments of Mangalore Basin, India: Palaeoenvironmental and Palaeoclimatic Implications
Authors: Rao M. R. , Verma Poonam 
Published: July 2014

Abstract
A rich palynological assemblage consisting of algal remains (5 genera and 7 species, including dinoflagellate cysts), fungal spores (2 genera and 3 species), pteridophytic spores (5 genera and 8 species), gymnospermous pollen grains (3 genera and 3 species) and angiospermous pollen grains (17 genera and 22 species) has been recorded for the first time from the Miocene sediments exposed along Kullur-Kavur road, near Mangalore along the west coast of Karnataka. Among the important genera are: Achomosphaera, Leptodinium, Staphlosporonites, Hammenisporis, Polypodiaceaesporites, Quilonipollenites, Myricipites, Graminidites, Malvacearumpollis, Palaeomalvaceaepollis and Chenopodipollis. Qualitative and quantitative analyses reveal that the angiosperm pollen grains are dominant over pteridophytic spores and an overall, a warm and humid tropical-sub-tropical coastal climate with heavy precipitation is suggested for the site of deposition. The sediments were deposited in fluctuating conditions ranging from lacustrine to marine environments with fresh water swamps and ponds nearby. The occurrence of Hammenisporis, Polypodiaceaesporites, Quilonipollenites, Myricipites, Graminidites, Malvacearumpollis, Palaeomalvaceaepollis and Chenopodipollis in the present assemblage suggests an early Miocene age. A comparison of the present palynofloral assemblage with those known from the Indian Tertiary sediments shows its close resemblances with the Miocene palynoflora recovered from Quilon and Warkalli beds of Kerala basin.
A Grain Size Model for Role of Tectonics and Climate on Sedimentation in Siwaliks in Mohand Area
Authors: Mishra Manas , Chakrapani G. J. 
Published: July 2014

Abstract
The physical characteristics of sedimentary record are governed largely by grain size distribution in Mohand area where Middle and Upper Siwalik successions are investigated to characterize the sediments deposited in response to the prevailing tectonic activities and climatic conditions. Here we show with the help of cluster analysis that precipitation and tectonic perturbations generate characteristic patterns of grain sizes and stratigraphic succession. Previous studies suggested an increase in precipitation represented by the abrupt accumulation of sediments to foreland Siwalik basin around 11 to 10 Ma. First appearance of diagnostic minerals of the Great Himalayan complex in Siwalik sediments at 9.2 Ma implies the accelerated erosion of Himalaya during Middle to Late Miocene. The response of sedimentation to tectonic activity is resulted by the presence of coarse grained gravel units in Siwalik succession of Mohand area. Apatite fission-track dates and muscovite cooling ages confirm the strong activity on boundary thrusts during 8-6 Ma. Although the responses are non-linear and transient, we clusterize these non-linear responses to tectonics and climate and quantify them to find out the role of tectonics and climate in architecture of sedimentary succession.
Early menarche, depressive symptoms, and coping strategies
Authors: Alcalá‐Herrera Verónica , Marván Ma. Luisa 
Published: July 2014

ABSTRACTDuring the time around menarche, young women must make many emotional and social adjustments to adapt to a new life stage. We compared depressive symptomatology and coping strategies between early and average maturer Mexican adolescents girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. Three hundred eighty post‐menarcheal students from 11 to 15 years completed the Children's Depression Scale and the Children's Situational Coping Scale. Early maturers showed more depressive symptoms than their peers, but they reported having used fewer non‐productive coping strategies. Early maturers who experienced menarche one to three years previously reported more non‐productive coping strategies than those who had experienced menarche four to six years ago. However, no differences were found in the results of the average maturers depending on the time elapsed since menarche. These findings are discussed in light of the psychosocial context of early maturers.
S-phase fraction as a useful marker for prognosis and therapeutic response in patients with aplastic anemia
Authors: Tripathi Anil Kumar , Tripathi Payal , Kumar Ashutosh , Ahmad Rizwan , Singh Raj K. , Balapure Anil K. , Vishwakerma Achchhe L. 
Published: July 2014

BACKGROUND:
The functional definition of aplastic anemia (AA) is the failure of hematopoietic stem cells to proliferate. The aim of the present study was to analyze the S-phase fraction (SPF) (proliferative activity) in patients with AA at diagnosis to explore its relationship with disease characteristics and its value in discriminating among patients with different prognoses. We also investigated whether the SPF value influenced the response to immunosuppressive therapy in AA patients.

PATIENTS AND METHODS:
The analysis of SPF at the time of diagnosis was carried out by flow cytometry on peripheral blood samples from 53 consecutive patients with AA and 30 age- and sex-matched controls. All patients were given cyclosporine and followed up periodically to determine response to therapy.

RESULTS:
Based on the median SPF, AA patients were divided into two groups: patients with SPF <0.59% (n=27) and patients with SPF >0.59% (n=26). An SPF <0.59% was associated with advanced age (P=.02) and elevated serum LDH level (P=.01). Patients with an SPF <0.59% also had a higher incidence of paroxysmal nocturnal hemoglobinuria and cytogenetic abnormalities. During a median follow-up of 18 months, 3.7% of patients with SPF >0.59 and 11.5% of patients with SPF <0.59% developed dysplasia and one patient with SPF >0.59% converted into AML. A significantly higher (P=.018) overall response rate of 53.9% was found in patients with SPF >0.59% versus 22.2% of patients with SPF <0.59% at 6 months.

CONCLUSIONS:
Independently of the peripheral blood count, the SPF at diagnosis may provide information on the expected response to immunosuppressive therapy and the propensity for disease to evolve into MDS/AML. Hence, SPF may serve as an early indicator for the evolution of MDS/AML in patients with AA and thus contribute to therapeutic decisions.
Pediatric immunohematopoietic stem cell transplantation at a tertiary care center in Cape Town
Authors: Wood Lucille , Juritz June , Havemann Jonathan , Lund Jo , Waldmann Herman , Hale Geoffrey , Jacobs Peter 
Published: July 2014

INTRODUCTION AND STUDY DESIGN:
We conducted a retrospective analysis of consecutive referrals of patients under 18 years of age undergoing immunohematopoietic stem cell transplantation to assess the influence of age, diagnosis, graft type and gender on survival. We also contrasted program activity and outcome to that reported from a state hospital in the same geographical area over a comparable period.

METHODS:
conditioning employed either a sequential combination of fractionated 12Gy whole body and 6Gy total nodal irradiation separated by 120mg/kg of cyclophosphamide in patients over 1 5 years of age. Alternatively, the latter agent was combined initially with oral busulphan and later the intravenous equivalent. Neuroblastoma cases were prepared using a different regimen. In allografts the harvested product underwent ex vivo T-cell depletion with the humanized version of anti-CD 52 monoclonal antibody designated Campath 1H. No additional immunosuppression was given except where matched unrelated volunteer donors were employed.

RESULTS:
Sixty-eight procedures were carried out in 61 patients over a 6-year period. Of 11 with acute myeloid leukemia, 8 are alive and well whereas 8 of the 14 with the lymphoblastic variant have died. Of the remaining 12 with hematologic malignancy, all but 2 are alive. Ten of the 17 with aplasia are alive as are all with thalassemia or sickle cell disease. None of the four variables tested affected survival.

CONCLUSION:
Our analysis indicates that the standardized preparative regimen, coupled with a now well-es-tablished immunosuppressive regimen, is as effective in patients under 1 8 years of age as in adults. Our analysis also indicates that in a resource-scarce or developing country, it is mandatory to limit high-risk and relatively expensive procedures to active teams that enjoy international accreditation, whether these be in the state or private sector.
Accuracy of the Fischer scoring system and the Breast Imaging Reporting and Data System in identification of malignant breast lesions
Authors: Al-Khawari Hanaa , Athyal Reji , Kovacs Agnes , Al-Saleh Mervat , Madda John Patrick 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Fischer developed a scoring system in 1999 that made identifying malignant lesions much easier for inexperienced radiologists. Our study was performed to assess whether this scoring system would help beginners to accurately diagnose breast lesions on magnetic resonance (MR) imaging and to assess the correlation between the magnetic resonance mammography Breast Imaging Reporting and Data system (MRM BI-RADS) grade and the final diagnosis.

PATIENTS AND METHODS:
The lesion morphology and contrast kinetics of 63 masses in 41 patients were evaluated on MRI and accorded a MRM BI-RADS final assessment category using the Fischer scoring system. The accuracy was evaluated after the final diagnosis was obtained by tissue sampling and follow-up imaging.

RESULTS:
There were 25 malignant and 30 benign lesions. Eight lesions were seen by MRI only and we could not verify their pathology since we did not have MR-guided biopsy facilities at the time of the study. On MR mammography, the proven carcinomatous lesions were characterized as BI-RADS category V in 16 (64%), category IV in 7 (28%), and category III in 2 (8%) lesions. Benign lesions were graded as category V in 3 (10%), category IV in 6 (20%), and category III in 3 (10%), category II in 10 (33%) and category I in 8 (27%) lesions. The MRM BI-RADS category accurately predicted malignancy in 92% and a benign pathology in 70% of the lesions. The overlap between the MRM features of chronic inflammatory lesions and carcinomas resulted in a lower accuracy in diagnosing benign as compared to malignant lesions.

CONCLUSION:
The MRM BI-RADS lexicon using the Fischer scoring system is useful and has a high predictive value, especially for malignant breast lesions, and is easy to apply. Overlapping features between benign inflam-matory and malignant lesions might yield a reduced accuracy in inflammatory pathologies.
Immunohematopoietic stem cell transplantation in Cape Town
Authors: Wood Lucille , Haveman Jonathan , Juritz June , Waldmann Herman , Hale Geoffrey , Jacobs Peter 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Immunohematopoietic stem cell transplantation has curative potential in selected hematologic disorders. Stem cell transplantation was introduced into South Africa in 1970 as a structured experimental and clinical program. In this report, we summarize the demography and outcome by disease category, gender, and type of procedure in patients older than 18 years of age who were seen from April 1995 to December 2002.

PATIENTS AND METHODS:
This retrospective analysis included 247 individuals over 18 years of age for whom complete data were available. These patients received grafts mostly from peripheral blood with the appropriate stem cell population recovered by apheresis.

RESULTS:
Patient ages ranged from 20 to 65 years with a median age of 42 years. There were 101 females and 146 males. There were no withdrawals and 63% survived to the end of the study. At 96 months of follow-up, a stable plateau was reached for each disease category. Median survival was 3.3 years (n=6, 14.6%) for acute lymphoblastic anemia, 3.1 years (n=44, 18%) for acute myeloid leukemia, 2.8 years (n=47, 19%) for chronic granulocytic leukemia, 2.8 years (n=71, 29%) for lymphoma, 1.5 years (n=23, 9%) for myeloma, 1.43 years (n=10, 4%) for aplasia, and 1.4 years (n=38, 15%) for a miscellaneous group comprising less than 10 examples each. Multivariate analysis showed that only diagnosis and age had a significant impact on survival, but these two variables might be interrelated. There was no significant difference in outcome by source of graft.

CONCLUSION:
The results confirm that procedures carried out in a properly constituted and dedicated unit, which meets established criteria and strictly observes treatment protocols, generate results comparable to those in a First World referral center. Low rates of transplant-related mortality, rejection and graft-versus-host disease are confirmed, but the benefits cannot be extrapolated outside of academically oriented and supervised facilities.
Multimodality treatments in locally advanced stage thymomas
Authors: Hassan Mohammad , Seoud Diaa Eldin A. 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Complete surgical resection is the main goal in the treatment of thymoma, but is not always achievable in stage III and IVA thymoma because of local invasion of the neighboring organs or the presence of diffuse pleural or pericardial implants. We reviewed our experience in multimodality treatment of advanced stage (III and IVA) thymic tumors to evaluate the effectiveness and safety in patients with locally advanced unresectable thymoma.

PATIENTS AND METHODS:
We studied patients with newly diagnosed, histologically proven, unresectable malignant thymoma who underwent a multimodality treatment regimen that consisted of neoadjuvant chemotherapy (three courses of cisplatin and etoposide), followed by surgical resection, postoperative radiation therapy, and consolidation chemotherapy (three courses of cisplatin and etposide).

RESULTS:
Nine patients were consecutively enrolled from December 2001 to June 2007, and all were valuable for assessment. Disease responded to neoadjuvant chemotherapy completely in 1 patient (11%) and partially in 6 patients (66%) with an overall response of 77%. Two patients had a minor response (22%). Eight patients had surgical resection; 1 refused surgery. Tumors were removed completely in 5 patients (62.5%) and incompletely in 3 (37.5%). All patients received radiation therapy and consolidation chemotherapy. seven patients were alive (77% at 4 years), with a median follow-up of 31 months, and 6 patients were disease free (66.6% disease-free survival at 4 years). The major side effect from neoadjuvant and consolidation chemotherapy was myelosup- pression.

CONCLUSION:
The multimodality treatment of stage III and IVA thymic tumors by integration of surgery, radiotherapy, and chemotherapy, contributed to a good long-term outcome. The neoadjuvant chemotherapy improves the resectability rate and the survival of locally advanced stages of the disease.
Thyroid carcinoma in Pakistan
Authors: Bukhari Uzma , Sadiq Saleem , Memon Jawaid , Baig Farooq 
Published: July 2014

BACKGROUND AND OBJECTIVES:
To address the need for epidemiologic data on thyroid carcinoma in Pakistan, we evaluated the frequency and types of thyroid carcinoma with respect to age and sex.

METHODS:
In a a retrospective study conducted at the Jinnah postgraduate Medical centre in Karachi, we reviewed thyroid lesions reported over a period of 5 years, from July 2000 to June 2005. pathology slides were studied to determine the types and frequencies of malignant lesions of the thyroid.

RESULTS:
Of 998 thyroid lesions reviewed, 153 cases were malignant. papillary carcinoma was the commonest malignant lesion with a frequency of 90.2%, followed by 4.5% for medullary carcinoma, 2% for follicular carcinoma, 2% for undifferentiated carcinoma and 0.7% each for mixed medullary and papillary carcinoma and poorly differentiated carcinoma. Females were predominant (82.4%) as compared with males (17.6%) for a female-to-male ratio 4.7:1. The maximum number of the patients were in the fourth decade of life followed by the third and second decades.

CONCLUSION:
The commonest malignant thyroid lesion was papillary carcinoma. Thyroid cancer was more common in females. papillary, medullary and follicular carcinomas were found in patients in the third and fourth decades of life, while poorly and undifferentiated carcinomas were diagnosed from the fifth to seventh decades of life.
Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit
Authors: Charoo Bashir Ahmad , Iqbal Javeed , Iqbal Qazi , Mushtaq Sheikh , Bhat Abdul Wahid , Nawaz Imtiyaz 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Late onset sepsis (LOS)(onset of sepsis >72 hours of age or nosocomial sepsis) is an important cause of morbidity and mortality in the neonatal intensive care unit (NICU). Thrombocytopenia is an important complication of sepsis. We investigated the incidence of thrombocytopenia in LOS patients and studied the influence of various parameters on platelet response.

PATIENTS AND METHODS:
Infants born in the level 3 neonatal intensive care unit between January 2002 and December 2006 with documented LOS were included in this prospective study. Multiple hemograms with platelet counts, bacterial blood culture and fungal blood culture were obtained in all patients. Demographic and clinical data were compared between patients without thrombocytopenia and with mild, moderate and severe thrombocytopenia. Duration of thrombocytopenia in relation to type of organism and mortality with respect to degree of thrombocytopenia were also studied.

RESULTS:
Of 200 patients with culture-proven nosocomial sepsis, 119 (59.5%) patients developed thrombocytopenia (platelet count >150×109/L). in our series Klebsiella pneumoniae was the most frequently isolated organism (125/200, 62.5%) and the incidence of thrombocytopenia was 60.0% (75/125). However, the incidence of thrombocytopenia was highest among patients who had concurrent bacterial and fungal sepsis (28/31, 90.3%). coagulase- negative staphylococcal (CONS) sepsis was present in 21 (10.5%) patients and the incidence of thrombocytopenia was 33.3%. isolated fungal sepsis was present only in 6 (3%) patients and the incidence of thrombocytopenia was 66.0%. The incidence of thrombocytopenia was highest among preterm babies and low-birth weight (LBW) babies. Twenty-seven percent (54/200) of babies presented with mild thrombocytopenia, 20% (40/200) presented with moderate thrombocytopenia, and 12.5%(25/200) developed severe thrombocytopenia. severity of thrombocytopenia was also directly related to the presence of necrotizing enterocolitis (NEC) and disseminated intravascular coagulation (DIC). The mortality rate was significantly associated with the degree of thrombocytopenia.

CONCLUSION:
LOS sepsis is an important risk factor for thrombocytopenia in the NICU. Fungal and gramnegative sepsis are frequently associated with a decreased platelet count. sepsis-induced thrombocytopenia is more common among LBW babies and preterm babies. The mortality rate is significantly related to degree of thrombocytopenia.
A retrospective comparison of allogeneic peripheral blood stem cell versus bone marrow transplantation
Authors: Henrique Bittencourt , Monalisa Lopes , Antonio Vaz de Macedo , Elen Rose Teixeira , Gabriel Gomes Sabido Gomes , Ferreira Galileu Galilei , Leandro Amaral , Priscila Soares , Mônica Vieira , Dusse Luci Maria 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Disease evolution depends in part on the source of transplanted cells. Therefore, we compared outcomes after allogeneic bone marrow (BM) and peripheral blood stem cell (PBSC) transplantation in patients who underwent transplant at Hospital das Clinicas of the Federal university of Minas Gerais, Brazil.

PATIENTS AND METHODS:
We studied 364 patients who received allogeneic BM (n=142) or PBSC transplantation (n=222) between July 1995 and May 2005. The median age of the patients was 31 years (range, 3.1-58 years). chronic myeloid leukemia was the predominant diagnosis (41.2%). A conditioning regimen with cy- closphosphamide and busulfan was used in 79.4% (n=289) and graft-versus-host disease (GVHD) prophylaxis was cyclosporine/methotrexate in 95.9% (n=349) of cases.

RESULTS:
The patients in the PBSC group had faster neutrophil (p<.001) and platelet engraftment (p=.03) but increased rates of acute GVHD (p<.001) vs. those in the BM group. There was no significant difference between the groups in chronic GVHD, transplant-related mortality, relapse and survival rates.

CONCLUSIONS:
Although allogeneic PBSC transplant results in a faster hematopoietic engraftment, there was an increase in acute GVHD. There was no clear benefit in relapse rate and no evidence that transplantation with PBSC benefits patient survival in our institution.
Clinical characteristics and outcome of pediatric patients with stage IV Hodgkin lymphoma
Authors: Belgaumi Asim , Al-Kofide Amani A. , Khafaga Yasser , Joseph Nicey , Jamil-Malik Rubina , Siddiqui Khawar S. , Sabbah Rajeh S. 
Published: July 2014

BACKGROUND AND OBJECTIVES:
While treatment outcomes for patients with Hodgkin lymphoma (HL) have improved remarkably, patients with disseminated disease still have a poorer outcome. stage IV HL is often reported with other ‘advanced stage’ categories, confusing the specific contribution of disease dissemination to the outcome. This single-institution report looks at characteristics and outcomes of this specific category.

PATIENTS AND METHODS:
The medical records of pediatric HL patients (<14 years) from 1975 through 2003 were retrospectively reviewed and the data analyzed.

RESULTS:
Stage IV patients (n=67) had more poor-risk characteristics than patients in stages I-III (n=300) (B symptoms 86.6% vs. 19.3%, bulky disease 57.6% vs. 45.5% and mediastinal mass 77.6% vs. 29.7%; P<.001 for all characteristics). The liver was the most common extralymphatic site (in 51.5% of patients with stage IV disease. Stage IV patients received chemotherapy (CT) alone (n=55) or combined modality therapy (CMT) (n=12). Fifty-four patients (80.6%) achieved complete remission, 2 (3%) partial remission, 10 (14.9%) had progressive disease and 1 was lost to follow up. Overall survival was 79.4% and event-free survival (EFS) was 63.9% at 5 years. There was a non-significant benefit for CMT (OS=91.7% v. 77.1%, P=.3; EFS=70.7% v. 62.7%, p=.3). Ten of 12 relapsed and only 1 of 10 progressive disease patients were salvaged. On multivariate analysis, failure to achieve complete remission with CT was associated with a poorer outcome.

CONCLUSION:
Stage IV disease is associated with poor risk features and confers a worse outcome than stage I-III disease. Achievement of complete remission with CT is an important prognostic feature. Slow responders may require novel and/or aggressive therapy to achieve complete remission.