bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modern Imaging Modalities in the Assessment of Acute Stroke
Authors: Zlatareva Dora K. , Traykova Nikoleta I. 
Published: August 2014

Abstract
The AIM of this review was to present the modern concepts of diagnostic imaging in acute stroke. Neuroimaging in acute stroke aims at diagnosing the condition as early as possible and assessing the extent of parenchymal perfusion and the intracranial vessels patency. A modern approach would involve a combination of various imaging modalities as multidetector computed tomography and high field magnetic resonance imaging. A non-enhanced computed tomography (CT) is used to detect hemorrhage or to identify early signs of ischemic stroke. CT angiography finds evidence of intravascular thrombi or significant stenoses, and CT perfusion displays brain tissue at risk of irreversible alterations that can be salvaged therapeutically. Magnetic resonance imaging (MRI) is a more sensitive modality than CT in diagnosing acute brain ischemia. MR diffusion-weighted imaging is more sensitive than conventional MR sequences in hyperacute stage. MR angiography as a non-invasive and non-ionizing imaging method is used as an alternative modality to CT angiography. To find brain tissue at risk diffusion- and perfusion-weighted magnetic resonance imaging modalities are used. The authors present briefly the modern neuroimaging modalities used in patients with transient ischemic attack, minor stroke and venous infarction. By combining different imaging techniques in a multimodal approach we can acquire the information necessary for therapeutic planning and differentiate patients who need thrombolysis.
Clinical Investigations: Somatosensory Evoked Potentials in Full-Term Neonates With Perinatal Asphyxia
Authors: Geneva Ina E. , Krasteva Maya B. , Kostianev Stefan S. 
Published: August 2014

Abstract
OBJECTIVE: To explore the capacity of somatosensory evoked potentials (SEP) to assess maturation processes in the development of the nervous system, and the characteristics of SEP in healthy full-term infants and full-term newborns with perinatal asphyxia and their follow up until the age of 14 months.
MATERIALS AND METHODS: SEP were studied in 21 healthy full-term infants and 38 full-term newborns with perinatal asphyxia. The children with asphyxia were studied longitudinally until they were 14 months old. To assess the SEP we measured the latency of the P15, N20 and P25 components, the amplitude ratio N20/ P25 and inter-peak intervals P15-N20 and N20-P25. RESULTS: The component that was most typically always found in the SEP recordings of both healthy infants and those with perinatal asphyxia was N20. The mean latency values of P15, N20 and P25 were higher in the children with perinatal asphyxia (p ⋋ 0.001). The SEP amplitude was highly variable (CoV% = 76.6%). The latencies became shorter with age in asphyxia patients aged 0 to 14 months, the shortening being the greatest in the first trimester, while they showed no statistically significant differences in infants aged 6 to 12 months. CONCLUSIONS: SEPs in the neonatal period differ considerably from those of adults and older children in the morphology and longer potential latency, which can be accounted for by the incomplete myelination of nerve fibers. The changes in SEP latency in patients with HIE stages I and II follow the same pattern found in healthy children - latency became shorter with increasing age, which was most pronounced in the first 3 months. SEP latency was found to be correlated with height and age. No differences were found in the latency of potentials between healthy infants and infants with brain hemorrhage. Recording SEP is a sensitive method to assess the CNS in children with perinatal asphyxia and to monitor the maturation of the somatosensory pathway.
Paroxysmal Atrial Fibrillation: Dynamics of The Main Antioxidant Enzymes - Superoxide Dismutase and Catalase
Authors: Negreva Mariya N. , Penev Atanas P. , Georgiev Svetoslav Zh. , Aleksandrova Albena A. 
Published: August 2014

Abstract
INTRODUCTION: Researchers have a particularly strong interest in the mechanisms implicated in the clinical manifestation of atrial fibrillation.
OBJECTIVE: To examine dynamically the activity of the antioxidant enzymes, su-peroxide dismutase and catalase in patients with paroxysmal atrial fibrillation (duration ⋋ 48 hours).
MATERIALS AND METHODS: The studied parameters were examined in the erythrocytes of 51 patients (59.84 ± 1.60, 26 men) immediately after their hospitalization, at 24 hours and 28 days after restoration of sinus rhythm. 52 controls (59.50 ± 1.46, 26 men) were also included, none of which had a history of arrhythmia. Propafenone was used to manage the rhythm abnormality. The enzyme activity was determined by a spectrophotometric method.
RESULTS: The average duration of atrial fibrillation episodes until the time of hospitalization was 8.14 hours (from 2 to 24 hours). During patient hospitalization the activity of superoxide dismutase and catalase was considerably higher compared to that of the controls (8.46 ± 0.26 vs 5.81 ± 0.14 U/mg Hb; 7.36 ± 0.25 vs 4.76 ± 0.12 E240/min/mg Hb; P ⋋ 0.001). This difference was maintained 24 hours after the rhythm regularization (7.19 ± 0.25 vs 5.81 ± 0.14 U/mg Hb, p ⋋ 0.001; 5.30 ± 0.21 vs 4.76 ± 0.12 E240/min/mg Hb, p ⋋ 0.05). Twenty-eight days after the restoration of sinus rhythm, the activity of catalase remained increased (5.11 ± 0.08 vs 4.76 ± 0.12 E240/min/mg Hb, p ⋋ 0.05).
CONCLUSION: The paroxysmal atrial fibrillation in our study was characterized with significantly increased activity of superoxide dismutase and catalase even in the early hours of clinical manifestation of the disorder, which then slowly decreased with the restoration of sinus rhythm. Therefore, we can conclude that changes in oxidative status are closely related to the disease and are probably a part of the intimate mechanisms related to its initiation and clinical course.
Fourier Analysis of Peripheral Blood Pressure and Flow in Intraoperative Assessment of Infrainguinal Arterial Reconstructions
Authors: Cheshmedzhiev Mihail V. , Mircheva Iskra S. , Jordanov Emil D. , Kovacheva Nina R. 
Published: August 2014

Abstract
AIM: To assess infrainguinal arterial reconstructions by intraoperative flowmetry under the distal anastomosis using a fast Fourier transformation; calculate and compare the amplitude ratios of peripheral arterial blood pressure and volume flow before and after drug-induced vasodilation of occluded bypass grafts and bypass grafts that have been patent at least for 1 year. To find what magnitude of the change of these ratios indicate a long-term patency of the bypass grafting. PATIENTS AND METHODS: We compared the results of the intraoperative flowmetry tests of 97 patients with infrainguinal arterial reconstructions. The patients were divided into two groups based on the graft status: the grafts in 49 patients were patent for at least a year, and 48 patients had failed bypass. We used a fast Fourier transform (FFT) of the pressure and blood flow waves and compared the ratios of their amplitudes before and after administration of a vasodilator drug into the graft. Comparing the ratios obtained before and those after administration of the drug we quantified their change in each group and analysed them. RESULTS: After a drug-induced vasodilation, the blood pressure and flow amplitude ratios for the group with compromised reconstructions were less than 1.9 times smaller than those before drug infusion, while for the group with bypass grafts that had been functional for at least 12 months the ratios declined by more than 1.9≈2 times. CONCLUSION: The magnitude of the change of amplitude ratios of the peripheral pressure and volume flow after drug-induced vasodilation can be used to make an assessment of the bypass graft and the distal arterial segment.
Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis
Authors: Mlachkova Antoaneta M. , Popova Christina L. 
Published: August 2014

Abstract
INTRODUCTION: Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. MATERIALS AND METHODS: The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). RESULTS: Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth ⋋ 5 mm (PD ⋋ 5 mm). Pockets with PD > 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. CONCLUSION: The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate chronic periodontitis. Given a good patient compliance, the antimicrobial periodontal therapy can be quite efficient in arresting the inflammatory process and reducing the depth of periodontal pockets; it can also achieve a stable attachment loss level and obviate the need to use a surgical periodontal treatment modality.
Validating a Short Bulgarian Version of a Psychometric Instrument for Multidimensional Noise Sensitivity Assessment
Authors: Dzhambov Angel M. , Dimitrova Donka D. 
Published: August 2014

Abstract
BACKGROUND: Noise sensitivity (NS) is a key construct in the fields of hygiene, planning and occupational medicine. It refers to a personality trait representing the reactivity to noise and is associated with various psycho-physiological health outcomes. AIM: This study aimed to develop a shorter version of the original Noise Sensitivity Questionnaire (NoiSeQ), retaining its dimensions and assess its validity and reliability. METHODS: A test-retest study was carried out in a convenience sample of 56 participants. A short 15-item form of the original NoiSeQ (NoiSeQSF) questionnaire was developed and then administered. All major analyses were based on the coeffi cient of equivalence and stability, the generalizability theory and linear regression. RESULTS: Relative (ρ = 0.83) and absolute (ρ = 0.80) G coefficients for global NS exceeded the lower reliability limit according to G- and D-studies. Sleep subscale can readily be used to assess sleep-related NS (ρ = 0.76/θ = 0.75). Moreover, NoiSeQSF predicted some cardiac symptoms (with age of participants as a moderator factor), which demonstrated nomological validity. CONCLUSION: NoiSeQSF is a reliable estimate for global NS and NS related to sleep quality. It might prove useful to experts in environmental hygiene, urban planning and occupational diseases when dealing with noise-impaired occupational, social or psycho-physiological functioning.
Endoscopic Diagnosis of Intramural Hematoma in The Colon sigmoideum In a Child With High Titer Inhibitory Hemophilia A
Authors: Yankov Ivan V. , Spasova Maria I. , Andonov Vladimir N. , Cholakova Efimia N. , Yonkov Alexander S. 
Published: August 2014

Abstract
Lower gastrointestinal bleeding is a rare condition in childhood pathology. The incidence of this disorder in the general population of Bulgarian children is unknown.
We report a case of a 7-year-old child with diagnosed hemophilia A and high titer of factor VIII inhibitor; the patient was admitted into the Department of Pediatrics and Medical Genetics for rectorrhagia after falling onto his buttocks while playing. Colonoscopy showed submucosal hematoma 25 cm from the anocutaneous line occluding the intestinal lumen with a lesion of the overlying mucosa as long as 20 mm.
If a patient presents with rectorrhagia, timely and carefully planned colonoscopy could identify the source of bleeding, determine the severity of bleeding and the size of hematoma, and assess the need for surgical intervention. The reported case supports the modern view that patients with inhibitor hemophilia should not be denied interventional procedure or surgical intervention for fear of uncontrolled bleeding.
Influence Of Promoter Polymorphisms Of The Tnf-α (-308g/A) And IL-6 (-174g/C) Genes On Therapeutic Response To Etanercept In Rheumatoid Arthritis
Authors: Jančić Ivan , Šefik-Bukilica Mirjana , Živojinović Slađana , Damjanov Nemanja , Spasovski Vesna , Kotur Nikola , Klaassen Kristel , Pavlović Sonja , Bufan Biljana , Arsenović-Ranin Nevena 
Published: August 2014

SummaryBackground:The study was undertaken to assess the influence of functional -308G/A TNF-α (rs 1800629) and -174G/C IL-6 (rs1800795) promoter polymorphisms on the therapeutic response to etanercept, a TNF-α blocker, in patients with rheumatoid arthritis (RA).Methods:Seventy-three patients suffering from active RA were studied, at baseline and 6 and 12 months after therapy. The therapeutic response was estimated according to the European League Against Rheumatism response criteria. Patients were genotyped for -308G/A TNF-α and -174G/C IL-6 polymorphisms by the PCR-RFLP method, and the influence of genotype on etanercept response was assessed.Results:No difference in the percentage of responders (patients who had DAS28 improvement > 1.2) between patients with the TNF-α-308GG and GA and AA genotype was detected after 6 and 12 months of treatment. After 12 months of treatment the percentage of responders was significantly increased in patients with the IL-6 -174GG genotype compared with those with the GC or CC genotype (p=0.006 by Chi-square test). Evaluation of the patients according to their combined IL-6/TNF-α genotypes showed that patients with the IL-6 -174GG / TNF-α -308GG genotype were more frequent among the responders compared to those with other combined genotypes (p=0.022 by Chisquare test). More precisely, all patients with the combined IL-6 -174GG / TNF-α -308GG genotype were responders after 12 months of etanercept treatment.Conclusions:The study suggests that patients who are genetically low TNF-α and IL-6 producers are the best responders to etanercept therapy.
A Comparative Study of Magnetic Resonance Angiography & Digital Subtraction Angiography in Diagnosis of Cerebral Arteriovenous Malformation
Authors: Chowdhury AH , Islam M , Rahman A , Chowdhury SJH , Islam MN , Khan S , Rahman KM , Mohammad QD , Sarker R , Mondol G 
Published: August 2014

Background and purpose: Although phase-contrast MR angiography (MRA) provides some information regarding hemodynamics of cerebral arteriovenous malformations (AVMs), but mos t Conventional MR angiographic techniques have not been helpful in this respect. We attempted to determine the value of MR digital subtraction angiography (DSA) in assessing AVM hemodynamics. Soin this retrospective observational study was carried out to compare MRA and DSA in diagnosis of cerebral AVM. Methods and materials: It was a retrospective observational study conducted in the Department of Neurology Dhaka Medical College Hospital (DMCH), Dhaka during the period of January 2010 to December 2010. Thirty patients with haemorrhagic stroke age ranging from 13 to 65 years were selected on the basis of inclusion and exclusion criteria as the study sample. MRA and DSA were done in all the selected patients. Results: The mean age of the patients of haemorrhagic stroke was 30.3±14.3years and male female ratio was 2.7:1.The venous drainage of AVM 13 and 12 were superficial and deep respectively evaluated 100% by MRA. In the diagnosis of cerebral AVM nidussize S1<3, S2:6 cm sensitivity 100% but accuracy 100% and 73.3% respectively. Sensitivity 33.3% found in diagnosis of cerebral AVM nidus size S3:>6cm, 100% sensitive in the diagnosis of superficial and deep venous drainage AVM. Regarding the eloquence of brain area 15 was no eloquence by both MRA and DSA and identification of eloquence of brain area sensitivity 73.3% and accuracy 86.7%.The feeding vessels main vessels was found 22(73.3%) in both DSA and MRA findings. Distal vessels was seen 8(26.7%) in DSA but not seen in MRA findings. Intranidal aneurysm and Angiopathic AVM were seen 3(10.0%) and 4(13.3%) respectively in DSA, Conclusion: This study was carried out to diagnose the patients presented with cerebral AVM by MRA and DSA. MRA could not be evaluated flow status of AVM, distal feeding arteries, intranidal aneurysm and angiopathic AVM which could be detected by DSA. So, DSA is superior to MRA in diagnosis of cerebral AVM. DOI: http://dx.doi.org/10.3329/bjmed.v24i2.18699 Bangladesh J Medicine 2013; 24 : 51-58
Transformation de la sphère alimentaire au Vanuatu : des moyens nouveaux pour des objectifs identiques
Authors: Walter Annie , Greindl Delphine , Tzerikiantz Fabienne , Allen Mathew 
Published: August 2014

This paper is about agrarian change in Kanak society of New Caledonia. While more than 70% of Kanak population is still living in rural areas, the decline of farming activities have been observed among this population for many years. This decline is frequently related to the development of non farming salaried work and urban migration.
In the first part, we are proposing a survey of historical changes in Kanak farming systems. We then, turn to an analysis of the changing place of agriculture, both in people representation and rural households economy. In the final part, we suggest an explanation - based on a rural survey conducted in Northern Province of New Caledonia - about how households manage to secure incomes in their rural settings, while agriculture is declining.
Retour critique sur l'éthos
Authors: Maingueneau Dominique 
Published: August 2014

Cet article entend mener une réflexion critique sur l’usage qui est communément fait de l’éthos discursif dans les travaux d’analyse du discours depuis une quinzaine d’années. Cette réflexion est en même temps autocritique, dans la mesure où depuis les années 1980 j’ai contribué au développement de cette problématique. Dans un premier temps, je m’efforce d’analyser plus précisément le contenu de la notion d’éthos, dans laquelle je distingue trois dimensions : catégorielle, expérientielle et idéologique. Cette tripartition est nécessaire si l’on veut tenir compte de la diversité des manifestations du discours. Dans un second temps, je réfléchis sur le processus même de construction de l’éthos en m’appuyant sur des données – en particulier les annonces de sites de rencontre – différentes de celles qu’on étudie habituellement quand on travaille sur l’éthos. Enfin, dans un troisième temps, je m’intéresse aux problèmes que pose l’analyse de l’éthos discursif quand on a affaire à des textes où sont étroitement mêlées dimension verbale et iconique. Deux types de phénomènes sont considérés : les sites Web, dans lesquels sont impliqués éthos verbal et éthos numérique, et les publicités.
The Cross-Priming Capacity and Direct Presentation Potential of an Autoantigen Are Separable and Inversely Related Properties
Authors: Wang Jinguo , Nanjundappa Roopa Hebbandi , Shameli Afshin , Clemente-Casares Xavier , Yamanouchi Jun , Elliott John F. , Slattery Robyn , Serra Pau , Santamaria Pere 
Published: August 2014

Abstract
We investigated whether a prevalent epitope of the β-cell–specific autoantigen islet-specific glucose-6-phosphatase catalytic subunit–related protein (IGRP206–214) reaches regional Ag-presentation pathways via unprocessed polypeptide chains, as free IGRP206–214 peptide or via preformed IGRP206–214/Kd complexes. This was accomplished by expressing bacterial artificial chromosome transgenes encoding wild-type (stable) or ubiquitinated (unstable) forms of IGRP in IGRP-deficient NOD mice carrying MHC class I–deficient β-cells, dendritic cells, or B cells. We investigated the ability of the pancreatic lymph nodes of these mice to prime naive IGRP206–214-reactive CD8+ T cells in vivo, either in response to spontaneous Ag shedding, or to synchronized forms of β-cell necrosis or apoptosis. When IGRP was made unstable by targeting it for proteasomal degradation within β-cells, the cross-priming, autoimmune-initiating potential of this autoantigen (designated autoantigenicity) was impaired. Yet at the same time, the direct presentation, CTL-targeting potential of IGRP (designated pathogenicity) was enhanced. The appearance of IGRP206–214 in regional Ag-presentation pathways was dissociated from transfer of IGRP206–214 or IGRP206–214/Kd from β cells to dendritic cells. These results indicate that autoantigenicity and pathogenicity are separable and inversely related properties and suggest that pathogenic autoantigens, capable of efficiently priming CTLs while marking target cells for CTL-induced killing, may have a critical balance of these two properties.
Diagnosis of atypia/follicular lesion of undetermined significance: An institutional experience
Authors: Wong Lawrence Q. , LiVolsi Virginia A. , Baloch Zubair W. 
Published: August 2014

Background:The overall malignancy rate for the thyroid fine-needle aspiration (FNA) diagnosed as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) ranges from 5% to 30%. In this study, we present our institutional experience with thyroid nodules diagnosed as AUS/FLUS and further stratified into subcategories. In addition, we also assessed the significance of various clinicopathologic factors that may influence AUS/FLUS diagnoses and their outcomes.Design:A search of our laboratory information system was performed to identify all in-house thyroid FNA cases diagnosed as AUS/FLUS from 2008 to 2012. The data were collected and characterized by patient demographic information, cytopathology diagnosis with sub-classifiers and follow-up.Results:The case cohort included 457 cases diagnosed as AUS/FLUS. These were further sub-classified into one of six subcategories depending on the cytomorphologic findings and suspicion for or against a neoplastic process. Of the 457 cases, repeat FNA and/or surgical follow-up was available in 363 cases. There were 182 (39.8%) cases with cytologic follow-up only; 18 (9.9%) remained as AUS/FLUS, while 158 (86.8%) were re-classified with the majority being benign (142 cases). Histologic follow-up was available in 181 (39.6%) cases. There were 60 malignant cases confirmed by surgical excision, with an overall malignancy rate of 33.1%. The malignancy rate was 38.8% for cases with a repeat FNA versus 25.6% for cases that went directly to surgery without a repeat FNA. Papillary thyroid carcinoma accounted for 93.3% (56 cases) of the malignant cases.Conclusion:Based on our study, even though the malignancy rate of AUS/FLUS cases is similar to those reported for cases diagnosed as follicular neoplasm/suspicious for follicular neoplasm, we are of the belief that these comparable malignancy rates are a product of better clinical management and selection of patients diagnosed as AUS/FLUS for surgery after a repeat FNA.