bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute monoarthritis in a delayed diagnosis of syphilis patient with persistent rupioid psoriasis-like lesions
Authors: Zhu Kejian , Zhou Qiang , Han Rui , Cheng Hao 
Published: December 2012

Abstract

Background
The incidence of syphilis is increasing in many parts of the world. Clinicians may have limited experience in the diagnosis when the clinical appearance is unusual. If early diagnosis is not made and prompt treatment not given, then the disease may remain quiescent until more serious symptoms or systemic involvement develops.

Case presentation
We report the first case of a delayed diagnosis of syphilis with a ten-year history of persistent rupioid psoriasis-like lesions. Acute monoarthritis and high fever together with aggravation of skin lesions led to a careful clinical examination. Skin biopsies demonstrated syphilis spirochetes on immunohistochemical stain, and syphilis serological titers were positive. Standard treatment with benzathine penicillin brought a partial and transient improvement. A complete clinical and serological resolution of the disease was achieved by a prolonged and repeated penicillin treatment combined with methylprednisolone. A 7-year follow-up of the patient proved a full recovery.

Conclusion
Our case highlights the fact that clinical signs of syphilis can be diverse and complicated. Unusual clinical manifestations can happen in an immunocompetent individual. Treatment strategy may need to be adjusted in a difficult case.
Childhood immunization rates in rural Intibucá, Honduras: an analysis of a local database tool and community health center records for assessing and improving vaccine coverage
Authors: He Yuan , Zarychta Alan , Ranz Joseph B , Carroll Mary , Singleton Lori M , Wilson Paria M , Schlaudecker Elizabeth P 
Published: December 2012

Abstract

Background
Vaccines are highly effective at preventing infectious diseases in children, and prevention is especially important in resource-limited countries where treatment is difficult to access. In Honduras, the World Health Organization (WHO) reports very high immunization rates in children. To determine whether or not these estimates accurately depict the immunization coverage in non-urban regions of the country, we compared the WHO data to immunization rates obtained from a local database tool and community health center records in rural Intibucá, Honduras.

Methods
We used data from two sources to comprehensively evaluate immunization rates in the area: 1) census data from a local database and 2) immunization data collected at health centers. We compared these rates using logistic regression, and we compared them to publicly available WHO-reported estimates using confidence interval inclusion.

Results
We found that mean immunization rates for each vaccine were high (range 84.4 to 98.8 percent), but rates recorded at the health centers were significantly higher than those reported from the census data (p≤0.001). Combining the results from both databases, the mean rates of four out of five vaccines were less than WHO-reported rates (p <0.05). Overall immunization rates were significantly different between townships (p=0.03). The rates by individual vaccine were similar across townships (p >0.05), except for diphtheria/tetanus/pertussis vaccine (p=0.02) and oral polio vaccine (p <0.01).

Conclusions
Immunization rates in Honduras were high across data sources, though most of the rates recorded in rural Honduras were less than WHO-reported rates. Despite geographical difficulties and barriers to access, the local database and Honduran community health workers have developed a thorough system for ensuring that children receive their immunizations on time. The successful integration of community health workers and a database within the Honduran decentralized health system may serve as a model for other immunization programs in resource-limited countries where health care is less accessible.
Different distribution of breast ductal carcinoma in situ, ductal carcinoma in situ with microinvasion, and invasion breast cancer
Authors: Wei Zhang , Er-li Gao , Yi-li Zhou , Qi Zhai , Zhang-yong Zou , Gui-long Guo , Guo-rong Chen , Hua-min Zheng , Guan-li Huang , Xiao-hua Zhang 
Published: December 2012

Abstract

Background
Breast ductal cancer in situ (DCIS) can recur or progress to invasive ductal cancer (IDC), and the interim stage include DCIS with microinvasion (DCIS-Mi). In this article, we attempt to study the study the differences of clinicopathological features, imaging data, and immunohistochemical-based subtypes among DCIS, DCIS-Mi, and IDC.

Methods
In this retrospective study, we attempt to compare the clinicopathological features, immunohistochemical results and imaging data of 866 patients (included 73 DCIS, 72 DCIS-Mi, and 721 IDC).

Results
Patients with DCIS and DCIS-Mi were younger than those with IDC (P = 0.007). DCIS and DCIS-Mi often happened in premenopausal women while IDC was opposite (P <0.001). The incidence of IDC with node-positive was significantly higher than it in DCIS and DCIS-Mi (P <0.001). We also observed that the Her2-positive was more often found in patients with pure DCIS compared to those with DCIS-Mi and DCIS-I (P <0.001). There was a significant difference between the four subgroups (Luminal-A, Luminal-B, ERBB2+, Basal-like) from DCIS, DCIS-Mi, and IDC (P <0.001). Basal-like patients were fewer than other subgroups in DCIS, DCIS-Mi, and IDC. The incidence of the first performance of ultrasound (catheter winded and nodular mass) and mammography (nodular mass) had significantly difference among patients with DCIS, DCIS-Mi, and IDC (P <0.001).

Conclusions
Different clinicopathological, immunohistochemical, and imaging features among DCIS, DCIS-Mi, and IDC indicate that they are distinct entities. A larger sample size is needed for further study.
Development and validation of a chromatographic method for determining Clematichinenoside AR and related impurities
Authors: Zhou Yang , Guan Yue , Shi Ji , Zhang Xiaolin , Yao Lan , Liu Lifang 
Published: December 2012

Abstract

Background
Clematichinenoside AR is a promising lead compound for the treatment of rheumatoid arthritis. A systematic research for the related impurities in AR bulk samples is still lacking. For the safe use of this natural product in future clinical practice, the structure and content of each constituent, including the main ingredient as well as the impurities in AR bulk sample must be characterized in detail.

Results
A simple and stability indicating RP-HPLC method was developed and validated for determining the purity of clematichinenoside AR (AR), a natural product from the roots of Clematis manshurica Rupr. (Ranunculaceae) with the potential of treating rheumatoid arthritis. Five impurities were characterized, and impurity 2 (Clematomandshurica saponin F) is a new triterpenoid saponin isolated from this product. Optimum separation for clematichinenoside AR and five related impurities was carried out on an Agilent octadecylsilane bonded silica gel column (TC-C18, 4.6 mm ×150 mm, 5 μm) using a gradient HPLC method. The validation results showed good sensitivity, specificity, linearity(r2>0.9992) precision(RSD<1.63%), accuracy(recoveries in the range of 95.60%-104.76%) and robustness. Three AR bulk samples containing all the impurities were examined by two methods, and the stability of correction factors for the determination of related impurities was discussed. The proposed stability-indicating method was suitable for the quality control of this natural product.

Conclusion
Five related impurities of clematichinenoside AR were characterized, including a new triterpenoid saponins firstly found in clematichinenoside AR bulk samples. In the simple chromatographic method for determining clematichinenoside AR and its related impurities in bulk samples, the correction factor was better for the quality control in the relative stable concentrations.
Jejunoileal atresia and cystic fibrosis: don’t miss it
Authors: Siersma Carolien L , Rottier Bart L , Hulscher Jan BF , Bouman Katelijne , van Stuijvenberg Margriet 
Published: December 2012

Abstract

Background
While an increased prevalence of cystic fibrosis (CF) in patients with jejunal atresia and ileal atresia (JIA) has been described previously, it still may not be a practice routine to indicate a sweat test or DNA test for CFTR mutations in newborns presenting with JIA. Leading textbooks do not mention JIA as a possible presenting clinical feature of CF. We describe two cases of JIA with a delayed diagnosis of CF (4 months [post mortem] and 19 months). This led to a retrospective review of all patients with JIA in our hospital. We hypothesised that also in the past although indicated further testing for CF had not always been performed.

Methods
Over an 18-year period from January 1991 until December 2008, all cases of JIA in our centre were reviewed (n=50). We compared patients who have been tested for CF (n=18) with patients who have not been tested for CF (n=32), with respect to their patient characteristics, either by logistic regression analysis or a nonparametric test (p<0.05).

Results
Of all 50 patients the proportion of infants actually tested for CF was 18 (36%). A statistical significant difference between the group of patients who were tested for CF versus the group of those who were not tested was found in a higher occurrence of postoperative bilious retention after 7 days (56% versus 25%, respectively), and postoperative complications (78% versus 34%, respectively). CF was confirmed in 4 (8%).

Conclusion
Testing for CF in newborns presenting with JIA does not appear to be common practice. A timely diagnosis of CF leads to presymptomatic treatment and has beneficial effects on morbidity and mortality. CF should be tested for in all children with JIA. We recommend a sweat test for term children and CFTR DNA testing as a first step for preterm infants. Medical professional awareness may be increased if future editions of leading text books in the relevant fields should include JIA as an indication to follow an appropriate CF-diagnostic algorithm.

Trial registration
Statement on reporting of a clinical trial: This article is not based on a clinical trial.
Duplex quantitative real-time PCR assay for the detection and discrimination of the eggs of Toxocara canis and Toxocara cati (Nematoda, Ascaridoidea) in soil and fecal samples
Authors: Durant Jean-Francois , Irenge Leonid M , Fogt-Wyrwas Renata , Dumont Catherine , Doucet Jean-Pierre , Mignon Bernard , Losson Bertrand , Gala Jean-Luc 
Published: December 2012

Abstract

Background
Toxocarosis is a zoonotic disease caused by Toxocara canis (T. canis) and/or Toxocara cati (T. cati), two worldwide distributed roundworms which are parasites of canids and felids, respectively. Infections of humans occur through ingestion of embryonated eggs of T. canis or T. cati, when playing with soils contaminated with dogs or cats feces. Accordingly, the assessment of potential contamination of these areas with these roundworms eggs is paramount.

Methods
A duplex quantitative real-time PCR (2qPCR) targeting the ribosomal RNA gene internal transcribed spacer (ITS2) has been developed and used for rapid and specific identification of T. canis and T. cati eggs in fecal and soil samples. The assay was set up on DNA samples extracted from 53 adult worms including T. canis, T. cati, T. leonina, Ascaris suum (A. suum) and Parascaris equorum (P. equorum). The assay was used to assess the presence of T. cati eggs in several samples, including 12 clean soil samples spiked with eggs of either T. cati or A. suum, 10 actual soil samples randomly collected from playgrounds in Brussels, and fecal samples from cats, dogs, and other animals. 2qPCR results on dogs and cats fecal samples were compared with results from microscopic examination.

Results
2qPCR assay allowed specific detection of T. canis and T. cati, whether adult worms, eggs spiked in soil or fecal samples. The 2qPCR limit of detection (LOD) in spiked soil samples was 2 eggs per g of soil for a turnaround time of 3 hours. A perfect concordance was observed between 2qPCR assay and microscopic examination on dogs and cats feces.

Conclusion
The newly developed 2qPCR assay can be useful for high throughput prospective or retrospective detection of T.canis and/or T. cati eggs in fecal samples as well as in soil samples from playgrounds, parks and sandpits.
Cognitive analytic therapy for personality disorder: randomised controlled trial
Authors: Clarke Susan , Thomas Peter , James Kirsty 
Published: December 2012

BackgroundCognitive analytic therapy (CAT) is a theoretically coherent approach developed to address common processes underlying personality disorders, but is supported by limited empirical evidence.AimsTo investigate the effectiveness of time-limited CAT for participants with personality disorder.MethodA service-based randomised controlled trial (trial registration: ISRCTN79596618) comparing 24 sessions of CAT (n = 38) and treatment as usual (TAU) (n = 40) over 10 months for individuals with personality disorder. Primary outcomes were measures of psychological symptoms and interpersonal difficulties.ResultsParticipants receiving CAT showed reduced symptoms and experienced substantial benefits compared with TAU controls, who showed signs of deterioration during the treatment period.ConclusionsCognitive analytic therapy is more effective than TAU in improving outcomes associated with personality disorder. More elaborate and controlled evaluations of CAT are needed in the future.
Thiourea Dioxide as a Green Reductant for the Mass Production of Solution-Based Graphene
Authors: Wang Yanqing , Sun Ling , Fugetsu Bunshi 
Published: December 2012

Abstract
Mass production of solution-based graphene derived from the precursor graphene oxide is a challenging step toward achieving industrialization of graphene. Inspired by a classical reducing method performed in the textile and paper making industries, we report here a rapid, cost-effective, and safer approach to the facile production of graphene that employs thiourea dioxide (TDO) as the green reductant. Graphene oxide was converted into high quality graphene within 30 min with TDO as the reductant under moderate reaction conditions. The C/O ratio of the TDO reduced graphene was ca. 5.9 with the yield of graphene from graphene oxide &gt;99%. This is better than the reduction efficiency under the identical experimental conditions by using l-ascorbic acid as the reductant which required a reaction time of about 48 h. This simple and effective procedure should offer an alternative route to the mass production of solution-based graphene for practical applications.
Label-free Fluorescent Detection of Loop-mediated Isothermal Amplification of Nucleic Acid Using Pyrophosphate-selective Xanthene-based Zn(II)-coordination Chemosensor
Authors: Kittiloespaisan Ekkachai , Ojida Akio , Hamachi Itaru , Seetang-Nun Yortyot , Kiatpathomchai Wansika , Wongkongkatep Jirarut 
Published: December 2012

Abstract
A label-free fluorescent detection method for the loop-mediated isothermal amplification (LAMP) of nucleic acids was first developed by using the pyrophosphate-selective xanthene-based Zn(II)-coordination chemosensor 1–2Zn(II). In this method, the production of inorganic pyrophosphate (PPi), a by-product of the LAMP reaction, was detected by 1–2Zn(II) with a large fluorescence enhancement. On combination with the fluorescent plate reader technique, this method allows us to detect the shrimp white spot syndrome virus in a high-throughput manner with high sensitivity and selectivity.
Association of Clinical Symptomatic Hypoglycemia With Cardiovascular Events and Total Mortality in Type 2 Diabetes
Authors: Hsu Pai-Feng , Sung Shih-Hsien , Cheng Hao-Min , Yeh Jong-Shiuan , Liu Wen-Ling , Chan Wan-Leong , Chen Chen-Huan , Chou Pesus , Chuang Shao-Yuan 
Published: December 2012

OBJECTIVE
Hypoglycemia is associated with serious health outcomes for patients treated for diabetes. However, the outcome of outpatients with type 2 diabetes who have experienced hypoglycemia episodes is largely unknown.

RESEARCH DESIGN AND METHODS
The study population, derived from the National Health Insurance Research Database released by the Taiwan National Health Research Institutes during 1998–2009, comprised 77,611 patients with newly diagnosed type 2 diabetes. We designed a prospective study consisting of randomly selected hypoglycemic type 2 diabetic patients and matched type 2 diabetic patients without hypoglycemia. We investigated the relationships of hypoglycemia with total mortality and cardiovascular events, including stroke, coronary heart disease, cardiovascular diseases, and all-cause hospitalization.

RESULTS
There were 1,844 hypoglycemic events (500 inpatients and 1,344 outpatients) among the 77,611 patients. Both mild (outpatient) and severe (inpatient) hypoglycemia cases had a higher percentage of comorbidities, including hypertension, renal diseases, cancer, stroke, and heart disease. In multivariate Cox regression models, including diabetes treatment adjustment, diabetic patients with hypoglycemia had a significantly higher risk of cardiovascular events during clinical treatment periods. After constructing a model adjusted with propensity scores, mild and severe hypoglycemia still demonstrated higher hazard ratios (HRs) for cardiovascular diseases (HR 2.09 [95% CI 1.63–2.67]), all-cause hospitalization (2.51 [2.00–3.16]), and total mortality (2.48 [1.41–4.38]).

CONCLUSIONS
Symptomatic hypoglycemia, whether clinically mild or severe, is associated with an increased risk of cardiovascular events, all-cause hospitalization, and all-cause mortality. More attention may be needed for diabetic patients with hypoglycemic episodes.
Effects of action of proparacaine and tetracaine topical ophthalmic formulations on corneal sensitivity in horses
Authors: Sharrow-Reabe Karen L. , Townsend Wendy M. 
Published: December 2012

Abstract
Objective—To compare the corneal anesthetic effects and duration of action of 2 ophthalmic anesthetic agents in horses.
Design—Prospective, randomized masked crossover study.
Animals—8 clinically normal adult horses.
Procedures—Corneal sensitivity was determined by measuring each eye's corneal touch threshold (CTT) with a Cochet-Bonnet esthesiometer. Each eye's baseline CTT was recorded prior to anesthetic instillation at 0 minutes and every 10 minutes thereafter for 60 minutes. Each eye was randomly assigned to receive 2 of 4 treatments: 0.5% aqueous proparacaine ophthalmic solution (aqueous proparacaine; 8 eyes); 0.5% aqueous tetracaine ophthalmic solution (aqueous tetracaine; 8 eyes); 0.5% viscous tetracaine ophthalmic solution (viscous tetracaine; 8 eyes); and saline (0.9% NaCl) eyewash solution (8 eyes) as a negative control. There was a 48-hour washout period. Every horse received all treatments.
Results—Median baseline CTT of eyes was 4.5 cm (range, 0.5 to 6 cm). Median CTT for saline solution–treated eyes never differed significantly from baseline. The maximum anesthetic effect with the other 3 treatments occurred at 10 minutes. Median CTT of eyes at 10 minutes was 0.5 cm (range, 0 to 2.5 cm) with aqueous proparacaine treatment, 0.25 cm (range, 0 to 2.0 cm) with aqueous tetracaine treatment, and 0 cm (range, 0 to 0.5 cm) with viscous tetracaine treatment. Maximum anesthetic duration was 20 minutes with aqueous proparacaine and aqueous tetracaine treatments and 30 minutes with viscous tetracaine treatments.
Conclusions and Clinical Relevance—Treatment of eyes with viscous tetracaine resulted in the greatest decrease in CTT and the longest duration of action, compared with treatment with aqueous proparacaine or aqueous tetracaine.
Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)
Authors: Rubio-Martínez Luis M. , Elmas Colette R. , Black Belinda , Monteith Gabrielle 
Published: December 2012

Abstract
Objective—To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients.
Design—Retrospective case series.
Animals—174 horses.
Procedures—Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted.
Results—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up.
Conclusions and Clinical Relevance—The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.
Effect of lentil and bean flours on rheological and baking properties of wheat dough
Authors: Kohajdová Zlatica , Karovičová Jolana , Magala Michal 
Published: December 2012

AbstractThe potential of legume flours (lentil and bean) in bakery applications was investigated. The study indicated that legume flours were characterised by high protein (27.30–27.35 mass %) and total dietary fibre (14.91–21.52 mass %), relatively high water holding capacity (4.71–5.42 g g−1), and good emulsifying properties (emulsifying capacity: 32.73–46.96 cm3 per 100 cm3 and emulsion stability: 60.52–90.90 cm3 per 100 cm3). Fine wheat flour was partially substituted with 10 mass %, 20 mass %, and 30 mass % levels of lentil and bean flours in order to study their farinographic characteristics and baking behaviour. The addition of legume flours increased water absorption capacity (from 58.50 mass % to 74.90 mass %) and dough development time (from 3.50 min to 5.50 min), whereas dough stability was reduced (from 6.67 min to 2.30 min). The presence of legume flours in dough negatively affected the physical parameters of baked rolls and resulted in the reduction in volume, specific volume, and cambering. Sensory evaluation showed that the most acceptable baked rolls were obtained when the wheat-legume blend flour containing 10 mass % of legume flour was applied. Higher levels of legume flours in the products adversely affected the shape, crust colour, crumb elasticity, and hardness of the final products.