bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poisoning with illicit substances: toxicology for the anaesthetist
Authors: Wong G. T. C. , Irwin M. G. 
Published: December 2012

SummaryThe consumption of illicit substances represents a considerable threat to the health and wellbeing of particular sectors of our communities. Hospitalisation is sometimes required for the treatment of the direct toxic effects of the drugs as well as for injuries sustained while under their influence. Although poisoning with ‘traditional‘ substances of abuse such as opioids, cocaine and cannabis still predominate in terms of numbers, the availability and use of new psychoactive substances are on the rise. These latter agents, some of which began life as failed pharmaceutical products, have enjoyed renewed status as recreational stimulants, entactogens or hallucinogens, properties that originally precluded them from legitimate use. These drugs may act by enhancing endogenous release of neurotransmitters, inhibiting their reuptake back into neurons or having direct effects on receptors, and may involve adrenergic, dopaminergic or serotonergic systems. The use of intravenous lipid emulsion for the symptomatic treatment of drug overdose has become a fertile ground for research and may hold promise as a non‐specific treatment for poisoning with illicit substances. Dexmedetomidine, an α2‐receptor agonist with a central sympatholytic effect, may be able to counteract the cardiovascular and central nervous system overstimulation that may accompany stimulant toxicity.
Haemorrhage and coagulopathy in the Defence Medical Services
Authors: Mercer S. J. , Tarmey N. T. , Woolley T. , Wood P. , Mahoney P. F. 
Published: December 2012

SummaryOver the past 12 years, the United Kingdom Defence Medical Services have evolved an integrated ‘damage control resuscitation – damage control surgery’ sequence for the management of patients sustaining complex injuries. During 2009, over 3200 units of blood products were administered as massive transfusions to severely injured UK personnel. An important part of the approach to traumatic bleeding is the early, empirical use of predefined ratios of blood and clotting products. As soon as control of bleeding is achieved, current practice is to switch towards a tailored transfusion, based on clinical and laboratory assessments, including point‐of‐care coagulation testing. A key goal is to provide resuscitation seamlessly throughout surgery, so that patients leave the operating room with their normal physiology restored. This article outlines the current management of haemorrhage and coagulation employed in Afghanistan from the point of wounding to transfer back to the National Health Service.
Anaesthesia and pre‐hospital emergency medicine
Authors: Booth A. , Steel A. , Klein J. 
Published: December 2012

SummaryMajor trauma is a leading cause of death and disability in the UK, particularly in the young. Pre‐hospital emergency medicine (PHEM) involves provision of immediate medical care to critically ill and injured patients, across all age ranges, often in environments that may be remote and are not only physically challenging but also limited in terms of time and resources. PHEM is now a GMC‐recognised subspecialty of anaesthesia or emergency medicine and the first recognised training program in the UK commenced in August 2012. This article discusses subspeciality development in PHEM, the competency based framework for training in PHEM, and the provision of pre‐hospital emergency anaesthesia.
Congenital cataract screening in maternity wards is effective: evaluation of the Paediatric Cataract Register of Sweden
Authors: Magnusson Gunilla , Bizjajeva Svetlana , Haargaard Birgitte , Lundström Mats , Nyström Alf , Tornqvist Kristina 
Published: December 2012

AbstractAimTo study which eye‐screening protocol prevails in Swedish maternity/neonatal wards, evaluate efficacy in a prospective study and compare results with earlier Swedish retrospective results.MethodsSurveys were sent in 2006 to maternity/neonatal and women's health departments regarding screening policy. Response frequency was 96% (122/127). Data were derived from the Paediatric Cataract Register (PECARE), Sweden. All Swedish children diagnosed with congenital cataract and operated on before 1 year of age between January 2007 and December 2009 were included. Statistical comparison with earlier retrospective results was performed.ResultsEye screening is a routine protocol at a rate of 90% of Swedish maternity wards. Sixty‐one children were included in the study. An increase was shown in case referrals from maternity wards compared to 10 years ago (64% vs. 50%). Detection was performed within 6 weeks of age in 75% of the cases. A significant difference between the probabilities of early referral (0.38; p < 0.001, < 6 weeks of age) and early surgery (0.36; p < 0.001) (PECARE) was found in comparison with the historical data of no maternity‐ward screening. Well‐baby clinics were instrumental in early detection, as well.ConclusionEye screening in maternity wards is effective. Clear Swedish directives are to be preferred.
Management of renal dysfunction following term perinatal hypoxia‐ischaemia
Authors: Sweetman Deirdre U , Riordan Michael , Molloy Eleanor J 
Published: December 2012

AbstractAcute kidney injury frequently develops following the term perinatal hypoxia‐ischaemia. Quantifying the degree of acute kidney injury is difficult, however, as the methods currently in use are suboptimal. Acute kidney injury management is largely supportive with little evidence basis for many interventions. This review discusses management strategies and novel biomarkers that may improve diagnosis and management of renal injury following perinatal hypoxia‐ischaemia.ConclusionFollowing perinatal hypoxia‐ischaemia, acute kidney injury is common. Management of neonatal acute kidney injury is largely supportive. Novel acute kidney injury biomarkers may play a role in optimizing new categorical definitions of renal injury. Studies are needed to investigate the impact of neonatal acute kidney injury on long‐term outcome.
Prospective antibody case finding of coeliac disease in type‐1 diabetes children: need of biopsy revisited
Authors: Popp Alina , Mihu Mihaela , Munteanu Mihai , Ene Adina , Dutescu Monica , Colcer Florin , Raducanu Diana , Laurila Kaija , Anca Ioana , Mäki Markku 
Published: December 2012

AbstractAimTo evaluate whether coeliac disease (CD) can be diagnosed by measuring autoantibodies without small‐intestinal mucosal biopsies in children with type 1 diabetes.MethodsCase finding of CD was undertaken in 181 consecutive IgA‐competent children with type 1 diabetes using transglutaminase 2 (TG2) and endomysial IgA antibody (EMA) tests in serum and the rapid point of care test in fingertip whole‐blood sample. Endoscopy with intestinal biopsies was recommended for patients with high TG2‐IgA titres (>96 U) and in children with lower positive tests if either the EMA test or the rapid point of care test was additionally positive. The duodenal mucosal biopsies were graded according to the Marsh classification.ResultsThe TG2‐IgA test had a 15.5% and the EMA test a 6.0% seropositivity. All seven biopsied high‐titre TG2‐IgA‐positive children were symptom free and found to have CD (Marsh 3 type lesion). These patients were also positive for EMA and in the rapid point of care test. Lower titre TG2‐IgA‐positive children had histological Marsh 1 to 3a lesions.ConclusionsNone of the type 1 diabetes children with high TG2‐IgA titres would have needed endoscopy with duodenal biopsies to reach a CD diagnosis. Lower TG2‐IgA‐positive patients need to be biopsied.
Smoking is a risk factor for recurrence of intestinal stricture after endoscopic dilation in Crohn's disease
Authors: Gustavsson A. , Magnuson A. , Blomberg B. , Andersson M. , Halfvarson J. , Tysk C. 
Published: December 2012

SummaryBackgroundEndoscopic balloon dilation is an efficacious and safe alternative to surgery as treatment of short intestinal strictures in Crohn's disease (CD). Factors predicting outcome of the procedure are not well described.AimTo evaluate whether smoking at diagnosis, treatment with azathioprine, or other clinical variables may affect clinical outcome after endoscopic dilation. The endpoint was requirement of a new intervention such as dilation or surgery with intestinal resection or strictureplasty.MethodsRetrospective study of 83 patients with CD who underwent endoscopic balloon dilation of an intestinal stricture between 1987 and 2009.ResultsAfter index dilation 55/83 patients underwent a new intervention. Among current smokers, 31/32 (97%) underwent another intervention compared to 18/33 (55%) among never smokers (adjusted HR: 2.50, 95% CI: 1.14–5.50, P = 0.022). After 5 years, cumulative probability of new intervention was 0.81 in smokers compared to 0.52 in never smokers; difference 0.29 (95% CI: 0.07–0.52, P = 0.01). In 16 patients, therapy with azathioprine was initiated before or shortly after the index dilation; 7/16 underwent a new intervention compared to 48/67 of those without azathioprine (HR: 0.46, 95% CI: 0.21–1.03, P = 0.06). After adjustment for other variables, the association was even weaker (HR: 0.80, 95% CI: 0.29–2.18, P = 0.668). Sex, age at diagnosis, age at first dilation, balloon size, location of stricture, and treatment period did not influence outcome.ConclusionsSmoking doubles the risk of recurrent stricture formation requiring a new intervention after index dilation. Maintenance therapy with azathioprine did not influence the subsequent course and need for a new intervention.
Effect of fructo‐oligosaccharide on nitrogen utilization in guinea pigs
Authors: Kawasaki Kiyonori , Min Xiao , Nishiyama Ai , Sakaguchi Ei 
Published: December 2012

AbstractThe present study was conducted to determine the effects of fructo‐oligosaccharide (FOS) on the nitrogen (N) utilization and digestibilities of dietary nutrients through cecotrophy in guinea pigs. Adult male guinea pigs that were housed or not housed in wooden frames to prevent cecotrophy were fed a commercial pellet diet (50 g/day) with 3% and 5% glucose or FOS for 8 days in individual metabolism cages. In the guinea pigs allowed cecotrophy, addition of FOS to the diet had no significant effects on body weight gain or apparent digestibility of N, but showed significantly lower value for the urinary N excretion and acid‐detergent fiber digestibility (P < 0.05 and P < 0.01, respectively) and significantly higher value for N retention and the N retention rate (P < 0.05). In the guinea pigs prevented from cecotrophy, FOS had no effect on N retention, but showed tendencies toward a higher value for fecal N excretion and a lower value for urinary N excretion. These results suggest that FOS stimulates cecal microbial proliferation, thereby improving N utilization in guinea pigs.
Disturbance and recovery in semi‐arid Mediterranean grasslands
Authors: Merou Theodora P. , Tsiftsis Spyros , Papanastasis Vasilios P. 
Published: December 2012

AbstractAims(1) To investigate the temporal response of semi‐arid Mediterranean grasslands to multiple disturbances as well as P fertilization and irrigation; and (2) to determine the reaction of single species or groups of species as well as the extent of recovery of the grassland community following cessation of the above interventions.LocationNorth Greece.MethodsIn a fenced area, six treatments (burning, irrigation, digging, cutting, P fertilization and control) were applied, for three growing seasons, in a completely randomized block design with four blocks. Biomass was sampled in five (0.5 × 0.5 m) quadrats per plot at the end of the growing season and sorted into the following functional groups: annual grasses, perennial grasses, annual legumes and forbs (that included all the other species). Measurements were repeated 1 and 7 yr after cessation of the treatments.ResultsAnnual grasses and legumes were positively favoured by cutting, burning and digging, which produced changes in vegetation composition over time. P fertilization had a positive influence on total legume biomass. Effects on individual species were not uniform. Plant composition after cessation of the disturbance treatments was quite different. Total legume biomass remained high 1 yr after the cessation of P fertilization but declined thereafter. Annual grasses and legumes constituted the largest portion of the total biomass in the first year of the experiment. Disturbance (burning, cutting and digging) gradually reduced their biomass in favour of forbs. Seven years after cessation of the treatments, the tall annual, as well as perennial grasses constituted more than 80% of the total biomass. Under conditions of disturbance, short annual species had an advantage over perennials, while cessation of disturbance enables perennial grasses to dominate.ConclusionsDisturbance promotes the dominance of annuals, especially species with a persistent seed bank. Repeated disturbance encourages an increase of small or prostrate species. Cessation of disturbance leads to the rapid recovery of biomass production. Tall annuals are promoted. P fertilization clearly favours legumes in the short term.
Expression of CD70 in nasal natural killer/T cell lymphoma cell lines and patients; its role for cell proliferation through binding to soluble CD27
Authors: Yoshino Kazumi , Kishibe Kan , Nagato Toshihiro , Ueda Seigo , Komabayashi Yuki , Takahara Miki , Harabuchi Yasuaki 
Published: December 2012

SummaryNasal natural killer (NK)/T cell lymphoma (NNKTL) is associated with Epstein–Barr virus (EBV). The present study analysed gene expression patterns of the NNKTL cell lines SNK6, SNK1 and SNT8, which are positive for EBV and latent membrane protein (LMP)‐1, using a complementary DNA array analysis. We found that CD70 was specifically expressed in SNK6 and SNT8. Reverse transcription polymerase chain reaction and flow cytometric analyses confirmed that CD70 was expressed in all 3 NNKTL cell lines, but not in the other EBV‐positive NK‐cell lines. In vitro studies showed that NNKTL cell lines proliferated, in a dose‐dependent fashion, in response to exogenous soluble CD27, which is the ligand for CD70. In NNKTL patients, we confirmed that the CD70 was expressed on the lymphoma cells in NNKTL tissues and that soluble CD27 was present in sera at higher levels as compared to healthy individuals. Finally, complement‐dependent cytotoxicity assay showed that anti‐CD70 antibody mediated effective complement‐dependent killing of NNKTL cells and the affected target CD70 expression on the cells. These results suggest that CD70 acts as a functional receptor binding to soluble CD27, resulting in lymphoma progression and that immunotherapy using anti‐CD70 antibody may be a potential candidate for treatment for NNKTL.
Diagnostic evaluation of patients with suspected haemophagocytic lymphohistiocytosis
Authors: Lehmberg Kai , Ehl Stephan 
Published: December 2012

SummaryHaemophagocytic lymphohistiocytosis (HLH) is a life‐threatening hyperinflammatory syndrome characterized by severely disturbed immune homeostasis. It can affect all age groups. Diagnostic evaluation of the patient with suspected HLH has to address three main questions: (i) does the patient have HLH? There is no simple diagnostic test, but a number of clinical and laboratory criteria define this clinical syndrome. (ii) Can a trigger be identified? A variety of infections, malignant or autoimmune diseases can contribute to the disturbed immune homeostasis with important consequences for treatment. (iii) Does the patient suffer from a genetic disease predisposing to HLH? Recent advances in the understanding of the genetic and pathophysiological basis of HLH have enabled a better and more rapid answer to this question, which is relevant for prognosis and the decision to perform haematopoietic stem cell transplantation. This review summarizes the current diagnostic approach to the patient with HLH.
Calsenilin Contributes to Neuronal Cell Death in Ischemic Stroke
Authors: Park Jong‐Sung , Manzanero Silvia , Chang Jae‐Woong , Choi Yuri , Baik Sang‐Ha , Cheng Yi‐Lin , Li Yu‐I , Gwon A‐Ryeong , Woo Ha‐Na , Jang Jiyeon , Choi In‐Young , Lee Joo‐Yong , Jung Yong‐Keun , Tang Sung‐Chun , Sobey Christopher G. , Arumugam Thiruma V. , Jo Dong‐Gyu 
Published: December 2012

AbstractCalsenilin is a calcium sensor protein that interacts with presenilin and increases calcium‐triggered neuronal apoptosis, and γ‐secretase activity. Notch is a cell surface receptor that regulates cell‐fate decisions and synaptic plasticity in brain. The aim of the present study was to characterize the role of calsenilin as a regulator of the γ‐secretase cleavage of Notch in ischemic stroke. Here, we determined the modulation of expression level and cellular distribution of calsenilin in neurons subjected to ischemic‐like conditions. The levels of calsenilin and presenilin were increased in primary neurons after oxygen and glucose deprivation. Furthermore, calsenilin was found to enhance the γ‐secretase cleavage of Notch and to contribute to cell death under ischemia‐like conditions. The inhibition of γ‐secretase activity and a presenilin deficiency were both found to protect against calsenilin‐mediated ischemic neuronal death. The expression of calsenilin was found to be increased in brain following experimental ischemic stroke. These findings establish a specific molecular mechanism by which the induction of calsenilin enhances Notch activation in ischemic stroke, and identify calsenilin as an upstream of the γ‐secretase cleavage of Notch.
Negative Effects of Conspecific Floral Density on Fruit Set of Two Neotropical Understory Plants
Authors: Stein Katharina , Templin Mathias , Hensen Isabell , Fischer Markus , Matthies Diethart , Schleuning Matthias 
Published: December 2012

AbstractPlant reproductive success is usually positively related to conspecific floral density, but neutral or negative effects of floral density on reproduction have also been reported. Differences in the relationship between reproduction and floral density largely originate from a trade‐off between increasing attractiveness versus increasing competition for pollinators at high floral densities. Although floral densities strongly vary in the understory of tropical forests, for instance, due to variation in light availability, little is known about the density dependence of reproduction in tropical understory plants. We used path analyses to disentangle direct and indirect effects of canopy openness and floral density on fruit set and analyzed the relationship between pollen load and floral density for two Neotropical understory plants, Heliconia metallica and Besleria melancholica. In both species, fruit set was not directly related to canopy openness, but decreased with increasing floral density. In H. metallica, canopy openness had an indirect negative effect on reproduction mediated by its effects on floral density. Effects of floral density on pollen loads were species‐specific. In B. melancholica, pollen loads linearly decreased with increasing floral density, indicating competition for pollinators at high densities. In H. metallica, pollen loads were reduced at both low and high densities, indicating an interplay of facilitative and competitive effects of floral density on pollen deposition. In contrast to other studies, we found negative density dependence of reproduction in both understory species. Negative effects of floral density on reproduction appear to be related to pollinator‐mediated effects on reproduction rather than to variation in abiotic conditions.
Clinical Effectiveness of Rivastigmine Monotherapy and Combination Therapy in Alzheimer's Patients
Authors: Sonali Nirmal , Tripathi Manjari , Sagar Rajesh , Velpandian Thirumurthy , Subbiah Vivekanandhan 
Published: December 2012

SummaryBackgroundRivastigmine is an acetylcholinesterase inhibitor; the genotype data seen alongside the phenotype data explain the mutation or the molecular genetics involved and also help to relate the phenotype of an individual with their genotype.AimTo determine the clinical effectiveness of CYP2D6, CYP3A4, CYP2C9/19, and UGT polymorphism on the steady‐state plasma concentrations and therapeutic outcome of rivastigmine monotherapy and combination therapy in patients with Alzheimer's disease.ResultIn this study, a significant allele frequency was observed for CYP2D6*3 polymorphism in patients under rivastigmine combination therapy (A>del = 0.50 [patients] and A>del = 0.20 [controls]), UGT2B7 (T = 0.17 [patients] and 0.33 [Controls], and UGT1A9*5 A = 0.58 [patients] and 0.26 [Controls]). The drug levels and P value of responders/nonresponders were found to be 0.17 ± 0.08/0.22 ± 0.16 and 0.574 for rivastigmine and 0.18 ± 0.11/0.66 ± 0.63 and 0.009 for rivastigmine in combination therapy and 1.40 ± 0.65/0.59 ± 0.84 and 0.05 for memantine in combination therapy.ConclusionPoor metabolizer subjects of UGT2B7 polymorphism in patients under rivastigmine combination therapy have higher drug levels with a poor response to the drug treatments.
Developing Corporate Governance Research through Qualitative Methods: A Review of Previous Studies
Authors: McNulty Terry , Zattoni Alessandro , Douglas Thomas 
Published: December 2012

AbstractManuscript TypeReviewResearch Question/IssueThe article is concerned with the prevalence, character, and development of qualitative research within the field of corporate governance. The paper provides an overview of published qualitative research in the field of corporate governance based on a structured literature search of papers published in scholarly peer‐reviewed journals between 1986 and 2011.Research Findings/InsightsA fine‐grained search based on key words resulted in a sample of 78 qualitative corporate governance studies. A review and content analysis of these studies show that qualitative studies in governance have grown in number since the 1990s, but remain a small fraction of the published work on corporate governance. Studies are mostly developed by UK and European scholars, published in European journals and tend to explore boards of directors more than other governance related actors and mechanisms. These studies utilize a range of disciplines, predominantly management, adopting a wide range of methods, the most prevalent being that of the interview, often in combination with other methods to get a better account of the empirical phenomenon.Theoretical/Academic ImplicationsThe search reveals an eclectic range of theories, spanning several disciplines, which is serving to generate, elaborate, and refine theorizing about corporate governance and the associated meanings, mechanisms, processes and relationships. There is much scope and need for more qualitative studies of significant rigor and relevance which explore the array of interactions and processes involved in corporate governance, across different levels of analysis and contexts.Practitioner/Policy ImplicationsAfter over two decades of research and reform of corporate governance, problems of practice remain, and corporate governance prescription via codes and other forms of regulation is increasing in search of better governance. Qualitative research can assist policy‐makers and practitioners to develop more efficient governance mechanisms, by shedding light on the efficacy of policy prescription. Qualitative research provides a basis for rethinking and challenging some of the dominant assumptions and meanings about how governance actors and institutions actually function.