bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal mortality in Sudan: analysis of the Sudan household survey, 2010
Authors: Bashir Amal O , Ibrahim Ghada H , Bashier Igbal A , Adam Ishag 
Published: April 2013

Abstract

Background
Sudan is classified as having insufficient progress in achieving the Millennium Development Goal (MDG-4), where the levels of child and infant mortality are among the highest in the region and the world. This study investigated factors associated with neonatal mortality in Sudan. Neonatal death is defined as death within the first 28 days of life.

Methods
This study analysed data from the Sudan Household Health Survey 2nd round, which was carried out in 2010. Total of 6,198 live-born infants delivered within the two years preceding the survey were included as the study population. Multivariate logistic regression was used to model neonatal mortality as a function of maternal health parameters, socioeconomic indicators and the sex of the child.

Results
There were 189 neonatal deaths out of 6,198 live births (3.0%). In the multiple logistic regression, the factors associated with neonatal mortality were advanced maternal age (≥ 40 years; OR = 2.4; 95% CI: 1.21, 4.78, p = 0.012), poor household wealth index (OR = 1.6; 95% CI: 1.18, 2.47, p = 0.005), male child (OR = 1.8; 95% CI: 1.31, 2.42, p < 0.001), delivery of baby by Caesarean section (OR = 1.6; 95% CI: 1.78, 2.42, p = 0.013) and delivery complications (OR = 1.4; 95% CI: 1.18, 2.15, p = 0.002).

Conclusion
Public health interventions which target neonatal mortality reduction should adopt a risk-factor-based approach to detect pregnancy complications early and once identified, the health system should be strengthened so that these complications can be dealt with adequately.
Benign proliferative breast diseases among female patients at a sub Saharan Africa tertiary hospital: a cross sectional study
Authors: Okoth Christopher , Galukande Moses , Jombwe Josephat , Wamala Dan 
Published: April 2013

Abstract

Background
Non-cancerous diseases of the breast have assumed increasing importance because of the public awareness of breast cancer. These benign diseases are a recognized important risk factor for later breast cancer which can develop in either breast. The risk estimate of these benign breast diseases has not been well established in sub Saharan Africa. Women with benign proliferative or atypical breast lesions have a two- fold risk of developing breast cancer in western populations. The purpose of this study therefore was to determine the prevalence of proliferative disease ( BPBD) with and without atypia among Ugandan Black women.

Methods
A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened. Fine needle aspiration biopsies were taken for cytological examination.

Results
Of the 208 women with benign breast lumps screened, 195 were recruited in the study. The prevalence of BPBD was 18% (35/195). BPBD with atypia was 5.6% (11/195). The mean age and body mass index (BMI) were 28.4 years and 23.26 kg/m2 respectively. The commonest lesions were fibroadenomas for 57%, (111/195), and fibrocystic change were 21% (40/195). Most BPBD with atypia lesions were in the fibrocystic category.

Conclusions
Benign proliferative breast diseases are common, found mostly among premenopausal women. A significant proportion of BPBD had atypical proliferation. An accurate breast cancer risk estimate study for BPBD is recommended.
Comparative measurement of CNP and NT-proCNP in human blood samples: a methodological evaluation
Authors: Kuehnl Andreas , Pelisek Jaroslav , Bruckmeier Martin , Safi Wajima , Eckstein Hans-Henning 
Published: April 2013

Abstract

Background
C-type natriuretic peptide (CNP) has anti-inflammatory, anti-proliferative, and anti-migratory properties. During the past years, CNP has attained an increasing interest by many research groups, especially in the cardiovascular field. Nevertheless, still no reliable data exist on the difference of CNP concentration between serum and plasma samples. Also, the influence of delayed blood sample proceeding is unknown. The aim of this study was to investigate the difference of CNP and NT-proCNP concentrations between serum and plasma samples. In order to identify potential methodological bias, this study should also validate the stability of CNP and NT-proCNP in full blood samples stored at room temperature.

Findings
Triplets (serum, plasma, full blood) of fasting blood samples from 12 healthy male individuals were collected. Analysis of CNP and NT-proCNP concentration was performed immediately following sampling, and after 30 minutes or 2 hours of storage at room temperature. Mean serum concentrations at baseline were 0.997 ± 0.379 ng/ml for CNP and 58.5 ± 28.3 pg/ml for NT-proCNP. Furthermore, NT-proCNP concentration did not change significantly during the allotted time and did not differ between serum, plasma, and full blood samples. At baseline, concentrations of CNP were significantly different between samples containing either sodium-citrate or EDTA as a clotting inhibitor (1.933 ± 0.699 ng/ml vs. 0.991 ± 0.489 ng/ml, p = 0.001).

Conclusions
CNP and NT-proCNP are stable for at least two hours, even when sample processing is delayed or blood probes are stored at room temperature. NT-proCNP assay demonstrated more consistent and reliable data and should therefore be preferred for usage in clinical applications. Nevertheless, as recommended for ANP and BNP, immunoassays for CNP should also be standardized or harmonized in the future.
Cytogenetic analysis in three Bryconamericus species (Characiformes, Characidae): first description of the 5S rDNA-bearing chromosome pairs in the genus
Authors: Piscor Diovani , Ribacinko-Piscor Daniela Bocagini , Fernandes Carlos Alexandre , Parise-Maltempi Patricia Pasquali 
Published: April 2013

AbstractBackgroundNowadays, the genusBryconamericusis placed in subfamily Stevardiinae within of Characidae, but not shows consistent evidence of monophyletism. The purpose of this work was to study the chromosomes of three species ofBryconamericus, aiming to add cytogenetic knowledge and contribute to the understanding of the chromosomal evolution of this genus.ResultsThe chromosomes of three species ofBryconamericuswere analyzed using cytogenetic techniques. The karyotype ofBryconamericus stramineuscontained 6 metacentric (m) + 10 submetacentric (sm) + 16 subtelocentric (st) + 20 acrocentric (a), the fundamental number (FN) of 84, one silver impregnated (Ag-NOR) pair, one pair bearing the 18S ribosomal DNA sites, another pair bearing the 5S rDNA sites, and a few positive C-bands.Bryconamericus turiubahad a karyotype containing 8 m + 10sm + 14st + 20a (FN = 84), one chromosome pair Ag-NOR, two pairs bearing the 18S rDNA sites, two pairs bearing the 5S rDNA sites, and a few C-band regions.Bryconamericuscf.iheringiihad a karyotype containing 10 m + 14sm + 18st + 10a (FN = 94), including one pair with a secondary constriction Ag-NOR positive. In this karyotype the fluorescent in situ hybridization (FISH) showed the 18S and 5S rDNA probe in adjacent position.ConclusionsThe results obtained in this work showed different characteristics in the organization of two multigene families, indicating that distinct evolutionary forces acting on the diversity of rDNA sequences in the genome of threeBryconamericusspecies.
Germ-line DICER1 mutations do not make a major contribution to the etiology of familial testicular germ cell tumours
Authors: Sabbaghian Nelly , Bahubeshi Amin , Shuen Andrew Y , Kanetsky Peter A , Tischkowitz Marc D , Nathanson Katherine L , Foulkes William D 
Published: April 2013

Abstract

Background
The RNase III enzyme DICER1 plays a central role in maturation of microRNAs. Identification of neoplasia-associated germ-line and somatic mutations in DICER1 indicates that mis-expression of miRNAs in cancer may result from defects in their processing. As part of a recent study of DICER1 RNase III domains in 96 testicular germ cell tumors, a single RNase IIIb domain mutation was identified in a seminoma. To further explore the importance of DICER1 mutations in the etiology of testicular germ cell tumors (TGCT), we studied germ-line DNA samples from 43 probands diagnosed with familial TGCT.

Findings
We carried out High Resolution Melting Curve Analysis of DICER1 exons 2–12, 14–19, 21 and 24–27. All questionable melt curves were subjected to confirmatory Sanger sequencing.
Sanger sequencing was used for exons 13, 20, 22 and 23. Intron-exon boundaries were included in all analyses. We identified 12 previously reported single nucleotide polymorphisms and two novel single nucleotide variants. No likely deleterious variants were identified; notably no mutations that were predicted to truncate the protein were identified.

Conclusions
Taken together with previous studies, the findings reported here suggest a very limited role for either germ-line or somatic DICER1 mutations in the etiology of TGCT.
Thyroid hormone-induced cell-cell interactions are required for the development of adult intestinal stem cells
Authors: Hasebe Takashi , Fu Liezhen , Miller Thomas C , Zhang Yu , Shi Yun-Bo , Ishizuya-Oka Atsuko 
Published: April 2013

AbstractThe mammalian intestine has long been used as a model to study organ-specific adult stem cells, which are essential for organ repair and tissue regeneration throughout adult life. The establishment of the intestinal epithelial cell self-renewing system takes place during perinatal development when the villus-crypt axis is established with the adult stem cells localized in the crypt. This developmental period is characterized by high levels of plasma thyroid hormone (T3) and T3 deficiency is known to impair intestinal development. Determining how T3 regulates adult stem cell development in the mammalian intestine can be difficult due to maternal influences. Intestinal remodeling during amphibian metamorphosis resembles perinatal intestinal maturation in mammals and its dependence on T3 is well established. A major advantage of the amphibian model is that it can easily be controlled by altering the availability of T3. The ability to manipulate and examine this relatively rapid and localized formation of adult stem cells has greatly assisted in the elucidation of molecular mechanisms regulating their formation and further revealed evidence that supports conservation in the underlying mechanisms of adult stem cell development in vertebrates. Furthermore, genetic studies inXenopus laevisindicate that T3 actions in both the epithelium and the rest of the intestine, most likely the underlying connective tissue, are required for the formation of adult stem cells. Molecular analyses suggest that cell-cell interactions involving hedgehog and BMP pathways are critical for the establishment of the stem cell niche that is essential for the formation of the adult intestinal stem cells.
Prosthetic metal implants and airport metal detectors
Authors: Ismail A , Dancey A , Titley OG 
Published: March 2013

Introduction Metal detectors have been present in airports and points of departure for some time. With the introduction of heightened security measures in response to fears of an increased threat of terrorism, they may become more prevalent in other public locations. The aim of this study was to ascertain which prosthetic devices activated metal detector devices used for security purposes. Methods A range of prosthetic devices used commonly in orthopaedic and plastic surgery procedures were passed through an arch metal detector at Birmingham Airport in the UK. Additionally, each item was passed under a wand detector. Items tested included expandable breast prostheses, plates used in wrist and hand surgery, screws, K-wires, Autosuture™ ligation clips and staples. Results No prostheses were detected by the arch detector. The expandable implants and wrist plates were the only devices detected by passing the wand directly over them. No device was detected by the wand when it was under cover of the axillary soft tissue. Screws, K-wires, Autosuture™ clips and staples were not detected under any of the study conditions. Conclusions Although unlikely to trigger a detector, it is possible that an expandable breast prosthesis or larger plate may do so. It is therefore best to warn patients of this so they can anticipate detection and further examination.
Assessing the effectiveness of retrograde autologous priming of the cardiopulmonary bypass machine in isolated coronary artery bypass grafts
Authors: Kearsey C , Thekkudan J , Robbins S , Ng A , Lakshmanan S , Luckraz H 
Published: March 2013

Introduction Currently, around 35–80% of patients undergoing cardiac surgery in the UK receive a blood transfusion. Retrograde autologous priming (RAP) of the cardiopulmonary bypass circuit has been suggested as a possible strategy to reduce blood transfusion during cardiac surgery. Methods Data from 101 consecutive patients undergoing isolated coronary artery bypass grafts (where RAP was used) were collected prospectively and compared with 92 historic patients prior to RAP use in our centre. Results Baseline characteristics (ie age, preoperative haemoglobin [Hb] etc) were not significantly different between the RAP and non-RAP groups. The mean pump priming volume of 1,013ml in the RAP group was significantly lower (p<0.001) than that of 2,450ml in the non-RAP group. The mean Hb level at initiation of bypass of 9.1g/dl in patients having RAP was significantly higher (p<0.001) than that of 7.7g/dl in those who did not have RAP. There was no significant difference between the RAP and non-RAP groups in transfusion of red cells, platelets and fresh frozen plasma, 30-day mortality, re-exploration rate and predischarge Hb level. The median durations of cardiac intensive care unit stay and in-hospital stay of 1 day (interquartile range [IQR]: 1–2 days) and 5 days (IQR: 4–6 days) in the RAP group were significantly shorter than those of the non-RAP group (2 days [IQR: 1–3 days] and 6 days [IQR: 5–9 days]). Conclusions In the population group studied, RAP did not influence blood transfusion rates but was associated with a reduction in duration of hospital stay.
The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications
Authors: Panagiotopoulou I G , Parashar D , Lin R , Antonowicz S , Wells AD , Bajwa FM , Krijgsman B 
Published: March 2013

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.
The impact of trauma centre designation on open tibial fracture management
Authors: Stammers J , Williams D , Hunter J , Vesely M , Nielsen D 
Published: March 2013

Introduction The British Orthopaedic Association/British Association of Plastic, Reconstructive and Aesthetic Surgeons guidelines for the management of open tibial fractures recommend early senior combined orthopaedic and plastic surgical input with appropriate facilities to manage a high caseload. The aim of this study was to assess whether becoming a major trauma centre has affected the management of patients with open tibial fractures. Methods Data were obtained prospectively on consecutive open tibial fractures during two eight-month periods: before and after becoming a trauma centre. Results Overall, 29 open tibial fractures were admitted after designation as a major trauma centre compared with 15 previously. Of the 29 patients, 21 came directly or as transfers from another accident and emergency deparment (previously 8 of 15). The time to transfer patients admitted initially to local orthopaedic departments has fallen from 205.7 hours to 37.4 hours (p=0.084). Tertiary transferred patients had a longer hospital stay (16.3 vs 14.9 days) and had more operations (3.7 vs 2.6, p=0.08) than direct admissions. As a trauma centre, there were improvements in time to definitive skeletal stabilisation (4.7 vs 2.2 days, p=0.06), skin coverage (8.3 vs 3.7 days, p=0.06), average number of operations (4.2 vs 2.3, p=0.002) and average length of hospital admission (26.6 vs 15.3 days, p=0.05). Conclusions The volume and management of open tibial fractures, independent of fracture grade, has been directly affected by the introduction of a trauma centre enabling early combined senior orthopaedic and plastic surgical input. Our data strongly support the benefits of trauma centres and the continuing development of trauma networks in the management of open tibial fractures.
Challenging boundaries: an enhanced recovery programme for radical cystectomy
Authors: Mukhtar S , Ayres BE , Issa R , Swinn MJ , Perry MJA 
Published: March 2013

Introduction The implementation of enhanced recovery programmes (ERPs) in colorectal surgery has seen improvements in the length of inpatient stay with no increase in complications. We investigated the role of ERP in radical cystectomy at our institution. Methods Prospective data were collected from 26 consecutive patients prior to the introduction of the ERP and 51 patients who underwent open radical cystectomy within an ERP. Individuals in the ERP cohort did not receive bowel preparation or nasogastric drainage but received preoperative carbohydrate drinks, perioperative epidural analgesia and immediate mobilisation on day 1. Primary outcome measures included duration of intensive care unit (ICU) stay and length of hospital stay. Secondary outcome measures included the time to the passage of flatus and faeces, and time to mobilisation. Other measures that were analysed included operation time and complications. Results Baseline characteristics for both groups were similar. The median length of hospital stay fell from 11.5 days to 10.4 days and the mean ICU stay dropped from 2.4 days to 1.0 days (p=0.01). Time to removal of nasogastric tube, and time to passage of flatus and faeces were significantly shorter in the ERP group, as was the time to full oral diet. Clavien complication rates and 30-day mortality rates were similar in both groups. There were no readmissions. Conclusions ERP in radical cystectomy is safe and not associated with any increase in complications or readmissions. It is associated with reductions in ICU stay, and could also reduce length of hospital stay and duration of postoperative ileus.
Long-term results of endonasal dacryocystorhinostomy with and without stenting
Authors: Mohamad SH , Khan I , Shakeel M , Nandapalan V 
Published: March 2013

Introduction This study aimed to evaluate the short and long-term results of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting in chronic dacrocystorhinitis due to postsaccal blockage. Methods The study involved a case series of consecutive 89 patients (128 eyes) who underwent endoscopic DCR. All patients were operated on by the senior author. The stent group comprised 63 eyes (44 patients), for which the DCR was performed between September 2002 and September 2005. The non-stent group with 65 eyes (45 patients) underwent the DCR between October 2005 and December 2006. The follow-up duration was up to 33 months after surgery. The statistical significance (p-value) was calculated using the chi-squared test. Results The short-term success rate at six months’ follow-up was 70% in the stent group and 97% in the non-stent group (p=0.0005) while the long-term success rate at 33 months was only 57% in stent group compared with 89% in the non-stent group (p=0.0003). Conclusions In this study, the non-stent group showed a higher success rate than the stent group on both short and longterm follow-up. Our study suggests that postoperative stents are not necessary for primary DCR and may be associated with a worse outcome.
Using therapeutic mammoplasty to extend the role of breast-conserving surgery in women with larger or ptotic breasts
Authors: Currie A , Chong K , Davies GL 
Published: March 2013

Introduction The equivalence of breast-conserving surgery followed by postoperative radiotherapy against mastectomy is now firmly established in patients with early breast cancer. The results of surgery in large-breasted women can be poor, with radiation-induced fibrosis, chronic pain and poor cosmesis contributing to long-term psychological and physical morbidity. Therapeutic mammoplasty offers an alternative management strategy to both enhance the role of breast-conserving surgery and provide better outcomes. Methods A retrospective note review was undertaken of all patients undergoing therapeutic mammoplasty for breast malignancy between 2007 and 2011. All cases were performed using a Wise pattern-reduction technique. Histology and pathological outcomes were assessed. Postoperative outcomes reviewed included wound infection, seroma and need for further intervention. Results During the study period, 20 patients underwent therapeutic mammoplasty with a mean follow-up duration of 36 months. The mean weight of the lumpectomy specimen was 330g. The average cancer size was 34mm, with a mean margin clearance of 7mm. There was one episode of wound infection and three of delayed wound healing at the T-junction. One patient required a mastectomy for involved margins. There were no recurrences at the most recent follow-up visit. Conclusions Therapeutic mammoplasty offers a tailored approach to women with larger breasts and early breast cancers with good cosmetic results and oncological outcomes.
Damage control – trauma care in the first hour and beyond: a clinical review of relevant developments in the field of trauma care
Authors: Sharrock AE , Midwinter M 
Published: March 2013

Introduction Trauma provision in the UK is a topic of interest. Regional trauma networks and centres are evolving and research is blossoming, but what bearing does all this have on the care that is delivered to the individual patient? This article aims to provide an overview of key research concepts in the field of trauma care, to guide the clinician in decision making in the management of major trauma. Methods The Ovid MEDLINE®, EMBASE™ and PubMed databases were used to search for relevant articles on haemorrhage control, damage control resuscitation and its exceptions, massive transfusion protocols, prevention and correction of coagulopathy, acidosis and hypothermia, and damage-control surgery. Findings A wealth of research is available and a broad range has been reviewed to summarise significant developments in trauma care. Research has been categorised into disciplines and it is hoped that by considering each, a tailored management plan for the individual trauma patient will evolve, potentially improving patient outcome.