bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulse oximetry screening and prenatal diagnosis play complementary roles in reducing risks in simple transposition of the great arteries
Authors: Bartos Marie , Lannering Katarina , Mellander Mats 
Published: February 2015

AbstractAimThis study quantified the contribution of pulse oximetry screening to an early diagnosis of simple transposition. We also estimated the proportion of neonates with this life‐threatening cardiac defect who could benefit from prenatal diagnosis, even when pulse oximetry screening had been implemented.MethodsThis population‐based, retrospective, cohort study of cases born from 2003 to 2013 used data from surgical files, the Swedish Causes of Death Registry and the National Forensic Medicine database. The main outcome measures were early postnatal circulatory instability, pre‐operative death, neurological morbidity and risk of discharge before diagnosis.ResultsWe identified 89 cases, including three diagnosed prenatally. Hospitals using pulse oximetry screening diagnosed all 31 neonates before discharge, including seven as a result of screening, but 10 of 55 infants in the nonscreening hospitals were discharged undiagnosed (p = 0.017). Prenatal diagnosis could have decreased the risk of early circulatory instability, pre‐operative death or neurological morbidity in 12 of the 72 infants born in referring hospitals (17%). There was one pre‐operative death and no postoperative deaths at a mean follow‐up of 4.7 years.ConclusionPulse oximetry screening minimised the risk of discharging infants with transposition, but prenatal diagnosis would have been necessary to avoid early circulatory instability in 17% of cases.
Morbidity and mortality in hospitalised neonates in central Vietnam
Authors: Tran Hoang T. , Doyle Lex W. , Lee Katherine J. , Dang Na M. , Graham Stephen M. 
Published: February 2015

AbstractAimThis study explored neonatal morbidity and mortality in hospitalised patients in central Vietnam and risk factors associated with mortality.MethodsWe conducted a prospective cohort study of all newborn infants (<28 days) hospitalised in a neonatal unit over a 1‐year period and followed until discharge. The main outcome measures were case fatality rate and the rate of different clinical diagnoses.ResultsThere were 2555 admissions during the study period. The leading primary causes of admissions were infections (41%), haematological problems such as jaundice (23%) and prematurity and its complications (18%). The overall case fatality rate was 8.6%, and it was 59% among very low‐birthweight (<1500 g) neonates. Mortality was inversely associated with birthweight and gestational age. Of the 220 deaths, 57% occurred within the first 7 days of life. Although the causes of death were often multifactorial, the leading primary causes were infections (32%), prematurity and its complications (25%), birth defects (24%) and birth asphyxia (6%). Risk factors associated with death were being outborn, early gestational age, small for gestational age, confirmed sepsis and birth defects.ConclusionMortality rates were high among hospitalised neonates in central Vietnam, and this paper suggests interventions that might improve outcomes.
Epigenetics and Future Generations
Authors: del Savio Lorenzo , Loi Michele , Stupka Elia 
Published: February 2015

AbstractRecent evidence of intergenerational epigenetic programming of disease risk broadens the scope of public health preventive interventions to future generations, i.e. non existing people. Due to the transmission of epigenetic predispositions, lifestyles such as smoking or unhealthy diet might affect the health of populations across several generations. While public policy for the health of future generations can be justified through impersonal considerations, such as maximizing aggregate well‐being, in this article we explore whether there are rights‐based obligations supervening on intergenerational epigenetic programming despite the non‐identity argument, which challenges this rationale in case of policies that affect the number and identity of future people. We propose that rights based obligations grounded in the interests of non‐existing people might fall upon existing people when generations overlap. In particular, if environmental exposure in F0 (i.e. existing people) will affect the health of F2 (i.e. non‐existing people) through epigenetic programming, then F1 (i.e. existing and overlapping with both F0 and F2) might face increased costs to address F2's condition in the future: this might generate obligations upon F0 from various distributive principles, such as the principle of equal opportunity for well being.
Transperineal biopsy prostate cancer detection in first biopsy and repeat biopsy after negative transrectal ultrasound‐guided biopsy: the Victorian Transperineal Biopsy Collaboration experience
Authors: Ong Wee Loon , Weerakoon Mahesha , Huang Sean , Paul Eldho , Lawrentschuk Nathan , Frydenberg Mark , Moon Daniel , Murphy Declan , Grummet Jeremy 
Published: February 2015

ObjectivesTo present the Victorian Transperineal Biopsy Collaboration (VTBC) experience in patients with no prior prostate cancer diagnosis, assessing the cancer detection rate, pathological outcomes and anatomical distribution of cancer within the prostate.Patients and MethodsVTBC was established through partnership between urologists performing transperineal biopsies of the prostate (TPB) at three institutions in Melbourne. Consecutive patients who had TPB, as first biopsy or repeat biopsy after previous negative transrectal ultrasound‐guided (TRUS) biopsy, between September 2009 and September 2013 in the VTBC database were included. Data for each patient were collected prospectively (except for TPB before 2011 in one institution), based on the minimum dataset published by the Ginsburg Study Group. Univariate and multivariate analyses were used to identify factors predictive of cancer detection on TPB.ResultsIn all, 160 patients were included in the study, of whom 57 had TPB as first biopsy and 103 had TPB as repeat biopsy after previous negative TRUS biopsies. The median patient age at TPB was 63 years, with the repeat‐biopsy patients having a higher median serum PSA level (5.8 ng/mL for first biopsy and 9.6 ng/mL for repeat biopsy) and larger prostate volumes (40 mL for first biopsy, and 51 mL for repeat biopsy). Prostate cancer was detected in 53% of first‐biopsy patients and 36% of repeat‐biopsy patients, of which 87% and 81%, respectively, were clinically significant cancers, defined as a Gleason score of ≥7, or more than three positive cores of Gleason 6. Of the cancers detected in repeat biopsies, 75% involved the anterior region (based on the Ginsburg Study Group's recommended biopsy map), while 25% were confined exclusively within the anterior region; a lower proportion of only 5% of cancers detected in first biopsies were confined exclusively within the anterior region. Age, serum PSA level and prostate volume were predictive of cancer detection in repeat biopsies, while only age was predictive in first biopsies.ConclusionsTPB is an alternative approach to TRUS biopsy of the prostate, offering a high rate of detection of clinically significant prostate cancer. It provides excellent sampling of the anterior region of the prostate, which is often under‐sampled using the TRUS approach, and should be considered as an option for all men in whom a prostate biopsy is indicated.
Oral health impacts on self‐rated general and oral health in a cross‐sectional study of working age adults
Authors: Brennan David S. , Teusner Dana N. 
Published: February 2015

AbstractObjectivesThe aims were to assess the joint effects of oral health and general health functional problems on self‐ratings of general and oral health among adults.MethodsData were collected from adults aged 30–61 years in Australia by mailed survey in 2009–2010. Self‐rated health of ‘very good/excellent’ was analysed by oral health impact (OHIP‐14) and number of health problems (EQ‐5D) controlling for socio‐demographics.ResultsResponses were collected from n = 1093 persons (response rate = 39.1%). General health self‐ratings were higher in the high‐income group (prevalence ratio [PR] = 1.06, 1.00–1.12) but lower for those with a higher number of health problems (PR = 0.84, 0.76–0.93). The interaction of health problems with oral health impact indicated that self‐rated general health was worst when both the number of health problems and OHIP score were higher. Oral health self‐ratings were lower for males (PR = 0.92, 0.87–0.98), those aged 50–61 years (PR = 0.92, 0.85–0.99), for those with more health problems (PR = 0.82, 0.71–0.95) and higher oral health impact scores (PR = 0.54, 0.46–0.64).ConclusionsFor working age adults, oral health impact was associated with general health for those with more health problems indicating those in worse health suffer more impact from oral health problems.
What goes up must come down: biomarkers and novel biologicals in severe asthma
Authors: Hilvering B. , Pavord I. D. 
Published: February 2015

SummaryAsthma is a heterogeneous airway disease characterized by typical symptoms in combination with variable airway obstruction. Most patients with asthma have well controlled symptoms and a low risk of asthma attacks with inhaled corticosteroid (ICS) treatment. However, a clinically important subgroup (~ 10%) remains symptomatic and/or at risk of asthma attacks despite maximum inhaled therapy. Patients with severe asthma are responsible for a significant proportion of healthcare costs attributable to asthma and have a large unmet need for better treatments. An important advance in recent years has been the recognition that severe asthma is heterogeneous with respect to clinical problems and the pattern of lower airway inflammation. Identification of eosinophilic inflammation in the airways has become an important priority as novel biologicals that target Th2 cytokines, such as anti‐IL5, anti‐IL‐13 and combined anti‐IL‐4/13 are showing considerable promise as treatments for this subgroup. It has also become clear that anti‐IgE (Omalizumab), the first monoclonal antibody registered for treatment of severe asthma, is only active in patients with active eosinophilic airway inflammation. The future will be identification of potentially responsive patients on the basis of raised biomarkers and, as suggested by the title of this review, targeted treatment with specific cytokine blockade that has a direct effect on the biomarkers. In this review, we outline an approach to the clinical assessment of patients potentially suitable for biological treatment and describe in detail the likely clinical impact of established and new biological treatments.
Dietary treatment modulates mast cell phenotype, density, and activity in adult eosinophilic oesophagitis
Authors: Arias Á. , Lucendo A. J. , Martínez‐Fernández P. , González‐Castro A. M. , Fortea M. , González‐Cervera J. , Yagüe‐Compadre J. L. , Mota‐Huertas T. , Vicario M. 
Published: February 2015

SummaryBackgroundMast cells (MCs) are abundant in the inflammatory infiltrate in eosinophilic oesophagitis (EoE), but decrease with disease remission. However, their phenotype, role in the pathophysiology of the disease, and modulation after effective dietary therapy are still unclear.ObjectiveTo define the phenotype of oesophageal MCs, their modulation through dietary therapy, and their association with clinical manifestations of EoE.MethodsOesophageal mucosal samples from 10 adult patients with EoE obtained before and after effective six‐food elimination diet (SFED) therapy, as well as from 10 control subjects were analysed. Eosinophil and MC density were quantified. Gene expression of chemoattractants for eosinophils (CCL11, CCL24, and CCL26), MCs (SCF), and their receptors (CCR3 and SCFR, respectively) were assessed by means of qPCR. Gene and protein expression of specific MC proteases (CPA3, CMA, and TPSB2) were evaluated with qPCR and immunofluorescence. Clinical manifestations and atopic background were recorded.ResultsMC density was significantly increased in EoE compared with controls, decreasing after dietary treatment (18.6 to 1.44 cells/hpf, respectively; P < 0.001). The MCTC subtype predominated in the oesophageal mucosa (90%) in both patients with EoE and controls. Gene expression of MC‐related proteases, eotaxins, and SCF were up‐regulated in patients with EoE, but significantly decreased after therapy, regardless of atopic background. Epithelial peaks of MCs and eosinophils were significantly associated (ρ = 0.80) in EoE and correlated with the symptom score (ρ = 0.78). Gene expression of MC proteases and eotaxins also correlated with the symptom score (P < 0.05).Conclusions and Clinical RelevanceMC and its proteases seem to play a relevant role in the pathophysiology and symptoms of EoE, which can be reversed after effective dietary treatment.
Effects of short‐term oral corticosteroid intake on dietary intake, body weight and body composition in adults with asthma – a randomized controlled trial
Authors: Berthon B. S. , Gibson P. G. , McElduff P. , MacDonald‐Wicks L. K. , Wood L. G. 
Published: February 2015

SummaryBackgroundOral corticosteroids (OCS) are an efficacious treatment for asthma exacerbations, yet risk of adverse effects may decrease patient adherence to therapy. In particular, changes in appetite and dietary intake, which lead to weight gain and changes in body composition, are considered undesirable.ObjectiveTo determine whether 10‐day OCS therapy in adults with asthma causes changes in leptin, appetite, dietary intake, body weight and body composition.MethodsDouble‐blinded, placebo‐controlled randomized cross‐over trial of 10 days prednisolone (50 mg) in adults with stable asthma (n = 55) (ACTRN12611000562976). Pre‐ and post‐assessment included spirometry, body weight, body composition measured by dual‐energy X‐ray absorptiometry and bioelectrical impedance analysis, appetite measured using a validated visual analogue scale (VAS) and dietary intake assessed using 4‐day food records. Leptin was measured as a biomarker of appetite and eosinophils as an adherence biomarker. Outcomes were analysed by generalized linear mixed models.ResultsSubject adherence was confirmed by a significant decrease in blood eosinophils (× 109/L) following prednisolone compared to placebo [Coef. −0.29, 95% CI: (−0.39, −0.19) P < 0.001]. There was no difference in serum leptin (ng/mL) [Coef. 0.13, 95% CI: (−3.47, 3.72) P = 0.945] or appetite measured by VAS (mm) [Coef. −4.93, 95% CI: (−13.64, 3.79) P = 0.267] following prednisolone vs. placebo. There was no difference in dietary intake (kJ/day) [Coef. 255, 95% CI: (−380, 891) P = 0.431], body weight (kg) [Coef. −0.38, 95% CI: (−0.81, 0.05) P = 0.083] or body fat (%) [Coef. −0.31, 95% CI: (−0.81, 0.20) P = 0.230]. Symptoms including sleep and gastrointestinal disturbance were reported significantly more often during prednisolone vs. placebo.Conclusions and Clinical RelevanceShort‐term OCS in stable asthma did not induce significant changes in appetite, dietary intake, body weight or composition, although other adverse effects may require medical management. This evidence may assist in increasing medication adherence of asthmatics prescribed OCS for exacerbations.
What is the optimal bone‐preserving strategy for patients with Addison's disease?
Authors: Lee Paul , Greenfield Jerry R. 
Published: February 2015

SummaryAddison's disease is associated with low bone mineral density and increased risk of hip fractures. Causes are multifactorial, contributed by underlying adrenocortical hormonal deficiency, associated autoimmune endocrinopathies, electrolyte disturbances and, in some patients, supraphysiologic glucocorticoid replacement. Recent realization of physiologic cortisol production rate has revised downwards glucocorticoid replacement dosages. Meanwhile, new research has emerged suggesting complex interplay between sodium and calcium homoeostasis under the influence of mineralocorticoid and parathyroid hormone that may impact bone health. As the prevalence of Addison's disease is rising, and osteoporosis and fractures are associated with significant morbidity and increased mortality, attention to bone preservation in Addison's disease is of clinical relevance and importance. We suggest an approach to bone health in Addison's disease integrating physiologic adrenocortical hormonal replacement with electrolyte and mineral homoeostasis optimization.
Attenuation of the oestrogen positive feedback mechanism with the age in postmenopausal women
Authors: Dimitraki Marina , Koutlaki Nikoletta , Gioka Theodora , Messini Christina I. , Dafopoulos Konstantinos , Anifandis George , Messinis Ioannis E. 
Published: February 2015

SummaryObjectiveIt has been reported that the positive feedback mechanism of oestrogens and progesterone is preserved, although attenuated, in late postmenopausal years. Whether this is also true for the positive feedback effect of oestrogens alone has not been investigated.DesignProspective intervention study.PatientsThirty healthy postmenopausal women.MeasurementsThe women were divided into three groups according to the years since menopause (group I: 2–8 years, group II: 9–17 years, group III: 18–25 years). They were studied during a period of 41 days. Two acute experiments (EP) of exogenous oestradiol, given via skin patches, were performed from days 1 to 7 (EP1) and from days 35 to 41 (EP2) to induce an LH surge. Between the two experiments (days 7–34), oestradiol was given at the dose of 100 μg every 3 days, while oral progesterone was added from day 21 to day 34 in order to simulate a luteal phase. Blood samples were taken every 6 h during EP1 and EP2 as well as on days 8, 13, 20, 21, 27 and 34. FSH, LH, oestradiol and progesterone were measured in all blood samples.ResultsAn LH surge occurred as a result of the oestradiol positive feedback mechanism in group I and in group II, in both EP1 and EP2. Peak LH values during the surge were significantly lower in group II than in group I in both experiments. None of the patients in group III displayed an LH surge.ConclusionsThese results demonstrate for the first time a gradual attenuation of the pituitary response to oestrogenic provocation over a certain period following the menopause, with complete abolition after 20 years. It is suggested that the reserves of pituitary gonadotrophs diminish with age.
Risk factors for postoperative bleeding in ABO‐incompatible kidney transplantation
Authors: Kim Mi Hyeong , Jun Kang Woong , Hwang Jeong Kye , Kim Ji Il , Chung Byung Ha , Choi Bum Soon , Kim Yong Soo , Yang Chul Woo , Moon In Sung 
Published: February 2015

AbstractIntroductionThe outcome of ABO‐incompatible kidney transplantation (ABOi KT) has improved and is now comparable to that of ABO‐compatible kidney transplantation (ABOc KT). However, ABOi KT may be associated with a higher risk of postoperative bleeding than ABOc KT.MethodsSeventy patients with ABOi KT were divided into a bleeding group (n = 9) and non‐bleeding group (n = 61). General, immunologic, and hematological characteristics were compared to identify the risk factors for postoperative bleeding.ResultsPre‐emptive transplantation and a high pre‐transplant blood urea nitrogen level were more common in the bleeding group (p = 0.0176 and 0.023, respectively). A high anti‐ABO antibody titer after plasmapheresis (median, ≥16; p = 0.0226), a low platelet count of ≤100 000/mm3 after plasmapheresis (p = 0.0289), a prolonged activated partial thromboplastin time (p = 0.0073), and impaired platelet function (p = 0.0274) were associated with an increased risk of bleeding after ABOi KT.ConclusionPostoperative bleeding after ABOi KT was difficult to control and increased the risk of immediate graft loss (p = 0.015). Our results suggest that changes in coagulability associated with uremia and plasmapheresis may increase the risk of bleeding after ABOi KT.
Community‐based learning in a challenging context: the development and evaluation of an outreach dental public health programme in Damascus University, Syria
Authors: Joury E. 
Published: February 2015

AbstractIntroductionThis study aimed to describe the development and evaluation of an outreach dental public health (DPH) programme in Damascus University, in terms of developing undergraduates' required knowledge, skills and attitudes (KSA), improving the quality aspects of training and assessment (T&A), and achieving the satisfaction of served children and their social network.MethodsThe outreach DPH programme offered opportunities to undergraduates to carry out outreach health‐promotion activities, conduct and communicate the results of applied DPH research, and build partnership with students in other higher education sectors. A cross‐sectional evaluation collected mixed qualitative and quantitative data, by a means of a short‐essay and a self‐completed questionnaire, from 400 third‐year dental undergraduates, on KSA gained from outreach activities and quality aspects of T&A. The latter were compared with corresponding figures of other traditional dental programmes (TDP). Satisfaction with the outreach activities were collected from 215 children with special needs and 130 parents and school staff, by questionnaires.ResultsThe response rates were 74.8%, 100% and 100% for undergraduates, children and parents/school staff, respectively. The derived categories of students' gained KSA included the following: unique clinical skills, social responsibility, voluntarism, communication, team working, personal growth, reflection on career aspirations and self‐satisfaction with the contribution to needy groups. Their satisfaction with quality aspects of T&A was significantly higher than TDP (P < 0.001). Children's and parents/school staff's satisfaction was high.ConclusionThe outreach DPH programme in Damascus University is a successful example of developing undergraduates' required KSA, improving the quality aspects of T&A, and achieving the satisfaction of served community.
Parietal transcranial direct current stimulation modulates primary motor cortex excitability
Authors: Rivera‐Urbina Guadalupe Nathzidy , Batsikadze Giorgi , Molero‐Chamizo Andrés , Paulus Walter , Kuo Min‐Fang , Nitsche Michael A. 
Published: February 2015

AbstractThe posterior parietal cortex is part of the cortical network involved in motor learning and is structurally and functionally connected with the primary motor cortex (M1). Neuroplastic alterations of neuronal connectivity might be an important basis for learning processes. These have however not been explored for parieto‐motor connections in humans by transcranial direct current stimulation (tDCS). Exploring tDCS effects on parieto‐motor cortical connectivity might be functionally relevant, because tDCS has been shown to improve motor learning. We aimed to explore plastic alterations of parieto‐motor cortical connections by tDCS in healthy humans. We measured neuroplastic changes of corticospinal excitability via motor evoked potentials (MEP) elicited by single‐pulse transcranial magnetic stimulation (TMS) before and after tDCS over the left posterior parietal cortex (P3), and 3 cm posterior or lateral to P3, to explore the spatial specificity of the effects. Furthermore, short‐interval intracortical inhibition/intracortical facilitation (SICI/ICF) over M1, and parieto‐motor cortical connectivity were obtained before and after P3 tDCS. The results show polarity‐dependent M1 excitability alterations primarily after P3 tDCS. Single‐pulse TMS‐elicited MEPs, M1 SICI/ICF at 5 and 7 ms and 10 and 15 ms interstimulus intervals (ISIs), and parieto‐motor connectivity at 10 and 15 ms ISIs were all enhanced by anodal stimulation. Single pulse‐TMS‐elicited MEPs, and parieto‐motor connectivity at 10 and 15 ms ISIs were reduced by cathodal tDCS. The respective corticospinal excitability alterations lasted for at least 120 min after stimulation. These results show an effect of remote stimulation of parietal areas on M1 excitability. The spatial specificity of the effects and the impact on parietal cortex–motor cortex connections suggest a relevant connectivity‐driven effect.