bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling the Influence of the A118G Polymorphism in the OPRM1 Gene and of Noxious Stimulation on the Synergistic Relation between Propofol and Remifentanil
Authors: Borrat Xavier , Trocóniz Iñaki F. , Valencia José F. , Rivadulla Silvia , Sendino Oriol , Llach Josep , Muñoz Jenifer , Castellví-Bel Sergi , Jospin Mathieu , Jensen Erik W. , Castells Antoni , Gambús Pedro L. 
Published: March 2013

Abstract

Background:
The presence of the A118G single nucleotide polymorphism in the OPRM1 gene as well as noxious stimulation might affect the requirements of remifentanil for patients undergoing ultrasonographic endoscopy under sedation-analgesia with propofol and remifentanil. Bispectral index (BIS) was used as a surrogate measure of effect.

Methods:
A total of 207 patients were screened for A118G and randomly received different combinations of propofol and remifentanil, changed depending on the nausea response to endoscopy tube introduction. Nonlinear mixed effects modelling was used to establish the relation between propofol and remifentanil with respect to BIS and to investigate the influence of A118G or noxious stimulation. The value of ke0 for propofol and remifentanil was estimated to avoid the hysteresis between predicted effect site concentration (Ce) and BIS.

Results:
Data from 176 patients were analysed. Eleven were recessive homozygous for A118G (OPRM = 1). A total of 165 patients were either dominant homozygous or heterozygous and considered normal (OPRM = 0). The estimated values of ke0 for propofol and remifentanil were 0.122 and 0.148min−1. Propofol and remifentanil were synergistic with respect to the BIS (α = 1.85). EC50 estimate for propofol was 3.86 µg/ml and for remifentanil 19.6 ng/ml in normal patients and 326ng/ml in OPRM = 1 patients. BIS increases around 4% for the same effect site concentrations with noxious stimulation.

Conclusions:
Predicted effect site concentration of remifentanil ranging 1–5ng/ml synergistically potentiates the effects of propofol on the BIS but has no effect in A118G patients. Noxious stimulation increases BIS values by 4% at the same concentrations of propofol and remifentanil.
Isoflurane Regulates Atypical Type-A γ-Aminobutyric Acid Receptors in Alveolar Type II Epithelial Cells
Authors: Xiang Yun-Yan , Chen Xuanmao , Li Jingxin , Wang Shuanglian , Faclier Gil , MacDonald John F. , Hogg James C. , Orser Beverley A. , Lu Wei-Yang 
Published: March 2013

Abstract

Background:
Volatile anesthetics act primarily through upregulating the activity of γ-aminobutyric acid type A (GABAA) receptors. They also exhibit antiinflammatory actions in the lung. Rodent alveolar type II (ATII) epithelial cells express GABAA receptors and the inflammatory factor cyclooxygenase-2 (COX-2). The goal of this study was to determine whether human ATII cells also express GABAA receptors and whether volatile anesthetics upregulate GABAA receptor activity, thereby reducing the expression of COX-2 in ATII cells.

Methods:
The expression of GABAA receptor subunits and COX-2 in ATII cells of human lung tissue and in the human ATII cell line A549 was studied with immunostaining and immunoblot analyses. Patch clamp recordings were used to study the functional and pharmacological properties of GABAA receptors in cultured A549 cells.

Results:
ATII cells in human lungs and cultured A549 cells expressed GABAA receptor subunits and COX-2. GABA induced currents in A549 cells, with half-maximal effective concentration of 2.5 µm. Isoflurane (0.1–250 µm) enhanced the GABA currents, which were partially inhibited by bicuculline. Treating A549 cells with muscimol or with isoflurane (250 µm) reduced the expression of COX-2, an effect that was attenuated by cotreatment with bicuculline.

Conclusions:
GABAA receptors expressed by human ATII cells differ pharmacologically from those in neurons, exhibiting a higher affinity for GABA and lower sensitivity to bicuculline. Clinically relevant concentrations of isoflurane increased the activity of GABAA receptors and reduced the expression of COX-2 in ATII cells. These findings reveal a novel mechanism that could contribute to the antiinflammatory effect of isoflurane in the human lung.
Effects of Volatile Anesthetic Agents on Cerebral Cortical Synchronization in Sheep
Authors: Li Duan , Voss Logan J. , Sleigh Jamie W. , Li Xiaoli 
Published: March 2013

Abstract

Background:
The exact neurophysiological mechanisms of anesthetic-induced unconsciousness are not yet fully elucidated. The cortical information integration theory hypothesizes that loss of consciousness during general anesthesia is associated with breakdown of long-distance cortical connectivity across multiple brain regions. However, what is the effect of anesthetics on neural activities at a smaller spatial scale?

Methods:
The authors analyzed a set of previously published eight-channel electrocorticogram data, obtained from a 14-mm-long linear array of electrodes in eight adult merino sheep during general anesthesia induced by sevoflurane, desflurane, isoflurane, and enflurane. The S-estimator was applied to the bi-channel coherence matrix to construct an overall index called the SI, which is the entropy of the eigenvalues of the cortical coherence for each pair of channels within the multichannel electrocorticographic dataset.

Results:
The SI values increased ~30–50% from the waking to the burst-suppression states, and returned to baseline during recovery. The anesthetic-induced increase in synchrony was most marked in the α (8–13 Hz) and β (13–30 Hz) frequency bands (P &lt; 0.05). Using prediction probability (PK) analysis, we found a significant correlation between the increase in spatial synchrony (as estimated by the SI at various frequency bands) and anesthetic-induced cortical depression (as estimated by the approximate entropy).

Conclusions:
The results suggest that it is feasible to use the SI to measure cortical synchrony, and over a local spatial scale of 2–14 mm, synchrony increased during general anesthesia.
Postoperative B-type Natriuretic Peptide for Prediction of Major Cardiac Events in Patients Undergoing Noncardiac Surgery
Authors: Rodseth Reitze N. , Biccard Bruce M. , Chu Rong , Lurati Buse Giovana A. , Thabane Lehana , Bakhai Ameet , Bolliger Daniel , Cagini Lucio , Cahill Thomas J. , Cardinale Daniela , Chong Carol P. W. , Cnotliwy Miłosław , Di Somma Salvatore , Fahrner René , Lim Wen K. , Mahla Elisabeth , Le Manach Yannick , Manikandan Ramaswamy , Pyun Wook B. , Rajagopalan Sriram , Radovic´ Milan , Schutt Robert C. , Sessler Daniel I. , Suttie Stuart , Vanniyasingam Thuvaraha , Waliszek Marek , Devereaux P. J. 
Published: March 2013

Abstract

Background:
It is unclear whether postoperative B-type natriuretic peptides (i.e., BNP and N-terminal proBNP) can predict cardiovascular complications in noncardiac surgery.

Methods:
The authors undertook a systematic review and individual patient data meta-analysis to determine whether postoperative BNPs predict postoperative cardiovascular complications at 30 and 180 days or more.

Results:
The authors identified 18 eligible studies (n = 2,051). For the primary outcome of 30-day mortality or nonfatal myocardial infarction, BNP of 245 pg/ml had an area under the curve of 0.71 (95% CI, 0.64–0.78), and N-terminal proBNP of 718 pg/ml had an area under the curve of 0.80 (95% CI, 0.77–0.84). These thresholds independently predicted 30-day mortality or nonfatal myocardial infarction (adjusted odds ratio [AOR] 4.5; 95% CI, 2.74–7.4; P < 0.001), mortality (AOR, 4.2; 95% CI, 2.29–7.69; P < 0.001), cardiac mortality (AOR, 9.4; 95% CI, 0.32–254.34; P < 0.001), and cardiac failure (AOR, 18.5; 95% CI, 4.55–75.29; P < 0.001). For greater than or equal to 180-day outcomes, natriuretic peptides independently predicted mortality or nonfatal myocardial infarction (AOR, 3.3; 95% CI, 2.58–4.3; P < 0.001), mortality (AOR, 2.2; 95% CI, 1.67–86; P < 0.001), cardiac mortality (AOR, 2.1; 95% CI, 0.05–1,385.17; P < 0.001), and cardiac failure (AOR, 3.5; 95% CI, 1.0–9.34; P = 0.022). Patients with BNP values of 0–250, greater than 250–400, and greater than 400 pg/ml suffered the primary outcome at a rate of 6.6, 15.7, and 29.5%, respectively. Patients with N-terminal proBNP values of 0–300, greater than 300–900, and greater than 900 pg/ml suffered the primary outcome at a rate of 1.8, 8.7, and 27%, respectively.

Conclusions:
Increased postoperative BNPs are independently associated with adverse cardiac events after noncardiac surgery.
Change in Angular Alignment Is Associated With Early Dysphagia After Anterior Cervical Discectomy and Fusion
Authors: Radcliff Kristen E. , Bennett Jonathan , Stewart Robert J. , Kepler Chris K. , Sidhu Gursukhman S. , Hilibrand Alan S. , Kane Justin , Albert Todd J. , Vaccaro Alexander R. , Rihn Jeffrey A. 
Published: March 2013

Study Design:
Retrospective analysis of a prospective cohort.

Objective:
Change in cervical angular alignment may be associated with dysphagia.

Summary of Background Data:
Bony deformities of the cervical spine may be associated with secondary contractures of soft tissues in the neck. Acute surgical deformity correction causes in changes in soft tissue tension in the anterior neck, resulting in dysphagia.

Methods:
The study population included patients undergoing 1 and 2 level elective anterior cervical discectomy and fusion for cervical myelopathy or radiculopathy. Preoperative and postoperative radiographs at 2 weeks were measured by a blinded observer for C2–C7 endplate angle, C2–C7 posterior vertebral body length, and occipital condyle plumb line distance on upright lateral radiographs at 2, 6, and 12 weeks postoperatively. Patients were prospectively queried about dysphagia incidence and severity using a numeric rating scale. Multiple linear regression analysis was used to determine the effect of change in radiographic parameters controlling for demographic characteristics.

Results:
The study population included 25 patients with complete radiographs. The mean change in C2–C7 angle was −0.6 degrees (SD 9), the mean change in C2–C7 length was 1.7 mm (SD 26), the mean change in occipital condyle plumb line distance was 2.3 mm (SD 20).
Multiple linear regression analysis was performed including operative time, age, sex, number of levels, and change in radiographic parameters as independent variables and using dysphagia score as the dependent variable. The change in C2–C7 angle and operative time were the only statistically significant predictors of change in dysphagia at 2 and 6 weeks postoperatively.

Conclusions:
These results indicate that lordotic change in spinal alignment and longer operative times are associated with increased postoperative dysphagia. Surgeons should counsel patients in whom a large angular correction is expected about the possibility for postoperative dysphagia. Furthermore, future studies on dysphagia incidence should include radiographic alignment as an independent predictor of dysphagia.
Outcomes of Statin Myopathy After Statin Withdrawal
Authors: Armour Ryan , Zhou Lan 
Published: March 2013

Abstract

Objective:
To study the outcomes of statin myopathy after statin withdrawal.

Methods:
Sixty-nine patients with mild statin myopathy were studied by chart review.

Results:
Mean age at presentation was 62.1 years. Forty-nine (71.0%) of the 69 patients were men. Mean duration of follow-up after statin withdrawal was 18.2 months. Muscle symptoms improved in 9 (13.0%) and completely resolved in 50 (72.5%) patients. Thirteen (18.8%)/69 patients had symptoms lingered beyond 14 months. Creatine kinase (CK) levels were elevated in 52 (75.4%)/69 patients at initial presentation and returned to normal in 11 (21.3%)/52 patients at follow-up. Symptom improvement was not influenced by the initial presence of weakness, CK elevation, or myopathic changes on electromyography or muscle biopsy.

Conclusions:
Muscle symptoms can linger beyond 14 months, and it is difficult to predict which patients will have a prolonged recovery course. CK normalization often lags behind symptom improvement, and this should not be the only indication for muscle biopsy.
Knowledge and Practice Styles of Pediatricians in Saudi Arabia Regarding Childhood Constipation
Authors: Hasosah Mohammed , Telmesani Abdulwahab , Al‐Binali Ali , Sarkhi Ahmed , Alghamdi Sharifah , Alquair Khalid , Alturaiki Moath , Alanazi Aziz , Alsahafi Ashraf , Alzaben Abdullah , Di Lorenzo Carlo 
Published: March 2013

ABSTRACTObjectives:The aim of the present study was to evaluate knowledge and practice styles among medical providers working in 5 regions of Saudi Arabia regarding their approach to childhood constipation.Methods:A survey of 850 pediatric providers (PPs) conducted in 5 regions of Saudi Arabia. PPs included pediatric specialists (PSs), pediatric consultants (PCs), general practitioners (GPs), family physicians (FPs), and pediatric gastroenterologists (PGs). They were asked anonymously about definition, causes, diagnosis, and management of constipation. Information about family concerns regarding constipation and the source of constipation‐related information was also collected.Results:A response rate of 73% yielded 622 questionnaires. Among respondents, 61.2% were aware of the Rome definition of functional constipation. More pediatricians (PSs and PCs) than other physicians (GPs and FPs) reported the definition of constipation correctly (P > 0.05). Stool withholding was reported as the most common cause of constipation by 27% of pediatricians (PSs and PCs), 24% of other physicians (GPs and FPs), and 50% of PGs (P = 0.097). Rectal examination was performed by 39% of all PPs and 78.6% of PGs (P = 0.009). Pediatricians prescribed lactulose significantly more often than physicians (P = 0.001). Pediatricians recommended disimpaction before maintenance treatment significantly more than other physicians (P = 0.001). Twenty‐three percent of families believed that constipation was caused by a stricture and 10% feared it was caused by a malignancy.Conclusions:Significant differences in knowledge and practice patterns exist regarding the approach to pediatric constipation. Identification of knowledge gaps may be useful to develop educational materials to improve proper diagnosis and treatment of childhood constipation.
Latest statistics on cardiovascular disease in Australia
Authors: Waters Anne‐Marie , Trinh Lany , Chau Theresa , Bourchier Michael , Moon Lynelle 
Published: March 2013

Summary

The results presented herein summarize the most up‐to‐date cardiovascular statistics available at this time in Australia. The analysis presented here is based on and extends results published in two Australian Institute of Health and Welfare (AIHW) reports, namely Cardiovascular disease: Australian facts 2011 and the cardiovascular disease (CVD) section of Australia's Health 2012.

Despite significant improvements in the cardiovascular health of Australians in recent decades, CVD continues to impose a heavy burden on Australians in terms of illness, disability and premature death. Direct health care expenditure for CVD exceeds that for any other disease group.

The most recent national data have been analysed to describe patterns and trends in CVD hospitalization and death rates, with additional analysis by Indigenous status, remoteness and socioeconomic group. The incidence of and case‐fatality from major coronary events has also been examined.

Although CVD death rates have declined steadily in Australia since the late 1960s, CVD still accounts for a larger proportion of deaths (33% in 2009) than any other disease group. Worryingly, the rate at which the coronary heart disease death rate has been falling in recent years has slowed in younger (35–54 years) age groups.

Between 1998–99 and 2009–10, the overall rate of hospitalizations for CVD fell by 13%, with declines observed for most major CVDs.

In conclusion, CVD disease remains a significant health problem in Australia despite decreasing death and hospitalization rates.
Amino acid polymorphisms flanking the EPIYA‐A motif of Helicobacter pylori CagA C‐terminal region is associated with gastric cancer in East China: Experience from a single center
Authors: Chen Chun Yan , Wang Fang Yu , Wan Hai Jun , Jin Xin Xin , Wei Juan , Wang Zhen Kai , Liu Chang , Lu Heng , Shi Hui , Li Dong Hai , Liu Jiong 
Published: March 2013

ObjectiveThe study aimed to investigate the relationship between gastroduodenal disease and the diversity of the cagA 3′ variable region and the amino acid polymorphisms in the Glu‐Pro‐Ile‐Tyr‐Ala (EPIYA) segments of the CagA C‐terminal region of Helicobacter pylori (H. pylori).MethodsGastric mucosal specimens from 170 patients in our center (Nanjing, Jiangsu Province, China) were collected and the genomic DNA of the H. pylori strains was extracted directly from biopsied specimens. Polymerase chain reaction (PCR) was used to amplify the cagA gene, and diversity in its 3′ variable region was assessed by direct sequencing.ResultsA total of 154 (90.6%) H. pylori isolates were cagA‐positive, but the presence of this gene alone was not associated with the type of gastroduodenal disease. A total of 151 (88.8%) strains had the East Asian type EPIYA‐D sequence, most of which were of ABD subtype. Three isolates from patients with chronic gastritis possessed the EPIYA‐C segment. The sequences flanking the EPIYA motifs contained polymorphisms at seven residues, among which amino acid positions 878 and 879 had a statistically significant association with gastric cancer (P = 0.021). Amino acid change from glycine to aspartic acid at residue 968 was present only in patients with gastric cancer (4/20) (P < 0.001).ConclusionsMost H. pylori strains present in our study are of the CagA‐ABD subtype. Polymorphisms at amino acids 878 and 879 flanking the EPIYA‐A motif are statistically associated with gastric cancer.
Abnormally invasive placenta: changing trends in diagnosis and management
Authors: Guleria Kiran , Gupta Bindiya , Agarwal Shuchi , Suneja Amita , Vaid Neelam , Jain Sandhya 
Published: March 2013

AbstractTrends in patient profile, clinical presentation, diagnosis, management options and outcome of abnormally invasive placenta (AIP) were retrospectively evaluated at a tertiary care centre from 2001 to 2010. AIP was diagnosed when confirmed by ultrasound or MRI, when complete manual removal of placenta was not possible or when histological confirmation was achieved in a hysterectomy specimen. The first and second halves of the time period were compared. The total number of cases was 56 and the incidence increased significantly in the second half. Main risk factors were placenta previa and previous cesarean section. Antenatal diagnosis by ultrasound was made in 72% in the second half, compared with 35% in the first half (p = 0.009). Maternal mortality was 29% in the first half and 21% in the second half. Hysterectomy was the mainstay in management; elective procedures being significantly higher in the second half.
Tissue Accumulation Kinetics of Ciclesonide‐active Metabolite and Budesonide in Mice
Authors: Mårs Ulla , d'Argy Roland , Hallbeck Karin , Miller‐Larsson Anna , Edsbäcker Staffan 
Published: March 2013

AbstractInhaled corticosteroids (ICS) are mainstay treatment of asthma and chronic obstructive pulmonary disease. However, highly lipophilic ICS accumulate in systemic tissues, which may lead to adverse systemic effects. The accumulation of a new, highly lipophilic ICS, ciclesonide and its active metabolite (des‐CIC) has not yet been reported. Here, we have compared tissue accumulation of des‐CIC and an ICS of a moderate lipophilicity, budesonide (BUD), after 14 days of once‐daily treatment in mice. Single, three or 14 daily doses of [3H]‐des‐CIC or [3H]‐BUD were administered subcutaneously to male CD1 albino mice, which were killed at 4 hr, 24 hr or 5 days after the last dose. Distribution of tissue concentration of radioactivity was studied by quantitative whole‐body autoradiography. Pattern of radioactivity distribution across most tissues was similar for both corticosteroids after a single as well as after repeated dosing. However, tissue concentration of radioactivity differed between des‐CIC and BUD. After a single dose, concentrations of radioactivity for both corticosteroids were low for most tissues but increased over 14 days of daily dosing. The tissue radioactivity of des‐CIC at 24 hr and 5 days after the 14th dose was 2–3 times higher than that of BUD in majority of tissues. Tissue accumulation, assessed as concentration of tissue radioactivity 5 days after the 14th versus 3rd dose, showed an average ratio of 5.2 for des‐CIC and 2.7 for BUD (p < 0.0001). In conclusion, des‐CIC accumulated significantly more than BUD. Systemic accumulation may lead to increased risk of adverse systemic side effects during long‐term therapy.
Retracted: Quercetin Decreases Liver Damage in Mice with Non‐Alcoholic Steatohepatitis
Authors: Marcolin Éder , Forgiarini Luiz Felipe , Rodrigues Graziella , Tieppo Juliana , Borghetti Greice Stefani , Bassani Valquiria Linck , Picada Jaqueline Nascimento , Marroni Norma Possa 
Published: March 2013

AbstractNon‐alcoholic steatohepatitis (NASH) is a frequent condition in obese patients that may progress to end‐stage liver disease. This study was designed to evaluate the modulation of this condition by use of quercetin (Q), a flavonoid largely found in vegetable foods, with known anti‐inflammatory and antioxidant properties, in the experimental model of non‐alcoholic steatohepatitis (NASH) using a diet deficient in methionine and choline (MCD). Male C57BL6 mice were divided into four groups (n = 16): (i) Control plus vehicle (control ration plus carboxymethylcellulose 1% used as vehicle, CO + V); (ii) Control ration plus Q 50 mg/kg (CO + Q); (iii) MCD diet plus vehicle (NASH + V); and (iv) MCD diet plus Q (NASH + Q). Diets were administered for 4 weeks. At the end of the experimental period, liver alterations, bioindicators of oxidative stress and DNA damage were assessed. NASH was diagnosed in 100% of the mice that were fed the MCD diet. In addition, a significant increase in DNA damage in liver tissue from NASH + V group was observed in comparison with CO + V. The group NASH + Q showed a significant decrease in hepatic damage enzymes, lipoperoxidation, DNA damage and a lower degree of macrovesicular steatosis, ballooning and inflammatory process. These findings suggest that Q may have protective effects by improving liver integrity in NASH.