bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of scintigraphy and ultrasound in the imaging of neonatal hypothyroidism: 5‐year retrospective review of single‐centre experience
Authors: De Silva Ami , Jong Ian , McLean Glenda , Bergman Philip , Rodda Christina , Brown Justin , Nandurkar Dee 
Published: March 2014

AbstractIntroductionCongenital hypothyroidism (CH), as indicated by an elevation of capillary thyroid‐stimulating hormone (TSH) at newborn screening, is a preventable cause of mental retardation with varying aetiology; it can be transient or permanent. Radionuclide assessment is currently the gold standard for imaging CH. This study aimed to (i) review the different scintigraphic patterns and correlate them with TSH levels/patient outcomes, (ii) assess the role of sonography in neonates with apparent agenesis as indicated by scintigraphy and (iii) develop a diagnostic investigative algorithm.MethodsThe technetium thyroid scans of 83 consecutive patients (49 females, average age 32 days) with CH scanned between 2005 and 2009 were retrospectively reviewed. Two nuclear medicine physicians blinded to the clinical details interpreted the scans in consensus. Scintigram appearances were categorised into five groups. Patients scintigraphically diagnosed with thyroid agenesis were evaluated with ultrasound. TSH values and scintigraphic and sonographic findings were correlated with patients' final diagnosis.ResultsBased on scintigraphy, 14, 13 and 19 patients out of 83 were assessed as having normal thyroid sites with normal, increased and decreased uptake, respectively. Twenty‐two of 83 patients had no uptake, and 15 of 83 patients had ectopic uptake. Higher median TSH levels were seen in no‐uptake and ectopic uptake subgroups. Eighteen of 22 patients with no uptake were evaluated with ultrasound. Three of the 18 patients had a normal thyroid gland, and three of 18 patients had a hypoplastic thyroid.ConclusionScintigram findings in patients with congenital hypothyroidism fall into five major categories, which have therapeutic implications (lifelong thyroxine in agenesis versus trial of stopping thyroxine in other subgroups). Sonographic demonstration of thyroid tissue in patients scintigraphically diagnosed with thyroid agenesis has major management implications.
Exploring the Role of Central Astrocytic Glutamate Uptake in Ethanol Reward in Mice
Authors: Smith Karen L. , John Catherine S. , Sypek Elizabeth I. , Öngür Dost , Cohen Bruce M. , Barry Sarah M. , Bechtholt Anita J. 
Published: March 2014

BackgroundAlcoholism is associated with specific brain abnormalities revealed through postmortem studies, including a reduction in glial cell number and dysregulated glutamatergic neurotransmission. Whether these abnormalities contribute to the etiology of alcoholism, are consequences of alcohol use, or both is still unknown.MethodsWe investigated the role of astrocytic glutamate uptake in ethanol (EtOH) binge drinking in mice, using the “drinking in the dark” (DID) paradigm by blocking the astrocytic glutamate transporter (GLT‐1) with intracerebroventricular (ICV) administration of dihydrokainic acid (DHK). To determine whether astrocytic glutamate uptake regulates the conditioned rewarding effects of EtOH, we examined the effects of ICV DHK on the acquisition and expression of EtOH‐induced conditioned place preference.ResultsBlocking central astrocytic glutamate uptake selectively attenuated EtOH binge drinking behavior in mice. DHK did not alter the acquisition or expression of preference for EtOH‐associated cues, indicating that reduced astrocytic glutamate trafficking may decrease binge‐like drinking without altering the conditioned rewarding effects of EtOH.ConclusionsSeveral alternative conclusions are plausible, however, interpreting these data in the context of the human literature, these findings suggest that the reduction of glia in the alcoholic brain may not be a predisposing factor to developing alcoholism and could be a consequence of EtOH toxicity that decreases excessive EtOH intake.
Increased Cut‐Point of the TACER‐3 Screen Reduces False Positives Without Losing Sensitivity in Predicting Risk Alcohol Drinking in Pregnancy
Authors: Chiodo Lisa M. , Delaney‐Black Virginia , Sokol Robert J. , Janisse James , Pardo Yobany , Hannigan John H. 
Published: March 2014

BackgroundDetection of in‐pregnancy maternal risk alcohol drinking is an essential first step in preventing fetal alcohol spectrum disorders, and the widely used T‐ACE screen was developed for that purpose. We recently reported that increasing the total T‐ACE score cut‐point from 2 to 3 doubled specificity of detecting risk drinking in pregnancy and identified 4‐year‐old children with neurobehavioral effects associated with prenatal alcohol exposure.MethodsIn this study, the TACER‐3 was further validated in another prospectively identified high‐risk urban cohort. Women were categorized as follows: (i) Not At‐Risk Group (negative on T‐ACE and TACER‐3); (ii) At‐Risk Group (positive on T‐ACE and TACER‐3); and (iii) Change Risk Group (positive on T‐ACE but negative on TACER‐3).ResultsThe TACER‐3 total score cut‐point of 3 yielded fewer “false positives” than the T‐ACE cut‐point of 2. Based on relative risk scores, women in the TACER‐3‐positive At‐Risk Group were more likely to drink alcohol during pregnancy than women in the Change Risk Group. In contrast, women in the Not At‐Risk Group were largely not different in their drinking from women in the Change Risk Group. The largest increases in relative risk of the At‐Risk Group compared to the Change Risk Group were for the amount of drinking per day across pregnancy (RR = 11.4) and for the amount of drinking per drinking day at the first prenatal visit (RR = 12.7). For both of these measures, the relative risk of at‐risk alcohol consumption in the At‐Risk Group was over >10 times that of the Change Risk Group.ConclusionsThus, the TACER‐3 was more effective at selectively identifying women drinking at fetal risk levels than the original T‐ACE. The TACER‐3 allows for more efficient use of healthcare provider time in directing targeted clinical interventions with pregnant women identified as drinking at fetal risk levels.
Cardiac Reactivity During the Ascending Phase of Acute Intravenous Alcohol Exposure and Association with Subjective Perceptions of Intoxication in Social Drinkers
Authors: Vatsalya Vatsalya , Momenan Reza , Hommer Daniel W. , Ramchandani Vijay A. 
Published: March 2014

BackgroundThe aim of this study was to characterize cardiac reactivity measures, heart rate (HR), and heart rate variability (HRV), following acute intravenous (IV) alcohol administration and their association with subjective responses in social drinkers.MethodsTwenty‐four subjects (11 females) received IV alcohol infusions to attain and clamp the breath alcohol concentration (BrAC) at 50 mg% or placebo in separate sessions. Serial 5‐minute cardiac recordings at baseline and during the infusion were analyzed to obtain frequency and time domain cardiac measures. Self‐reported subjective perceptions were also obtained at the same time points.ResultsHR showed significant decreases from baseline, while the HRV measure pNN50 showed steady increases during the ascending phase of alcohol infusion. HR was inversely correlated with pNN50 across time and treatment. There was a significant association of HR with subjective feelings of high, intoxication, feeling drug effects, and liking drug effects across time during the ascending phase.ConclusionsAcute IV alcohol resulted in decreases in HR and increases in HRV consistent with autonomic parasympathetic activation. The association of these changes with subjective responses suggests that cardiac reactivity may serve as a physiological marker of subjective alcohol effects. This study broadens the understanding of acute cardiovascular effects of alcohol and clinically significant cardiac conditions such as arrhythmia and cardiomyopathy associated with chronic alcohol drinking.
An In Vivo 1H Magnetic Resonance Spectroscopy Study of the Deep Cerebellar Nuclei in Children with Fetal Alcohol Spectrum Disorders
Authors: du Plessis Lindie , Jacobson Joseph L. , Jacobson Sandra W. , Hess Aaron T. , van der Kouwe Andre , Avison Malcolm J. , Molteno Christopher D. , Stanton Mark E. , Stanley Jeffrey A. , Peterson Bradley S. , Meintjes Ernesta M. 
Published: March 2014

BackgroundPrenatal alcohol exposure has been linked to impairment in cerebellar structure and function, including eyeblink conditioning. The deep cerebellar nuclei, which play a critical role in cerebellar‐mediated learning, receive extensive inputs from brain stem and cerebellar cortex and provide the point of origin for most of the output fibers to other regions of the brain. We used in vivo 1H magnetic resonance spectroscopy (MRS) to examine effects of prenatal alcohol exposure on neurochemistry in this important cerebellar region.MethodsMRS data from the deep cerebellar nuclei were acquired from 37 children with heavy prenatal alcohol exposure and 17 non‐ or minimally exposed controls from the Cape Coloured (mixed ancestry) community in Cape Town, South Africa.ResultsIncreased maternal alcohol consumption around time of conception was associated with lower N‐Acetylaspartate (NAA) levels in the deep nuclei (r = −0.33, p < 0.05). Higher levels of alcohol consumption during pregnancy were related to lower levels of the choline‐containing metabolites (r = −0.37, p < 0.01), glycerophosphocholine plus phosphocholine (Cho). Alcohol consumption levels both at conception (r = 0.35, p < 0.01) and during pregnancy (r = 0.38, p < 0.01) were related to higher levels of glutamate plus glutamine (Glx). All these effects continued to be significant after controlling for potential confounders.ConclusionsThe lower NAA levels seen in relation to prenatal alcohol exposure may reflect impaired neuronal integrity in the deep cerebellar nuclei. Our finding of lower Cho points to disrupted Cho metabolism of membrane phospholipids, reflecting altered neuropil development with potentially reduced content of dendrites and synapses. The alcohol‐related alterations in Glx may suggest a disruption of the glutamate–glutamine cycling involved in glutamatergic excitatory neurotransmission.
Are older Western Australians exposed to potentially inappropriate medications according to the Beers Criteria? A 13‐year prevalence study
Authors: Price Sylvie D , Holman C D'Arcy J , Sanfilippo Frank M , Emery Jon D 
Published: March 2014

AimTo examine time trends and factors associated with exposure to potentially inappropriate medications (PIMs) by the Beers Criteria.MethodsPIM consumption days accumulated from the pharmaceutical claims of 251 305 Western Australians aged ≥65 years (1993–2005) and person follow‐up times produced counts/rates. Logistic/Poisson regression generated odds/rate ratios.ResultsA total of 187 616 participants (74.7%) took ≥1 PIM (1993–2005), the cohort consuming 109 415 PIM daily doses/1000 person‐years. Annual exposure decreased from 45–47% to 40%, and annual consumption rate declined from 117 836 to 90 364 daily doses/1000 person‐years. Temazepam had the highest exposures (>17 000 daily doses/1000 person‐years). Number of medications taken (OR 35.03; 95% CI 34.37–35.71 for ≥10 vs. 0–2 drugs), annual drug intake (2.08; 2.04–2.12 for highest vs. lowest quartile), and high‐level residential aged care (1.96; 1.91–2.01) were most predictive of PIM exposure.ConclusionsPIM exposure remains high in older Western Australians. Our findings identify patients most at risk and medications to consider on Australia‐specific PIM lists.
Peripheral hypertrophic subepithelial corneal degeneration – clinical and histopathological features
Authors: Järventausta Petri J. , Tervo Timo M. T. , Kivelä Tero , Holopainen Juha M. 
Published: March 2014

AbstractPurposeTo refine the diagnostic criteria for peripheral hypertrophic subepithelial corneal degeneration (PHSD) and characterize its clinical phenotype, histopathology and immunohistochemical features.MethodsDiagnostic criteria were refined on the basis of literature data. Fourteen patients (13 women and one man; median age 52 years, range 33–66) were identified based on these criteria. Keratectomy specimens were evaluated via routine and immunohistochemical stainings. The main outcome measures were symptoms, clinical phenotype, immunological status and histopathologic results.ResultsWe defined the diagnostic criteria of typical PHSD as elevated circumferential and perilimbal subepithelial fibrosis with focal superficial corneal neovascularization, which were supported by female sex (93%), bilaterality (86%), the centre being in the upper quadrants (81%) and irregular astigmatism of two dioptres or more. The typical symptoms were reduced vision (86%) and the symptoms of ocular surface disease (64%). Light microscopy showed fibrosis with abundant collagen deposition but no inflammation in all patients. An immunohistochemical analysis of nine patients showed uniform staining for vimentin in three distinct types of fibroblasts in variable proportions: keratocyte‐like cells that were positive for CD34, myofibroblasts that were positive for smooth muscle actin (SMA) and fibroblasts that were negative for CD34 and SMA. Small numbers of CD68‐positive macrophages were also found.ConclusionsPeripheral hypertrophic subepithelial degeneration is characteristic of middle‐aged women, in whom it is typically a bilateral idiopathic degeneration of the cornea associated with ocular surface disease and reduced vision. The fibrotic lesions probably undergo remodelling, inducing changes in corneal contour. A smouldering low‐grade inflammation favouring low TGF‐β1 concentrations is postulated as the primary pathological process leading to PHSD.
Plasma Levels of 25‐Hydroxyvitamin D3 and In Vivo Markers of Cytochrome P450 3A Activity in Swedes and Koreans: Effects of a Genetic Polymorphism and Oral Contraceptives
Authors: Nylén Hanna , Björkhem‐Bergman Linda , Ekström Lena , Roh Hyung‐Keun , Bertilsson Leif , Eliasson Erik , Lindh Jonatan D. , Diczfalusy Ulf 
Published: March 2014

AbstractIn vitro studies have shown that vitamin D may induce several cytochrome P450 (CYP) enzymes in general and CYP3A4 in particular. The primary aim of this study was to investigate the relationship between plasma levels of 25‐hydroxyvitamin D3 and suggested in vivo markers of CYP3A activity in healthy volunteers from Sweden and Korea. Plasma concentrations of 25‐hydroxyvitamin D3 were analysed in samples from three previously performed studies, and the correlation between these levels and suggested in vivo markers of CYP3A activity was investigated by means of nonparametric correlation. In addition, we studied the modulating effects of three vitamin D receptor promoter polymorphisms on the association between 25‐hydroxyvitamin D3 and CYP3A enzyme activity in Swedish subjects. The plasma levels of 25‐hydroxyvitamin D3 were not significantly associated with CYP3A phenotypes in any of the three studies, but after accounting for the vitamin D receptor polymorphism rs4516035, there was a significant positive association between 25‐hydroxyvitamin D3 and CYP3A activity (p = 0.004). Swedes (n = 65) had significantly higher 25‐hydroxyvitamin D3 levels than Koreans (n = 67), 75 nM compared with 31 nM (p < 0.001). Swedish women taking oral contraceptives (OC) (n = 19) had somewhat higher plasma levels of 25‐hydroxyvitamin D3 compared with Swedish women not taking oral contraceptives (n = 21), 89 and 72 nM, respectively (p = 0.02). In conclusion, our results suggest that the overall influence on the CYP3A activity by 25‐hydroxyvitamin D3 is of marginal importance.
Fistula and Other Adverse Reproductive Health Outcomes among Women Victims of Conflict‐Related Sexual Violence: A Population‐Based Cross‐Sectional Study
Authors: Dossa Nissou Ines , Zunzunegui Maria Victoria , Hatem Marie , Fraser William 
Published: March 2014

AbstractBackgroundSexual violence (SV) is being used widely as a weapon of war. However, few studies have investigated its health effects. The objective of the present study is to investigate the relationship between sexual violence and several serious reproductive health conditions including fistula.MethodsWe conducted a cross‐sectional study among 320 women living in Goma, the Democratic Republic of Congo. We assessed the association of four outcomes: fistula, chronic pelvic pain, desire for sex, and desire for children, with SV in two contexts: conflict‐related and nonconflict‐related. Two groups of women: those who experienced conflict‐related sexual violence (CRSV) and those who experienced nonconflict‐related sexual violence (NCRSV), were compared with women who had not experienced SV. Data were collected by trained interviewers using a standard questionnaire.ResultsCompared with women who did not experience SV, after adjustment for potential confounders, women who experienced CRSV were significantly more likely to have fistula (OR = 11.1, 95% CI [3.1–39.3]), chronic pelvic pain (OR = 5.1, 95% CI [2.4–10.9]), and absence of desire for sex (OR = 3.5, 95% CI [1.7–6.9]) and children (OR = 3.5, 95% CI [1.6–7.8]). Women who experienced NCRSV were more likely to report absence of desire for children (OR = 2.7, 95% CI [1.1–6.5]), and seemed more likely to report chronic pelvic pain (OR = 2.3, 95% CI [0.95–5.8]), although the difference was not statistically significant. Women who experienced NCRSV did not have higher odds for fistula and absence of sexual desire.ConclusionConflict‐related sexual violence can contribute to women's adverse reproductive health outcomes. Its impact is more devastating than that of NCRSV.
Trends in Family Physicians Performing Deliveries, 2003–2010
Authors: Rayburn William F. , Petterson Stephen M. , Phillips Robert L. 
Published: March 2014

AbstractObjectiveThis observational study examined the proportion of family physicians continuing to perform deliveries from 2003–2010.MethodsData were collected annually from the same census questionnaire completed by family physicians who passed their recertification examination. Aggregated responses began in 2003 when data first became available electronically and ended in 2009 before recertification changes. Using cross‐sectional design and logistic regression analysis, we examined associations between physician demographic or geographic factors and performance of deliveries.ResultsThe sample consisted of 49,267 family physicians between 2003 and 2009, including 7,456 in 2009. The proportion performing any deliveries declined by 40.6 percent, from 17.0 percent in 2003 to 10.1 percent in 2009. Most recently, 5.5 percent of all family physicians delivered 1–25 babies per year, whereas 2.8 percent delivered 26–50, and 1.9 percent delivered ≥ 51. Those who performed deliveries were most likely to be junior members of a partnership or group practice, and provided prenatal and newborn care. Deliveries were more common in nonmetropolitan areas, where other obstetric practitioners were unavailable.ConclusionsThe proportion of family physicians performing deliveries continues to decline with most delivering 25 or fewer babies per year. This change will require more effort by obstetrician‐gynecologists and midwives in being primary birth attendants.
Interrelations Between Four Antepartum Obstetric Interventions and Cesarean Delivery in Women at Low Risk: A Systematic Review and Modeling of the Cascade of Interventions
Authors: Rossignol Michel , Chaillet Nils , Boughrassa Faiza , Moutquin Jean‐Marie 
Published: March 2014

AbstractObjectivesTo critically appraise the literature on the relations between four intrapartum obstetric interventions—electronic fetal monitoring (EFM), epidural analgesia, labor induction, and labor acceleration; and two types of delivery—instrumental (forceps and vacuum) and cesarean section.MethodsThis review included meta‐analyses published between January 2000 and April 2012 including at least one randomized clinical trial published after 1995 and presenting results on low‐risk pregnancies between 37 and 42 weeks of gestation, searched in the databases Medline, Cochrane Library, and EMBASE with no language restriction.ResultsOf 306 documents identified, 8 fulfilled the inclusion criteria and presented results on women at low risk. EFM at admission (vs intermittent auscultation) was associated with cesarean delivery (odds ratio [OR] = 1.20, 95% confidence interval [CI] 1.00–1.44) and epidural analgesia (OR = 1.25, 95% CI 1.09–1.43). Epidural on request was associated with cesarean delivery (OR = 1.60, 95% CI 1.18–2.18), instrumental delivery (OR = 1.21, 95% CI 1.03–1.44), and oxytocin use (OR = 1.20, 95% CI 1.01–1.43) when compared with epidural on request plus nonpharmacological labor pain control methods such as one‐to‐one support, breathing techniques, and relaxation. Induction and acceleration of labor showed heterogeneous patterns of associations with cesarean delivery and instrumental delivery.ConclusionsComplex patterns of associations between obstetric interventions and modes of delivery were illustrated in an empirical model. Intermittent auscultation and nonpharmacological labor pain control interventions, such as one‐to‐one support during labor, have the potential for substantially reducing cesarean deliveries.
The Role of Labor Pain and Overall Birth Experience in the Development of Posttraumatic Stress Symptoms: A Longitudinal Cohort Study
Authors: Garthus‐Niegel Susan , Knoph Cecilie , von Soest Tilmann , Nielsen Christopher S. , Eberhard‐Gran Malin 
Published: March 2014

AbstractBackgroundThe aim of this prospective study was to investigate the role of labor pain and overall birth experience in the development of posttraumatic stress symptoms in a comprehensive framework.MethodsThe study sample (N = 1893) comprised women with a vaginal delivery and was drawn from the Akershus Birth Cohort, which targeted all women scheduled to give birth at Akershus University Hospital in Norway. Questionnaires were given at three different stages: from pregnancy weeks 17 to 32, from the maternity ward, and from 8 weeks postpartum. Data were also obtained from the hospital's birth record. Using structural equation modeling, a prospective mediation model was tested.ResultsPosttraumatic stress symptoms were significantly related to both labor pain (r = 0.23) and overall birth experience (r = 0.39). A substantial portion (33%) of the effect of labor pain on posttraumatic stress symptoms was mediated by the overall birth experience.ConclusionsAlthough the results of this study showed that both labor pain and overall birth experience played a role in the development of posttraumatic stress symptoms after childbirth, overall birth experience appeared to be the central factor. The women's birth experience was not only related to posttraumatic stress symptoms directly but also mediated a substantial portion of the effect of labor pain on posttraumatic stress symptoms. Future work should address which areas of birth experience confer protective effects on women to improve clinical care.