bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroactive steroids for the treatment of status epilepticus
Authors: Rogawski Michael A. , Loya Carlos M. , Reddy Kiran , Zolkowska Dorota , Lossin Christoph 
Published: September 2013

SummaryBenzodiazepines are the current first‐line standard‐of‐care treatment for status epilepticus but fail to terminate seizures in about one third of cases. Synaptic GABAA receptors, which mediate phasic inhibition in central circuits, are the molecular target of benzodiazepines. As status epilepticus progresses, these receptors are internalized and become functionally inactivated, conferring benzodiazepine resistance, which is believed to be a major cause of treatment failure. GABAA receptor positive allosteric modulator neuroactive steroids, such as allopregnanolone, also potentiate synaptic GABAA receptors, but in addition they enhance extrasynaptic GABAA receptors that mediate tonic inhibition. Extrasynaptic GABAA receptors are not internalized, and desensitization of these receptors does not occur during continuous seizures in status epilepticus models. Here we review the broad‐spectrum antiseizure activity of allopregnanolone in animal seizure models and the evidence for its activity in models of status epilepticus. We also demonstrate that allopregnanolone inhibits ongoing behavioral and electrographic seizures in a model of status epilepticus, even when there is benzodiazepine resistance. Parenteral allopregnanolone may provide an improved treatment for refractory status epilepticus.
Cognitive behavior therapy for depression in people with epilepsy: A systematic review
Authors: Gandy Milena , Sharpe Louise , Perry Kathryn Nicholson 
Published: September 2013

SummaryCognitive behavioral therapy (CBT) is a recommended treatment for depression in people with epilepsy (PWE); however, a recentCochrane review found that there was insufficient evidence that any psychological therapy is effective. This conclusion provides little help to clinicians who provide interventions for depressedPWE. The aim of this review was to systematically and qualitatively review the literature on the efficacy ofCBTfor depression inPWEbased on randomized controlled trials (RCTs) and case series. We aim to determine patterns in the literature to inform the type ofCBT, if any, that should be offered toPWEwho are depressed. DatabasesMEDLINE,PsycINFO, and theCochraneEBMReviews were searched viaOVID. Selection criteria included the following: (1) participants with epilepsy; (2) use ofCBT; (3) valid depression outcome measure; and (4) published in peer‐reviewed journal inEnglish. Inclusions of studies were assessed by two independent researchers. We identified 14 outcome papers for 13CBTtrials including 6 randomized controlled trials (RCTs) and 7 case series. Positive effects ofCBTon depression were reported in three of sixRCTs. A review of their content revealed that all effectiveRCTs specifically tailoredCBTto improve depression. Conversely, two of threeRCTs that failed to find depression‐related effects focused on improving seizure‐control. This pattern was also observed in the case series. Although limited in number and having methodologic limitations, the treatment studies included in our review suggest that interventions tailored toward improving depression are possibly efficacious, whereas those that focus on improving seizure control do not appear to be. However, this review highlights that there is need for furtherRCTs in this area in order to confirm the possible efficacy ofCBTfor depression inPWE.
The carrier prevalence of severe combined immunodeficiency, lavender foal syndrome and cerebellar abiotrophy in Arabian horses in South Africa
Authors: Tarr C. J. , Thompson P. N. , Guthrie A. J. , Harper C. K. 
Published: September 2013

SummaryReasons for performing studyThe carrier prevalence of severe combined immunodeficiency (SCID), lavender foal syndrome (LFS) and cerebellar abiotrophy (CA) in Arabian foals in South Africa was determined in order to quantify the potential impact of these conditions locally. Furthermore, the carrier prevalence of SCID prior to and following the introduction of a genetic test was compared to evaluate the effect of testing in the population.ObjectivesTo estimate the carrier prevalence of SCID, LFS and CA in registered purebred Arabians born in South Africa in the 2004/5 and 2009/10 foaling seasons and compare the changes in prevalence in these disorders between the 2 groups of foals.Study designCross‐sectional survey.MethodsSamples were collected from individuals randomly selected from 2 populations of purebred Arabian foals born during the 2004/5 and 2009/10 foaling seasons. Genetic testing for SCID, LFS and CA was performed on DNA extracts using specific polymerase chain reactions, with the products being analysed using fragment analysis on a genetic analyser.ResultsThe carrier prevalence of LFS and CA for the 2009/10 season was 11.7% (95% confidence interval [CI] 7.6–17.0%) and 5.1% (95% CI 2.5–9.1%), respectively, with no statistically significant change in prevalence between the 2004/5 and 2009/10 foaling seasons. However, the carrier prevalence of SCID was found to have decreased significantly from 6.4% (95% CI 4.8–8.3%) in the 2004/5 foals to 3.4% (95% CI 2.2–5.1%) in the 2009/10 foals (P = 0.009).ConclusionsThe results of this study indicate that genetic screening of Arabian horses for SCID may have played a role in significantly reducing the carrier prevalence within the breeding population and thereby reducing the birth of clinically affected individuals. This study provides an indication of the positive effect of genetic screening for specific conditions in horses.
Characterizing drought stress and trait influence on maize yield under current and future conditions
Authors: Harrison Matthew T. , Tardieu François , Dong Zhanshan , Messina Carlos D. , Hammer Graeme L. 
Published: September 2013

AbstractGlobal climate change is predicted to increase temperatures, alter geographical patterns of rainfall and increase the frequency of extreme climatic events. Such changes are likely to alter the timing and magnitude of drought stresses experienced by crops. This study used new developments in the classification of crop water stress to first characterize the typology and frequency of drought‐stress patterns experienced by European maize crops and their associated distributions of grain yield, and second determine the influence of the breeding traits anthesis‐silking synchrony, maturity and kernel number on yield in different drought‐stress scenarios, under current and future climates. Under historical conditions, a low‐stress scenario occurred most frequently (ca. 40%), and three other stress types exposing crops to late‐season stresses each occurred in ca. 20% of cases. A key revelation shown was that the four patterns will also be the most dominant stress patterns under 2050 conditions. Future frequencies of low drought stress were reduced by ca. 15%, and those of severe water deficit during grain filling increased from 18% to 25%. Despite this, effects of elevated CO2 on crop growth moderated detrimental effects of climate change on yield. Increasing anthesis‐silking synchrony had the greatest effect on yield in low drought‐stress seasonal patterns, whereas earlier maturity had the greatest effect in crops exposed to severe early‐terminal drought stress. Segregating drought‐stress patterns into key groups allowed greater insight into the effects of trait perturbation on crop yield under different weather conditions. We demonstrate that for crops exposed to the same drought‐stress pattern, trait perturbation under current climates will have a similar impact on yield as that expected in future, even though the frequencies of severe drought stress will increase in future. These results have important ramifications for breeding of maize and have implications for studies examining genetic and physiological crop responses to environmental stresses.
Post‐Traumatic Stress Disorder in U.S. Soldiers With Post‐Traumatic Headache
Authors: Rosenthal Jacqueline F. , Erickson Jay C. 
Published: September 2013

ObjectiveTo determine the impact of post‐traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post‐traumatic headache.BackgroundPTSD and post‐concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post‐traumatic headache has not been determined in U.S. Army soldiers.MethodsA retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post‐traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post‐traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.ResultsOf 270 soldiers with post‐traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache‐related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post‐traumatic headache cases with and without PTSD (25.9% vs 26.8%).ConclusionPTSD is prevalent among U.S. Army soldiers with post‐traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post‐traumatic headache. Comorbid PTSD does not adversely affect short‐term headache outcomes, although prospective controlled trials are needed to better assess this relationship.
Catastrophic Reversible Cerebral Vasoconstriction Syndrome Associated With Serotonin Syndrome
Authors: John Seby , Donnelly Megan , Uchino Ken 
Published: September 2013

ObjectivesTo report fulminant cases of reversible cerebral vasoconstriction syndrome (RCVS) in the setting of serotonin syndrome.BackgroundRCVS is characterized by acute onset of severe headaches, with or without neurologic deficit, with evidence of reversible cerebral vasoconstriction. It is often benign, and prognosis is generally considered favorable. In the largest prospective study on RCVS, only 4% of patients were disabled from strokes and there were no fatalities.MethodsWe report a case series.ResultsWe report 2 women with history of depression on selective serotonin re‐uptake inhibitors who presented with thunderclap headache and dizziness, respectively. Through the course of hospitalization, both patients developed rigidity, diaphoresis, fever, tachycardia with labile blood pressures and clonus on examination. Since there was a recent addition/increase in a known serotonergic agent, they met criteria for serotonin syndrome. Cerebrovascular imaging in both patients revealed severe multi‐focal vessel narrowing. The first patient developed large bi‐hemispheric ischemic infarcts and increased intra‐cranial pressure that was refractory to management, and she eventually expired. The second patient developed bilateral parieto‐occipital strokes and decerebrate posturing. Her course slowly stabilized, and she was eventually discharged with residual left‐sided hemiparesis. Repeat cerebrovascular imaging 1 month later showed normal vessels. In both patients, intra‐arterial nicardipine infusion improved angiographic appearance of stenoses, consistent with RCVS.ConclusionsBoth cases satisfied the Sternbach criteria for serotonin syndrome. Fatality in case 1 prevents demonstration of reversal of cerebral vasoconstriction, but improvement of arterial diameters with intra‐arterial calcium channel blockers in both cases suggests that both had RCVS. Serotonergic agents are known triggers of RCVS, but the concurrent presence of serotonin syndrome likely precipitated the malignant course in our patients. Severe clinical and angiographic manifestations should be considered as part of the spectrum of RCVS.
Therapeutic strategy for patients with bleeding rectal varices complicating liver cirrhosis
Authors: Yoshino Kiyoko , Imai Yukinori , Nakazawa Manabu , Chikayama Taku , Ando Satsuki , Sugawara Kayoko , Hamaoka Kazuhiro , Inao Mie , Oka Masashi , Mochida Satoshi 
Published: September 2013

AimAlthough rupture of rectal varices is rarely encountered, it may provoke massive and fatal hemorrhage in patients with liver cirrhosis. We examined the clinical features of patients showing bleeding from rectal varices to establish a suitable therapeutic strategy for the lesions.MethodsTwelve cirrhotic patients with bleeding rectal varices were enrolled. Surgical suture, endoscopic variceal ligation (EVL) or balloon tamponade was performed to achieve the initial hemostasis. Then, the feeding and drainage vessels of the varices were evaluated by computed tomography, and additional procedures were undertaken: EVL was performed when the sizes of the varices and feeding vessels were small. In contrast, in patients with varices of large sizes, balloon‐occluded retrograde transvenous obliteration (B‐RTO) was performed when single or two drainage vessels were identified, while endoscopic injection sclerotherapy (EIS) using ethanolamine oleate was carried out for varices with three or more drainage vessels.ResultsThe Child–Pugh class was grade A in four, B in six and C in two patients. Eleven patients had received previous therapy for esophageal varices. Initial hemostasis was achieved by surgical suture in three patients, EVL in one patient and balloon tamponade in two patients. EVL, EIS and B‐RTO were carried out as additional procedures in seven, three and one patient, respectively. Rebleeding from the rectal varices occurred in only one patient who underwent EVL as an additional procedure.ConclusionBleeding from rectal varices was controlled satisfactorily by the therapeutic strategy of selecting EVL, EIS or B‐RTO as an additional therapy according to the size and hemodynamics of the varices.
Influence of splenectomy in patients with liver cirrhosis and hypersplenism
Authors: Nomura Yoriko , Kage Masayoshi , Ogata Toshirou , Kondou Reiichirou , Kinoshita Hisafumi , Ohshima Kouichi , Yano Hirohisa 
Published: September 2013

AimSplenectomy improves hypersplenic thrombocytopenia in cirrhotic patients with hypersplenism. However, the long‐term influence of splenectomy has not been clarified. We examined whether splenectomy improved liver fibrosis and caused immunological changes.MethodsWe collected liver and spleen specimens and peripheral blood (PB) from 26 patients with hepatitis C virus‐related liver cirrhosis. An immunohistochemical examination of CD4, CD8, forkhead box P3, granzyme B and transforming growth factor‐β1, and Masson‐trichrome stain were performed in spleen and liver tissues and in seven cases of follow‐up liver biopsy sections obtained after splenectomy. We obtained PB before and at various intervals after splenectomy. We also examined the ratio of CD4+ and CD8+ lymphocytes in PB using flow cytometry.ResultsWe observed improvements in liver fibrosis in four biopsy specimens obtained after splenectomy, in which fibrotic areas significantly decreased from 19.5% to 8.2% (P < 0.05). Increases were also observed in the ratio of CD8+ cells in PB after splenectomy, which resulted in a significant decrease in the CD4+/CD8+ ratio (P < 0.001). The carcinogenic rate in patients with a CD4+ : CD8+ ratio that decreased by more than 0.5 at 1 month after splenectomy was significantly lower than that in patients with a ratio that decreased by less than 0.5 (P < 0.05).ConclusionSplenectomy may improve liver fibrosis and cause beneficial immunological changes in cirrhotic patients with hepatitis. Improvements in antitumor mechanisms can be also expected.
Implications of combined ovariectomy and glucocorticoid (dexamethasone) treatment on mineral, microarchitectural, biomechanical and matrix properties of rat bone
Authors: Govindarajan Parameswari , Khassawna Thaqif , Kampschulte Marian , Böcker Wolfgang , Huerter Britta , Dürselen Lutz , Faulenbach Miriam , Heiss Christian 
Published: September 2013

SummaryOsteoporosis is one of the deleterious side effects of long‐term glucocorticoid therapy. Since the condition is particularly aggressive in postmenopausal women who are on steroid therapy, in this study we have attempted to analyse the combined effect of glucocorticoid (dexamethasone) treatment and cessation of oestrogen on rat bone. The dual aim was to generate osteoporotic bone status in a short time scale and to characterise the combination of glucocorticoid–postmenopausal osteoporotic conditions. Sprague Dawley rats (N = 42) were grouped randomly into three groups: untreated control, sham‐operated and ovariectomized–steroid (OVX‐Steroid) rats. Control animals were euthanized with no treatment [Month 0 (M0)], while sham and OVX‐Steroid rats were monitored up to 1 month (M1) and 3 months (M3) post laparotomy/post OVX‐Steroid treatment. Histology, dual‐energy X‐ray absorptiometry (DXA), micro‐computed tomography (micro‐CT), and biomechanical andmRNAexpression analysis of collagenous, non‐collagenous matrix proteins and osteoclast markers were examined. The study indicated enhanced osteoclastogenesis and significantly lower bone mineral density (BMD) in the OVX‐Steroid rats withZ‐scores below −2.5, reduced torsional strength, reduced bone volume (BV/TV%), significantly enhanced trabecular separation (Tb.S), and less trabecular number (Tb.N) compared with sham rats. Osteoclast markers, cathepsin K and MMP 9 were upregulated along with Col1α1 and biglycan with no significant expression variation in fibronectin, MMP 14, LRP‐5, Car II and TNC. These results show higher bone turnover with enhanced bone resorption accompanied with reduced torsional strength in OVX‐Steroid rats; and these changes were attained within a short timeframe. This could be a useful model which mimics human postmenopausal osteoporosis that is associated with steroid therapy and could prove of value both in disease diagnosis and for testing generating and testing biological agents which could be used in treatment.
Effect of mechanically damaged starch on wheat flour, noodle and steamed bread making quality
Authors: Liu Chong , Li Limin , Hong Jing , Zheng Xueling , Bian Ke , Sun Yu , Zhang Jie 
Published: September 2013

SummaryWheat flour was ground in an ultrafine pulveriser to obtain different levels of damaged starch (DS). The effect of DS content on physicochemical properties of flour and quality attributes of Chinese noodles and northern‐style Chinese steamed bread were investigated. Results showed that the degree of starch damage raised from 6.54% to 12.06% as grinding intensity increased from 0 to 130 Hz (P < 0.05). The falling number, sedimentation value, starch pastes' viscosity, dough proofing stability were negatively, while water absorption, pastes thermal stability, the degree of starch pastes and dough level were positively correlated with DS content, respectively (P < 0.05). The increase in DS content from 6.54% to 8.86% did not lead to a deterioration of texture characteristic, which might be attributed to the slight declining in hardness while enhancing in springiness and cohesiveness. The flour with DS content of 6.54–9.66% was suitable for steamed bread making.
Proteolysis texture and microstructure of low‐fat Tulum cheese affected by exopolysaccharide‐producing cultures during ripening
Authors: Oluk Aylin C. , Güven Mehmet , Hayaloglu Ali A. 
Published: September 2013

SummaryThe objective of the study was to determine the effects of exopolysaccharide (EPS)‐producing or non‐EPS‐producing starters on proteolysis, physical and microstructural characteristics of full‐fat or low‐fat Tulum cheeses during ripening. For this purpose, Tulum cheese was manufactured using full‐ or low‐fat milk with EPS‐producing and non‐EPS‐producing starter cultures. Chemical composition, proteolysis, texture profiles and microstructure of the cheeses were studied during 90 days of ripening. Urea‐PAGE of water‐insoluble and RP‐HPLC peptide profiles of water‐soluble fractions of the cheeses showed that the use of starters resulted in different degradation patterns in all cheeses during ripening. Although β‐casein exhibited similar degradation patterns in all cheeses, small differences are present in αs1‐casein degradation during ripening. Reducing fat in Tulum cheese changed the RP‐HPLC peptide profile of the cheeses. The use of EPS‐producing cultures improved the textural characteristics and changed the microstructure and proteolysis of low‐fat Tulum cheese.
Immune complexes and persistent high levels of serum vitamin B12
Authors: Remacha A. F. , Zapico E. , Sarda M. P. , Rojas E. , Simó M. , Remacha J. , Homs R. , Queralto J. M. 
Published: September 2013

SummaryIntroductionPatients with persistent high levels of serum vitamin B12 were often referred to Hematology departments. In this study, characteristic of patients with serum vitamin B12 levels higher than 2500 pmol/L (high B12) were studied.MethodsPrevalence of high B12 was evaluated during a 10‐month period. Samples with high B12 were incubated with polyethylene glycol (PEG) and a new measurement of vitamin B12 was carried out using the supernatant. As a pilot study, 26 frozen samples with high B12 were evaluated for changes in vitamin B12 after PEG. Moreover, a prospective study was carried out during three consecutive months. Size exclusion chromatography was employed to demonstrate the presence of immune complexes (ICs) with plasma vitamin B12‐binding proteins in some serum samples with high B12.ResultsPrevalence of high B12 was 1.3%. Results from 26 frozen samples and from a prospective study (28 cases) showed that undergoing vitamin B12 treatment was the main cause of high B12. However, ICs were detected in 10 frozen samples and in seven cases (25%) of the prospective study, respectively. Serum vitamin B12 decreased to normal values after precipitation with PEG, and size exclusion chromatography confirmed ICs. An association with autoimmune or hematological disorders was observed.ConclusionsIn patients with repeatedly high B12 levels, ICs were detected in approximately 25% of samples. Precipitation with PEG is an easy method to confirm the presence of ICs and to evaluate serum vitamin B12 levels in these patients.