bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing Status in Adult Individuals with Lifetime, Untreated Isolated Growth Hormone Deficiency
Authors: Prado‐Barreto Valéria M. , Salvatori Roberto , Santos Júnior Ronaldo C. , Brandão‐Martins Mariane B. , Correa Eric A. , Garcez Flávia B. , Valença Eugênia H. O. , Souza Anita H. O. , Pereira Rossana M. C. , Nunes Marco A. P. , D'Avila Jeferson S. , Aguiar‐Oliveira Manuel H. 
Published: January 2014

ObjectiveTo evaluate the hearing status of growth hormone (GH)–naive adults with isolated GH deficiency (IGHD) belonging to an extended Brazilian kindred with a homozygous mutation in the GH‐releasing hormone receptor gene.Study DesignCross‐sectional.SettingDivisions of Endocrinology and Otorhinolaryngology of the Federal University of Sergipe.Subjects and MethodsTwenty‐six individuals with IGHD (age, 47.6 ± 15.1 years; 13 women) and 25 controls (age, 46.3 ± 14.3 years; 15 women) were administered a questionnaire on hearing complaints and hearing health history. We performed pure‐tone audiometry, logoaudiometry, electroacoustic immittance, and stapedial reflex. To assess outer hair cell function in the cochlea, we completed transient evoked otoacoustic emissions (TEOAEs). To assess the auditory nerve and auditory brainstem, we obtained auditory brainstem responses (ABRs).ResultsMisophonia and dizziness complaints were more frequent in those with IGHD than in controls (P =. 011). Patients with IGHD had higher thresholds at 250 Hz (P =. 005), 500 Hz (P =. 006), 3 KHz (P =. 008), 4 KHz (P =. 038), 6 KHz (P =. 008), and 8 KHz (P =. 048) and mild high‐tones hearing loss (P =. 029). Stapedial reflex (P <. 001) and TEOAEs (P =. 025) were more frequent in controls. There were no differences in ABR latencies. Hearing loss in patients with IGHD occurred earlier than in controls (P <. 001).ConclusionCompared with controls of the same area, subjects with untreated, congenital lifetime IGHD report more misophonia and dizziness, have predominance of mild high‐tones sensorineural hearing loss, and have an absence of stapedial reflex and TEOAEs.
Sevoflurane/remifentanil versus propofol/remifentanil for electroconvulsive therapy: Comparison of seizure duration and haemodynamic responses
Authors: Ulusoy Hulya , Cekic Bahanur , Besir Ahmet , Geze Sukran , Hocaoglu Cicek , Akdogan Ali 
Published: January 2014

Objective To compare the anaesthetic and convulsive effects of sevoflurane/remifentanil versus propofol/remifentanil combination in electroconvulsive therapy (ECT). Methods In this prospective, randomized double-blind study, patients diagnosed with treatment-resistant depression were included for ECT. Prior to treatment, 1 µg/kg remifentanil was intravenously administered to all patients, followed by anaesthetic induction with either 0.5 mg/kg propofol or 8% sevoflurane. Following muscular paralysis with succinylcholine and hypnosis, bitemporal ECT was applied. Vital signs, depth of sedation, recovery parameters, motor and electroencephalography (EEG) convulsion activity and postictal suppression index scores were recorded. Results A total of 120 sessions of ECT were administered to 12 patients. Heart rate was higher in the sevoflurane group than the propofol group. Compared with the sevoflurane group, bispectral index level was lower in the propofol group during the induction period and higher during the recovery period. Anaesthetic induction and recovery times were lower, and average motor and EEG convulsion activity was longer, in the propofol group than in the sevoflurane group. Conclusion Propofol/remifentanil is more successful compared with sevoflurane/remifentanil in anaesthesia management during ECT since it provides quick induction and recovery, longer seizure activity and stable haemodynamics.
Truth-telling and hematopoietic stem cell transplantation
Authors: Valizadeh Leila , Zamanzadeh Vahid , Sayadi Leila , Taleghani Fariba , Howard A Fuchsia , Jeddian Alireza 
Published: January 2014

Background: Hematopoietic stem cell transplantation is a potential cure for a range of life-threatening diseases, but is also associated with a high mortality rate. Nurses encounter a variety of situations wherein they are faced with discussing bad news with hematopoietic stem cell transplantation patients. Research objective: The aim of this study was to explore the experiences and strategies used by Iranian nurses related to truth-telling and communicating bad news to hematopoietic stem cell transplantation patients. Research design: A qualitative approach using content analysis of interview data was conducted. Participants and research context: A total of 18 nurses from the main hematopoietic stem cell transplantation center in Iran participated in semi-structured interviews. Ethical considerations: The Institutional Review Board of the Tabriz University of Medical Sciences and the Hematology-Oncology and Stem Cell Transplantation Research Center affiliated with the Tehran University of Medical Sciences approved the study. Findings: In the first main category, not talking about the disease and potential negative outcomes, the nurses described the strategies of not naming the disease, talking about the truth in indirect ways and telling gradually. In the second main category, not disclosing the sad truth, the nurses described the strategies of protecting patients from upsetting information, secrecy, denying the truth and minimizing the importance of the problem. The nurses used these strategies to minimize psychological harm, avoid patient demoralization, and improve the patient’s likelihood of a fast and full recovery. Discussion: The priority for Iranian hematopoietic stem cell transplantation nurses is to first do no harm and to help patients maintain hope. This reflects the Iranian healthcare environment wherein communicating the truth to hematopoietic stem cell transplantation patients is commonly considered inappropriate and avoided. Conclusion: Iranian nurses require education and support to engage in therapeutic, culturally appropriate communication that emphasizes effective techniques for telling the truth and breaking bad news, thereby potentially improving patient outcomes and protecting patient rights.
Disability weight for each level of the Expanded Disability Status Scale in multiple sclerosis
Authors: Cho Joong-Yang , Hong Keun-Sik , Kim Ho Jin , Kim Su-Hyun , Min Ju-Hong , Kim Nam-Hee , Ahn Suk-Won , Park Min Su , An Jae-Young , Kim Byung-Jo , Kim Woojun 
Published: January 2014

Background: The Expanded Disability Status Scale (EDSS) is the most widely employed ordinal disability scale in multiple sclerosis (MS). However, how far apart the individual EDSS levels are along the disability spectrum has not been formally quantified. Objectives: The objective of this paper is to generate refined disability weights (DWs) for each of the ordinal EDSS levels. Methods: We performed the person trade-off (PTO) procedure to derive DWs of five representative EDSS categories (2, 4, 6, 7 and 9), and DWs of the remaining EDSS categories were assigned by linear interpolation. The modified Delphi process was used to achieve consensus among raters. Results: DWs were 0.021 for EDSS 2, 0.199 for EDSS 4, 0.313 for EDSS 6, 0.617 for EDSS 7, and 0.926 for EDSS 9. Panel members achieved a high degree of consensus for each DW, as indicated by low coefficients of variation. Conclusions: Our DWs confirmed that EDSS is an ordinal scale with highly variable intervals. The availability of DW for each EDSS level allows direct comparison of each MS outcome state with other health states and provides a foundation for the estimation of the disability-adjusted life-years lost of individual patients.
Perioperative Levels of Tumor Necrosis Factor-α Correlate With Outcomes in Children and Adults With Tetralogy of Fallot Undergoing Corrective Surgery
Authors: Sethi Brijindera Singh , Kapoor Poonam Malhotra , Chauhan Sandeep , Chowdhury Ujjwal K. , Kiran Usha , Choudhury Minati 
Published: January 2014

Background: Previous studies reporting on tumor necrosis factor-α (TNF-α) as a marker of inflammatory response (IR) in patients with congenital heart disease were limited by small sample size and variability in diagnosis. We report perioperative changes in TNF-α levels and their correlation with preoperative factors and clinical outcomes in a large homogenous group of patients with tetralogy of Fallot (TOF) undergoing definitive repair at a tertiary care center. Methods: A total of 167 patients were divided into four groups on the basis of age. Group 1 included infants less than 1 year, group 2 included children between 1 and 12 years, group 3 included adolescents between 12 and 18 years, and group 4 included adults more than 18 years of age. Serum TNF-α levels were measured at three time points and correlated with perioperative variables. Results: The baseline TNF-α level correlated with patients’ nutritional status and degree of cyanosis in all four groups. The magnitude of IR in the postcardiopulmonary bypass (post-CPB) period as measured by TNF-α level was much higher and correlated more consistently with adverse clinical outcomes in the younger age group (groups 1 and 2). On multivariable analysis; age at operation, preoperative degree of hypoxemia and TNF-α levels were found to be independent predictors of clinical outcomes. Conclusion: We demonstrated a rise in serum TNF-α levels in patients with TOF undergoing definitive repair on CPB, which correlated with preoperative severity of cyanosis, nutritional status, and adverse clinical outcomes. The TNF-α levels may be monitored to identify cyanotic patients at an increased risk of exhibiting augmented IR to CPB.
Glycol-split nonanticoagulant heparins are inhibitors of hepcidin expression in vitro and in vivo
Authors: Poli Maura , Asperti Michela , Naggi Annamaria , Campostrini Natascia , Girelli Domenico , Corbella Michela , Benzi Marina , Besson-Fournier Celine , Coppin Helene , Maccarinelli Federica , Finazzi Dario , Arosio Paolo 
Published: January 2014

Key Points
Chemically modified nonanticoagulant heparins are strong inhibitors of hepcidin expression in normal and Bmp6−/− mice. These heparins abolish hepcidin induction caused by LPS, a model of inflammation, and are candidates for treatment of inflammatory anemia.
Comparative analysis of sodium coupled vitamin C transporter 2 in human osteoarthritis grade 1 and grade 3 tissues
Authors: Blackburn Alan R , Hamrick Mark W , Chutkan Norman , Sangani Rajnikumar , Waller Jennifer L , Corpe Raymond , Prasad Puttur D , Isales Carlos M , Ganapathy Vadivel , Fulzele Sadanand 
Published: January 2014

Abstract

Background
Nutrient levels are known to influence the development of osteoarthritis (OA), presumably by modulating levels of matrix biosynthesis and degradation. These processes may be affected by ascorbic acid (AA), an antioxidant which acts as a cofactor for numerous biochemical reactions and is essential for post-translational modifications of collagen. In this study we examined the expression of SVCT2, the only known Sodium coupled vitamin C transporter isoform present in articular cartilage, in human articular cartilage explants derived from both normal and osteoarthritis articular cartilage.

Methods
OA1 and OA3 human articular cartilage was carefully dissected and macroscopically graded for degeneration via the Collins scale. The tissue samples were histologically examined by Hematoxylin and Eosin and Safranin O and Fast Green staining. SVCT2 expression analysis was performed at mRNA level by quantitative real time PCR and at a protein level by immunohistochemistry.

Results
Our quantitative real time PCR showed marked variation in the expression of SVCT2 in human osteoarthritic articular cartilage. SVCT2 expression was significantly down-regulated (p = 0.0001) in the Collins grade 3 (OA3) compared to Collins grade 1 (OA1) tissue. Furthermore, slides stained with fluorescent antibodies to SVCT2 demonstrated greatly reduced fluorescence for the SVCT2 transporter on the chondrocyte plasma membrane in the osteoarthritic tissue samples.

Conclusions
These findings demonstrate that the expression of SVCT2 transporter is significantly altered in human osteoarthritic tissues (OA3). The modulation of this transporter could therefore potentially influence the prevention, management and treatment of osteoarthritis.
Jejunoduodenal intussusception caused by a solitary polyp in a woman with Peutz-Jeghers syndrome: a case report
Authors: Ozer Ali , Sarkut Pinar , Ozturk Ersin , Yilmazlar Tuncay 
Published: January 2014

Abstract

Introduction
Peutz-Jeghers syndrome is a rare autosomal dominant disorder characterized by hamartomatous polyps and characteristic mucocutaneous pigmentation. The hamartomatous polyps of Peutz-Jeghers syndrome can cause intestinal occlusion, especially in the small intestine. Intussusception is seen frequently in children, but rarely in adults.

Case presentation
We present the case of a 21-year-old female patient who was admitted to our emergency service with symptoms of ileus as a result of intussusception due to duodenal polyps. Radiological and endoscopic findings determined a jejunoduedonal intussusception. After an unsuccessful endoscopic attempt, a laparotomy was performed that revealed a polypoid mass originating from the fourth part of her duodenum, with intussusception of her proximal jejunum.

Conclusion
Intussusception caused by Peutz-Jeghers syndrome is a rare diagnosis and is mostly jejunojejunal or jejunoileal. Despite the fact that a few duodenojejunal cases have been reported, this is to the best of our knowledge the first case of jejunoduedonal intussusception in a patient with Peutz-Jeghers syndrome to be described in the literature.
Capsule deletion via a λ-Red knockout system perturbs biofilm formation and fimbriae expression in Klebsiella pneumoniae MGH 78578
Authors: Huang Tzu-Wen , Lam Irene , Chang Hwan-You , Tsai Shih-Feng , Palsson Bernhard O , Charusanti Pep 
Published: January 2014

Abstract

Background

Klebsiella pneumoniae is a leading cause of hospital-acquired urinary tract infections and pneumonia worldwide, and is responsible for many cases of pyogenic liver abscess among diabetic patients in Asia. A defining characteristic of this pathogen is the presence of a thick, exterior capsule that has been reported to play a role in biofilm formation and to protect the organism from threats such antibiotics and host immune challenge.

Findings
We constructed two knockout mutants of K. pneumoniae to investigate how perturbations to capsule biosynthesis alter the cellular phenotype. In the first mutant, we deleted the entire gene cluster responsible for biosynthesis of the extracellular polysaccharide capsule. In the second mutant, we deleted the capsule export subsystem within this cluster. We find that both knockout mutants have lower amounts of capsule but produce greater amounts of biofilm. Moreover, one of the two mutants abolishes fimbriae expression as well.

Conclusions
These results are expected to provide insight into the interaction between capsule biosynthesis, biofilm formation, and fimbriae expression in this organism.
A preliminary investigation of anticholinesterase activity of some Iranian medicinal plants commonly used in traditional medicine
Authors: Jazayeri Seyed Behzad , Amanlou Arash , Ghanadian Naghmeh , Pasalar Parvin , Amanlou Massoud 
Published: January 2014

Abstract

Background
The aim of this study was to evaluate acetylcholinesterase inhibitory activity of some commonly used herbal medicine in Iran to introduce a new source for management of Alzheimer’s disease. A total of 18 aqueous-methanolic extract (1:1; v/v) from the following plants: Brassica alba, Brassica nigra, Camellia sinensis, Cinchona officinalis, Citrus aurantifolia, Citrus x aurantium, Ferula assafoetida, Humulus lupulus, Juglans regia, Juniperus sabina, Myristica fragrans, Pelargonium graveolens, Pistacia vera, Punica granatum, Rheum officinale, Rosa damascena, Salix alba, and Zizyphus vulgaris were prepared and screened for their acetylcholinesterase inhibitory activity using in vitro Ellman spectrophotometric method.

Results
According to the obtained results, the order of inhibitory activity (IC50 values, μg /ml) of extracts from highest to the lowest was: C. sinensis (5.96), C. aurantifolia (19.57), Z. vulgaris (24.37), B. nigra (84.30) and R. damascena (93.1).

Conclusions
The results indicated and confirmed the traditional use of these herbs for management of central nervous system disorders. C. sinensis showed the highest activity in inhibition of acetylcholinesterase. However, further investigations on identification of active components in the extracts are needed.
Noise annoyance through railway traffic - a case study
Authors: Trombetta Zannin Paulo Henrique , Bunn Fernando 
Published: January 2014

Abstract
This paper describes an assessment of noise caused by railway traffic in a large Latin American city. Measurements were taken of noise levels generated by trains passing through residential neighborhoods with and without blowing their horns. Noise maps were also calculated showing noise pollution generated by the train traffic. In addition - annoyance of the residents - affected by railway noise, was evaluated based on interviews. The measurements indicated that the noise levels generated by the passage of the train with its horn blowing are extremely high, clearly exceeding the daytime limits of equivalent sound pressure level - Leq = 55 dB(A) - established by the municipal laws No 10.625 of the city of Curitiba. The Leq = 45 dB (A) which is the limit for the night period also are exceeded during the passage of trains. The residents reported feeling affected by the noise generated by passing trains, which causes irritability, headaches, poor concentration and insomnia, and 88% of them claimed that nocturnal noise pollution is the most distressing. This study showed that the vast majority of residents surveyed, (69%) believe that the noise of the train can devalue their property.
Patients with rheumatoid arthritis in clinical remission and ultrasound-defined active synovitis exhibit higher disease activity and increased serum levels of angiogenic biomarkers
Authors: Ramírez Julio , Ruíz-Esquide Virginia , Pomés Isaac , Celis Raquel , Cuervo Andrea , Hernández Mª Victoria , Pomés Jaume , Pablos José L , Sanmartí Raimon , Cañete Juan D 
Published: January 2014

Abstract
Introduction
The aim of this study was to identify and characterize subclinical synovitis in patients with rheumatoid arthritis (RA) in clinical remission using power Doppler ultrasound (PDUS) and serum levels of biomarkers of inflammation and/or angiogenesis.

Methods
We selected patients with RA in clinical remission defined as a Disease activity score of 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) <2.6 for more than six months tested by two independent rheumatologists. Clinical, epidemiological, demographic and serological data were analyzed. PDUS of knees and hands was performed by a sonographer. Synovial hypertrophy (SH) and PDUS signal were scored (grades 0 to 3). SH ≥2 and a PDUS signal was classified as active synovitis. Serum levels of biomarkers of inflammation/angiogenesis were determined by Quantibody® Human Array.

Results
This study included 55 patients, of whom 25 (45.4%) met criteria for ultrasound-defined active synovitis. Patients with active synovitis had higher DAS28-C reactive protein (P = 0.023), DAS28-ESR (P = 0.06), simplified disease activity score, SDAI (P = 0.064), and only 12% were taking oral glucocorticoids (≤5 mg/day) compared with 40% of patients without active synovitis (P = 0.044). Patients with synovitis also had significantly higher serum levels of the angiogenic biomarkers angiopoietin-2 (P = 0.038), vascular endothelial growth factor-D (P = 0.018), placental growth factor (P = 0.043), stromal cell-derived factor-1 (P = 0.035), matrix metallopeptidase-2 (P = 0.027) and basic fibroblast growth factor (bFGF) (P = 0.007), but not of pro-inflammatory cytokines.
In the multivariate logistic regression model used to explore prognostic biomarkers for active synovitis, serum levels of bFGF, DAS28-ESR and not receiving glucocorticoids were the best predictors of active synovitis. The predictive indexes provided by the model were specificity 73.3%, sensitivity 72%, and area under the curve in receiver operating characteristic 81.5% (95% CI: 70.1% to 92.8%).

Conclusions
Nearly half of the patients with RA in clinical remission had ultrasound-defined active synovitis, higher disease activity and less frequent oral glucocorticoid consumption than patients without active synovitis. This clinical situation was associated with a specific biological profile characterized by an excess of angiogenic mediators rather than persistent proinflammatory cytokine responses.
Definition and Measurement of Follicle Stimulating Hormone
Authors: Rose Matthew P. , Gaines Das Rose E. , Balen Adam H. 
Published: January 2014

AbstractFSH has a key role in the development and function of the reproductive system and is widely used both diagnostically and therapeutically in developmental and reproductive medicine. The accurate measurement of FSH levels, in patients for diagnosis and monitoring and in therapeutic preparations for clinical use, is essential for safe and successful treatment. Historically, FSH was defined on the basis of classical in vivo endocrine activity, and early therapeutic preparations were calibrated using in vivo bioassays. There was early recognition that reference preparations were required for calibration if the results from different laboratories were to be comparable. In response to the perceived need, the World Health Organization established the first standard for such preparations in 1959. Subsequent developments in biotechnology have led to recognition that there is no single molecule that can be uniquely defined as FSH, and that FSH can induce a range of biological activities. Several highly purified standards for FSH are now available, but discontinuity and heterogeneity of estimates of FSH activity in terms of these standards made using in vitro assays and binding assays have been noted. It is thus essential that any measurement of FSH include specification both of the standard with which the measured FSH is compared and the assay method used for that comparison.
Management of Graves’ Ophthalmopathy: Reality and Perspectives*
Authors: Bartalena Luigi , Pinchera Aldo , Marcocci Claudio 
Published: January 2014

AbstractGraves’ ophthalmopathy is an debilitating disease impairing the quality of life of affected individuals. Despite recent progress in the understanding of its pathogenesis, treatment is often not satisfactory. In mild cases, local therapeutic measures (artificial tears and ointments, sunglasses, nocturnal taping of the eyes, prisms) can control symptoms and signs. In severe forms of the disease (3–5%), aggressive measures are required. If the disease is active, high-dose glucocorticoids and/or orbital radiotherapy, or orbital decompression represent the mainstay of treatment. If the disease is severe but inactive, orbital decompression is preferred. Novel treatments such as somatostatin analogs or intravenous immunoglobulins are under evaluation. Rehabilitative (extraocular muscle or eyelid) surgery is often needed after treatment and inactivation of eye disease. Correction of both hyper- and hypothyroidism is crucial for the ophthalmopathy. Antithyroid drugs and thyroidectomy do not influence the course of the ophthalmopathy, whereas radioiodine treatment may cause the progression of preexisting ophthalmopathy, especially in smokers. The exacerbation, however, is prevented by glucocorticoids. In addition, thyroid ablation may prove beneficial for the ophthalmopathy in view of the pathogenetic model relating eye disease to autoimmune reactions directed against antigens shared by the thyroid and the orbit.