bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Effect of Diacetyl Morphine on Salivary Factors and their Changes after Methadone Therapy
Authors: Akbari Majid , Afshari Reza , Sharifi Mahsa , Hashemy Seyed Isaac , Majidinia Sara , Tousi Naser Karimian 
Published: March 2015

ABSTRACT

Objectives
Psychoactive drugs are responsible for pathological changes in the mouth including dental caries, which most troublesome. The aim of the present study was to evaluate the effect of heroin on several salivary factors which are involved in the oral health and their changes after methadone maintenance therapy (MMT).

Materials and methods
Forty patients with heroin abuse history, who referred to Imam Reza Hospital for MMT were included.
Saliva sampling was carried out two times; at the first visit (time 1) and repeated 1 month after MMT (time 2). The saliva was analyzed immediately to evaluate the total volume, Ph, CPR, the Uric acid concentration, nitric oxide and antioxidant capacity.

Results
The mean values for saliva volume, pH, CRP, Uric acid, antioxidant and nitric oxide were 0.38 ± 0.14, 7.63 ± 1.22, 5.2 ± 2.3, 1.47 ± 0.8, 0.80 ± 0.23, and 0.26 ± 0.03, respectively at first visit and 0.34 ± 0.22, 7.37 ± 1.01, 6.1 ± 2.6, 2.18 ± 0.9, 0.74 ± 0.3 and 0.29 ± 0.08 after 1 month of MMT.
These values are below the normal ranges; however, there was no significant difference between two times in term of saliva volume, pH and saliva component (p > 0.05).

Conclusion
Heroin addiction changed the effective salivary factors and therefore could negatively contribute to oral health. These factors were not return to the normal range after 1 month of MMT. Physicians should be informed about focusing on oral health in patients under MMT.

Clinical significance
Heroin addiction changed the effective salivary factors and these factors were not return to the normal range after 1 month of MMT.

How to cite this article
Akbari M, Afshari R, Sharifi M, Hashemy SI, Majidinia S, Tousi NK. Evaluation of the Effect of Diacetyl Morphine on Salivary Factors and their Changes after Methadone Therapy. J Contemp Dent Pract 2014;15(6):730-734.
Analysis of the Proliferative Potential of Odontogenic Epithelial Cells of Pericoronal Follicles
Authors: Cimadon Natalia , Lauxen Isabel Silva , Carrard Vinicius Coelho , Filho Manoel Sant'Ana , Rados Pantelis Varvaki , Oliveira Márcia Gaiger 
Published: March 2015

ABSTRACT

Aim
To evaluate the proliferative potential and the cell proliferation rate of odontogenic epithelial cells.

Materials and methods
Forty-two cases of pericoronal follicles of impacted third molars were submitted to silver impregnation technique for quantification of argyrophilic nucleolar organizer regions (AgNOR) and immunohistochemical staining for EGFR and Ki-67. For AgNOR quantification, the mean number of active nucleolar organizer regions per nucleus (mAgNOR) and the percentage of cells with 1, 2, 3 and 4 or more AgNORs per nucleus (pAgNOR) were quantified. Ki-67 immunolabeling was quantified, whereas for EGFR, a descriptive analysis of staining patterns (membrane, cytoplasm or membrane + cytoplasm positivity) was performed. We evaluated the reduced epithelium of the enamel organ and/or islands of odontogenic epithelium present in the entire connective tissue.

Results
mAgNOR were 1.43 (1.0-2.42) and were significantly different among pericoronary follicles from upper and lower teeth (p = 0.041). Immunostaining of Ki-67 was negative in all cases. EGFR immunolabeling was found mainly in the cytoplasm and was more intense in islands and cords when compared to reduced epithelium of the enamel organ.

Conclusion
Odontogenic epithelial cells of some pericoronal follicles have proliferative potential, suggesting their association with the development of odontogenic lesions.

Clinical significance
The authors suggest that nonerupted, especially of the lower teeth, should be monitored and if necessary removed.

How to cite this article
Cimadon N, Lauxen IS, Carrard VC, Filho MSA, Rados PV, Oliveira MG. Analysis of the Proliferative Potential of Odontogenic Epithelial Cells of Pericoronal Follicles. J Contemp Dent Pract 2014;15(6):761-765.
Oliphant, T., & McNally, M. (2014). Professional Decline and Resistance: The Case of Library and Archives Canada. Radical Teacher, 99, 54-61. doi:10.5195/rt.2014.105
Authors: Editor Managing 
Published: March 2015

Correction to “Professional Decline and Resistance: The Case of Library and Archives Canada” by Tami Oliphant and Michael McNally, published in Radical Teacher 99.
Effect of Interferon α2a in Cystoid Macular Edema due to Intraocular Infection
Authors: Qian Zhuyun , Fardeau Christine , Cardoso Joao Nobre , Jellab Badr , Fan Xianqun , LeHoang Phuc 
Published: March 2015

Purpose Cystoid macular edema (CME) is a severe complication and a major cause of visual loss in patients with intraocular infection. In this type of CME, therapeutic strategies remain controversial. We aimed to investigate the efficacy and tolerability of interferon (IFN)-α2a in cystoid macular edema caused by intraocular infection. Methods In this retrospective, noncomparative, interventional case series, 5 patients (6 eyes) who were diagnosed with intraocular infection with chronic CME were included. Interferon-α2a (3 million units 3 times a week) was administered subcutaneously. Clinical observations were recorded before and after treatment. Results The average duration of CME before treatment with IFN-α was 26 months. According to the preset criteria, IFN-α2a therapy was shown to be effective in 2 patients (3 eyes), effective dose-dependent in 2 patients, and partly effective in 1 patient, and was well-tolerated in 4 patients. The most common side effect was flu-like symptoms. Conclusions Interferon α-2a may be an effective alternative treatment for CME due to intraocular infection that is resistant to other treatment. Studies with larger sample sizes are required to confirm this conclusion.
The Intracavitary ECG Method for Insertion of a Tunneled Dialysis Catheter without using Fluoroscopy
Authors: Cho Seong , Lee Yu-Ji , Kim Sung-Rok 
Published: March 2015

Purpose Recently, there have been many reports that exact central vein catheter tip positioning was possible using intracardiac electrocardiographic (ECG) monitoring. Ultrasonic guidance in combination with intracardiac ECG monitoring may allow for a tunneled dialysis catheter to be inserted at the bedside without using fluoroscopy. Therefore we report on the intracavitary ECG method for insertion of a tunneled dialysis catheter with ultrasound guidance and the feasibility, safety, effectiveness, complications and limitations of this method. Methods From April 2012 to June 2014, we evaluated 142 hemodialysis (HD) patients who were dialyzed by a tunneled dialysis catheter that was inserted using intracardiac ECG monitoring without fluoroscopic usage. We checked the intracardiac P wave and the point at which it gradually rose to the highest P wave morphology, we stopped inserting the catheter. Results Catheter flow during dialysis was adequate in 139 cases. There were three cases where it malfunctioned. Catheter malposition occurred in 6 out of 142 cases. The correct matching rate between the intracardiac ECG and chest posteroanterior (PA) view was 98.5%. No significant complications developed. Conclusions To conclude, in this single-center study, the intracavitary ECG method for assessing the position of the tip of tunneled dialysis catheter was proven to be safe and feasible in virtually all adult patients who had an evident P wave at the basal ECG tracking.
Minimally Invasive Video-assisted Thyroidectomy for Papillary Thyroid Cancer: A Prospective 5-year follow-up Study
Authors: Del Rio Paolo , Maestroni Umberto , Sianesi Mario , Viani Lorenzo , Vicente Diego , Stojadinovic Alexander , Avital Itzhak 
Published: March 2015

Background Minimally invasive video-assisted thyroidectomy (MIVAT) was initially introduced for the treatment of selected patients who met certain thyroid volume, nodule size and pathological criteria. Recent studies indicate that the completeness of resection of malignant nodules is comparable to that obtained with conventional thyroidectomy. Aims To compare the 5-year outcomes in patients with papillary thyroid carcinoma (PTC) treated with MIVAT versus conventional thyroidectomy. Methods In this prospective cohort study conducted over 2 years (July 2005–June 2007), 172 patients with node-negative, nonmetastatic PTC underwent either MIVAT (n = 67) or conventional thyroidectomy (n = 105). Study outcomes were 1) the cumulative dose of radioactive iodine (RAI) to achieve a disease-free state, defined as a stimulated serum thyroglobulin (Tg) level <2 ng/mL with negative Tg antibody and no tumor on a whole-body scan or cross-sectional imaging, and 2) the 5-year serum Tg level. Results The clinical parameters of the MIVAT and conventional thyroidectomy groups were comparable except for age (mean 43 ± 12 vs. 59 ± 17 years, respectively; p = 0.03) and operative time (mean 69 ± 24 vs. 53 ± 16 minutes, p = 0.02); the mean tumor size was similar between groups (1.3 ± 0.7 vs. 1.6 ± 0.9 cm, p = 0.14). Surgical morbidity was similar in both groups. Median follow-up was 5 years. RAI dose (mean 72 ± 38 vs. 96 ± 47 mCu, p = 0.34) and serum Tg at 5 years (mean 0.3 ± 0.2 vs. 0.5 ± 0.3 ng/mL, p = 0.30) were not significantly different between the MIVAT and conventional thyroidectomy groups. Conclusions MIVAT can be safely utilized in patients with localized PTC, providing comparable completeness of resection and oncological outcome to conventional thyroidectomy.
Management of Patients with Recurrent Glioblastoma using Hypofractionated Stereotactic Radiotherapy
Authors: Dincoglan Ferrat , Beyzadeoglu Murat , Sager Omer , Demiral Selcuk , Gamsiz Hakan , Uysal Bora , Ebruli Cuneyt , Akin Mustafa , Oysul Kaan , Sirin Sait , Dirican Bahar 
Published: March 2015

Background Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. The chance of cure is very limited due to treatment-refractory disease course with frequent recurrences despite aggressive multimodality management. In this retrospective study, we evaluated treatment outcomes of hypofractionated stereotactic radiotherapy (HFSRT) in the management of recurrent GBM and report our single-center experience. Methods Twenty-eight patients receiving HFSRT for recurrent GBM between September 2008 and February 2014 were retrospectively assessed. Total radiotherapy dose was 25 Gy delivered in 5 fractions over 5 consecutive days for all patients. High-precision, image-guided volumetric modulated arc therapy was delivered with a linear accelerator using 6-MV photons using the frameless technique. Analyzed prognostic factors were age, gender, Karnofsky performance status (KPS), tumor location, planning target volume (PTV) size, overall survival (OS), progression-free survival (PFS), time interval between completion of treatment with Stupp protocol at primary diagnosis and recurrence. Results Median follow-up time was 42 months (range 2–68). Median time interval between primary chemoradiotherapy and HFSRT was 11.2 months (range 4–57.9). Median OS and PFS calculated from reirradiation was 10.3 months and 5.8 months, respectively. Longer interval between initial treatment and recurrence (p = 0.01), smaller PTV size (p = 0.001), KPS ≥70 (p = 0.005) and younger age (p = 0.004) were associated with longer OS on statistical analysis. Conclusion HFSRT offers a feasible and effective salvage treatment option for recurrent GBM management. Prognostic factors associated with longer OS in our study were longer interval between initial treatment and recurrence, smaller PTV size, KPS ≥70 and younger age.
Identité et sentiment d’appartenance chez les jeunes anglophones de Montréal
Authors: Gérin-Lajoie Diane 
Published: March 2015

Résultat d’une construction sociale, l’identité ne peut être considérée comme linéaire et figée. Elle représente plutôt un phénomène fluide, fortement influencé par des pratiques sociales imbriquées dans des rapports de pouvoir précis. Ce phénomène est d’autant plus vrai dans le cas des minorités linguistiques que celles-ci sont amenées à vivre à la frontière de deux langues et de deux cultures – et parfois même de trois dans le cas de minorités ethniques. Les résultats de notre analyse sont tirés d’une étude ethnographique effectuée en milieu scolaire anglophone dans la région de Montréal. Au terme de trois années de terrain, nous avons fait trois constatations : qu’une identité bilingue ou trilingue était présente chez ces jeunes, que diverses représentations de la communauté anglophone et de l’appartenance de groupe coexistaient, et enfin que les jeunes participants ont dit ne pas se sentir intégrés à la majorité francophone de la province, même si leur discours ne démontre aucunement qu’ils éprouvent un sentiment de minorisation dans leurs rapports avec le groupe majoritaire.
La scène musicale anglo-québécoise : institutionnalisation, mutations et représentations
Authors: Robineau Anne 
Published: March 2015

Cet article interroge le lien entre la plus grande reconnaissance attribuée à une partie de la scène musicale anglo-québécoise et le développement d’institutions et d’organismes artistiques et culturels anglophones au Québec. Certaines représentations sociales quant au mythe des deux solitudes tendent à se reproduire dans le monde des arts, mais à se transformer aussi dans le cas de coproductions franco et anglo-québécoises qui attirent un public nouveau, encore mal circonscrit, un public bilingue et principalement montréalais. Nous abordons ce sujet en traitant de l’identité anglo-québécoise et de son rapport à la culture, en décrivant plusieurs aspects de l’institutionnalisation et de la professionnalisation des artistes anglophones du Québec depuis les années 1960, puis en tentant d’identifier les mutations récentes de la scène musicale anglo-montréalaise en abordant la question de la relève et de la diversité culturelle.
What are the constraints and opportunities for HIVST scale‐up in Africa? Evidence from Kenya, Malawi and South Africa
Authors: van Rooyen Heidi , Tulloch Olivia , Mukoma Wanjiru , Makusha Tawanda , Chepuka Lignet , Knight Lucia C , Peck Roger B , Lim Jeanette M , Muturi Nelly , Chirwa Ellen , Taegtmeyer Miriam 
Published: March 2015

IntroductionHIV self‐testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub‐Saharan Africa and is on the brink of scale‐up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country‐preparedness for scale‐up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub‐Saharan countries.MethodsFifty‐four key informant interviews were conducted in Kenya (n=16), Malawi (n=26) and South Africa (n=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter‐country analysis to identify common and divergent themes across contexts.ResultsRespondents welcomed the idea of an accurate, easy‐to‐use, rapid HIV self‐test which could increase testing across all populations. High‐risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community‐based distribution points. HIVST is already endorsed in Kenya, and political support for scale‐up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context‐specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self‐testing.ConclusionsStakeholders in three HIV endemic sub‐Saharan countries felt that HIVST will be an important complement to existing community and facility‐based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale‐up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance.
Do Doppler Studies Enhance Surveillance of Uncomplicated Monochorionic Diamniotic Twins?
Authors: Pessel Cara , Merriam Audrey , Vani Kavita , Brubaker Sara G. , Zork Noelia , Zhang Yuan , Simpson Lynn L. , Gyamfi-Bannerman Cynthia , Miller Russell 
Published: March 2015

ObjectivesTo determine whether isolated abnormal Doppler indices before 28 weeks predict adverse pregnancy outcomes in uncomplicated monochorionic diamniotic (MCDA) twins.MethodsA retrospective cohort study of MCDA twin pregnancies receiving antenatal testing at a single center between 2007 and 2013 was conducted. Sonographic surveillance, including Doppler velocimetric studies of the umbilical artery, ductus venosus, and middle cerebral artery of each twin, was initiated by 28 weeks and repeated at least every 2 weeks. All pregnancies were deemed “uncomplicated” at initial sonography, without evidence of polyhydramnios, oligohydramnios, intrauterine growth restriction, twin growth discordance of at least 20%, structural or chromosomal anomalies, or unclear chorionicity. Pregnancies were divided into 2 groups: those with isolated Doppler abnormalities before 28 weeks and those with normal Doppler indices. The primary outcome was a composite including twin‐twin transfusion syndrome, intrauterine growth restriction of more than 1 twin, growth discordance of at least 20%, preterm delivery before 34 weeks for fetal indications, or demise of more than 1 fetus.ResultsNinety‐six patients were included, with 22 (22.9%) having isolated Doppler abnormalities before 28 weeks. The incidence of the primary outcome did not differ between groups (36.4% versus 28.4%; P = .47). The abnormal Doppler group underwent a greater number of sonographic examinations (15 versus 10; P= .001) and more antenatal admissions for fetal concerns (50.0% versus 12.2%; P < .001).ConclusionsIsolated Doppler abnormalities are commonly encountered in uncomplicated MCDA pregnancies before 28 weeks yet are not clearly predictive of twin‐specific complications. Doppler abnormalities were associated with increased sonographic surveillance and antenatal hospitalizations, suggesting an influence on physician practice patterns. Data may not support Doppler studies before 28 weeks for routine MCDA twin monitoring.
A review of the clinical utility of serum clozapine and norclozapine levels
Authors: Ellison Justin C. , Dufresne Robert L. 
Published: March 2015

Abstract
Treatment refractory schizophrenia is a serious issue affecting at least 30% of all patients with schizophrenia despite the continued emergence of new agents aimed at treating this disease. Clozapine therapy remains the most efficacious treatment for patients with schizophrenia who have failed two prior antipsychotics or those deemed an imminent harm to themselves or others. Because data are lacking on how to proceed if a patient should prove nonresponsive to clozapine therapy, the utmost care should be taken to ensure the optimization of clozapine. Therapeutic drug monitoring (TDM) is used with many other psychoactive agents to ensure the optimal therapeutic efficacy while minimizing adverse effects. The unique pharmacology of clozapine and the inter- and intraindividual variations in its pharmacokinetics make it a difficult agent with which to use TDM. The consensus is that 350 ng/mL is the lower threshold of therapeutic efficacy to define an adequate trial of clozapine. As of this writing, no clearly defined threshold exists for the upper limit of therapeutic efficacy or toxicity. TDM of clozapine can be useful in the following circumstances: when a clozapine-induced central nervous system toxicity is suspected, a medication that can inhibit or induce the metabolism of clozapine is being added or withdrawn, a change in smoking status has occurred, concerns for medication nonadherence are present, or decompensation while on a previously effective clozapine dosage is observed. The psychiatric pharmacist may play a crucial role in the interpretation and effective utilization of serum clozapine and norclozapine levels. This review will examine the current evidence for the clinical utility of monitoring serum levels of clozapine and its metabolites.
Clozapine-induced myocarditis may warrant cardiac monitoring protocol
Authors: Miller Lacey J. , Grande Rachel E. 
Published: March 2015

Abstract

Background
Myocarditis, or inflammation of the heart muscle, is a black box warning associated with the use of clozapine. Although the incidence of clozapine-induced myocarditis is only 0.015% to 1.2%, recent retrospective studies have found that up to 66% of clozapine patients develop nonspecific symptoms consistent with myocarditis. Because of the difficulty in distinguishing these symptoms (including fever, tachycardia, and fatigue) from clozapine dose titration, myocarditis may be difficult to recognize. If left undetected, the condition could be fatal.

Patient Case
A 25-year-old Filipino male with a history of schizoaffective disorder, bipolar type, continued to endorse persistent and distressing command auditory and visual hallucinations despite therapy with olanzapine, 40 mg daily. Clozapine was initiated for refractory psychosis and titrated up to 125 mg over 17 days. On day 14, the patient reported “feeling sick,” having chills, a nonproductive cough, and fatigue; he was febrile and tachycardic. Abnormal laboratory values included elevated troponin-1, C-reactive protein (CRP), and creatinine phosphokinase (CPK). The last dose of clozapine was administered on day 17 with resolution of the above-mentioned signs and symptoms within 3 days.

Discussion
A literature search revealed several cases demonstrating a strong association between clozapine and myocarditis. Despite suggestions from case reports for cardiac monitoring at baseline, there are no universal monitoring guidelines.

Conclusion
As a result of this patient case of clozapine-induced myocarditis, the Veterans Affairs Palo Alto Health Care System Clozapine Tracking Team developed a cardiac monitoring protocol for veterans being initiated on clozapine.