bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enzogenol for cognitive functioning in traumatic brain injury: a pilot placebo‐controlled RCT
Authors: Theadom A. , Mahon S. , Barker‐Collo S. , McPherson K. , Rush E. , Vandal A. C. , Feigin V. L. 
Published: February 2013

Background and purposeEnzogenol, a flavonoid‐rich extract from Pinus radiata bark with antioxidant and anti‐inflammatory properties has been shown to improve working memory in healthy adults. In traumatic brain injury (TBI), oxidation and inflammation have been linked to poorer cognitive outcomes. Hence, this phase II, randomized controlled trial investigated safety, compliance and efficacy of Enzogenol for improving cognitive functioning in people following mild TBI.MethodsSixty adults, who sustained a mild TBI, 3–12 months prior to recruitment, and who were experiencing persistent cognitive difficulties [Cognitive Failures Questionnaire (CFQ) score > 38], were randomized to receive Enzogenol (1000 mg/day) or matching placebo for 6 weeks. Subsequently, all participants received Enzogenol for a further 6 weeks, followed by placebo for 4 weeks. Compliance, side‐effects, cognitive failures, working and episodic memory, post‐concussive symptoms and mood were assessed at baseline, 6, 12 and 16 weeks. Simultaneous estimation of treatment effect and breakpoint was effected, with confidence intervals (CIs) obtained through a treatment–placebo balance‐preserving bootstrap procedure.ResultsEnzogenol was found to be safe and well tolerated. Trend and breakpoint analyses showed a significant reduction in cognitive failures after 6 weeks [mean CFQ score, 95% CI, Enzogenol versus placebo −6.9 (−10.8 to −4.1)]. Improvements in the frequency of self‐reported cognitive failures were estimated to continue until week 11 before stabilizing. Other outcome measures showed some positive trends but no significant treatment effects.ConclusionsEnzogenol supplementation is safe and well tolerated in people after mild TBI, and may improve cognitive functioning in this patient population. This study provides Class IIB evidence that Enzogenol is well tolerated and may reduce self‐perceived cognitive failures in patients 3–12 months post‐mild TBI.
Arteriovenous fistula for the 80 years and older patients on hemodialysis: Is it worth it?
Authors: Nadeau‐Fredette Annie‐Claire , Goupil Rémi , Montreuil Bernard , Carignan Annie , Leblanc Martine 
Published: February 2013

AbstractOver the last years, the proportion of patients older than 80 years with end‐stage renal disease has been constantly growing. Arteriovenous fistula (AVF) is known as the best vascular access for hemodialysis, but evidence for its added value is lacking for elderly. We retrospectively identified new vascular access (AVF and central venous catheter) created or installed between June 2005 and June 2008 in patients 80 years and older and in patients between 50 and 60 years. For every new AVF, we calculated primary failure, primary and secondary patency durations. Fifty‐five and 57 patients had a new vascular access in the >80 years old and 50 to 60 years old groups. Among these, 25 and 41 were new AVF in the older and younger groups. Primary failure was more frequent in elderly than in the younger (40% vs. 17%, P = 0.04). Primary patency was not significantly different in both groups (P = 0.06). Secondary patency was shorter in elderly (P = 0.005). Among the older group, the presence of an AVF was not associated with a difference in mortality (46% vs. 60%, P = 0.28), whereas there was a lower mortality in the younger group with AVF (12% vs. 43% P = 0.008). These results indicate lower patency duration in very elderly patients compared to middle‐aged patients. Without leading to the exclusion of patients over 80 years old for AVF creation, it might reinforce the need of a careful selection and evaluation in this population prior to referral.
Histomorphological factors in the risk prediction of lymph node metastasis in papillary thyroid carcinoma
Authors: Chung Yun J , Lee Jae S , Park So Y , Park Hyo J , Cho Bo Y , Park Sung J , Lee Sei Y , Kang Kyung‐Ho , Ryu Han S 
Published: February 2013

AimsFew clinicopathological parameters have been identified as independent predictive factors for lymph node metastasis. This study evaluated the predictive ability of three histological characteristics of PTC in lymph node metastases: hobnail features, loss of cohesiveness/polarity (LOCP) and micropapillary structures.Methods and resultsTissue specimens from 153 patients with histologically confirmed PTC including 112 cases of papillary thyroid microcarcinoma (PTMC) were enrolled in this study. Three histological characteristics (hobnail features, LOCP and micropapillary structures) and several clinicopathological parameters were evaluated for their value in predicting lymph node metastasis. Hobnail features, LOCP and micropapillary structures were each significantly associated with and found to be independent predictive factors for lymph node metastasis (P < 0.05). These three histological characteristics were closely correlated with one another (P < 0.001). Six of the seven possible combinations of these three histological characteristics were independently correlated with lymph node metastasis (P < 0.05). Among these combinations, the coincidence of all three histological parameters represented the strongest independent predictive factor for lymph node metastasis (OR: 3.270, P = 0.006).ConclusionsOur study demonstrates that hobnail features, LOCP and micropapillary structures, either alone or in combinations, represent strong independent predictive factors for lymph node metastasis in PTC.
Butterflies in semi‐natural pastures and power‐line corridors – effects of flower richness, management, and structural vegetation characteristics
Authors: Berg Åke , Ahrné Karin , Öckinger Erik , Svensson Roger , Wissman Jörgen 
Published: February 2013

Abstract

The aim of this study was to compare the butterfly assemblages in semi‐natural pastures and power‐line corridors and to analyse the effects of vegetation height, occurrence of trees and shrubs and different flowering vascular plant groups on butterfly diversity and abundance.

Twelve of 26 analysed butterfly species were more abundant in power‐line corridors than in semi‐natural pastures. Only one species preferred semi‐natural pastures.

In semi‐natural pastures butterflies were most common in segments with tall vegetation, whereas butterflies in power‐line corridors were most common in segments with vegetation of short or intermediate height. Short vegetation was sparser in power‐line corridors (mean cover 4%) than in semi‐natural pastures (33%), whereas tall vegetation was more common in power‐line corridors (59%) than in semi‐natural pastures (35%).

The amount of flowers was the factor that affected the abundance of most species. Twenty‐one of the 26 species showed positive associations with numbers of flowers of different families.

Flowers of the plant families Apiaceae, Caryophyllaceae, Primulaceae, Rubiaceae, Scrophulariaceae, and Violaceae showed positive associations with the abundance of several butterfly species.

Vegetation height seems to be a limiting factor in semi‐natural pastures, and less intensive management (division of pastures into grazing pens, late season grazing, grazing every second year, or reduced grazing pressure) would benefit butterflies. In power‐line corridors (dominated by tall vegetation) the opposite would be beneficial for butterflies, for example more frequent clearing of vegetation along the power‐line trails combined with mowing of selected areas.
Iatrogenic splenectomy during nephrectomy for renal tumors
Authors: Wang Jeffrey K , Tollefson Matthew K , Kim Simon P , Boorjian Stephen A , Leibovich Bradley C , Lohse Christine M , Cheville John C , Thompson R Houston 
Published: February 2013

ObjectivesTo evaluate risk factors associated with iatrogenic splenectomy during nephrectomy and to assess outcomes among patients undergoing nephrectomy for renal tumors.MethodsOf 4323 patients who underwent nephrectomy at Mayo Clinic between 1992 and 2008, 33 (0.8%) had an iatrogenic/unplanned splenectomy. In a case–control study design, controls without splenectomy were matched 1:3 based on age, sex, surgical date, side of the renal tumor, surgical approach and surgeon. Perioperative features and survival were evaluated using conditional logistic and Cox regression.ResultsAmong the 33 iatrogenic splenectomy patients, the majority (94%) underwent radical, open and left‐sided nephrectomy. Primary tumor classification ≥T3 was the only clinicopathological risk factor significantly associated with splenectomy (odds ratio 3.4; P = 0.02). Compared with controls, patients with an iatrogenic splenectomy were more likely to have longer operative time (205 vs 171 min; P = 0.02), higher estimated blood loss (1.3 vs 0.3 L; P = 0.001), longer length of stay (median 7 vs 5 days; P = 0.03) and a higher likelihood for postoperative complications (odds ratio 5.3; P = 0.002). With a median of 9.8 years of follow up, splenectomy patients tended to have greater all‐cause mortality (hazard ratio 1.6; P = 0.07), although this difference approached statistical significance.ConclusionsIatrogenic splenectomy is a rare complication during nephrectomy and is associated with locally advanced tumors (≥pT3). It also carries prognostic significance for adverse perioperative outcomes and possibly diminished survival, although this warrants further study.
Effects of long‐term ketamine administration on rat bladder protein levels: A proteomic investigation using two‐dimensional difference gel electrophoresis system
Authors: Gu Di , Huang Jun , Shan Zhengfei , Yin Youle , Zheng Shaobin , Wu Peng 
Published: February 2013

ObjectivesLong‐term ketamine abuse can affect the urinary system, resulting in interstitial cystitis‐like syndrome. However, its pathogenesis remains unclear. In the present study, a proteomic approach of two‐dimensional difference gel electrophoresis followed by matrix‐assisted laser desorption/ionization time‐of‐light mass spectrometry was carried out to investigate the potential disease‐associated proteins in a rat model of ketamine‐associated cystitis.MethodsRats were randomly assigned to control, normal saline, low dose of ketamine (10 mg/kg) and high‐dose of ketamine (50 mg/kg) groups with six rats in each group. The two experimental groups were given ketamine hydrochloride i.p. daily, whereas the normal saline group rats were treated with saline. After 16 weeks of treatment, all bladders were excised, and samples from normal saline and high dose of ketamine groups were resolved in two‐dimensional difference gel electrophoresis. Differentially expressed spots were excised and identified by matrix‐assisted laser desorption/ionization time‐of‐light mass spectrometry. Phosphoprotein and non‐phosphoprotein purification, histopathology, immunohistochemistry, and western blot were carried out in all groups.ResultsHistological study showed hyperplastic epithelium and inflammatory cells infiltration in the high dose of ketamine‐treated rat bladders. Two‐dimensional difference gel electrophoresis revealed 30 altered expressions between the normal saline and high dose of ketamine‐treated group. Among these proteins, two upregulated and two downregulated protein spots were all identified as smooth muscle protein‐22/transgelin. Immunohistochemical staining and western blot analysis showed that the expression of total transgelin had no significant difference between groups. However, the expression of phosphorylated transgelin in the low‐dose and high dose of ketamine groups was increased, whereas the non‐phosphorylated transgelin was decreased when compared with the normal saline group.ConclusionsLong‐term ketamine abuse induces phosphorylation of transgelin in the bladder wall, and this might play an important role in the pathogenesis of ketamine‐associated cystitis.
Signet‐ring cell change in adenoid cystic carcinoma: a clinicopathological and immunohistochemical study of four cases
Authors: Altemani Albina , Costa Ana Flávia , Montalli Victor Angelo M , Mosqueda‐Taylor Adalberto , Paes de Almeida Oslei , León Jorge E , Hermsen Mario 
Published: February 2013

AimsSignet‐ring cell (SRC) change has not been reported in adenoid cystic carcinoma (ACC). The aim of this study was to describe the clinicopathological and immunohistochemical findings in four cases of ACC with SRCs (ACC‐SRC), in which the relative proportion of the SRC component ranged from 25% to 50%.Methods and resultsThe median age was 58 years (range: 48–81 years), and all patients were women. The involved sites were sinonasal, lip, and submandibular. Two patients developed lung metastasis, and one died of disease 63 months after tumour resection. Neither mucinous nor lipid substances were detected in the SRCs. These showed positive staining for AE1/AE3, cytokeratin 14, and epithelial membrane antigen, which highlighted the intracytoplasmic vacuole borders. The SRC nests were surrounded by myoepithelial cells positive for α‐smooth muscle actin and p63. The SRCs showed similar p53 positivity but lower Ki67 and mitotic indices than the conventional component. SRCs were c‐Myb‐negative. Ultrastructural examination revealed that the intracytoplasmic vacuoles were lumina lined by microvilli.ConclusionsACC‐SRC is a non‐mucin‐producing and non‐lipid‐producing phenomenon, possibly related to disturbed differentiation of ductal/luminal cells. This cellular modification in ACC apparently does not change the biological behaviour of the tumour, but it may cause significant diagnostic problems, particularly in incisional biopsies.
Associations among depression, anxiety and somatic symptoms in peri‐ and postmenopausal women
Authors: Terauchi Masakazu , Hiramitsu Shiro , Akiyoshi Mihoko , Owa Yoko , Kato Kiyoko , Obayashi Satoshi , Matsushima Eisuke , Kubota Toshiro 
Published: February 2013

AbstractAimThe aim of this study was to investigate the associations among depression, anxiety and physical symptoms in peri‐ and postmenopausal women in a clinical setting.Material and MethodsTwo hundred and thirty‐seven peri‐ and postmenopausal women enrolled in the Systematic Health and Nutrition Education Program at the Menopause Clinic of the Tokyo Medical and Dental University Hospital. Their responses to the Menopausal Health‐Related Quality of Life (MHR‐QOL) and Hospital Anxiety and Depression Scale (HADS) questionnaires were subjected to a cross‐sectional analysis. The study focused on the relationship between the scores for HADS depression (HADS‐D) and anxiety (HADS‐A) subscales and those for somatic (nausea, dizziness, numbness, muscle and joint pains, tiredness, headaches), urinary (frequent urination), and vasomotor symptoms (hot flashes, night sweats) in the MHR‐QOL questionnaire.ResultsThe correlations among the scores for the six somatic symptoms and HADS‐D and HADS‐A were stronger than those for urinary or vasomotor symptoms. Multiple logistic regression analysis revealed that the score for headaches and that for HADS‐A were significantly associated with severe depression after adjustment (odds ratio (OR) [95% confidence interval (CI)]: 1.49 [1.06–2.10] and 1.58 [1.37–1.83], respectively), whereas the scores for nausea and numbness, as well as HADS‐D, were significantly associated with severe anxiety (OR [95% CI]: 1.65 [1.15–2.39], 1.39 [1.05–1.84], and 1.36 [1.23–1.50], respectively).ConclusionHeadaches were associated with depression, whereas nausea and numbness were associated with anxiety in peri‐ and postmenopausal women. The assessment of underlying mood disorders is required for the management of middle‐aged women presenting with these somatic symptoms.
Pregnancy following ovarian induction in a patient with premature ovarian failure and undetectable serum anti‐Müllerian hormone
Authors: Tsuji Isao , Ami Kazumi , Fujinami Nahoko 
Published: February 2013

AbstractWe report the first case, to the best of our knowledge, of successful conception following ovarian induction in a patient with premature ovarian failure and undetectable serum anti‐Müllerian hormone. A 34‐year‐old woman was referred because of ovarian amenorrhea. After endogenous gonadotrophins were normalized by hormone‐replacement therapy and gonadotrophin‐releasing hormone agonist, ovarian induction was performed using exogenous gonadotrophins. On ovarian induction day 8, one follicle had reached a mean diameter of 19.6 mm, the serum estradiol level had increased to 516 pg/mL, and human chorionic gonadotrophin (HCG) was injected. On HCG injection day 7, ultrasonography was unable to detect the follicle, and serum progesterone levels had increased to 6.1 ng/mL. One month after HCG injection, ultrasonography detected an intrauterine fetus with beating heart. Even with serum anti‐Müllerian hormone levels below the threshold of detection, there is a chance for patients with premature ovarian failure.
Comparison of robot‐assisted laparoscopic myomectomy and traditional laparoscopic myomectomy
Authors: Hsiao Sheng‐Mou , Lin Ho‐Hsiung , Peng Fu‐Shaing , Jen Pei‐Jung , Hsiao Chin‐Fen , Tu Fung‐Chao 
Published: February 2013

AbstractAimThe benefit of robot‐assisted laparoscopic myomectomy (RALM) over traditional laparoscopic myomectomy (TLM) remains undetermined. The aim of this study was to reveal any potential advantage of RALM over TLM.Material and MethodsBetween June 2010 and October 2011, all women presenting with symptomatic uterine myomas were enrolled in this study. Perioperative variables were compared between these two groups. The patients recruited in this study were allocated into the two groups based on their financial considerations.ResultsA total of 42 patients received RALM (n = 20) or TLM (n = 22) for symptomatic uterine myomas. The operation time was longer in the RALM group; but the total abdominal drainage amount on postoperative day 1 was significantly less in the RALM group than the TLM group. Multivariate analysis revealed that the RALM procedure (coefficient = 79.1, P < 0.001), number of myomas (coefficient = 15.4, P = 0.002), and the presence of a cervical myoma (coefficient = 54.9, P = 0.01) were independent factors affecting operation time; the maximum myoma diameter was the only factor affecting blood loss (coefficient = 113.4, P = 0.003). However, the RALM procedure was the only factor affecting the amount of abdominal drainage on postoperative day 1 (coefficient = −86.3, P = 0.006).ConclusionsAlthough RALM is a longer operation than TLM, it might result in less postoperative abdominal drainage than TLM and help alleviate short‐term morbidity.
Single‐Center Experience With Extracorporeal Life Support in 103 Nonpostcardiotomy Patients
Authors: Schopka Simon , Philipp Alois , Lunz Dirk , Camboni Daniele , Zacher Raffaela , Rupprecht Leopold , Zimmermann Markus , Lubnow Matthias , Keyser Andreas , Arlt Matthias , Schmid Christof , Hilker Michael 
Published: February 2013

AbstractExtracorporeal membrane oxygenation (ECMO) has been successfully used to support patients with cardiac arrest failing to respond to conventional cardiopulmonary resuscitation (CPR). Preimplant factors being indicative for success are unknown up to now. The study describes single center experience with special focus on differences between survivors and nonsurvivors. Between 2002 and 2009, 103 patients were supported within the scope of CPR by means of ECMO. Besides primary diagnosis, duration, and outcome, pH, lactate, mean arterial pressure, aspartate aminotransferase, bilirubin, catecholamine dosage, and oxygenation ratio before ECMO, after 2 h, 1 day, and at explantation were analyzed. One hundred three patients (51.2 ± 16 years, 35 women, 68 men) were analyzed. Primary cardiac failure led to CPR in 54%. Duration of support was 4.8 ± 0.6 days. Twenty‐nine (28.1%) patients survived to hospital discharge. On ECMO support, pH, lactate, and mean arterial pressure improved significantly. Catecholamine dosage was significantly reduced after ECMO implantation. Demographic data and primary diagnosis revealed no significant influence on outcome. pH, lactate, creatinine, and bilirubin differed significantly between survivors and nonsurvivors in the course of ECMO support. ECMO support during CPR reliably improves the circulatory and respiratory situation. Considering observed survival critical patient selection is mandatory. Although there are several significant differences between surviving patients and patients with fatal outcome, patient selection turns out to be difficult as clinically relevant factors show only limited predictive value. Future research should focus on better defining a population that may be best of all suited for the use of ECMO support in CPR.
The Hemodynamic Effect of the Support Mode for the Intra‐Aorta Pump on the Cardiovascular System
Authors: Gao Bin , Chang Yu , Xuan Yanjiao , Zeng Yi , Liu Youjun 
Published: February 2013

AbstractIntra‐aorta pump is a novel rotary ventricular assist device. Because of the special structure and connection with the native heart, the hemodynamic effect of support mode of this pump on the cardiovascular system is not clear. In this work, three support modes, including “constant speed” mode, “co‐pulse” mode, and “counter‐pulse” mode, have been designed for the intra‐aorta pump to evaluate the hemodynamic effect of different support modes on the cardiovascular system. Simulation results demonstrate that that both “co‐pulse” mode and “counter‐pulse” mode can achieve better unloading performance than “constant speed” mode. The intra‐aorta pump controlled by “co‐pulse” mode is beneficial for improving coronary flow. Moreover, the external work, which is defined as the product of left ventricular pressure and cardiac output, under “co‐pulse” mode is the minimum of the three support modes (0.783 w vs. 0.615 w vs. 0.702 w). The pulsatility ratio, defined as the ratio of the peak‐to‐peak value of arterial pressure (AP) to the mean arterial pressure value, under “co‐pulse” mode is the maximum of the three modes (24% vs. 32.8% vs. 23.7%). The equivalent afterload value, which is the ratio of pulsatile pressure at the pump inflow and pulsatile pump flow, is larger than other support modes (0.596 mm Hg.s/mL vs. 0.9704 mm Hg.s/mL vs. 0.55 mm Hg.s/mL). In brief, the intra‐aorta pump under “co‐pulse” mode support is beneficial for improving myocardial perfusion and restoring pulsatility of AP, while “counter‐pulse” mode is beneficial to the perfusion of vital organs.
A Risk‐Adjusted O–E CUSUM with Monitoring Bands for Monitoring Medical Outcomes
Authors: Sun Rena Jie , Kalbfleisch John D. 
Published: February 2013

SummaryIn order to monitor a medical center's survival outcomes using simple plots, we introduce a risk‐adjusted Observed–Expected (O–E) Cumulative SUM (CUSUM) along with monitoring bands as decision criterion.The proposed monitoring bands can be used in place of a more traditional but complicated V‐shaped mask or the simultaneous use of two one‐sided CUSUMs. The resulting plot is designed to simultaneously monitor for failure time outcomes that are “worse than expected” or “better than expected.” The slopes of the O–E CUSUM provide direct estimates of the relative risk (as compared to a standard or expected failure rate) for the data being monitored. Appropriate rejection regions are obtained by controlling the false alarm rate (type I error) over a period of given length. Simulation studies are conducted to illustrate the performance of the proposed method. A case study is carried out for 58 liver transplant centers. The use of CUSUM methods for quality improvement is stressed.