bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problematic severe asthma: A proposed approach to identifying children who are severely resistant to therapy
Authors: Konradsen Jon R. , Nordlund Björn , Lidegran Marika , Pedroletti Christophe , Grönlund Hans , van Hage Marianne , Dahlen Barbro , Hedlin Gunilla ,   In Cooperation with the Swedish network of Pediatric Allergists, Severe Asthma Network
Published: September 2010

To cite this article: Konradsen JR, Nordlund B, Lidegran M, Pedroletti C, Gro¨nlund H, van Hage M, Dahlen B, Hedlin G and In Cooperation with the Swedish network of Pediatric Allergists, Severe Asthma Network. Problematic severe asthma: A proposed approach to identifying children who are severely resistant to therapy. Pediatric Allergy Immunology 2011: 22: 9–18.AbstractChildren with problematic severe asthma (PA) are either difficult to treat because of the presence of aggravating factors or else severely resistant to therapy. We investigated a cohort of school‐aged children with PA and compared these children to age‐matched peers with controlled persistent asthma (CA). The aims were to characterize features of children suffering from PA and identify children who were severely resistant to therapy. In this cross‐sectional, multicenter comparison of children with different manifestations of persistent asthma, PA was defined as insufficient asthma control despite level 4 treatment, according to GINA. The protocol included questionnaires, spirometry, methacholine provocation, measurement of fraction of nitric oxide in exhaled (FENO) and nasal air, blood sampling for inflammatory biomarkers and atopy, and computerized tomography of sinuses and lungs (in the PA group only). Of the 54 children with PA, 61% had therapy‐resistant asthma, with the remaining being difficult to treat because of identified aggravating factors. Children with PA more often had parents with asthma (p = 0.003), came from families with a lower socioeconomic status (p = 0.01), were less physically active (p = 0.04), and had more comorbidity with rhinoconjunctivitis (p = 0.01) than did the 39 children with CA. The former also exhibited lower FEV1 values (p = 0.02) and increased bronchial hyper‐responsiveness (p = 0.01), but there were no differences in atopy (p = 0.81) or FENO (p = 0.16). A non‐invasive protocol, involving a standardized and detailed clinical characterization, revealed distinguishing features of children with PA and enabled the identification of children with therapy‐resistant asthma.
Preparing for transition? The allocation of oral medication regimen tasks in adolescents with renal transplants
Authors: Pai Ahna L. H. , Ingerski Lisa M. , Perazzo Lauren , Ramey Christina , Bonner Margaret , Goebel Jens 
Published: September 2010

Pai ALH, Ingerski LM, Perazzo L, Ramey C, Bonner M, Goebel J. Preparing for transition? The allocation of oral medication regimen tasks in adolescents with renal transplants. Pediatr Transplantation 2011: 15:9–16. © 2010 John Wiley & Sons A/S.Abstract: A mixed‐methods design was utilized to examine strategies that families use to manage the post‐transplant oral medication regimen of adolescents with renal transplants. Seventeen adolescents and their caregivers were administered structured interviews assessing the tasks that families identified as comprising the oral medication regimen, how tasks were allocated across family members and how the dyad decided on the allocation of tasks. Adherence was assessed via electronic pill bottles and calculated by dividing the number of doses taken by those prescribed. Patients and their caregivers identified the following tasks as part of the oral medication regimen: filling the pillbox (71%), calling for refills (65%) and verifying that the pillbox is filled correctly (47%). Adult caregivers were primarily responsible for managing the medication regimen for the majority of adolescents (70%). Secondary analyses revealed that the number of oral medication regimen tasks identified by the dyad was significantly associated with patient adherence. Our findings highlight the need to bolster efforts to develop methods to quantitatively assess and promote self‐management skills among adolescents with renal transplants.
Is endoscopic surveillance for non‐dysplastic Barrett's esophagus cost‐effective? Review of economic evaluations
Authors: Hirst Nicholas G , Gordon Louisa G , Whiteman David C , Watson David I , Barendregt Jan J 
Published: September 2010

AbstractBackground and Aim: Several health economic evaluations have explored the cost‐effectiveness of endoscopic surveillance for patients with non‐dysplastic Barrett's esophagus, with conflicting results. By comparing results across studies and highlighting key methodological and data limitations a platform for future, more rigorous analyses, can be developed.Methods: A systematic literature review was undertaken of studies evaluating cost‐effectiveness of surveillance for non‐dysplastic Barrett's esophagus. Articles were included if they assessed both cost and health outcomes for surveillance versus no surveillance. A descriptive review was undertaken and the quality of the studies appraised against best‐practice recommendations for economic evaluations and modeling studies.Results: Seven publications met the inclusion criteria. All used decision‐analytic Markov models. Half of the evaluations found surveillance was not cost‐effective. At best, surveillance produced improved outcomes at a cost of US$16 640 per quality‐adjusted life‐year, and at worst it did more harm than good and at a greater cost. The quality of the evaluations and generalizability to the Asia‐Pacific region was diminished as a result of inadequate or inconsistent evidence supporting parameter estimates, such as quality of life, endoscopic sensitivity and specificity and cancer recurrence rates.Conclusions: Unless newly emerging technologies improve the quality‐adjusted survival benefit conferred by endoscopic surveillance, this strategy is unlikely to be cost‐effective. Obsolete assumptions and incomplete analyses reduce the quality of published evaluations. For these reasons new evaluations are required that encompass the growing evidence base for new technologies, such as new endoscopic therapies for high‐grade dysplasia and intramucosal cancer.
Predicting early mortality in acute exacerbation of chronic obstructive pulmonary disease using the CURB65 score
Authors: CHANG Catherina L. , SULLIVAN Glenda D. , KARALUS Noel C. , MILLS Graham D. , MCLACHLAN John D. , HANCOX Robert J. 
Published: September 2010

ABSTRACTBackground and Objective:  Hospitalization for exacerbation of COPD is associated with a high risk of mortality. A risk‐prediction model using information easily obtained on admission could help to identify high‐risk individuals. The CURB65 score was developed to predict mortality risk in community acquired pneumonia. A retrospective study found that this score was also associated with mortality in COPD exacerbations. We conducted a prospective study to assess the utility of the CURB65 score in acute COPD exacerbations.Methods:  Consecutive patients with physician diagnosed COPD exacerbations admitted to a public hospital during a 1‐year period were studied prospectively. The CURB65 scores were calculated from information obtained at initial hospital presentation. CURB65 = one point each for Confusion, Urea > 7 mmol/L, Respiratory rate ≥ 30/min, low Blood pressure, age ≥ 65 years.Results:  30‐day mortality data were available for 249 of 252 patients. CURB65 scores on admission significantly predicted risk of death during the hospital admission and at 30 days. The 30‐day mortality by score groups were: low risk (scores 0–1) 2.0% (2/98), moderate risk (score 2) 6.7% (6/90) and high risk (scores 3–5) 21.3% (13/61). CURB65 scores were not predictive of 1‐year mortality.Conclusions:  A simple 6‐point score based on confusion, blood urea, respiratory rate, blood pressure and age can be used to stratify patients with COPD exacerbation into different management groups. The CURB65 score was as effective in predicting early mortality in our cohort of acute COPD exacerbations as it was in previous cohorts with community acquired pneumonia. Our findings suggest that CURB65 scores can help clinicians to assess patients with exacerbation of COPD.
Effects of adding salmeterol/fluticasone propionate to tiotropium on airway dimensions in patients with chronic obstructive pulmonary disease
Authors: HOSHINO Makoto , OHTAWA Junichi 
Published: September 2010

ABSTRACTBackground and objective:  Although salmeterol/fluticasone propionate combination (SFC) therapy has been widely used for the treatment of COPD, the relationship between airway dimensions and improvement in pulmonary function remains unknown. The aim of this study was to compare the effects of SFC in combination with tiotropium (Tio) and Tio alone, on airway dimensions and pulmonary function in COPD patients.Methods:  Thirty COPD patients were randomized to receive inhaled Tio (18 µg once daily) or inhaled SFC (50/250 µg twice daily) plus Tio for 12 weeks. Spirometry and CT were performed, and the St. George's Respiratory Questionnaire (SGRQ) was completed, before and after the trial. Airway dimensions were assessed by a validated CT technique, and airway wall area (WA) corrected for body surface area (BSA), percentage wall area (WA%), absolute wall thickness (T)/√BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus, were measured.Results:  Treatment with SFC plus Tio significantly decreased WA/BSA (P < 0.05), WA% (P < 0.01) and T/√BSA (P < 0.01), and increased Ai/BSA (P < 0.01), whereas treatment with Tio alone had no effect. The changes in WA/BSA and Ai/BSA were significantly correlated with increases in FEV1 (r = 0.48, P < 0.05, and r = 0.36, P < 0.05, respectively). There were significant improvements in SGRQ scores after treatment with SFC plus Tio.Conclusions:  Airway wall thickening and airway narrowing decreased after treatment with SFC plus Tio, and the changes in airway dimensions were proportional to the improvements in FEV1. These results suggest that SFC plus Tio is more effective than Tio alone in the management of COPD patients.
Comparison of 21‐gauge and 22‐gauge aspiration needle during endobronchial ultrasound‐guided transbronchial needle aspiration
Authors: NAKAJIMA Takahiro , YASUFUKU Kazuhiro , TAKAHASHI Ryo , SHINGYOJI Masato , HIRATA Tetsushi , ITAMI Makiko , MATSUI Yukiko , ITAKURA Meiji , IIZASA Toshihiko , KIMURA Hideki 
Published: September 2010

ABSTRACTBackground and objective:  Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has typically been performed using the 22gauge (G) dedicated TBNA needle. Recently a new 21G TBNA needle has been introduced. The efficacy of using a larger gauge biopsy needle during EBUS‐TBNA has not been reported. The purpose of this study was to compare the diagnostic yield and utility of 21G and 22G needles during EBUS‐TBNA.Methods:  EBUS‐TBNA was performed using both 21G and 22G needles. Cytological and histological findings were recorded for each samples obtained by an independent cytologist and pathologist. The cellularity and blood contamination were evaluated in the cytological samples. The quality of the histological core was evaluated by the amount of blood clots versus the actual tissue. Each factor was compared within two slides from the two different size needles. The diagnostic yield and the differences of the cytology and histology were analysed.Results:  The evaluation of 45 lesions by EBUS‐TBNA revealed that tumour cells were equally detected by both 21G and 22G needles. Two patients of adenocarcinoma were histologically diagnosed only by the 21G needle. Although histological structure was better preserved in five lesions collected by the 21G needle, there was more blood contamination with the 21G needle (P < 0.0001).Conclusions:  There were no differences in the diagnostic yield between the 21G and 22G needles during EBUS‐TBNA. The preserved histological structure of the samples obtained by the 21G needle may be useful for the diagnosis of mediastinal and hilar adenopathy of unknown aetiology which may be a challenge with the 22G needle.
Effect of HIV‐1 infection and increasing immunosuppression on menstrual function
Authors: Ezechi Oliver C. , Jogo Andrea , Gab‐Okafor Chidinma , Onwujekwe Dan I. , Ezeobi Paschal M. , Gbajabiamila Titi , Adu Rosemary A. , Audu Rosemary A. , Musa Adesola Z. , Salu Olumuyiwa B. , Meschack Emily , Herbertson Ebiere , Odunukwe Nkiru , Idigbe Oni E. 
Published: September 2010

AbstractAim:  The aim of this study was to determine the prevalence, pattern and determinants of menstrual abnormalities in HIV‐positive Nigerian women.Methods:  A cross‐sectional study was carried out involving 3473 (2549 HIV‐seropositive and 924 seronegative) consecutive and consenting women seen at the HIV treatment centers at the Nigerian Institute of Medical Research, Lagos and the Federal Medical Centre, Markurdi.Results:  The sociodemographic characteristics of the two groups were comparable, except for body mass index (BMI): the HIV‐negative women (28.1 ± 8.1) had statistically significantly (P < 0.005) higher BMI compared to the HIV‐positive women (21.9 ± 7.5).Menstrual abnormalities were significantly more common in women living with HIV/AIDS (29.1%) compared to the HIV‐negative (18.9%) women (P < 0.001). The proportions of women in the two groups with intermenstrual bleeding, menorrhagia, hypermenorrhea, and postcoital bleeding were similar (P > 0.005), however amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea were more common in the HIV‐positive women (P < 0.02). Primary dysmenorrhea was less common in HIV‐positive women (P < 0.03). Among the HIV‐positive women, menstrual dysfunction was more common in women living with HIV/AIDS with opportunistic infections, CD4 count < 200, not undertaking therapy, symptomatic disease and BMI < 20. However, after controlling for cofounders, only CD4 < 200 (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.2–9.7), BMI < 20 (OR, 2.4; 95%CI, 1.3–3.5) and not taking antiretroviral drugs (OR, 2.05; CI, 1.7–6.5) were associated with amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea.Conclusion:  HIV‐positive women in this study experienced more menstrual abnormalities of amenorrhea, oligomenorrhea, and irregular periods compared to the HIV‐negative controls. HIV‐positive women with CD4 count < 200, BMI < 20 and who do not take antiretroviral drugs are at the greatest risk.
Ruptured ovarian endodermal sinus tumor diagnosed during pregnancy: Case report and review of the literature
Authors: Benjapibal Mongkol , Chaopotong Pattama , Leelaphatanadit Chairatana , Jaishuen Atthapon 
Published: September 2010

AbstractPregnancy complicated by endodermal sinus tumor of the ovary is a very rare event. We present a case report of a pregnant woman with a ruptured primary endodermal sinus tumor of the ovary that was diagnosed at 13 weeks of gestation. After right salpingo‐oophorectomy had been performed the patient received four cycles of combination chemotherapy (bleomycin, etoposide, and cisplatin) starting at the 15th week of pregnancy. The patient did not have any evidence of tumor recurrence for 23 months. Her baby did not have any evidence of malformations and showed normal growth and development at 21 months of follow up.
Preoperative transvaginal ultrasound guided needle biopsy for primary squamous cell carcinoma of the endometrium
Authors: Kashima Katsunori , Iwasaki Chikako , Yahata Tetsuro , Tanaka Kenichi 
Published: September 2010

AbstractPrimary squamous cell carcinoma of the endometrium (PSCCE) is an extremely rare tumor and little information is available about its treatment and prognosis. We report a case of PSCCE diagnosed with preoperative transvaginal ultrasound guided needle biopsy. A 73‐year‐old woman presented with prolonged abdominal pain. Her endometrium was found to be slightly thickened, and endometrial biopsy showed no carcinoma tissues. Magnetic resonance imaging (MRI) demonstrated a uterine tumor and transvaginal ultrasound guided needle biopsy specimens of the tumor showed squamous cell carcinoma. The patient underwent laparotomy and was given a diagnosis of PSCCE in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa. After the operation, the patient was treated with concurrent chemoradiation therapy (CCRT) using cisplatin. She remains free of disease at 6 months after CCRT. Preoperative needle biopsy may be helpful to make a diagnosis of PSCCE.
Recurrent cervical cancer presented with lymphangitic carcinomatosis
Authors: Baiocchi Glauco , Neto Renato Cagnacci , Fukazawa Elza Mieko , Faloppa Carlos Chaves , Avertano‐Rocha Antonio Bomfim , Begnami Maria Dirlei 
Published: September 2010

AbstractLymphangitic carcinomatosis of the lungs secondary to cervical cancer is a rare condition. It still has an unknown pathophysiology and is related to high mortality rates. Diagnosis is often delayed due to the common symptoms of nonproductive cough and dyspnea. There are only 10 cases described in the literature. Most of the reported cases received only supportive care due to low performance status. Only three reported patients received palliative chemotherapy. We describe a case that has successfully received platinum‐based chemotherapy.
Alterations of CXCR4 function in μ‐opioid receptor‐deficient glia
Authors: Burbassi Silvia , Sengupta Rajarshi , Meucci Olimpia 
Published: September 2010

AbstractThe chemokine receptor CXCR4 and the μ‐opioid receptor (MOR) are G‐protein‐coupled receptors that are essential for normal function of the nervous and immune systems. Several studies have suggested that MOR is a key regulator of CXCR4 in the brain; however, the molecular basis of the opioid–chemokine interaction is not fully understood, and it may involve different mechanisms in neuronal and glial cells. Our previous studies demonstrated that MOR stimulation specifically upregulates the protein ferritin heavy chain – an inhibitor of CXCR4 – in neurons, and suggested that additional mechanisms could be operative in glia. In this study, we investigated CXCR4 function in brains and astroglial cultures deprived of MOR. Reduced coupling of CXCR4 to G‐proteins was found in brain slices and tissue homogenates of MOR−/− mice as compared with wild‐type controls. CXCR4‐induced signaling was also reduced in glial cultures from MOR−/− mice, as shown by analysis of CXCR4 downstream targets (Akt and ERK1/2). Pharmacological studies with δ‐opioid receptor (DOR)‐specific ligands suggested that DOR–CXCR4 interactions are implicated in the inhibition of CXCR4 in MOR‐deficient cells both in vitro and in vivo. Moreover, increased CXCR4/DOR co‐immunoprecipitation was found in brain tissue and cultured glia from MOR−/− mice. Importantly, CXCR4 function was restored by pretreatment with a DOR antagonist. Overall, these findings indicate that DOR plays a crucial role in the regulation of CXCR4 in glia, probably via silent receptor heterodimers. The data also suggest that the opiate system interferes with normal CXCR4 function in different ways, depending on receptor subtypes.
Amygdala, deep cerebellar nuclei and red nucleus contribute to delay eyeblink conditioning in C57BL /6 mice
Authors: Sakamoto Toshiro , Endo Shogo 
Published: September 2010

AbstractThat the cerebellum plays an essential role in delay eyeblink conditioning is well established in the rabbit, but not in the mouse. To elucidate the critical brain structures involved in delay eyeblink conditioning in mice, we examined the roles of the deep cerebellar nuclei (DCN), the amygdala and the red nucleus (RN) through the use of electrolytic lesions and reversible inactivation. All mice received eyeblink training of 50 trials during a daily session in the higher‐intensity conditioned stimulus (CS) condition (10 kHz, 70 dB). DCN lesions caused severe ataxia; nonetheless, the mice acquired conditioned responses (CRs). Reversible inactivation of DCN, by muscimol (MSC) injection, led to a severe CR impairment in the early sessions of conditioning; however, in later sessions, the mice acquired CRs. Amygdala lesions impaired the acquisition of CRs, which did not reach the level of sham‐operated mice, even after prolonged training sessions. MSC injections into the lateral amygdala severely impaired CRs, which began to recover after the removal of MSC. RN inactivation with MSC completely abolished CRs, and removal of MSC immediately restored CRs to the level of control mice. The results indicate that: (i) the DCN are important, but not essential, at least for the late acquisition in mouse eyeblink conditioning; (ii) the amygdala plays an important role in the acquisition and expression of CRs; and (iii) the RN is essential for the expression of CRs. Our findings reveal the various brain areas critically involved in mouse eyeblink conditioning, which include the cerebellum, amygdala and RN.
A mutation in dnaK causes stabilization of the heat shock sigma factor σ32, accumulation of heat shock proteins and increase in toluene‐resistance in Pseudomonas putida
Authors: Kobayashi Yuka , Ohtsu Iwao , Fujimura Makoto , Fukumori Fumiyasu 
Published: September 2010

SummaryHeat shock gene expression is regulated by the cellular level and activity of the stress sigma factor σ32 in Gram‐negative bacteria. A toluene‐resistant, temperature‐sensitive derivative strain of Pseudomonas putida KT2442, designated KT2442‐R2 (R2), accumulated several heat shock proteins (HSPs) under non‐stress conditions. Genome sequencing of strain R2 revealed that its genome contains a number of point mutations, including a CGT to CCT change in dnaK resulting in an Arg445 to Pro substitution in DnaK. DNA microarray and real‐time reverse transcription polymerase chain reaction analyses revealed that the mRNA levels of representative hsp genes (e.g. dnaK, htpG and groEL) were upregulated in R2 cells in the stationary phase. Wild‐type and R2 cells showed similar heat shock responses at hsp mRNA and HSP levels; however, the σ32 level in the mutant was not downregulated in the shut‐off stage. Strain R2 harbouring plasmid‐borne dnaK grew at 37°C, did not accumulate HSPs, and was more sensitive to toluene than strain R2. It is worth to note that that revertant of R2 able to grow at 37°C were isolated and exhibited a replacement of Pro445 by Ser or Leu in DnaK. Thus, the mutation in dnaK causes the temperature‐sensitive phenotype, improper stabilization of σ32 leading to HSP accumulation and increased toluene resistance in strain R2.