bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modification to reporting of qualitative fluorescent spot test results improves detection of glucose‐6‐phosphate dehydrogenase (G6PD)‐deficient heterozygote female newborns
Authors: NADARAJAN V. , SHANMUGAM H. , STHANESHWAR P. , JAYARANEE S. , SULTAN K. S. , ANG C. , ARUMUGAM S. 
Published: April 2011

SummaryIntroduction:  The glucose‐6‐phosphate dehydrogenase (G6PD) fluorescent spot test (FST) is a useful screening test for G6PD deficiency, but is unable to detect heterozygote G6PD‐deficient females. We sought to identify whether reporting intermediate fluorescence in addition to absent and bright fluorescence on FST would improve identification of mildly deficient female heterozygotes.Methods:  A total of 1266 cord blood samples (705 male, 561 female) were screened for G6PD deficiency using FST (in‐house method) and a quantitative enzyme assay. Fluorescence intensity of the FST was graded as either absent, intermediate or normal. Samples identified as showing absent or intermediate fluorescence on FST were analysed for the presence of G6PD mutations using TaqMan@SNP genotyping assays and direct nucleotide sequencing.Results:  Of the 1266 samples, 87 samples were found to be intermediate or deficient by FST (49 deficient, 38 intermediate). Of the 49 deficient samples, 48 had G6PD enzyme activity of ≤ 9.5 U/g Hb and one sample had normal enzyme activity. All 38 intermediate samples were from females. Of these, 21 had G6PD activity of between 20% and 60%, and 17 samples showed normal G6PD activity. Twenty‐seven of the 38 samples were available for mutation analysis of which 13 had normal G6PD activity. Eleven of the 13 samples with normal G6PD activity had identifiable G6PD mutations.Conclusion:  Glucose‐6‐phosphate dehydrogenase heterozygote females cannot be identified by FST if fluorescence is reported as absent or present. Distinguishing samples with intermediate fluorescence from absent and bright fluorescence improves detection of heterozygote females with mild G6PD deficiency. Mutational studies confirmed that 85% of intermediate samples with normal enzyme activity had identifiable G6PD mutations.
Paediatric CT imaging trends in Australia
Authors: Brady Zoe , Cain Timothy M , Johnston Peter N 
Published: April 2011

AbstractIntroduction: The use of CT has rapidly increased since its introduction. Although an important medical tool for diagnosis and treatment, CT is recognised as being among the highest contributors to population radiation exposure. As the risks associated with exposure are higher for children than for adults, this study assessed the impact of paediatric CT in Australia by analysing imaging trends.Methods: CT imaging trends were derived from Medicare data. Comparable data from a dedicated paediatric hospital (Royal Children's Hospital Melbourne (RCH)) were analysed to determine the validity of utilising Medicare statistics in the younger age groups. The resulting trends reflect the situation for paediatric CT imaging in Australia.Results: In 2009, 2.1 million CT services were billed to Medicare in Australia for children and adults. The average annual growth in the number of CT services provided since 1994 was 8.5%, compared with population growth of 1.4%. Comparison of RCH and Medicare data revealed that only one third of paediatric CT imaging is captured by Medicare. Combining the data sets showed that over the last 20 years, there has been an average annual increase of 5.1% in the CT imaging rate for 0 to 18‐year‐olds. However, in recent years, growth in the imaging rate for 11 to 18‐year‐olds has slowed, while for 5 to 10‐year‐olds the imaging rate has declined.Conclusions: The significant growth in CT services is attributable to increased demand from the adult demographic. Conversely, increases in the imaging rate for paediatric patients have slowed overall. In fact, for some age groups the rate has fallen.
Extracolonic findings at CT colonography: A review of 258 consecutive cases
Authors: Sutherland Tom , Coyle Elizabeth , Lui Belinda , Lee Wai‐Kit 
Published: April 2011

AbstractIntroduction: Computed tomographic colonography (CTC) is a non‐invasive method of examining the colon and is used for colorectal polyp and mass diagnosis. As the entire abdomen is examined, incidental extracolonic pathologies can be diagnosed. The types of extracolonic findings (ECFs) and their frequency have not been explored in an Australian setting.Methods: A retrospective review of all CTC examinations performed in an Australian tertiary hospital between February 2004 and July 2009 were reviewed to extract patient demographic data, reason for referral, presence of colonic polyps and masses, presence of other colonic and extracolonic pathologies. Statistical significance was determined using a Student's t‐test or Fisher's exact test where appropriate.Results: Two hundred fifty‐eight CTC examinations were performed and an ECF was present in 70.1% and were more common with increasing age (P ≤ 0.01), but were not related to gender, or source of referral or the presence of colonic findings. Major ECFs were diagnosed in 8.9% of patients.Conclusions: ECFs are more frequent with increasing age and although they are common, only a minority are of high significance.
Low‐osmolar monomeric versus iso‐osmolar dimeric contrast media: An intra‐individual comparison in CT angiography using an animal model
Authors: Behrendt Florian F , Pietsch Hubertus , Jost Gregor , Keil Sebastian , Mottaghy Felix M , Günther Rolf W , Mahnken Andreas H 
Published: April 2011

AbstractIntroduction: The aim of this study was to compare intra‐individual contrast enhancement in multidetector‐row computed tomography using the low‐osmolar monomeric iopromide 300 and the iso‐osmolar dimeric iodixanol 320.Methods: Repeated computed tomography scanning of the chest of five pigs was performed under standardised conditions using iopromide 300 (300 mg I/mL) and iodixanol 320 (320 mg I/mL) with an identical iodine delivery rate of 1.5 g I/sec and a total iodine dose of 300 mg/kg body weight. Time‐enhancement curves were computed, and pulmonary and aortic peak enhancement, time‐to‐peak and plateau time above 300 Hounsfield units (HU) were analysed.Results: Intra‐individual comparison revealed no statistically significant differences in contrast enhancement between the iopromide 300 and iodixanol 320 in the pulmonary artery and the aorta (620 vs 552 HU; P = 0.13). There was no significant difference between the two CM in the plateau time at the pulmonary artery and the aorta (P = 0.75 and P = 0.24, respectively). Aortic peak time was significantly earlier with iopromide 300 than with iodixanol 320 (P = 0.004).Conclusions: Low‐osmolar monomeric and iso‐osmolar dimeric CM provide a similar and suitable vascular contrast enhancement.
Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: A 7‐year study
Authors: Apisarnthanarak Piyaporn , Thairatananon Atita , Muangsomboon Kobkun , Lu David SK , Mundy Linda M , Apisarnthanarak Anucha 
Published: April 2011

AbstractPurpose: This study aimed to characterise the CT findings associated with hepatic and splenic melioid abscesses.Methods: Patients with CT evidence of hepatic and/or splenic abscesses were retrospectively evaluated for clinical evidence of melioidosis over a 7‐year period. After blinded review of the CT characteristics of intra‐abdominal abscesses (IAA), we conducted a stratified analysis of patients with and without melioid IAA.Results: Among 49 patients with CT evidence of hepatic and/or splenic IAA, the mean age was 50.2 years, 22 (44.9%) were women and eight (16.3%) had laboratory confirmation of melioidosis. For the 113 IAA, 33 were melioid abscesses (15 liver and 18 spleen) and 80 were non‐melioid abscesses (69 liver and 11 spleen). Splenic IAA were more common in the melioid group (P = 0.001) and smaller in diameter than the hepatic IAA (P < 0.001). Melioid IAA were smaller than non‐melioid IAA (P < 0.001) and the CT necklace sign was the strongest predictor for melioid IAA (odds ratio = 24.6, P = 0.006) with 100% specificity. Other significant predictors for melioidosis were concurrent hepatic and splenic involvement (P = 0.009), multiple abscesses (P = 0.015) and residence in an endemic area (P = 0.047). By multivariate analysis, concurrent hepatic and splenic involvement was the sole predictor of melioidosis (adjusted odds ratio = 11.3, 95% confidence interval = 1.6–77.5, P = 0.014).Conclusion: The CT necklace sign, along with concurrent hepatic and splenic IAA, were highly suggestive of melioidosis in persons from Central Thailand.
Constructive interference in steady‐state/FIESTA‐C clinical applications in neuroimaging
Authors: Kulkami Makarand 
Published: April 2011

SummaryHigh spatial resolution is one of the major problems in neuroimaging, particularly in cranial and spinal nerve imaging. Constructive interference in steady‐state/fast imaging employing steady‐state acquisition with phase cycling is a robust sequence in imaging the cranial and spinal nerve pathologies. This pictorial review is a concise article about the applications of this sequence in neuroimaging with clinical examples.
The utility of PET/CT in staging and assessment of treatment response of nasopharyngeal cancer
Authors: Law Alastair , Peters Lester J , Dutu Gaelle , Rischin Danny , Lau Eddie , Drummond Elizabeth , Corry June 
Published: April 2011

AbstractIntroduction: The aim of this study was to evaluate the impact of positron emission tomography/computerised tomography (PET/CT) as an adjunct to conventional imaging (CI) in the management of nasopharyngeal cancer (NPC) both for initial staging and assessment of post‐treatment response.Methods: All NPC cases referred to the Peter MacCallum Centre for Metabolic Imaging between January 2002 and December 2007 were identified.In patients undergoing initial staging, any differences between the pre‐PET/CT management plan based on CI and that following performance of the PET/CT scan were noted. Clinical impact was scored using the Centre's published criteria: 'high' if PET/CT changed the primary treatment modality or intent, ‘medium’ if treatment modality was unchanged but the radiotherapy technique or dose was altered, and ‘low’ if there was no change in treatment modality or intent.Patients undergoing PET/CT following definitive treatment were scored according to whether or not they achieved a complete metabolic response.Results: Forty‐eight patients underwent a staging PET/CT. The clinical impact was high in 8%, medium in 25% and low in 66% of patients. Twenty‐one patients were scanned for post‐treatment response. PET/CT was less frequently equivocal than MRI (3 vs 8/21). A complete metabolic response on PET/CT was associated with a 93% negative predictive value for subsequent recurrence.Conclusion: PET/CT is a valuable staging tool for the detection of occult metastatic disease and defining the extent of neck nodal disease. Post‐treatment, a complete metabolic response on PET/CT has a very high negative predictive value with fewer equivocal results than MRI.
Treatment of regional cutaneous nodular metastases from melanoma using high‐dose rate mould brachytherapy
Authors: Chaudhuri Anupam , De‐Groot Charles , Seel Matthew , Jolly Mike , Cameron Tina 
Published: April 2011

AbstractIntroduction: The involvement of a wide body surface area by regional cutaneous nodular metastases (RCNM) from melanoma poses a significant therapeutic challenge. We report our experience from Waikato Hospital, Hamilton, New Zealand in successfully treating this condition with high‐dose rate (HDR) surface mould brachytherapy (BT).Methods: We analysed six patients who had surgery and then developed RCNM, which was treated in our department by HDR mould BT using Iridium 192. Five out of six patients were treated with a dose of 30 Gy in five fractions to wide field with a further 6 Gy boost to tumour nodules. Our first patient received a higher dose of 36 Gy in six fractions followed by 6 Gy boost to tumour nodules.Results: All patients experienced a complete response (CR). Median follow up was 23 months and side effects were minimal, only Radiation Therapy Oncology Group (RTOG) grade I/II early and late toxicity. To date, no in‐field recurrence has been observed. Two patients died from metastatic disease at 33 and 34 months of follow up.Conclusion: There was a CR in all cases without in‐field recurrence. To our knowledge, this is the first reported experience in treating skin melanoma with a BT surface mould. We recommend that BT surface mould should be considered when treating patients with RCNM.
Larynx preservation with primary non‐surgical treatment for loco‐regionally advanced larynx cancer
Authors: Corry June , Rischin Danny , Cotton Sue , D'Costa Ieta , Chua Margaret , Vallance Neil , Lyons Bernard , Kleid Stephen , Sizeland Andrew , Peters Lester J 
Published: April 2011

AbstractIntroduction: The objective of this paper was to review the results of primary non‐surgical treatment with the aim of larynx preservation for loco‐regionally advanced larynx cancer (LALC).Methods: All patients with LALC presenting between January 2002 and December 2006 who were selected for primary non‐surgical treatment were included in this study.Results: There were 60 patients, 48% with stage III and 52% with stage IV disease. The median follow‐up of living patients was 41 months. Larynx preservation with local disease control was achieved in 83% and 77% of patients at 3 and 5 years, respectively. Failure‐free survival at 3 and 5 years was 66% and 59%, respectively, and overall survival was 67% and 45%, respectively. All patients with larynx preservation had a functional voice. Two patients became feeding tube dependant. Thirty‐nine percent of all deaths were unrelated to LALC.Conclusions: Primary non‐surgical treatment achieves high rates of larynx preservation with a low rate of severe complications but overall survival remains disappointing.
Use of prechemotherapy positron emission tomography‐CT imaging, acquired in the treatment position, to help plan involved nodal radiotherapy for a patient with diffuse large B‐cell lymphoma
Authors: David Steven P , Rees Heather S , MacManus Michael P 
Published: April 2011

SummaryFused positron emission tomography/computed tomography (PET‐CT) images are increasingly being used to assist radiation oncologists in the definition of treatment volumes for patients with metabolically active tumours. This is the first report in which baseline fluorodeoxyglucose‐PET‐CT images were acquired in the treatment position in a case of diffuse large B‐cell lymphoma and incorporated directly into the radiotherapy treatment planning process. It highlights the potential benefits of using combined 3‐D functional and structural imaging for the design of radiation target volumes in patients with aggressive lymphomas that are managed with combined chemo and radiotherapy.
Falling from the Tightrope: Double versus Single Tightropes in Patients with Acromioclavicular Joint Dislocations: Technique and Complications
Authors: Tsiouri Chrysi , Pan Yong-Wei , Mok Daniel 
Published: April 2011

Background We welcomed the innovative arthroscopic stabilization of the acromioclavicular joint dislocations with the Tightrope as it seemed promising regarding results and rehabilitation however our results were not satisfactory. Materials and Methods We clinically and radiographically reviewed the first thirty one consecutive patients treated with this method and analysed their scores in search of correlations between results and patient, injury or surgery factors. Results We had 19% failure rate that was not statistically correlated with any factors. Conclusion We believe the Tightrope alone is not adequate to stabilize the acromioclavicular joint as it does not address the acromioclavicular ligament and the instability at the anteroposterior plane.
Two-Screw, Arthroscopic Fixation of Os Acromiale Compared to a Similar, Open Procedure Incorporating a Tension Band: A Laboratory Study
Authors: Kummer Frederick J. , Van Gelderen Jeffrey , Meislin Robert J. 
Published: April 2011

Background A common treatment for symptomatic os acromiale is open fixation using two lag screws with a tension band. In several patients, we have used two screws alone inserted arthroscopically and posited that they would achieve equivalent fixation stability. Methods Twelve matched pairs of cadaver acromions had a simulated non-union created and were fixed with two cannulated lag screws. Six pairs used a Fiberwire (Arthrex, Naples, FL, USA) tension band in one of each pair; the other six pairs similarly used a stainless steel wire tension band. Specimens were mechanically loaded in a variety of modes to determine fixation stability. Results Neither of the tension band constructs demonstrated significantly stiffer or stronger fixations in the testing modes than the screws alone. Conclusion An arthroscopic fixation of os acromiale with two screws appears justified.
Restoration of Medial Hinge in Acute Complex Proximal Humeral Fractures using Intra-Medullary Strut Allograft
Authors: Karthik Karuppaiah , Khunda Aiman , Kamath Vijay , Rangan Amar 
Published: April 2011

Background Proximal humerus fractures with medial column comminution/collapse often pose management dilemmas to the treating surgeon. Medial column mechanical support of these fractures plays a significant role in the ultimate stability of fixation until healing. Methods Twelve patients (four men and eight women) with unstable proximal humerus fractures were taken up for study. The fractures were stabilized with intramedullary strut allograft and locking plate (PHILOS) by a deltoid splitting approach. The outcome was assessed clinically by Oxford Shoulder Score and radiologically by measuring the head shaft angle at follow-up. Results The mean age of the patients was 65 years (range 54 years to 72 years) with the dominant arm affected in nine. All fractures progressed to union at an average of 4 months and 15 days (3 months to 11 months). At final follow-up (average 29.7 months), all patients had good functional outcome, with an average Oxford Shoulder Score of 19.2 (12 to 32). The average loss of head shaft angle was 6° (0° to 8°). Conclusion The technique has potential technical advantages in the management of proximal humeral fractures with medial column comminution/collapse. The rate of union has been encouraging and we recommend it as a method of treatment.
Hepatic Akt expression correlates with advanced fibrosis in patients with chronic hepatitis C infection
Authors: Huang Jee‐Fu , Chuang Yen‐Hwang , Dai Chia‐Yen , Yu Ming‐Lung , Huang Chung‐Feng , Hsiao Pi‐Jung , Hsieh Ming‐Yen , Huang Ching‐I , Yeh Ming‐Lun , Yang Jeng‐Fu , Lin Zu‐Yau , Chen Shinn‐Chern , Chuang Wan‐Long 
Published: April 2011

Aim:  Hepatitis C virus (HCV) proteins can activate the PI3K/Akt pathway which is involved in multiple cellular functions such as inflammatory cell activation and liver fibrosis. The aim of the present study was to elucidate the correlation between Akt expression and liver fibrosis staging in chronic hepatitis C (CHC) patients.Methods:  Paraffin‐embedded liver sections from 133 consecutive treatment‐naïve CHC patients were recruited. The expression features of Akt were analyzed using immunohistochemical methods and the results were compared with histological, virological and biochemical profiles.Results:  The 73 patients with high Akt expression carried higher histological activity index scores (6.52 ± 2.5 vs 5.62 ± 2.4, P = 0.04) and advanced fibrosis (72.7% vs 26.3%, P < 0.01) than other 60 patients with low Akt expression. The high Akt expression showed a significant incremental trend dependent on fibrosis stages, from 33.3% of F0 to 85.7% of F4 (P = 0.005). Akt expression was not correlated with degrees of steatosis and virological features of HCV infection, such as viral load and genotypes. Multivariate logistic regression analysis showed advanced fibrosis was the most significant factor associated with high Akt expression (odds ratio = 3.16).Conclusion:  Hepatic Akt expression correlated with advanced liver fibrosis in CHC patients.
Relevance of Timing for Determination of Posaconazole Plasma Concentrations
Authors: Heinz Werner J. , Zirkel Janina , Kuhn Anna , Schirmer Diana , Lenker Ulrike , Keller Daniela , Klinker Hartwig 
Published: April 2011

ABSTRACT
For posaconazole, drug monitoring is suggested, but the relevance of timing for the determination of posaconazole concentration (PC) remains unclear. We investigated the variation of PC before and 4 and 8 h after the administration of 400 mg of posaconazole. Mean concentrations were 645, 678, and 616 ng/ml. The differences between trough and maximum concentrations were below 20% in 17 and below 30% in 20 of 25 patients. Hence, untimed posaconazole plasma concentrations give reliable information for most patients.
Randomized Pharmacokinetic and Pharmacodynamic Comparison of Fluoroquinolones for Tuberculous Meningitis
Authors: Thwaites Guy E. , Bhavnani Sujata M. , Chau Tran Thi Hong , Hammel Jeffrey P. , Török M. Estée , Van Wart Scott A. , Mai Pham Phuong , Reynolds Daniel K. , Caws Maxine , Dung Nguyen Thi , Hien Tran Tinh , Kulawy Robert , Farrar Jeremy , Ambrose Paul G. 
Published: April 2011

ABSTRACT

Tuberculous meningitis (TBM) is the most lethal form of tuberculosis, and new treatments that improve outcomes are required. We randomly assigned adults with TBM to treatment with standard antituberculosis treatment alone or in combination with ciprofloxacin (750 mg/12 h), levofloxacin (500 mg/12 h), or gatifloxacin (400 mg/24 h) for the first 60 days of therapy. Fluoroquinolone concentrations were measured with plasma and cerebrospinal fluid (CSF) specimens taken at predetermined, randomly assigned times throughout treatment. We aimed to describe the pharmacokinetics of each fluoroquinolone during TBM treatment and evaluate the relationship between drug exposure and clinical response over 270 days of therapy (Controlled Trials number ISRCTN07062956). Sixty-one patients with TBM were randomly assigned to treatment with no fluoroquinolone (
n
= 15), ciprofloxacin (
n
= 16), levofloxacin (
n
= 15), or gatifloxacin (
n
= 15). Cerebrospinal fluid penetration, measured by the ratio of the plasma area under the concentration-time curve from 0 to 24 h (AUC
0–24
) to the cerebrospinal fluid AUC
0–24
, was greater for levofloxacin (median, 0.74; range, 0.58 to 1.03) than for gatifloxacin (median, 0.48; range, 0.47 to 0.50) or ciprofloxacin (median, 0.26; range, 0.11 to 0.77). Univariable and multivariable analyses of fluoroquinolone exposure against a range of different treatment responses revealed worse outcomes among patients with lower and higher plasma and CSF exposures than for patients with intermediate exposures (a U-shaped exposure-response). TBM patients most likely to benefit from fluoroquinolone therapy were identified, along with exposure-response relationships associated with improved outcomes. Fluoroquinolones add antituberculosis activity to the standard treatment regimen, but to improve outcomes of TBM, they must be started early, before the onset of coma.
Clinical and Molecular Characteristics of Extended-Spectrum- β-Lactamase-Producing Escherichia coli Causing Bacteremia in the Rotterdam Area, Netherlands
Authors: van der Bij Akke K. , Peirano Gisele , Goessens Wil H. F. , van der Vorm Eric R. , van Westreenen M. , Pitout Johann D. D. 
Published: April 2011

ABSTRACT

We investigated the clinical and molecular characteristics of bacteremia caused by extended-spectrum-β-lactamase (ESBL)-producing
Escherichia coli
over a 2-year period (2008 to 2009) in the Rotterdam region (including 1 teaching hospital and 2 community hospitals) of Netherlands. The majority of patients presented with community onset urinary and intra-abdominal infections, with an increase in prevalence during 2009. The majority of
E. coli
isolates produced CTX-M-15, and 4 sequence types (ST38, ST131, ST405, and ST648) predominated. There were significant differences in clinical and molecular characteristics between the 2 community hospitals.