bluuebunny/crossref_metadata_2025_split huggingface dataset:
Door‐to‐door screening as a strategy for the detection of congenital Chagas disease in rural Bolivia
Authors: Romero Mario , Postigo Jorge , Schneider Dominique , Chippaux Jean‐Philippe , Santalla José Antonio , Brutus Laurent 
Published: February 2011

SummaryObjective  To demonstrate the feasibility of a house‐to‐house screening system used for congenital Chagas disease in rural areas based on an active search for pregnant women and newborns in their homes in addition to passive case detection in health facilities.Methods  Exploratory phase conducted by the research team followed by an operational period coordinated by municipal health service. A blood sample was taken for serological and parasitological tests of Trypanosoma cruzi from pregnant women who were searching antenatal care or visited at home by field investigators. Infants born to T. cruzi‐infected women were examined for infection at birth and again at 1 and 7 months of age.Results  64.5% of the pregnant women were infected. Congenital infection was diagnosed at birth in 4.0% (12/299) of the children born to seroreactive mothers. Twelve additional cases of infection (4%) were diagnosed in children between 1 and 7 months of age. Finally, 37% of the children were lost to follow‐up in the exploratory phase and 53% during the operational phase (P = 0.002), significantly fewer than in most passive case detection studies.Conclusion  Despite poorer outcomes after door‐to‐door screening activities have been transferred to the health system, a combined strategy based on active and passive case detection appeared to be efficient for identifying rural cases of congenital Chagas disease.
Five‐year experience using sirolimus‐based, calcineurin inhibitor‐free immunosuppression in pediatric renal transplantation
Authors: Hymes Leonard C. , Warshaw Barry L. 
Published: February 2011

Hymes LC, Warshaw BL. Five‐year experience using sirolimus‐based, calcineurin inhibitor‐free immunosuppression in pediatric renal transplantation. Pediatr Transplantation 2011: 15: 437–441. © 2011 John Wiley & Sons A/S.Abstract:  From December 2003 to December 2008, we employed a protocol for withdrawing TAC and converting to SRL in a cohort of low‐risk renal pediatric transplant recipients. We report our experience in these children with respect to graft survival, AR episodes, renal function, and adverse events. All patients received basiliximab induction and TAC, MMF, and prednisone. Criteria for conversion to SRL included first transplants without histologic evidence for AR on three‐month surveillance biopsies. Patient exclusion criteria included AR prior to or before surveillance biopsies, polyoma (BK) virus nephropathy, a history of nephrotic syndrome, or multiple organ transplants. Fifty‐one of 137 patients who received transplants from December 2003 to December 2008 met criteria for withdrawal of TAC and were converted to SRL. SRL was discontinued in 11 children because of adverse events within 12 months after conversion. Among the remaining 40 patients, actuarial graft survival was 91% at five yr. AR occurred in 13% of patients within one yr after conversion. Complications from SRL included aphthous ulcers (30%); viremia with BK virus (20%), EBV (13%), and CMV (3%); proteinuria (7%); elevated cholesterol (7%); diabetes mellitus (2%); thrombocytopenia (2%); erectile dysfunction (2%); and lymph edema (2%). SRL was discontinued in 20%, predominantly for aphthous ulcers. Our experience with SRL‐based immunosuppression demonstrates that a CNI‐free regimen can be successful in lower‐risk patients meeting our selection criteria. Aphthous ulcers and BK virus viremia were the most prevalent adverse events.
Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation
Authors: Gonzalez Elsa , Ettenger Robert , Rianthavorn Pornpimol , Tsai Eileen , Malekzadeh Mohammed 
Published: February 2011

Gonzalez E, Ettenger R, Rianthavorn P, Tsai E, Malekzadeh M. Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation.  Pediatr Transplantation 2011: 15: 495–501. © 2011 John Wiley & Sons A/S.Abstract:  FSGS has a high recurrence rate after renal transplantation. To examine the effects of the use of preemptive and post‐transplant PP on recurrence and graft outcome, we conducted a retrospective study on 34 pediatric patients (mean age 13 ± 5 yr) with biopsy‐proven pretransplant FSGS and who underwent a renal transplantation between 1996 and 2007. Recurrence was defined as a serum albumin level of <3.0 g/L in the presence of nephrotic‐range proteinuria (>40 mg/m2/h). Total response to PP therapy was defined as the resolution of the nephrotic‐range proteinuria and partial response as persistent proteinuria despite PP but not in the nephrotic range. Fifteen patients received a LD renal transplantation and 19 patients received a DD renal transplantation. Nineteen patients received CsA and 14 patients received tacrolimus. Nineteen patients (56%) had FSGS recurrence. There was no difference in the recurrence rate between patients receiving CsA vs. tacrolimus. Among the 15 LD patients, 13 received preemptive PP (1–10 sessions) and seven patients (47%) had subsequent FSGS recurrence. Among the 19 DD patients, four received preemptive PP and 12 (63%) had FSGS recurrence. The number of preemptive PP did not affect the recurrence rate. In a group of patients with a previous graft loss secondary to recurrence, the rate of recurrence was lower than expected (40%) and two of the three patients who did not recur had three or more sessions of preemptive PP. Of the 19 patients with recurrence, 17 were treated with PP therapy and 88% of the patients fully or partially responded. Only five patients had graft loss at three yr post‐transplant: two from FSGS recurrence and three from non‐compliance. These results suggest that preemptive PP does not decrease the rate of recurrence after transplantation but might be beneficial in treating high‐risk patients with documented recurrence. Patients with FSGS recurrence post‐transplant can achieve good graft survival with both LD and DD transplantation.
Granulomatous amebic encephalitis: an under‐recognized cause of infectious mortality after hematopoietic stem cell transplantation
Authors: Akpek G. , Uslu A. , Huebner T. , Taner A. , Rapoport A.P. , Gojo I. , Akpolat Y.T. , Ioffe O. , Kleinberg M. , Baer M.R. 
Published: February 2011

G. Akpek, A. Uslu, T. Huebner, A. Taner, A.P. Rapoport, I. Gojo, Y.T. Akpolat, O. Ioffe, M. Kleinberg, M.R. Baer. Granulomatous amebic encephalitis: an under‐recognized cause of infectious mortality after hematopoietic stem cell transplantation. Transpl Infect Dis 2011: 13: 366–373. All rights reservedAbstract: Granulomatous amebic encephalitis (GAE) is a rare, nearly always fatal form of encephalitis that occurs mostly in the setting of immune compromise or chronic disease. The prevalence and clinical characteristics of this Acanthamoeba infection in hematopoietic stem cell transplant (HSCT) recipients are not well described. We present an HSCT patient in whom the diagnosis of GAE was made at autopsy. A systematic review of previously reported cases is provided to highlight the clinical presentation and early diagnostic features of GAE in HSCT recipients. Amebic infection usually initially involves the skin or lungs over a period of months, and becomes rapidly fatal once it crosses the blood–brain barrier. GAE is usually discovered postmortem owing to lack of awareness of this deadly infection and delay in diagnosis. Subacute presentation of multiple recurrent panniculitis‐like subcutaneous nodules associated with eosinophilia and a history of chronic rhinitis or sinusitis warrant investigation for a possible amebic infection. Prolonged corticosteroid use and a recent exposure to unhygienic water are potential risk factors for GAE. Successful outcomes may be achieved with early intensive treatment using a combination of effective drugs.
Intravenous guanethidine in patients with reflex sympathetic dystrophy
Authors: Kaplan R. , Claudio M. , Kepes E. , Gu X. F. 
Published: February 2011

Background: Intravenous regional guanethidine Bier block (IVRGBB) has been used predominantly in Europe for treating reflex sympathetic dystrophy (RSD). Our experience in the United States, where its use has been limited, is reported. Methods: Fifty‐five patients received IVRGBB for RSD. Upper extremities received 20 mg (10 mg/ml) of guanethidine in 30–50 ml of 0.5% lidocaine; lower extremities received 40 mg in 40–75 ml of lidocaine (volume adjusted for size, weight, or prior adverse effect). Pain severity (mild, moderate, severe, excruciating) was obtained pretreatment. Pain severity and a global clinical assessment (GCA) (resolved, improved, no change, worse) were obtained following each treatment. The final GCA was analyzed vs: pretreatment score; age; sex; pain duration; number of treatments; and precipitating event. Adverse effects were documented.Results: Of 55 enrolled patients, 2 were lost to follow‐up, and 2 returned 1 and 4 years later for repeat treatment. Therefore, 53 patients were evaluated for 55 treatments. Age: 38.2 − 14.8 (SD) (range 10–77) years. Sex: 11 males, 44 females. Average pain duration: 2.0 − 1.7 years (3 days ‐ 7 years). Final assessment occurred at 3.88 − 5.21 months (6 days ‐ 2 2/3 years). Effect on pain: resolution‐9.1%; improved‐14.5%; no change‐61.8%; worsening‐14.5%. No significant relationship was found between GCA and the factors evaluated. There was a significant positive linear association between pretreatment pain and post treatment GCA (P = 0.032). Fifty‐six adverse effects occurred in 19 (34.5%) patients (nausea, vomiting, orthostatic hypotension, dizziness, diarrhea, weakness).Conclusions: IVRGBB does not provide long‐term pain relief and is associated with adverse effects in over 1 / 3 of patients.
Continuous end‐tidal carbon dioxide monitoring during normofrequent jet‐ventilation
Authors: Bach L. F. , Wanner‐Olsen H. , Andersen B. N. , Madsen I. K. , Kruse S. 
Published: February 2011

Background: Continuous end‐tidal carbon dioxide (ETCO2) monitoring during normofrequent jet‐ventilation (NFJV) has not previously been successful and no correspondence between ETCO2 and arterial carbon dioxide (PaCO2) demonstrated.Methods: During NFJV jet‐ventilation in 19 healthy volunteers, continuous ETCO2 was measured and compared to PaCO2 values. The original ETCO2 sampling line from our Datex CO2 measuring equipment was placed longitudinally against a suction catheter and both were wrapped with aluminium foil. They were placed 4–5 cm above the carina and the position was verified with a fiberoptic bronchoscope.Results: The correlation between methods gave a Pearson's product moment correlation (r value) of 0.836, significant at the P < 0.001 level, indicating a close correlation between methods. A difference against mean scatter diagram confirmed that ETCO2 and PaCO2 measurements are of equal value in monitoring healthy patients during NFJV.Conclusion: A valuable method of continuous ETCO2monitoring during NFJV is presented.
Anaesthesia and gastric content — new methods and new trends
Authors: Søreide E. 
Published: February 2011

Abstract: In the present investigation, factors that might influence gastric content and the risk of perioperative aspiration pneumonitis have been studied. Compared to fibre‐optic gastroscopy and electronic pH meter, a standardised blind orogastric aspiration and pH indicator paper technique was found to be simpler, less expensive and to produce gastric fluid volume and pH estimates with sufficient accuracy.In fasting, elective patients, neither benzodiazepine premedication nor level of anxiety influenced gastric fluid volume and acidity. Intramuscular morphine‐scopolamine premedication significantly reduced gastric acidity. No difference in gastric content could be detected between outpatients and inpatients or between patients taking an oral benzodiazepine premedication 1–2 h before anaesthesia with 20, 150 or 300–450 ml of water. Intake of 150 ml water was associated with the lowest anxiety scores. In a meta‐analysis of 12 randomised studies of the impact of oral fluid intake on gastric content, statistical and technical flaws rendered the conclusion of two studies invalid. This, however, did not change the main conclusion that intake of clear fluids up to 2 h preoperatively is safe as fluid intake either decreased or had no effect on gastric fluid volume.Use of sugarless gum was associated with a 50% increase in gastric fluid volume, but did not affect gastric fluid acidity or improve patients' well‐being. In smokers, nicotine gum improved the feeling of well‐being and did not increase gastric fluid volume or acidity. Using gastric ultrasonography in healthy female volunteers, it was shown that up to 4 hours is needed before a light breakfast meal is completely emptied. In order to provide some safety limits, a 6‐hour fasting period for solids was recommended.In a survey of Norwegian Departments of Anaesthesiology (100% response rate), the respondents showed considerable variation in use and attitudes towards preoperative fasting and aspiration pneumonitis prophylaxis in OB/GYN patients. In an audit of perioperative aspiration pneumonitis we identified 11 cases, giving an incidence of 1, 5 and 11 per 10000 anaesthesia in gynaecological in‐ and outpatients and caesarean section patients, respectively. Preventable factors were identified in all cases. Eight patients needed ICU treatment, but none died. At discharge all had symptoms of bronchial hyper‐reactivity, but during the follow‐up period they all experienced improvement in their condition. There appears to be a need for consensus discussions on the topic of preoperative fasting and aspiration pneumonitis prophylaxis.
Topical wound anesthesia for postoperative pain relief
Authors: Sinclair R. 
Published: February 2011

Abstract: Pain from uncomplicated surgical wounds is most pronounced during the first postoperative days. Effective pain relief with a minimum of sedation, motor paralysis or disturbance of protective reflex functions is a prerequisite for early mobilization of the patient in day‐case surgery as well as for reducing the risk of postoperative pulmonary and thromboembolic complications in connection with in‐hospital procedures. The aim of this thesis was to evaluate topical lidocaine aerosol in the surgical wound as a method of suppressing postoperative pain, and to study some of the mechanisms of amide local anesthetics on the pain‐inducing inflammatory responses of the wound area.Postoperative pain (VAS) and opioid analgesic consumption were measured after a single dose of lidocaine aerosol in the wound of minor and major surgical procedures. The accumulation, viability and metabolic responsiveness of leukocytes harvested from titanium chambers implanted in an experimental surgical wound of rats in vivo after treatment with lidocaine aerosol were studied. To investigate the dose‐response effects of lidocaine and bupivacaine on the metabolic response and release of leukotrienes and interleukins, human leukocytes were studied in vitro.Topical lidocaine aerosol administered as a single dose at wound closure was found to offer significant pain relief and reduced consumption of opioid analgesics during the first 24 postoperative hours. Combination with NSAID administered pre‐ and postoperatively did not add to the analgesic effect of lidocaine or NSAID alone. Lidocaine aerosol reduced the number and metabolic responsiveness of leukocytes harvested from rat experimental wounds without affecting the viability of the cells.In vitro, amide local anesthetics were shown to reduce in a dose‐dependent manner the metabolic response of human leukocytes as well as their release of leukotriene B4 and the release of interleukin‐lalpha from human monocytes.Results showed that a single dose of lidocaine aerosol in the surgical wound of extra‐ and intraabdominal procedures induced a long‐lasting analgesic effect. The duration and potency are suggested to be secondary to slow‐release and reduced washout of lidocaine from the aerosol solution and, apart from the nerve‐blocking effect, due to the anti‐inflammatory properties of amide local anesthetics.
Atropine premedication attenuates heart rate variability during high thoracic epidural anesthesia
Authors: Kawamoto M. , Matsumoto C. , Yuge O. 
Published: February 2011

Background: Atropine premedication is used as it possesses an anticholinergic effect on the cardiac autonomic nervous system (CANS). The aim of this study was to investigate the effect of atropine premedication on the CANS during thoracic epidural anesthesia (TEA) by assessing power spectral analysis of heart rate (HR) variability.Method: Female patients (n=28) undergoing elective mammary biopsy were randomly allocated into two groups; one received intramuscular premedication of 0.01 mg/kg of atropine 30 min before the procedure (group A: n=14), and the other did not (group N: n=14). Each electrocardiogram was digitally recorded before and during TEA, and played back off‐line to detect R‐R intervals. As a power spectrum required R‐R intervals of 256 s, this was analysed before TEA and repeated thereafter for 25 min. The spectra were quantified by determining the peak areas of the spectral density by integrating low frequency (Lo: 0.04‐0.15 Hz) and high frequency (Hi: 0.15‐0.40 Hz) bands as they showed sympathetic and parasympathetic nervous activity in the CANS. The neural balance was assessed by calculating Hi:Lo ratio.Results: Decreases in Lo and increases in Hi:Lo ratio were observed, suggesting sympathectomy and vagotonia with TEA in both groups. For 10 min after commencement, TEA maintained Hi:Lo ratios lower in group A than in group N, suggesting a vagolytic effect of premedication with atropine. With TEA, cardiac slowing was observed, which was dependent on the level of dermal analgesia.Conclusion: Power spectral analysis revealed that TEA had the effect of making CANS relatively vagotonic, and that atropine premedication would attenuate the effect of TEA.
Liver transplantation is associated with increased met‐enkephalin levels in the pig
Authors: Donovan K. L. , Janicki P. K. , Franks W. T. , Striepe V. I. , Pinson C. W. 
Published: February 2011

Background: It has been reported that less postoperative morphine is required following liver transplantation than is required following open cholecystectomy. This may be attributable to endogenous factors rather than to altered morphine pharmacokinetics. We measured the plasma concentrations of two endogenous neuropeptides associated with pain modulation, substance P (SP) and met‐enkephalin (ME), in pigs undergoing liver transplantation and in control pigs undergoing laparotomy.Methods: With the approval of the institutional Animal Care Committee, pigs were anesthetized with ketamine (30 mg/kg, IM), atropine (0.05 mg/kg, IM) and acetylpromazine (0.1 mg/kg, IM). Anesthesia was maintained with isoflurane in oxygen. Pigs in the transplantation group (n=10) underwent liver transplantation and control pigs (n=10) underwent laparotomy. Blood samples for SP and ME measurement were collected pre‐incision (Pre‐In), pre‐emergence (Pre‐Em) from anesthesia, 6–12 hours, 18 hours, and 24 hours after surgery. SP and ME levels were determined by radioimmunoassay. Results are expressed as mean±SEM (in pg/ml of plasma for both peptides) and were compared by the non‐parametric Mann‐Whitney U test. Statistical significance was inferred if P<0.05.Results: Plasma ME levels were significantly increased in the transplanted pigs at Pre‐Em, 6–12 hours and 18 hours after surgery. No statistically significant difference was observed for plasma SP level between the control and transplant pigs.Conclusions: Liver transplantation in the pig model is associated with increased concentrations of endogenous ME (but not SP) in plasma for at least 18 hours after surgery as compared to animals undergoing laparotomy.
No reversion to single mating in a socially parasitic ant
Authors: THURIN N. , ARON S. 
Published: February 2011

AbstractSocial Hymenoptera are ideal biological models for the study of the selective forces affecting the evolution of multiple mating (polyandry), because sister species can evolve different lifestyles and mating strategies. Single mating is predicted in workerless social parasites, because the key benefit of multiple mating in social insects, that is, the increase in genetic diversity among worker offspring, does not hold for workerless species. We compared the queen mating frequency between the ant Plagiolepis pygmaea and its derived social parasite P. xene. Previous studies showed that queens of the host P. pygmaea are obligately polyandrous. Here, pedigree analyses of mother–offspring combinations indicate that queens of the parasite P. xene did not revert to single mating; more than 50% of queens mated multiply, with 2–4 males. This result shows that reversal from multiple to single mating may be not selected in polyandrous social insect workerless parasites. We propose that such reversion does not occur when multiple mating is virtually cost free.
Identification and gene mapping of a soybean chlorophyll‐deficient mutant
Authors: Zhang H. , Zhang D. , Han S. , Zhang X. , Yu D. 
Published: February 2011

With 5 figures and 2 tables AbstractChlorophyll variation mutants are important materials for studying chlorophyll metabolism, photosynthesis, chloroplast biogenesis and related physiological processes. In this study, a chlorophyll‐deficient soybean mutant (cd1) was isolated by screening M2 progenies of cultivar ‘Nannong 86‐4’ treated with 0.4% ethyl methanesulfonate. cd1 displayed yellow‐green leaves from seedling stage V1 to fully flowering stage R2, abnormal chloroplasts, lower total chlorophyll content (30–66% reduction), lower plant height and lower seed yield compared to its wild‐type control. Genetic analysis demonstrated that the visible yellow‐green trait was controlled by a single recessive nuclear gene. Subsequently, the cd1‐mutant gene was mapped at a 6.9‐cM interval on chromosome 10, flanked by two simple sequence repeat markers Satt633 and Sat_291. These results provide us with the opportunity to study a novel gene regulating chlorophyll synthesis.
Two new species of Oxycanus Walker (Lepidoptera: Hepialidae) from Kosciuszko National Park, one with a sub‐brachypterous female
Authors: Edwards Edward D , Green Ken 
Published: February 2011

Abstract Oxycanus oreades sp.n. and Oxycanus oressigenes sp.n. (Lepidoptera: Hepialidae) are described from the subalpine and alpine zones above 1600 m in Kosciuszko National Park, New South Wales. The females of O. oreades are sub‐brachypterous and flightless. These species are compared to similar species of Oxycanus and to other Oxycanus found in the Mt Kosciuszko area. Sub‐brachypterous Hepialidae in New Zealand and Europe are discussed. Aspects of the biology of the new species are described and the suitability of O. oreades for assessing climatic change is evaluated.