bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower urinary tract injuries diagnosed after hysterectomy: Seven‐year experience at a cancer hospital
Authors: Lim Myong Cheol , Lee Bo‐Yon , Lee Dong Ock , Joung Jae Young , Kang Sokbom , Seo Sang‐Soo , Chung Jinsoo , Park Sang‐Yoon 
Published: March 2010

AbstractAim:  The aim of this study was to determine the incidence, patterns of development and treatment outcomes of lower urinary tract injuries (LUTI) after hysterectomy.Methods:  A retrospective analysis was conducted on 1443 hysterectomy cases (678 total laparoscopic hysterectomies, 65 laparoscopic radical hysterectomies, 455 total abdominal hysterectomies and 245 radical hysterectomies). LUTI diagnosed intraoperatively were excluded.Results:  The incidence of post‐hysterectomy LUTI was 0.8% (11/1443). LUTI were more commonly associated with laparoscopic hysterectomies (1.1%) than hysterectomies performed via laparotomy (0.4%). Amongst 11 patients with LUTI, six had gynecological malignancies. Ureteral and bladder injuries were identified in eight and three patients, respectively; one patient had bilateral ureteral injuries. Most of the cases involving post‐hysterectomy LUTI developed within 2–4 weeks. The high incidence of LUTI following laparoscopic hysterectomies, and the time of development after hysterectomy, are suggestive of electrocautery injuries rather than physical trauma as the cause of delayed diagnosis of LUTI. Four of five surgeons experienced LUTI in the first 10 hysterectomies. Proper training and guidance by an experienced attending physician are required when first performing hysterectomies.Conclusions:  The incidence of post‐hysterectomy LUTI was 0.8%. Five of the nine ureteral injuries and one of the three bladder injuries healed after double‐J stents and a Foley catheter were inserted, respectively.
Effect of psychosocial stress and physical activity on preterm birth: A cohort study
Authors: Abeysena Chrishantha , Jayawardana Pushpa , Seneviratne Rohini de A. 
Published: March 2010

AbstractAim:  To determine trimester‐specific effects of risk factors for preterm birth (PTB).Methods:  A prospective study was carried out in a district of Sri Lanka. A total of 885 pregnant mothers were recruited at equal to or less than 16 weeks of gestation and followed up until partus. Trimester‐specific exposure statuses and potential confounding factors were gathered on average at the 12th, 28th, and 36th weeks of gestation. Physical activities were assessed by obtaining information about the duration of specific postures adopted per day by housewives during each trimester at home and both at home and during working hours for those who were engaged in paid employment. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30. Multiple logistic regression analysis was applied and the results were expressed as adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results:  Standing equal to or less than 2.5 h/day during the first or second or both trimesters (OR 1.83, 95%CI 1.03, 3.25), maternal age of <25 years (OR 1.73, 95%CI 1.02, 2.95), education up to primary school level (OR 3.30, 95%CI 1.3, 8.36) and past history of low birthweight (OR 2.52, 95%CI 1.16, 5.48) were risk factors for PTB. Psychosocial stress was not found to be a risk factor for PTB.Conclusions:  Standing equal to or less than 2.5 h/day during the early trimesters was a risk factor for PTB among uncomplicated pregnancies. Further studies are recommended to assess the trimester‐specific effect of psychosocial stress on PTB.
Can a ring pessary have a lasting effect to reverse uterine prolapse even after its removal?
Authors: Matsubara Shigeki , Ohki Yoichi 
Published: March 2010

AbstractA vaginal ring pessary for uterine prolapse has been considered only to reposition the uterus during fitting and is thus palliative. A ring pessary was fitted in a 71‐year‐old woman with uterine prolapse to reposition the uterus. When the pessary was removed after 73 months, the prolapse disappeared and did not recur. In another five patients with uterine prolapse who were fitted with a ring pessary, prolapse also disappeared after pessary removal. In these six patients, the median duration of pessary implantation and observation after its removal was 27.5 and 42.0 months, respectively. In some women, a vaginal ring pessary may reposition the uterus not only during implantation but also after its removal.
Carcinomatous meningitis from adenocarcinoma of the uterine cervix: A case report and literature review
Authors: Yamauchi Noriyuki , Sameshima Hiroshi , Osato Kazuhiro , Fukushima Kazuko , Sato Yuichiro , Ikenoue Tsuyomu 
Published: March 2010

AbstractCarcinomatous meningitis from uterine cervix‐related malignancies is a rare complication. We found only eight cases of meningeal metastasis from primary cervical carcinoma in the English‐language medical literature. However, its incidence has increased recently, probably because carcinomatous meningitis is being identified more often and survival time for the primary disease is extended. Thus, the clinical signs and methods for diagnosis are of great importance. A 47‐year‐old Japanese woman had a stage IIIb uterine cervical adenocarcinoma. She chose initial chemotherapy followed by radical hysterectomy and adjuvant chemotherapy. Ten months after initial chemotherapy and 6 weeks after the last chemotherapy, she suddenly presented with unexplained neurological signs. We performed a lumbar puncture, which demonstrated adenocarcinoma cells compatible with metastases from the primary cervical adenocarcinoma. She died 7 weeks later. This rare complication occurs in the advanced stage of cervical cancer. Lumbar punctures for neoplastic cells are advised, and the prognosis remains poor.
Treatment with agalsidase beta during pregnancy in Fabry disease
Authors: Politei Juan M. 
Published: March 2010

AbstractFabry disease is an X‐linked lysosomal storage disease caused by a deficiency of α‐galactosidase A, which leads to excessive accumulation of glycosphingolipids in most tissues in the body, with life‐threatening clinical consequences in the kidney, heart, and cerebrovascular system. Enzyme replacement therapy using exogenously produced α‐galactosidase has been available for treatment of this multisystem progressive disease since 2001. Two different preparations of enzyme replacement therapy for Fabry disease are available outside of the USA: agalsidase alfa and agalsidase beta. Despite being X‐linked, Fabry disease affects many female patients, and this report presents a successful pregnancy of a female patient receiving agalsidase beta.
Effects of in vitro antagonism of endocannabinoid‐1 receptors on the glucose transport system in normal and insulin‐resistant rat skeletal muscle
Authors: Lindborg K. A. , Teachey M. K. , Jacob S. , Henriksen E. J. 
Published: March 2010

Objective: We determined the direct effects of modulating the endocannabinoid‐1 (CB1) receptor on the glucose transport system in isolated skeletal muscle from insulin‐sensitive lean Zucker and insulin‐resistant obese Zucker rats. Methods: Soleus strips were incubated in the absence or presence of insulin, without or with various concentrations of the CB1 receptor antagonist SR141716 or with the CB1 receptor agonist arachidonyl‐2‐chloroethylamide (ACEA). Results: CB1 receptor protein expression in visceral adipose (57%), soleus (40%) and myocardial (36%) tissue was significantly (p < 0.05) decreased in obese compared to lean animals, with a trend for a reduction (17%, p = 0.079) in the liver. In isolated soleus muscle from both lean and obese Zucker rats, CB1 receptor antagonism directly improved glucose transport activity in a dose‐dependent manner. Basal glucose transport activity was maximally enhanced between 100 and 200 nM SR141716 in lean (26–28%) and obese (22–31%) soleus. The maximal increase in insulin‐stimulated glucose transport for lean muscle (∼30%) was achieved at 50 nM SR141716 and for obese muscle (∼30%) at 100 nM SR141716. In contrast, CB1 receptor antagonism did not alter hypoxia‐stimulated glucose transport activity. CB1 receptor agonism (1 mM ACEA) significantly decreased both basal (15%) and insulin‐stimulated (22%) glucose transport activity in isolated lean soleus. This effect was reversed by 200 nM SR141716. In both lean and obese muscle, the functionality of key signalling proteins (insulin receptor β‐subunit, Akt, glycogen synthase kinase‐3β (GSK‐3β), AMP‐dependent protein kinase (AMPK), p38 mitogen‐activated protein kinase (p38 MAPK)) was not altered by either CB1 receptor agonism or antagonism. Conclusion: These results indicate that the engagement of CB1 receptor can negatively modulate both basal and insulin‐dependent glucose transport activity in lean and obese skeletal muscles, and that these effects are not mediated by the engagement of elements of the canonical pathways regulating this process in mammalian skeletal muscle.
Active immunization against (Pro3)GIP improves metabolic status in high‐fat‐fed mice
Authors: Montgomery I. A. , Irwin N. , Flatt P. R. 
Published: March 2010

Aim: Ablation of gastric inhibitory polypeptide (GIP) receptor signalling can prevent many of the metabolic abnormalities associated with dietary‐induced obesity‐diabetes. The present study was designed to assess the ability of active immunization against (Pro3)GIP to counter metabolic dysfunction associated with diet‐induced obesity in high‐fat‐fed mice. Methods: Normal male Swiss NIH mice were injected (s.c.) once every 14 days for 98 days with complexed (Pro3)GIP peptide, with transfer to a high‐fat diet on day 21. Results: Active immunization against (Pro3)GIP resulted in circulating GIP antibody production and significantly (p < 0.05 p < 0.01) reduced circulating blood glucose concentrations compared to high‐fat control mice from day 84 onwards. Glucose levels were not significantly different from lean controls. The glycaemic response to i.p. glucose was correspondingly improved (p < 0.01) in (Pro3)GIP‐immunized mice. Furthermore, circulating and glucose‐stimulated plasma insulin levels were significantly (p < 0.01 to p < 0.001) depressed compared to high‐fat control mice. Liver triglyceride, pancreatic insulin and circulating LDL‐cholesterol levels were also significantly reduced in (Pro3)GIP‐immunized mice. These changes were independent of any effects on food intake or body weight. The glucose‐lowering effect of native GIP was annulled in (Pro3)GIP‐immunized mice consistent with the induction of biologically effective GIP‐specific neutralizing antibodies. Conclusion: These results suggest that immunoneutralization of GIP represents an effective means of countering the disruption of metabolic processes induced by high‐fat feeding.
Extracorporeal shockwave lithotripsy vs ureteroscopy as first‐line therapy for patients with single, distal ureteric stones: a prospective randomized study
Authors: Verze Paolo , Imbimbo Ciro , Cancelmo Gennaro , Creta Massimiliano , Palmieri Alessandro , Mangiapia Francesco , Buonopane Roberto , Mirone Vincenzo 
Published: March 2010

Study Type – Therapy (RCT) Level of Evidence 1bOBJECTIVETo compare extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) as first‐line treatments for patients with distal ureteric stones.PATIENTS AND METHODSIn all, 273 patients with single, monolateral, radiopaque, distal ureteric stones of 0.5–1.5 cm were enrolled in a prospective randomized trial. Patients were randomized to undergo ESWL (137) or URS (136). The electromagnetic Modulith SLX lithotripter (Storz Medical, Switzerland) was used for ESWL and a semi‐rigid ureteroscope was used for URS. Patients in both groups were compared for overall stone‐free rates (SFRs), re‐treatment rates, need for auxiliary procedures and complication rates. A subgroup analysis was performed in both groups according to stone size of ≤1 cm and >1 cm.RESULTSPatients in the ESWL group achieved a 92.70% overall SFR with a 44.88% re‐treatment rate and an 11.02% auxiliary procedure rate. Complications occurred in 15.32% of patients treated with ESWL. Patients in the URS group achieved a 94.85% overall SFR with a re‐treatment rate of 7.75% and an auxiliary procedure rate of 18.60%. Complications occurred in 19.11% of patients treated with URS. In the ESWL group, the need for re‐treatments and for auxiliary procedures as well as the incidence of complications was significantly higher in patients with stones of >1 cm. In patients with stones of ≤1 cm treated with ESWL the need for re‐treatments and for auxiliary procedures as well as the incidence of complications was significantly lower than for those treated with URS.CONCLUSIONIn centres where both techniques are available, ESWL should be the preferred treatment for patients with single distal ureteric stones of ≤1 cm and URS should be reserved for patients with stones of >1 cm.
CONTINUING THE DEFINITION OF DEATH DEBATE: THE REPORT OF THE PRESIDENT'S COUNCIL ON BIOETHICS ON CONTROVERSIES IN THE DETERMINATION OF DEATH
Authors: THOMAS ALBERT GARTH 
Published: March 2010

ABSTRACTThe President's Council on Bioethics has recently released a report supportive of the continued use of brain death as a criterion for human death. The Council's conclusions were based on a conception of life that stressed external work as the fundamental marker of organismic life. With respect to human life, it is spontaneous respiration in particular that indicates an ability to interact with the external environment, and so indicates the presence of life. Conversely, irreversible apnoea marks an inability to carry out the necessary work of life, an inability which the Council considers an indicator of death. This conception has been conceived to circumvent criticisms of the previous model of loss of somatic integration, a model the Council admits that, in the presence of evidence of continuing functional integration in brain dead patients, was looking less than convincing. Nevertheless, by focusing on external work and ignoring the more essential work of integrative unity, the Council's conception of the nature of life is untenable, and of no assistance in supporting a relation of equivalence between the concepts of brain death and death. Consequently, the Council's conclusions do little to advance the definition of death debate, a potentially intractable debate that may necessitate the investigation of alternate ethical justifications for organ harvesting.
Effect of low dose ionizing radiation exposure in utero on cognitive function in adolescence
Authors: HEIERVANG KRISTIN SVERDVIK , MEDNICK SARNOFF , SUNDET KJETIL , RUND BJØRN RISHOVD 
Published: March 2010

Heiervang, K. S., Mednick, S., Sundet, K. & Rund, B. R. (2010). Effect of low dose ionizing radiation exposure in utero on cognitive function in adolescence. Scandinavian Journal of Psychology, 51, 210–215.Radiation from the Chernobyl nuclear power plant meltdown greatly affected several Norwegian counties. The cognitive consequences of in utero exposure to radiation from the Chernobyl accident have been intensely debated. This study examines the cognitive outcomes for those Norwegians who were exposed as fetuses to the fallout from Chernobyl. The participants, 84 adolescents who were exposed in utero to radiation from the most contaminated areas in Norway and 94 adolescents from areas not contaminated by the radiation, were tested on verbal and nonverbal IQ. Two data analyses were conducted. First, using a control‐group design, the IQ scores of exposed and unexposed adolescents were compared. Second, in a timing‐of‐exposure design, those exposed during the most sensitive period were contrasted with those exposed later in gestation. Adolescents exposed to low‐dose ionizing radiation in utero scored significantly lower in full‐scale IQ than unexposed adolescents. The difference was restricted to verbal IQ and was not evident for nonverbal IQ. The effect was not observed in exposed adolescents who had passed the most sensitive gestational period prior to the accident and thus were exposed to the radiation from Chernobyl exclusively after gestational week 16. These participants performed as well as the controls. Although the results should be interpreted cautiously due to the study’s nonrandomized design, the data add new and important support to the hypothesis that the Chernobyl accident may have had a subtle effect on the cognitive functioning of those exposed to low‐dose ionizing radiation in utero during the most sensitive gestational period.
Behaviour Problems Among Children with Down's Syndrome: Prevalence, Persistence and Parental Appraisal
Authors: Turner Stephen , Sloper Patricia 
Published: March 2010

Changes over time in the pattern of behaviour problems shown by 91 children with Down's syndrome, together with maternal appraisal of the seriousness of reported problems, were investigated through questionnaires completed by mothers. Fifty‐four individual behaviours were studied at mean ages 9 years 2 months and 13 years 9 months. There was a significant decline in the overall frequency of behaviour problems and in some disturbed behaviours, sleeping and toileting problems, and over‐activity. Only one problem‐lying‐became more common. However, many problems were found to be persistent among the same children.While mothers viewed relatively few behaviours as definite problems, a minority faced a multiplicity of perceived problems at both points in time. Running away was a common problem which particularly concerned mothers. Sleeping problems were generally seen as less problematic by Time 2, while stealing had become more so. Some individual problems were associated with the gender, age and developmental level of the children. Results suggest that behaviour problems may become set relatively early in life, and that families may benefit from help in preventing and dealing with problems well before the teenage years.
Public Expenditure on Services for People With Intellectual Disabilities
Authors: Jones Christopher , Wright Ken 
Published: March 2010

The allocation of resources to health and social care agencies for services for people with intellectual disabilities has led to considerable debate about the failure of the balance of financing to reflect recent changes in policy. Although the overwhelming need of people with intellectual disabilities is for social care in the community there is still concern that funds are tied to health or institutional services.This paper presents the results of a two‐year project to explore these and related issues by developing national estimates of expenditure on services for people with intellectual disabilities through information gathered from a stratified sample of local authority areas. At local levels, information was requested from social services, health authorities, district housing authorities and local education authorities. The information from health and social services authorities was extrapolated to national levels to allow comparison with the most recent national programme budget figures. The information from housing and education authorities was to inform debates over substitution, where health and social services substitute the activities of other local authority departments for their own.The results confirm that at local levels the majority of expenditure remains under health auspices. The national estimates generally represented an increase over the Department of Health's programme budget figures, though this was anticipated given the different service coverage. The paper concludes with a discussion of the implications of the results both for local agencies and central government.
A Longitudinal Comparison of Cognitive and Adaptive Changes in Subjects with Down's Syndrome and an Intellectually Disabled Control Group
Authors: Roeden J.M. , Zitman F.G. 
Published: March 2010

Sixty‐seven subjects with karyotypically verified Down's syndrome (DS+) and 48 matched controls without DS (DS− were examined on adaptive, intellectual, memory, orientation and motor functions during a period of 4½ years. The primary analysis compared changes in cognitive and adaptive functions in the two groups. Analysis of variance revealed that in adults with DS, over the age of 50 years, functional loss was statistically significant. Intelligence, memory and orientation functions deteriorated statistically significantly in 2½ years. The decrease in adaptive and motor functions took 4½ years to become statistically significant. No ageing effects were found in control subjects.Further investigation focused on the DS+ population over 50 years old (n = 28). The effects of dementia and sensory deficits on adaptive and cognitive decline were examined. Dementia was found to have a significant deteriorating influence on the majority of the adaptive and cognitive functions under study.Compared to the deteriorating influence of dementia, the impact of hearing and visual deficiencies on functional loss was limited. Only visual impairment was related to a lesser performance of personal daily living skills. Hearing handicaps were not significantly related to functional decline.
Staff Characteristics, Working Conditions and Outcomes Amongst Staff in Services for People with Intellectual Disabilities
Authors: Hatton Chris , Rivers Morna , Emerson Eric , Kiernan Chris , Reeves David , Alborz Alison , Mason Heidi , Mason Linda 
Published: March 2010

A survey of 512 staff working in UK services for people with intellectual disabilities was conducted. Descriptive findings regarding staff characteristics, working conditions and a range of staff outcomes are reported. The majority of staff were in their thirties, female, and married or living as married, and almost half of staff had dependants. Almost all the staff in this survey were white. On average, staff had spent approximately eight and a half years working in services for people with intellectual disabilities, and approximately three and a half years working in their current work location. Approximately one‐sixth of staff were working on a fixed‐term contract. Almost two‐thirds of staff were contracted to work full‐time, although nearly two‐fifths of staff reported working longer than their contracted hours.Regarding staff outcomes, almost one‐third of staff reported high levels of distress indicative of mental health problems, a proportion similar to that found in previous UK research but a higher proportion than NHS staff, employed adults or adults generally. This higher distress was reflected in poorer self‐reported health, greater self‐reported stress or pressure, and greater cigarette consumption compared to English adults generally. Just over half the staff had taken sick leave in the past six months, and approximately one‐eighth of staff had applied for another job in the past three months. The implications for services of the findings are briefly discussed.