bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seroepidemiological survey of cytomegalovirus infection among pregnant women in Nagasaki, Japan
Authors: Tagawa Masato , Minematsu Toshio , Masuzaki Hideaki , Ishimaru Tadayuki , Moriuchi Hiroyuki 
Published: November 2009

AbstractBackground:  Epidemiology of cytomegalovirus (CMV) infection varies widely, depending on ethnicity and socioeconomic status. A seroepidemiological survey was conducted to determine CMV infection among pregnant women in Nagasaki Prefecture, Japan.Methods:  We measured serum CMV‐specific immunoglobulin (Ig) M and IgG at the first and third trimesters. IgG avidity was determined when both CMV‐IgG and CMV‐IgM were positive.Results:  Of 339 pregnant women, 296 (87.3%) were CMV‐IgG‐positive at the first trimester. Of 267 paired sera, one (0.37%) had CMV‐IgG seroconversion, another one (0.37%) had CMV‐IgM seroconversion, and 12 had both CMV‐IgG and CMV‐IgM, two (0.75%) of whom had low IgG avidity, suggesting recent infection. Thus, the incidence of primary CMV infection during pregnancy was 0.74–1.5%. Assuming the rate of in utero transmission following maternal primary infection to be approximately 40%, the incidence of congenital infection is estimated to be 0.3–0.6%.Conclusion:  Although CMV seroprevalence among pregnant women has been decreasing in industrialized regions including other parts of Japan, CMV‐seroprevalence remains high in Nagasaki. Thus, epidemiology of CMV infection seems variable within Japan, a country generally considered to be ethnically and socioeconomically homogeneous. However, 40–80 infants may be congenitally infected and 15–27% (or 6–22) of them may ultimately suffer from certain neurological sequelae annually in Nagasaki Prefecture, so where annual live births are approximately 13,300, congenital CMV infection seems to be a significant public health problem in such an apparently low‐risk region as Nagasaki.
Surfactant lavage decreases systemic interleukin‐1β production in meconium aspiration syndrome
Authors: Wang Pei‐Wei , Jeng Mei‐Jy , Wang Liang‐Shun , Fang Li‐Jung , Soong Wen‐Jue 
Published: November 2009

AbstractBackground:  Surfactant lavage has been used to remove meconium debris in meconium aspiration syndrome (MAS), but the influence of surfactant lavage on pro‐inflammatory cytokines and cellular apoptosis is unclear. The aim of this study was to investigate the response of pro‐inflammatory cytokine and the influence on alveolar cellular apoptosis using therapeutic bronchoalveolar lavage with diluted surfactant to treat MAS.Methods:  Twelve newborn piglets were anesthetized, intubated via tracheostomy, and artificially ventilated. MAS was induced by intratracheal instillation of 3–5 mL/kg of 20% human meconium. The piglets were then randomly assigned to a surfactant lavage group (n= 6) or a control group (n= 6). Piglets in the lavage group received bronchoalveolar lavage with 30 mL/kg diluted surfactant (5 mg/mL) in two aliquots. Cardiopulmonary parameters were monitored continuously. Serum was obtained hourly to measure concentrations of pro‐inflammatory cytokines, including interleukin (IL)‐Iβ, IL‐6, and tumor necrosis factor α. Lung tissue was histologically examined after experiments, and terminal deoxynucleotidyl transferase‐mediated nick‐end labeling assay for apoptotic cell death was also performed.Results:  The animals in the lavage group displayed significantly better gas exchange and lower serum concentrations of IL‐1β than the animals in the control group (P < 0.05). The number of apoptotic cells in lung tissues was significantly lower in the lavage group than the control group, and also in the nondependent than the dependent site.Conclusion:  Therapeutic surfactant lavage improves oxygenation, decreases production of systemic pro‐inflammatory cytokine IL‐1β, and alleviates the severity of lung cell apoptosis in newborn piglets with experimentally‐induced MAS.
Intravesical prostatic protrusion predicts clinical progression of benign prostatic enlargement in patients receiving medical treatment
Authors: Lee Lui Shiong , Sim Hong Gee , Lim Kok Bin , Wang Delin , Foo Keong Tatt 
Published: November 2009

Objectives:  To assess intravesical prostatic protrusion (IPP) as a novel predictor of clinical progression in patients with benign prostatic enlargement (BPE).Methods:  All patients attending the outpatient clinic at our institution who were being treated for lower urinary tract symptoms (LUTS) secondary to BPE between January 1997 and December 2003 were recruited into the study. International Prostate Symptom Score (IPSS) scores, uroflowmetry parameters, post‐void residual urine volume (PVR), IPP and serum prostate‐specific antigen (PSA) were collected. IPP was classified into Grade 1, 2 or 3. Patients were stratified to different treatment options including watchful waiting, alpha blockers or 5‐alpha reductase inhibitors. Those who developed high post‐void residual urine volume (>100 mL), acute urinary retention or a deterioration of at least 4 points in IPSS score were considered to have disease progression. Using the Grade 1 IPP group as a reference, the odds ratio for clinical progression of Grade 2 and Grade 3 IPP were calculated by using multivariate analysis.Results:  A total of 259 patients with a mean age of 63 years (range 50–90 years) and mean follow‐up time of 32 months were available for analysis. Fifty‐two patients were found to have clinical progression. Odds ratio for progression of a Grade 2 IPP was 5.1 (95% confidence interval [CI] 1.6–16.2) and that of a Grade 3 IPP was 10.4 (95% CI 3.3–33.4).Conclusion:  A higher IPP grade is associated with a higher risk of clinical progression in BPE. IPP is a useful non‐invasive predictor for clinical progression in BPE.
Renal tubular epithelial cell injury and oxidative stress induce calcium oxalate crystal formation in mouse kidney
Authors: Hirose Masahito , Yasui Takahiro , Okada Atsushi , Hamamoto Shuzo , Shimizu Hideo , Itoh Yasunori , Tozawa Keiichi , Kohri Kenjiro 
Published: November 2009

Objectives:  To clarify the role of renal tubular cell (RTC) injury and oxidative stress in the early stage of renal calcium oxalate crystal formation in a mouse model.Methods:  Daily intra‐abdominal injections of glyoxylate (1.35 mmol/kg/day) into 8‐week‐old mice were carried out over 6 days. Kidneys were extracted before and at 6, 12 and 24 h and 3 and 6 days after glyoxylate injection. Crystal formation was detected using Pizzolato staining and polarized light optical microscopy. Immunohistochemical staining and western blotting of superoxide dismutase, and 4‐hydroxynonenal and malondialdehyde were carried out in order to observe oxidative stress and lipid peroxidation, respectively. RTC microstructural damage and crystal nuclei formation were observed using transmission electron microscopy. To ameliorate RTC injury, mice were treated with green tea 1 week before and 1 week after glyoxylate administration. The number of crystals and RTC damage were observed and comparisons were made between glyoxylate‐treated mice with and without green tea administration.Results:  Oxidative stress and lipid peroxidation were observed after 6 h. Crystal nuclei containing collapsed mitochondria and fallen microvilli appeared in the renal distal tubular lumen after 24 h. Crystals occupying the tubular lumen were detected on day 3. The number of crystals in mice receiving green tea was significantly lower than in those receiving glyoxylate alone.Conclusions:  RTC injury, especially mitochondrial damage, and oxidative stress induce the early stage of calcium oxalate crystal formation in mice.
Comparing peripheral venous access between obese and normal weight children
Authors: NAFIU OLUBUKOLA O. , BURKE CONSTANCE , COWAN ANDY , TUTUO NARKO , MACLEAN SARAH , TREMPER KEVIN K. 
Published: November 2009

SummaryIntroduction:  Intravenous (i.v.) access is sometimes a difficult, time‐consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures.Methods:  We prospectively collected data on children aged 2–18 years undergoing elective noncardiac surgery at our institution. A trained research assistant (RA) was present for PIV placement in all patients and noted the following: age, gender, ethnicity, weight, height, and BMI. We also collected data on i.v. insertion site, number of attempts, number of operators, and the number of i.v. cannula used. The main outcome variable was success or failure of i.v. placement on first attempt. Sample size calculation indicated a need for 40 obese and 40 control patients.Results:  A total of 103 (56 lean and 47 obese) patients comprised the study population. PIV cannulation was achieved on the first attempt in 55.2% while 39.6% of patients had 2–3 attempts before successful cannulation. Obese children were more likely to have failed attempt at first cannulation than lean controls (P < 0.001). Similarly, obese children were more likely to require two or more attempts at cannulation than lean children (P < 0.001).Conclusion:  These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.
A pretreatment nomogram predicting biochemical failure after salvage cryotherapy for locally recurrent prostate cancer
Authors: Spiess Philippe E. , Katz Aaron E. , Chin Joseph L. , Bahn Duke , Cohen Jeffrey K. , Shinohara Katsuto , Hernandez Mike , Bossier Julie , Kassouf Wassim , Pisters Louis L. 
Published: November 2009

Study Type – Prognosis (retrospective cohort) Level of Evidence 2bOBJECTIVETo gather a pooled database from six tertiary‐care referral centres using salvage cryotherapy (SC) for locally recurrent prostate cancer, and develop a pretreatment nomogram allowing a prediction of the probability of biochemical failure after SC, based on pretreatment clinical variables.PATIENTS AND METHODSWe retrospectively analysed 797 men treated at six tertiary‐care referral centres with SC for locally recurrent disease after primary radiotherapy with curative intent. The median duration of follow‐up from the time of SC to the date of last contact was 3.4 years. The primary study endpoint was biochemical failure, defined as a serum prostate‐specific antigen (PSA) level after SC of >0.5 ng/mL.RESULTSOverall, the rate of biochemical failure was 66% with a median of 3.4 years of follow‐up. A logistic regression model was used to predict biochemical failure. Covariates included serum PSA level at diagnosis, initial clinical T stage, and initial biopsy Gleason score. On the basis of these results, a pretreatment nomogram was developed which can be used to help select patients best suited for SC. Our pretreatment nomogram was internally validated using 500 bootstrap samples, with the concordance index of the model being 0.70.CONCLUSIONA pretreatment nomogram based on several diagnostic variables (serum PSA level at diagnosis, biopsy Gleason grade, and initial clinical T stage) was developed and might allow the selection of ideal candidates for SC.
Use of systemic therapy and factors affecting survival for patients undergoing cytoreductive nephrectomy
Authors: Kutikov Alexander , Uzzo Robert G. , Caraway Aaron , Reese Carl T. , Egleston Brian L. , Chen David Y.T. , Viterbo Rosalia , Greenberg Richard E. , Wong Yu‐Ning , Raman Jay D. , Boorjian Stephen A. 
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo present a multi‐institutional experience evaluating the use of systemic therapy in patients undergoing cytoreductive nephrectomy (CN), as prospective randomized trials showed a survival benefit for CN in patients with metastatic renal cell carcinoma treated with immunotherapy, and these data have been extrapolated to support CN in the era of targeted therapy, but the likelihood that patients with metastatic kidney cancer who undergo CN will receive systemic treatment afterward remains poorly defined.PATIENTS AND METHODSIn all, 141 patients who underwent CN between 1990 and 2008 were identified from our Institutional Kidney Cancer Registries. Kaplan‐Meier analyses and Cox regression models were used to assess the effect of clinicopathological and perioperative variables on patients’ subsequent receipt of systemic therapy, and survival after CN.RESULTSOverall, 98 of the 141 patients (69.5%) received postoperative systemic treatment, at a median (range) of 2.5 (0.1–61.5) months after CN. In this group, 52 (53%) patients received immunotherapy, 34 (35%) targeted agents, and 12 (12%) other regimens. By contrast, 43 patients (31%) did not receive systemic therapy, because of rapid disease progression (13, 30%), decision for surveillance by medical oncology (nine, 21%), patient refusal (10, 23%), perioperative death (eight, 19%), and unknown reasons in three (7%). The median (range) survival after CN was 16.7 (0–120) months. The risk of death after surgery correlated with the number of metastatic sites (P = 0.012) and symptoms (P = 0.001) at presentation, poor performance status (P = 0.001), high tumour grade (P = 0.006), and presence of sarcomatoid features (P < 0.024).CONCLUSIONNearly a third of patients undergoing CN did not receive systemic treatment. While some were electively observed or declined therapy, others did not receive treatment due to rapidly progressive disease. Further investigation is warranted to identify those patients at highest risk of rapid postoperative disease progression who might benefit instead from an initial approach to treatment with systemic therapy.
Are patients with non‐muscle‐invasive bladder cancer a suitable population for a lung cancer screening trial?
Authors: Del Rey Javier , Placer José , Vallmanya Felip , Pujol Núria , Prat Esther , Miró Rosa , Gelabert Antoni 
Published: November 2009

Study Type – Prognosis (case series) Level of Evidence 4OBJECTIVETo estimate the relative risk of developing a second primary neoplasm, in particular lung cancer, after having non‐muscle‐invasive bladder cancer (NMIBC).PATIENTS AND METHODSPatients were included in the study if they had developed NMIBC between 1995 and 2003. All clinical data were extracted from the medical records of our institution’s database. The interval between neoplasms, smoking habits, histological subtypes and survival were also analysed. Patient follow‐up was ≥5 years.RESULTSWe found 231 patients with NMIBC, 39 of which had a second primary neoplasm: 10 lung cancer, one pancreas, one gastric, one pharynx, one liver, one parathyroid, one oesophageal, five basal cell carcinoma, three larynx, two colon, three rectal and 10 prostate. In patients with lung cancer, NMIBC was the first primary tumour. Overall, the median (range) interval between occurrence of NMIBC and lung cancer was 54.2 (8–168) months. For the relationship between the observed and expected cases of lung cancer, after normalizing our frequencies to the sex ratio and age of our group of patients, the risk of lung cancer was 10.27‐fold higher in patients with NMIBC as compared with the general population of Catalonia (95% confidence interval 4.92–18.88).CONCLUSIONWe consider that an annual examination for the detection and prevention of lung cancer must be included in clinical guides for patients with NMIBC. This proposal is reinforced by the finding that death in our group of patients with both tumours was always derived from lung cancer and not from bladder cancer.
The EU Childhood Obesity Project
Authors: De La Hunty A. 
Published: November 2009

SummaryThe European Union Childhood Obesity Project was set up in 2001 to test the hypothesis that the higher risk of obesity seen in formula‐fed infants – as compared with breastfed babies – is a result of the higher protein content in infant formulas than in breastmilk. The infants participating in the study were recruited between 2002 and 2004 and followed up for 2 years. The first results of the study were published earlier this year. After 2 years, the weight‐for‐length and body mass index of the infants fed the lower‐protein formula were significantly lower than those fed the higher‐protein formulas. Extrapolating from previous studies suggests that the children in the higher‐protein group have a 13% increased risk of being obese in adolescence compared with those in the lower‐protein group. An analysis of the timing of weaning has also been published: this showed that formula‐fed infants were given solid foods on average 2 weeks earlier than breastfed infants (19 weeks compared with 21 weeks) and were twice as likely to be introduced to solid foods before the age of 4 months as breastfed infants.
Efficacy and safety of anti‐obesity drugs in children and adolescents: systematic review and meta‐analysis
Authors: Viner R. M. , Hsia Y. , Tomsic T. , Wong I. C. K. 
Published: November 2009

SummaryWe undertook a meta‐analysis of randomized controlled trials to summarize the efficacy of anti‐obesity drugs in reducing BMI and improving health in children and adolescents. Data sources included Medline, Embase, the Cochrane controlled trials register and other registers of controlled trials, together with reference lists of identified articles. All data sources were searched from January 1996 to July 2008. We searched for double blind randomized placebo controlled trials of approved anti‐obesity drugs used in children and adolescents (age <20) with primary obesity for ≥6 months. Six trials, 4 of sibutramine (total patients = 686) and 2 of orlistat (n = 573) met inclusion criteria. No trials of rimonabant were identified. Compared with placebo, sibutramine together with behavioural support reduced BMI by 2.20 kg/m2 (95% CI: 1.57 to 2.83) and orlistat together with behavioural support reduced BMI by 0.83 kg/m2 (95% CI 0.47 to 1.19). Sibutramine improved waist circumference, triglycerides and high density lipoprotein (HDL)‐cholesterol, but raised systolic and diastolic blood pressure and pulse. Orlistat increased rates of gastrointestinal side‐effects. We conclude that sibutramine in adolescents produces clinically meaningful reductions in BMI and waist circumference of approximately 0.63 SD, with improvements in cardiometabolic risk. Orlistat modestly reduces BMI (effect size approximately 0.24 SD) with a high prevalence of gastrointestinal adverse effects.
Obesity, intentional weight loss and physical disability in older adults
Authors: Rejeski W. J. , Marsh A. P. , Chmelo E. , Rejeski J. J. 
Published: November 2009

SummaryWe examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short‐term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat‐free mass during caloric restriction. Multi‐year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long‐term feasibility and effects of combining resistance exercise with weight loss in older adults.
Obesity is a sign – over‐eating is a symptom: an aetiological framework for the assessment and management of obesity
Authors: Sharma A. M. , Padwal R. 
Published: November 2009

SummaryObesity is characterized by the accumulation of excess body fat and can be conceptualized as the physical manifestation of chronic energy excess. Using the analogy of oedema, the consequence of positive fluid balance or fluid retention, obesity can be seen as the consequence of positive energy balance or calorie ‘retention’. Just as the assessment of oedema requires a comprehensive assessment of factors related to fluid balance, the assessment of obesity requires a systematic assessment of factors potentially affecting energy intake, metabolism and expenditure. Rather than just identifying and describing a behaviour (‘this patient eats too much’), clinicians should seek to identify the determinants of this behaviour (‘why, does this patient eat too much?’). This paper provides an aetiological framework for the systematic assessment of the socio‐cultural, biomedical, psychological and iatrogenic factors that influence energy input, metabolism and expenditure. The paper discusses factors that affect metabolism (age, sex, genetics, neuroendocrine factors, sarcopenia, metabolically active fat, medications, prior weight loss), energy intake (socio‐cultural factors, mindless eating, physical hunger, emotional eating, mental health, medications) and activity (socio‐cultural factors, physical and emotional barriers, medications). It is expected that the clinical application of this framework can help clinicians systematically assess, identify and thereby address the aetiological determinants of positive energy balance resulting in more effective obesity prevention and management.
Path Analysis for Discrete Variables: The Role of Education in Social Mobility
Authors: Kuha Jouni , Goldthorpe John H. 
Published: November 2009

SummaryAn important open question in sociology with obvious policy implications is how to assess the magnitude of the effect of educational attainment on intergenerational social mobility. To examine this, we propose a general method of path analysis, which can be used to estimate direct and indirect effects even in systems where some of the variables are categorical. It provides an additive decomposition of total effects which is exact when the effects are expressed as mean differences, and approximate but typically quite accurate for other measures of association such as log-odds-ratios. Estimates of the effects and their standard errors can be calculated by using standard output for fitted models. The method is illustrated by an analysis of British survey data on social mobility.