bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cortical dysfunction underlies disability in multiple sclerosis
Authors: Vucic Steve , Burke Therese , Lenton Kerry , Ramanathan Sudarshini , Gomes Lavier , Yannikas Con , Kiernan Matthew C 
Published: October 2011

Background: Gray matter atrophy has been implicated in the development of secondary progressive multiple sclerosis (SPMS). Cortical function may be assessed by transcranial magnetic stimulation (TMS). Determining whether cortical dysfunction was a feature of SPMS could be of pathophysiological significance. Objectives: Consequently, novel paired-pulse threshold tracking TMS techniques were used to assess whether cortical dysfunction was a feature of SPMS. Methods: Cortical excitability studies were undertaken in 15 SPMS, 25 relapsing–remitting MS patients (RRMS) and 66 controls. Results: Short interval intracortical inhibition (SPMS 3.0 ± 2.1%; RRMS 12.8 ± 1.7%, p < 0.01; controls 10.5 ± 0.7%, p < 0.01) and motor evoked potential (MEP) amplitude (SPMS 11.5 ± 2.2%; RRMS 26.3 ± 3.6%, p <0.05; controls 24.7 ± 1.8%, p < 0.01) were reduced in SPMS, while intracortical facilitation (SPMS -5.2 ± 1.9%; RRMS -2.0 ± 1.4, p < 0.05; controls -0.9 ± 0.7, p < 0.01) and resting motor threshold were increased (SPMS 67.5 ± 4.5%; RRMS 56.0 ± 1.5%, p < 0.01; controls 59.0 ± 1.1%, p < 0.001). Further, central motor conduction time was prolonged in SPMS (9.1 ± 1.2 ms, p < 0.001) and RRMS (7.0 ± 0.9 ms, p < 0.05) patients compared with controls (5.5 ± 0.2 ms). The observed changes in cortical function correlated with the Expanded Disability Status Scale. Conclusion: Together, these findings suggest that cortical dysfunction is associated with disability in MS, and documentation of such cortical dysfunction may serve to quantify disease severity in MS.
Cost of multiple sclerosis in the Czech Republic: The COMS study
Authors: Blahova Dusankova J , Kalincik T , Dolezal T , Kobelt G , Havrdova E 
Published: October 2011

Background: Information about cost of multiple sclerosis (MS) is available from a number of European countries, but no data from the Czech Republic have been published so far. Objective: The objective of this study was to establish the cost of MS in the Czech Republic, overall and by level of disease severity. Methods: Data on demographics, disease history, resource consumption and production losses were collected from 909 patients recruited in 7 MS centres in the Czech Republic. Annual costs were estimated in the societal perspective, using 2007 unit costs. To evaluate the relationship between disability and costs, patients were stratified into those with mild (67%), moderate (27%) and severe (10%) disability using the Expanded Disability Status Scale. Results: Mean total annual costs per patient were €12,272, of which 51% were direct medical costs, 4% direct non-medical costs and 45% indirect costs. The average annual costs in patients with mild, moderate and severe disability amounted to €9905, €14,064 and €22,880, respectively. Conclusion: The total costs of MS in the Czech Republic are estimated at €208.6 million per year. Consistent with other studies, the costs increase significantly with the severity of MS.
Intrathecal synthesis of IgM measured after a first demyelinating event suggestive of multiple sclerosis is associated with subsequent MRI brain lesion accrual
Authors: Durante Laurence , Zaaraoui Wafaa , Rico Audrey , Crespy Lydie , Wybrecht Delphine , Faivre Anthony , Reuter Françoise , Malikova Irina , Pommier Gilbert , Confort-Gouny Sylviane , Cozzone Patrick J , Ranjeva Jean-Philippe , Pelletier Jean , Boucraut Jose , Audoin Bertrand 
Published: October 2011

Background: Previous studies have demonstrated that intrathecal synthesis of IgM is observed in multiple sclerosis (MS) and correlates with a worse disease course. These results suggest that IgM participates in the formation of MS lesions. Objective: The aim of the present study was to assess the potential association between the level of intrathecal synthesis of IgM measured after a clinically isolated syndrome (CIS) and the subsequent formation of brain lesions. Methods: Fifty seven patients with a CIS and a high risk developing MS were enrolled in a longitudinal study. Examination of cerebrospinal fluid was performed after the CIS and included measures of intrathecal IgM and IgG synthesis. Patients were assessed with the same 1.5 Tesla magnetic resonance imaging (MRI) system at baseline and after a mean follow-up period of 49 months (range 36–60). Spearman Rank correlation was used to assess the potential correlations between levels of intrathecal immunoglobulin synthesis and MRI data. Results: The level of intrathecal IgM synthesis was correlated with the number of gadolinium-enhancing lesions at baseline ( p = 0.01) and with accrual of brain lesions during the follow-up period ( p = 0.02). By taking into account brain sub-regions, we demonstrated that the level of intrathecal IgM synthesis was only correlated with the increased number of lesions in the periventricular regions ( p = 0.004). The level of intrathecal IgG synthesis was not correlated with any MRI data. Conclusion: The present longitudinal study demonstrates that the level of intrathecal IgM synthesis measured after a CIS is associated with subsequent lesion accrual during the first years of MS. This result emphasizes the involvement of IgM in plaque formation.
Quantitative measurement of anti-aquaporin-4 antibodies by enzyme-linked immunosorbent assay using purified recombinant human aquaporin-4
Authors: Kim Woojun , Lee Ji-Eun , Li Xue Feng , Kim Su-Hyun , Han Byeong-Gu , Lee Byung Il , Kim Jong Kuk , Choi Kyungho , Kim Ho Jin 
Published: October 2011

Background: Antibodies to aquaporin-4 (AQP4-Ab), known as NMO-IgG, are a sensitive and specific marker for neuromyelitis optica (NMO). Methods: To develop an enzyme-linked immunosorbent assay (ELISA) for AQP4-Ab, we expressed M23 isoform of human AQP4 in a baculovirus system, and used it as an antigen. We measured AQP4-Ab in the sera of 300 individuals: 64 with definite NMO, 31 with high-risk NMO, 105 with multiple sclerosis (MS), 57 with other neurological diseases (ONDs), and 43 healthy controls. We also performed longitudinal measurements of AQP4–Ab in 787 samples collected from 51 patients with definite or high-risk NMO. Results: AQP4-Abs were positive in 72% with definite NMO, 55% with high-risk NMO, and 4% with MS, but none of the OND patients and the healthy individuals. The longitudinal measurement showed AQP4-Ab levels correlating with disease activity. Out of 38 initially seropositive patients, 21 became seronegative under effective immunosuppressive therapy. During most relapses, the serum AQP4-Ab levels were either high or rising compared with the previous value, although rising AQP4-Ab levels did not always lead to acute exacerbation. Two of the 13 initially seronegative patients converted to seropositive following acute exacerbations. Conclusions: We established an AQP4-Ab ELISA, which could be a potential monitoring tool of disease activity.
Cytokine mapping in cerebrospinal fluid and blood in multiple sclerosis patients without oligoclonal bands
Authors: Vrethem M , Kvarnström M , Stenstam J , Cassel P , Gustafsson M , Landtblom AM , Ernerudh J 
Published: October 2011

Objective: Since there are clinical and genetic differences between MS patients with intrathecal oligoclonal bands (OCB+) in the cerebrospinal fluid (CSF) compared with those without (OCB−), the aim was to find out if OCB− patients showed a different pattern of cytokine immune activation compared with OCB+ patients. Methods: The study included 25 MS patients (10 OCB− and 15 OCB+) and 13 controls. A panel of cytokines was measured; IL-1β, IL-6, IL-8/CXCL8, IL-10, TNF and GM-CSF in serum, CSF and in supernatants from polyclonally stimulated blood mononuclear cells, where also levels of IL-12p40, IL-13, IL-15, IL-17 and IFN-γ were measured. The concentrations of soluble (s) VCAM-1 and sCD14 were measured in serum and CSF. Results: In general, there were no extensive differences in cytokine concentrations between the OCB− and OCB+ groups. Conclusion: OCB− MS patients do not seem to constitute a separate entity concerning inflammatory parameters measured as cytokine concentrations in CSF and blood.
The aerodynamic performance of a range of FIFA-approved footballs
Authors: Passmore M , Rogers D , Tuplin S , Harland A , Lucas T , Holmes C 
Published: October 2011

Much discussion surrounds the flight of a football, especially that which is perceived as irregular, and is typically done so with little understanding of the aerodynamic effects or substantive evidence of the path taken. This work establishes that for a range of FIFA-approved balls there is a significant variation in aerodynamic performance. This paper describes the methods used for mounting stationary and spinning footballs in a wind tunnel enabling accurate force data to be obtained, and the analysis techniques used. The approach has been to investigate a number of scenarios: the non-spinning Reynolds sweep, unsteady loads, orientation sensitivity (yaw sweep), and the spinning Reynolds sweep. The techniques are applied to a number of footballs with differing constructions and the results reported. To put the aerodynamic data into context, the results are applied in a flight model to predict the potential differences in the behaviour of each ball in the air. This paper concludes that, although the drag characteristics are different for each different ball tested, the simulation suggests that this has only a limited effect on the flight of the ball. It is also shown that the unsteadiness of the aerodynamic loads is unlikely to be responsible for unpredictable behaviour. However, it is also shown that there are significant differences in the lateral aerodynamic forces for a range of FIFA-approved match balls, and that these aerodynamic differences have a significant effect on the flight path for both spinning and slowly rotating balls.
Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population
Authors: Bhattacharya Ijen , Saxena Rahul , Gupta Veena 
Published: October 2011

Background: Osteoarthritis (OA) is the most common cause of chronic pain and disability in the elderly. It involves progressive destruction of articular cartilage as a consequence of various factors including augmented oxidative stress with advancing age which has not yet been controlled. It is conceivable that exogenous vitamin E supplementation ameliorates the modifiable indexes via regulation of free radical production and the consumption of antioxidant reserve. The objectives of the present study were to investigate the therapeutic effect of vitamin E supplementation in ameliorating the altered activity of antioxidant enzymes (superoxide dismutase, ceruloplasmin, glutathione peroxidase and catalase), erythrocyte malondialdehyde level (MDA, i.e. marker of lipid peroxidation) and markers of systemic inflammation (plasma C-reactive protein [CRP] and synovial fluid interleukin 6 [IL-6]) in osteoarthritic elderly. Methods: Antioxidant enzymes status, MDA, IL-6 and CRP levels were estimated by using standard methods in 40 healthy individuals (control group) and in 40 osteoarthritic patients aged 50–70 years before and after 3 months of vitamin E supplementation, i.e. group I (nonsupplemented) and group II (200 mg/day vitamin E supplemented). The obtained values were compared statistically by using Student’s t-test. Results: Marked alteration in antioxidant enzymes, MDA and inflammatory markers were observed in group I ( p < 0.05) as compared with controls. These levels were ameliorated significantly after vitamin E supplementation ( p < 0.05) in group II. However, elevated levels of serum CRP and synovial fluid IL-6 ( r = 0.034; p < 0.05) were decreased insignificantly ( p < 0.1) after vitamin E supplementation in knee OA patients. Conclusions: These findings confirm the protective role of vitamin E supplementation against oxidative stress mediated biomolecular deterioration in OA. However, the anti-inflammatory role of vitamin E remains to be explored.
A Case Report of Fibular Aplasia, Tibial Campomelia, and Oligosyndactyly (FATCO) Syndrome Associated With Klinefelter Syndrome and Review of the Literature
Authors: Ekbote Alka V. , Danda Sumita 
Published: October 2011

Limb development is a complex regulated development phenomenon involving multiple genes. Fibular Aplasia, Tibial Campomelia and Oligosyndactyly (FATCO) syndrome (MIM#246570) is a syndrome of unknown genetic basis and inheritance with variable expressivity and penetrance. Its counterpart, Fuhrmann syndrome or Femoral-Fibularaplasia-Campomelia and Oligosyndactyly are a result of defect in the WNT7a gene located on the 3p25. Former is proposed to be a development dysplasia of defective dorso-ventral polarity assignment and distal limb development. Ectrodactyly and fibular a/hypoplasia (EFA, MIM# 113310) share the full phenotypic spectrum of FATCO syndrome, whether they are allelic disorders or represent two variable presentations in the spectrum of the same disorder is not an established fact. We report here one Indian patient with findings of FATCO syndrome with associated Klinefelter syndrome. This is the first such report which is likely to be a co-incidental finding and has implications for genetic counseling. Levels of Evidence: Therapeutic, Level IV
Osteoarthritis of the Ankle and Foot Complex in Former Greek Soccer Players
Authors: Armenis Elias , Pefanis Nikolaos , Tsiganos Georgios , Karagounis Panagiotis , Baltopoulos Panagiotis 
Published: October 2011

Sports activities cause increased loads in elite athletes’ joints. Current scientific knowledge highlights the importance of applied mechanical loads on the physiology and pathophysiology of the articular cartilage. Thus, it is possible that sporting activity has a role in the development of osteoarthritis (OA), a painful and damaging joint disease. The aim of the present study was to investigate and record osteoarthritic alterations in the ankle and foot complex in former Greek soccer players and also compare them with those in the general population. The study sample consisted of 170 male, former elite soccer players, aged between 42 and 55 years (mean = 49.8 years, standard deviation [SD] = 7.4). A control group of 132 men, aged between 42 and 55 years (mean, 50.7 years, SD = 9.9), with no regular athletic activity were examined. The development of osteoarthritic alterations was recorded through a questionnaire and clinical and radiological examination. Radiographic analysis of the images in former athletes group showed not only more signs of cartilage degeneration in comparison with the control group (P < .05) but also similar clinical manifestations (pain and impaired mobility; P > .05). Osteophyte formation is a frequent disease among former soccer players—with variations on radiographic images—but it does not appear in their clinical picture. However, it is likely that both spurs and subchondral sclerosis (main findings) are preclinical manifestations of OA. Levels of Evidence: Prognostic, Level II
Efficacy of Intravenous Tissue Plasminogen Activator in Frostbite Patients and Presentation of a Treatment Protocol for Frostbite Patients
Authors: Johnson Adam R. , Jensen Heather L. , Peltier George , DelaCruz Eugene 
Published: October 2011

Frostbite can be a devastating and even debilitating injury. Early identification and proper treatment of frostbite is critical in saving digits and limbs. Tissue plasminogen activator (tPA) has been shown to be effective in reducing the number of digits amputated after severe frostbite injury. Nothing has been presented in the podiatric literature regarding the use of tPA in treating frostbite patients for preserving toes and feet. Intravenous tPA and IV heparin were used to treat severe frostbite injuries that did not show improvement after rapid rewarming, had absent Doppler pulses in the distal limb or digits, showed limited or no perfusion by Tc-99 3-phase bone scan, and had no contraindications to use of tPA. All 11 patients included in this study were treated at Hennepin County Medical Center between 2008 and 2010. A total of 73 digits (upper and lower extremity) were considered at risk for amputation after evaluation with Tc-99 bone scan. Of those digits that were affected, 43 were amputated. Intravenous tPA is a safe and effective treatment to reduce the number of digital amputations after severe frostbite injury. The authors’ protocol for treating severe frostbite includes the use of tPA. Levels of Evidence: Therapeutic, Level IV
A Method Used to Access the Functional Outcome of Tibial Posterior Tendon Transfer for Foot Drop in Leprosy
Authors: Reis Felipe J. J. , Knackfuss Irocy , Verçosa Nubia , de Menezes Sara Lúcia , Gomes Maria Kátia 
Published: October 2011

Objectives. The aim of this study was to access the postoperative functional results of posterior tibial tendon transfer for foot drop as a consequence of nerve palsy in leprosy. Material and Methods. Thirteen patients (9 males and 4 females) with ages ranging from 9 to 69 years were submitted to posterior tibial tendon transfer by the circumtibial route to correct foot drop in leprosy. The length of postoperative follow-up ranged from 1 to 5 years. The Stanmore system was used as a method for evaluating the functional results of postoperative posterior tibial tendon transfer. This system is made up of 7 different categories and the total score is 100. Results. According to the Stanmore system, the results were poor in 1 patient (7.6%), moderate in 2 feet (15.3%), good in 5 feet (38.4%), and excellent in 5 feet (38.4%). All the patients were satisfied with the final outcome. Conclusion. The posterior tibial tendon transfer for foot drop in leprosy was efficient in restoring normal function of the foot and gait without changing foot posture. In the absence of a standardized method for assessing the results of posterior tibial tendon transfer, the Stanmore system seems to be a good tool for an objective evaluation. Levels of Evidence: Therapeutic, Level IV
Retigabine (ezogabine) as add-on therapy for partial-onset seizures: an update for clinicians
Authors: Harris Jacklyn A. , Murphy Julie A. 
Published: October 2011

Objective: The present study reviewed the pharmacology, pharmacokinetics, efficacy, and safety of retigabine (ezogabine), a potential agent for use as adjunctive treatment in refractory partial-onset seizures. Methods: A MEDLINE search (1966–May 2011) was conducted using the key words retigabine, ezogabine, D-23129, epilepsy, and anticonvulsant. Bibliographies of all articles retrieved were also reviewed. All studies including humans and published in English with data describing retigabine for the adjunctive treatment of partial-onset seizures were reviewed. Results: Retigabine has been shown to interact with the KCNQ2/KCNQ3 subunits of the potassium channels, GABAA receptors, and weakly block sodium and calcium channels. Retigabine is 50–60% bioavailable, metabolized by N-glucuronidation and N-acetylation, 80% protein bound, and has few drug–drug interactions. Recent data suggest that retigabine may have a role as adjunctive treatment for refractory partial-onset seizures. Placebo-controlled trials demonstrated a 23.4–44.3% reduction in seizure frequency with 50% responder rates ranging from 23.2% to 47.0% with varying doses of retigabine. The most common adverse effects, occurring in greater than 10% of subjects in the clinical trials, include abnormal gait, confusion, dizziness, fatigue, headache, nausea, somnolence, speech disorder, tremor, urinary tract infection, and blurred vision. Conclusions: Retigabine is a promising agent for adjunctive treatment of refractory partial-onset seizures.
Serum adiponectin and resistin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome
Authors: Pangaribuan Bertha , Yusuf Irawan , Mansyur Muchtaruddin , Wijaya Andi 
Published: October 2011

Objective: The role of insulin resistance in polycystic ovary syndrome (PCOS) has been established. However the role of adiponectin and resistin in the relationship between insulin resistance as markers of obesity and PCOS has not been conclusive. This study aims to determine the influence of the serum levels of adiponectin and resistin on PCOS, and assess possible correlations with the hormonal and metabolic parameters of the syndrome and obesity. Methods: This study continued a case control study that had finished recruiting 24 subjects of reproductive women with PCOS as a case group, and 24 subjects of normal ovulatory reproductive women without hyperandrogenism as a control group. Further, only 18 subjects of the control group had a body mass index (BMI) <25 kg/m2 and were included the data analysis, whereas others were excluded. Therefore, these study data were divided into three groups. Twenty-four PCOS patients from the case group were allocated to two groups, A ( n = 14) patients had PCOS + BMI ≥25 kg/m2; B ( n = 10) patients had PCOS + BMI <25 kg/m2. Group C was the control group of 18 reproductive women without PCOS + BMI <25 kg/m2. Blood samples were collected between day 3 and 5 of a spontaneous menstrual cycle, at 07:00 to 09:00, after overnight fasting. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, prolactin, sex hormone-binding globulin (SHBG), glucose, insulin, adiponectin and resistin were measured. Results: Serum adiponectin levels were significantly decreased in group A compared with group B and group C. No significant difference existed in adiponectin between group B and group C. Homeostasis Model of Assessment—Insulin Resistance (HOMA-IR) value in group A was found to be significantly higher than group C, but no significant differences were found between group B and group C or between group A and group B. There was no significant difference in serum resistin between all groups, nevertheless the resistin-to-adiponectin (R:A) ratio was significantly decreased in group A compared with groups B and C. In a multiple regression model, BMI, testosterone and insulin resistance were the major determinants of hypoadiponectinemia. However, only BMI was the major determinant of the resistin represented by the R:A ratio. Conclusions: Serum adiponectin levels and the ratio of resistin to adiponectin levels are reduced in obese women with PCOS. These results suggest that, by reducing adiponectin serum level, hyperandrogenemia, together with nutritional status of obesity, might contribute to insulin resistance in the pathogenesis of PCOS.