bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphocyte subset changes between 3 and 15 months of age in infants born to HIV‐seropositive women in South Africa
Authors: Moodley D. , Bobat R. A. , Coovadia H. M. , Doorasamy T. , Munsamy S. , Gouws E. 
Published: October 2009

Summary The evolution of T‐lymphocyte subsets during infancy in perinatally HIV‐infected African babies has not been previously described. In a hospital‐based cohort study, T‐lymphocyte subset changes were investigated in 72 South African black children born to HIV seropositive mothers. Sixteen (22.2%) children were classified as infected and 56 (77.8%) as uninfected by 18 months of age. Four (25%) of the infected infants died before the age of 9 months from HIV‐related disease.The CD4 and CD8 T‐lymphocyte subsets, expressed in absolute numbers, as percentages, percentiles or as ratios, were clear indicators of HIV infection at all ages between 3 and 15 months. The most marked changes were a decreased percentage of CD4 cells and an increase in percentage of CD8 cells in the infected group. In the 4 infected infants who died, CD8 count and CD4:CD8 ratio clearly predicted poor clinical outcome at 3 months. Taken together, both CD4:CD8 ratio and CD4 percentage are reliable markers of HIV infection in an African paediatric population; however, a raised CD8 lymphocyte count rather than a CD4 count is a more specific prognostic marker of disease progression in HIV infected children.
Efficacy of artemisinin and mefloquine combinations against Plasmodium falciparum. In vitro simulation of in vivo pharmacokinetics
Authors: Bwijo B. , Alin M. Hassan , Abbas N. , Wernsdorfer W. , Björkman A. 
Published: October 2009

Summary The activity of artemisinin in combination with mefloquine was tested in vitro against a chloroquine‐sensitive (F32) strain of Plasmodium falciparum. A method of repetitive dosing and extending the culture observation period to 28–30 days was used to mimic the in vivo pharmacokinetic situation. Plasmodium falciparum was exposed to artemisinin from 10‐8 to 10‐5 M, mefloquine from 3 × 10‐9 to 10‐5 M and their combinations. The exposure time for artemisinin was 3 hours twice daily and for mefloquine 24 hours. The drug‐dosing duration was 3 days.Neither artemisinin nor mefloquine alone provided radical clearance of P. falciparum, even when maximum concentrations (10‐5 M) were applied. The antiparasitic activity of artemisinin and mefloquine were significantly higher when dosed alone. Effective concentrations for different degrees of inhibition (EC 50, 90 and 99) of both artemisinin and mefloquine respectively were significantly lower when used in combination. At concentrations normally reached in vivo, this effect was clearly synergistic (P= 0.016)Our in vitro model of intermittent dosing of artemisinin and mefloquine combinations for 3 days provides significant evidence of positive interaction between the two compounds. Lower combination concentrations around the MIC‐values for the individual compounds showed synergistic effect, and high concentrations showed additive effect. This indicates that such drug combinations may provide radical clearance at concentrations lower than those required for single‐drug treatment.
Non‐classic cystic fibrosis associated with D1152H CFTR mutation
Authors: Burgel P‐R , Fajac I , Hubert D , Grenet D , Stremler N , Roussey M , Siret D , Languepin J , Mely L , Fanton A , Labbé A , Domblides P , Vic P , Dagorne M , Reynaud‐Gaubert M , Counil F , Varaigne F , Bienvenu T , Bellis G , Dusser D 
Published: October 2009

Burgel P‐R, Fajac I, Hubert D, Grenet D, Stremler N, Roussey M, Siret D, Languepin J, Mely L, Fanton A, Labbé A, Domblides P, Vic P, Dagorne M, Reynaud‐Gaubert M, Counil F, Varaigne F, Bienvenu T, Bellis G, Dusser D. Non‐classic cystic fibrosis associated with D1152H CFTR mutation.Background: Limited knowledge exists on phenotypes associated with the D1152H cystic fibrosis transmembrane conductance regulator (CFTR) mutation.Methods: Subjects with a D1152H allele in trans with another CFTR mutation were identified using the French Cystic Fibrosis Registry. Phenotypic characteristics were compared with those of pancreatic insufficient (PI) and pancreatic sufficient (PS) cystic fibrosis (CF) subjects in the Registry (CF cohort).Results: Forty‐two subjects with D1152H alleles were identified. Features leading to diagnosis included chronic sinopulmonary disease (n = 25), congenital absence of the vas deferens (n = 11), systematic neonatal screening (n = 4), and genetic counseling (n = 2). Median age at diagnosis was 33 [interquartile range (IQR, 24–41)] years in D1152H subjects. Median sweat chloride concentrations were 43.5 (39–63) mmol/l in D1152H subjects and were markedly lower than in PI and PS CF subjects (p < 0.05). Bronchiectasis was present in 67% of D1152H subjects, but Pseudomonas aeruginosa colonization and pancreatic insufficiency were present in <30% of subjects. Estimated rates of decline in forced expiratory volume in 1 s (FEV1) were lower in D1152H subjects vs PI CF subjects (p < 0.05). None of the D1152H subjects identified since 1999 had died or required lung transplantation.Conclusions: When present in trans with a CF‐causing mutation, D1152H causes significant pulmonary disease, but all subjects had prolonged survival.
Two‐stage liver transplantation: an effective procedure in urgent conditions
Authors: Montalti Roberto , Busani Stefano , Masetti Michele , Girardis Massimo , Di Benedetto Fabrizio , Begliomini Bruno , Rompianesi Gianluca , Rinaldi Laura , Ballarin Roberto , Pasetto Alberto , Gerunda Giorgio E. 
Published: October 2009

Montalti R, Busani S, Masetti M, Girardis M, Di Benedetto F, Begliomini B, Rompianesi G, Rinaldi L, Ballarin R, Pasetto A, Gerunda GE. Two‐stage liver transplantation: an effective procedure in urgent conditions. Clin Transplant 2010: 24: 122–126. © 2009 John Wiley & Sons A/S.Abstract:  Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non‐function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instability in three of them. Etiologies of these three patients were as follows: PNF after liver transplantation, ischemic hepatitis after right hepatic artery embolization, and massive reperfusion syndrome during a liver transplantation. In the fourth patient, during the liver transplantation when hepatic artery was ligated, a kidney carcinoma in the donor graft was discovered. We decided to complete the hepatectomy and to construct a temporary portocaval shunt.Mean anhepatic phases were 19 h and 15 min. All patients survived the two‐stage liver transplantation procedure without major complications. Our cases demonstrated that temporary portocaval shunt while awaiting urgent liver transplantation could be an effective “bridge” in selected patients who develop toxic liver syndrome; however, a short time between portocaval shunt and transplantation and careful intensive care managements are mandatory.
Chylopericardium in a child with impaired venous access following small bowel transplantation
Authors: Bhole V. , Gozzini S. , Stumper O. , Advani S. , Sullivan P. B. , Rodrigues A. F. , Gupte G. L. 
Published: October 2009

Bhole V, Gozzini S, Stumper O, Advani S, Sullivan PB, Rodrigues AF, Gupte GL. Chylopericardium in a child with impaired venous access following small bowel transplantation. Pediatr Transplantation 2011: 15:e39–e41. © 2009 John Wiley & Sons A/S.Abstract:A 10‐yr‐old child with impaired venous access (bilateral occlusion of internal jugular veins, subclavian veins, and inominate veins) underwent an isolated small bowel transplant. He presented with lethargy, shortness of breath 13 months into his follow‐up and was diagnosed to have chylopericardium. MR venography and lymphangiography could not demonstrate the site of lymphatic leak. His chyloperciardium was treated with pericardiocentesis and MCT diet. The most likely cause for the chylopericardium was venous occlusion of the subclavian veins with backpressure resulting in a lymphatic leak. A brief review of literature along with treatment options is discussed.
Xenon and isoflurane improved biventricular function during right ventricular ischemia and reperfusion
Authors: HEIN M. , ROEHL A. B. , BAUMERT J. H. , BLEILEVENS C. , FISCHER S. , STEENDIJK P. , ROSSAINT R. 
Published: October 2009

Background: Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynamics, especially during right ventricular ischemia, which is generally characterized by a high acute complication rate.Methods: The effects of 70 vol% xenon and 0.9 vol% isoflurane on biventricular function were assessed in a porcine model (n=36) using the conductance catheter technique, and the expression of the type B natriuretic peptide (BNP) gene was measured. The animals underwent 90 min of right ventricular ischemia followed by 120 min of reperfusion. A barbiturate‐anesthetized group was included as a control.Results: Cardiac output was compromised in unprotected animals during ischemia by 33±18% and during reperfusion by 53±17%. This was mainly due to impaired contractility in the left ventricle (LV) and increased stiffness. Isoflurane attenuated the increase in stiffness and resulted in a higher preload. In contrast, xenon increased the right ventricular afterload, which was compensated by an increase in contractility. Its effects on diastolic function were less pronounced. Upregulation of BNP mRNA expression was impeded in the remote area of the LV by both isoflurane and xenon.Conclusions: Xenon and isoflurane demonstrated equipotent effects in preventing the hemodynamic compromise that is induced by right ventricular ischemia and reperfusion, although they acted through somewhat differential inotropic and vasodilatory effects.
Unilateral paravertebral block: an alternative to conventional spinal anaesthesia for inguinal hernia repair
Authors: BHATTACHARYA P. , MANDAL M. C. , MUKHOPADHYAY S. , DAS S. , PAL P. P. , BASU S. R. 
Published: October 2009

Background: Inguinal herniorrhaphy can be successfully performed using general, regional or local anaesthesia. Paravertebral block (PVB) has been used for unilateral procedures such as thoracotomy, breast surgery, chest wall trauma, hernia repair or renal surgery.Methods: We compared unilateral lumbar PVB with conventional spinal anaesthesia (SA) in 60 consenting ASA I and II males aged 18–65 years, scheduled for unilateral inguinal hernia repair. Patients were randomly assigned into two groups, P (n=30) or S (n=30) to receive either PVB or SA, respectively. Two patients (7%) in group P had to be converted to general anaesthesia due to block failure. During surgery, patients of both groups received intravenous infusion of propofol titrated to light sedation.Results: The time to first post‐operative analgesic requirement (primary outcome measure) as 342 ± 73 min in group P and 222 ± 22 min in group S (P<0.0001). Time to ambulation was 234 ± 111 min in group P and 361 ± 32 min in group S (P<0.0001). Urinary retention requiring catheterization were found in zero (0%) patients in group P compared with five (16%) in group S (P=0.024).Conclusion: It can be concluded that unilateral PVB is more efficacious than conventional SA in terms of prolonging post‐operative analgesia and reducing morbidities in patients undergoing elective unilateral inguinal hernia repair.
Neurolytic phenol blockade of the obturator nerve for severe adductor spasticity
Authors: AKKAYA T. , UNLU E. , ALPTEKIN A. , GUMUS H. I. , UMAY E. , CAKCI A. 
Published: October 2009

Background: In this study, we present the 3‐month follow‐up results of a retrospective analysis of obturator nerve (ON) phenol neurolysis performed between 2000 and 2007 in patients with adductor spasticity.Methods: The study was performed by retrospective investigation of the clinical follow‐up results of 80 ON phenol treatments in 62 patients. Neurolysis using 5–10 ml 6% phenol was applied with the guidance of fluoroscopy and a peripheral nerve stimulator. Pain, spasticity and hygiene were evaluated and the hip abduction range of motion (ROM) was measured at the end of the first week and in the first, second and third months following the intervention.Results: The visual analogue scale scores decreased significantly in the first week, first month and the second month, but reached their initial values in the third month. A drastic increase in the ROM values was shown in hip abduction in the first week, first month and second month. An increase in the Ashworth Scale values was observed in the second and third months, but they did not reach their initial values. The hygiene score decreased drastically in the first week and the first and second months, but worsened in the third month. The success rate in nerve localization during ON neurolysis was 100%.Conclusion: ON phenol blockade with fluoroscopy and peripheral nerve stimulator guidance in patients with adductor spasticity led to a decrease in spasticity and pain with an increase in the ROM of the hip and better hygiene with an efficacy lasting for about 3 months.
Histochemical Analysis of Glycoconjugates in the Skin of a Catfish (Arius Tenuispinis, Day)
Authors: Al‐Banaw A. , Kenngott R. , Al‐Hassan J. M. , Mehana N. , Sinowatz F. 
Published: October 2009

SummaryA histochemical study using conventional carbohydrate histochemistry (periodic‐acid staining including diastase controls, alcian blue staining at pH 1 and 2.5) as well as using a battery of 14 fluorescein isothiocyanate (FITC)‐labelled lectins to identify glycoconjugates present in 10 different areas of the skin of a catfish (Arius tenuispinis) was carried out. The lectins used were: mannose‐binding lectins (Con A, LCA and PSA), galactose‐binding lectins (PNA, RCA), N‐acetylgalactosamine‐binding lectins (DBA, SBA, SJA and GSL I), N‐acetylglucosamine‐binding lectins (WGA and WGAs), fucose‐binding lectins (UEA) and lectins which bind to complex carbohydrate configurations (PHA E, PHA L). Conventional glycoconjugate staining (PAS staining, alcian blue at pH 1 and 2.5) showed that the mucous goblet cells contain a considerable amount of glycoconjugates in all locations of the skin, whereas the other unicellular gland type, the club cells, lacked these glycoconjugates. The glycoproteins found in goblet cells are neutral and therefore stain magenta when subjected to PAS staining. Alcian blue staining indicating acid glycoproteins was distinctly positive at pH 1, but gave only a comparable staining at pH 2.5. The mucus of the goblet cells therefore also contains acid glycoproteins rich in sulphate groups. Using FITC‐labelled lectins, the carbohydrate composition of the glycoproteins of goblet cells could be more fully characterized. A distinct staining of the mucus of goblet cells was found with the mannose‐binding lectins LCA and PSA; the galactosamine‐binding lectins DBA, SBA and GLS I; the glucosamine‐binding lectin WGA; and PHA E which stains glycoproteins with complex carbohydrate configurations. No reaction occurred with the fucose‐binding lectin UEA and the sialic acid‐specific lectin SNA. In addition, the galactose‐binding lectins PNA and RCA showed only a weak or completely negative staining of the mucus in the goblet cells. The specificity of the lectin staining could be proved by inhibiting binding of the lectins by competitive inhibition with the corresponding sugars. From these data, we can conclude that the mucus produced by the epidermal goblet cells of A. tenuispinis is rich in mannose, N‐acetylgalactosamine and N‐acetylglucosamine residues.
Evidence‐based management of heart failure in clinical practice: a review of device‐based therapy use
Authors: Thavapalachandran S. , Leong D. P. , Stiles M. K. , John B. , Dimitri H. , Lau D. H. , Psaltis P. J. , Brooks A. G. , Alasady M. , Lim H. S. , Young G. D. , Sanders P. 
Published: October 2009

AbstractBackground:  Heart failure is a growing health issue and is associated with significant mortality risk. Device therapy is efficacious in preventing sudden death in patients with heart failure; however, this evidence comes from rigorous clinical trials. It is unclear how device therapy is utilized in ‘real‐world’ practice. The primary objective was to characterize patterns of device use in patients with heart failure at risk of sudden death and to identify barriers to guideline‐driven prescription of implantable cardioverter–defibrillators.Methods:  We report a cross‐sectional study of patients attending general cardiology clinic over a 3‐month period.Results:  Of 1003 consecutive patients attending the cardiology clinic, 176 had heart failure. Of these, 66 were potentially eligible for device therapy, but only 16 of these had actually undergone device implantation. Potentially eligible non‐recipients were older (P < 0.001), more likely to have ischaemic cardiomyopathy (P= 0.002), less likely to be prescribed spironolactone (P= 0.005) or warfarin (P= 0.02), and less likely to have a widened QRS > 120 ms (P= 0.005). There was a high prevalence of underuse of evidence‐based pharmacotherapies among patients with heart failure.Conclusion:  There is substantial underuse of device therapy in patients with heart failure. Strikingly, whereas patients with symptoms of heart failure were more likely to receive a device, those being managed for ischaemic heart disease were not. There is also a high prevalence of failure to prescribe evidence‐based pharmacotherapy in a tertiary hospital general cardiology clinic. This may be explained in part by the lack of a patient database to record treatment contraindications and to alert clinicians to possible gaps in patient therapy.
The occurrence of asthma in hospitalized patients with type 2 diabetes mellitus
Authors: Hashemzadeh M. , Movahed M. R. 
Published: October 2009

AbstractDiabetes mellitus (DM) has been found to be associated with cardiovascular disease. The goal of this study is to evaluate the prevalence of asthma in patients with type II DM after adjusting for other comorbid conditions. We used patient treatment files of inpatients' admissions containing discharge diagnosis (Classification of Mental and Behavioural Disorders (ICD)‐9 codes) from Veterans Health Administration Hospitals. The patients were divided into two groups: ICD‐9 code for DM and a control group with hypertension but no DM. ICD‐9 codes for asthma were used to study the prevalence of asthma in DM patients versus the control. We performed uni‐ and multi‐variable analysis adjusting for comorbid conditions. Asthma was present in 13 242 (4.5%) of DM patients versus 16 038 (2.9%) in the control group. Using multi‐variable analysis, DM remained independently associated with asthma (odds ratio: 2.99; confidence interval: 2.92–3.06; P < 0.0001). The prevalence of asthma is significantly higher in hospitalized patients with type II DM independent of other comorbid conditions. The pathogenesis of this association is not known warranting further investigation.
Testing the outcome score of spontaneous intracerebral haemorrhage in haemodialysis patients
Authors: Huang B.‐R. , Lo Y.‐L. , Chang C.‐H. , Chen T.‐Y. 
Published: October 2009

AbstractThe aim of this study is to determine the predictive value of the spontaneous intracerebral haemorrhage (ICH) outcome score (which we described previously) in haemodialysis (HD) patients who develop spontaneous ICH. The validation cohort consisted of all HD patients with spontaneous ICH presenting to Chang Gung Memorial Hospital in Taiwan during 2005–2007. The data were collected from one hospital and prospectively analysed, and the predictive model was tested using an external validation dataset. The prognostic factors were confirmed by chi‐squared testing. We calculated the 30‐day mortality in different groups of the validation cohort divided according to outcome score and tested the predictive value of the outcome score. The overall mortality rate was 52.6% in 38 HD patients. The originally identified prognostic factors were Glasgow Coma Scale score, age ≥70 years, systolic blood pressure <130 or ≥200 mmHg, ICH volume ≥30 mL, presence of intraventricular haemorrhage and serum glucose ≥8.8 mmol/L. All but one (serum glucose ≥8.8 mmol/L (P= 0.07)) were subsequently found to be associated with 30‐day mortality. In patients scoring 6 and 7, mortality was 100%, but in patients scoring 0, it was only 11.1%. The 30‐day mortality in the validation cohort increased steadily with score and had good predictive value (correlation coefficient = 0.986, P < 0.001). Similar results in two different cohorts indicate that the ICH outcome score is a reliable outcome measure.
Are specialist physicians missing out on the e‐Health boat?
Authors: Osborn M. , Day R. , Westbrook J. 
Published: October 2009

AbstractBackground:  Nationally health systems are making increasing investments in the use of clinical information systems. Little is known about current computer use by specialist physicians, particularly outside the hospital setting.Aims:  To identify the extent and reasons physician Fellows of the Royal Australasian College of Physicians (RACP) use computers in their work.Methods:  A self‐administered survey was emailed from the RACP to all practising physicians in 2007 that were living in Australia and New Zealand who had consented to email contact with the College.Results:  The survey was sent to a total of 7445 eligible physicians, 2328 physicians responded (31.3% response rate), but only 1266 responses (21.0%) were able to be analysed. Most 97.5% had access to computers at work and 96.5% used home computers for work purposes. Physicians in public hospitals (72.6%) were more likely to use computers for work (65.6%) than those in private hospitals (12.6%) or consulting rooms (27.3%). Overall physicians working in public hospitals used a wider range of applications with 70.5% using their computers for searching the internet, 53.7% for receiving results and 52.7% used their computers to engage in specific educational activities. Physicians working from their consulting rooms (33.6%) were more likely to use electronic prescribing (11%) compared with physicians working in public hospitals (5.7%).Conclusions:  Fellows have not incorporated computers into their consulting rooms over which they have control. This is in contrast to general practitioners who have embraced computers after the provision of various incentives. The rate of use of computers by physicians for electronic prescribing in consulting rooms (11%) is very low in comparison with general practitioners (98%). One reason may be that physicians work in multiple locations whereas general practitioners are more likely to work from one location.
Stress‐life fatigue assessment of pipelines with plain dents
Authors: CUNHA S. B. , PASQUALINO I. P. , PINHEIRO B. C. 
Published: October 2009

ABSTRACTThis paper presents a new algorithm for assessing the fatigue life of dented pipelines. The proposed methodology was conceived according to the current stress‐life fatigue theory and design practice: it employs S–N curves inferred from tensile test material properties and uses well established methodologies to deal with the stress concentration, the mean stress and the multi‐axial stress state that characterizes a dented pipe. Finite element analyses are carried out to model the denting process and to determine the stress concentration factors of several pipe‐dent geometries. Using dimensional analysis over the numerical results, a non‐dimensional number to characterize the pipe‐dent geometry is determined and linear interpolation expressions for the stress concentration factors of dented pipelines are developed. Fatigue tests are conducted with the application of cyclic internal pressure on small‐scale dented steel pipe models. In view of the fatigue test results, the more appropriate S–N curve and mean stress criteria are selected.