bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial fibrillation and anticoagulation in a stroke unit population
Authors: Ahmad O. , Ahmad K. E. , Dear K. B. G. , Harvey I. , Hughes A. , Lueck C. J. 
Published: November 2009

AbstractBackground:  Atrial fibrillation (AF) is an important predisposing factor for ischaemic stroke. There is evidence to suggest that even in appropriate candidates warfarin therapy is underutilized. We assessed the prevalence of AF in an Australian stroke unit to determine the degree of undertreatment at presentation.Methods:  A retrospective analysis of all patients admitted to our Stroke Unit between October 2004 and September 2006 was carried out. All patients with a diagnosis of AF, either new or old, were then selected from this group to determine the overall prevalence and anticoagulation status. Data regarding prior stroke, stroke severity and discharge anticoagulation status were also determined.Results:  Data from a total of 500 patients were analysed. Our results showed that AF‐related strokes accounted for a large proportion (28%) of all admissions and were associated with a larger neurological deficit. Most patients (68%) with a prior diagnosis of AF without having obvious contraindications were either not anticoagulated or under‐anticoagulated when presenting with an ischaemic stroke or transient ischaemic attack.Conclusion:  Our results stress the importance of initiating and maintaining anticoagulation in patients with AF and without obvious contraindications to minimize the risk of subsequent stroke.
Pulmonary hypertension in pregnancy: two cases and review of the literature
Authors: Higton A. M. , Whale C. , Musk M. , Gabbay E. 
Published: November 2009

AbstractPulmonary arterial hypertension (PAH) in pregnancy carries a mortality of 30–56%. There are few published data to guide clinicians in its management. Two pregnant women with severe PAH have been treated at Royal Perth Hospital with a successful result in both. Their presentation and management are described. We review the physiological changes in pregnancy, pathophysiology in PAH, and review the literature describing treatment of PAH in pregnancy.
Cancer in older people: a tale of two disciplines
Authors: Steer C. B. , Marx G. M. , Singhal N. , McJannett M. , Goldstein D. , Prowse R. 
Published: November 2009

AbstractManagement of cancer in the elderly presents an unprecedented challenge in Australia with the proportion of the population aged over 65 years set to double over the next four decades. Despite the complex healthcare needs of the older patient with cancer, there is currently little communication or cooperation between the fields of oncology and geriatrics. Improved interdisciplinary communication would facilitate care that is framed within current oncology practice while taking account of physiological age, complex comorbidities, risk of adverse events and pharmacological interactions as well as the implications of cognitive impairment on suitability for treatment and consent. An important first step has been taken towards the development of a strategic, focused and collaborative approach to the management of cancer in older people through a national interdisciplinary workshop convened by the Clinical Oncological Society of Australia in April 2008. Engagement and commitment of both oncology and geriatric disciplines is now critical to ensure that momentum is not lost in progressing this important and growing area of healthcare.
Comparative observation of freeze–thaw‐induced damage in pig, rabbit, and human corneal stroma
Authors: Oh Joo Youn , Kim Mee Kum , Lee Hyun Ju , Ko Jung Hwa , Wee Won Ryang , Lee Jin Hak 
Published: November 2009

AbstractObjective  Although variations exist between species with respect to outcomes after cryopreservation, little is known about the differences in the susceptibility of the corneal stroma to cryoinjury. We performed this study to investigate freeze–thaw‐induced damage in keratocytes and collagen in rabbit, pig, and human corneas.Animals studied  Rabbit, pig, and human.Procedures  We prepared 250‐μm‐thick anterior stroma from rabbit, pig, and human corneas after scraping off the epithelium and endothelium. Each 250‐μm‐thick corneal stroma without epithelium was placed in a 50‐mL tube, frozen with liquid N2 for 15 min and taken out to thaw rapidly at 37 °C. This procedure of rapid freezing and thawing was repeated three times. Differences between the species with respect to cells and collagen structures were examined using hematoxylin–eosin (H&E) staining, terminal deoxynucleotidyl transferase‐mediated nick end labeling (TUNEL) assay, and transmission electron microscopy (TEM). We orthotopically transplanted the pig and rabbit corneal transplants after the triple freeze–thaw cycle into rabbit eyes and evaluated graft survival.Results  On gross examination, rabbit corneas became opaque after the triple freeze–thaw procedure, while pig and human corneas remained transparent. Histologically, keratocytes were apoptotic on TUNEL assay and TEM in rabbit, pig, and human corneas. Collagen fibrils were fragmented and the arrangement of collagen fibrils was severely disturbed in rabbit corneas on H&E staining and TEM; collagen was well preserved in pig and human corneas. Rabbit corneal stroma underwent autolysis after transplantation, whereas the pig corneal stroma remained clear for 1 month.Conclusions  Our study showed that rabbit corneal stroma was more susceptible to freeze–thaw injury than pig and human corneas.
Establishing a reproducible method for the culture of primary equine corneal cells
Authors: Mathes Rachel L. , Dietrich Ursula M. , Krunkosky Thomas M. , Hurley David J. , Reber Adrian J. 
Published: November 2009

AbstractObjective To establish a reproducible method for the culture of primary equine corneal epithelial cells, keratocytes, and endothelial cells and to describe each cell’s morphologic characteristics, immunocytochemical staining properties and conditions required for cryopreservation.Procedures Corneas from eight horses recently euthanized for reasons unrelated to this study were collected aseptically and enzymatically separated into three individual layers for cell isolation. The cells were plated, grown in culture, and continued for several passages. Each cell type was characterized by morphology and immunocytochemical staining.Results All three equine corneal cell types were successfully grown in culture. Cultured corneal endothelial cells were large, hexagonal cells with a moderate growth rate. Keratocytes were small, spindloid cells that grew rapidly. Epithelial cells had heterogenous morphology and grew slowly. The endothelial cells and keratocytes stained positive for vimentin and were morphologically distinguishable from one another. The epithelial cells stained positive for cytokeratin. Keratocytes and endothelial cells were able to be cryopreserved and recovered. The cryopreserved cells maintained their morphological and immunocytochemical features after cryopreservation and recovery.Discussion This work establishes reproducible methods for isolation and culture of equine corneal keratocytes and endothelial cells. Cell morphology and cytoskeletal element expression for equine corneal epithelial cells, keratocytes, and endothelial cells are also described. This has not previously been reported for equine corneal cells. This report also demonstrates the ability to preserve equine keratocytes and endothelial cells for extended periods of time and utilize them long after the primary‐cell collection, a feature that has not been reported for veterinary corneal cell culture.
In vivoconfocal microscopy of the normal equine cornea and limbus
Authors: Ledbetter Eric C. , Scarlett Janet M. 
Published: November 2009

AbstractObjective To describe morphologic features, pachymetry and endothelial cell density of the normal equine cornea and limbus byin vivoconfocal microscopy.Animals studied Ten horses without ocular disease.Procedure The central and peripheral corneas were examined with a modified Heidelberg Retina Tomograph II and Rostock Cornea Module using a combination of automated and manual image acquisition modes. Thickness measurements of various corneal layers were performed and endothelial cell density determined.Results Images of the constituent cellular and noncellular elements of the corneal epithelium, stroma, endothelium, and limbus were acquired in all horses. Corneal stromal nerves, the subepithelial nerve plexus, and the sub‐basal nerve plexus were visualized. Cells with an appearance characteristic of Langerhans cells and corneal stromal dendritic cells were consistently detected in the corneal basal epithelium and anterior stroma, respectively. Median central total corneal thickness was 835 μm (range 725–920 μm) and median central corneal epithelial thickness was 131 μm (range 115–141 μm). Median central endothelial cell density was 3002 cells per mm2(range 2473–3581 cells per mm2).Conclusions In vivocorneal confocal microscopy provides a noninvasive method of assessing normal equine corneal structure at the cellular level and is a precise technique for corneal sublayer pachymetry and cell density measurements. A resident population of presumed Langerhans cells and corneal stromal dendritic cells was detected in the normal equine cornea. The described techniques can be applied to diagnostic evaluation of corneal alternations associated with disease and have broad clinical and research applications in the horse.
Efficacy of lamellar resection, cryotherapy, and adjunctive grafting for the treatment of canine limbal melanoma
Authors: Featherstone Heidi J. , Renwick Peter , Heinrich Christine L. , Manning Sue 
Published: November 2009

AbstractObjective To evaluate the efficacy and complication rate of partial lamellar resection followed by cryotherapy for the management of canine limbal melanoma.Animals studied Fourteen dogs with unilateral canine limbal melanoma which were managed surgically by partial lamellar resection, cryotherapy (1,1,1,2‐tetrafluoroethane) and an adjunctive graft procedure.Methods The clinical records of dogs treated between June 1998 and June 2008 were reviewed. The signalment, approximate size and location of the melanoma, variation in surgical technique, recurrence rate, short‐term (< three months) and long‐term (> three months) complications were assessed. Follow‐up information was collected by patient re‐examination or telephone interview.Results The mean age at diagnosis was 6.3 years, with a range from 3.2 to 12 years. Seven breeds were affected, including five cross‐breed dogs and four Golden Retrievers. The tumour involved the dorsal arc (from the dorsomedial to the ventrolateral quadrant) in 12 eyes and the ventral arc in two eyes. The size of the tumour ranged from 30 to 180 degrees of the limbal circumference. A double freeze‐thaw cycle of cryotherapy was performed in 7/14 eyes and a triple freeze‐thaw cycle in 7/14 eyes. An adjunctive conjunctival graft was performed in 13/14 eyes (free graft n = 3, posterior nictitans conjunctiva/cartilage n = 4, advancement graft n = 5, small intestinal submucosa/advancement graft n = 1) and a frozen homologous graft in 1/14 eyes. The duration of follow‐up ranged from 6 months to 8.5 years with a median of 2.1 years. Recurrence was not clinically detected in any of the 14 eyes. Early complications occurred in 8/14 eyes and included anterior uveitis (7/14), corneal ulceration (5/14), marked corneal granulation tissue at the graft margin (2/14), dyscoria (2/14), corneal lipidosis (1/14) and corneal oedema (1/14). Intra‐operative globe perforation had occurred in 5/7 eyes with anterior uveitis and 2/2 eyes with transient dyscoria. Late complications occurred in 3/14 eyes and included corneal lipidosis which was either mild (<2mm in diameter, 1/14) or marked (>1cm in diameter, 2/14). Marked lipidosis only occurred following the treatment of extensive limbal melanomas which involved approximately 50% of the limbal circumference.Conclusions Surgical management comprising partial lamellar resection, cryotherapy and adjunctive graft placement is technically straightforward, minimally invasive, well tolerated and highly effective. Marked corneal lipidosis is most likely to occur as a post‐operative complication when the limbal melanoma is extensive.
Light and electron microscopic evaluation of canine corneal endothelium following CO2 photokeratotomy
Authors: Hoffman Allison , Ownby Charlotte , Lehenbauer Terry W. , Samuelson Don , Gilmour Margi , Bartels Kenneth 
Published: November 2009

AbstractObjective  To determine using light and scanning electron microscopy if treatment with CO2 photokeratotomy alters the corneal endothelium in healthy dogs.Procedure  Eight surgery laboratory dogs were determined to be free of ocular abnormalities. Under general anesthesia, the left eye of each dog was treated in a quadrant from 12 to 3 o’clock with the CO2 laser in a defocused mode. The right eye served as a control. There were four treatment groups, each with 2 dogs: group 1 (2 W, 0.1 J/s, 0.8 mm tip), group 2 (3 W, 0.3 J/s, 0.8 mm tip), group 3 (2 W, 0.04 J/s NovaScan), group 4 (3 W, 0.06 J/s, NovaScan). The 0.8 mm tip delivered a power density of 382 W/cm2 or 573 W/cm2, at 2 or 3 watts respectively. The NovaScan handpiece delivered a power density of 30 W/cm2 or 40 W/cm2, at 2 or 3 Watts respectively. Following euthanasia, right and left corneas including a 2‐mm scleral rim were harvested and fixed in commercial grade Karnovsky’s fixative. One piece of cornea was processed routinely, embedded in Embed 812 resin, sectioned at 1 um, stained with toluidine blue and evaluated with the light microscope. A separate piece of each cornea was routinely processed and examined with a JEOL 6400 scanning electron microscope (SEM) at 20 KV.Results  No changes in endothelial cell morphology were detected by light microscopy in the sections examined. SEM indicated normal endothelial cell morphology in control eyes with presumed artifactual changes at the corneal free margin (4/8 eyes). Multiple punctate to linear regions of endothelial cell destruction were observed in 6/8 laser‐treated corneas. A significant increase in corneal thickness ranging from 1.90 to 37.28% was observed in all laser treated corneas. This increase in thickness correlated linearly with the degree of endothelial damage. Ultrastructural findings also correlated with postoperative clinical findings.Conclusion  CO2 laser photokeratotomy alters corneal endothelial cell morphology and thickness.
Association of age and response to androgen‐deprivation therapy with or without radiotherapy for prostate cancer: data from CaPSURE
Authors: Aaronson David , Cowan Janet , Carroll Peter , Konety Badrinath 
Published: November 2009

Study Type – Therapy (prospective cohort) Level of Evidence 2bOBJECTIVETo assess whether the response to primary androgen‐deprivation therapy (PADT) and radiotherapy (RT) plus adjuvant ADT would be muted in older men, as their tumours might already be relatively androgen insensitive, because serum testosterone levels decline with increasing age.PATIENTS AND METHODSUsing the Cancer of the Prostate Strategic Urologic Research Endeavor database, we conducted an observational study evaluating two groups of men treated for prostate cancer from 1995 to 2006. One group of 1748 men was treated with PADT and the second group of 612 men was treated with RT (external beam RT or brachytherapy) with neoadjuvant and/or adjuvant ADT. We tested whether age was a predictor of disease progression in the PADT group and prostate‐specific antigen (PSA) recurrence in the RT + ADT group (Phoenix definition). Secondary outcomes were all cause (ACM) and prostate cancer‐specific mortality (PCSM).RESULTSIn both univariate and multivariate analysis stratifying by clinical risk group, age (<65, 65–69, 70–74, and ≥75 years) was not associated with the risk of secondary treatment or PSA recurrence for the PADT and the RT + ADT groups, respectively. Age category had no relationship to increased ACM or PCSM for the RT + ADT group. However, for the PADT group the oldest category (>75 years) had an increased hazard ratio (2.26, 95% confidence interval 1.04–4.88; P = 0.02) for ACM, but a decreased ratio for PCSM (0.29, 0.21–0.42; P < 0.01).CONCLUSIONIf we assume that age is a valid proxy measure for free available testosterone levels, then these levels do not seem to affect the likelihood of response to ADT, either used alone or combined with RT.
Use of Doppler ultrasonography and rigid ureteroscopy for managing symptomatic ureteric stones during pregnancy
Authors: Elgamasy Abdelnaser , Elsherif Ashraf 
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo evaluate the use of Doppler ultrasonography (DUS) and rigid ureteroscopy (RU) for managing symptomatic ureteric stones during pregnancy.PATIENTS AND METHODSThe study comprised 15 pregnant women with persistent renal pain; all were assessed with conventional US followed by DUS in both kidneys.RESULTSThe mean period of gestation at presentation was 25.5 weeks. Stones were found in the right side in 11 patients (73%), in the left in three (20%) while no stone was found in the remaining patient (7%). There was a significantly higher mean resistive index in all 15 obstructed kidneys than in the contralateral normal kidneys. RU was used in all patients, with removal of the stones and fixation of JJ stent. All patients improved after the procedure and completed pregnancy safely up to full‐term, except for premature labour in one patient.CONCLUSIONDUS and RU are efficient for the diagnosis and treatment of symptomatic ureteric stones during pregnancy.
Clinical and magnetic resonance imaging characteristics of vaginal and paraurethral leiomyomas: can they be diagnosed before surgery?
Authors: Hubert Katherine C. , Remer Erick M. , Rackley Raymond R. , Goldman Howard B. 
Published: November 2009

Study Type – Diagnostic (non‐consecutive) Level of Evidence 3bOBJECTIVETo describe the clinical and magnetic resonance imaging (MRI) characteristics of vaginal and paraurethral leiomyomas.PATIENTS AND METHODSAll patients with pathologically confirmed paraurethral and vaginal wall leiomyomas from January 2006 to August 2007 were reviewed. Patients with no preoperative MRI of the pelvis were excluded.RESULTSFive patients were identified; all had a firm, smooth, non‐tender, non‐fluctuant mass. MRI showed a well‐circumscribed shape, a homogeneous signal that was hypointense or isointense to muscle on T1‐ and hyperintense or isointense to muscle on T2‐weighted images, and uniform enhancement. In all cases, MRI excluded urethral diverticulae, and pathology showed leiomyoma, of which one had atypical features.CONCLUSIONParaurethral and vaginal wall leiomyomas can be identified before surgery with a reasonable degree of certainty, based on their clinical and MRI characteristics.
Genetic risks and healthy choices: creating citizen‐consumers of genetic services through empowerment and facilitation
Authors: Harvey Alison 
Published: November 2009

AbstractGenetic testing to identify susceptibility to a variety of common complex diseases is increasingly becoming available. In this article, focusing on the development of genetic susceptibility testing for diet‐related disease, I examine the emergence of direct‐to‐the‐consumer genetic testing services and the (re)configuration of healthcare provision, both within and outside the specialist genetics service, in the UK. I identify two key techniques within these practices: empowerment and facilitation. Using Foucauldian social theory, I show that empowerment and facilitation are being positioned as tools for the creation of citizen‐consumers who will make appropriate dietary choices, based on the results of their genetic analysis. Through these techniques, individuals are transformed into properly entrepreneurial citizens who will, through judicious choices, act to maximise their ‘vital capital’ (their health) and the capital of the social body. I argue that the user of these services is not purely an economic figure, making rational choices as a consumer, but that her configuration as a citizen‐consumer who avails herself of genetic information and services in a proper manner ensures that she is fit to contribute to the economic life of our present.
Practitioner Review: Non‐pharmacological treatments for ADHD: A lifespan approach
Authors: Young Susan , Myanthi Amarasinghe J. 
Published: November 2009

Background:  Attention‐deficit/hyperactivity disorder (ADHD) is a chronic and pervasive developmental disorder that is not restricted to the childhood years.Methods:  This paper reviews non‐pharmacological interventions that are available at present for preschoolers, school‐age children, adolescents and adults.Results:  The most appropriate intervention for preschoolers is parent training. For school‐age children with moderate impairments there is some evidence to suggest that group parent training programmes and classroom behavioural interventions may suffice as a first‐line treatment. For school‐age children with severe impairments, interventions are more appropriate when combined with stimulant medication (i.e., integrated treatment packages are likely to be more successful than ‘standalone’ treatments). Multimodal interventions seem to be best suited for middle school/adolescent children, which most likely reflects that these interventions usually integrate home and school treatment strategies and often include an element of social skills training. Stimulant medication is generally the first line of treatment for adults but CBT has also been found to be effective at addressing the complex needs of this population.Conclusion:  Current research has largely ignored that ADHD is a developmental disorder that spans the preschool to adult years. Most studies focus on young school‐age children and outside of this age group there is a dearth of controlled trials that provide conclusive evidence. As children mature the mode and agent of intervention will shift to reflect the developmental needs and circumstances of the individual.
3‐Methylcholanthrene and benzo(a)pyrene modulate cardiac cytochrome P450 gene expression and arachidonic acid metabolism in male Sprague Dawley rats
Authors: Aboutabl Mona E , Zordoky Beshay NM , El‐Kadi Ayman OS 
Published: November 2009

Background and purpose: There is a strong correlation between cytochrome P450 (P450)‐dependent arachidonic acid metabolism and the pathogenesis of cardiac hypertrophy. Several aryl hydrocarbon receptor (AhR) ligands were found to alter P450‐dependent arachidonic acid metabolism. Here, we have investigated the effect of 3‐methylcholanthrene (3‐MC) and benzo(a)pyrene (BaP), two AhR ligands, on the development of cardiac hypertrophy.Experimental approach: Male Sprague Dawley rats were injected (i.p.) daily with either 3‐MC (10 mg·kg−1) or BaP (20 mg·kg−1) for 7 days. Then hearts were removed, and the heart to body weight ratio and the gene expression of the hypertrophic markers and P450 genes were determined. Levels of arachidonic acid metabolites were determined by liquid chromatography‐electron spray ionization‐mass spectrometry.Key results: Both 3‐MC and BaP increased the heart to body weight ratio as well as the hypertrophic markers, atrial natriuretic peptide and brain natriuretic peptide. 3‐MC and BaP treatment increased the gene expression of CYP1A1, CYP1B1, CYP2E1, CYP4F4, CYP4F5 and soluble epoxide hydrolase. Both 3‐MC and BaP treatments increased the dihydroxyeicosatrienoic acids (DHETs) : epoxyeicosatrienoic acids (EETs) ratio and the 20‐hydroxyeicosatetraenoic acid (20‐HETE) : total EETs ratio. Treatment with benzo(e)pyrene, an isomer of BaP that is a poor ligand for the AhR, did not induce cardiac hypertrophy in rats, confirming the role of AhR in the development of cardiac hypertrophy. Treatment with the ω‐hydroxylase inhibitor, HET0016, significantly reversed BaP‐induced cardiac hypertrophy.Conclusions and implications: 3‐MC and BaP induce cardiac hypertrophy by increasing the ratio of DHETs : EETs and/or the ratio of 20‐HETE : total EETs, through increasing soluble epoxide hydrolase activity.