bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of octyl methoxycinnamate in preventing postoperative peritoneal adhesions: An experimental model
Authors: Aysan Erhan , Bektas Hasan , Kaygusuz Arslan 
Published: December 2009

AbstractAim:  To evaluate the effect of octyl methoxycinnamate on preventing postoperative peritoneal adhesions (PPA).Methods:  Forty outbred Wistar albino female rats (mean weight, 230 ± 25 g; mean age, 6 months) were divided into four equal groups. In Group 1, 0.1 mL octyl methoxycinnamate was injected into the peritoneal cavity. In Group 2, only an adhesion model was generated. In Group 3, an adhesion model was generated, and then this area was covered with 0.1 mL octyl methoxycinnamate. In Group 4, an adhesion model was generated after the area was covered with 0.1 mL octyl methoxycinnamate. All rats were sacrificed on postoperative day 10, and adhesions were scored both macroscopically and microscopically.Results:  The macroscopic adhesion score of Group 2 differed significantly from the scores in Groups 3 and 4 (P < 0.05), but there was no difference between Groups 3 and 4 (P > 0.05). Microscopic evaluation showed that the mean histopathological fibrosis score of Group 3 differed significantly from the score in Group 4 (P = 0.029).Conclusion:  Octyl methoxycinnamate covering peritoneal surfaces effectively decreases adhesion formation, but the effect is more pronounced if octyl methoxycinnamate is applied before trauma induction. These results indicate that covering of peritoneal surfaces with viscous liquids, such as octyl methoxycinnamate, which have no toxic effects on vital tissues and especially on peritoneal mesothelial cells, prior to peritoneal trauma (e.g. laparotomy) may decrease PPA formation by preventing or decreasing the trauma.
Prenatal spontaneous disruption of the dividing membrane in monochorionic diamniotic twins detected at the time of fetoscopic laser photocoagulation
Authors: Yoshimura Kazuaki , Aiko Yukiyo , Inagaki Hirohide , Nakata Masahiko , Hachisuga Toru 
Published: December 2009

AbstractSpontaneous antepartum rupture of the dividing membrane occurring in monochorionic diamniotic twins (MD twin) is an extremely rare complication and difficult to diagnose prenatally. We present a case of pseudo‐monoamniotic twins derived from an MD twin gestation, which was suspected by ultrasound and was confirmed by antepartum fetoscopy. A 28‐year‐old woman, gravida 1, para 1 at 24 weeks of gestation was referred because of suspected polyhydroamnios in an MD twin. Ultrasound suggested twin–twin transfusion syndrome stage III, spontaneous rupture of the dividing membranes and cord entanglement. Fetoscopic laser photocoagulation (FLP) was performed using the Nd:YAG laser on 12 placental vascular connections. Fetoscopy revealed the spontaneous rupture of the dividing membrane and cord entanglement. The remainder of the pregnancy was managed as a monoamniotic twin gestation. Elective cesarean section was performed at 32 weeks of gestation following antenatal steroids and concordantly grown healthy male infants were delivered.
Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm
Authors: PATRIANAKOS‐HOOBLER ATHENA I , MSALL MICHAEL E , HUO DEZHENG , MARKS JEREMY D , PLESHA‐TROYKE SUSAN , SCHREIBER MICHAEL D 
Published: December 2009

Aim  To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth.Method  Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric oxide for respiratory distress syndrome. Abnormal outcomes at the age of 2 years were defined as neurosensory disability (cerebral palsy, blindness, or bilateral hearing loss) or delay (no neurosensory disability but Bayley Scales of Infant Development mental or performance developmental index scores <70). School readiness (assessed at a mean age of 5y 6mo, SD 1y) was determined using neurodevelopmental assessments of motor, sensory, receptive vocabulary, perceptual, conceptual, and adaptive skills.Results  The mean birthweight of the cohort (57 males, 64 females) was 987g (SD 374), and the mean gestational age was 27.3 weeks (SD 2.6). At the age of 2 years, the neurodevelopmental classification was ‘disabled’ in 11% and ‘delayed’ in 23%. At the age of 5 years 6 months, intensive special education was required for 11% and some special education for 21%. Disability and delay at the age of 2 years were 92% and 50% predictive of lack of school readiness respectively, whereas only 15% of children who were normal at the age of 2 years were not school ready at the later assessment. Children with delay at 2 years were more likely to need special education if they were socially disadvantaged.Interpretation  Without preschool developmental supports, preterm survivors living in poverty will require more special education services.
Relationship between gross motor capacity and daily‐life mobility in children with cerebral palsy
Authors: SMITS DIRK‐WOUTER , GORTER JAN WILLEM , KETELAAR MARJOLIJN , VAN SCHIE PETRA EM , DALLMEIJER ANNET J , LINDEMAN ELINE , JONGMANS MARIAN J 
Published: December 2009

Aim The aim of this study was to examine the relationship between gross motor capacity and daily‐life mobility in children with cerebral palsy (CP) and to explore the moderation of this relationship by the severity of CP.Method Cross‐sectional analysis in a cohort study with a clinic‐based sample of children with CP (n=116; 76 males, 40 females; mean age 6y 3mo, SD 12mo, range 4y 8mo–7y 7mo) was performed. Gross motor capacity was assessed by the Gross Motor Function Measure (GMFM‐66). Daily‐life mobility was assessed using the Pediatric Evaluation of Disability Inventory (PEDI): Functional Skills Scale (FSS mobility) and Caregiver Assistance Scale (CAS mobility). Severity of CP was classified by the Gross Motor Function Classification System (48% level I, 17% level II, 15% level III, 8% level IV, 12% level V), type of motor impairment (85% spastic, 12% dyskinetic, 3% ataxic), and limb distribution (36% unilateral, 49% bilateral spastic).Results Scores on the GMFM‐66 explained 90% and 84% respectively, of the variance of scores on PEDI‐FSS mobility and PEDI‐CAS mobility. Limb distribution moderated the relationship between scores on the GMFM‐66 and the PEDI‐FSS mobility, revealing a weaker relationship in children with unilateral spastic CP (24% explained variance) than in children with bilateral spastic CP (91% explained variance).Interpretation In children aged 4 to 7 years with unilateral spastic CP, dissociation between gross motor capacity and daily‐life mobility can be observed, just as in typically developing peers.
Pyruvate dehydrogenase complex deficiency: four neurological phenotypes with differing pathogenesis
Authors: BARNERIAS CHRISTINE , SAUDUBRAY JEAN‐MARIE , TOUATI GUY , DE LONLAY PASCALE , DULAC OLIVIER , PONSOT GERARD , MARSAC CÉCILE , BRIVET MICHÈLE , DESGUERRE ISABELLE 
Published: December 2009

Aim  To describe the phenotype and genotype of pyruvate dehydrogenase complex (PDHc) deficiency.Method  Twenty‐two participants with enzymologically and genetically confirmed PDHc deficiency were analysed for clinical and imaging features over a 15‐year period.Results  Four groups were identified: (1) those with neonatal encephalopathy with lactic acidosis (one male, four females; diagnosis at birth); (2) those with non‐progressive infantile encephalopathy (three males, three females; age at diagnosis 2–9mo); (3) those with Leigh syndrome (eight males; age at diagnosis 1–13mo); and (4) those with relapsing ataxia (three males; 18–30mo). Seventeen mutations involved PDHA1 (a hotspot was identified in exons 6, 7, and 8 in seven males with Leigh syndrome or recurrent ataxia). Mutations in the PDHX gene (five cases) were correlated with non‐progressive encephalopathy and long‐term survival in four cases.Interpretation  Two types of neurological involvement were identified. Abnormal prenatal brain development resulted in severe non‐progressive encephalopathy with callosal agenesis, gyration anomalies, microcephaly with intrauterine growth retardation, or dysmorphia in both males and females (12 cases). Acute energy failure in infant life produced basal ganglia lesions with paroxysmal dystonia, neuropathic ataxia due to axonal transport dysfunction, or epilepsy only in males (11 cases). The ketogenic diet improved only paroxysmal dysfunction, providing an additional argument in favour of paroxysmal energy failure.
A comparison of Hausman's and Breslaw–Smith's methods in estimating consumer welfare loss because of fuel taxes
Authors: Shin Sang‐Cheol , Burke Dock 
Published: December 2009

AbstractIn this paper, we investigate the welfare effect of US gasoline consumption caused by fuel taxes. Using two different economics approaches – the Hausman method and the Breslaw and Smith method – in measuring consumer welfare loss, we calculate compensating variation (CV) and the corresponding dead weight loss (DWL) assuming there are changes in motor gasoline tax. Our analysis shows that tax revenue, CV and DWL increases as motor gasoline tax increases, but the social welfare loss measured in DWL increases far more rapidly than the other two.
De novo epileptic confusion in the elderly: A 1‐year prospective study
Authors: Veran Olivier , Kahane Philippe , Thomas Pierre , Hamelin Sophie , Sabourdy Cecile , Vercueil Laurent 
Published: December 2009

SummaryPurpose: Nonconvulsive status epilepticus (NCSE) is clinically difficult to diagnose, especially in old patients without epilepsy, and requires electroencephalography (EEG) for diagnosis. Its incidence among elderly patients with confusion of unknown origin (CUO) remains undetermined.Methods: A 1‐year prospective study was conducted in patients aged 60 years or older, for whom EEG was requested because of confusion considered to be of unknown origin after initial clinical, biologic, and imaging investigations. Diagnosis criteria included a validated clinical assessment scale to confirm confusion.Results: Of 44 patients with confirmed CUO, 7 presented with de novo NCSE. NCSE population had a mean age of 76 years (range, 60–97 years). No statistically significant differences were found between NCSE patients and others for age, drugs, presence of myoclonia, eyelid myoclonia, tachycardia, or agitation. In contrast, an acute onset (<24 h), gender (100% female among NCSE patients), and lack of clinical response to simple commands were significantly associated with NCSE. No differences between the two groups were evidenced for mortality and morbidity (length of hospitalization, social outcome, and so on).Discussion: Almost 16% of patients aged 60 or older with confusion of unknown origin had NCSE, according to this first prospective study. Female patients with rapid onset (<24 h) of symptoms and lack of response to simple commands were at a higher risk of presenting with NCSE.
Inhibition of long‐term potentiation by valproic acid through modulation of cyclic AMP
Authors: Chang Pishan , Chandler Kate E. , Williams Robin S.B. , Walker Matthew C. 
Published: December 2009

SummaryPurpose: Valproic acid (VPA) is widely used clinically in epilepsy, bipolar disorder, and migraine. In experimental models, it has also been shown to have neuroprotective and antiepileptogenic effects. Its mechanisms of action in these diverse conditions are, however, unclear, but there is some evidence indicating an effect of VPA upon protein kinase A (PKA) activity. We, therefore, asked whether VPA modulates cyclic adenosine monophosphate (cAMP)/PKA–dependent synaptic plasticity and whether this mode of action could explain its anticonvulsant effect.Methods: We first tested the effects of VPA on PKA‐dependent synaptic plasticity at mossy fiber to CA3 synapses in rat hippocampus slices following very high‐frequency stimulation or application of the adenylyl cyclase activator forskolin. Using biochemical assays, we then tested whether VPA had a direct effect on PKA activity or an indirect effect through modulating cAMP production. Lastly, VPA and inhibitors of adenylyl cyclase (SQ22536) and PKA (H89) were tested in in vitro models of epileptiform activity induced in hippocampal–entorhinal cortex slices using either pentylenetetrazol (2 mM) or low magnesium.Results: VPA (1 mm) inhibited PKA‐dependent long‐term potentiation of mossy fiber to CA3 pyramidal cell transmission. However, VPA did not directly modulate PKA activity but rather inhibited the accumulation of cAMP. In acute in vitro seizure models, the anticonvulsant activity of VPA is not mediated through modulation of adenylyl cyclase or PKA.Conclusions: These results indicate that VPA through an action on cAMP accumulation can inhibit synaptic plasticity, but this cannot fully explain its anticonvulsant effect.
Collaborative Problem Solving Using an Industrial Ecology Approach
Authors: Boehme Susan E. , Panero Marta A. , Muñoz Gabriela R. , Powers Charles W. , Valle Sandra N. 
Published: December 2009

SummaryOver the course of ten years, a consortium of stakeholders (the Harbor Consortium) used a collaborative approach to identify viable pollution prevention (P2) strategies for specific contaminants, namely mercury, cadmium, polychlorinated biphenyls (PCBs), dioxins, and polycyclic aromatic hydrocarbons (PAHs) as well as suspended solids entering the New York/New Jersey Harbor. The project, titled “The New York/New Jersey Harbor Watershed Pollution Prevention and Industrial Ecology Project,” in a very conscious and overt way engaged stakeholders in the process of developing P2 recommendations for the Harbor. The industrial ecology (IE) tools applied by the Harbor Consortium include substance flow analysis (SFA), material flow analysis (MFA), and, to a limited extent, life cycle analysis (LCA) and fate and transport analysis (F&T), to quantify and characterize how the contaminants flow through the regional economy and the Harbor Watershed once released to the environment. The application of these scientific tools to five contaminants at such a large geographical scale, within the context of a broad and inclusive stakeholder process, and with the goal of identifying and implementing pollution prevention strategies, led to a wide range of surprising outcomes and lessons learned. Undertaking this IE research with the key institutions and stakeholders at the table resulted in the identification and the implementation of many P2 opportunities.
Needs of Older Caregivers of Patients with Advanced Cancer
Authors: Daly Barbara J. , Douglas Sara , Lipson Amy , Foley Helen 
Published: December 2009

OBJECTIVES: To determine whether age or stage of cancer can be used to identify caregivers at high risk for excessive burden or distress.DESIGN: Descriptive data collected as part of a psychosocial research registry, comparing younger caregivers with older and caregivers of early‐stage patients with those of later stage.PARTICIPANTS: Caregivers of newly diagnosed adult cancer patients.MEASUREMENTS: Caregiver Reaction Assessment (CRA), the Profile of Mood States (POMS), single‐item indicators from the Patient Reported Outcome Measurement Information System set, and the Medical Outcomes Study Social Support (MOS‐SS) Scale. Patient information was obtained from the medical record.RESULTS: Younger caregivers and caregivers of patients with Stage I and II cancer identified a greater lack of family support than older caregivers and caregivers of patients with Stage III and IV cancer. Significant regression models were found for three CRA subscales (Disrupted Schedule, Lack of Family Support, and Health Problems), as well as for the POMS depression and fatigue scales. Caregiver social support (MOS‐SS) made the only significant contribution to the models. There were significant differences between caregivers with high and low levels of social support on almost all measures of well‐being.CONCLUSION: Incorporating formal assessment of social support may be useful in identifying at‐risk caregivers. In addition, there is a need to further investigate which dimensions of social support are most strongly related to measures of well‐being.
Predictors of Engagement in a Coping and Communication Support Intervention for Older Patients with Advanced Cancer
Authors: Rose Julia Hannum , Bowman Karen F. , Radziewicz Rosanne M. , Lewis Steven A. , O'Toole Elizabeth E. 
Published: December 2009

OBJECTIVES: To examine patterns and predictors of engagement in a coping and communication support (CCS) intervention tailored to the preferences of middle‐aged and older patients in the early treatment phase for late‐stage cancer.DESIGN: Randomized controlled trial examining processes and outcomes of a CCS intervention for patients with late‐stage cancer over time.SETTING: Two ambulatory cancer clinics providing care for underserved populations in Cleveland.PARTICIPANTS: One hundred nine middle‐aged (MA: aged 40–60) and 101 young‐old (YO: aged 61–80) patients randomized to the CCS intervention, surviving to 3 months after enrollment and averaging 2 months of 24/7 access to the intervention.MEASUREMENTS: Engagement was assessed in the average number of patient–CCS practitioner (CCSP) contacts per month during the initial 2 months of access to the intervention. Baseline data from patient interviews and chart reviews were used to test a model of prediction.RESULTS: MA patients averaged more patient–CCSP contacts per month than YO patients (mean 2.6 ± 2.5 vs 2.0 ± 1.2, P=.02), although both age groups were engaged. African‐American patients (P=.007) and those with a higher blunting style (P<.01), reporting more family discord in cancer communication (P=.009), and receiving fewer active cancer treatments (P=.008) were more engaged in the CCS intervention in the initial months.CONCLUSIONS: Psychooncology interventions individualized to patient preferences can effectively reach older and underserved populations. Such interventions may be especially important to patients using more avoidant behaviors, experiencing more family discord communicating about cancer, or receiving fewer aggressive treatments in the early treatment phase for late‐stage cancer.
Highlights in Emergency Medicine Medical Education Research: 2008
Authors: Farrell Susan E. , Coates Wendy C. , Khun Gloria J. , Fisher Jonathan , Shayne Philip , Lin Michelle 
Published: December 2009

AbstractObjectives:  The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine.Methods:  Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis‐testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review.Results:  Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi‐experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies.Conclusions:  This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.
Emergency Medicine Residents Do Not Document Detailed Neurologic Examinations
Authors: Sarko John 
Published: December 2009

AbstractObjectives:  Physical examinations performed by residents in many specialties are often incomplete and inaccurate. This report assessed the documentation of the neurologic examination performed by emergency medicine (EM) residents when examining patients with potential psychiatric or neurologic chief complaints.Methods:  A retrospective chart review of neurologic examinations documented by EM residents was performed. An eight‐item neurologic examination score was created and analyzed by resident postgraduate year. A linear mixed model was used to determine if differences in neurologic examination scores existed between resident year, type of complaint, and resident year and type of complaint. A one‐point difference in scores was considered clinically important.Results:  A total of 384 charts were reviewed. An average of 4.26 items (95% confidence interval [CI] = 3.91 to 4.62) out of a possible eight were documented that did not vary by resident year of training (p = 0.08). An effect was found for type of complaint. Documentation was lower for psychiatric than for neurologic complaints: mean score for psychiatric complaints 3.97 vs. mean score for neurologic complaints 4.55 (difference –0.58, 95% CI = –1.02 to –0.14). No interaction was found for type of complaint and resident year. A clustering effect was identified for individual residents.Conclusions:  Emergency medicine residents do not document detailed neurologic examinations on patients with neurologic or psychiatric complaints. Individual resident variation contributes to this documentation.
Serious Bacterial Infection in Recently Immunized Young Febrile Infants
Authors: Wolff Margaret , Bachur Richard 
Published: December 2009

AbstractObjective:  The objective of this study was to investigate the prevalence of serious bacterial infection (SBI) in febrile infants without a source aged 6–12 weeks who have received immunizations in the preceding 72 hours.Methods:  The authors conducted a medical record review of infants aged 6–12 weeks with a fever of ≥38.0°C presenting to the pediatric emergency department (ED) over 88 months. Infants were classified either as having received immunizations within the 72 hours preceding the ED visit (recent immunization [RI]) or as not having received immunizations during this time period (no recent immunization [NRI]). Primary outcome of an SBI was based on culture results; only patients with a minimum of blood and urine cultures were studied.Results:  A total of 1,978 febrile infants were studied, of whom 213 (10.8%) had received RIs. The overall prevalence of definite SBI was 6.6% (95% confidence interval [CI] = 5.5 to 7.7). The prevalence of definite SBI in NRI infants was 7.0% (95% CI = 5.9 to 8.3) compared to 2.8% (95% CI = 0.6 to 5.1) in the RI infants. The prevalence of definite SBI in febrile infants vaccinated in the preceding 24 hours decreased to 0.6% (95% CI = 0 to 1.9). The prevalence of definite SBI in febrile infants vaccinated greater than 24 hours prior to presentation was 8.9% (95 CI = 1.5 to 16.4). The relative risk of SBI with RI was 0.41 (95% CI = 0.19 to 0.90). All SBIs in the RI infants were urinary tract infections (UTI).Conclusions:  Among febrile infants, the prevalence of SBI is less in the initial 24 hours following immunizations. However, there is still a substantial risk of UTI. Therefore, urine testing should be considered in febrile infants who present within 24 hours of immunization. Infants who present greater than 24 hours after immunizations with fever should be managed similarly to infants without RIs.