bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidermal growth factor in clinical practice – a review of its biological actions, clinical indications and safety implications
Authors: Berlanga‐Acosta Jorge , Gavilondo‐Cowley Jorge , López‐Saura Pedro , González‐López Tania , Castro‐Santana María D , López‐Mola Ernesto , Guillén‐Nieto Gerardo , Herrera‐Martinez Luis 
Published: November 2009

ABSTRACTChemotaxis, mitogenesis, motogenesis and cytoprotection are common cellular events involved in both tumourigenesis and tissue repair, which appear amplified upon growth factors exposure. Epidermal growth factor (EGF) promotes these events in epithelial and mesenchymal cells through the binding to a specific tyrosine kinase receptor. In experimental oncology settings, EGF does not initiate malignant transformation but exhibits ‘tumour promotion’. These observations have raised doubts on the clinical use of EGF despite solid demonstrations of efficacy in experimental conditions and clinical trials. The results of a Pubmed and Bioline investigation on EGF clinical uses and preclinical safety data are presented here. EGF topical administration has been used since 1989 to enhance the healing process of a variety of peripheral tissues wounds (16 clinical reports), as well as its intravenous, oral and rectal administration for gastrointestinal damages (11 clinical reports). EGF therapeutic efficacy and excellent tolerability seem demonstrated. Lack of long‐term adverse effects is highlighted in those studies with 6, 12 and 24 months of patients follow‐up. Although post‐treatment follow‐up may fall short for malignant growth, there are no reports on evidences linking EGF clinical use with cancer. A multicentre, nationwide survey in Cuba, 15 years after randomly using silver sulphadiazine with EGF or not in burn victims yielded that cancer incidence was comparable between EGF‐treated and control subjects and that such incidence rate does not differ from the age‐matched national incidence for those 15‐year period. All the animal species subjected to long‐term EGF systemic administration exhibit dose‐dependent and reversible epithelial organs hyperplasia with no changes in cells phenotypic differentiation. Histotypic pre‐malignant markers were not identified. The results emerged from co‐carcinogenesis studies and from transgenic mice over‐expressing EGF are conflicting and indicate that EGF overexposure, either innate or postnatal, may not be sufficient to transform cells. The ability of EGF to heal injured tissues in life‐threatening scenarios or to assist in preventing physical and social disability advocates for its clinical use under a rational medical risk/benefit balance.
A prospective evaluation of lower extremity ulcers in a Zimbabwean population
Authors: Sibanda Martin , Sibanda Ellopy , Jönsson Kent 
Published: November 2009

ABSTRACTAetiological factors and their frequencies, causes, level and impact of immunosuppression on outcome of lower extremity ulcers were prospectively recorded. A total of 100 patients were evaluated. Consent for HIV testing was given by 68 patients and 31 (46%) of these were HIV infected. Thirty patients were diabetic. CD 4+ T‐lymphocyte count was assessed in 41 patients. Eleven were HIV infected with a mean CD 4+ count of 229 ± 137 cells/µl. Six had non insulin‐dependent diabetes mellitus (NIDDM) with a mean CD 4+ count 430 ± 308 cells/µl. Five had both HIV infection and NIDDM with a mean CD 4+ count of 299 ± 120 cells/µl. All three groups differed from the normal 707 ± 285 cells/µl found in 17 non HIV‐infected non diabetic patients (P < 0· 05). The main aetiologies were bacterial infection, arterial disease, trauma and neuropathy. Ulcer healing and limb salvage were noted in 71%. Mortality was 10%; seven in HIV‐infected and three in non HIV‐infected non diabetic patients (P = 0· 06). Amputation rate was 9%. Persisting ulcers were noted in 8% and 2% were lost to follow‐up. Our evaluation shows that wound aetiologies in Zimbabwe differ from those in the West. Immunosuppression because of HIV infection and NIDDM was noted in more than half of the patients. HIV infection may increase mortality in this group of patients.
Topical silver‐impregnated dressings and the importance of the dressing technology
Authors: Cutting Keith , White Richard , Hoekstra Hans 
Published: November 2009

ABSTRACTA wide variety of silver‐impregnated wound dressings has become available in recent years. This has given the practitioner choice but little evidence by which an appropriate dressing may be selected. In many instances, the ancillary function(s) of the dressing will become differentiating factors that influence choice. For example, the dressing capacity to manage exudate, maintain an optimum moist environment, reduce or avoid maceration, maintain an intimate contact with the wound bed, promote autolytic debridement, sequester bacteria and bind matrix metallo proteases (MMPs) are some of those functions that are of clinical significance and may dictate choice. In this article we present the evidence for these functions, thereby enabling practitioners to evaluate comparative dressing attributes, and so make an informed choice of which silver dressing best suits the needs of the wound under differing circumstances.
The Relationship of Testosterone to Prostate-Specific Antigen in Men with Sexual Dysfunction
Authors: Corona Giovanni , Boddi Valentina , Lotti Francesco , Gacci Mauro , Carini Marco , De Vita Giulia , Sforza Alessandra , Forti Gianni , Mannucci Edoardo , Maggi Mario 
Published: November 2009

ABSTRACT

Introduction
Concern about a testosterone (T)-induced prostate-specific antigen (PSA) increase is often perceived as one of the main limitations in treating hypogonadism even when it is symptomatic, such as in subjects with sexual dysfunction (SD).

Aim
The aim of this study was to evaluate the relationship between T and PSA levels in subjects with SD.

Methods
We retrospectively evaluated the relationship between T and PSA in 2,291 subjects seeking medical care at our outpatient clinic for SD (sample A). The analysis was then repeated in a selected subpopulation of 1,421 subjects apparently free from prostatic diseases (sample B).

Main Outcome Measures
The specific association between PSA levels, circulating androgens, and different clinical signs and symptoms of hypogonadism, as assessed by ANDROTEST structured interview, was evaluated.

Results
In both samples A and B, subjects with higher PSA levels reported a lower prevalence of hypogonadism-related symptoms and signs, as well as higher total testosterone (TT), and analogue and calculated free T. However, when the association between PSA and T was evaluated as a function of T deciles, the upper nine groups had similar PSA values, with the lowest demonstrated a significantly reduced PSA (the lowest vs. the rest of the sample: 0.61[0.38–1.23] ng/mL vs. 0.86[0.57–1.44] ng/mL, and 0.51[0.30–0.94] ng/mL vs. 0.73[0.52–1.10] ng/mL, respectively, for samples A and B; both P &lt;0.0001). Furthermore, when the relationship between hypogonadism (TT&lt;8 nmol/L) and PSA levels was evaluated according to age, it was significant only in younger subjects, but not in the older ones.

Conclusions
Our data demonstrated that PSA is unrelated to T concentration across most of the T range, except for the most severely T deficient, and that a significant relationship between T and PSA is seen in younger but not in older men.
Restless Genital Syndrome Before and After Clitoridectomy for Spontaneous Orgasms: A Case Report
Authors: Waldinger Marcel D. , Venema Pieter L. , Van Gils Ad P.G. , Schutter Eltjo M.J. , Schweitzer Dave H. 
Published: November 2009

ABSTRACT

Introduction
Females despairing of restless genital syndrome (ReGS) may request clitoridectomy for treatment of unwanted genital sensations.

Aim
The aim of this study was to report persistence of ReGS despite clitoridectomy.

Methods
Following a clitoridectomy for spontaneous orgasms, a 77-year-old woman was referred to our clinic for persistent unwanted genital sensations and feelings of imminent orgasm. An in-depth interview, routine and hormonal investigations, electroencephalography (EEG) and magnetic resonance imaging (MRI) of the brain and pelvis were performed. The localizations of genital sensations were investigated by manual examination of the ramus inferior of the pubic bone (RIPB) and by sensory testing of the skin of the genital area with a cotton swab.

Main Outcome Measures
The main outcome measures included sensitivity of dorsal nerve of the clitoris in RIPB and MRI-pelvis.

Results
Genital dysesthesias, paresthesias, intolerance (allodynia) for tight clothes, aggravation of symptoms during sitting, restless legs, and overactive bladder were diagnosed. Laboratory assessments, and EEG and MRI of the brain were in agreement with aging, but all results were within the normal range. MRI of the pelvis disclosed varices of the uterus and of the left ovarian vein, and a visible scar in the region of the clitoris. Sensory testing of the genital area showed various points of static mechanical hyperesthesia at the left dermatome of the pudendal nerve. Manual examination of the RIPB also elicited the genital sensations at the left side of the vagina at about the 3 o’clock position.

Conclusions
This patient fulfilled all clinical criteria of ReGS that is believed to be caused by neuropathy of the left pudendal nerve. Clitoridectomy abolished spontaneous orgasms for a great part but not completely, and it did not diminish the typical dysesthesias, paresthesias, and feelings of imminent orgasms that typically belong to ReGS. Clitoridectomy is no optional treatment of ReGS. There is a need for publications of ReGS in general medical journals.
Erectile Dysfunction as a Predictor for Subsequent Atherosclerotic Cardiovascular Events: Findings from a Linked-Data Study
Authors: Chew Kew-Kim , Finn Judith , Stuckey Bronwyn , Gibson Nicholas , Sanfilippo Frank , Bremner Alexandra , Thompson Peter , Hobbs Michael , Jamrozik Konrad 
Published: November 2009

ABSTRACT

Introduction
In spite of the mounting interest in the nexus between erectile dysfunction (ED) and cardiovascular (CV) diseases, there is little published information on the role of ED as a predictor for subsequent CV events.

Aim
This study aimed to investigate the role of ED as a predictor for atherosclerotic CV events subsequent to the manifestation of ED.

Method
The investigation involved the retrospective study of data on a cohort of men with ED linked to hospital morbidity data and death registrations. By using the linked data, the incidence rates of atherosclerotic CV events subsequent to the manifestation of ED were estimated in men with ED and no atherosclerotic CV disease reported prior to the manifestation of ED. The risk of subsequent atherosclerotic CV events in men with ED was assessed by comparing these incidence rates with those in the general male population.

Main Outcome Measure
Standardized incidence rate ratio (SIRR), comparing the incidence of atherosclerotic CV events subsequent to the manifestation of ED in a cohort of 1,660 men with ED to the incidence in the general male population.

Results
On the basis of hospital admissions and death registrations, men with ED had a statistically significantly higher incidence of atherosclerotic CV events (SIRR 2.2; 95% confidence interval 1.9, 2.4). There were significantly increased incidence rate ratios in all age groups younger than 70 years, with a statistically highly significant downward trend with increase of age (P &lt;0.0001) across these age groups. Younger age at first manifestation of ED, cigarette smoking, presence of comorbidities and socioeconomic disadvantage were all associated with higher hazard ratios for subsequent atherosclerotic CV events.

Conclusions
The findings show that ED is not only significantly associated with but is also strongly predictive of subsequent atherosclerotic CV events. This is even more striking when ED presents at a younger age.
Cerebral oxygenation decreases but does not impair performance during self‐paced, strenuous exercise
Authors: Billaut F. , Davis J. M. , Smith K. J. , Marino F. E. , Noakes T. D. 
Published: November 2009

AbstractAim:  The reduction in cerebral oxygenation (Cox) is associated with the cessation of exercise during constant work rate and incremental tests to exhaustion. Yet in exercises of this nature, ecological validity is limited due to work rate being either fully or partly dictated by the protocol, and it is unknown whether cerebral deoxygenation also occurs during self‐paced exercise. Here, we investigated the cerebral haemodynamics during a 5‐km running time trial in trained runners.Methods:  Rating of perceived exertion (RPE) and surface electromyogram (EMG) of lower limb muscles were recorded every 0.5 km. Changes in Cox (prefrontal lobe) were monitored via near‐infrared spectroscopy through concentration changes in oxy‐ and deoxyhaemoglobin (Δ[O2Hb], Δ[HHb]). Changes in total Hb were calculated (Δ[THb] = Δ[O2Hb] + Δ[HHb]) and used as an index of change in regional blood volume.Results:  During the trial, RPE increased from 6.6 ± 0.6 to 19.1 ± 0.7 indicating maximal exertion. Cox rose from baseline to 2.5 km (↑Δ[O2Hb], ↑Δ[HHb], ↑Δ[THb]), remained constant between 2.5 and 4.5 km, and fell from 4.5 to 5 km (↓Δ[O2Hb], ↑Δ[HHb], ↔Δ[THb]). Interestingly, the drop in Cox at the end of the trial coincided with a final end spurt in treadmill speed and concomitant increase in skeletal muscle recruitment (as revealed by higher lower limb EMG).Conclusion:  Results confirm the large tolerance for change in Cox during exercise at sea level, yet further indicate that, in conditions of self‐selected work rate, cerebral deoxygenation remains within a range that does not hinder strenuous exercise performance.
Impact of the Global Financial Crisis on China: Empirical Evidence and Policy Implications
Authors: Liu Ligang 
Published: November 2009

AbstractThis paper applies a structural vector autoregression analysis to quantify the impact of the global financial crisis on China. It is found that the impact is indeed sizeable: a 1‐percent decline in economic growth in the USA, the EU and Japan is likely to lead to a 0.73‐percent decline in growth in China. The article discusses whether the current measures of fiscal stimulus are adequate to offset the sharp decline in external demand. Although there is little doubt that the massive fiscal stimulus will largely offset the significant shortfalls in external demand, the current growth pattern in China will be increasingly unsustainable in the long term. China's reform cycles suggest that external shocks are often opportunities for structural reforms. Therefore, the crisis could also be a catalyst for rebalancing China's economic structure so as to return the economy to a sustainable path.
China: Unscathed through the Global Financial Tsunami
Authors: Sun Mingchun 
Published: November 2009

AbstractThis paper investigates the reasons behind the resilience of China's economy to the global financial tsunami. China's economy is lowly leveraged in its banking, household, public and external sectors and, therefore, is less plagued by the global deleveraging than most developed economies. Chinese domestic sectors have improved significantly over the past decade, giving them larger capacity to cope with external shocks than during the Asian financial crisis a decade ago. Contrary to the conventional wisdom that China's economic growth is highly dependent on exports, we find that the main growth engine for China is domestic demand. Destocking, rather than falling exports, was the main cause of the sharp economic slowdown in China in late 2008 and early 2009. Therefore, the global economic slowdown should have limited impact on China's economy. We forecast a sustained economic recovery in China in 2009–2011, with real GDP growth exceeding 10 percent in 2010.
Is the Chinese Economy Moving in the Direction of Tertiarization?
Authors: Cheng Dazhong , Blanchard Jean‐Marc 
Published: November 2009

AbstractDrawing upon output, employment, consumption and trade data, this article examines whether there is an economic tertiarization trend in China 's economy and evaluates the common factors driving current trends. It shows that the tertiarization trend is evident for the overall economy and most regions in terms of the service nominal value‐added ratio and service employment and consumption. However, the tertiarization trend is not significant in terms of the service real value‐added ratio, and there is even some concurrent “detertiarization” because of the decreasing proportion of services in imports and exports. Indeed, China's tertiarization trend is far behind its industrialization trend. The rise in the relative prices of services explains the rising proportion of household service consumption expenditure and further illuminates why the service real value‐added ratio has not grown. The main cause for the growing percentage of service employment is the lag in service labor productivity growth in interaction with the price inelasticity of service demand. “Cost disease” has appeared in service consumption.
Investigation of a Q Fever Outbreak in a Scottish Co‐Located Slaughterhouse and Cutting Plant
Authors: Wilson L. E. , Couper S. , Prempeh H. , Young D. , Pollock K. G. J. , Stewart W. C. , Browning L. M. , Donaghy M. 
Published: November 2009

SummaryOutbreaks of Q fever are rare in the UK. In 2006, the largest outbreak of Q fever in Scotland occurred at a co‐located slaughterhouse and cutting plant with 110 cases. Preliminary investigations pointed to the sheep lairage being the potential source of exposure to the infective agent. A retrospective cohort study was carried out among workers along with environmental sampling to guide public health interventions. A total of 179 individuals were interviewed of whom 66 (37%) were migrant workers. Seventy‐five (41.9%) were serologically confirmed cases. Passing through a walkway situated next to the sheep lairage, a nearby stores area, and being male were independently associated with being serologically positive for Q fever. The large proportion of migrant workers infected presented a significant logistical problem during outbreak investigation and follow up. The topic of vaccination against Q fever for slaughterhouse workers is contentious out with Australasia, but this outbreak highlights important occupational health issues.
Methods for Genotyping Verotoxin‐Producing Escherichia coli
Authors: Karama M. , Gyles C. L. 
Published: November 2009

SummaryVerotoxin‐producing Escherichia coli (VTEC) is annually incriminated in more than 100 000 cases of enteric foodborne human disease and in losses amounting to $US 2.5 billion every year. A number of genotyping methods have been developed to track VTEC infections and determine diversity and evolutionary relationships among these microorganisms. These methods have facilitated monitoring and surveillance of foodborne VTEC outbreaks and early identification of outbreaks or clusters of outbreaks. Pulsed‐field gel electrophoresis (PFGE) has been used extensively to track and differentiate VTEC because of its high discriminatory power, reproducibility and ease of standardization. Multiple‐locus variable‐number tandem‐repeats analysis (MLVA) and microarrays are the latest genotyping methods that have been applied to discriminate VTEC. MLVA, a simpler and less expensive method, is proving to have a discriminatory power comparable to that of PFGE. Microarrays are successfully being applied to differentiate VTEC and make inferences on genome diversification. Novel methods that are being evaluated for subtyping VTEC include the detection of single nucleotide polymorphisms and optical mapping. This review discusses the principles, applications, advantages and disadvantages of genotyping methods that have been used to differentiate VTEC strains. These methods have been mainly used to differentiate strains of O157:H7 VTEC and to a lesser extent non‐O157 VTEC.
Epidemiological Survey on EquineCryptosporidiumandGiardiaInfections in Italy and Molecular Characterization of Isolates
Authors: Veronesi F. , Passamonti F. , Cacciò S. , Diaferia M. , Piergili Fioretti D. 
Published: November 2009

SummaryCryptosporidiumandGiardiaare two of the most common enteric pathogens of domestic and wild animals and humans. However, little is known on the prevalence, clinical manifestations and economic and zoonotic significance of these infections in horses. This study was undertaken to investigate the prevalence, excretion patterns and risk factors related to the faecal shedding ofCryptosporidiumoocysts andGiardiacysts in horses and the zoonotic potential of species/genotypes isolated. The survey was performed on 120 foals and 30 broodmares reared in five Italian farms. Foals were divided in four homogeneous groups of 30 animals each (age classes: 0–2, 2–4, 4–8, >8 weeks). Three sequential faecal samples were collected from each animal and analysed by three techniques: direct fluorescent antibody test (DFA), faecal flotation (FF) and stained faecal smears (SFS). The DFA results showed a prevalence of 8% forCryptosporidiumand of 13.33% forGiardia; the prevalence values obtained by FF and SFS were lower and in poor agreement with DFA results.GiardiaandCryptosporidiuminfections were more common in foals (23.33% and 26.66% respectively) and higher excretions were observed in the youngest foals. Distribution ofCryptosporidiumprevalence was statistically related to farms (P < 0.01), age of animals (P < 0.01), but was unrelated to the presence of diarrhoea. In the case ofGiardia, the prevalence was only related to age (P < 0.01). Pattern sheddings were related to intestinal diseases and horse age (P < 0.01). Risk factors for shedding included residence farms and age older than 8 weeks for both parasites. All DFA‐positive faecal samples were submitted to DNA extraction and PCR to determineGiardiaandCryptosporidiumspecies/genotypes. Sequence analysis of the COWP gene ofCryptosporidiumand of the SSU‐rRNA gene ofGiardiarevealed that they were identical to each other and identifiedCryptosporidium parvumandGiardia duodenalisassemblage E. The potential role of infected horses in zoonotic transmission ofCryptosporidiumwas supported by the findings of this study.