bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and management of methotrexate hepatotoxicity in psoriasis patients: report from a consensus conference to evaluate current practice and identify key questions toward optimizing methotrexate use in the clinic
Authors: Barker J. , Horn E.J. , Lebwohl M. , Warren R.B. , Nast A. , Rosenberg W. , Smith C. ,   on behalf of the International Psoriasis Council
Published: December 2010

AbstractExperts in psoriasis, hepatology, pharmacokinetics and pharmacogenetics convened to discuss the safety and monitoring of methotrexate with respect to hepatotoxicity when used in the treatment of psoriasis. Methotrexate is an efficacious and cost‐effective treatment for psoriasis, but is associated with significant safety issues, particularly relating to hepatotoxicity. Current British, Dutch, German, EU and US guidelines for baseline evaluations, monitoring and prevention of hepatotoxicity in patients with psoriasis receiving methotrexate were evaluated. Liver safety monitoring is currently reliant upon multiple methods, including biopsy, serological tests for biomarkers such as type III procollagen amino terminal propeptide (PIIINP), and liver function tests based on liver enzymes. Monitoring of patients receiving long‐term therapy is expected to be improved by the utilization of serum biomarkers currently in development such as the Enhanced Liver Fibrosis (ELF) panel and other non‐invasive tests of hepatic architecture, such as fibroelastography, microbubbles and magnetic resonance imaging. Appropriate studies to determine optimal dosing to maximize efficacy and minimize toxicity, potentially utilizing pharmacogenetic principles, are clearly needed. Key questions for future research are identified including needs for optimal screening and monitoring, identification of appropriate biomarkers, assessment of relationships between dosing and safety, utility of liver biopsy, optimal dosing regimens (including route of administration), methods to measure methotrexate levels in blood, and use of methotrexate as a standardized active comparator in trials of experimental drugs used to treat psoriasis.
Pemphigus vegetans: a clinical, histological, immunopathological and prognostic study
Authors: Zaraa I. , Sellami A. , Bouguerra C. , Sellami M.K. , Chelly I. , Zitouna M. , Makni S. , Hmida A.B. , Mokni M. , Osman A.B. 
Published: December 2010

AbstractBackground  Pemphigus vegetans (P Veg) is a rare clinical form of pemphigus. Studies on P Veg are rare in the literature and none has so far evaluated the prognostic parameters.Objective  In this retrospective study of P Veg, we aimed to analyse epidemiological, clinical, immunopathological and therapeutic data. Study of prognostic factors with accuracy of patient survival was also carried out.Methods  This is a retrospective study (1981–2009) including 17 cases of P Veg. Statistical analysis was performed with chi‐square and Fisher tests looking for a possible relationship between clinical data and prognostic factors. Follow‐up time and disease‐free survival time were estimated using Kaplan–Meier methods. Clinical data were evaluated in univariate analysis looking for a significant association with survival. Equality of survival distribution was studied using log rank test.Results  The hospital prevalence of P Veg was 0.084‰ with a frequency of 9.1% among pemphigus. The mean age at onset was 47.6 years, with a sex‐ratio (F/M) about 4.66. Neumann P Veg was the predominant clinical form (11/17). Clinically, the lesions were multifocal (16/17), prevailed on folds and mucous membranes. Under corticosteroids the mean period for healing was 24 ± 9 days. During the follow‐up time, three patients died and 11 patients relapsed. Median of overall relapse‐free survival was 13 ± 1.7 months. No significant association between clinical data and prognostic factors was found.Limitations  This study was a retrospective chart analysis and the number of patients was small.Conclusion  The P Veg seems to be more frequent in Tunisia with high rate of mortality.
Cognitive training with photographs as a new concept in an education campaign for self‐detection of melanoma: a pilot study in the community
Authors: Gaudy‐Marqueste C. , Dubois M. , Richard M.‐A. , Bonnelye G. , Grob J.‐J. 
Published: December 2010

AbstractBackground  Cognitive education using only photographs has been shown to be more effective than the ABCD algorithm to improve melanoma recognition in the general population.Objective  The aim of this study was to assess the feasibility and acceptability of a campaign based on cognitive education by photographs instead of the usual ABCD algorithm.Methods  Brochures including a panel of photographs of melanoma and moles were mailed, supported by a media campaign and followed by a telephone survey of a representative sample of the district population.Results  Among the 855 people interviewed, 38% recalled the campaign and 13% had actually read the brochures. Among the 13%, 99% found them useful, 52% reassuring and 40% anxiety provoking, while 92% agreed that using images of skin cancer was the best way to recognize melanoma. Sixty‐four percent declared that this campaign had prompted them to examine their own moles, 39% were prompted to check moles of family members, and only 11% would immediately visit a doctor.Conclusion  This pilot study shows that a melanoma campaign based exclusively on images is well accepted in the community, and is associated with a favourable impact on self‐surveillance, while limiting overflow of unjustified consultations. We recommend this innovative concept be applied to large scale campaigns.
Advantages of preoperative hybrid SPECT/CT in detection of sentinel lymph nodes in cutaneous head and neck malignancies
Authors: Klode J. , Poeppel T. , Boy C. , Mueller S. , Schadendorf D. , Körber A. , Stoffels I. , Dissemond J. 
Published: December 2010

AbstractBackground  There is some controversy around the value of sentinel lymph node excision (SLNE). Especially SLNE of cutaneous head and neck malignancies has been debated intensively, in part because of the complexity of the lymphatic drainage in this region associated with potential high morbidity. In order to improve preoperative three‐dimensional mapping of sentinel lymph nodes (SLN), in the head and neck region, by means of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) is gaining significance. Our study seeks to identify the potential medical and economic advantages of preoperative SPECT/CT in direct comparison to standard SLNE without SPECT/CT in patients with cutaneous head and neck malignancies.Methods  We retrospectively analysed the data of 48 clinically lymph node‐negative patients with early stage melanoma, high risk cutaneous squamous cell carcinoma and porocarcinoma, who underwent SLNE with or without preoperative SPECT/CT within 4 years.Results  The SLNE in the head and neck region with SPECT/CT‐technique demonstrated better postoperative aesthetic results had lower morbidity and significantly reduced operating time. Moreover, SLNE with SPECT/CT‐technique in the head and neck region was feasible using local anaesthesia (LA) and significantly reduced resulting costs (€32.65/SLNE with LA vs. €334.57/SLNE with general anaesthesia, P < 0.0001).Conclusion  SPECT/CT is an innovative imaging technique, reliably and readily providing additional anatomical/functional information to detect and to excise SLN in the head and neck region. Therefore, SLNE with SPECT/CT‐technique is an attractive option to improve the detection of SLN in cutaneous head and neck malignancies.
Involvement of the bulge region with decreased expression of hair follicle stem cell markers in senile female cases of alopecia areata
Authors: Yoshida R. , Tanaka K. , Amagai M. , Ohyama M. 
Published: December 2010

AbstractBackground  Alopecia areata (AA) is a common hair loss disorder characterized by cellular autoimmune reaction predominantly involving the bulbar portion of anagen hair follicles. In most cases of AA, the bulge stem cell area remains intact. Recently, a couple of molecules, such as keratin15 (K15) and CD200, have been identified as biomarkers of human bulge cells. Of note, an immunosuppressive molecule, CD200 is speculated to provide an immune privilege for bulge stem cells.Objective  To investigate expression levels of stem cell markers, especially CD200, in two senile female cases of AA with unusual lymphocytic cell infiltrates surrounding both the bulge and the bulbar regions. Then, compare them with those in common AA cases without the bulge involvement.Methods  Transverse sections containing the bulge levels were prepared from unaffected and affected lesions, respectively, from each AA group and immunohistochemical investigation using anti‐K15 and CD200 antibodies was performed. Importantly, an approach to detect CD200 in paraffin sections was newly developed. Immunoreactivities of individual antibodies were compared between corresponding lesions in each patient group.Results  In unaffected bulge lesions, K15 immunoreactivity was not different between bulge‐involving AA and common AA groups, whilst that of CD200 was decreased in the former group. Both K15 and CD200 immunoreactivities were decreased in affected bulge lesions of bulge‐involving AA compared to the bulge of common AA cases.Conclusion  Selective downregulation of CD200 in the bulge area could contribute to the collapse of immune privilege with resultant unusual bulge involvement in a subset of AA.
Converging forest community composition along an edaphic gradient threatens landscape‐level diversity
Authors: Amatangelo Kathryn L. , Fulton Mark R. , Rogers David A. , Waller Donald M. 
Published: December 2010

AbstractAim  Plant communities across the temperate zone are changing in response to successional processes and human‐induced disturbances. Here, we assess how upland forest under‐ and overstorey community composition has changed along an edaphic gradient.Location  Northern Wisconsin, USA.Methods  Forest sites initially sampled in the 1950s were resampled for overstorey composition and diversity, basal area, and understorey composition and diversity. We used clustering methods to identify groups of stands based on overstorey composition, and we used similarity indices, ordination and diversity indices to evaluate changes in species abundance and overall community structure.Results  Sites clustered into four overstorey groups along the edaphic gradient: ‘hemlock’ sites dominated by hemlock in 1950, ‘mesic’ sites dominated by northern hardwoods, ‘dry’ sites with a significant pine inclusion in the canopy and diverse ‘dry‐mesic’ sites in the middle. Collectively, forests gained maple, ash and cherry while losing pines, birches and red oaks. The hemlock forest sites gained hardwoods, while the dry‐mesic sites shifted towards a more mesic hardwood composition. Only the driest sites have remained relatively stable in species composition.Main conclusions  These trends reflect both ‘mesification’ and homogenization among northern forests. Highly diverse mid‐gradient and mesic hemlock‐dominated stands are transitioning to maple dominance. Fire suppression may be favouring invasions of more mesic plants into historically drier sites, while high deer abundance likely limits hemlock regeneration. If current trends continue, maples will dominate the majority of northern forests, with significant losses of local native species richness and substantial shifts in understorey composition.
Fruit quantity of invasive shrubs predicts the abundance of common native avian frugivores in central Pennsylvania
Authors: Gleditsch Jason M. , Carlo Tomás A. 
Published: December 2010

AbstractAim  Biological invasions pose one of the most severe threats to global biodiversity. Still, invasions can create positive ecological relationships and services, which can sometimes result in challenges for conservation efforts. A case in point is the invasion of alien plants that form mutualisms with native frugivorous birds. Here, we examined the correlation between honeysuckles (Lonicera spp.) and the bird communities in a landscape of central Pennsylvania during the fall months.Location  State College area in central Pennsylvania, USA.Methods  We conducted point counts to quantify the abundance of birds and fleshy‐fruited plant species within a 187.5 km2 landscape that included forested, urban and agricultural lands. We also compared fruit‐removal rates for a native fruiting plant under low and high Lonicera densities.Results  The abundance of birds showed a strong positive association with Lonicera fruits, with the abundance of Turdus migratorius and Dumetella carolinensis showing the strongest correlations. We also found that fruit‐removal rates were 30% larger for a native plant species in areas of high Lonicera density compared to a site with low density of Lonicera.Main conclusions  Our results suggest that Lonicera may currently serve as a main axis for the organization of bird communities and the networks of frugivore–plant interactions in central Pennsylvania. Since populations of key bird frugivores may be currently depending on Lonicera resources, we argue that control measures should account for the negative effects that the loss of this fruit resource could have on populations of native consumers in highly invaded regions.
SHORT SELLING AND MISPRICINGS WHEN FUNDAMENTALS ARE KNOWN: EVIDENCE FROM NYSE‐TRADED CLOSED‐END FUNDS
Authors: Flynn Sean Masaki 
Published: December 2010

AbstractThe larger a closed‐end fund's premium over its portfolio value, the more intensely it is sold short. This behavior should reduce mispricings. However, short selling affects neither the observed rate at which premia revert to fundamental values nor the rate of return on a fund's shares. This apparent contradiction can be explained as follows: short selling does reduce prices, but the effect is impounded into prices by the time short positions are tabulated by the NYSE each month. Consequently, the monthly short selling data do not predict future price movements.
RISK AND HEDGING BEHAVIOR: THE ROLE AND DETERMINANTS OF LATENT HETEROGENEITY
Authors: Pennings Joost M. E. , Garcia Philip 
Published: December 2010

AbstractThe notion of heterogeneous behavior is well grounded in economic theory. Recently it has been shown in a hedging context that the influence of risk attitudes and risk perceptions varies for different segments using a generalized mixture regression model. Here, using recently developed individual risk attitude measurement techniques and experimental and accounting data from investors with differing decision environments, we examine the determinants of heterogeneity in hedging behavior in a concomitant mixture regression framework. Allowing for latent heterogeneity, we find that risk attitudes and risk perceptions do not influence behavior uniformly and that the heterogeneity is influenced by manager's focus on shareholder value and the firm's capital structure.
Effect of Pregabalin in the Treatment of Refractory Neck Pain: Cost and Clinical Evidence from Medical Practice in Orthopedic Surgery and Rehabilitation Clinics
Authors: Flórez‐García Mariano , Ceberio‐Balda Félix , Morera‐Domínguez Carles , Masramón Xavier , Pérez María 
Published: December 2010

AbstractBackground:  The study aims to prospectively analyze the effect of adding pregabalin upon costs and consequences in the treatment of refractory neck pain under routine medical practice.Methods:  A secondary analysis was carried out including patients over 18 years, with 6‐month chronic neck pain refractory from a prospective, naturalistic, 12‐week two‐visit study. The analysis compared patients adding pregabalin to its therapy vs. usual care. Severity of pain, healthcare resources utilization, lost workday equivalents (LWDE) because of pain, and related cost‐adjusted reductions were assessed.Results:  A total of 312 patients (65.3% women, age 54.2 [12.1] years), 78.2% receiving pregabalin, were analyzed. Adding pregabalin was associated with higher adjusted reduction in pain severity: −3.2 (1.8) points, 55.4% responders (≥ 50% baseline pain reduction) vs. −2.3 (2.0) and 38.2%, respectively; P < 0.001, yielding a higher reduction in mean LWDE: 20.1 (23.1) vs. 8.2 (22.4); P = 0.014, which produced significant reductions in the indirect components of cost: €1,041.0 (1,222.8) vs. €457.3 (1,132.1), P = 0.028. The costs of pregabalin (€309.8 [193.2] vs. €26.4 [79.6], P < 0.001) was offset by higher numerical reductions in the other components of costs, producing similar direct cost reductions in both groups at the end of the study: €66.8 (1,080.8) and €143.5 (1,922.4), respectively; P = 0.295.Conclusion:  Compared with usual care, the addition of pregabalin to treat refractory neck pain seems to be associated with a higher reduction in pain severity and lost work‐days equivalents, which in turn results in a greater reduction of the indirect components of cost while maintaining similar healthcare cost levels despite its higher price.
18. Painful Diabetic Polyneuropathy
Authors: Pluijms Wouter , Huygen Frank , Cheng Jianguo , Mekhail Nagy , van Kleef Maarten , Van Zundert Jan , van Dongen Robert 
Published: December 2010

AbstractIn the industrialized world, polyneuropathy induced by diabetes mellitus (DM) is one of the most prevalent forms of neuropathy. Diabetic neuropathy can result from a direct toxic effect of glucose on nerve cells. Additionally, the damage of the nerve structures (central and peripheral) is accompanied by a microvascular dysfunction, which damages the vasa nervorum. More than 80% of the patients with DM‐induced polyneuropathy have a distal and symmetric presentation. The initial symptoms are: signs of diminished sensation, burning feet, which may occur particularly during the night and worsen when touched, and tingling sensation in the feet. Attacks of shooting pain may also occur.Proper control of DM is mandatory. Based on the recently published National Institute for Health and Clinical Excellence guidelines, treatment of painful diabetic neuropathy should start with duloxetine or amitriptyline if duloxetine is contraindicated. If pain relief is inadequate, monotherapy with amitriptyline or pregabalin, or combination therapy with amitriptyline and pregabalin should be considered. If pain relief is still insufficient, tramadol instead of or in combination with a second‐line agent should be considered. In patients who are unable to take oral medication, topical lidocaine can be considered for localized pain. There are currently four studies showing that spinal cord stimulation can potentially provide pain alleviation for the longer term in patients with painful diabetic polyneuropathy. Complications are mainly implant related, though infections also occur. The available evidence (2 C+) justifies spinal cord stimulation to be considered, preferably study related.
Are Psychoactive Substance (Opioid)‐Dependent Chronic Pain Patients Hyperalgesic?
Authors: Fishbain David A. , Lewis John E. , Gao Jinrun 
Published: December 2010

AbstractObjectives:  One indirect line of evidence for opioid‐induced hyperalgesia (OIH) in humans is decreased pain thresholds (PTREs) and tolerances (PTOLs) in opioid addicts on opioids. There are a number of such studies in opioid maintained addicts, but no such studies in chronic pain patients (CPPs) with current opioid addiction. The objective of this study was to determine if this group demonstrates hyperalgesia.Methods:  CPPs were subdivided into those with psychoactive substance (opioid dependence) (PSOD) (n = 38) (addicted) and those taking opioids but without PSOD (n = 198) (not addicted). A group of opioid‐free non‐CPPs served as a control group (n = 36). PTREs/PTOLs were determined in each group by pressure pain stimulation in both the right and left index fingers. PTREs/PTOLs were compared by analysis of variance among the three groups controlling for sex/age and by analysis of covariance between the PSOD CPPs and non‐PSOD CPPs controlling for duration of pain and visual analog scale pain level over the last 24 hours.Results:  The PSOD and non‐PSOD CPPs had significantly lower PTREs and PTOLs vs. the control group, ie, were hyperalgesic. However, they were not significantly different from each other.Conclusions:  This study contributes to the human OIH literature. However, because of the potential confounders in this study, the issue of OIH in humans remains unresolved.
Exposure to Potential CYP450 Pharmacokinetic Drug–Drug Interactions among Osteoarthritis Patients: Incremental Risk of Multiple Prescriptions
Authors: Pergolizzi Jr Joseph V. , Labhsetwar Sumedha A. , Puenpatom R. Amy , Joo Seongjung , Ben‐Joseph Rami , Summers Kent H. 
Published: December 2010

AbstractPatients taking more than one drug metabolized through the cytochrome P450 (CYP450) enzyme system experience a drug–drug exposure (DDE), which puts them at risk for a potential pharmacokinetic drug–drug interaction (DDI), defined as two or more drugs interacting in such a way that the effectiveness and/or toxicity of one or all drugs are changed. Any patient subjected to a DDE is at risk for a potentially serious DDI, the epidemiology of which has not been thoroughly studied. Many drugs are metabolized primarily via the CYP450 enzyme system, including certain opioids used to manage moderate to severe chronic pain. We conducted a retrospective analysis of a large commercial claims database and a Medicare database to assess the prevalence of DDEs among patients with osteoarthritis taking CYP450‐metabolized opioids. The overall prevalence of DDEs in this population was 26%, with females more likely to experience DDEs than males (28.4% vs. 21.0%, respectively). The number of unique concurrent prescriptions at baseline, gender, age, and Charlson Comorbidity Index were statistically significant predictors of DDEs (P < 0.05). This study challenged previous assumptions about DDEs in that advanced age was not positively associated with the risk of DDE. However, the number of prescriptions the patient received in the 90‐day window prior to the index date was a risk factor. For patients taking at least two medications in the 90‐day period prior to the index date, every additional prescription taken increased their risk for a DDE during the observation period by 138% (on average). The risk of DDE during the study period was threefold greater for patients with one medication in the 90‐day period before index date compared with similar patients with no prescriptions in that same period before the index date. DDEs are more common than may be generally believed in patients with osteoarthritis, regardless of age, and can occur even in patients taking few medications. When selecting an opioid analgesic to treat osteoarthritis, physicians should consider the potential for exposure of these patients to drugs that could interact unfavorably. ▪