bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric sedation – evolution and revolution
Authors: Cravero Joseph P. , Havidich Jeana E. 
Published: May 2011

SummaryPediatric sedation continues to change in terms of the professionals who provide this care, those who produce original research on this topic, guidelines and literature concerning risk, medications employed, and methods for training for new providers. Some of the changes could be categorized as ‘evolutionary’ or gradual in nature and predictable – such as the changing role of anesthesiologists in the field of pediatric sedation and the use of the well‐established dissociative sedative, ketamine. Other changes in pediatric sedation are more radical or ‘revolutionary’. They include reconsideration of what is defined as an ‘adverse event’ during sedation, the use of propofol or dexmedetomidine, and the application of human patient simulation for training. This review will highlight the ongoing changes in the dynamic field of pediatric sedation by focusing on some of the important progress (both evolutionary and revolutionary) that has occurred across the varied specialties that provide this care.
Role of combination of l‐arginine and α‐tocopherol in renal transplantation ischaemia/reperfusion injury: a randomized controlled experimental study in a rat model
Authors: Shokeir Ahmed A. , Barakat Nashwa , Hussein Abdel‐Aziz M. , Awadalla Amira , Abdel‐Aziz Azza , Abo‐Elenin Hassan 
Published: May 2011

What’s known on the subject? and What does the study add? Renal ischaemia/reperfusion (I/R) injury is an inevitable consequence of kidney transplantation. It contributes to delayed graft function (DGF), acute renal failure and graft rejection.The present study investigates for the first time the impact of a combination of l‐arginine and alpha tocopherol on the renal ischemia/reperfusion injury in a rodent model of kidney transplation. We found that concomitant administration of l‐arginine and α‐tocopherol has a more protective effect and synergistic antioxidant effect on ischaemia/reperfusion injury in transplanted rat kidneys.OBJECTIVESTo investigate the role of l‐arginine and α‐tocopherol in ischaemia/reperfusion injury in a kidney transplanted rat model.MATERIALS AND METHODSIn total, 40 male Sprague‐Dawley rats subjected to renal transplantation received FK506 (tacrolimus) to overcome early acute rejection episodes. Animals were divided randomly into four groups (ten rats each). Group I were treated with FK506 (2 mg/kg/bw/day) and served as the control group. Group II were treated with l‐arginine 300 mg/kg/bw. Group III were treated with α‐tocopherol 30 mg/kg/bw. Group IV were treated with l‐arginine and α‐tocopherol. Urine and blood samples were taken at 0 (before operation), 2, 7 and 14 days post‐transplantation for estimation of urine sodium, creatinine, fractional excretion of sodium, serum creatinine, sodium and blood urea nitrogen. Histological examination and measurement of malondialdehyde in kidney tissues were also performed.RESULTSSerum creatinine and blood urea nitrogen significantly decreased in l‐arginine and α‐tocopherol, as well as combination groups, compared to the control group. Malondialdehyde was significantly decreased in the combination group compared to l‐arginine and α‐tocopherol alone. Histological examination of the control group showed that acute tubular necrosis was markedly decreased in transplanted kidneys treated with a combination of both l‐arginine and α‐tocopherol.CONCLUSIONSConcomitant administration of l‐arginine and α‐tocopherol has a more protective effect and synergistic antioxidant effect on ischaemia/reperfusion injury in transplanted rat kidneys.
Peripheral neuropathy: an underdiagnosed cause of erectile dysfunction
Authors: Valles‐Antuña Consuelo , Fernandez‐Gomez Jesus , Fernandez‐Gonzalez Fernando 
Published: May 2011

OBJECTIVES• To assess the prevalence of peripheral neuropathy in patients with erectile dysfunction (ED).• To evaluate the reliability of clinical tests such as the five‐item version of the International Index of Erectile Function (IIEF‐5) and the Neuropathy Symptom Score (NSS) classification system in predicting the concurrence of peripheral neuropathy.PATIENTS AND METHODS• We studied 90 patients who were consecutively recruited from the Department of Andrology of the Central Hospital of Asturias.• Anamnesis included questions about risk factors related to ED.• The severity of ED was classified according to IIEF‐5 scores and symptoms of peripheral neuropathy were assessed using the NSS.• Neurophysiological tests included electromyography, nerve conduction studies, evoked potentials from pudendal and tibial nerves as well as bulbocavernosus reflex.• Small fibre function was assessed using quantitative sensory tests and sympathetic skin response. Statistical analysis was performed using the SPSS‐11 program.RESULTS• Patients with more severe symptoms of peripheral neuropathy showed lower (worse) IIEF‐5 scores (P= 0.015) and required more aggressive therapies (P < 0.001).• Neurophysiological exploration confirmed neurological pathology in 68.9% of patients, of whom 7.8% had myelopathy and 61.1% peripheral neuropathy.• Polyneuropathy was found in 37.8% of the patients, of whom 8.9% had pure small fibre polyneuropathy, and pudendal neuropathy was diagnosed in 14.4%.• No association between neurophysiological diagnosis and IIEF‐5 score was detected, but a statistical association was found between neuropathy and NSS scores.CONCLUSIONS• Up to now, the impact of peripheral neuropathy in the pathogenesis of ED has been underestimated. The combination of anamnesis and an ad hoc neurophysiological protocol showed its high prevalence and provided a more accurate prognosis.• In future, clinical practice should optimize the assessment of pelvic small fibre function.
Second to fourth digit ratio, adult testosterone level and testosterone deficiency
Authors: García‐Cruz Eduardo , Huguet Jorge , Piqueras Marta , Ribal María J. , Alcaraz Antonio 
Published: May 2011

Study Type – Diagnostic (exploratory cohort)Level of Evidence 2bWhat’s known on the subject? and What does the study add? 2D/4D digit ratio is inversely related to intrauterus exposure to androgens. Our experience suggests that 2D/4D digit ratio inversely predicts adult testosterone levels and is directly related to hypogonadism.OBJECTIVES• The ratio of the second and fourth finger lengths (2D/4D) is related to intrauterine exposure to testosterone. The relationship between 2D/4D and adult hormonal pattern is controversial.• The aim of our study was to determine if there was a relationship between adult serum testosterone levels and the 2D/4D ratio.PATIENTS AND METHODS• We prospectively recruited 204 consecutive patients referred for transrectal prostate biopsy between January 2008 and June 2009. The same physician performed clinical examinations, 2D/4D measurements and the transrectal biopsy in all cases.• Cut‐off points of 231 and 346 ng/dL testosterone (8 and 12 nmol/L) were used. 2D/4D determination was done with a vernier calliper on the left hand.• The hormonal profile (testosterone and sexual hormone binding globulin) of the patients was determined between 7.00 am and 11.00 am.• Age, weight, height, body mass index, toxic habits, digital rectal examination, prostate‐specific antigen and 2D and 4D measurements were recorded prospectively.RESULTS• The mean age was 67 ± 7 years and the mean testosterone level was 413 ± 18 ng/dL (14.33 ± 0.62 nmol/L).• The percentages of patients with testosterone <231 ng/dL (8 nmol/L) and testosterone <346 ng/dL (12 nmol/L) were 6.1 and 30.6 respectively.• Univariate analysis showed that low 2D/4D ratios were related to higher levels of testosterone (B=−741.98; β=−0.165, P= 0.045) and also with low prevalence of biochemical hypogonadism (testosterone <346 ng/dL).• Mean 2D/4D ratio in patients with testosterone >346 ng/dL was lower than in patients with testosterone <346 ng/dL (2D/4D 0.97 ± 0.037 vs 0.99 ± 0.043 depending on their hormonal status, P= 0.05). High 2D/4D ratio was associated with low testosterone serum levels (P= 0.046).CONCLUSIONS• The 2D/4D ratio is related to adult testosterone levels and the presence of testosterone deficiency syndrome.• Patients with high 2D/4D ratios have lower testosterone levels and higher risk of testosterone deficiency syndrome.
Histopathological variables and biomarkers enhancer of zeste homologue 2, Ki‐67 and minichromosome maintenance protein 7 as prognosticators in primarily endocrine‐treated prostate cancer
Authors: Tolonen Teemu T. , Tammela Teuvo L.J. , Kujala Paula M. , Tuominen Vilppu J. , Isola Jorma J. , Visakorpi Tapio 
Published: May 2011

Study Type – Prognosis (case series)Level of Evidence 4What’s known on the subject? and What does the study add?Gleason score is a strong prognostic factor, but its reproducibility is not optimal. Our data show that multipte perineural invasion and Ki‐67 index are signs of early biochemical progression in patients treated with hormonal therapy.OBJECTIVE• To evaluate the prognostic value of histopathological variables and immunostainings of biomarkers enhancer of zeste homologue 2 (EZH2), Ki‐67 and minichromosome maintenance protein 7 (MCM7) from core biopsies of hormonally treated patients with prostate cancer.PATIENTS AND METHODS• Biopsies of 247 primarily endocrine‐treated patients were analysed for histopathological characteristics and Gleason scores (GS) according to the revised guidelines of International Society of Urologic Pathology (ISUP) consensus conference 2005.• Immunohistochemical stainings were analysed with the aid of digital image analysis.• The prognostic value of the histopathological variables and the biomarkers was analysed with univariate and multivariate Cox regression analysis, with biochemical recurrence as an endpoint.RESULTS• Biomarkers EZH2 (relative risk [RR] 2.0, 95% confidence interval 1.2–3.3), Ki‐67 (3.4, 2.1–5.5) and MCM7 (2.4, 1.5–3.9) were significantly associated with progression‐free survival in a univariate analysis.• Ki‐67 immunostaining index detected high‐risk patients with GS of 7 (9.1, 8.0–10.3).• In a multivariate analysis with non‐conventional GS groups 5–7 (3 + 4), 7(4 + 3)–8, and 9–10, the independent prognostic markers were pretreatment GS (2.2, 1.5–3.2), prostate‐specific antigen (PSA) level (2.1, 1.1–4.2), perineural invasion (PNI) (1.6, 1.2–2.2), and clinical T‐stage (cT) (1.9, 1.0–3.7).• Combination of the independent markers (PSA level >20 ng/mL or GS >3 + 4 or PNI >3 or cT >2) yielded best risk stratification (RR 11.6, 10.4–12.7).CONCLUSIONs• GS remains one of the most important prognostic factors in prostate cancer. However, the refined guidelines by ISUP 2005 might have shifted the threshold between low‐grade and high‐grade cancers from GS 6 vs 7 to GS 3 + 4 vs 4 + 3.• PNI is an independent prognostic marker superior to cT.• Ki‐67 is the most useful biomarker in detecting patients with GS = 7 at high risk for progression.
Changing patterns of bladder cancer in the USA: evidence of heterogeneous disease
Authors: Zhang Yawei , Zhu Cairong , Curado Maria Paula , Zheng Tongzhang , Boyle Peter 
Published: May 2011

Study Type – Disease prevalence (retrospective cohort)Level of Evidence 2bWhat’s known on the subject? and What does the study add?The incidence of bladder cancer has shown a slightly decreasing trend during the past several decades. All published epidemiological studies have trended papillary transitional cell carcinoma (PTCC) and non‐papillary transitional cell carcinoma (NPTCC) as one single disease called transitional cell carcinoma (TCC).This study for the first time examined the time trends by PTCC and NPTCC and found that these two histological subtypes presented different temporal trends. The study results support the hypothesis that bladder cancer is a heterogeneous disease and taking disease’s heterogeneity into consideration in future epidemiological studies is essential.OBJECTIVE• To test the hypothesis that bladder cancer is a heterogeneous disease.PATIENTS AND METHODS• We examined the temporal trends of bladder cancer by histological subtype and by disease stage and grade using the National Cancer Institute’s Surveillance, Epidemiology, and End Results data collected in 1973–2007.RESULTS• The age‐adjusted incidence rates of bladder cancer showed a slight decrease from 1973 to 2007 (annual percentage change [APC]=−0.4, P < 0.05).• Although the age‐adjusted incidence rates of non‐papillary transitional cell carcinoma decreased by about 53% from 7.9 per 100 000 in 1973 to 3.7 per 100 000 in 2007 (APC =−2.2, P < 0.05), the age‐adjusted incidence rates of papillary transitional cell carcinoma increased by about 56% from 6.8 per 100 000 in 1973 to 10.6 per 100 000 in 2007 (APC = 0.5, P < 0.05).• Among other rare histological subtypes, except for small cell carcinoma which showed a slightly rising trend, squamous cell carcinoma, adenocarcinoma and others all presented a decreasing trend.• Similar patterns were found for different stages (localized, regional and distant), but a dramatic increasing trend of grade IV was found between 1998 and 2007 when a corresponding decreasing trend was shown for grades I, II and III.CONCLUSION• The results support the hypothesis that bladder cancer is a heterogeneous disease and taking disease heterogeneity into consideration in future epidemiological studies is essential.
The breast care nurse: the care specialist in breast centres
Authors: Voigt B. , Grimm A. , Loßack M. , Klose P. , Schneider A. , Richter‐Ehrenstein C. 
Published: May 2011

VOIGT B., GRIMM A., LOßACK M., KLOSE P., SCHNEIDER A. & RICHTER‐EHRENSTEIN C. (2011) The breast care nurse: the care specialist in breast centres. International Nursing Review58, 450–453Background:  In Europe, breast cancer is the most common form of cancer in women; 26.5 per cent of all new malignant diseases and 17.5 per cent of all cancer deaths are due to this type of cancer. In Germany, approximately every tenth woman is diagnosed with breast cancer during her lifetime.Objective:  In order to increase the quality of life of breast cancer patients, the European Society of Mastology (EUSOMA) requires the availability of, and an integration of qualified and specialized care into the interdisciplinary team. Thus, in Germany, a new type of job profile for ‘breast nurse’ as a qualified care specialist has to be established and has to be oriented towards the international standards of a breast care nurse (BCN).Methods:  The Charité's Academy of Health – in cooperation with the Interdisciplinary Breast Centre of the Charité– has offered a career advisory service curriculum for the BCN since 2006 in accordance with the EUSOMA guidelines.Results:  In three courses, 45 BCNs have been trained. In the first refresher seminar in May 2009, the BCNs were given an opportunity to exchange with fellow BCNs their experiences.Conclusion:  We were able to set up a new curriculum to train nurses as BCNs as to improve the quality of care for breast cancer patients and to orientate the training towards the international standards of a BCN qualification.
The psychological neuroscience of depression: Implications for understanding effects of deep brain stimulation
Authors: SJÖBERG RICKARD L. , BLOMSTEDT PATRIC 
Published: May 2011

Sjöberg, R. L. & Blomstedt, P. (2011). The psychological neuroscience of depression: Implications for understanding effects of deep brain stimulation.Scandinavian Journal of Psychology 52, 411–419.In this article it is suggested that current psychological theories of depression presuppose that this condition will develop as a result of a vicious circle involving negatively biased communication between systems of emotional stress‐/alarm‐signaling, executive functions and mood regulation. These systems may from a neuroanatomical point of view be located in the limbic system, the orbitofrontal and lateral prefrontal cortex and the hypothalamus‐pituitary‐adrenal (HPA‐) axis respectively. The theoretical and practical implications of this model for the understanding of pharmacological treatments of depression are briefly discussed and this theory is related to the catecholamine hypothesis of depression. The model is furthermore discussed in relation to deep brain stimulation (DBS) of treatment resistant major depression. Similarities and differences between this perspective and the one advocated by the “homeostatic theory” of depression are discussed. It is concluded that a topographical psychological theory may offer a useful heuristic in thinking about depression and that it offers several testable predictions about treatments of the disorder.
The rumouring of SARS during the 2003 epidemic in China
Authors: Tai Zixue , Sun Tao 
Published: May 2011

AbstractBy analysing rumour content as covered by major Chinese newspapers, this article explores the multiple dimensions of SARS‐related rumouring throughout China during the 2003 epidemic. Findings indicate a strong correlation between the scale of SARS infections and level of rumour activities across regions. As for channels of dissemination, the rumour process still found a natural habitat in word of mouth, while internet‐based platforms and cell phone text messaging emerged as viable grapevines. Our particular typology of SARS‐incurred rumours leads us to identify four distinct types of rumours: legendary rumours; aetiological narratives; proto‐memorates; and bogies. The four types of rumours are discussed against the background of superstitious beliefs, folklore practices, popular mentalities, and China’s particular socio‐political information environment.
Tissue donation to biobanks: a review of sociological studies
Authors: Lipworth Wendy , Forsyth Rowena , Kerridge Ian 
Published: May 2011

AbstractCollections of human tissue (biobanks) are thought to be an essential resource for biomedical research. Biobanks have, however, been a source of debate in both bioethics and sociology. In recent years this theorising has been supplemented with empirical research, including a significant body of qualitative research, into donors’ experiences and attitudes. To date, this literature has not been synthesised. We report the findings of a review of qualitative literature regarding the ways in which lay people construct and experience the process of donation to biobanks. Our aim was to determine what the qualitative research literature tells us about the process of donating to biobanks, and how this can enrich existing insights from quantitative research and from theoretical sociology and bioethics. Qualitative research shows that donation to biobanks is a complex process shaped by donors’ embeddedness in a number of social contexts; by complex relations of trust in biomedicine; and by the ambiguous status of human tissue. While these findings are theoretically and practically useful, current sociological theorising is very general. A more detailed and nuanced ‘sociology of biobanking’ is needed, and this might be best achieved by exploring specific theoretical questions in a variety of biobanking settings.
Association of SPINK5 gene polymorphisms with atopic dermatitis in Northeast China
Authors: Zhao L.P. , Di Z. , Zhang L. , Wang L. , Ma L. , Lv Y. , Hong Y. , Wei H. , Chen H.D. , Gao X.H. 
Published: May 2011

AbstractBackground  Defect in the SPINK5 gene is known to be implicated in Netherton syndrome (NS), and has been suggested to be a locus predisposing to atopy in general. Coding polymorphisms in SPINK5 exons 13, 14 and 26 have been reported to be associated with atopic dermatitis (AD), asthma and high level of IgE.Objectives  To examine whether the SPINK5 gene polymorphisms are associated with AD in Northeast China, and to assess how variants influence selected phenotypic traits.Methods  A case–control study was conducted on four non‐synonymous polymorphisms in the coding region of SPINK5 in AD and controls. The SPINK5 gene polymorphisms were analyzed using the PCR and RFLP methods.Results  For the four non‐synonymous SNPs, A1103G(Asn368Ser), G1156A(Asp386Asn), G1258A(Glu420Lys), G2475T(Glu825Asp) in SPINK5, the allelic frequencies in the AD cohort were 0.55 for 1103G, 0.57 for 1156A, 0.54for 1258A, 0.62 for 2475T, consistent with those already published in the original British and Japanese cohorts. The T allele of SNP 2475G > T was found to be significantly associated with AD. There were significant differences in genotype frequencies for G1258A(Glu420Lys) and G2475T(Glu825Asp) but not for A1103G(Asn368Ser) and G1156A(Asp386Asn). Genotypes GA(420Glu/Lys), TT (2475Asp/Asp) and GT(2475Glu/Asp) were significantly more frequent in AD. However, the SPINK5 gene polymorphisms was found not to be associated with AD in regard to either serum IgE levels, concurrent allergic asthma or early onset of AD.Conclusions  Our study confirms the association between SPINK5 and AD.
Clinical and dermoscopic characteristics of amelanotic melanomas that are not of the nodular subtype
Authors: Jaimes N. , Braun R.P. , Thomas L. , Marghoob A.A. 
Published: May 2011

AbstractBackground  Amelanotic melanomas remain challenging to diagnose.Objective  To analyze and describe the clinical and dermoscopic characteristics of amelanotic melanomas that are not of the nodular subtype.Patients/Methods  We conducted a retrospective review of 20 consecutively diagnosed amelanotic melanomas. The clinical and dermoscopic images of pathologically confirmed amelanotic melanomas that were not of the nodular subtype were analyzed. In addition, the clinical diagnosis and the reasons why these lesions were biopsied were examined.Results  All 20 amelanotic melanomas were erythematous and lacked any of the clinical ABCD features commonly attributed to melanoma. The lesions appeared clinically to be relatively symmetric with regular borders and manifesting a circular to oval morphology. Dermoscopically, all lesions manifested polymorphous vascular pattern.Conclusions  Amelanotic melanomas that are not of the nodular subtype often present as clinically symmetric erythematous lesions. Therefore, it is important to consider AMs in the differential diagnosis of isolated and persistent erythematous outlier lesions, even if they are symmetric in appearance. Additionally, the presence of a polymorphous vascular pattern seen with dermoscopy can facilitate in correctly identifying these melanomas.
Parents with learning disabilities and speech and language therapy. A service evaluation of referrals and episodes of care
Authors: Stansfield Jois 
Published: May 2011

Accessible summary
Some people with learning disabilities are parents.
Sometimes, it is hard to understand and explain things when you are a parent.
Speech and language therapists can help parents to understand and explain things.
SummaryThe speech and language therapy (SLT) service in an area of northern England receives referrals of parents who have learning disabilities. The aim of this study was to identify current referral patterns and quantify the level of demand upon the SLT service from this relatively new referral population to enable to service to meet the needs of these clients. Data covering a 24‐month period was collected. The SLT clinical database was interrogated to establish the number of parent referrals, and a case note audit was carried out to identify the reason for referral and number of contacts. Results indicted that over a fifth of referrals during that period were of parents, including a relatively high proportion of young women. The SLT service in the area appears to be seen by referrers as a source of support for people with learning disabilities who are or are about to become parents. Several referrals were related to the imminence of court cases, while others reflected the possibility of supporting parents to increase their communication skills to be good enough parents. The level of demand on the service suggests an increase in people who are experiencing communication challenges resulting from their opportunities to live an ordinary life as parents.