bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histological examination in sudden unexpected death in infancy: evidence base for histological sampling
Authors: Weber M A , Pryce J W , Ashworth M T , Malone M , Sebire N J 
Published: October 2011

AimPathologists currently follow the ‘Kennedy guidelines’ when performing autopsies for sudden unexpected death in infancy (SUDI); these include extensive histological sampling. This study establishes the frequency with which histological examination of visceral organs determines cause of death and examines associations between clinical, macroscopic and microscopic findings.MethodsRetrospective review of 546 SUDI autopsies performed for a 10-year period (1996–2005) at a single centre. The proportion of cases in which non-neuropathological histological examination directly determined the cause of death was identified, and clinical, macroscopic and histological findings at autopsy were compared.ResultsOf 510 SUDIs included, 166 cases were explained SUDI, and of these, 54% (89/166) were identified solely on microscopic examination, based on histology of the lungs in 71 (43%), heart in 13 (8%), liver in 4 (2%) and kidneys in 1 (<1%). The proportions of macroscopically normal organs with significant histological findings were 26% lungs, 2% heart and 1% each of liver and kidneys, but none of spleen, thymus, pancreas or adrenals. Macroscopically abnormal organs were more likely to yield significant histological features. Symptoms preceding death were more common in cases with significant histological findings in lungs, heart, liver and adrenals.ConclusionA non-neuropathological cause of death in explained SUDI can be established from histological examination of lungs, heart, liver and kidneys. Significant histological abnormalities may be detected in selected organs with macroscopically normal appearances. Routine histological sampling of other organs in the absence of specific clinical history or macroscopic abnormalities has a low yield for establishing cause of death.
A clinicopathological aspect of primary small-cell carcinoma of the uterine cervix: a single-centre study of 25 cases
Authors: Li Jun-Dong , Zhuang Yuan , Li Yan-Fang , Feng Yan-Ling , Hou Jin-Hui , Chen Liang , Zhu An-Na , Wu Qiu-liang , Yun Jing-Ping 
Published: October 2011

AimsSmall-cell carcinoma is a variant of poorly differentiated neuroendocrine carcinoma. Primary small-cell carcinoma of the cervix (SCCC) is recognised as a rare and aggressive malignant tumour with poor prognosis. In this study, the authors report 25 Chinese cases of SCCC, with a particular focus on their clinical and pathological characteristics.Material and methodsThe records of 25 patients from 4075 Chinese patients with cervical cancer were collected and reviewed, including the patients' age, initial symptoms, cervical tumour size, International Federation of Gynaecology and Obstetrics clinical stage, lymph-node metastasis, treatments and follow-up results. Immunohistochemical detection was performed for cytokeratin, epithelial membrane antigen, neuron-specific enolase (NSE), synaptophysin (Syn), chromogranin A (CgA), neuronal cell adhesion molecules (CD56), thyroid transcriptional factor-1 and S100 protein (S100).ResultsThe median age of 25 patients with SCCC was 43.7 years. The most common symptom was abnormal vaginal bleeding. Histologically, there were 19 ‘homogenous’ SCCC samples and six samples of SCCC mixed with adenocarcinoma. The proportion of SCCC samples with positive immunoreactivity were 100.0% for NSE, 96.0% for Syn, 68.0% for CD56, 76.0% for CgA, 40.0% for thyroid transcriptional factor-1, 84.0% for epithelial membrane antigen, 68.0% for cytokeratin and 8.0% for S100, respectively. Every patient received one to three types of treatments, including surgery, chemotherapy and radiotherapy. The median survival time of patients was 20.9 months after diagnosis.ConclusionThe higher proportion of positive labelling of Syn, CD56, CgA, and NSE in SCCC implicated that they are valuably applied in a differential diagnosis of the malignancy. The patients with SCCC receive one to three types of therapies, including surgery, chemotherapy and radiotherapy, and have a poor prognosis.
Multicentric evaluation of a second generation assay to detect antiviral citrullinated peptide antibodies: a collaborative study by the Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni
Authors: Bizzaro N , Allegri F , Alpini C , Doria A , Gerli R , Lotzniker M , Mathieu A , Morozzi G , Bellisai F , Riccieri V , Tampoia M , Migliorini P 
Published: October 2011

AimsA novel immunoenzymatic assay using viral citrullinated peptides derived from Epstein–Barr virus-encoded proteins (viral citrullinated peptide 2 (VCP2)) has been developed and evaluated by means of a multicentre collaborative study.MethodsThree hundred nine sera from patients with established rheumatoid arthritis (RA), 36 with early arthritis, 12 with juvenile arthritis and 453 controls were tested for VCP2 and cyclic citrullinated peptide (CCP) antibodies.ResultsThe VCP2 assay showed 78.3% sensitivity and 97.1% specificity. VCP2 and CCP had a high concordance rate in patients with RA (88%) and controls (97%). However, 36 RA sera were positive in the CCP assay but negative on VCP2, and two RA sera reacted only on VCP2.ConclusionsThe new VCP2 assay is endowed with high sensitivity and specificity. VCP2-positive RA sera are mostly but not completely contained in the CCP-positive population. Studies are in progress to establish whether the VCP2 assay can detect clinically distinct subsets of patients with RA.
Handling and reporting of nephrectomy specimens for adult renal tumours: a survey by the European Network of Uropathology
Authors: Algaba Ferran , Delahunt Brett , Berney Daniel M , Camparo Philippe , Compérat Eva , Griffiths David , Kristiansen Glen , Lopez-Beltran Antonio , Martignoni Guido , Moch Holger , Montironi Rodolfo , Varma Murali , Egevad Lars 
Published: October 2011

AimTo collect information on current practices of European pathologists for the handling and reporting of nephrectomy specimens with renal tumours.Methods and ResultsA questionnaire was circulated to the members of the European Network of Uropathology, which consists of 343 pathologists in 15 European countries. Replies were received from 48% of members. These replies indicated that nephrectomy specimens are most often received in formalin. Lymph nodes are found in less than 5% of nephrectomy specimens. All respondents give an objective measure of tumour size, most commonly in three diameters. The most common method to search for capsule penetration is to slice tissue outside the tumour perpendicularly into the tumour. The most common sampling algorithm from tumours greater than 2 cm is one section for every centimetre of maximum tumour diameter. Most respondents use the 2004 WHO renal tumour classification although only slightly over half consider small papillary tumours malignant if the diameter is greater than 5 mm. The Fuhrman grading system is widely used. Almost all use immunohistochemistry for histological typing in some cases, while only 7% always use it. The most utilised special stains are CK7 (95%), CD10 (93%), vimentin (86%), HMB45 (68%), c-kit (61%) and Hale's colloidal iron (52%). Only 18% use other ancillary techniques for diagnosis in difficult cases.ConclusionsWhile most pathologists appear to follow published guidelines for reporting renal carcinoma, there is still a need for the development of consensus and further standardisation of practice for contentious areas of specimen handling and reporting.
Endoscopic ultrasound guided transbronchial fine needle aspiration: a French Department of Pathology's 4-year experience
Authors: Delattre Claire , Fournier Clément , Bouchindhomme Brigitte , Renaud Florence , Escande Fabienne , Ramon Philippe , Copin Marie-Christine 
Published: October 2011

BackgroundEndobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) is an accurate outpatient procedure used to explore mediastinal lymph nodes for lung cancer staging and unexplained mediastinal masses.Aims and methodsA retrospective study was conducted over four years on EBUS-TBNA sampled lymph nodes investigated for the staging of lung cancer or unexplained mediastinal lymphadenopathies, first using the conventional method (CM) and then a liquid based cytology (LBC).ResultsOf the 628 specimens (355 patients) collected, the overall rate of adequacy was 88% and the diagnosis of malignancy was achieved in 43% of cases. The inadequate rate was 6% with LBC and 21% with CM. A paraffin cytoblock was available in 80% with LBC and 62% with CM. Of the 628 aspirates, 270 (43%) were categorised as negative for malignancy including 26 cases consistent with sarcoidosis, 272 (43%) as malignant, 9 (1.4%) as suspicious for non-small-cell carcinoma and 77 as inadequate samples (12%). Of the 272 cases diagnosed as malignant, 87 (32%) were classified as non-small-cell carcinoma, 106 (39%) as adenocarcinoma, 48 (18%) as squamous cell carcinoma and 20 (7%) as small cell carcinoma. Five lymphomas, four metastatic melanomas and two carcinoids were also diagnosed.ConclusionsEBUS-TBNA is a reliable method for the staging of lung cancer and for unexplained mediastinal mass exploration. The LBC has a lower rate of inadequate samples, a better yield of cytoblock for immunohistochemistry and a dramatically reduced time requirement for interpretation as compared to CM.
Social Stress Promotes and γ-Aminobutyric Acid Inhibits Tumor Growth in Mouse Models of Non–Small Cell Lung Cancer
Authors: Al-Wadei Hussein A.N. , Plummer Howard K. , Ullah Mohammad F. , Unger Benjamin , Brody Joel R. , Schuller Hildegard M. 
Published: September 2011

Abstract
Psychologic distress is associated with increased lung cancer incidence and mortality. We have shown that non–small cell lung cancer (NSCLC) cells in vitro are stimulated by the cyclic AMP (cAMP)-dependent activation of cAMP-responsive element binding protein (CREB) and extracellular signal–regulated kinase (ERK) downstream of β-adrenergic receptors and that this pathway is inhibited by the neurotransmitter γ-aminobutyric acid (GABA). Because the stress neurotransmitters noradrenalin and adrenalin are β-adrenergic agonists, the current study has tested the hypothesis that social stress stimulates NSCLC growth in vivo and that GABA inhibits this effect. Social stress was induced in mice carrying xenografts from two NSCLC cell lines in the presence and absence of treatment with GABA. Xenograft sizes were measured after 30 days. Noradrenalin, adrenalin, cortisol, GABA, and cAMP were measured in blood and tumor tissues by immunoassays. Expression of nicotinic receptors in the xenografts was assessed by real-time PCR and Western blotting. Protein expression of phospho (p)-CREB, CREB, phospho (p)-ERK, ERK, and glutamate decarboxylase (GAD) 65 and 67 were determined by Western blotting. Xenograft sizes in stress-exposed mice were significantly increased. Nicotinic acetylcholine receptor (nAChR) subunits α3, α4, α5, and α7 in xenograft tissues showed posttranscriptional induction. Noradrenalin, adrenalin, and cortisol were elevated in serum and xenograft tissue whereas GABA was suppressed. Levels of cAMP, p-CREB, and p-ERK were increased whereas GAD65 and GAD67 were suppressed in tumor tissue. Treatment with GABA reversed the effects of stress. Our findings suggest that social stress stimulates NSCLC by increasing nAChR-mediated stress neurotransmitter signaling and that GABA is a promising novel agent for NSCLC intervention. Cancer Prev Res; 5(2); 189–96. ©2011 AACR.
Paced Left Ventricular QRS Width and ECG Parameters Predict Outcomes After Cardiac Resynchronization Therapy
Authors: Hsing Jeff M. , Selzman Kimberly A. , Leclercq Christophe , Pires Luis A. , McLaughlin Michael G. , McRae Scott E. , Peterson Brett J. , Zimetbaum Peter J. 
Published: September 2011

Background—
For patients with symptomatic New York Heart Association class III or IV, ejection fraction ≤35%, and QRS ≥130 ms, cardiac resynchronization therapy (CRT) has become an established treatment option. However, use of these implant criteria fails to result in clinical or echocardiographic improvement in 30% to 45% of CRT patients.

Methods and Results—

The Predictors of Response to CRT (PROSPECT)-ECG is a substudy of the prospective observational PROSPECT trial. ECGs collected before, during, and after CRT implantation were analyzed. Primary outcomes were improvement in clinical composite score (CCS) and reduction of left ventricular end systolic volume (LVESV) of >15% after 6 months. Age, sex, cause of cardiomyopathy, myocardial infarction location, right ventricular function, mitral regurgitation, preimplantation QRS width, preimplantation PR interval, preimplantation right ventricular–paced QRS width, preimplantation axis categories, LV-paced QRS width, postimplantation axis categories, difference between biventricular (Bi-V) pacing and preimplantation QRS width, and QRS bundle branch morphological features were analyzed univariably in logistic regression models to predict outcomes. All significant predictors (α=0.1), age, and sex were used for multivariable analyses. Cardiomyopathy cause interaction and subanalyses were also performed. In multivariable analyses, only QRS left bundle branch morphological features predicted both CCS (odds ratio [OR]=2.46,
P
=0.02) and LVESV (OR=2.89,
P
=0.048) response. The difference between Bi-V and preimplantation QRS width predicted CCS improvement (OR=0.89,
P
=0.04). LV-paced QRS width predicted LVESV reduction (OR=0.86,
P
=0.01). Specifically, an LV-paced QRS width of ≤200 ms was predictive of nonischemic LVESV reduction (OR=5.12,
P
=0.01).

Conclusions—
Baseline left bundle branch QRS morphological features, LV-paced QRS width, and the difference between Bi-V and preimplantation QRS width can predict positive outcomes after CRT and may represent a novel intraprocedural method to optimize coronary sinus lead placement.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00253357.
Recovery of Mitral Isthmus Conduction Leads to the Development of Macro-Reentrant Tachycardia After Left Atrial Linear Ablation for Atrial Fibrillation
Authors: Sawhney Navinder , Anand Kislay , Robertson Clare E , Wurdeman Taylor , Anousheh Ramtin , Feld Gregory K 
Published: October 2011

Background—
Left atrial linear ablation for atrial fibrillation (AF) may be proarrhythmic, leading to left atrial macro-reentrant tachycardia (LAT). Whether due to failure to achieve block initially or to recovery of conduction after ablation is unknown. This study was designed to evaluate the frequency of recovery of mitral isthmus (MI) conduction compared with cavo-tricuspid isthmus (CTI) conduction, and the relationship between recovery of MI conduction and postablation LAT.

Methods and Results—

Of 163 patients with AF who underwent circumferential pulmonary vein ablation plus left atrial linear ablation, in whom MI and CTI ablation produced bidirectional conduction block, 52 underwent repeat ablation for recurrent atrial arrhythmias (AF or LAT). Of these 52 patients, coronary sinus ablation was required in 48 to achieve bidirectional MI block at the index ablation. During repeat ablation, MI and CTI conduction was assessed in sinus rhythm. At repeat ablation, MI conduction had recovered in 38 of 52 patients, as compared with CTI conduction which recovered in only 12 of 52 patients (
P
=0.001). At repeat ablation, the recurrent clinical arrhythmia in 12 patients was MI-dependent LAT. Recovery of MI conduction was associated with development of MI-dependent LAT (
P
=0.01).

Conclusions—
Despite using bidirectional conduction block as a procedural end point, recovery of MI conduction is common and may lead to LAT after left atrial linear ablation for AF. The reason for greater recovery of MI versus CTI conduction is unknown but could be due to differences in isthmus anatomy or lower power used for ablation in the left versus right atrium.
Four Genetic Loci Influencing Electrocardiographic Indices of Left Ventricular Hypertrophy
Authors: Shah Sonia , Nelson Christopher P. , Gaunt Tom R. , van der Harst Pim , Barnes Timothy , Braund Peter S. , Lawlor Debbie A. , Casas Juan-Pablo , Padmanabhan Sandosh , Drenos Fotios , Kivimaki Mika , Talmud Philippa J. , Humphries Steve E. , Whittaker John , Morris Richard W. , Whincup Peter H. , Dominiczak Anna , Munroe Patricia B. , Johnson Toby , Goodall Alison H. , Cambien Francois , Diemert Patrick , Hengstenberg Christian , Ouwehand Willem H. , Felix Janine F. , Glazer Nicole L. , Tomaszewski Maciej , Burton Paul R. , Tobin Martin D. , van Veldhuisen Dirk J. , de Boer Rudolf A. , Navis Gerjan , van Gilst Wiek H. , Mayosi Bongani M. , Thompson John R. , Kumari Meena , MacFarlane Peter W. , Day Ian N.M. , Hingorani Aroon D. , Samani Nilesh J. 
Published: October 2011

Background—
Presence of left ventricular hypertrophy on an ECG (ECG-LVH) is widely assessed clinically and provides prognostic information in some settings. There is evidence for significant heritability of ECG-LVH. We conducted a large-scale gene-centric association analysis of 4 commonly measured indices of ECG-LVH.

Methods and Results—

We calculated the Sokolow-Lyon index, Cornell product, 12-lead QRS voltage sum, and 12-lead QRS voltage product in 10 256 individuals from 3 population-based cohorts and typed their DNA using a customized gene array (the Illumina HumanCVD BeadChip 50K array), containing 49 094 genetic variants in ≈2100 genes of cardiovascular relevance. We followed-up promising associations in 11 777 additional individuals. We identified and replicated 4 loci associated with ECG-LVH indices: 3p22.2 (
SCN5A
, rs6797133,
P
=1.22×10
−7
) with Cornell product and 12q13.3 (
PTGES3
, rs2290893,
P
=3.74×10
−8
), 15q25.2 (
NMB
, rs2292462,
P
=3.23×10
−9
), and 15q26.3 (
IGF1R
, rs4966014,
P
=1.26×10
-7
) with the 12-lead QRS voltage sum. The odds ratio of being in the top decile for the 12-lead QRS voltage sum for those carrying 6 trait-raising alleles at the 12q13.3, 15q25.2, and 15q26.3 loci versus those carrying 0 to 1 alleles was 1.60 (95% CI: 1.20 to 2.29). Lead single-nucleotide polymorphisms at the 12q13.3 and 15q25.2 loci showed significant expression quantitative trait loci effects in monocytes.

Conclusions—
These findings provide novel insights into the genetic determination of ECG-LVH. The findings could help to improve our understanding of the mechanisms determining this prognostically important trait.
Telemedicine for multiple sclerosis patients: assessment using Health Value Compass
Authors: Zissman Keren , Lejbkowicz Izabella , Miller Ariel 
Published: October 2011

Background: Telemedicine carries the potential of improving accessibility to health services, especially for disabled people. Objective: To assess the health-related outcomes of short-term implementation of telemedicine (telemed) for MS patients. Methods: A prospective study of 40 MS patients divided into a control group and a telemed group was conducted, in two stages: A. Six months’ follow-up for measurement of baseline health-related variables; B. Implementation stage, adding home telecare to the telemed group. A Health Value Compass was applied to assess the outcomes of home telecare implementation. Clinical status, cost data, patients’ self-assessment of Health Related Quality of Life (HRQoL) and satisfaction with telecare were studied. Results: Patients in the telemed group demonstrated improved clinical outcome measured by symptoms severity. There was a decrease of at least 35% in the medical costs for 67% of the telemed group patients. Satisfaction with telecare was high and most patients would recommend this service to others. Conclusions: The present pilot study, applying Health Value Compass-based analysis, suggests that telecare is a powerful tool for monitoring MS patients at home, carries the potential to improve health care while reducing costs, and should be considered for implementation as part of the management of chronic neurological diseases.
Altered effective connectivity during performance of an information processing speed task in multiple sclerosis
Authors: Leavitt Victoria M , Wylie Glenn , Genova Helen M , Chiaravalloti Nancy D , DeLuca John 
Published: October 2011

Background: Functional magnetic resonance imaging (fMRI) studies of persons with multiple sclerosis (MS) reveal distinct patterns of activation during task performance. We were interested in determining whether distinct patterns of effective connectivity would be revealed with Granger causality analysis (GCA). Objective: To characterize directed neural connections in persons with MS during a processing speed task between brain regions known to be activated in healthy controls. Methods: fMRI and GCA were used to examine effective connectivity underlying performance of a processing speed task in persons with MS. In total, 16 individuals with MS and 17 healthy controls (HC) performed a modified version of the Symbol Digit Modality Task (mSDMT) in the MRI scanner. Eight seed regions were selected on the basis of a priori data showing areas involved in mSDMT performance of HC. Results: Behaviorally, the MS group attained a level of accuracy equivalent to the HC group, although they were significantly slower. While there was a great deal of overlap in the connections relied upon by both groups, the MS group showed significant differences in connectivity between critical brain regions. Specifically, the MS group had more connections from multiple regions to frontal cortices bilaterally relative to HCs. Conclusions: Greater neural recruitment by the MS group relative to HC is consistent with the neural efficiency hypothesis, and lends further support to the notion that more connections must be recruited to maintain performance in the presence of brain pathology.
Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)
Authors: Wynia K , van Wijlen AT , Middel B , Reijneveld SA , Meilof JF 
Published: October 2011

Background: Evidence on the progress of disease severity in Multiple Sclerosis (MS) is generally limited in scope. Objectives: To examine the course of a broad spectrum of MS-related disabilities and quality of life (QOL) in relation to disease severity, and responsiveness of the Multiple Sclerosis Impact Profile (MSIP). Methods: The mortality rate was calculated after checking the national population register for vital status of the initial cohort. We performed a longitudinal study among 245 patients with MS attending the Groningen MS Center in the Netherlands. We assessed these patients in 2004 and 2009 using a postal survey including the MSIP to evaluate disabilities, the World Health Organization Quality of Life-Abbreviation version (WHOQOL-BREF) to evaluate QOL, and the ambulation question of the Expanded Disability Status Scale (EDSS) to evaluate disease severity. Responsiveness of the MSIP was estimated using standardized response mean (SRM). Results: Increase of disability in the MSIP disability domains and loss of QOL were most prevalent and pronounced in patients with EDSS 0 to < 4.5 in 2004. MSIP and QOL scores were remarkably stable in the higher disease severity groups. Mortality rates were highest (24%) in patients with EDSS ≥ 7 to < 10 in 2004. SRM indices for the MSIP ranged between 0.26 and 0.56. Conclusions: Prominent increases in multiple aspects of disability and loss of QOL occur especially in the early stages in MS. Health care interventions may lead to health and QOL gains, in particular when offered to patients in the first stage of the MS process. Responsiveness was sufficient for nine of the 11 MSIP domains.