bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathologic Features of Agranulocytosis in the Setting of Levamisole-Tainted Cocaine
Authors: Czuchlewski David R. , Brackney Monica , Ewers Christina , Manna Jonaki , Fekrazad M. Houman , Martinez Afton , Nolte Kurt B. , Hjelle Brian , Rabinowitz Ian , Curtis Brian R. , McFarland Janice G. , Baumbach Joan , Foucar Kathryn 
Published: February 2010

Abstract
Levamisole is a known contaminant of cocaine and, via this route, has been associated with otherwise unexplained agranulocytosis. Levamisole is currently present in the majority of cocaine samples seized by the US Drug Enforcement Agency. We identified 20 cases of unexplained agranulocytosis in our practice locations of Albuquerque, NM, and Vancouver, Canada. Epidemiologic investigation revealed recent or ongoing cocaine use in 14 cases (70%). Certain morphologic features, including circulating plasmacytoid lymphocytes, increased bone marrow plasma cells, and mild megakaryocytic hyperplasia, were associated with the cocaine-exposed group. Of 5 patients tested, 3 (60%) were HLA-B27+ and showed antineutrophil antibodies, consistent with known associations of levamisole-induced agranulocytosis. One patient, who was positive for cocaine and levamisole by toxicology testing, died of infectious complications. Inadvertent consumption of levamisole via cocaine is a severely underappreciated risk factor for agranulocytosis, and specific laboratory features are suggestive of this etiology.
Conjunctive p16INK4a Testing Significantly Increases Accuracy in Diagnosing High-Grade Cervical Intraepithelial Neoplasia
Authors: Bergeron Christine , Ordi Jaume , Schmidt Dietmar , Trunk Marcus J. , Keller Thomas , Ridder Ruediger 
Published: February 2010

Abstract
The histopathologic interpretation of cervical intraepithelial neoplasia (CIN) is subject to a high level of interobserver variability and a substantial number of false-positive and false-negative results. We assessed the impact of the conjunctive interpretation of p16INK4a-immunostained slides on the accuracy of community-based pathologists in diagnosing high-grade cervical intraepithelial neoplasia (CIN; CIN 2 and CIN 3) in biopsy specimens. Twelve pathologists rendered independent diagnoses on a set of 500 H&E-stained cervical punch and conization specimens. Results were compared with a dichotomized “gold standard” established by consensus of 3 gynecopathology experts. When p16INK4a-immunostained slides were added and conjunctively interpreted with the H&E-stained slides, a significant increase in diagnostic accuracy for the detection of high-grade CIN was observed (P = .0004). Sensitivity for high-grade CIN was increased by 13%, cutting the rate of false-negative results in half. Agreement of community-based pathologists in diagnosing high-grade CIN was significantly improved (mean κ values advanced from 0.566 to 0.749; P &lt; .0001). Reproducibility of p16INK4a stain interpretation was excellent (κ = 0.899). Our results show that conjunctive interpretation of p16INK4a-stained slides could significantly improve the routine interpretation of cervical histopathology.
Efficacy and Safety of Ibuprofen and Acetaminophen in Children and Adults: A Meta-Analysis and Qualitative Review
Authors: Pierce Catherine A , Voss Bryan 
Published: February 2010

Objective: To evaluate the analgesic and antipyretic efficacy and safety of ibuprofen compared to acetaminophen in children and adults. Data Sources: Literature searches were performed using PubMed/MEDLINE (through August 2009) and EMBASE (through January 2008) and were restricted to the English language. In PubMed/MEDLINE, search terms used were ibuprofen, acetaminophen, paracetamol, clinical trials, and randomized controlled trials. EMBASE search terms included ibuprofen and acetaminophen, restricted to human and clinical trials. Study Selection And Data Extraction: All English-language articles identified from the data sources were reviewed. Multiple review articles were studied for any pertinent references and this yielded additional articles. Only articles that directly compared ibuprofen and acetaminophen were eligible for this review. Data Synthesis: Eighty-five studies that directly compared ibuprofen to acetaminophen were identified; 54 contained analgesic efficacy data, 35 contained antipyretic/temperature reduction data, and 66 contained safety data (some articles contained more than 1 type of data). Qualitative review of the literature revealed that, for the most part, ibuprofen was more efficacious than acetaminophen for the treatment of pain and fever in both pediatric and adult populations, and that these 2 drugs were equally safe. Meta-analyses on the subset of randomized clinical trial articles that reported sufficient quantitative information to calculate either an odds ratio (adverse event [AE]) or standardized mean difference (pain and fever) confirmed the qualitative results for adult (standardized mean difference [SMD] 0.69; 95% CI 0.57 to 0.81) and pediatric (SMD 0.28; 95% CI 0.10 to 0.46) pain at 2 hours postdose and pediatric fever (SMD 0.26; 95% CI 0.10 to 0.41) at 4 hours postdose. Conclusions regarding adult fever/temperature reduction could not be made due to a lack of evaluable data. The combined odds ratio for the proportion of adult subjects experiencing at least 1 AE slightly favored ibuprofen; however, the difference was not statistically significant (1.12; 95% CI 1.00 to 1.25). No significant difference between drugs in AE incidence was found for pediatric patients (0.82; 95% CI 0.60 to 1.12). Conclusions: Ibuprofen is as or more efficacious than acetaminophen for the treatment of pain and fever in adult and pediatric populations and is equally safe.
Interpersonal problems in alexithymia: A study in three primary care groups
Authors: Vanheule Stijn , Vandenbergen Jan , Verhaeghe Paul , Desmet Mattias 
Published: February 2010

Objectives.The present study investigated the relation between alexithymia and interpersonal problems in a sample of primary care patients with either chronic fatigue syndrome (CFS); a chronic cardiovascular or auto‐immune disease; or a minor medical condition. It was hypothesized that the relation between cold interpersonal functioning would account for the differences in alexithymia scores between the patient groups.Design and methods.Participants were 155 primary care patients that were recruited through 52 general practitioners: 52 CFS patients; 52 patients with a chronic cardiovascular or auto‐immune disease; 51 patients with a minor medical condition. Interpersonal problems were assessed by means of the Inventory of Interpersonal Problems and alexithymia was assessed by means of the Toronto Alexithymia Scale.Results.CFS patients and patients with a chronic cardiovascular or auto‐immune disease have substantially higher alexithymia scores than patients with a minor medical condition. Alexithymia is positively related to cold and distant interpersonal functioning; negatively related to self‐sacrificing and overly accommodating in relation to others; and positively related to vindictiveness and self‐centredness. The relation between alexithymia and these interpersonal problems accounts for the differences in alexithymia scores between the patient groups.Conclusions.Alexithymia and interpersonal problems should be considered together, in terms of one deficient affect regulatory system, and the relation between alexithymia and specific illness conditions is secondary to this. Clinical assessment of patients with problems in naming and discussing affective states should never be isolated from an examination of their interpersonal problems, and vice versa. Mentalization‐based therapy is recommended for patients with problems in naming affective states, interpersonal problems, and concomitant CFS or other alexithymia‐related diseases.
Correlation between glucose and bupivacaine levels in cerebrospinal fluid after spinal anesthesia: glycorrhachia as predictor for duration of sensory block
Authors: Estañ-Capell Nuria , Quiñones-Torrelo Carmen , Sánchez-Morillo Jorge , Estañ-Jago Luis 
Published: February 2010

Abstract

Background: Prediction of the duration of motor block after injection of a local anesthetic into cerebrospinal fluid (CSF) would be a very useful tool in clinical practice. However, previous attempts have not shown conclusive results. In this work, glycorrhachia is demonstrated to be an adequate predictive parameter after spinal anesthesia using 0.5% hyperbaric bupivacaine.

Methods: Two mL of local anesthetic through a continuous spinal catheter was administered to 40 patients. CSF was sampled at different time intervals from the onset of infusion to motor recovery. CSF bupivacaine concentrations were measured using chromatography. An automated analyzer was used for determining glycorrhachia in the same samples.

Results: For all patients, good correlation (r2>0.95, p<0.05) was obtained. From these results, it was possible to develop a general model which establishes the relationship between CSF glucose and bupivacaine concentrations (R2=0.987, p<0.05). Motor block is reached when CSF glucose concentration is about 245 mg/dL (13.5 mmol/L), which corresponds to 35 μg/mL of bupivacaine.

Conclusions: Glycorrhachia measured during surgical intervention in patients undergoing spinal anesthesia with hyperbaric bupivacaine provides a mechanism for predicting the duration of motor block in a rapid and simple manner.
Clin Chem Lab Med 2010;48:523–30.
Pregnancy-associated plasma protein-A as a marker for long-term mortality in patients with peripheral atherosclerosis: inconclusive findings from the Linz Peripheral Arterial Disease (LIPAD) study
Authors: Mueller Thomas , Dieplinger Benjamin , Forstner Thomas , Poelz Werner , Haltmayer Meinhard 
Published: February 2010

Abstract

Background: Pregnancy-associated plasma protein-A (PAPP-A) has been associated with peripheral artery disease (PAD). The aim of this study was to evaluate the utility of PAPP-A as a marker for long-term mortality in patients with atherosclerotic PAD.

Methods: PAPP-A serum concentrations were measured using an enzymatically amplified two-step sandwich-type immunoassay in 487 consecutive patients admitted to a tertiary care hospital with symptomatic PAD. The main outcome measure was all-cause mortality at 5 years.

Results: During follow-up, 114 patients died and 373 survived. The median PAPP-A concentration was higher among decedents compared with survivors (0.96 vs. 0.78 mU/L, p=0.024). The area under the receiver operating characteristic curve for the prediction of 5-year mortality by PAPP-A was 0.57 [95% confidence interval (CI), 0.53–0.61; p=0.026]. Survival probability was not significantly associated with PAPP-A concentrations using Kaplan-Meier curve analysis. However, univariate Cox proportional-hazards regression analysis revealed that PAPP-A was associated with 5-year mortality [risk ratio 1.25; 95% CI, 1.05–1.50; p=0.013 per one standard deviation (SD) increase in log transformed values]. In the multivariate model using a bootstrapping method, the predictive value of PAPP-A remained significant (risk ratio 1.31; 95% CI, 1.01–1.73; p=0.024 per 1 SD increase in log transformed values), even after adjustment for clinical confounders and other biomarkers, such as high-sensitivity C-reactive protein and amino terminal pro-B-type natriuretic peptide.

Conclusions: In this study, PAPP-A was an independent predictor of 5-year all-cause mortality in patients with symptomatic PAD. However, based on the weak association between PAPP-A and outcome in our cohort, we consider PAPP-A measurements to not be useful in clinical practice for prognostic purposes in patients with PAD.
Clin Chem Lab Med 2010;48:537–42.
Association of Periodontitis With Rheumatoid Arthritis: A Pilot Study
Authors: Dissick Addie , Redman Robert S. , Jones Miata , Rangan Bavana V. , Reimold Andreas , Griffiths Garth R. , Mikuls Ted R. , Amdur Richard L. , Richards John S. , Kerr Gail S. 
Published: February 2010

Background: Similarities exist in the epidemiology and immunopathogenesis of periodontitis and rheumatoid arthritis (RA), but the associations between their respective disease activities and severities are less well documented. We evaluated the prevalence and severity of periodontitis in United States (U.S.) veterans with RA and their relationship to RA disease activity and severity.Methods: Patients with RA from an outpatient rheumatology clinic were eligible, and patients with osteoarthritis (OA) served as controls. Dentists, masked to the rheumatologic diagnoses, performed periodontal probing and examined dental panoramic radiographs to assess the presence and severity of periodontitis. Associations of periodontitis with RA were examined using multivariate regression, whereas the association of periodontitis with disease‐severity measures in RA was examined using the χ2 test.Results: Sixty‐nine patients with RA (57 males and 12 females) and 35 patients with OA (30 males and five females) were studied. Moderate to severe periodontitis was more prevalent in patients with RA (51%) than controls (26%) (P = 0.03), an association independent of age, race, smoking, diabetes mellitus, and gender. Patients with RA who were seropositive for rheumatoid factor (RF) were more likely to have moderate to severe periodontitis (59%) than patients who were RF negative (15%) (P = 0.02). Likewise, patients with RA who were positive for the anti–cyclic citrullinated peptide (CCP) antibodies were more likely to have moderate to severe periodontitis (56%) than patients who were anti‐CCP negative (22%) (P = 0.01). There were no associations of periodontitis status with other measures of RA disease activity or severity.Conclusions: In a cohort of U.S. veterans, periodontitis was more common and severe in patients with RA compared to patients with OA. Although unrelated to disease activity, the presence of periodontitis in patients with RA was associated with seropositivity for RF and the anti‐CCP antibody, which was highly relevant given the associations of these autoantibodies with poor outcomes and disease pathogenesis in RA.
Periodontal Diseases, Preterm Births, and Low Birth Weight: Findings From a Homogeneous Cohort of Women in Madagascar
Authors: Rakoto‐Alson Simone , Tenenbaum Henri , Davideau Jean‐Luc 
Published: February 2010

Background: Studies on the possible influence of periodontal disease on preterm birth (PB) and/or low birth weight (LBW) remain inconclusive especially due to the difficulty of assessing the numerous pregnancy risk factors. The aim of this study is to compare periodontal parameters in non‐smoking pregnant women in Madagascar.Methods: A cohort study with 204 pregnant women (mean age: 25.6 years) was conducted in public prenatal care health clinics in Madagascar. Socioeconomic and obstetric information was obtained. Periodontal parameters, such as periodontal probing depth and clinical attachment loss (AL), were recorded during the second semester of pregnancy.Results: The mean gestational age was 37.8 weeks. At delivery, 42 newborns (20.6%) were PBs (<37 weeks) and 22 newborns (10.8%) were of LBW (<2,500 g). Nine (4.4%) newborns were PBs and of LBW (PLBW), and 149 newborns (73%) were of normal birth. The mean plaque index and papillary bleeding index were significantly higher (P <0.05 and P <0.001, respectively) in the PB group than in the normal birth group. Periodontitis (at least three sites from different teeth with clinical AL ≥4 mm) was significantly associated with PB (P <0.001), LBW (P <0.001), and PLBW (P <0.01). The rates of periodontitis were considerably higher in PB (78.6%), LBW (77.3%), and PLBW (77.8%) groups than in the full‐term (8.6%), normal weight (16.5%), and normal birth (2.7%) groups.Conclusion: The strong association among periodontitis, PB, and LBW in this study highlights the need to consider the periodontal status of pregnant women in Madagascar.
Association of Gingival Crevicular Fluid Biomarkers During Periodontal Maintenance With Subsequent Progressive Periodontitis
Authors: Reinhardt Richard A. , Stoner Julie A. , Golub Lorne M. , Lee Hsi‐Ming , Nummikoski Pirkka V. , Sorsa Timo , Payne Jeffrey B. 
Published: February 2010

Background: The analysis of biomarkers in gingival crevicular fluid (GCF) may be helpful in forecasting patient vulnerability to future attachment loss. The purpose of this study is to correlate GCF biomarkers of inflammation and bone resorption with subsequent periodontal attachment and bone loss in a longitudinal trial of a matrix metalloproteinase (MMP) inhibitor.Methods: GCF was collected from two periodontal pockets (mean ± SD: 5.1 ± 1.0 mm) at baseline and annually in postmenopausal females with moderate to advanced periodontitis undergoing periodontal maintenance every 3 to 4 months during a 2‐year double‐masked, placebo‐controlled, randomized clinical trial of subantimicrobial dose doxycycline (SDD; 20 mg two times a day). Subjects were randomized to SDD (n = 64) or a placebo (n = 64). GCF was analyzed for the inflammation markers interleukin (IL)‐1β (using enzyme‐linked immunosorbent assay), total collagenase activity (using hydrolysis of a synthetic octapeptide), and MMP‐8 (using a Western blot) and the bone‐resorption marker carboxyterminal telopeptide cross‐link fragment of type I collagen (ICTP) (using a radioimmunoassay). Generalized estimating equations were used to associate these biomarkers, categorized into tertiles, with subsequent clinical attachment (using an automated disk probe) or interproximal bone loss (using radiography). Odds ratio (OR) values compared highest to lowest tertile groups.Results: Increases in GCF IL‐1β and MMP‐8 during the first year of periodontal maintenance were associated with increased odds of subsequent (year 2) periodontal attachment loss (OR = 1.67; P = 0.01 and OR = 1.50; P = 0.02, respectively) driven by the placebo group. Elevated baseline ICTP was also associated with increased odds of 1‐ and 2‐year loss of alveolar bone density (OR = 1.98; P = 0.0001) in the placebo group, not the SDD group, and a loss of bone height (OR = 1.38; P = 0.06), again driven by the placebo group.Conclusion: These data support the hypothesis that elevated GCF biomarkers of inflammation and bone resorption from a small number of moderate/deep sites have the potential to identify patients who are vulnerable to progressive periodontitis, and SDD may modify that risk.
Characterization of Mandibular Bone in a Mouse Model of Chronic Kidney Disease
Authors: Lee Melissa M. , Chu Emily Y. , El‐Abbadi Mohga M. , Foster Brian L. , Tompkins Kevin A. , Giachelli Cecilia M. , Somerman Martha J. 
Published: February 2010

Background: Chronic kidney disease (CKD) is a worldwide health problem with increasing prevalence and poor outcomes, including severe cardiovascular disease and renal osteodystrophy. With advances in medical treatment, patients with CKD are living longer and require oral care. The aim of this study is to determine the effects of CKD and dietary phosphate on mandibular bone structure using a uremic mouse model.Methods: Uremia (U) was induced in female dilute brown agouti/2 mice by partial renal ablation. Uremic mice received a normal‐phosphate (NP) or a high‐phosphate (HP) diet. sham surgeries were performed in a control group of mice; half received an NP diet, and the other half was fed an HP diet. At termination, animals were sacrificed, and mandibles were collected for microcomputed tomography (micro‐CT) and histologic analysis.Results: Sera levels of blood urea nitrogen, parathyroid hormone, and alkaline phosphatase were significantly increased in U/NP and U/HP mice versus sham controls, whereas serum calcium was increased in the U/HP group, and no differences were noted in serum phosphate levels among groups. Micro‐CT analyses revealed a significant reduction in cortical bone thickness and an increase in trabecular thickness and trabecular bone volume/tissue volume in U/NP and U/HP groups compared to the sham/NP group. A significant reduction in cortical bone thickness was also found in the sham/HP group versus the sham/NP group. Histologic evaluation confirmed increased trabeculation in the U groups.Conclusion: CKD in mice, especially under conditions of HP feeding, results in marked effects on alveolar bone homeostasis.
Clinical and Histologic Evaluation of Granular Beta‐Tricalcium Phosphate for the Treatment of Human Intrabony Periodontal Defects: A Report on Five Cases
Authors: Stavropoulos Andreas , Windisch Péter , Szendröi‐Kiss Dora , Peter Rosta , Gera István , Sculean Anton 
Published: February 2010

Background: The aim of the study is to clinically and histologically evaluate the healing of advanced intrabony defects treated with open flap debridement and the adjunct implantation of granular beta tricalcium phosphate (β‐TCP).Methods: Five patients, each displaying advanced combined 1‐ and 2‐wall intrabony defects around teeth scheduled for extraction or root resection, were recruited. Approximately 6 months after surgery, the teeth or roots were removed together with a portion of their surrounding soft and hard tissues and processed for histologic evaluation.Results: The mean probing depth (PD) was reduced from 10.8 ± 2.3 mm presurgically to 4.6 ± 2.1 mm, whereas a mean clinical attachment level (CAL) gain of 5.0 ± 0.7 mm was observed. The increase in gingival recession was 1.2 ± 3.2 mm. The histologic evaluation indicated the formation of new cellular cementum with inserting collagen fibers to a varying extent (mean: 1.9 ± 0.7 mm; range: 1.2 to 3.03 mm) coronal to the most apical extent of the root instrumentation. The mean new bone formation was 1.0 ± 0.7 mm (range: 0.0 to 1.9 mm). In most specimens, β‐TCP particles were embedded in the connective tissue, whereas the formation of a mineralized bone‐like or cementum‐like tissue around the particles was only occasionally observed.Conclusion: The present data indicates that treatment of intrabony periodontal defects with this β‐TCP may result in substantial clinical improvements such as PD reduction and CAL gain, but this β‐TCP does not seem to enhance the regeneration of cementum, periodontal ligament, and bone.