bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological stage review is indicated in primary pT1 bladder cancer
Authors: Van Rhijn Bas W.G. , Van Der Kwast Theo H. , Kakiashvili David M. , Fleshner Neil E. , Van Der Aa Madelon N.M. , Alkhateeb Sultan , Bangma Chris H. , Jewett Michael A.S. , Zlotta Alexandre R. 
Published: June 2010

Study Type – Diagnosis (case series) Level of Evidence 4OBJECTIVETo evaluate the effect of a pathology review on the clinical outcome of patients with primary pT1 bladder cancer (BC), as the clinical course of such patients is variable.PATIENTS AND METHODSThe slides of 164 primary (first diagnosis) pT1 bladder tumours from two university hospitals were reviewed by one pathologist for stage and grade (World Health Organization 1973 and 2004). Patients were initially managed conservatively with bacille Calmette‐Guérin (BCG). Uni‐ and multivariate analyses compared the predictive value of age, gender, hospital, carcinoma in situ (CIS), tumour‐size, reviewed grade and reviewed stage.RESULTSWith a mean follow‐up of 6.4 years, there was disease progression in 48 (29%) patients and 26 (16%) died from BC. Associated CIS was found in 55 (34%) patients. After reviewing the slides, 24 (15%) tumours were downstaged to pTa, 134 (82%) remained pT1 and six (4%) were upstaged to ≥pT2. The grade review resulted in 74 G2, 90 G3, 37 low‐grade and 127 high‐grade lesions for the two systems used. In multivariate analyses, reviewed stage (both P < 0.001) and CIS (P = 0.017 and 0.023) had independent significance for progression and disease‐specific survival, respectively.CONCLUSIONA stage review is indicated in pT1 BC, as almost 20% of pT1 tumours were up‐ or downstaged, and the reviewed stage predicted the patient’s prognosis. Hence, pathology review identified patients with different prognoses who might benefit from other treatment strategies than BCG. We confirmed that CIS is an unfavourable sign in pT1 bladder cancer.
The cost‐effectiveness of targeted or universal screening for vasa praevia at 18–20 weeks of gestation in Ontario
Authors: Cipriano LE , Barth WH , Zaric GS 
Published: June 2010

Please cite this paper as: Cipriano L, Barth W, Zaric G. The cost‐effectiveness of targeted or universal screening for vasa praevia at 18–20 weeks of gestation in Ontario. BJOG 2010;117:1108–1118.Objectives  To estimate the cost‐effectiveness of targeted and universal screening for vasa praevia at 18–20 weeks of gestation in singleton and twin pregnancies.Design  Cost–utility analysis based on a decision‐analytic model comparing relevant strategies and life‐long outcomes for mother and infant(s).Setting  Ontario, Canada.Population  A cohort of pregnant women in 1 year.Methods  We constructed a decision‐analytic model to estimate the lifetime incremental costs and benefits of screening for vasa praevia. Inputs were estimated from the literature. Costs were collected from the London Health Sciences Centre, the Ontario Health Insurance Program, and other sources. We used one‐way, scenario and probabilistic sensitivity analysis to determine the robustness of the results.Main outcome measures  Incremental costs, life expectancy, quality‐adjusted life‐years (QALY) and incremental cost‐effectiveness ratio (ICER).Results  Universal transvaginal ultrasound screening of twin pregnancies has an ICER of $5488 per QALY‐gained. Screening all singleton pregnancies with the risk factors low‐lying placentas, in vitro fertilisation (IVF) conception, accessory placental lobes, or velamentous cord insertion has an ICER of $15,764 per QALY‐gained even though identifying some of these risk factors requires routine use of colour Doppler during transabdominal examinations. Screening women with a marginal cord insertion costs an additional $27,603 per QALY‐gained. Universal transvaginal screening for vasa praevia in singleton pregnancies costs $579,164 per QALY compared with targeted screening.Conclusions  Compared with current practice, screening all twin pregnancies for vasa praevia with transvaginal ultrasound is cost‐effective. Among the alternatives considered, the use of colour Doppler at all transabdominal ultrasound examinations of singleton pregnancies and targeted use of transvaginal ultrasound for IVF pregnancies or when the placenta has been found to be associated with one or more risk factors is cost‐effective. Universal screening of singleton pregnancies is not cost‐effective compared with targeted screening.
Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart
Authors: Boulkedid R , Sibony O , Bossu‐Salvador C , Oury JF , Alberti C 
Published: June 2010

Please cite this paper as: Boulkedid R, Sibony O, Bossu‐Salvador C, Oury J, Alberti C. Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart. BJOG 2010;117:1225–1235.Objective  To use cumulative sum (CUSUM) charts for the early detection of variations in quality of care in a maternity department.Design  Retrospective analysis of prospectively collected data.Setting  Maternity department of a teaching hospital in Paris (France).Population  Data from 20 519 women and 21 448 infants were collected between January 2000 and December 2007.Methods  CUSUM charts were used to monitor the rate of 19 pre‐selected quality indicators over 3 years (2005–2007), against standards developed by department obstetrician gynaecologists. Periods with adverse event rates that did not meet the standards were identified.Main outcome measures  Quality indicator rates.Results  Indicators fell into three groups based on the number of periods with unacceptable rates: less than one per year [e.g. the rate of intensive care unit (ICU) admission of mothers and rate of third‐ or fourth‐degree perineal tears]; one every 2–12 months on average (e.g. blood transfusion and sulprostone use in the overall population of women); and at least one per month (insufficient availability of epidural analgesia).Conclusion  CUSUM charts for a broad range of quality indicators can be used to monitor the quality of care in an obstetrics department. A prospective study investigating the ability of CUSUM‐based monitoring to improve maternal and neonatal outcomes would be of interest.
The role of lymph node resection in ovarian cancer: analysis of the surveillance, epidemiology, and end results (SEER) database
Authors: Rouzier R , Bergzoll C , Brun J‐L , Dubernard G , Selle F , Uzan S , Pomel C , Daraï E 
Published: June 2010

Please cite this paper as: Rouzier R, Bergzoll C, Brun J, Dubernard G, Selle F, Uzan S, Pomel C, Daraï E. The role of lymph node resection in ovarian cancer: analysis of the surveillance, epidemiology, and end results (SEER) database. BJOG 2010;117:1451–1458.Objective  The therapeutic role of lymphadenectomy on the survival in patients with ovarian cancer is controversial. The aim of this study was to evaluate the survival impact of lymphadenectomy, depending on the disease stage and extent of the surgery.Design  The surveillance, epidemiology, and end results (SEER) registry provided ovarian cancer data from 17 registries.Setting  Surveillance, Epidemiology, and End Results database.Population  The study population comprised 49 783 patients.Methods  Survival was studied according to the number of lymph nodes removed, with stratifications on disease stage and extent of surgery.Main outcome measure  The 5‐year cause‐specific survival rate.Results  The median follow up for patients alive at the last follow‐up visit was 39 months. The five‐year cause‐specific survival rates were 37, 62, and 71% for the groups in which no lymph nodes were examined, in which between one and nine nodes were examined, and in which ten or more nodes were examined, respectively (P < 0.001). Avoiding lymphadenectomy was deleterious in all stages of the disease. It was maximal for International Federation of Gynecology and Obstetrics (FIGO) stage‐II patients, but there was no significant interaction between stage and extent of lymphadenectomy. The cause‐specific survival was found to significantly increase when more nodes were resected, even if the surgical procedure consisted of debulking surgery or a pelvic exenteration.Conclusion  Our study suggests a beneficial effect of lymphadenectomy in epithelial ovarian tumours, regardless of the stage of disease and extent of surgery. However, potential biases inherent to this retrospective methodology, such as staging migration, defining the extent of residual disease, and the possibility that thorough lymphadenectomy may reflect the quality of cytoreductive surgery, preclude any formal conclusions on the therapeutic role of lymphadenectomy.
Depressive symptoms in adulthood and intrauterine exposure to pre‐eclampsia: the Helsinki Birth Cohort Study
Authors: Tuovinen S , Räikkönen K , Kajantie E , Pesonen A–K , Heinonen K , Osmond C , Barker DJP , Eriksson JG 
Published: June 2010

Please cite this paper as: Tuovinen S, Räikkönen K, Kajantie E, Pesonen A, Heinonen K, Osmond C, Barker D, Eriksson J. Depressive symptoms in adulthood and intrauterine exposure to pre‐eclampsia: the Helsinki Birth Cohort Study. BJOG 2010;117:1236–1242.Objective  We studied whether pre‐eclampsia predicts depressive symptoms in offspring.Design  Retrospective longitudinal cohort study.Setting  Participants in the Helsinki Birth Cohort 1934–44 Study.Population  We classed 788 women and men born at term after a normotensive, hypertensive or pre‐eclamptic pregnancy, by using the mother’s blood pressure and urinary protein measurements, at maternity clinics and birth hospitals.Methods  Linear and logistic regression analyses. We made adjustments for the mother’s age and body mass index (BMI) at delivery, the participant’s body size at birth/length of gestation, sex and childhood socio‐economic status, age and educational attainment at testing.Main outcome measures  Beck depression inventory (BDI) scores completed twice, at the ages of 60 and 63 years.Result  Participants born after a primiparous pregnancy complicated by pre‐eclampsia had over 30% (P < 0.04) higher depressive symptom scores in adulthood compared with those born after a primiparous normotensive pregnancy. We found no evidence of the association between pre‐eclampsia and depression among participants born after multiparous pregnancies. Gestational hypertension and depressive symptoms were not significantly associated. The models adjusting for mother’s age and BMI at delivery, the participant’s body size at birth/length of gestation, sex, childhood socio‐economic status, age and educational attainment at testing did not change the results.Conclusion  Pre‐eclampsia is associated with later depressive symptoms in individuals born at term and after a primiparous pregnancy. These findings are compatible with the adverse fetal ‘programming’ by a suboptimal prenatal environment.
Dopamine inhibition of glycine release in the rat trigeminal nucleus pars caudalis: possible involvement of trace amine receptors
Authors: Choi In‐Sun , Cho Jin‐Hwa , Jang Il‐Sung 
Published: June 2010

J. Neurochem.(2010)114, 1639–1650.AbstractDopamine (DA)‐induced pre‐synaptic inhibition of glycinergic transmission was studied from substantia gelatinosa (SG) neurons of the trigeminal nucleus pars caudalis using a conventional whole‐cell patch clamp technique. The action potential‐dependent glycinergic inhibitory post‐synaptic currents (IPSCs) were recorded from SG neurons in the presence of 3 mM kynurenic acid and 10 μM 6‐imino‐3‐(4‐methoxyphenyl)‐1(6H)‐pyridazinebutanoic acid HBr (SR95531). In these conditions, bath applied DA (100 μM) reduced the amplitude of glycinergic IPSCs and increased the paired‐pulse ratio, suggesting that DA acts pre‐synaptically to reduce the probability of glycine release. However, the inhibitory action of DA on glycinergic IPSCs was not blocked by SCH23390 (10 μM) and spiperone (1 μM), selective D1‐ and D2‐like receptor antagonists, respectively. In addition, either SKF38393 (100 μM), a selective D1‐like receptor agonist, or quinpirole (100 μM), a selective D2‐like receptor agonist, had no pre‐synaptic effect on glycinergic IPSCs. The results suggest that both D1‐ and D2‐like receptors are not involved in the DA‐induced decrease in glycinergic IPSCs. On the other hand, tyramine (100 μM), one of representative trace amines, reduced the amplitude of glycinergic IPSCs and increased the paired‐pulse ratio, suggesting that tyramine acts pre‐synaptically to reduce the probability of glycine release. Considering that DA can activate trace amine (TA) receptors and that TA receptors are exclusively expressed on the trigeminal nucleus pars caudalis, DA might act on putative pre‐synaptic TA receptors, rather than classical DA receptors, to inhibit glycinergic transmission onto SG neurons of the trigeminal nucleus pars caudalis.
t‐SNARE cluster organization and dynamics in chromaffin cells
Authors: López‐Font Inmaculada , Torregrosa‐Hetland Cristina J. , Villanueva José , Gutiérrez Luis M. 
Published: June 2010

J. Neurochem. (2010) 114, 1550–1556.AbstractAdrenomedullary chromaffin cells represent an excellent model to study the molecular events linked to exocytosis, because they use the same type of SNAREs for vesicle docking and fusion as neurons. In these cells, both in the intact tissue and in isolated cells in culture, syntaxin‐1 and SNAP‐25 are present in the plasmalemma unevenly distributed in patches, even when exogenous t‐SNAREs are expressed. In fact, the expression of SNAP‐25 fused to green fluorescent protein has been useful to study the movement of these clusters by total internal reflection fluorescent microscopy. These microdomains move little in the plasma membrane plane but they undertake relatively large displacements of 100 nm in the axis perpendicular to the membrane. Movement in either axis is dependent on molecular interactions within the t‐SNARE complex and indeed, clusters formed by recombinant SNAP‐25 Δ9, the product of Botulinum neurotoxin A cleavage, undergo larger displacement. Interestingly, altering the movement of t‐SNARE clusters also influences the mobility of the chromaffin vesicles associated with these t‐SNAREs. Furthermore, highly mobile vesicles associated with the clusters formed by SNAP‐25 Δ9 present a low probability of exocytosis and also slower fusion kinetics. Finally, we discuss some of the factors that could influence the movement of t‐SNARE clusters and how these dynamics may influence the mobility and the fusion properties of the vesicles in the vicinity of active sites.
A Remarkable Increase in Total Homocysteine Concentrations in the CSF of Migraine Patients With Aura
Authors: Isobe Chiaki , Terayama Yasuo 
Published: June 2010

(Headache 2010;50:1561‐1569)Objective.— To investigate whether total and free homocysteine (HC) levels are increased in the cerebrospinal fluid (CSF) of patients with migraine headache compared with normal control populations.Methods.— The concentrations of free and total HC in the CSF of migraine without aura (MOA) and migraine with aura (MWA) patients were determined.Results.— The concentration of free HC did not differ significantly from normal controls, but the total HC concentration was significantly higher in MOA and MWA patients (41% increase in MOA, P < .001 and 376% increase in MWA, P < .0001) in the mean of the confidence interval of each groups compared with normal controls).Conclusions.— These findings suggest that an increase of total HC concentration in the brain is commonly seen in migraine patient and is particularly pronounced in MWA sufferers. We speculate that total HC not only contribute to the development of atherosclerotic conditions, including cardiocerebrovascular diseases, but also reflects an epiphenomenon.
Orthostatic Headaches in the Syndrome of the Trephined: Resolution Following Cranioplasty
Authors: Mokri Bahram 
Published: June 2010

Objective.—To draw attention to the syndrome of the trephined as a potential cause for orthostatic headaches without cerebrospinal fluid (CSF) leak.Background.—Orthostatic headaches typically result from CSF leaks but sometimes may occur in conditions without any evidence of CSF leakage.Methods.—A 37‐year‐old right‐handed woman became comatose after a motor vehicle accident with cerebral contusions and massive left cerebral edema. A large frontoparietal craniectomy was carried out. In 5 months, she made good neurologic recovery. Freeze‐preserved bone flap was placed back. In several weeks she was functionally near normal. Two years later, she began to complain of orthostatic headache and gradually additional manifestations appeared including progressive gait unsteadiness, imprecise speech, cognitive difficulties, and an increasing left hemiparesis along with progressive sinking of the skull defect and shift of the midline and ventricular distortion. She underwent removal of resorptive sinking bone flap and construction of an acrylic cranioplasty.Results.—At 6‐month follow‐up, there was complete resolution of the orthostatic headaches, remarkable neurologic improvement along with resolution of midline shift and ventricular distortion.Conclusion.—The syndrome of the trephined is yet another cause of orthostatic headaches without CSF leak.
Familial form of typical childhood absence epilepsy in a consanguineous context
Authors: Abouda Hanen , Hizem Yosr , Gargouri Amina , Depienne Christel , Bouteiller Delphine , Riant Florence , Tournier‐Lasserve Elisabeth , Gourfinkel‐An Isabelle , LeGuern Eric , Gouider Riadh 
Published: June 2010

SummaryCausative genes for childhood absence epilepsy (CAE) are unknown partly because families are small or phenotypically heterogeneous. In five consanguineous Tunisian families with at least two sibs with CAE, 14 patients fulfilled the diagnostic criteria for CAE (Epilepsia 1989;30:389–399). Linkage analyses or direct sequencing excluded CACNG2, CACNA1A, CACNB4, and CACNA2D2, orthologs of genes responsible for autosomal recessive (AR) absence seizures in mice. These families will help identify (a) gene(s) responsible for CAE.
Historical control monotherapy design in the treatment of epilepsy
Authors: French Jacqueline A. , Wang Steven , Warnock Bob , Temkin Nancy 
Published: June 2010

SummaryPurpose: Monotherapy approvals have been difficult to obtain from the U.S. Food and Drug Administration (FDA), and have almost all been achieved using a trial design entitled “withdrawal to monotherapy” in treatment‐resistant patients, which employs a so‐called “pseudo‐placebo” as a comparator arm. The authors submitted a white paper to the FDA advocating use of a virtual placebo historical control as an alternative to pseudo‐placebo. Such an approach reduces patient risk that would result from exposure to pseudo‐placebo. In this article, we present the data submitted to the FDA to justify a historical control.Methods: We analyzed individual patient data from eight previously completed withdrawal to monotherapy studies, which we determined had similar design. All studies employed percent meeting predetermined exit criteria (denoting worsening of seizure control) as the outcome measure. Kaplan‐Meier estimates of the percent exiting were calculated at 112 days.Results: The percent meeting exit criteria were uniformly high, ranging from 74.9–95.9%. The eight studies appear to meet the criteria set forth for use of historical control. The estimate of the combined percent exit based on the noniterative mixed‐effects model is 85.1%, with a lower bound of the 95% prediction interval of 65.3%, and 72.2% for an 80% prediction interval.Conclusion: There is justification for proposing that these data can serve as a historical control for future monotherapy studies, obviating the need for a placebo/pseudo‐placebo arm in trials intended to demonstrate the efficacy of approved drugs as monotherapy in treatment‐resistant patients.
The effects of cryopreservation on red blood cell rheologic properties
Authors: Henkelman Sandra , Lagerberg Johan W.M. , Graaff Reindert , Rakhorst Gerhard , Van Oeveren Willem 
Published: June 2010

BACKGROUND: In transfusion medicine, frozen red blood cells (RBCs) are an alternative for liquid‐stored RBCs. Little is known about the rheologic properties (i.e., aggregability and deformability) of thawed RBCs. In this study the rheologic properties of high‐glycerol frozen RBCs and postthaw stored in saline‐adenine‐glucose‐mannitol medium were compared to those of conventionally liquid‐stored and fresh RBCs.STUDY DESIGN AND METHODS: Fresh RBCs were obtained from healthy volunteers. Leukoreduced liquid‐stored and thawed deglycerolized RBC units were obtained from the Sanquin Blood Bank. RBCs were tested for aggregability (aggregation index [AI]), deformability (elongation index [EI]), and various hematologic variables.RESULTS: The AI of thawed RBCs was reduced, compared to fresh and liquid‐stored RBCs (p < 0.05). The EI of stored RBCs was significantly enhanced over a shear stress range of 2.0 to 50 Pa compared to fresh RBCs (p < 0.05). No significant differences in EI between thawed and 21‐ or 35‐day liquid‐stored RBCs were observed. The osmotic fragility, hemolysis, mean cell volume, and mean cell hemoglobin concentration of thawed RBCs were markedly altered, compared to fresh and liquid‐stored RBCs (p < 0.05). The adenosine triphosphate (ATP) content of thawed RBCs was similar to 3‐ or 21‐day liquid‐stored and fresh RBCs.CONCLUSIONS: Thawed RBCs are more fragile than conventionally liquid‐stored and fresh RBC. The freeze‐thaw‐wash process, however, did not adversely affect the aggregability and deformability or the ATP content of thawed RBCs. Based on the rheologic properties, cryopreserved RBCs are a valuable alternative to liquid‐stored RBCs.
Two cases of platelet transfusion refractoriness associated with anti‐CD36
Authors: Saw Chee‐Loong , Szykoluk Helen , Curtis Brian R. , Zelcer Shayna , Eckert Kathleen , Forrest Donna , Nickerson Peter , Petraszko Tanya , Goldman Mindy 
Published: June 2010

BACKGROUND: Antibodies to platelet (PLT) glycoprotein (GP) IV (CD36) have been implicated in rare cases of PLT refractoriness, particularly in non‐Caucasians. We report two cases of PLT transfusion refractoriness linked to anti‐CD36.STUDY DESIGN AND METHODS: A 5‐year‐old female of Lebanese descent and a 70‐year‐old male of Chinese descent both failed to respond to HLA‐matched PLT transfusions during acute myelogenous leukemia induction therapy. Antibody screening was performed using a PLT antibody solid‐phase kit (PAKPLUS, GTI Diagnostics), followed by the monoclonal antibody–specific immobilization of PLT antigen (MAIPA) test and, for the second case, the modified antigen capture enzyme‐linked immunosorbent assay (MACE).RESULTS: Both patients demonstrated antibody to GP IV (CD36) on the PAKPLUS assay. On MAIPA testing, both phenotyped as CD36 negative. Anti‐CD36 was demonstrated by MAIPA in the first case. In the second case, antibodies were not detected by MAIPA and variably detectable by MACE, depending on the mouse monoclonal antibody (MoAb) used. Because no Canadian CD36‐negative donors were available, antigen‐negative plateletpheresis units from the BloodCenter of Wisconsin were successfully transfused.CONCLUSION: Two cases of clinically significant CD36 antibodies are reported. Investigation of one case was complicated by steric inhibition of binding in the MAIPA and MACE assays with certain MoAbs. The cases demonstrate the importance of maintaining an ethnically diverse pool of rare donors and the value of international cooperation in the management of these patients.