bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperparathyroidism in Pregnancy: Options for Localization and Surgical Therapy
Authors: McMullen Todd P. W. , Learoyd Diana L. , Williams David C. , Sywak Mark S. , Sidhu Stan B. , Delbridge Leigh W. 
Published: April 2010

AbstractBackgroundHyperparathyroidism in pregnancy is a threat to the health of both mother and fetus. The mothers suffer commonly from nephrolithiasis, hyperemesis, or even hypercalcemic crisis. Untreated disease will commonly complicate fetal development and fetal death is a significant risk. Treatment options, including medical and surgical therapy, are debated in the literature.MethodsThis is a case series comprising seven patients with primary hyperparathyroidism in pregnancy. Data collected included symptoms at diagnosis, biochemical abnormalities, pathologic findings, treatment regimes, and subsequent maternal and fetal outcomes.ResultsSeven women, aged 20 to 39 years, presented with hyperparathyroidism during pregnancy. The earliest presented at 8 weeks and the latest at 38 weeks. Four of seven patients experienced renal calculi. Calcium levels were 2.7–3.5 mmol/l. All were found to have solitary parathyroid adenomas, of which two were in ectopic locations. Fetal complications included three preterm deliveries and one fetal death with no cases of neonatal tetany. Maternal and fetal complications could not be predicted based on duration or severity of hypercalcemia. Three patients were treated during pregnancy with surgery, and two of these had ectopic glands that required reoperations with a novel approach using Tc‐99m sestamibi scanning during pregnancy to assist in localizing the abnormal gland. Four cases were treated postpartum with a combination of open and minimally invasive approaches after localization. No operative complications or fetal loss related to surgery were observed in this cohort.ConclusionsPrimary hyperparathyroidism in pregnancy represents a significant risk for maternal and fetal complications that cannot be predicted by duration of symptoms or serum calcium levels. Surgical treatment should be considered early, and a minimally invasive approach with ultrasound is best suited to mitigating risk to mother and fetus. Equally important, Tc‐99m sestamibi imaging may be used safely for localization of the parathyroids after negative cervical explorations.
Incidence and Risk Factors of Peripheral Arterial Occlusive Disease in a Prospective Cohort of 700 Adult Elderly Men Followed for 5 Years
Authors: Merino Jana , Planas Adriana , Elosua Roberto , de Moner Ana , Gasol Ana , Contreras Carmen , Vidal‐Barraquer Francesc , Clarà Albert 
Published: April 2010

AbstractObjectiveThis study was designed to assess the incidence of peripheral arterial occlusive disease (PAOD) in a population‐based cohort of men aged 55–74 years and to establish a predictive function based on risk factors for the disease.MethodsThis was a prospective study of 699 men representative of an urban population. Cardiovascular risk factors, history of cardiovascular events, and ankle‐brachial index (ABI) at baseline and at 5 years were measured. PAOD was defined as a confirmed ABI <0.9.ResultsA total of 468 (67%) subjects could be evaluated at 5 years. In the remaining 233 subjects, 94 had PAOD at baseline, 66 died during the study, and 73 were lost to follow‐up. At the end of the 5‐year study period, 56 (12%) subjects developed PAOD (21.4% ABI <0.6, 78.6% ABI between 0.61 and 0.9). Independent predictors for PAOD were age older than 70 years at baseline (odds ratio [OR] 2.5, P = 0.004), smoking history more than 40 pack‐year (OR = 2.27, P = 0.007), history of cerebrovascular disease (OR = 3.49, P = 0.02), and symptomatic coronary disease (OR = 3.36, P = 0.004). The 5‐year incidence of PAOD was 22.4% for subjects older than 70 years, 21.5% for heavy smokers, 29.4% for those with previous cerebrovascular events, and 25% for subjects with ischemic heart disease. The risk for PAOD in subjects without risk factors was 6%.ConclusionsTwelve percent of adult men aged between aged 55 and 74 years developed PAOD during a follow‐up of 5 years. Besides subjects with history of cardiovascular disease, men older than aged 70 years and heavy smokers constituted a high‐risk group for PAOD and, therefore, the object of directed efforts of primary prevention.
Pregnancy in glycogen storage disease type Ib: gestational care and report of first successful deliveries
Authors: Dagli Aditi I. , Lee Philip J. , Correia Catherine E. , Rodriguez Christina , Bhattacharya Kaustav , Steinkrauss Linda , Stanley Charles A. , Weinstein David A. 
Published: April 2010

AbstractPatients with type Ia glycogen storage disease (GSD) have been surviving well into adulthood since continuous glucose therapy was introduced in the 1970s, and there have been many documented successful pregnancies in women with this condition. Historically, few individuals with type Ib GSD, however, survived into adulthood prior to the introduction of granulocyte colony stimulating factor (G‐CSF) in the late 1980s. There are no previously published reports of pregnancies in GSD type Ib. In this case report we describe the course and management of five successful pregnancies in three patients with GSD type Ib. Patient 1 experienced an increase in glucose requirement in all three of her pregnancies, starting from the second trimester onwards. There were no major complications related to neutropenia except for oral ulcers. The infants did well, except for respiratory distress in two of them at birth. Patient 2 used cornstarch to maintain euglycemia, but precise dosing was not part of her regimen, and, hence, an increase in metabolic demands was difficult to demonstrate. She developed a renal calculus and urinary tract infection during her pregnancy and had chronic iron deficiency anemia but no neutropenia. The neonate did well after delivery. Patient 3 had poor follow‐up during pregnancy. Increasing glucose requirements, worsening lipid profile, neutropenia associated with multiple infections, and anemia were noted. The newborn infant did well after delivery. In addition to the case reports, the challenges of the usage of G‐CSF, the treatment of enterocolitis, and comparisons with the management of GSD Ia are discussed.
Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: A systematic review
Authors: Bonnet Marie‐Pierre , Mignon Alexandre , Mazoit Jean‐Xavier , Ozier Yves , Marret Emmanuel 
Published: April 2010

AbstractBackground: The optimal effective dose of epidural morphine that provides postoperative analgesia after caesarean section with minimal side effects remains debated.Aims: We performed a systematic review to assess the analgesic efficacy and the incidence of adverse effects of epidural morphine after caesarean section compared to systemic analgesia with opioids.Methods: We searched Medline, Embase and Cochrane Collaboration Library databases. Studies were evaluated with the Modified Oxford Scale. Prospective randomized studies comparing analgesic efficacy and/or adverse effects of a single epidural morphine administration versus systemic opioids after elective caesarean section were included.Results: Ten studies (n = 431) were selected. Epidural morphine increases the time until the first request for a rescue analgesic (Emax, 29.7 h; 95% confidence interval, 25.2–33.9) and decreases pain scores and postoperative morphine request during the first 24 h compared to systemic opioid analgesia. However, epidural morphine increases the incidence of pruritus (relative risk, 2.7; 95% CI, 2.1–3.6) and nausea (relative risk, 2.0; 95% CI, 1.2–3.3).Conclusions: A single bolus of epidural morphine provides better analgesia than parenteral opioids but with an effect limited to the first postoperative day after caesarean section and with an increase in morphine side effects.
Changes in motor unit recruitment strategy during pain alters force direction
Authors: Tucker Kylie J. , Hodges Paul W. 
Published: April 2010

AbstractMotor unit (MU) recruitment is altered (decreased discharge rate and cessation of discharge in some units, and recruitment of new units) in force‐matched contractions during pain compared to contractions performed before pain. As MU's within a motoneurone pool have different force direction properties we hypothesised that altered MU recruitment during experimental knee pain would change the force vector (total force (FT): amplitude and angle) generated by the quadriceps. Force was produced at two levels during 1 × 60‐s and 3 × 10‐s isometric contractions of knee extensors, and recorded by two force transducers at right angles. This enabled calculation of both FE (extension force) and FT. MU recruitment was recorded from the medial and lateral vastii with four fine‐wire electrodes. Pain was induced by hypertonic saline injection in the infra‐patella fat pad. Nine subjects matched FE and six subjects also matched both medial and lateral forces (FT) before and during pain. Changes in MU discharge pattern (decreased discharge rate (P < 0.001), complete cessation of firing, and recruitment of new units) during pain were associated with a ∼5° change in absolute force angle. As force angle changed in both directions (left/right) for individual subjects with pain there was no change in average FT amplitude between conditions. When both medial and lateral forces were matched MU discharge rate decreased (P < 0.001) with pain, but, fewer units ceased firing or were newly recruited during pain. Change in motoneurone recruitment during pain alters direction of muscle force. This may be a strategy to avoid pain or protect the painful part.
Double-blind, randomised, controlled study of post-operative pain in children undergoing radiofrequency tonsillotomy versus laser tonsillotomy
Authors: Stelter K , de la Chaux R , Patscheider M , Olzowy B 
Published: April 2010

AbstractIntroduction:In the last decade tonsillotomy has come into vogue again, whereas the number of tonsillectomies is decreasing rapidly. Currently, most tonsils are reduced by utilise electrosurgery, radiofrequency or carbon dioxide laser. However, it is not clear whether radiofrequency tonsillotomy is as effective as laser or other surgical techniques in respect of post-operative pain and haemorrhage.Material and methods:A prospective, randomised, double-blinded, controlled, clinical study was conducted in the otorhinolaryngology department of Ludwig Maximilians University, Munich, Germany. Twenty-six children with tonsillar hypertrophy were included. Exclusion criteria were: history of peritonsillar abscess, previous tonsil surgery, tonsillitis within two weeks, pain before surgery, psychiatric illness, asymmetrical tonsils, chronic analgesic usage, bleeding disorders and other surgical procedures during the same operation. Tonsillotomy was performed on one side with radiofrequency and on the other side with a carbon dioxide laser. All procedures were performed by a single surgeon, under general anaesthesia. A visual analogue scale was used to measure patients' pain on each side, administered by a ‘blinded’ nurse on the three post-operative mornings and evenings, within the hospital.Results:There was no difference in post-operative pain scores or haemorrhage, comparing laser versus radiofrequency tonsillotomy. Patient's overall reported pain was very modest compared with post-tonsillectomy pain. No haemorrhage or other adverse effects were observed.
Is metal accumulation in Pomphorhynchus laevis dependent on parasite sex or infrapopulation size?
Authors: NACHEV M. , ZIMMERMANN S. , RIGAUD T. , SURES B. 
Published: April 2010

SUMMARYConcentrations of the elements As, Cd, Co, Cu, Fe, Mn, Mo, Ni, Pb, Sn, V, Zn were analysed by inductively coupled plasma mass spectrometry (ICP-MS) in the acanthocephalan Pomphorhynchus laevis and its fish host Barbus barbus. A total of 27 barbels were collected from the Danube River in autumn 2006 close to the town Kozloduy (685 river kilometer) on the Bulgarian river bank. Fish were divided into 3 groups. According to their P. laevis infrapopulation size hosts were considered as heavily infected (>100 worms per fish) and lightly infected (<20 worms per fish). The third group was used to compare heavy metal concentrations between male and female P. laevis. The 5 elements As, Cd, Cu, Pb and Zn were detected in significantly higher concentrations in parasites compared to host tissues (muscle, intestine, liver). According to the calculated mean bioconcentration factors, 3 more elements (Co, Mn, V) showed usually higher concentrations in P. laevis. Comparisons between heavily and lightly infected fish revealed significant differences only for V with higher concentrations for the heavily infected group. Concerning sex-specific metal accumulation V and Zn showed significant differences (V, at P<0·05; Zn, at P=0·05), with higher levels of both metals in females of P. laevis. Our results suggest that – for the metals analysed – the size of the parasite infrapopulation plays no role in the degree of metal accumulation. Similarly, parasite sex seems not to be a crucial factor for metal accumulation in the parasites. Thus, for metal monitoring purposes there is no need to take these aspects into account, which makes the use of parasites as bioindicators more applicable.
Association of the5-HTTLPRgenotype and unipolar depression: a meta-analysis
Authors: Clarke H. , Flint J. , Attwood A. S. , Munafò M. R. 
Published: April 2010

BackgroundWe sought to ascertain the strength of evidence for association between the 5-HTTLPRpolymorphism and unipolar depression.MethodWe applied meta-analytic techniques to data from relevant published studies, and obtained an estimate of the likely magnitude of effect of any association. We also tested for possible publication bias, and explored the impact of various study design characteristics on the magnitude of the observed effect size.ResultsMeta-analysis indicated evidence of a small but statistically significant association between the 5-HTTLPRpolymorphism and unipolar depression [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.03–1.12]. This remained significant when data from samples of European and East Asian ancestry were analyzed separately. In all cases there was evidence of significant between-study heterogeneity, although the observed associations were robust to the application of a random-effects framework.ConclusionsOur results support the presence of a small effect of a polymorphism in the serotonin transporter promoter on susceptibility to depression. However, we caution that it is possible that the effect has an artifactual basis, rather than a biological origin.
Predictors and moderators of time to remission of major depression with interpersonal psychotherapy and SSRI pharmacotherapy
Authors: Frank E. , Cassano G. B. , Rucci P. , Thompson W. K. , Kraemer H. C. , Fagiolini A. , Maggi L. , Kupfer D. J. , Shear M. K. , Houck P. R. , Calugi S. , Grochocinski V. J. , Scocco P. , Buttenfield J. , Forgione R. N. 
Published: April 2010

BackgroundAlthough many studies suggest that, on average, depression-specific psychotherapy and antidepressant pharmacotherapy are efficacious, we know relatively little about which patients are more likely to respond to one versus the other. We sought to determine whether measures of spectrum psychopathology are useful in deciding which patients with unipolar depression should receive pharmacotherapy versus depression-specific psychotherapy.MethodA total of 318 adult out-patients with major depression were randomly assigned to escitalopram pharmacotherapy or interpersonal psychotherapy (IPT) at academic medical centers at Pittsburgh, Pennsylvania and Pisa, Italy. Our main focus was on predictors and moderators of time to remission on monotherapy at 12 weeks.ResultsParticipants with higher scores on the need for medical reassurance factor of the Panic–Agoraphobic Spectrum Self-Report (PAS-SR) had more rapid remission with IPT and those with lower scores on the psychomotor activation factor of the Mood Spectrum Self-Report (MOODS-SR) experienced more rapid remission with selective serotonin reuptake inhibitor (SSRI) pharmacotherapy. Non-specific predictors of longer time to remission with monotherapy included several panic spectrum and mood spectrum factors and the Social Phobia Spectrum (SHY) total score. Higher baseline scores on the 17- and 25-item Hamilton Depression Rating Scales (HAMD-17 and HAMD-25) and the Work and Social Adjustment Scale (WSAS) also predicted a longer time to remission, whereas being married predicted a shorter time to remission.ConclusionsThis exploratory study identified several non-specific predictors but few moderators of psychotherapy versus pharmacotherapy outcome. It offers useful indicators of the characteristics of patients that are generally difficult to treat, but only limited guidance as to who benefits from IPT versus SSRI pharmacotherapy.
Predictability of oppositional defiant disorder and symptom dimensions in children and adolescents with ADHD combined type
Authors: Aebi M. , Müller U. C. , Asherson P. , Banaschewski T. , Buitelaar J. , Ebstein R. , Eisenberg J. , Gill M. , Manor I. , Miranda A. , Oades R. D. , Roeyers H. , Rothenberger A. , Sergeant J. , Sonuga-Barke E. , Thompson M. , Taylor E. , Faraone S. V. , Steinhausen H.-C. 
Published: April 2010

BackgroundOppositional defiant disorder (ODD) is frequently co-occurring with attention deficit hyperactivity disorder (ADHD) in children and adolescents. Because ODD is a precursor of later conduct disorder (CD) and affective disorders, early diagnostic identification is warranted. Furthermore, the predictability of three recently confirmed ODD dimensions (ODD-irritable, ODD-headstrong and ODD-hurtful) may assist clinical decision making.MethodReceiver-operating characteristic (ROC) analysis was used in order to test the diagnostic accuracy of the Conners' Parent Rating Scale revised (CPRS-R) and the parent version of the Strength and Difficulties Questionnaire (PSDQ) in the prediction of ODD in a transnational sample of 1093 subjects aged 5–17 years from the International Multicentre ADHD Genetics study. In a second step, the prediction of three ODD dimensions by the same parent rating scales was assessed by backward linear regression analyses.ResultsROC analyses showed adequate diagnostic accuracy of the CPRS-R and the PSDQ in predicting ODD in this ADHD sample. Furthermore, the three-dimensional structure of ODD was confirmed by confirmatory factor analysis and the CPRS-R emotional lability scale significantly predicted the ODD irritable dimension.ConclusionsThe PSDQ and the CPRS-R are both suitable screening instruments in the identification of ODD. The emotional lability scale of the CPRS-R is an adequate predictor of irritability in youth referred for ADHD.
Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study
Authors: Grynszpan O. , Perbal S. , Pelissolo A. , Fossati P. , Jouvent R. , Dubal S. , Perez-Diaz F. 
Published: April 2010

BackgroundCognitive remediation is frequently based on computerized training methods that target different cognitive deficits. The aim of this article was to assess the efficacy of computer-assisted cognitive remediation (CACR) in schizophrenia and to determine whether CACR enables selective treatment of specific cognitive domains.MethodA meta-analysis was performed on 16 randomized controlled trials evaluating CACR. The effect sizes of differences between CACR and control groups were computed and classified according to the cognitive domain assessed. The possible influences of four potential moderator variables were examined: participants' age, treatment duration, weekly frequency, and control condition type. To test the domain-specific effect, the intended goal of each study was determined and the effect sizes were sorted accordingly. The effect sizes of the cognitive domains explicitly targeted by the interventions were then compared with those that were not.ResultsCACR enhanced general cognition with a mean effect size of 0.38 [confidence interval (CI) 0.20–0.55]. A significant medium effect size of 0.64 (CI 0.29–0.99) was found for Social Cognition. Improvements were also significant in Verbal Memory, Working Memory, Attention/Vigilance and Speed of Processing with small effect sizes. Cognitive domains that were specifically targeted by the interventions did not yield higher effects than those that were not.ConclusionsThe results lend support to the efficacy of CACR with particular emphasis on Social Cognition. The difficulty in targeting specific domains suggests a ‘non-specific’ effect of CACR. These results are discussed in the light of the possible bias in remediation tasks due to computer interface design paradigms.
Rethinking the genetic architecture of schizophrenia
Authors: Mitchell K. J. , Porteous D. J. 
Published: April 2010

BackgroundFor many years, the prevailing paradigm has stated that in each individual with schizophrenia (SZ) the genetic risk is due to a combination of many genetic variants, individually of small effect. Recent empirical data are prompting a re-evaluation of this polygenic, common disease–common variant (CDCV) model. Evidence includes a lack of the expected strong positive findings from genome-wide association studies and the concurrent discovery of many different mutations that individually strongly predispose to SZ and other psychiatric disorders. This has led some to adopt a mixed model wherein some cases are caused by polygenic mechanisms and some by single mutations. This model runs counter to a substantial body of theoretical literature that had supposedly conclusively rejected Mendelian inheritance with genetic heterogeneity. Here we ask how this discrepancy between theory and data arose and propose a rationalization of the recent evidence base.MethodIn light of recent empirical findings, we reconsider the methods and conclusions of early theoretical analyses and the explicit assumptions underlying them.ResultsWe show that many of these assumptions can now be seen to be false and that the model of genetic heterogeneity is consistent with observed familial recurrence risks, endophenotype studies and other population-wide parameters.ConclusionsWe argue for a more biologically consilient mixed model that involves interactions between disease-causing and disease-modifying variants in each individual. We consider the implications of this model for moving SZ research beyond statistical associations to pathogenic mechanisms.
Optical guiding of a laser beam in an axially nonuniform plasma channel
Authors: Singh Arvinder , Singh Navpreet 
Published: April 2010

AbstractThe guiding of a laser beam in a plasma channel formed by a short laser prepulse is investigated. Due to the self defocusing of an ionizing short laser prepulse, the plasma channel formed is axially nonuniform. When a delayed second laser beam is allowed to propagate through such a preformed plasma channel, convergence and divergence of the beam is observed due to the relative competition of the refraction and diffraction phenomenon. We have solved the wave equation governing the propagation characteristics of an ionizing prepulse and a delayed pulse by the moment theory approach. Results have been compared with the paraxial ray model of Liu and Tripathi (1994). The moment theory predicts the propagation of guided laser beam over several Rayleigh lengths.