bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conversion to Sirolimus in Renal Transplant Recipients: A Single‐Center Experience
Authors: Yelken Berna , Caliskan Yasar , Ozkan Oktay , Gorgulu Numan , Yazici Halil , Turkmen Aydin , Sever Mehmet S. 
Published: July 2010

AbstractMaintenance immunosuppression with calcineurin inhibitors (CNI) following renal transplantation is associated with nephrotoxicity and accelerated graft loss. Sirolimus (SRL) is a nonnephrotoxic immunosuppressive agent. We retrospectively analyzed our experience with kidney transplant recipients who were converted from CNI to SRL. A total of 58 renal transplant recipients were converted from CNI to SRL. SRL was started at a dose of 0.075 mg/kg and, at the same time, CNI dose was reduced by 50% daily for 3 days. SRL trough levels were targeted between 8 and 12 ng/mL. When target trough levels were achieved, CNI was withdrawn. The main indications for switching were posttransplant malignancies (n = 32) and chronic allograft nephropathy (CAN) (n = 10). The mean time from transplantation to conversion was 84 ± 71 months. Mean serum creatinine level was 1.63 ±  0.52 mg/dL before conversion. Serum creatinine levels at the 1, 3, 6 months, and 1, 2, 3 years after conversion were 1.64 ± 0.58 mg/dL (P = 0.67), 1.52 ± 0.53 mg/dL (P =  0.414), 1.62 ± 0.62 mg/dL (P = 0.734), and 1.48 ±  0.58 mg/dL (P = 0.065), 1.58 ± 0.53 mg/dL (P = 0.854), 1.88 ± 0.77 mg/dL (P = 0.083), respectively. Daily proteinuria levels increased from 0.04 ± 0.11 g/day at baseline to 0.55 ± 1.33 g/day (P = 0.037) after conversion, in the responders group. In the nonresponders group, baseline proteinuria was 0.13 ± 0.25 g/day, and increased to 1.44 ± 2.44 g/day after conversion (P = 0.008). SRL was discontinued in 16 patients (31%) because of the occurrence of severe side effects. The proportion of patients remaining on SRL therapy over time was 43.1% at 1 year, 15.5% at 2 years after conversion, and 10.3% at 3 years after conversion. SRL conversion may be very useful in patients suffering from neoplasia; however, frequent side effects related with this intervention should be considered, and routine conversion from CNI to SRL to reduce nephrotoxicity should be discouraged.
Capsule Thickness Correlates With Vascular Density and Blood Flow Within Foreign‐Body Capsules Surrounding Surgically Implanted Subcutaneous Devices
Authors: Bartoli Carlo R. , Nadar Menaka M. , Godleski John J. 
Published: July 2010

AbstractMedical devices implanted in subcutaneous tissue elicit wound‐healing events that encapsulate the device. To investigate the foreign‐body response to devices of clinically relevant size, we studied the relationship between capsule thickness, vascular density, and blood flow within the capsule. In nine canines, we implanted 40 subcutaneous devices (polysulfone n = 14, titanium n = 17, silicone‐coated n = 9). Devices and surrounding tissue structures were harvested at 208 ± 142 (mean ± standard deviation) days after implantation. Tissues were processed for histological analysis with light microscopy. Foreign‐body capsule (FBC) thickness and vascular density were determined. A subset of five animals was instrumented via thoracotomy for microsphere injections and reference blood sampling. In these animals, regional blood flow was determined in mL/min/g of tissue in the FBC to examine the relationship between capsule thickness and blood flow. One‐way analysis of variance and linear regression analyses were performed. The FBC thickness was 0.92 ±  0.67 mm for all devices studied and was not influenced by device material. Capsule thickness correlated with vascular density for all devices (R2 = 0.85, P < 0.0001) and for each device material (polysulfone R2 = 0.85, P < 0.0001; silicone R2 = 0.95, P < 0.0001; titanium R2 = 0.87, P < 0.0001). Capsule thickness correlated modestly with blood flow for all devices studied (R2 = 0.59, P < 0.0001) and for each device material (polysulfone R2 = 0.77, P < 0.001; silicone R2 = 0.65, P = 0.10; titanium R2 = 0.52, P = 0.03). Capsule thickness, vascular density, and blood flow were similar within individual animals but variable across animals. Material type did not influence the thickness of FBCs surrounding devices of clinically relevant size. Capsule thickness correlated strongly with vascular density and modestly with blood flow within the capsule. Individual animals exhibited variable foreign‐body responses.
Effects of intravenous iron combined with low‐dose recombinant human erythropoietin on transfusion requirements in iron‐deficient patients undergoing bilateral total knee replacement arthroplasty (CME)
Authors: Na Hyo‐Seok , Shin Soon‐Young , Hwang Jin‐Young , Jeon Young‐Tae , Kim Chong‐Soo , Do Sang‐Hwan 
Published: July 2010

BACKGROUND: The authors examined the impact of parenteral iron and recombinant human erythropoietin‐β (rHuEPO‐β) administered in the bilateral total knee replacement arthroplasty (TKRA), on postoperative anemia and transfusion requirements in iron‐deficient patients.STUDY DESIGN AND METHODS: A total of 108 iron‐deficient patients were randomly assigned to two groups: Group C (control) or Group IE (200 mg of iron sucrose intravenously over 1 hr and 3000 IU of rHuEPO‐β subcutaneously during the operation and during the postoperative period if the hemoglobin [Hb] level was 70‐80 g/L). One or 2 units of blood were transfused to patients in both groups according to postoperative Hb level (between 60 and 70 g/L or betweeen 50 and 60 g/L, respectively). Perioperative laboratory and clinical outcomes (Hb, iron variables, postoperative bleeding amount, and number of units of RBCs transfused and incidences) were documented.RESULTS: Although preoperative Hb and the amount of postoperative bleeding were comparable in the two groups, Hb levels at 1, 2, and 3 days and at 2 and 6 weeks postoperation were significantly higher in Group IE. Furthermore, the transfusion rate was significantly lower in Group IE (20.4% vs. 53.7%, p = 0.011) and the mean number of red blood cell units transfused was markedly lower in Group IE (0.2 ± 0.5 vs. 0.8 ± 0.8, p = 0.005). Postoperative iron, ferritin, and transferrin saturation levels were significantly higher in Group IE.CONCLUSIONS: Treatment with parenteral iron and low‐dose rHuEPO‐β in bilateral TKRA effectively attenuated anemia and decreased transfusion requirements in iron‐deficient patients.
Bedside Ultrasound Diagnosis of Clavicle Fractures in the Pediatric Emergency Department
Authors: Cross Keith P. , Warkentine Fred H. , Kim In K. , Gracely Edward , Paul Ronald I. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:687–693 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Clavicle fractures are among the most common orthopedic injuries in children. Diagnosis typically involves radiographs, which expose children to radiation and may consume significant time and resources. Our objective was to determine if bedside emergency department (ED) ultrasound (US) is an accurate alternative to radiography.Methods:  This was a prospective study of bedside US for diagnosing clavicle fractures. A convenience sample of children ages 1–18 years with shoulder injuries requiring radiographs was enrolled. Bedside US imaging and an unblinded interpretation were completed by a pediatric emergency physician (EP) prior to radiographs. A second interpreter, a pediatric EP attending physician with extensive US experience, determined a final interpretation of the US images at a later date. This final interpretation was blinded to both clinical and radiography outcomes. The reference standard was an attending radiologist’s interpretation of radiographs. The primary outcome was the accuracy of the blinded US interpretation for detecting clavicle fractures compared to the reference standard. Secondary outcome measures included the interrater reliability of the unblinded bedside and the blinded physicians’ interpretations and the FACES pain scores (range, 0–5) for US and radiograph imaging.Results:  One‐hundred patients were included in the study, of whom 43 had clavicle fractures by radiography. The final US interpretation had 95% sensitivity (95% confidence interval [CI] = 83% to 99%) and 96% specificity (95% CI = 87% to 99%), and overall accuracy was 96%, with 96 congruent readings. Positive and negative predictive values (PPVs and NPVs, respectively) were 95% (95% CI = 83% to 99%) and 96% (95% CI = 87% to 99%), respectively. Interrater reliability (kappa) was 0.74 (95% CI = 0.60 to 0.88). FACES pain scores were available for the 86 subjects who were at least 5 years old. Pain scores were similar during US and radiography.Conclusions:  Compared to radiographs, bedside US can accurately diagnose pediatric clavicle fractures. US causes no more discomfort than radiography when detecting clavicle fractures. Given US’s advantage of no radiation, pediatric EPs should consider this application.
Neuroimaging for Pediatric Head Trauma: Do Patient and Hospital Characteristics Influence Who Gets Imaged?
Authors: Mannix Rebekah , Bourgeois Florence T. , Schutzman Sara A. , Bernstein Ari , Lee Lois K. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:694–700 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to identify patient, provider, and hospital characteristics associated with the use of neuroimaging in the evaluation of head trauma in children.Methods:  This was a cross‐sectional study of children (≤19 years of age) with head injuries from the National Hospital Ambulatory Medical Care Survey (NHAMCS) collected by the National Center for Health Statistics. NHAMCS collects data on approximately 25,000 visits annually to 600 randomly selected hospital emergency and outpatient departments. This study examined visits to U.S. emergency departments (EDs) between 2002 and 2006. Multivariable logistic regression was used to analyze characteristics associated with neuroimaging in children with head injuries.Results:  There were 50,835 pediatric visits in the 5‐year sample, of which 1,256 (2.5%, 95% confidence interval [CI] = 2.2% to 2.7%) were for head injury. Among these, 39% (95% CI = 34% to 43%) underwent evaluation with neuroimaging. In multivariable analyses, factors associated with neuroimaging included white race (odds ratio [OR] = 1.5, 95% CI = 1.02 to 2.1), older age (OR = 1.3, 95% CI = 1.1 to 1.5), presentation to a general hospital (vs. a pediatric hospital, OR = 2.4, 95% CI = 1.1 to 5.3), more emergent triage status (OR = 1.4, 95% CI = 1.1 to 1.8), admission or transfer (OR = 2.7, 95% CI = 1.4 to 5.3), and treatment by an attending physician (OR = 2.0, 95% CI = 1.1 to 3.7). The effect of race was mitigated at the pediatric hospitals compared to at the general hospitals (p < 0.001).Conclusions:  In this study, patient race, age, and hospital‐specific characteristics were associated with the frequency of neuroimaging in the evaluation of children with closed head injuries. Based on these results, focusing quality improvement initiatives on physicians at general hospitals may be an effective approach to decreasing rates of neuroimaging after pediatric head trauma.
Kinetics and Efficacy of an Organophosphorus Hydrolase in a Rodent Model of Methyl‐parathion Poisoning
Authors: Gresham Chip , Rosenbaum Christopher , Gaspari Romolo J. , Jackson Colin J. , Bird Steven B. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:736–740 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Organophosphorus (OP) pesticides exert a tremendous health burden, particularly in the developing world. Limited resources, the severity of intentional OP ingestions, and a paucity of beneficial therapies all contribute to the morbidity and mortality of this broad class of chemicals. A novel theoretical treatment for OP poisoning is the use of an enzyme to degrade the parent OP in the circulation after poisoning. The aims of this study were to determine the pharmacokinetics and efficacy of an OP hydrolase (OpdA) in a rodent model of severe methyl‐parathion poisoning.Methods:  Two animal models were used. First, Wistar rats were administered two different doses of the hydrolase (0.15 and 1.5 mg/kg), and the ex vivo hydrolytic activity of plasma was determined by a fluorometric method. Second, an oral methyl‐parathion animal poisoning model was developed to mimic severe human poisoning, and the efficacy of postpoisoning OpdA (as measured by survival to 4 and 24 hours) was determined.Results:  The half‐life of OpdA in the Wistar rat was dependent on the dose administered and ranged between 45.0 and 57.9 minutes. The poisoning model of three times the lethal dose to 50% of the population (3 × LD50) of methyl‐parathion resulted in 88% lethality at 4 and 24 hours. Using a single dose of 0.15 mg/kg OpdA 10 minutes after poisoning resulted in 100% survival at 4 hours (p = 0.001 vs. placebo), but 0% at 24 hours postpoisoning (p = NS vs. placebo).Conclusions:  The OP hydrolase OpdA exhibits pharmacokinetics suitable for repeated dosing and increases short‐term survival after severe methyl‐parathion poisoning.
Patient Protection and Affordable Care Act of 2010: Summary, Analysis, and Opportunities for Advocacy for the Academic Emergency Physician
Authors: Kline Jeffrey A. , Walthall Jennifer D.H. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:E69–E74 © 2010 by the Society for Academic Emergency MedicineAbstractThe Patient Protection and Affordable Care Bill, commonly referred to as the “Health Care Bill” or the “Health Care Reform Bill,” was enacted in March 2010. This article is a review and analysis of the sections of this Act that are relevant to researchers and teachers of emergency care. The purpose of this document is to serve as a citable reference for interested parties and a reference to quickly locate the sections of the Bill relevant to academic emergency physicians. When appropriate, text was copied verbatim from the Bill. The source of the downloaded Act, and the page numbers of the text sections, are provided to help the reader to find the sections described. This review is presented in two parts. Part I presents 11 sections extirpated from the Act, with short interpretations of the significance of each section. Part II presents an analysis of the sections that the authors believe represent opportunities for emergency care researchers and teachers to make the most impact, through active involvement with the various departments and agencies of the federal government that will be charged with interpreting and implementing this Act. The Act contains sections that could lead to new funding opportunities for research in emergency care, especially for comparative clinical trials and clinical studies that focus on integration and efficiency of health care delivery. The Act will establish several new institutes, centers, and committees that will create policies highly relevant to emergency care. The authors conclude that this Act can be expected to have a profound influence on research and training in emergency care.
Resveratrol regulates p66Shc activation in HaCaT cells
Authors: Fabbrocini Gabriella , Kisslinger Annamaria , Iannelli Paola , Vitale Nicoletta , Procaccini Claudio , Sparaneo Giuseppina , Chieffi Paolo , Ayala Fabio , Mancini Francesco Paolo , Tramontano Donatella 
Published: July 2010

Please cite this paper as: Resveratrol regulates p66Shc activation in HaCaT cells. Experimental Dermatology 2010; 19: 895–903.Abstract:  Skin is exposed to both endogenous and environmental oxidant agents, leading to the harmful generation of reactive oxygen species. Particular interest has been pointed on plant antioxidants, such as resveratrol, because of their wide‐ranging biological activity and clinical potential. Resveratrol exerts antioxidant, metabolism‐regulating and pro‐apoptotic/anti‐cancer effects on a variety of experimental models and has been suggested to protect skin from ultraviolet‐induced photodamaging and photoaging. In parallel, also the biological significance of p66Shc, a member of the Src Homologue and Collagene homologue family with redox activity, is getting further attention. Because of the striking intersection among the activities of resveratrol with those of p66Shc, we investigated whether resveratrol would activate p66Shc in human immortalised keratinocytes (HaCaT cells), a well known and largely used model for skin keratinocytes. HaCaT cells were treated with resveratrol (10–150 μm) for different times. The effect of resveratrol on the proliferation of HaCaT cells and the activation of ERK1/2, AKT, and p66Shc was investigated by cell counting, fluorescence‐activated cell sorting, and western blot analysis of total or immunoprecipitated cell extracts. In HaCaT cells, resveratrol induces dose‐ and time‐dependent growth arrest, p66Shc‐Ser36 phosphorylation, ERK1/2 phosphorylation and AKT dephosphorylation. Finally, we showed that resveratrol‐induced p66Shc‐Ser36 phosphorylation is dependent on ERK1/2 activation. Interestingly, these resveratrol‐induced molecular effects were associated with reduced adhesion and reversible growth arrest rather than cell death pathways. This is the first evidence linking resveratrol with p66Shc and suggests that p66Shc may contribute to the effect of resveratrol on cell proliferation and function in the outermost layer of the skin.
Spatial variability of common carp populations in relation to lake morphology and physicochemical parameters in the upper Midwest United States
Authors: Weber M. J. , Brown M. L. , Willis D. W. 
Published: July 2010

Weber MJ, Brown ML, Willis DW. Spatial variability of common carp populations in relation to lake morphology and physicochemical parameters in the upper Midwest United States. Ecology of Freshwater Fish 2010: 19: 555–565. © 2010 John Wiley & Sons A/SAbstract –  Common carp (Cyprinus carpio) is a widespread invasive species that is tolerant of a wide range of environmental conditions. Despite the circumpolar distribution of the species, limited information is available describing factors related to spatial variation in population characteristics. Eighty‐four lakes and impoundments in the upper Midwest United States were sampled to investigate the relationships of common carp relative abundance with size structure, condition and growth rates. We also investigated abiotic factors (lake morphology, physical solids and water quality) that may broadly influence common carp populations. Common carp size structure and condition were inversely related to relative abundance. Common carp relative abundance increased and size structure shifted to smaller individuals with increased lake depth, whereas lake surface area, watershed:surface area ratio and physical solids were also important in explaining common carp abundance and size structure. Common carp condition was best explained by water quality parameters and increased with metrics of lake productivity. We conclude that knowledge of factors associated with variation in common carp populations among lakes provides insights into the autecology and broad provisions for management of this generalist invasive species.
Intestinal microbiota in allergic and nonallergic 1‐year‐old very low birth weight infants after neonatal glutamine supplementation
Authors: Van Zwol A , Van Den Berg A , Knol J , Twisk JWR , Fetter WPF , Van Elburg RM 
Published: July 2010

AbstractAim: Previously, glutamine‐enriched enteral nutrition in very low birth weight infants (VLBW) decreased the incidence of atopic dermatitis at age 1 year. The aim of this study was to determine whether this effect is related to changes in intestinal bacterial species that are associated with allergy, such as bifidobacteria, clostridium histolyticum, clostridium lituseburense (Chis/lit group) andEscherichia coliat age 1 year.Methods: Eighty‐nine infants were eligible for this follow‐up study, conducted at a Tertiary care hospital. Bifidobacteria, Chis/lit group andE. coliwere measured by fluorescentin situhybridization in faecal samples collected at age 1 year. Information on allergic and infectious diseases was previously determined by questionnaire.Results: Seventy‐two of 89 (81%) infants were participated. Prevalence of all studied species was not different between glutamine‐supplemented and control groups. Allergic infants were less frequently colonized with bifidobacteria than nonallergic infants (p = 0.04). Between neonatal period and 1 year, prevalence of bifidobacteria was increased (p < 0.001), of Chis/lit group was unchanged (p = 0.84), and ofE. coliwas decreased (p < 0.001).Conclusion: The beneficial effect of glutamine‐enriched enteral nutrition on the incidence of atopic dermatitis in the first year of life in VLBW infants is not related to changes in bifidobacteria, Chis/lit group orE. coli. Allergic VLBW infants are less frequently colonized with bifidobacteria compared to nonallergic VLBW infants.
Premature Ejaculation in Infertile Couples: Prevalence and Correlates
Authors: Shindel Alan W. , Nelson Christian J. , Naughton Cathy K. , Mulhall John P. 
Published: July 2010

ABSTRACT

Introduction
The incidence of premature ejaculation (PE) and other sexual problems in infertile couples is unknown.

Aims
We attempted to determine the prevalence of PE in infertile couples.

Methods
Infertile couples presenting for evaluation at our institutions were invited to participate in our study. Multiple regression analysis was conducted to assess for associations between partner responses.

Main Outcome Measure
Respondents completed a demographic survey, the Short Form-36 (SF-36), and the Center for Epidemiological Studies Depression (CES-D) scale. Both partners also completed a gender-specific survey instrument to detect PE and distress related to the condition. Male partners completed the International Index of Erectile Function (IIEF) and the Self-Esteem and Relationship Quality (SEAR) scale. Female partners completed the Female Sexual Function Index (FSFI) and a modified version of the SEAR.

Results
Fifty percent of men reported that they ejaculated more rapidly than they wished. When men reported PE, their partners agreed with the diagnosis in 47% of cases. Female partners of men who did not report PE reported PE in 11% of cases. Partner frustration related to PE was reported by 30% of men. Partners agreed that they were frustrated in 43% of these cases. Among the 70% of men who did not report partner frustration from PE, 93% of the partners agreed that they were not frustrated. There was a statistically significant negative association between male and female report of PE and SEAR scores. There were no other statistically significant associations between PE responses and demographic variables, IIEF, FSFI, CES-D, and SF-36 scores.

Conclusions
PE is prevalent among infertile couples although the perceived incidence of the condition among men is higher than partner perceived incidence. Additionally, many men may overestimate the level of partner frustration related to PE. PE is associated with lower relationship satisfaction in both men and women. Further research is required.