bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atovaquone versus trimethoprim–sulfamethoxazole as Pneumocystis jirovecii pneumonia prophylaxis following renal transplantation
Authors: Gabardi Steven , Millen Peter , Hurwitz Shelley , Martin Spencer , Roberts Keri , Chandraker Anil 
Published: April 2012

AbstractPneumocystis pneumonia (PCP) is associated with significant morbidity and mortality in renal transplant recipients (RTR). Trimethoprim–sulfamethoxazole (TMP‐SMZ) is considered the prophylactic agent‐of‐choice. Some patients require an alternative owing to TMP‐SMZ intolerance. This is the first evaluation of full‐dose atovaquone vs. TMP‐SMZ for PCP prevention in RTR. One hundred and eighty‐five RTR were evaluated in this single‐center, retrospective analysis. Patients received either single‐strength TMP‐SMZ daily (group I; n = 160) or 1500 mg/d of atovaquone and of a fluoroquinolone for one month (group II; n = 25). The primary endpoint was the incidence of PCP at 12 months post‐transplant. There were no cases of PCP in either group. There were comparable rates of infections from bacterial pathogens and cytomegalovirus, but rates of BK viremia were significantly higher in group I (22.5%) vs. group II (4%; p = 0.03). The incidence of leukopenia was similar in both groups. Higher mean potassium levels were seen in group I at three months post‐transplant but were comparable at all other time points. The need for dose reduction and/or premature discontinuation of therapy secondary to adverse events was more prevalent in TMP‐SMZ‐treated patients. In our experience, atovaquone appears to be effective in preventing PCP post‐renal transplant and also demonstrates good tolerability.
Estimating the risks of acquiring a kidney abroad: a meta‐analysis of complications following participation in transplant tourism
Authors: Anker Ashley E. , Feeley Thomas H. 
Published: April 2012

AbstractA meta‐analysis of odds ratios comparing the risks of participating in transplant tourism by acquiring a kidney abroad to the risks associated with domestic kidney transplant was undertaken. Comparison across 12 medical outcomes indicates transplant tourists are significantly more likely to contract cytomegalovirus, hepatitis B, HIV, post‐transplantation diabetes mellitus, and wound infection than those receiving domestic kidney transplant. Results also indicate that domestic kidney transplant recipients experience significantly higher one‐yr patient‐ and graft‐survival rates. Analyses are supplemented by independent comparisons of outcomes and provide practitioners with weighted estimates of the proportion of transplant recipients experiencing 15 medical outcomes. Practitioners are encouraged to caution patients of the medical risks associated with transplant tourism. Despite the illegal and unethical nature of transplant tourism, additional efforts are indicated to eliminate the organ trade and to educate wait‐listed patients about the risks of transplant tourism.
The Response of the Leguminous Fodder Plant Bituminaria bituminosa to Water Stress
Authors: Martínez‐Fernández D. , Walker D. J. , Romero P. , Martínez‐Ballesta M. C. , Correal E. 
Published: April 2012

Abstract Bituminaria bituminosa (L.) C.H. Stirton (Fabaceae) is a biennial–perennial species, which grows throughout the Mediterranean basin and Macaronesia. It is cultivated to provide livestock fodder and shows promise as a source of furanocoumarins. This is the first report on its physiological and growth responses to water deprivation. We assessed these in a pot assay, in the field and in hydroponic culture, using two populations from southern Spain and two from the Canary Islands. Proline accumulation was much lower in the field than for pot‐grown plants, supporting recent indications that it is phytotoxic under combined drought and heat stress. In hydroponic culture, imposition of water stress by poly(ethylene glycol) increased the root/shoot ratio and decreased the root hydraulic conductivity. Overall, the results show B. bituminosa to be a species with high constitutive resistance to soil water deficit. For example, leaf turgor did not diminish, demonstrating its capacity for osmotic adjustment, and the specific leaf area in field conditions was similar to that of other species adapted to seasonal drought. Notwithstanding, the two Canarian populations (which complete their life cycles under very different conditions) maintained better their relative water content and water potential to avoid internal stress. Famara (Lanzarote, Canary Islands) is the most appropriate as a breeding line, which can maintain its shoot biomass under drought.
Endoscopic approach to pancreatic pseudocyst, abscess and necrosis: Review on recent progress
Authors: Chen Jie , Fukami Norio , Li Zhaoshen 
Published: April 2012

Aim:  The aim of this study is to introduce recent progress in the treatment of pancreatic pseudocyst, abscess and necrosis using the endoscopic approach.Methods:  Studies on PubMed and MEDLINE from the last 30 years on progress in the management of the complications from severe pancreatitis were researched and reviewed. Herein, the indication for intervention, definition of fluid collection associated with acute pancreatitis and treatment modalities of these complications are summarized.Results:  Three types of management are employed for complications of severe pancreatitis: the endoscopic, surgical and percutaneous approaches.Conclusions:  Over the years, as technical expertise has increased and instruments for endoscopy have improved, patients who had endoscopic surgery to address the complications of severe pancreatitis have had higher survival rates, lower mortality rates and lower complication rates than those having open debridement. However, traditional open abdominal surgery should be advocated when minimally invasive management fails or necrosis is extensive and extends diffusely to areas such as the paracolic gutter and the groin (i.e. locations not accessible by endoscopy).
What is the preferred shape for an esophageal stent flange?
Authors: Maetani Iruru , Shigoka Hiroaki , Omuta Shigefumi , Gon Katsushige , Saito Michihiro 
Published: April 2012

Aim:  Self‐expandable metallic stents (SEMS) for the gastrointestinal tract have different types of flanges at either the oral end or both ends to prevent stent migration. The effect of flange shape on the properties of SEMS, to our knowledge, has not been evaluated. The aim of this study was to measure the strain that a SEMS imposes on the adjacent wall and the anti‐migration force (AF) exerted by three stents, each with a different flange shape.Methods:  Stents with one of three different flanges (flared, dumbbell, and barrel) were designed and then their strain and AF values were measured with apparatuses devised in our laboratory.Results:  Although the average maximal strain values at the flange were similar (508.4 µm/m, 513.3 µm/m and 486.4 µm/m for flared, dumbbell and barrel, respectively), strain values for each position differed among the three different types of stents. Strain values for the flared shape increased toward the stent end, reaching the maximum value. Maximal strain values for the dumbbell and barrel shapes were observed near the flange's midpoint. Maximal AF values differed significantly according to flange shape. Thus, the median maximal AF values were 1.85 newton, 1.35 newton, and 1.13 newton, for barrel, dumbbell and flared shapes, respectively.Conclusions:  The performance of braided esophageal SEMS with barrel shaped flanges is superior to that of SEMS with dumbbell or flared flanges, based on the strain on the adjacent wall and the prevention of stent migration.
Signet‐ring cell carcinoma of the breast with uterine metastasis treated with extensive cytoreductive surgery: A case report and brief review of the literature
Authors: Ertas Ibrahim Egemen , Sayhan Sevil , Karagoz Gurhan , Yildirim Yusuf 
Published: April 2012

AbstractPrimary signet‐ring cell carcinoma (SRCC) of the breast is an uncommon variant, accounting for 2–4.5% of all primary breast cancers. Secondary SRCC of the endometrium is very rare and usually originates from the breast or gastrointestinal tract. A 54‐year‐old, postmenopausal woman with a past history of breast cancer four years previously was admitted with abnormal uterine bleeding. An endometrial biopsy revealed undifferentiated adenocarcinoma with signet‐ring cells. The patient underwent laparotomy and cytoreductive surgery was performed. Pathological analysis and immunohistochemical tests demonstrated a uterine (endomyometrial) metastasis of breast SRCC. Omentum, peritoneal surfaces and retroperitoneal lymph nodes also included tumoral tissue with signet‐ring cell morphology. The patient received adjuvant systemic chemotherapy with adriamycin, cyclophosphamide and paclitaxel. This case report discusses the patient's clinical characteristics and the role of cytoreductive surgery on patient survival in SRCC of the breast metastasizing to the uterus.
Single nucleotide polymorphisms of RAD51 G135C, XRCC2 Arg188His and XRCC3 Thr241Met homologous recombination repair genes and the risk of sporadic endometrial cancer in Polish women
Authors: Romanowicz‐Makowska Hanna , Smolarz Beata , Połać Ireneusz , Sporny Stanisław 
Published: April 2012

AbstractBackground:  The genes RAD51, XRCC2 and XRCC3 encode proteins that are important for the repair of double‐strand DNA breaks by homologous recombination. Therefore, genetic variability in these genes may contribute to the occurrence and progression of endometrial cancer.Methods:  The subject of investigation in the reported study was the distribution of genotypes and the prevalence of alleles of the RAD51 G135C, XRCC2 Arg188His and XRCC3 Thr241Met polymorphism in 230 cases of sporadic endometrial cancer; the polymorphisms were determined by polymerase chain reaction–restriction fragment‐length polymorphism methods.Results:  The obtained results demonstrated a significant positive association between the RAD51 C/C genotype and endometrial carcinoma, with an adjusted odds ratio (OR) of 3.75 (P < 0.0001). The homozygous C/C genotype was found in 72% of endometrial cancer cases and in 19% of the used controls. The variant 135C allele of RAD51 increased the cancer risk (OR = 1.64 [1.28–2.10]P < 0.0001). There were no significant differences between the distribution of G135C, Arg188His and Thr241Met genotypes in the subgroups assigned to histological grades.Conclusions:  The obtained results indicate that the polymorphism of RAD51, but not of either XRCC2 or XRCC3 genes, may be positively associated with the incidence of endometrial carcinoma in the population of Polish women. Further studies, including those on a larger group of patients, are required to further clarify this point.
Altered arterial stiffness in male‐to‐female transsexuals undergoing hormonal treatment
Authors: Sharula  , Chekir Chebib , Emi Yayoi , Arai Fujimi , Kikuchi Yukako , Sasaki Aiko , Matsuda Miwa , Shimizu Keiko , Tabuchi Kazuhiro , Kamada Yasuhiko , Hiramatsu Yuji , Nakatsuka Mikiya 
Published: April 2012

AbstractAim:  Male‐to‐female (MTF) transsexuals are treated with estrogen with and without progestin through a variety of routes. The aim of this study is to evaluate the arterial stiffness in MTF transsexuals undergoing hormonal treatment.Methods:  We evaluated the arterial stiffness in 156 MTF transsexuals (22 untreated and 129 treated with estrogen only or plus progestin) using a volume‐plethysmographic apparatus equipped with a multi‐element applanation tonometry sensor.Results:  MTF transsexuals treated with parenteral estrogen were significantly older than untreated MTF transsexuals. Hematocrit, uric acid and activated partial thromboplastin time in treated MTF transsexuals were significantly lower than in untreated MTF transsexuals. The level of high‐density lipoprotein cholesterol in MTF transsexuals treated with oral estrogen was significantly higher than in untreated MTF transsexuals or those treated with parenteral estrogen with and without progestin. The systolic blood pressure in MTF transsexuals treated with estrogen only is significantly lower than that in untreated MTF transsexuals. The brachial–ankle pulse wave velocity was significantly decreased in MTF transsexuals treated with estrogen compared to that in untreated MTF transsexuals or in those treated with estrogen plus progestin. The carotid augmentation index in MTF transsexuals treated with oral estrogen was significantly lower than that in MTF transsexuals treated with parenteral estrogen or oral estrogen plus progestin.Conclusions:  Estrogen treatment is likely to have some beneficial effects on lipid metabolism and vascular function in MTF transsexuals; however, progestin administered with estrogen may have adverse effects on arterial stiffness.
Cost–benefit analysis of laparoscopic surgery versus laparotomy for patients with endometrioid endometrial cancer: Experience from an institute in China
Authors: Lu Zhiying , Yi Xiaofang , Feng Weiwei , Ding Jingxin , Xu Huan , Zhou Xianrong , Hua Keqin 
Published: April 2012

AbstractAim:  To compare the clinical outcomes and associated costs between laparoscopic and abdominal surgery for patients with endometrioid endometrial cancer.Methods:  From 2003 to 2008, 115 patients who underwent laparoscopically‐assisted surgery for endometrioid endometrial cancers were enrolled in this retrospective study. Another 123 patients who had abdominal surgery for the same histological type of endometrial cancer were included as the control group. The clinico‐pathological variables, surgical outcome, costs, death and case recurrence of the two groups were compared.Results:  There was no difference in the patients' age, body mass index, FIGO stage, histological grade or surgical types between the two groups. The patients in the laparoscopy group had less blood loss (P = 0.010), a shorter hospital stay (P < 0.001), less postoperative pain (P < 0.001) and lower complication rates (P < 0.001) than those treated by laparotomy. The total costs in the laparoscopy group were higher than that in the laparotomy group ($2073 vs $1638, P < 0.001). Patients in the laparoscopy group returned to usual activity more quickly (P = 0.001) and went back to work earlier (P = 0.013) than those in laparotomy group. With a median follow‐up of 42 months for the laparoscopy group and 40 months for the laparotomy group, there was no significant difference in the number of cases with respect to death (P = 1.000) or recurrence (P = 1.000).Conclusions:  Laparoscopically‐assisted surgery is as effective as the laparotomy approach for the treatment of early‐stage and advanced‐stage endometrial cancer. The relatively higher cost of the laparoscopic surgery may be compensated by its benefits. In developing countries such as China, laparoscopically‐assisted surgery is also an attractive alternative for selected patients with endometrial cancer.
How far has the pendulum swung in the surgical management of sigmoid volvulus? Experience from the KwaZulu‐Natal Teaching Hospitals and review of the literature
Authors: Mnguni M. N. , Islam J. , Manzini V. , Govindasamy V. , Zulu B. M. W. , Clarke D. L. , Madiba T. E. 
Published: April 2012

AbstractAim  Sigmoid volvulus is common in sub‐Saharan Africa. The aim of the study was to document the clinicopathological patterns of sigmoid volvulus in KwaZulu‐Natal.Method  Analysis was performed of prospectively collected data of patients presenting with sigmoid volvulus at the KwaZulu‐Natal Teaching Hospitals from 2000 to 2009. Data collected included demographics, clinical presentation, operative findings, management and outcome.Results  There were 135 patients (122 male) of mean age 39.3 ± 17 years. Management was by emergency surgery (103), elective surgery (23), no surgery (9). The level of the twist was at the pelvic brim. Fifty‐four patients had gangrenous bowel and 81 had viable bowel. Resection was accompanied by primary anastomosis (80) and Hartmann’s procedure (46). Complication and mortality rates were 47% and 17% respectively. Mortality rates for emergency and elective surgery were 19% and 9% (P = 0.330), and those for primary anastomosis and Hartmann’s procedure were 14% and 24% respectively (P = 0.305). Mortality rates for gangrenous and viable bowel were 21% and 15% respectively (P = 0.624). Twenty‐eight (22%) patients required intensive care in the intensive care unit (ICU) with an ICU stay of 8.8 ± 8 days. Hospital stay was 10.5 ± 14.4 days.Conclusion  The clinicopathological picture of sigmoid volvulus resembles that in the rest of Africa in that it affects predominantly young African males. The level of the twist is at the pelvic brim. The timing of surgery, the type of anastomosis and the viability of the bowel does not influence outcome.
Effect of antidiabetic agents added to metformin on glycaemic control, hypoglycaemia and weight change in patients with type 2 diabetes: a network meta‐analysis
Authors: Liu S.‐C. , Tu Y.‐K. , Chien M.‐N. , Chien K.‐L. 
Published: April 2012

Aim: Most guidelines recommend metformin as first‐line therapy in patients with type 2 diabetes. However, the choice of a second‐line drug lacks consistent consensus. We aimed to assess available information of antidiabetic drugs added to metformin on the change in glycated haemoglobin A1c (A1C), risk of hypoglycaemia and change in body weight.Methods: PubMed and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) written in English through December 2011. We analysed direct and indirect comparisons of different treatments using Bayesian network meta‐analysis.Results: Thirty‐nine RCTs involving 17 860 individuals were included. Glucagon‐like peptide‐1 (GLP‐1) analogues resulted in greater decrease in A1C compared with sulfonylureas, glinides, thiazolidinediones, α‐glucosidase inhibitors and DPP‐4 inhibitors [−0.20% (95% CI −0.34 to −0.04%), −0.31% (95% CI −0.61 to −0.02%), −0.20% (95% CI −0.38 to −0.00), −0.36% (95% CI −0.64 to −0.07%), −0.32% (95% CI −0.47 to −0.17%), respectively] and was comparable with basal insulin and biphasic insulin. A1C decrease was greater for sulfonylureas compared with DPP‐4 inhibitors [−0.12% (−0.23 to −0.03%)], and for biphasic insulin compared with glinides (−0.36%; 95% CI −0.82 to −0.11%). Compared with placebo, the risk of hypoglycaemia was increased in the sulfonylureas, glinides, basal insulin and biphasic insulin. Weight increase was seen with sulfonylureas, glinides, thiazolidinediones, basal insulin and biphasic insulin, and weight loss was seen with α‐glucosidase inhibitors and GLP‐1 analogues.Conclusions: Biphasic insulin, GLP‐1 analogues and basal insulin were ranked the top three drugs in terms of A1C reduction. GLP‐1 analogues did not increase the risk of hypoglycaemia and resulted in a significant decrease in body weight. Most oral antidiabetic drugs had similar effects on A1C, but some agents had a lower risk of hypoglycaemia and body weight gain.
Refractive state of the Spanish Thoroughbred horse: a comparison with the crossbred horse
Authors: Rull‐Cotrina Jorge , Molleda Jose M. , Gallardo José , Martín‐Suárez Eva 
Published: April 2012

AbstractObjective To assess the refractive state of the equine eye utilizing retinoscopy. To compare the refractive state of Spanish Thoroughbred horses with the refractive state of Crossbred horses.Procedures The refractive state of 135 horses (264 eyes) was assessed utilizing streak retinoscopy. Two perpendicular meridians were examined in order to assess astigmatism at a working distance of approximately 67 cm. A group of 81 Spanish Thoroughbred horses was compared with a group of 54 Crossbred horses. Cyclopentolate ophthalmic solution was instilled in the eyes of a group of 18 horses to determine if accommodation has any influence on the assessment of the refractive state.Results Mean ± SE refractive state of all horses examined was −0.17 ± 0.04 D. The mean refractive state of the Spanish Thoroughbred was −0.28 ± 0.06 D while that of the Crossbred was −0.01 ± 0.05 D. The refractive state of the Spanish Thoroughbred was found to be statistically different to that of the Crossbred. The most prevalent refractive state was emmetropia in all cases, followed by hyperopia for the Crossbred, and myopia for the Spanish Thoroughbred. Astigmatism ≥0.50 D present in both eyes from the same individual was found in 21.7% of all horses examined. Anisometropia ≥1.00 D was diagnosed in 4 out of 129 horses with both visual eyes. Cycloplegia did not statistically affect the refractive state of the evaluated eyes.Conclusions The equine eye has a refractive state close to emmetropia. Myopia is higher among Spanish Thoroughbred horses than among Crossbred horses.
Adding pharmacists to primary care teams reduces predicted long‐term risk of cardiovascular events in Type 2 diabetic patients without established cardiovascular disease: results from a randomized trial
Authors: Ladhani N. N. , Majumdar S. R. , Johnson J. A. , Tsuyuki R. T. , Lewanczuk R. Z. , Spooner R. , Simpson S. H. 
Published: April 2012

AbstractAim  To determine the impact of adding pharmacists to primary care teams on predicted 10‐year risk of cardiovascular events in patients with Type 2 diabetes without established cardiovascular disease.Methods  This was a pre‐specified secondary analysis of randomized trial data. The main study found that, compared with usual care, addition of a pharmacist resulted in improvements in blood pressure, dyslipidaemia, and hyperglycaemia for primary care patients with Type 2 diabetes. In this sub‐study, predicted 10‐year risk of cardiovascular events at baseline and 1 year were calculated for patients free of cardiovascular disease at enrolment. The primary outcome was change in UK Prospective Diabetes Study (UKPDS) risk score; change in Framingham risk score was a secondary outcome.Results  Baseline characteristics were similar between the 102 intervention patients and 93 control subjects: 59% women, median (interquartile range) age 57 (50–64) years, diabetes duration 3 (1–6.5) years, systolic blood pressure 128 (120–140) mmHg, total cholesterol 4.34 (3.75–5.04) mmol/l and HbA1c 54 mmol/mol (48–64 mmol/mol) [7.1% (6.5–8.0%)]. Median baseline UKPDS risk score was 10.2% (6.0–16.7%) for intervention patients and 9.5% (5.8–15.1%) for control subjects (P = 0.80). One‐year post‐randomization, the median absolute reduction in UKPDS risk score was 1.0% greater for intervention patients compared with control subjects (P = 0.032). Similar changes were seen with the Framingham risk score (median reduction 1.2% greater for intervention patients compared with control subjects, P = 0.048). The two risk scores were highly correlated (rho = 0.83; P < 0.001).Conclusion  Adding pharmacists to primary care teams for 1 year significantly reduced the predicted 10‐year risk of cardiovascular events for patients with Type 2 diabetes without established cardiovascular disease.
The Multifaceted Impact of Corruption on International Trade
Authors: Thede Susanna , Gustafson Nils‐Åke 
Published: April 2012

AbstractThe purpose of this paper is to perform a detailed examination of corruption effects on trade based on corruption characteristics known to affect economic exchange within the corruption research field. These characteristics are the level, prevalence, customs location, function and predictability of corruption. The multifaceted corruption impact on trade is empirically examined using a corruption‐augmented gravity equation. The equation is estimated using a Heckman version of a GMM instrumental variable method. Our results provide strong evidence of that import flows vary systematically with the investigated corruption characteristics and enable the identification of channels through which corruption affects international trade. The empirical investigation clearly indicates the need to examine the multifaceted role of corruption to properly assess the trade effects of corruption.