bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erlotinib and pantoprazole: a relevant interaction or not?
Authors: Ter Heine Rob , Fanggiday James C. , Lankheet Nienke A. G. , Beijnen Jos H. , Van Der Westerlaken Monique M. L. , Staaks Gerald H. A. , Malingré Mirte M. 
Published: July 2010

AIMSThere is increasing evidence that erlotinib exposure correlates well with treatment outcome. In this report we present a case of therapeutic drug monitoring of erlotinib in a patient with a gastric ulcer, treated with the proton pump inhibitor pantoprazole. This agent may cause an unwanted, but not always unavoidable, interaction since absorption of erlotinib is pH dependent.METHODSErlotinib trough concentrations were monitored in a patient during treatment with orally and intravenously administered pantoprazole.RESULTSErlotinib trough concentrations were diminished during high dose intravenously administered pantoprazole, but returned to normal when the dose was reduced and pantoprazole was administered orally.CONCLUSIONSMore studies are needed to assess the dose dependency of the interaction between pantoprazole and erlotinib. Furthermore, we advise to monitor closely erlotinib plasma concentrations and adjust the erlotinib dose accordingly when a clinically relevant interaction is suspected and no proper dosing guidelines are available.
Atorvastatin and cardiac hypertrophy and function in hypertrophic cardiomyopathy: a pilot study
Authors: Nagueh Sherif F. , Lombardi Raffaella , Tan Yanli , Wang Jianwen , Willerson James T. , Marian Ali J. 
Published: July 2010

Eur J Clin Invest 2010; 40 (11): 976–983AbstractBackground  Hypertrophic cardiomyopathy (HCM) is a genetic paradigm of cardiac hypertrophy. Cardiac hypertrophy is a major determinant of risk of sudden death and morbidity in HCM. Treatment with statins reverses hypertrophy in animal models of HCM. Thus, statins may afford therapeutic benefits in HCM.Methods  We performed a feasibility study with atorvastatin to gather the pre‐requisite data for designing randomized efficacy studies.Results  We screened 32 patients with HCM in 18 months. Twenty‐one patients met the study criteria and consented to participate. The demographics and echocardiographic phenotype of those who did and those who did not participate were not significantly different. We treated the participants with escalating doses of atorvastatin (20, 40 and 80 mg day−1) for 2 years. We performed ECG and echocardiography and measured plasma lipids, liver enzymes, creatine kinase and B‐type natriuretic peptide levels before and after 3, 6, 12 and 24 months of therapy. Fifteen, 12 and 11 patients completed 6, 12 and 24 months of therapy respectively. Six patients discontinued atorvastatin because of perceived lack of benefit. We stopped atorvastatin in 4 patients because of modest elevations in liver enzymes, creatine kinase or back pain. The characteristics of those who did or did not complete the study were not significantly different. The mean plasma low‐density lipoprotein‐cholesterol level was reduced by 55%. However, echocardiographic indices of cardiac hypertrophy and function remained unchanged.Conclusions  The findings illustrated the challenges that will be encountered in designing efficacy studies to test the potential beneficial effects of atorvastatin in human HCM.
Effects of upland clearcutting and riparian partial harvesting on leaf pack breakdown and aquatic invertebrates in boreal forest streams
Authors: KREUTZWEISER DAVID , MUTO ELISA , HOLMES STEPHEN , GUNN JOHN 
Published: July 2010

Summary1. Leaf litter breakdown and associated invertebrates were compared among three logged and three reference stream reaches 2–3 years before and 3–4 years after logging to assess the environmental impacts of partial‐harvest logging as a novel riparian management strategy for boreal forest streams.2. Partial‐harvest logging at three sites resulted in 10, 21 and 28% average basal area removal from riparian buffers adjacent to upland clear‐cut areas.3. Leaf litter breakdown rates were not significantly different between reference and logged sites after logging, but litter breakdown was significantly different from year to year at all sites.4. Significant post‐logging differences in aquatic invertebrate communities were detected at only one of the three logged sites. These differences were largely the result of increases in some leaf‐shredding stoneflies and a detritivorous mayfly and a decrease in a chironomid group 2–4 years after logging. This site where significant change was detected had the lowest intensity of riparian logging (average 10% removal) but the highest proportion of the catchment area that was clear cut (85%).5.The post‐logging differences in invertebrate communities at this site were more related to catchment‐wide influences (e.g. weather patterns, water yield, possibly upland clearcutting) than to reach‐level disturbances from riparian logging.6.The study indicates that partial‐harvest logging in riparian buffers at up to 50% removal should pose little risk of harm to leaf litter breakdown processes or aquatic invertebrate communities beyond any impacts that might arise from upland logging disturbance or catchment‐wide influences. However, the results should be viewed in the context of the natural disturbance (summer drought conditions) through the post‐logging assessment period of this study. Post‐logging summer drought conditions may have masked or confounded logging impacts on streams.
Early predictors of morbidity and mortality in trauma patients treated in the intensive care unit
Authors: BRATTSTRÖM O. , GRANATH F. , ROSSI P. , OLDNER A. 
Published: July 2010

Background: We investigated the incidence and severity of post‐injury morbidity and mortality in intensive care unit (ICU)‐treated trauma patients. We also identified risk factors in the early phase after injury that predicted the later development of complications.Methods: A prospective observational cohort study design was used. One hundred and sixty‐four adult patients admitted to the ICU for more than 24 h were included during a 21‐month period. The incidence and severity of morbidity such as multiple organ failure (MOF), acute lung injury (ALI), severe sepsis and 30‐day post‐injury mortality were calculated and risk factors were analyzed with uni‐ and multivariable logistic regression analysis.Results: The median age was 40 years, the injury severity score was 24, the new injury severity score was 29, the acute physiology and chronic health evaluation II score was 15, sequential organ failure assessment maximum was 7 and ICU length of stay was 3.1 days. The incidences of post‐injury MOF were 40.2%, ALI 25.6%, severe sepsis 31.1% and 30‐day mortality 10.4%. The independent risk factors differed to some extent between the outcome parameters. Age, severity of injury, significant head injury and massive transfusion were independent risk factors for several outcome parameters. Positive blood alcohol was only a predictor of MOF, whereas prolonged rescue time only predicted death. Unexpectedly, injury severity was not an independent risk factor for mortality.Conclusions: Although the incidence of morbidity was considerable, mortality was relatively low. Early post‐injury risk factors that predicted later development of complications differed between morbidity and mortality.
The association between early hemodynamic variables and outcome in normothermic comatose patients following cardiac arrest
Authors: TORGERSEN C. , SCHMITTINGER C. A. , TAKALA J. , JAKOB S. M. , DÜNSER M. W. 
Published: July 2010

Background: Currently, few data exist on the association between post‐cardiac arrest hemodynamic function and outcome. In this explorative, retrospective analysis, the association between hemodynamic variables during the first 24 h after intensive care unit admission and functional outcome at day 28 was evaluated in 153 normothermic comatose patients following a cardiac arrest.Methods: Medical records of a multidisciplinary intensive care unit were reviewed for comatose patients (Glasgow Coma Scale ≤9) admitted to the intensive care unit after successful resuscitation from an in‐ or an out‐of‐hospital cardiac arrest. The hourly variable time integral of hemodynamic variables during the first 24 h after admission was calculated. At day 28, outcome was assessed as favorable or adverse based on a Cerebral Performance Category of 1–2 and 3–5, respectively. Bi‐ and multivariate regression models adjusted for relevant confounding variables were used to evaluate the association between hemodynamic variables and functional outcome.Results: One hundred and fifty‐three normothermic comatose patients were admitted after a cardiac arrest, of whom 64 (42%) experienced a favorable outcome. Neither in the adjusted bivariate models (r2, 0.61–0.78) nor in the adjusted multivariate model (r2, 0.62–0.73) was the hourly variable time integral of any hemodynamic variable during the first 24 h after intensive care unit admission associated with functional patient outcome at day 28 in all patients as well as in patients after an in‐ or an out‐of‐hospital cardiac arrest.Conclusion: Commonly measured hemodynamic variables during the first 24 h following intensive care unit admission due to a cardiac arrest do not appear to be associated with the functional outcome at day 28.
Extubation score in the operating room after liver transplantation
Authors: SKURZAK S. , STRATTA C. , SCHELLINO M. M. , FOP F. , ANDRUETTO P. , GALLO M. , RAMPA P. , CRUCITTI M. , ZABATTA D. , PANIO A. , CERUTTI E. 
Published: July 2010

Background:Early extubation after liver transplantation (LT) is an increasingly applied safe practice. The aim of the present study was to provide a simple extubation rule for accelerated weaning in the operating room (OR).Methods:Data of 597 patients transplanted at the LT center of Turin (Italy) were retrospectively analyzed. Fifty‐two nonextubated patients (excluding those with a scheduled early reoperation) were compared with 545 successfully extubated patients (not in need of reintubation within the first 48 h). Significant variables at univariate analysis were entered into a logistic regression model and the regression coefficients of independent predictors were used to yield a prognostic score called the safe operating room extubation after liver transplantation (SORELT) score.Results:Two major and three minor criteria were found. The major ones were blood transfusions (higher than/or equal to 7 U of packed red blood cells) and end of surgery lactate (higher than/or equal to 3.4 mmol/l). The minor ones were status before LT (home vs. hospitalized patient), duration of surgery (longer than/or equal to 5 h), vasoactive drugs at the end of surgery (dopamine higher than 5 μg/kg/min or norepinephrine higher than 0.05 μg/kg/min). Patients who fulfill the SORELT score‐derived criteria (fewer than two major/one major plus two minor/three minor criteria) can be considered for OR extubation.Conclusion:Early extubation after LT requires a very careful assessment of the pre‐operative, intraoperative, graft and post‐operative care data available. The SORELT score helps as a simple and objective aid in considering such a decision.
Insights into the adaptive significance of vertical pupil shape in snakes
Authors: BRISCHOUX F. , PIZZATTO L. , SHINE R. 
Published: July 2010

AbstractPupil shape in vertebrates ranges from circular to vertical, with multiple phylogenetic shifts in this trait. Our analyses challenge the widely held view that the vertical pupil evolved as an adaptation to enhance night vision. On functional grounds, a variable‐aperture vertical pupil (i) allows a nocturnal species to have a sensitive retina for night vision but avoid dazzle by day by adjusting pupil closure, and (ii) increases visual acuity by day, because a narrow vertical pupil can project a sharper image onto the retina in the horizontal plane. Detection of horizontal movement may be critical for predators that wait in ambush for moving prey, suggesting that foraging mode (ambush predation) as well as polyphasic activity may favour the evolution of vertical pupil shape. Camouflage (disruption of the circular outline of the eye) also may be beneficial for ambush predators. A comparative analysis in snakes reveals significant functional links between pupil shape and foraging mode, as well as between pupil shape and diel timing of activity. Similar associations between ambush predation and vertically slit pupils occur in lizards and mammals also, suggesting that foraging mode has exerted major selective forces on visual systems in vertebrates.
Effects of carvedilol on delayed rectifier and transient inactivating potassium currents in rat hippocampal CA1 neurons
Authors: Duan Jing‐Jing , Wang Qin , Deng Chun‐Yu , Kuang Su‐Juan , Chen Ru‐Zhu , Tao Liang 
Published: July 2010

Summary1. The aims of the present study were to investigate the mechanism(s) underlying the protective effect of carvedilol against neural damage.2. The transient inactivating potassium current (IA) and the delayed rectifier potassium current (IK) in rat hippocampal CA1 pyramidal neurons were recorded using whole‐cell patch‐clamp techniques.3. Carvedilol (0.1–3 μmol/L) significantly inhibitedIKwith an IC50of 1.3 μmol/L and the inhibition was voltage independent. Over the same concentration range, carvedilol had no effect on the amplitude ofIA. At 1 μmol/L, carvedilol did not significantly change the steady state activation curves ofIAandIK, but did negatively shift their steady state inactivation curves. Recovery from inactivation was slowed for bothIAandIK. The inhibitory effect of carvedilol onIKwas not affected by the adrenoceptor agonists phenylephrine and prazosin or the adrenoceptor antagonist isoproterenol, but propranolol was able to shift the dose–response curve of carvedilol forIKto the right.4. BecauseIKis the main pathway for loss of intracellular potassium from depolarized neurons, selective obstruction ofIKby carvedilol could be useful for neuroprotection.
Hyperglycaemia in hospital inpatients: still a sticky situation
Authors: Tonks K. T. , Jones G. R. , McGeechan K. , Campbell L. V. 
Published: July 2010

AbstractBackground: Diabetes diagnosis is delayed 4–7 years and 50% are undiagnosed. Forty percent of hospitalized patients with any blood glucose level (BGL) ≥10 mmol/L have diabetes 3 months post‐discharge, yet less than 5% are detected in hospital. We review identification of, and responses to, hyperglycaemia in inpatients at a teaching hospital.Methods: The world's largest retrospective review of medical records for inpatients with venous BGL ≥11.1 mmol/L without known diabetes over 12 months (2005–2006). The primary outcome was recognition of hyperglycaemia; secondary outcomes were treatment and documentation of follow up. Logistic regression was performed with variables including BGL, admitting team, length of stay and endocrine team review.Results: Of 10 973 people screened, 162 were eligible. The median age was 58 years and BGL 13.3 mmol/L, with increased mortality and length of stay. Hyperglycaemia was noted as definitely in 26%, maybe in 24% and definitely not in 50%. Forty percent of patients were treated in hospital and 19% on discharge. Follow up was documented for 24%. A higher BGL and review by the endocrine team were strongly associated with clinical recognition on uni‐ and multivariate analyses. However, where an endocrine review was sought for non‐hyperglycaemia reasons, similar rates of non‐recognition occurred.Conclusion: Despite evidence for improved inpatient outcomes when treated, and high short‐term progression to frank diabetes, inpatient hyperglycaemia remains frequently missed. In‐hospital recognition is cheap, and vital for the implementation of activities to improve outcomes and prevent progression and complications. Changes to systems for checking pathology results, medical officer education and inpatient screening guidelines are indicated.
Metastatic osteosarcoma to the breast: A rare case
Authors: Vieira Sabas Carlos , Tavares Marília Buenos Aires Cabral , Da Cruz Filho Alexandre Jorge Gomes , Sousa Rodrigo Beserra , Dos Santos Lina Gomes 
Published: July 2010

AbstractOsteosarcoma is the most common malignant bone neoplasia and metastasizes mainly to the lung. Breast metastasis is an extremely rare event and poorly reported in the literature. We present a case of a 51‐year‐old patient, with a past surgical history of thigh osteosarcoma presented metastasis to the right breast and lung. She underwent the metastasis resection and later abandoned the treatment. Metastasis of osteosarcoma to the breast is an extremely rare event, but this diagnosis should be considered when meeting patients with a large breast nodule and a past history of osteosarcoma.
Analysis of birth‐related medical malpractice litigation cases in Japan: Review and discussion towards implementation of a no‐fault compensation system
Authors: Uesugi Nana , Yamanaka Michiko , Suzuki Toshihiro , Hirahara Fumiki 
Published: July 2010

AbstractAim:  We examined birth‐related malpractice civil litigation cases in Japan to clarify the actual status related to the implementation of an obstetrical no‐fault compensation system in 2009.Material & Methods:  In this retrospective review, we analyzed legal and medical information from 64 cases with a delivery date after 1987 and a judgment date between April 1997 and March 2007.Results:  The malpractice claim was accepted in 44 cases and rejected in 20 cases. The period from the delivery to the judgment date was lengthy (90.1 months overall). The average amount of damages awarded was ¥97 810 000 for cases of cerebral palsy (CP). Preterm births and less than 2500 g infants represented a higher incidence rate in the rejected cases. There were 32 cases (50.0%) with CP, 18 (28.1%) with infant death, 10 (15.6%) with neonatal death, and 4 (6.3%) with fetal death. Twenty‐three of 44 accepted cases (52.3%) and 11/20 rejected cases (55.0%) had a gestational age of more than 33 weeks at birth and weighed more than 2000 g. Forced deliveries were performed in 45/64 cases (70.3%), and augmentation/induction of labor was performed in 28/64 cases (43.8%). There were 13/16 (81.3%) accepted cases that underwent vacuum and/or forceps extraction after labor augmentation/induction.Conclusions:  More than half of our cases could be sufficient for a no‐fault compensation system in Japan. Though the system is considered to have some problems that need to be solved, this finding suggests that many children and their families may benefit from the new system without having to file.
Clinical diagnosis and treatment of acute fatty liver of pregnancy: A literature review and 11 new cases
Authors: Wei Qiang , Zhang Li , Liu Xinghui 
Published: July 2010

AbstractAim:  To determine the clinical presentation, biochemical findings, complications, clinical diagnosis and management of patients with acute fatty liver of pregnancy (AFLP). The influence of the mode of delivery on maternal–perinatal mortality is analyzed and two methods of diagnostic imaging are compared.Material & Methods:  Eleven cases of AFLP identified at the West China Second Hospital of Sichuan University from January 2003 to June 2008 were studied. To provide additional evidence, 342 cases of AFLP were reviewed retrospectively from original articles researched in the China National Knowledge Infrastructure between the same period.Results:  All cases presented with a prodrome of nausea, vomiting, malaise and jaundice. Raised transaminases and serum bilirubin were found in all patients (100%), hypoglycemia was found in two patients (18.2%) and hypoproteinemia was found in five patients (45.5%). All cases were confirmed by diagnostic criteria and clinical assessment. Diagnostic imaging helped to confirm the diagnoses. Ultrasound was used to diagnose nine patients (81.8%), and two (18.2%) patients were diagnosed by computerized tomography. Except for one patient whose labor was induced with oxytocin because of fetal death before admission, all other pregnancies were terminated by cesarean section within 24 h of definitive diagnosis. All patients and neonates survived delivery. One (9.1%) maternal death and one (7.2%) fetal death occurred.Conclusions:  Early diagnosis, termination of pregnancy by Cesarean section as soon as possible and comprehensive therapy are crucial for improving the prognoses of both mother and newborn.
Glutamate receptor phosphorylation and trafficking in pain plasticity in spinal cord dorsal horn
Authors: Liu Xue Jun , Salter Michael W. 
Published: July 2010

AbstractGlutamate is the major excitatory neurotransmitter in the central nervous system. Considerable evidence suggests that both ionotropic and metabotropic glutamate receptors are involved in pain hypersensitivity. However, glutamate receptor‐based therapies are limited by side‐effects because the activities of glutamate receptors are essential for many important physiological functions. Here, we review recent key findings in molecular and cellular mechanisms of glutamate receptor regulation and their roles in triggering and sustaining pain hypersensitivity. Targeting these molecular mechanisms could form the basis for new therapeutic strategies for the treatment of chronic pain.
Environmental correlates of physical activity and dietary behaviours among young people: a systematic review of reviews
Authors: de Vet E. , de Ridder D. T. D. , de Wit J. B. F. 
Published: July 2010

SummaryAn extensive body of research exists on environmental influences on weight‐related behaviours in young people. Existing reviews aimed to synthesize this body of work, but generally focused on specific samples, behaviours or environmental influences and integration of findings is lacking. Hereto, we reviewed 18 reviews representing 671 unique studies, aiming to identify what environmental factors do and do not affect physical activity and dietary behaviours in children and adolescents. Eleven reviews focused exclusively on physical activity, six on diet, and one review focused on both physical activity and dietary behaviours with only small overlap in included studies. Physical activity was more consistently related to school and neighbourhood characteristics than to interpersonal and societal environments. In contrast, interpersonal factors played a pronounced role in dietary behaviours; no school, neighbourhood or societal factors were consistently related to dietary behaviours. This review of reviews adds to the literature by providing a comprehensive synthesis of factors related to physical activity and dietary behaviours that could be targeted in interventions. Moreover, by identifying factors that are unrelated to physical activity and dietary behaviours, this review may help to narrow the scope of future studies and environmental interventions.