bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypertonic Saline Hydroxyethylstarch Restores Right Ventricular-Arterial Coupling after Normovolemic Hemodilution in Piglets
Authors: Kerbaul François , Rondelet Benoît , Bénas Vincent , Grisoli Dominique , De Waroquier Arnaud , Fesler Pierre , Fusai Thierry , Brimioulle Serge 
Published: May 2011

Background
Normovolemic hemodilution is known to inhibit hypoxic pulmonary vasoconstriction. How the coupling between the pulmonary arterial (PA) circulation and the right ventricle (RV) is affected by normovolemic hemodilution and by the composition of replacement solutions remains unknown. Therefore, the effects of isotonic and hypertonic saline hydroxyethylstarch solutions on the pulmonary circulation and RV, in control and hypoxic conditions, were compared.

Methods
Anesthetized piglets (n = 14) were equipped with manometer-tipped catheters in the RV and main PA and an ultrasonic flow probe around the main PA. The pulmonary circulation was assessed by pressure-flow relations and vascular impedance, RV afterload by effective arterial elastance (Ea), RV contractility by end-systolic elastance (Ees), and RV-PA coupling by the Ees/Ea ratio. Measurements were done in control (Fio2 0.40) and hypoxic (Fio2 0.12) conditions before and after acute normovolemic hemodilution with either 20 ml/kg isotonic saline hydroxyethylstarch (hydroxyethylstarch 130/0.4 6% in NaCl 0.9%, Voluven, Fresenius-Kabi, Sevres, France) or 5 ml/kg hypertonic saline hydroxyethylstarch (hydroxyethylstarch 200/0.5 6% in NaCl 7.2%, HyperHES, Fresenius-Kabi) solutions.

Results
Hypoxic pulmonary vasoconstriction was associated with proportional increases in Ea and Ees and did not affect RV-PA coupling. Hemodilution attenuated the hypoxic response. Hemodilution with isotonic saline hydroxyethylstarch did not affect the RV-PA coupling, whereas hemodilution with hypertonic saline hydroxyethylstarch increased Ees and the Ees/Ea ratio.

Conclusion
In experimental normovolemic hemodilution, both in control and in hypoxic conditions, RV-PA coupling is unaffected by isotonic saline hydroxyethylstarch but improved by hypertonic saline hydroxyethylstarch, mainly because of an increase in RV contractility.
HLA‐DQ Genotyping Combined With Serological Markers for the Diagnosis of Celiac Disease: Is Intestinal Biopsy Still Mandatory?
Authors: Clouzeau‐Girard Haude , Rebouissoux Laurent , Taupin Jean‐Luc , Le Bail Brigitte , Kalach Nicolas , Michaud Laurent , Dabadie Alain , Olives Jean‐Pierre , Blanco Patrick , Morali Alain , Moreau Jean‐François , Lamireau Thierry 
Published: May 2011

ABSTRACTObjectives:The aim of this study was to evaluate the value of HLA‐DQ2/DQ8 allelic genotyping combined with serologic testing for the diagnosis of celiac disease (CD).Patients and Methods:One hundred seventy children, who underwent jejunal biopsy for digestive symptoms or malnutrition, were tested for HLA‐DQ2/DQ8 and serologic markers (tTG and/or anti‐endomysial antibodies). Children were classified in 2 groups, according to jejunal histology: group 1, when partial or total villous atrophy was associated with an increased intraepithelial lymphocytosis suggesting CD, and group 2, when these histological criteria were absent.Results:Eight children were excluded from the study because their intestinal histology was not informative; 82 children were classified in group 1 and 80 in group 2. Eighty‐one of 82 children in group 1 were positive for HLA and serologic testing. The other child had negative HLA and serologic testing but marked villous atrophy, and further investigation showed an allergic disease. Among the 80 children in group 2, 53 were negative for both HLA and serologic testing, 22 were positive for HLA but negative for serologic testing, 2 were negative for HLA and positive for serologic testing, and 3 patients were positive for both HLA and serologic testing. The last 3 children were shown to have an autoimmune background and had probably a latent form of CD. The association of HLA‐DQ2/DQ8 and serologic markers had a sensitivity of 98.8%, a specificity of 96.2%, a positive likelihood ratio of 26.3, and a negative likelihood ratio of 0.013.Conclusions:The association of positive HLA‐DQ2/DQ8 and serologic testing has a high predictive value for CD. We suggest that symptomatic children with high titers of immunoglobulin (Ig)A tTG could be diagnosed as patients with CD without performing jejunal biopsy. In other children, HLA‐DQ2/DQ8 could be useful to exclude the diagnosis of CD if negative. In cases of low IgA tTG titers or in patients with IgA deficiency, intestinal biopsy remains mandatory.
Do Children With IBD Really Respond Better Than Adults to Thiopurines?
Authors: Goodhand JR , Tshuma N , Rao A , Kotta S , Wahed M , Croft NM , Sanderson IR , Epstein J , Rampton DS 
Published: May 2011

ABSTRACTBackground and Objectives:Children and adolescents with inflammatory bowel disease (IBD) have more extensive and severe disease than adults. Despite a lack of comparative studies, thiopurines are frequently cited as being more efficacious in children. To test this assertion, we compared the efficacy of thiopurines in children with IBD with that in adults matched for disease phenotype.Patients and Methods:Fifty paediatric and adult patients with IBD started on a thiopurine were matched for sex, disease type, and extent. Retrospective data were obtained by electronic case note review, and corticosteroid‐free clinical remission and tolerance rates at 6 months as well as relapse rates during the subsequent year were recorded.Results:Adverse effects caused discontinuation of thiopurines in 1 of 50 children and 16% (8/50) of adults (P < 0.05). At 6 months, steroid‐free remission was achieved in 30% (15/50) of children and 38% (19/50) of adults (P = 0.53). No differences in remission rates were seen according to disease type. At the end of the following year, 73% (11/15) of children and 68% (13/19) of adults remained in remission (P = 1).Conclusions:Thiopurines are tolerated better by children. When phenotype is matched, there is no difference in the therapeutic response to thiopurines between children and adults with IBD.
Variation in Care for Children With Esophageal Varices: A Study of Physicians', Patients', and Families' Approaches and Attitudes
Authors: Gana Juan Cristóbal , Valentino Pamela L , Morinville Veronique , O'Connor Constance , Ling Simon C 
Published: May 2011

ABSTRACTBackground and Aims:Inadequate evidence to guide the management of children with esophageal varices may lead to variation in care and the provision of poor‐quality care to some children. The aims of the study were to describe approaches taken by pediatric gastroenterologists for the management of esophageal varices in children, and to determine the attitudes of children, parents, and physicians toward screening endoscopy for identification of varices.Methods:Canadian pediatric gastroenterologists and hepatologists were questioned about their approaches to screening for esophageal varices and therapy to prevent or treat variceal hemorrhage. Consecutive children with portal hypertension and their parents were surveyed about attitudes to screening endoscopy.Results:Forty‐seven of 72 (65%) physicians responded. Seventy percent of respondents screen for esophageal varices in selected children, most using endoscopy (77%). Fifty‐eight percent of respondents who screen for varices would provide primary prophylactic treatment. Most would treat an acute variceal bleed with antibiotics, acid suppression, octreotide, and endoscopy within 24 hours (76%) and then secondary prophylaxis with endoscopic variceal ligation (96%) or β‐blockers (28%). Among 29 families surveyed, 63% of parents and 50% of patients would agree to screening endoscopy to understand their risk of variceal bleeding and 67% if prophylactic therapy were available. Families were more concerned about the risk of endoscopic adverse events than were gastroenterologists.Conclusions:Pediatric gastroenterologists vary in the care they provide for children at risk for esophageal varices and their attitudes toward the role of screening endoscopy differ from that of their patients. Further evidence is required to support practice guidelines that may reduce variation in care and thus improve its quality.
Gene Expression Profiling Reveals Upregulated UCA1 and BMF in Gallbladder Epithelia of Children With Pancreaticobiliary Maljunction
Authors: Kaneko Kenitiro , Ito Yoshinori , Ono Yasuyuki , Tainaka Takahisa , Tsuchiya Hironori , Shimoyama Yoshie , Ando Hisami 
Published: May 2011

ABSTRACTBackground:Pancreaticobiliary maljunction is usually associated with choledochal cysts and often causes biliary carcinoma; however, the mechanism of carcinogenesis remains unknown. No study has analyzed overall changes in genetic expression beginning during childhood in gallbladder epithelia with pancreaticobiliary maljunction.Patients and Methods:The genomewide expression of gallbladder epithelia was analyzed in 6 children with pancreaticobiliary maljunction and in 4 pediatric controls. Selected genes that were expressed differentially were further analyzed by the real‐time reverse transcription‐polymerase chain reaction (RT‐PCR). The products of upregulated genes confirmed by real‐time RT‐PCR were immunohistochemically analyzed using gallbladders from 19 children with pancreaticobiliary maljunction, 5 pediatric controls, and 5 children with gallstones.Results:Microarray analysis identified 188 upregulated and 160 downregulated genes. RT‐PCR confirmed upregulation in 5 of 6 genes and downregulation in 1 of 5 genes, including UCA1, DUOX2, DUOXA2, ID1, BMF, and GP2. Immunohistochemistry showed a significantly higher expression of BMF in the pancreaticobiliary maljunction patients than in the controls and gallstone patients.Conclusions:This study identified several deregulated genes in the gallbladder of children with pancreaticobiliary maljunction, which may contribute to the pathophysiology. UCA1, a noncoding RNA, is an oncofetal gene, and its upregulation may be important for biliary carcinogenesis. The elevated expression of BMF may function as an apoptotic activator in proliferative gallbladder epithelia.
A mechanism‐based model for the population pharmacokinetics of free and bound aflibercept in healthy subjects
Authors: Thai Hoai‐Thu , Veyrat‐Follet Christine , Vivier Nicole , Dubruc Catherine , Sanderink Gerard , Mentré France , Comets Emmanuelle 
Published: May 2011

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Anti‐angiogenic drugs have been developed as an effective therapeutic strategy for inhibiting tumour growth. However, their pharmacokinetics (PK) and their ligand inhibition properties have not been well characterized. The binding to a circulating target, such as vascular endothelial growth factor (VEGF), makes the PK of these drugs more complex. WHAT THIS STUDY ADDS • The underlying mechanism of disposition of aflibercept, where a saturable and high affinity binding of aflibercept to VEGF was adequately characterized by the Michaelis–Menten approximation of a target‐mediated drug distribution model. To our knowledge, this is the first published mechanism‐based population PK model for an anti‐VEGF drug.AIM Aflibercept (VEGF‐Trap), a novel anti‐angiogenic agent that binds to VEGF, has been investigated for the treatment of cancer. The aim of this study was to develop a mechanism‐based pharmacokinetic (PK) model for aflibercept to characterize its binding to VEGF and its PK properties in healthy subjects.METHODS Data from two phase I clinical studies with aflibercept administered as a single intravenous infusion were included in the analysis. Free and bound aflibercept concentration−time data were analysed using a nonlinear mixed‐effects modelling approach with MONOLIX 3.1.RESULTS The best structural model involved two compartments for free aflibercept and one for bound aflibercept, with a Michaelis–Menten type binding of free aflibercept to VEGF from the peripheral compartment. The typical estimated clearances for free and bound aflibercept were 0.88 l day−1 and 0.14 l day−1, respectively. The central volume of distribution of free aflibercept was 4.94 l. The maximum binding capacity was 0.99 mg day−1 and the concentration of aflibercept corresponding to half of maximum binding capacity was 2.91 µg ml−1. Interindividual variability of model parameters was moderate, ranging from 13.6% (Vmax) to 49.8% (Q).CONCLUSION The present PK model for aflibercept adequately characterizes the underlying mechanism of disposition of aflibercept and its nonlinear binding to VEGF.
Thyroid incidentaloma identified by 18F‐fluorodeoxyglucose positron emission tomography with CT (FDG‐PET/CT): clinical and pathological relevance
Authors: Pagano L. , Samà M. T. , Morani F. , Prodam F. , Rudoni M. , Boldorini R. , Valente G. , Marzullo P. , Baldelli R. , Appetecchia M. , Isidoro C. , Aimaretti G. 
Published: May 2011

AbstractObjective  The percentage of patients with thyroid cancer incidentally diagnosed during a 18F‐fluorodeoxyglucose Positron Emission Tomography with computed tomography (CT) (FDG‐PET/CT) for nonthyroid diseases ranges between 26% and 50%.Design  Retrospective assessment of the clinical and pathological features of thyroid incidentalomas at FDG‐PET/CT, aiming to identify potential predictors of malignancy.Patients  Fifty‐two patients with incidental thyroid uptake at FDG‐PET/CT were retrospectively included [38 W, age 64·1 ± 12·5 years (mean ± SD)]. An arbitrary cut‐off level of 5·0 for the ‘maximum standardized uptake value’ (SUV max) was chosen to differentiate benign from malignant tumours. Complete thyroid function, neck ultrasonography (US) features, and cyto‐histological results were reported for all cases.Results  In our institution, the prevalence of incidental thyroid 18F‐fluorodeoxyglucose (18F‐FDG) uptake was nearly 1·76%. The prevalence of focal uptake correlated with greater risk of malignancy (P < 0·01). In particular, the euthyroidism (P < 0·003) and a SUV max >5·0 (P < 0·0001) were associated with the diagnosis of thyroid cancer. Diffusely increased FDG‐PET/CT uptake in the thyroid was related to benign conditions.Conclusions  The presence of focal uptake with high SUV max and euthyroidism correlate with high likelihood of malignancy. Performing a neck US would have to be recommended in all patients with euthyroidism and an incidental FDG‐PET/CT focal thyroid uptake. We do not suggest to use FDG‐PET/CT as a screening tool for thyroid cancer in the general population, because of both its high cost and low incidence of thyroid incidentaloma at FDG‐PET/CT.
Body mass index and obesity in adolescents in a psychiatric medium secure service
Authors: Haw C. , Bailey S. 
Published: May 2011

How to cite this article
Haw C. & Bailey S. (2012) Body mass index and obesity in adolescents in a psychiatric medium secure service. J Hum Nutr Diet.25, 167–171AbstractBackground:  Obesity is more prevalent in adults with severe mental illness than in the general population. Little is known about the prevalence of obesity in mentally ill adolescents. The present study aimed to determine the prevalence of obesity and its complications among inpatients in a psychiatric medium secure service for adolescents and young people.Methods:  The study comprised a cross‐sectional survey of routinely collected data, including body mass index (BMI) both currently and 3 months previously, serum cholesterol and psychotropic prescription data, as well as the number of patients known to have type II diabetes mellitus and hypertension.Results:  Of the 95 patients studied, 33 (34.7%) were overweight and 45 (47.4%) were obese. Twenty‐six (56.5%) females were obese, including seven who were morbidly obese. Nineteen (38.8%) males were obese, one of whom was morbidly obese. Prescription of antipsychotics was associated with obesity and the total percentage dose of antipsychotic correlated with BMI. Two patients had type 2 diabetes mellitus and two had hypertension. Seventeen patients had a serum cholesterol of over 5 mm.Conclusions:  Being overweight and obesity were very common in the young people studied and appeared to be related to the prescription of antipsychotics. Interventions are needed to reduce unhealthy raised BMI and prevent the physical complications of obesity.
Fecundity selection on ornamental plumage colour differs between ages and sexes and varies over small spatial scales
Authors: PARKER T. H. , WILKIN T. A. , BARR I. R. , SHELDON B. C. , ROWE L. , GRIFFITH S. C. 
Published: May 2011

AbstractAvian plumage colours are some of the most conspicuous sexual ornaments, and yet standardized selection gradients for plumage colour have rarely been quantified. We examined patterns of fecundity selection on plumage colour in blue tits (Cyanistes caeruleus L.). When not accounting for environmental heterogeneity, we detected relatively few cases of selection. We found significant disruptive selection on adult male crown colour and yearling female chest colour and marginally nonsignificant positive linear selection on adult female crown colour. We discovered no new significant selection gradients with canonical rotation of the matrix of nonlinear selection. Next, using a long‐term data set, we identified territory‐level environmental variables that predicted fecundity to determine whether these variables influenced patterns of plumage selection. The first of these variables, the density of oaks within 50 m of the nest, influenced selection gradients only for yearling males. The second variable, an inverse function of nesting density, interacted with a subset of plumage selection gradients for yearling males and adult females, although the strength and direction of selection did not vary predictably with population density across these analyses. Overall, fecundity selection on plumage colour in blue tits appeared rare and inconsistent among sexes and age classes.
The development of pistillate and perfect florets in Xeranthemum squarrosum (Asteraceae)
Authors: Dadpour M. R. , Naghiloo S. , Neycharan S. Faridi 
Published: May 2011

AbstractThe formation of capitulum inflorescence with two different types of floret is an interesting issue in floral biology and evolution. Here we studied the inflorescence, floral ontogeny and development of the everlasting herb, Xeranthemum squarrosum, using epi‐illumination microscopy. The small vegetative apex enlarged and produced involucral bracts with helical phyllotaxy, which subtended floret primordia in the innermost whorl. Initiation of floret primordia was followed by an acropetal sequence, except for pistillate peripheral florets. The origin of receptacular bracts was unusual, as they derived from the floral primordia rather than the receptacular surface. The order of whorl initiation in both disc and pistillate flowers included corolla, androecium and finally calyx, together with the gynoecium. The inception of sepals and stamens occurred in unidirectional order starting from the abaxial side, whereas petals incepted unidirectionally from the adaxial or abaxial side. Substantial differences were observed in flower structure and the development between pistillate and perfect florets. Pistillate florets presented a zygomorphic floral primordium, tetramerous corolla and androecium and two sepal lobes. In these florets, two sepal lobes and four stamen primordia stopped growing, and the ovary developed neither an ovule nor a typical stigma. The results suggest that peripheral pistillate florets in X. squarrosum, which has a bilabiate corolla, could be considered as an intermediate state between ancestral bilabiate florets and the derived ray florets.
Photosynthetic acclimation to light in woody and herbaceous species: a comparison of leaf structure, pigment content and chlorophyll fluorescence characteristics measured in the field
Authors: Hallik L. , Niinemets Ü. , Kull O. 
Published: May 2011

AbstractAcclimation of foliage photosynthetic properties occurs with varying time kinetics, but structural, chemical and physiological factors controlling the kinetics of acclimation are poorly understood, especially in field environments. We measured chlorophyll fluorescence characteristics, leaf total carotenoid (Car), chlorophyll (Chl) and nitrogen (N) content and leaf dry mass per area (LMA) along vertical light gradients in natural canopies of the herb species, Inula salicina and Centaurea jacea, and tree species, Populus tremula and Tilia cordata, in the middle of the growing season. Presence of stress was assessed on the basis of night measurements of chlorophyll fluorescence. Our aim was to compare the light acclimation of leaf traits, which respond to light availability at long (LMA and N), medium (Chl a/b ratio, Car/Chl ratio) and short time scales (fluorescence characteristics). We found that light acclimation of nitrogen content per unit leaf area (Narea), chlorophyll content per unit dry mass (Chlmass) and Chl/N ratio were related to modifications in LMA. The maximum PSII quantum yield (Fv/Fm) increased with increasing growth irradiance in I. salicina and P. tremula but decreased in T. cordata. Leaf growth irradiance, N content and plant species explained the majority of variability in chlorophyll fluorescence characteristics, up to 90% for steady‐state fluorescence yield, while the contribution of leaf total carotenoid content was generally not significant. Chlorophyll fluorescence characteristics did not differ strongly between growth forms, but differed among species within a given growth form. These data highlight that foliage acclimation to light is driven by interactions between traits with varying time kinetics.
Interchangeable effects of gibberellic acid and temperature on embryo growth, seed germination and epicotyl emergence in Ribes multiflorum ssp. sandalioticum (Grossulariaceae)
Authors: Mattana E. , Pritchard H. W. , Porceddu M. , Stuppy W. H. , Bacchetta G. 
Published: May 2011

AbstractMorphophysiological dormancy was investigated in seeds of Ribes multiflorum Kit ex Roem et Schult. ssp. sandalioticum Arrigoni, a rare mountain species endemic to Sardinia (Italy). There were no differences in imbibition rates between intact and scarified seeds, suggesting a lack of physical dormancy, while methylene blue solution (0.5%) highlighted a preferential pathway for solution entrance through the raphe. Embryos were small at seed dispersal, with an initial embryo:seed ratio (E:S) of ca. 0.2 (embryo length, ca. 0.5 mm), whereas the critical E:S ratio for germination was three times longer (ca. 0.6). Gibberellic acid (GA3, 250 mg·l−1) and warm stratification (25 °C for 3 months) followed by low temperature (<15 °C) enhanced embryo growth rate (maximum of ca. 0.04 mm·day−1 at 10 °C) and subsequent seed germination (radicle emergence; ca. 80% at 10 °C). Low germination occurred at warmer temperatures, and cold stratification (5 °C for 3 months) induced secondary dormancy. After radicle emergence, epicotyl emergence was delayed for ca. 2 months for seeds from three different populations. Mean time of epicotyl emergence was affected by GA3. Seeds of this species showed non‐deep simple (root) ‐ non‐deep simple (epicotyl) morphophysiological dormancy, highlighting a high synchronisation with Mediterranean seasonality in all the investigated populations.