bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenges of prompt identification and resuscitation in children with acute fulminant myocarditis: case series and review of the literature
Authors: Ramachandra Geethanjali , Shields Lynn , Brown Katherine , Ramnarayan Padmanabhan 
Published: July 2010

Aim:  To describe the clinical presentation, triage, resuscitation and outcome of acute fulminant myocarditis in children presenting to district hospitals and referred for cardiac intensive care.Methods:  Case series describing five patients (from 2 weeks to 12 years old) with a diagnosis of acute fulminant myocarditis, presented to outlying hospitals between December 2006 and December 2007 and retrieved to a cardiac intensive care unit.Results:  All children were admitted with non‐specific symptoms such as vomiting, cough and poor feeding to their local hospital, where various provisional diagnoses such as viral gastroenteritis, bronchitis or renal failure were considered. Acute physiological deterioration usually prompted the referral for intensive care. Two children died at the referring hospital during stabilisation by the retrieval team. Three children survived transport to intensive care and to hospital discharge; two received mechanical support and one underwent urgent orthotopic heart transplantation. Enterovirus and parvovirus were identified as causative agents in two patients. In one case, macrophage activation syndrome was diagnosed although no clear viral trigger was identified. Median length of hospitalisation among survivors was 33 days, and mechanical cardiac support was required for a median of 12 days.Conclusions:  The diagnosis and initial management of acute fulminant myocarditis is extremely challenging. Prognosis for patients admitted to a cardiac centre for early mechanical support can be very favourable, while a delay in considering the diagnosis may result in poor outcome. The diagnosis of myocarditis should be considered in any previously well child presenting with a viral prodrome and non‐specific organ dysfunction associated with dysrhythmias, shock or acute heart failure, even in the absence of cardiomegaly.
Investigation of suspected Guillain–Barre syndrome in childhood: What is the role for gadolinium enhanced magnetic resonance imaging of the spine?
Authors: Smith Nicholas , Pereira John , Grattan‐Smith Padraic 
Published: July 2010

Aim:  To review the role of gadolinium‐enhanced magnetic resonance imaging of the spine in the diagnosis of paediatric Guillain–Barre syndrome and compare it with nerve conduction studies and cerebrospinal fluid analysis.Methods:  A retrospective review of investigations undertaken in children admitted to our institution with acute Guillain–Barre syndrome over a 10‐year period was performed.Results:  Seven of eight children (88%) displayed post‐gadolinium nerve root enhancement consistent with Guillain–Barre syndrome. This compared with supportive nerve conduction studies in 21/24 children (88%) and cerebrospinal fluid protein analysis consistent with the diagnosis in 16/20 children (80%).Conclusion:  Nerve conduction studies are the recognised ‘gold standard’ technique for confirming a clinical diagnosis of Guillain–Barre syndrome. In this study, a high positive rate was demonstrated. While more experience is necessary, this study and the literature support gadolinium enhanced magnetic resonance imaging of the spine as a valuable, although not necessarily superior, investigation in the diagnosis of Guillain–Barre syndrome. It may be of particular benefit when specialist neurophysiology expertise is unavailable.
Late toxicity after conformal and intensity‐modulated radiation therapy for prostate cancer: Impact of previous surgery for benign prostatic hyperplasia
Authors: Odrazka Karel , Dolezel Martin , Vanasek Jaroslav , Vaculikova Miloslava , Zouhar Milan , Sefrova Jana , Paluska Petr , Vosmik Milan , Kohlova Tereza , Kolarova Iveta , Navratil Pavel , Brodak Milos , Prosvic Petr , Hoffmann Petr 
Published: July 2010

Objectives:  To retrospectively compare late toxicity of conventional‐dose three‐dimensional conformal radiation therapy (3D‐CRT) and high‐dose intensity‐modulated radiation therapy (IMRT) for prostate cancer.Methods:  A total of 340 patients with T1‐3 prostate cancer were treated with 3D‐CRT (n = 228) and IMRT (n = 112). The median follow‐up time was 5.9 years and 3.0 years, respectively. The prescription dose was 70 Gy for 3D‐CRT and 78 Gy for IMRT. Late gastrointestinal (GI) and genitourinary (GU) toxicities were graded according to the Fox Chase modification of the Radiation Therapy Oncology Group and Late Effects Normal Tissue Task Force criteria.Results:  There was no difference between 3D‐CRT and IMRT in the incidence of GI and GU toxicity at 3 years. On multivariate analysis, transurethral resection of prostate/open transvesical prostatectomy (TURP/TVPE) for benign prostatic hyperplasia, carried out before radiotherapy, significantly increased the risk of Grade ≥2 GU toxicity (risk ratio 1.88). Among patients who experienced TURP/TVPE, the 5‐year actuarial likelihood of Grade 2–3 urinary incontinence was 23%, compared with 9% for those without prostate surgery (P = 0.01).Conclusions:  Tolerance of 3D‐CRT and IMRT was similar, despite the use of high radiation dose with IMRT. Previous TURP/TVPE increased the risk of GU toxicity.
Drugs of abuse and stress impair LTP at inhibitory synapses in the ventral tegmental area
Authors: Niehaus Jason L. , Murali Manjari , Kauer Julie A. 
Published: July 2010

AbstractSynaptic plasticity in the ventral tegmental area (VTA) is modulated by drugs of abuse and stress and is hypothesized to contribute to specific aspects of addiction. Both excitatory and inhibitory synapses on dopamine neurons in the VTA are capable of undergoing long‐term changes in synaptic strength. While the strengthening or weakening of excitatory synapses in the VTA has been widely examined, the role of inhibitory synaptic plasticity in brain reward circuitry is less established. Here, we investigated the effects of drugs of abuse, as well as acute stress, on long‐term potentiation of GABAergic synapses onto VTA dopamine neurons (LTPGABA). Morphine (10 mg/kg i.p.) reduced the ability of inhibitory synapses in midbrain slices to express LTPGABAboth at 2 and 24 h after drug exposure but not after 5 days. Cocaine (15 mg/kg i.p.) impaired LTPGABA24 h after exposure, but not at 2 h. Nicotine (0.5 mg/kg i.p.) impaired LTPGABA2 h after exposure, but not after 24 h. Furthermore, LTPGABAwas completely blocked 24 h following brief exposure to a stressful stimulus, a forced swim task. Our data suggest that drugs of abuse and stress trigger a common modification to inhibitory plasticity, synergizing with their collective effect at excitatory synapses. Together, the net effect of addictive substances or stress is expected to increase excitability of VTA dopamine neurons, potentially contributing to the early stages of addiction.
Glutamate‐induced alterations in Ca2+ signaling are modulated by mitochondrial Ca2+ handling capacity in brain slices of R6/1 transgenic mice
Authors: Rosenstock T. R. , Bertoncini C. R. A. , Teles A. V. , Hirata H. , Fernandes M. J. S. , Smaili S. S. 
Published: July 2010

AbstractHuntington’s disease is a neurodegenerative disorder caused by an expansion of CAGs repeats and characterized by alterations in mitochondrial functions. Although changes in Ca2+ handling have been suggested, the mechanisms involved are not completely understood. The aim of this study was to investigate the possible alterations in Ca2+ handling capacity and the relationship with mitochondrial dysfunction evaluated by NAD(P)H fluorescence, reactive oxygen species levels, mitochondrial membrane potential (ΔΨm) measurements and respiration in whole brain slices from R6/1 mice of different ages, evaluated in situ by real‐time real‐space microscopy. We show that the cortex and striatum of the 9‐month‐old R6/1 transgenic mice present a significant sustained increase in cytosolic Ca2+ induced by glutamate (Glu). This difference in Glu response was partially reduced in R6/1 when in the absence of extracellular Ca2+, indicating that N‐methyl‐d‐aspartate receptors participation in this response is more important in transgenic mice. In addition, Glu also lead to a decrease in NAD(P)H fluorescence, a loss in ΔΨm and a further increase in respiration, which may have evoked a decrease in mitochondrial Ca2+ () uptake capacity. Taken together, these results show that alterations in Ca2+ homeostasis in transgenic mice are associated with a decrease in uptake mechanism with a diminished Ca2+ handling ability that ultimately causes dysfunctions and worsening of the neurodegenerative and the disease processes.
Functional heterogeneity of NMDA receptors in rat substantia nigra pars compacta and reticulata neurones
Authors: Suárez F. , Zhao Q. , Monaghan D. T. , Jane D. E. , Jones S. , Gibb A. J. 
Published: July 2010

AbstractThe nigra substantia nigra pars compacta (SNc) and substantia pars reticulata (SNr) form two major basal ganglia components with different functional roles. SNc dopaminergic (DA) neurones are vulnerable to cell death in Parkinson’s disease, and NMDA receptor activation is a potential contributing mechanism. We have investigated the sensitivity of whole‐cell and synaptic NMDA responses to intracellular ATP and GTP application in the SNc and SNr from rats on postnatal day (P) 7 and P28. Both NMDA current density (pA/pF) and desensitization to prolonged or repeated NMDA application were greater in the SNr than in the SNc. When ATP levels were not supplemented, responses to prolonged NMDA administration desensitized in P7 SNc DA neurones but not at P28. At P28, SNr neurones desensitized more than SNc neurones, with or without added ATP. Responses to brief NMDA applications and synaptic NMDA currents were not sensitive to inclusion of ATP in the pipette solution. To investigate these differences between the SNc and SNr, NR2 subunit‐selective antagonists were tested. NMDA currents were inhibited by ifenprodil (10 μm) and UBP141 (4 μm), but not by Zn2+(100 nm), in both the SNr and SNc, suggesting that SNc and SNr neurones express similar receptor subunits; NR2B and NR2D, but not NR2A. The different NMDA response properties in the SNc and SNr may be caused by differences in receptor modulation and/or trafficking. The vulnerability of SNc DA neurones to cell death is not correlated with NMDA current density or receptor subtypes, but could in part be related to inadequate NMDA receptor desensitization.
Cerebellar Golgi cells in the rat receive convergent peripheral inputs via a lateral reticular nucleus relay
Authors: Xu Wei , Edgley Steve A. 
Published: July 2010

AbstractGolgi cells are important players in the function of the cerebellar cortex, controlling the flow of incoming information from mossy fibres to the granule cells, which excite other cortical neurons. We recently showed that in anaesthetized rats most Golgi cells respond to stimulation of afferents from a very wide peripheral receptive field with a long‐lasting depression of firing. These responses are mediated via a crossed ascending afferent pathway but the supraspinal part of this pathway is unknown. Here we have examined the hypothesis that the lateral reticular nucleus, a brainstem nucleus with known broad afferent convergence that projects mossy fibres to much of the cerebellum, is involved. First, we showed that single‐pulse electrical microstimulation within the lateral reticular nucleus can elicit long‐lasting depressions in Golgi cells, which are qualitatively similar to those evoked by peripheral afferent stimulation. Second, we showed that the amplitude of the depressions of Golgi cell firing evoked by peripheral stimulation can be reduced by pharmacological manipulation of the lateral reticular nucleus, either ipsilateral or contralateral to the stimulus site, with local injections of either the GABAA receptor agonist muscimol or the AMPA receptor blocker 6‐cyano‐7‐nitroquinoxaline‐2,3‐dione. This evidence suggests that the lateral reticular nucleus is a relay nucleus in the brainstem for peripheral afferent information in a pathway that generates Golgi cell long‐lasting depression responses.
Preoperative chemoradiotherapy for rectal cancer: a comparison between intravenous 5‐fluorouracil and oral capecitabine
Authors: Ramani V. S. , Sun Myint A. , Montazeri A. , Wong H. 
Published: July 2010

AbstractIntroduction  Capecitabine provides an attractive alternative to intravenous (IV) 5‐flourouracil (5‐FU) in chemoradiation regimes for rectal cancer by avoiding the need for intravenous access and inpatient stay. We aimed to compare retrospectively the efficacy of concurrent capecitabine with IV 5‐FU in preoperative pelvic chemoradiation schedules for rectal cancer in our centre.Method  Patients treated from January 2005 to June 2007 were included. Information was collected on patient characteristics; treatment details; pathological response to treatment; recurrence and survival. All statistical analyses were performed using SPSS V17.Results  All patients had pelvic radiation. Ninety‐nine patients were treated with capecitabine and 97 with 5‐FU. The two groups were well matched for age, sex and TNM stage. There were significantly more PS (performance status) 0 patients in the capecitabine group (51%vs 30%) (P = 0.001). Of the 99 patients in the capecitabine group, 91 (92%) were able to undergo surgery with 84 (93%) achieving R0 resection. In the 5‐FU group, these proportions were 87 (90%) and 70 (80%). The difference in the rate of R0 resection was statistically significant (P = 0.024). The APR rate was 35% in the capecitabine group compared with 47% in the 5‐FU group (P = 0.06). There was no significant difference in pathological complete response (pCR) rates between capecitabine (14%) and 5‐FU(12%). A higher pCR rate (30%) was observed in patients who underwent a brachytherapy boost (P = 0.051). There were three local recurrences in the whole patient group, (capecitabine 1; 5‐FU 2). Thirty‐five patients had distant metastases, 14 in the capecitabine and 21 in the 5‐FU group. There was no significant difference in the risk of recurrence between the two groups. Six patients in each group had grade 3 toxicity with diarrhoea being more common with capecitabine.Conclusions  Preoperative chemoradiotherapy with capecitabine for rectal cancer is efficacious and comparable to 5‐FU (IV). It is more convenient, is well tolerated and avoids the need for inpatient admission.
Patient‐selected goals in overactive bladder: a placebo controlled randomized double‐blind trial of transdermal oxybutynin for the treatment of urgency and urge incontinence
Authors: Cartwright Rufus , Srikrishna Sushma , Cardozo Linda , Robinson Dudley 
Published: July 2010

Study Type – Therapy (RCT) Level of Evidence 1b What’s k
n
own on the subject? and What does
the study add? In common with other anticholinergics, transdermal oxybutynin improves symptoms, and disease specific quality of life for patients with urgency incontinence. Achievement of patient selected goals for treatment of overactive bladder has also been demonstrated in uncontrolled studies.Over a four week period, transdermal oxybutynin improved urinary urgency for patients with overactive bladder, including those without incontinence. However, in comparison to placebo it did not lead to significant achievement of patients’ own therapeutic goals.OBJECTIVETo assess patient selected goal improvement with transdermal oxybutynin, in a representative population of adult women with overactive bladder (OAB).SUBJECTS AND METHODSAdult women with ≥3 month history of OAB symptoms, with or without urgency urinary incontinence, were recruited from a tertiary referral urogynaecology unit. Participants were allocated to either transdermal oxybutynin 3.9 mg/day or matching placebo patches in a double‐blind, randomized parallel group design, over 4 weeks. Patient‐selected goal achievement was defined as the primary outcome measure. Participants selected their own goals for treatment at baseline, and subsequently scored achievement of these goals on a visual analogue scale. They completed 3‐day bladder diaries incorporating the Patients Perception of Intensity of Urgency Scale (PPIUS) to assess urgency and urgency incontinence episodes. Quality of life was assessed using the King’s Health Questionnaire (KHQ).RESULTSA total of 96 women were randomized; 78 (81.3%) participants completed 4 weeks double‐blind treatment. There was no significant difference between mean goal achievement in the transdermal oxybutynin and placebo groups (41.9% (SD 31.3) vs 32.2% (SD 27.3), P= 0.203). Transdermal oxybutynin was associated with significant improvements in urgency episodes (−1.23 episodes/day (SD1.40) vs −0.21 episodes/day (SD 1.58), P= 0.01). Both groups made non‐significantly different improvements in KHQ scores; 18 (38.2%) patients in the transdermal oxybutynin group experienced either erythema or pruritus, with 7 (14.9%) experiencing at least one systemic adverse event.CONCLUSIONSIn women with OAB, in comparison with placebo, transdermal oxybutynin 3.9 mg/day leads to significant objective improvements in urinary urgency, but with no significant difference observed in achievement of patients’ own goals for therapy, or improvement in disease specific quality of life.
Reduced incidence of blindness in relation to diabetes mellitus in southern Germany?
Authors: Genz J. , Scheer M. , Trautner C. , Zöllner I. , Giani G. , Icks A. 
Published: July 2010

Diabet. Med. 27, 1138–1143 (2010)AbstractAims  We estimated the incidence of blindness in the diabetic and non‐diabetic population in 2008 and compared it with results from 1990–1998 in a neighbouring region.Methods  All newly registered blindness allowance recipients in 2008 were drawn up in a German region (population 4.5 million). We estimated sex‐specific, age‐specific and standardized incidence rates of blindness in the diabetic and the non‐diabetic population and relative and attributable risks as a result of diabetes. A comparison to the data from 1990–1998 was performed using log‐linear Poisson regression.Results  Four‐hundred and sixty‐eight cases were drawn up (63% female). One‐hundred and twenty‐two (26.1%) had diabetes. Blindness incidence rates (per 100 000 person‐years) standardized to the 2008 German population were: men 9.1 (95% confidence interval 7.8–10.5), women 9.9 (8.8–11.1); diabetic population: men 21.8 (11.6–31.9), women 19.7 (9.2–30.1); non‐diabetic population: men 8.0 (6.6–9.5), women 9.1 (7.9–10.3). Relative risk of blindness, diabetic vs. non‐diabetic population: men 2.7 (1.6–4.5), women 2.2 (1.3–3.8). Attributable risk among exposed: 63% in men, 54% in women. Population attributable risk: 12% in men, 8% in women. Incidences of blindness were significantly lower than in all years of the period 1990–1998 in both the diabetic and the non‐diabetic population.Conclusions  We found the incidence of blindness to be approximately 2.5‐fold higher in the diabetic compared with the non‐diabetic population. Fifty‐eight per cent of the risk to become blind in diabetic individuals and 9% of the risk to become blind in the entire population were attributable to diabetes. The decrease of the blindness incidence observed during the 1990s may have continued.
Neutrophil Gelatinase‐Associated Lipocalin (NGAL) and Kidney Injury Molecule 1 (KIM1) in patients with diabetic nephropathy: a cross‐sectional study and the effects of lisinopril
Authors: Nielsen S. E. , Schjoedt K. J. , Astrup A. S. , Tarnow L. , Lajer M. , Hansen P. R. , Parving H.‐H. , Rossing P. 
Published: July 2010

Diabet. Med. 27, 1144–1150 (2010)AbstractAims  Our aim was to evaluate the markers of tubulointerstitial damage, neutrophil gelatinase‐associated lipocalin (NGAL) and kidney injury molecule 1 (KIM1) in Type 1 diabetic patients with different levels of albuminuria and in control subjects. In addition, the effect of renoprotective treatment on urinary NGAL was evaluated in diabetic nephropathy.Methods  This was a cross‐sectional study in 58 normoalbuminuric (u‐albumin < 30mg/24 h), 45 microalbuminuric (30–300 mg/24 h) and 45 macroalbuminuric (> 300 mg/24 h) Type 1 diabetic patients and 55 non‐diabetic control subjects. Furthermore, in a second study, urine‐NGAL was measured in a randomized cross‐over study of 56 Type 1 diabetic patients with diabetic nephropathy treated with lisinopril 20, 40 and 60 mg daily.Results  Urine‐NGAL levels were [geometric mean (95% CI)]: control subjects 74 (52–104) (pg/mmol creatinine), normoalbuminuric 146 (97–221), microalbuminuric 222 (158–312) and macroalbuminuric group 261 (175–390). Urine‐NGAL increased significantly from the normo‐ to the micro‐ and further to the macroalbuminuric group (P < 0.05). Urine‐NGAL was higher in normoalbuminuric vs. control subjects (P < 0.01). Plasma‐NGAL was significantly higher in the normoalbuminuric and macroalbuminuric groups than in the control group. Urine‐KIM1 was higher in all diabetic groups than in the control group (P < 0.001), with no difference between diabetic groups. During lisinopril treatment,urine‐NGAL was reduced (95% CI) 17% (11–50) (not significant).Conclusions  Urine‐NGAL and urine‐KIM1 (u‐KIM1) are elevated in Type 1 diabetic patients, with or without albuminuria, indicating tubular damage at an early stage. Urine‐NGAL increases significantly with increasing albuminuria. The ACE inhibitor lisinopril reduced urine‐NGAL, but this was not statistically significant.
Tilting at Windmills or Contested Norms? Dissident Proxy Initiatives in Canada
Authors: Bates Kimberly , Hennessy Dean 
Published: July 2010

ABSTRACTManuscript Type: EmpiricalResearch Question/Issue: Do shareholder activists influence standards of legitimacy with Dissident proxy initiatives? What are the antecedents and consequences of Dissident proxy initiatives?Research Findings/Insights: We use a longitudinal Canadian sample to evaluate the dynamics of Dissident proxy initiatives. Firms with lower legitimacy are more likely to receive governance‐ and performance‐oriented Dissident proxy initiatives. Firms with higher legitimacy were more likely to settle proxy initiatives of all types, and avoid publishing activist shareholders' concerns to all shareholders, but this relationship did not hold for governance‐oriented proposals. Firms that received more governance‐ and performance‐oriented proposals subsequently had lower legitimacy.Theoretical/Academic Implications: Dissident proxy initiatives are legitimation contests, where shareholders contest the legitimacy of corporate management's conduct. The dynamics that produce proposals and management responses are consistent with the predictions of institutional theories of legitimacy, institutional entrepreneurship, and legitimation contests. Because the ownership structure of Canadian corporations makes passage unlikely, they resemble a ritual for influencing legitimacy of a wide variety of practices.Practitioner/Policy Implications: Management's response to Dissident proxy initiatives makes a statement about the legitimacy of their conduct. Settling proxies may enable management to contribute to the acceptance or rejections of emerging practices. Management should consider whether attempts to decouple adoption of some practices from core operations are wise in the long term. Shareholder activists should consider whether management is seeking to ceremonially adopt policies demanded in dissident proxies.