bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subcutaneous fasciotomy and eradication of superficial venous reflux for chronic and recurrent venous ulcers: mid-term results
Authors: Christenson J T , Prins C , Gemayel G 
Published: March 2011

Objective Increased intramuscular and subcutaneous tissue pressures are often found in patients with severe chronic venous insufficiency venous ulcer disease. Additional subcutaneous para-tibial fasciotomy promotes early ulcer healing. This study evaluates the mid-term effect of eradication of superficial reflux with additional fasciotomy in patients with increased tissue pressures. Method Between January 2006 and June 2009, 58 patients underwent fasciotomy. Tissue pressures (intramuscular and subcutaneous) were measured. Sixty-nine limbs with 91 venous ulcers were treated. Mean duration of the venous ulcer was 3.4 years. Underlying disease was post-thrombotic syndrome (PT) in 19 patients (33%, 24 limbs, 27 ulcers) and non-post-thrombotic (non-PT) severe chronic venous insufficiency in 39 (67%, 45 limbs, 64 ulcers). All patients were C6 at the time of surgery. Preoperative tissue pressures were 23.5 ± 6.1 mmHg (intramuscularly) and 9.8 ± 3.2 mmHg (subcutaneously). Results Ninety ulcers (99%) healed postoperatively (42 with and 48 without skin grafting). Tissue pressures significantly decreased following surgery and remained low at three months postoperatively. Ten ulcers in six patients recurred six to 20 months postoperatively (11%), resulting in 86.4 actuarial freedom from venous ulcer recurrence at three years following surgery. Four patients (1 non-PT and 3 PT) had re-fasciotomy; all healed initially but two ulcers (2 patients, PT) recurred at 11 and 12 months. Those patients underwent re-fasciotomy, one healed and one recurred six months later. Conclusion Eradication of superficial reflux with additional subcutaneous fasciotomy for chronic and recurrent venous ulcer improves ulcer healing or success of skin grafting. Mid-term results are excellent particularly in patients with non-PT disease. Recurrence is more frequently seen in patients with PT syndrome. In patients with ulcer recurrence and high tissue pressures, re-fasciotomy can be helpful to promote healing, particularly in patients with primary venous disease.
The positive impact of physical activity on cognition during adulthood: a review of underlying mechanisms, evidence and recommendations
Authors: Ratey John J. , Loehr James E. 
Published: March 2011

AbstractA growing body of literature suggests that physical activity beneficially influences brain function during adulthood, particularly frontal lobe-mediated cognitive processes, such as planning, scheduling, inhibition, and working memory. For our hunter-gatherer ancestors, times of famine interspersed with times of feast necessitated bouts of intense physical activity balanced by periods of rest. However, the sedentary lifestyle that pervades modern society has overridden the necessity for a physically active lifestyle. The impact of inactivity on disease processes has been the focus of much attention; the growing understanding that physical activity also has the benefit of enhancing cognitive performance strengthens the imperative for interventions that are successful in increasing physical activity, with the outcomes of promoting health and productivity. Population health and performance programs that promote physical activity provide benefits for employees and employers through improvements in worker health and performance and financial returns for the company. In this review, we examine the mechanisms by which physical activity improves cognition. We also review studies that evaluate the effects of physical activity on cognitive executive performance in adulthood, including longitudinal studies that address the impact of physical activity during early adulthood and midlife on preservation of cognition later in life. This is of particular importance given that adulthood represents prime working years and that physical activity promotion is a key component of population health and performance programs. Finally, we provide recommendations for maximizing the lasting benefits of movement and physical activity on cognition in adulthood.
Circulating vaspin and visfatin are not affected by acute or chronic energy deficiency or leptin administration in humans
Authors: Kang Eun Seok , Magkos Faidon , Sienkiewicz Elizabeth , Mantzoros Christos S 
Published: March 2011

ObjectiveAnimal and in vitro studies indicate that leptin alleviates starvation-induced reduction in circulating vaspin and stimulates the production of visfatin. We thus examined whether vaspin and visfatin are affected by short- and long-term energy deprivation and leptin administration in human subjects in vivo.Design and methodsWe measured circulating levels of vaspin and visfatin i) before and after 72 h of starvation (leading to severe hypoleptinemia) with or without leptin administration in replacement doses in 13 normal-weight subjects, ii) before and after 72 h of starvation with leptin administration in pharmacological doses in 13 lean and obese subjects, iii) during chronic energy deficiency in eight women with hypothalamic amenorrhea on leptin replacement for 3 months, and iv) during chronic energy deficiency in 18 women with hypothalamic amenorrhea on leptin replacement or placebo for 3 months.ResultsAcute starvation decreased serum leptin to 21% of baseline values, (P=0.002) but had no significant effect on vaspin and visfatin concentrations (P>0.05). Nor did normalization of leptin levels affect the concentrations of these two adipokines (P>0.9). Leptin replacement in women with hypothalamic amenorrhea did not significantly alter vaspin and visfatin concentrations, whether relative to baseline or placebo administration (P>0.25). Pharmacological doses of leptin did not affect circulating vaspin and visfatin concentrations (P>0.9).ConclusionsCirculating vaspin and visfatin are not affected by acute or chronic energy deficiency leading to hypoleptinemia and are not regulated by leptin in human subjects, indicating that these adipocyte-secreted hormonal regulators of metabolism are independently regulated in humans.
A Double-Blind, Placebo-Controlled Study of Atomoxetine in Young Children With ADHD
Authors: Kratochvil Christopher J. , Vaughan Brigette S. , Stoner Julie A. , Daughton Joan M. , Lubberstedt Brian D. , Murray Desiree W. , Chrisman Allan K. , Faircloth Melissa A. , Itchon-Ramos Nilda B. , Kollins Scott H. , Maayan Lawrence A. , Greenhill Laurence L. , Kotler Lisa A. , Fried Jane , March John S. 
Published: March 2011

OBJECTIVE:To evaluate the efficacy and tolerability of atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in 5- and 6-year-old children.METHODS:This was an 8-week, double-blind, placebo-controlled randomized clinical trial of atomoxetine in 101 children with ADHD. Atomoxetine or placebo was flexibly titrated to a maximum dose of 1.8 mg/kg per day. The pharmacotherapist reviewed psychoeducational material on ADHD and behavioral-management strategies with parents during each study visit.RESULTS:Significant mean decreases in parent (P = .009) and teacher (P = .02) ADHD–IV Rating Scale scores were demonstrated with atomoxetine compared with placebo. A total of 40% of children treated with atomoxetine met response criteria (Clinical Global Impression–Improvement Scale indicating much or very much improved) compared with 22% of children on placebo, which was not significant (P = .1). Decreased appetite, gastrointestinal upset, and sedation were significantly more common with atomoxetine than placebo. Although some children demonstrated a robust response to atomoxetine, for others the response was more attenuated. Sixty-two percent of subjects who received atomoxetine were moderately, markedly, or severely ill according to the Clinical Global Impression–Severity Scale at study completion.CONCLUSIONS:To our knowledge, this is the first randomized controlled trial of atomoxetine in children as young as 5 years. Atomoxetine generally was well tolerated and reduced core ADHD symptoms in the children on the basis of parent and teacher reports. Reductions in the ADHD-IV Rating Scale scores, however, did not necessarily translate to overall clinical and functional improvement, as demonstrated on the Clinical Global Impression–Severity Scale and the Clinical Global Impression–Improvement Scale. Despite benefits, the children in the atomoxetine group remained, on average, significantly impaired at the end of the study.
Postnatal-Onset Microcephaly: Pathogenesis, Patterns of Growth, and Prediction of Outcome
Authors: Rosman N. Paul , Tarquinio Daniel C. , Datseris Marianna , Hou Wei , Mannheim Glenn B. , Emigh Christie E. , Rivkin Michael J. 
Published: March 2011

OBJECTIVE:Although children with postnatal-onset microcephaly (POM) generally have poor development, we speculated that better somatic growth would predict better development in these children.PATIENTS AND METHODS:We followed 57 children with POM for an average of 4.2 years (13 encephaloclastic, 14 dysgenetic, 6 with Rett syndrome, 24 idiopathic) and calculated the developmental quotient (DQ) at each visit (DQ &gt; 0.70 was considered normal). SD scores (SDS) for measurements were analyzed using a repeated measures mixed-effects model to assess effect of weight, height, head circumference (HC), and age on DQ. Pearson's correlation was used to examine the independent influence of each variable on final DQ.RESULTS:Forty-four children (77%) had a low DQ (mean: 0.33), but 13 (23%) had a normal DQ (mean: 0.93), including 10 idiopathic and 3 encephaloclastic. Mean HC fell below −2 SDS in all before 1 year (destructive at 3.3 months, idiopathic low-DQ at 7.5 months, dysgenetic at 8.5 months, Rett syndrome at 11 months, and idiopathic normal-DQ at 11.5 months). Mean weights and heights both fell below −2 SDS for all low-DQ groups but remained normal in both normal-DQ groups. Weight, height, and HC were independent predictors of DQ (P &lt; .0001). Final DQ correlated with weight (r = 0.27), height (r = 0.41), and HC (r = 0.13).CONCLUSIONS:Most children with POM have poor later development. Whatever the cause of POM, persons in whom postnatal body growth (weight, height, HC) is better sustained have more favorable development, and in one-quarter of such persons (mostly idiopathic POM), final DQ is normal.
Cost Comparison of Baby Friendly and Non–Baby Friendly Hospitals in the United States
Authors: DelliFraine Jami , Langabeer Jim , Williams Janet F. , Gong Alice K. , Delgado Rigoberto I. , Gill Sara L. 
Published: March 2011

OBJECTIVES:The objectives of this study were to provide an economic assessment of the incremental costs associated with obtaining the World Health Organization and United Nations International Children's Emergency Fund designation as a Infant-Friendly hospital. We hypothesized that baby-friendly hospitals will have higher costs than similar non–baby-friendly hospitals.METHODS:Data from the 2007 American Hospital Association and the 2007 Centers for Medicare and Medicaid Cost Reports were used to compare labor and delivery costs in baby-friendly and non–baby-friendly hospitals. Operational costs per delivery were calculated using a matched-pairs analysis of a sample of baby-friendly and non–baby-friendly hospitals in the United States. Costs associated with labor-and-delivery diagnosis–related codes were analyzed for each baby-friendly hospital and compared with the mean and median costs incurred by non–baby-friendly hospitals.RESULTS:Nursery plus labor-and-delivery costs for the baby-friendly sites were $2205 per delivery, compared with $2170 for the non–baby-friendly matched pair. Baby-friendly facilities have slightly higher costs than non–baby-friendly facilities, ranging from 1.6% to 5%, but these costs were not statistically significant (P &gt; .05).CONCLUSIONS:These results suggest that becoming baby-friendly is relatively cost-neutral for a typical acute care hospital. Although the overall expense of providing baby-friendly hospital nursery services is greater than nursery service costs of non–baby-friendly hospitals, the cost difference was not statistically significant. Additional research is needed to compare the economic impact of maternal and infant health benefits from breastfeeding versus the incremental expenses of becoming a baby-friendly hospital.
Pediatric Trauma BIG Score: Predicting Mortality in Children After Military and Civilian Trauma
Authors: Borgman Matthew A. , Maegele Marc , Wade Charles E. , Blackbourne Lorne H. , Spinella Philip C. 
Published: March 2011

OBJECTIVE:
To develop a validated mortality prediction score for children with traumatic injuries.

PATIENTS AND METHODS:
We identified all children (&lt;18 years of age) in the US military established Joint Theater Trauma Registry from 2002 to 2009 who were admitted to combat-support hospitals with traumatic injuries in Iraq and Afghanistan. We identified factors associated with mortality using univariate and then multivariate regression modeling. The developed mortality prediction score was then validated on a data set of pediatric patients (≤18 years of age) from the German Trauma Registry, 2002–2007.

RESULTS:
Admission base deficit, international normalized ratio, and Glasgow Coma Scale were independently associated with mortality in 707 patients from the derivation set and 1101 patients in the validation set. These variables were combined into the pediatric “BIG” score (base deficit + [2.5 × international normalized ratio] + [15 − Glasgow Coma Scale), which were each calculated to have an area under the curve of 0.89 (95% confidence interval: 0.83–0.95) and 0.89 (95% confidence interval: 0.87–0.92) on the derivation and validation sets, respectively.

CONCLUSIONS:
The pediatric trauma BIG score is a simple method that can be performed rapidly on admission to evaluate severity of illness and predict mortality in children with traumatic injuries. The score has been shown to be accurate in both penetrating-injury and blunt-injury populations and may have significant utility in comparing severity of injury in future pediatric trauma research and quality-assurance studies. In addition, this score may be used to determine inclusion criteria on admission for prospective studies when accurately estimating the mortality for sample size calculation is required.
Risk of Asthma in Young Adults Who Were Born Preterm: A Swedish National Cohort Study
Authors: Crump Casey , Winkleby Marilyn A. , Sundquist Jan , Sundquist Kristina 
Published: March 2011

OBJECTIVE:
Preterm birth is associated with asthma-like symptoms in childhood and possibly in adolescence, but the longer-term risk of asthma is unknown and increasingly relevant as larger numbers of these individuals enter adulthood. Our objective was to evaluate whether those who were born preterm are more likely to be prescribed asthma medications in young adulthood than those who were born term.

PATIENTS AND METHODS:
We conducted a national cohort study of all singleton infants born in Sweden from 1973 through 1979 (n = 622 616), followed to ages 25.5 to 35.0 years to determine whether asthma medications were prescribed in 2005–2007. Asthma medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. To improve the positive predictive value for asthma, the outcome was defined as prescription of (1) both a β-2 agonist inhalant and a glucocorticoid inhalant or (2) a combination inhalant containing a β-2 agonist and other drugs for obstructive airway diseases.

RESULTS:
Young adults who were born extremely preterm (23–27 weeks' gestation) were 2.4 times more likely (adjusted 95% CI: 1.41–4.06) to be prescribed asthma medications than those who were born term. No association was found between later preterm birth (28–32 or 33–36 weeks' gestation) and asthma medications in young adulthood.

CONCLUSIONS:
This is the first study with sufficient statistical power to evaluate the risk of asthma beyond adolescence in individuals who were born extremely preterm. The results suggest that extreme preterm birth (23–27 weeks' gestation), but not later preterm birth, is associated with an increased risk of asthma at least into young adulthood.
A Strong Synergism of Low Birth Weight and Prenatal Smoking on Asthma in Schoolchildren
Authors: Bjerg Anders , Hedman Linnea , Perzanowski Matthew , Lundbäck Bo , Rönmark Eva 
Published: March 2011

BACKGROUND:
Prenatal smoke exposure is associated with airway inflammation and asthma in children. It also increases the risk of low birth weight (LBW). LBW is associated with decreased lung function independently of smoking.

OBJECTIVE:
To study the independent and joint effects of prenatal smoking and LBW on childhood asthma.

METHODS:
In 1996, all children aged 7 to 8 years in 3 cities in northern Sweden were invited to an International Study of Asthma and Allergy in Childhood questionnaire survey. This study focused on the follow-up of children aged 11 to 12 years, in which 3389 children (96%) participated. A subset of 2121 children underwent skin-prick testing. Self-reported physician-diagnosed asthma has been clinically validated.

RESULTS:
Mean birth weight was 3360 g in children exposed to prenatal smoking and 3571 g in nonexposed children (P &lt; .001). The association of prenatal smoking with physician-diagnosed asthma was stronger in LBW children (risk ratio: 8.8 [95% confidence interval: 2.1–38]) than in normal birth weight children (risk ratio: 1.3 [95% confidence interval: 1.0–1.8]). LBW alone was not an independent predictor of asthma. These associations were similar in multivariate analysis, and the interaction term LBW × smoking was highly statistically significant.

CONCLUSIONS:
There was a strong interaction of LBW and prenatalsmoking on the risk of physician-diagnosed asthma, which has not been demonstrated previously. This was consistently seen with adjustment for known risk factors, including allergic sensitization. Plausibly, airway inflammation from prenatal smoke exposure induces obstructive symptoms more easily in the underdeveloped airways of LBW children.
Effect of Socioeconomic Status on Mortality Among People With Type 2 Diabetes
Authors: Walker Jeremy J. , Livingstone Shona J. , Colhoun Helen M. , Lindsay Robert S. , McKnight John A. , Morris Andrew D. , Petrie John R. , Philip Sam , Sattar Naveed , Wild Sarah H. ,   on behalf of the Scottish Diabetes Research Network Epidemiology Group
Published: March 2011

OBJECTIVE
The study objective was to describe the effect of socioeconomic status (SES) on mortality among people with type 2 diabetes.

RESEARCH DESIGN AND METHODS
We used a population-based national electronic diabetes database for 35- to 84-year-olds in Scotland for 2001–2007 linked to mortality records. SES was derived from an area-based measure with Q5 and Q1 representing the most deprived and affluent quintiles, respectively. Poisson regression was used to estimate relative risks (RRs) for mortality among people with type 2 diabetes compared with the population without diabetes stratified by age (35–64 and 65–84 years), sex, duration of diabetes (&lt;2 and ≥2 years), and SES.

RESULTS
Complete data were available for 210,994 eligible individuals (99.4%), and there were 33,842 deaths. Absolute mortality from all causes among people with type 2 diabetes increased with increasing age and socioeconomic deprivation and was higher for men than women. RR for mortality associated with type 2 diabetes was highest for women aged 35–64 years in Q1 with diabetes duration &lt;2 years at 4.83 (95% CI 3.15–7.40) and lowest for men aged 65–84 years in Q5 with diabetes duration ≥2 years at 1.13 (1.03–1.24).

CONCLUSIONS
SES modifies the association between type 2 diabetes and mortality so that RR for mortality is lower among more deprived populations. Age, sex, and duration of diabetes also interact with type 2 diabetes to influence RR of mortality. Differences in prevalence of comorbidities may explain these findings.
Heavy Metal and Bacterial Pollution of the Sava River in Serbia
Authors: Vuković Živorad , Marković Ljiljana , Radenković Mirjana , Vuković Dubravka , Stanković Srboljub 
Published: March 2011

Heavy Metal and Bacterial Pollution of the Sava River in Serbia
The aim of this study was to establish microbial and heavy metal pollution of the Sava River at three locations close to industry and urban areas (Šabac, Obrenovac, Beograd) in Serbia. Heavy metal analysis included Cu, Zn, Pb, and Cd in the river water and sediment samples. Using the microbiological analysis we tried to establish the effectiveness of total coliforms, faecal coliforms and Escherichia coli in detecting pollution of surface waters. We found that E. coli levels steadily increased downstream from Šabac (location 1; 2100 MPN per 100 mL) to Belgrade (location 3; 10000 MPN per 100 mL). To prevent bacterial contamination, it is necessary to reduce the discharge of wastewater with faecal matters near highly populated towns. Heavy metal levels in sediments correlated with those in the river water. Fluctuations attributed mainly to anthropogenic sources were not high. These results point to acceptable anthropogenic contribution to heavy metal content in the Sava River and to low environmental risk.
Long-Term Follow-Up Study of Genome Damage Elimination in Patients with Testicular Seminoma Exposed to Ionising Radiation during Radiotherapy
Authors: Gamulin Marija , Katić Jelena , Milić Mirta , Grgić Mislav , Fučić Aleksandra 
Published: March 2011

Long-Term Follow-Up Study of Genome Damage Elimination in Patients with Testicular Seminoma Exposed to Ionising Radiation during RadiotherapyThe rate of genome damage elimination after therapeutic exposure to ionising radiation was estimated in stage I testicular seminoma patients monitored over a seven-year follow-up. DNA damage elimination in peripheral lymphocytes of ten subjects was analysed by the chromosome aberration assay. Seven years after the end of radiotherapy, significantly increased frequency of ring and dicentric chromosomes was still detected in comparison with baseline values. These results indicate the induction of genome instability. Long-term follow-up studies of cancer patients after radiotherapy could give us valuable information on the rate of genome damage elimination after exposure to ionising radiation and about the duration and manifestation of genome instability. This may be used in health risk assessment related to the possible development of secondary neoplasia. Studies such as this could have a great value both for oncology and radiation protection management protocols, especially after accidental overexposures.