bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lumbar Plexus Block Using High-pressure Injection Leads to Contralateral and Epidural Spread
Authors: Gadsden Jeff C. , Lindenmuth Danielle M. , Hadzic Admir , Xu Daquan , Somasundarum Lakshmanasamy , Flisinski Kamil A. 
Published: January 2010

Background
The main advantage of lumbar plexus block over neuraxial anesthesia is unilateral blockade; however, the relatively common occurrence of bilateral spread (up to 27%) makes this advantage unpredictable. The authors hypothesized that high injection pressures during lumbar plexus block carry a higher risk of bilateral or neuraxial anesthesia.

Methods
Eighty patients undergoing knee arthroscopy (age 18-65 yr; American Society of Anesthesiologists physical status I or II) during a standard, nerve stimulator-guided lumbar plexus block using 35 ml mepivacaine, 1.5%, were scheduled to be studied. Patients were randomly assigned to receive either a low-pressure (< 15 psi) or a high-pressure (> 20 psi) injection, as assessed by an inline injection pressure monitor (BSmart; Concert Medical LLC, Norwell, MA). The block success rate and the presence of bilateral sensory and/or motor blockade were assessed.

Results
An interim analysis was performed at n = 20 after an unexpectedly high number of patients had neuraxial spread, necessitating early termination of the study. Five of 10 patients (50%) in the high-pressure group had a neuraxial block with a dermatomal sensory level T10 or higher. In contrast, no patient in the low-pressure group (n = 10) had evidence of neuraxial spread. Moreover, 6 patients (60%) in the high-pressure group demonstrated bilateral sensory blockade in the femoral distribution, whereas no patient in the low-pressure group had evidence of a bilateral femoral block.

Conclusions
Injection of local anesthetic with high injection pressure (> 20 psi) during lumbar plexus block commonly results in unwanted bilateral blockade and is associated with high risk of neuraxial blockade.
Differential Effect of Morphine and Morphine-6-glucuronide on the Control of Breathing in the Anesthetized Cat
Authors: Teppema Luc J. , van Dorp Eveline , Gourabi Babak Mousavi , van Kleef Jack W. , Dahan Albert 
Published: January 2010

Background
Morphine's metabolite, morphine-6-glucuronide (M6G), activates the mu-opioid receptor. Previous data suggest that M6G activates a unique M6G receptor that is selectively antagonized by 3-methoxynaltrexome (3mNTX). The authors compared the effects of M6G and morphine on breathing in the anesthetized cat and assessed whether 3mNTX reversal was selective for M6G.

Methods
Step changes in end-tidal carbon dioxide concentration were applied in cats anesthetized with alpha-chloralose-urethane. In study 1, the effect of the 0.15 mg/kg morphine followed by 0.2 mg/kg 3mNTX and next 0.8 mg/kg M6G was assessed in six cats. In study 2, the effect of 0.8 mg/kg M6G followed by 0.2 mg/kg 3mNTX and 0.15 mg/kg morphine was tested in another six cats. The ventilatory carbon dioxide responses were analyzed with a two-compartment model of the ventilatory controller, which consists of a fast peripheral and a slow central component.

Results
Both opioids shifted the ventilatory carbon dioxide responses to higher end-tidal carbon dioxide levels. Morphine had a preferential depressant effect within the central chemoreflex loop. In contrast, M6G had a preferential depressant effect within the peripheral chemoreflex loop. Irrespective of the opioid, 3mNTX caused full reversal of and prevented respiratory depression.

Conclusions
In anesthetized cats, the mu-opioids morphine and M6G induce respiratory depression at different sites within the ventilatory control system. Because 3mNTX caused full reversal of the respiratory depressant effects of both opioids, it is unlikely that a 3mNTX-sensitive unique M6G receptor is the cause of the differential respiratory behavior of morphine and M6G.
Time and Cardiac Risk of Surgery after Bare-metal Stent Percutaneous Coronary Intervention
Authors: Nuttall Gregory A. , Brown Michael J. , Stombaugh John W. , Michon Peter B. , Hathaway Matthew F. , Lindeen Kevin C. , Hanson Andrew C. , Schroeder Darrell R. , Oliver William C. , Holmes David R. , Rihal Charanjit S. 
Published: January 2010

Background
The duration of time that elective noncardiac surgery (NCS) should be delayed after percutaneous coronary intervention (PCI) with bare metal stents (BMSs) is unknown.

Methods
This large, single-center, retrospective study examined the relation between complication rate in patients with BMSs undergoing NCS and the duration of time between PCI and NCS. Primary endpoints included in-hospital major adverse cardiac events (death, myocardial infarction, stent thrombosis, or repeat revascularization with either coronary artery bypass grafting or PCI of the target vessel) and bleeding events. The relation between the events and the timing of noncardiac surgery after PCI with BMS was assessed using univariate analysis and multiple logistic regression.

Results
From January 1, 1990, to January 1, 2005, a total of 899 patients were identified. The frequency of major adverse cardiac events was 10.5% when NCS was performed less than 30 days after PCI with BMS, 3.8% when NCS was performed between 31 and 90 days after PCI with BMS, and 2.8% when NCS was performed more than 90 days after PCI with BMS. In univariate and multivariate analyses, a shorter time interval between PCI with BMS and noncardiac surgery was significantly associated with increased incidence of major adverse cardiac events (univariate: P < 0.001; odds ratio = 4.0; 95% confidence interval, 2.0-8.3; multivariate: P = 0.006; odds ratio = 3.2; 95% confidence interval, 1.5-6.9). Bleeding events were not associated with time between PCI with BMS and NCS or with the use of antiplatelet therapy in the week before NCS.

Conclusions
The incidence of major adverse cardiac events is lowest when NCS is performed at least 90 days after PCI with BMS.
Cardiac Risk of Noncardiac Surgery after Percutaneous Coronary Intervention with Drug-eluting Stents
Authors: Rabbitts Jennifer A. , Nuttall Gregory A. , Brown Michael J. , Hanson Andrew C. , Oliver William C. , Holmes David R. , Rihal Charanjit S. 
Published: January 2010

Background
The American College of Cardiology released a scientific advisory that included a recommendation to delay elective of noncardiac surgery (NCS) for 1 yr after percutaneous coronary intervention (PCI) with a drug-eluting stent (DES).

Methods
This single-center, retrospective study examined the risk for complications of NCS performed within 2 yr after DES placement and examined whether this risk changed based on the time between procedures. The primary endpoint was major adverse cardiac events (MACEs) during the hospitalization for NCS. Bleeding events were analyzed as a secondary endpoint.

Results
From April 22, 2003, to December 31, 2006, a total of 520 patients underwent NCS within 2 yr after PCI with a DES at Mayo Clinic. The majority, 84%, of the DES placed were Cypher stents. The frequency of MACE was not found to be significantly associated with the time between PCI and NCS (rate of MACEs 6.4, 5.7, 5.9, and 3.3% at 0-90, 91-180, 181-365, and 366-730 days after PCI with DES, respectively; P = 0.727 for comparison across groups). Characteristics found to be associated with MACEs in univariate analysis were advanced age (P = 0.031), emergent NCS (P = 0.006), shock at time of PCI (P = 0.035), previous history of myocardial infarction (P = 0.046), and continuation of a thienopyridine (ticlopidine or clopidogrel) into the preoperative period (P = 0.040). The rate of transfusion did not seem to be associated with antiplatelet therapy use.

Conclusions
The risk of MACEs with NCS after DES placement was not significantly associated with time from stenting to surgery, but observed rates of MACEs were lowest after 1 yr.
Effect of Progressive Mandibular Advancement on Pharyngeal Airway Size in Anesthetized Adults
Authors: Kuna Samuel T. , Woodson Lee C. , Solanki Daneshvari R. , Esch Oliver , Frantz Donald E. , Mathru Mali 
Published: January 2010

Background
General anesthesia in adult humans is associated with narrowing or complete closure of the pharyngeal airway. The purpose of this study was to determine the effect of progressive mandibular advancement on pharyngeal airway size in normal adults during intravenous infusion of propofol for anesthesia.

Methods
Magnetic resonance imaging was performed in nine normal adults during wakefulness and during propofol anesthesia. A commercially available intraoral appliance was used to manually advance the mandible. Images were obtained during wakefulness without the appliance and during anesthesia with the participants wearing the appliance under three conditions: without mandibular advancement, advancement to 50% maximum voluntary advancement, and maximum advancement. Using computer software, airway area and maximum anteroposterior and lateral airway diameters were measured on the axial images at the level of the soft palate, uvula, tip of the epiglottis, and base of the epiglottis.

Results
Airway area across all four airway levels decreased during anesthesia without mandibular advancement compared with airway area during wakefulness (P < 0.007). Across all levels, airway area at 50% advancement during anesthesia was less than that at centric occlusion during wakefulness (P = 0.06), but airway area with maximum advancement during anesthesia was similar to that during wakefulness (P = 0.64). In general, anteroposterior and lateral airway diameters during anesthesia without mandibular advancement were decreased compared with wakefulness and were restored to their wakefulness values with 50% and/or maximal advancement.

Conclusions
Maximum mandibular advancement during propofol anesthesia is required to restore the pharyngeal airway to its size during wakefulness in normal adults.
Brief alcohol intervention—where to from here? Challenges remain for research and practice
Authors: Nilsen Per 
Published: January 2010

ABSTRACTBrief intervention (BI) is intended as an early intervention for non‐treatment‐seeking, non‐alcohol‐dependent, hazardous and harmful drinkers. This text provides a brief summary of key BI research findings from the last three decades and discusses a number of knowledge gaps that need to be addressed. Five areas are described: patient intervention efficacy and effectiveness; barriers to BI implementation by health professionals; individual‐level factors that impact on BI implementation; organization‐level factors that impact on BI implementation; and society‐level factors that impact on BI implementation. BI research has focused largely upon the individual patient and health professional levels, with the main focus upon primary health care research, and studies are lacking in other settings. However, research must, to a larger degree, take into account the organizational and wider context in which BI occurs, as well as interaction between factors at different levels, in order to advance the understanding of how wider implementation of BI can be achieved in various settings and how different population groups can be reached. It is also important to expand BI research beyond its current parameters to investigate more ambitious long‐term educational programmes and new organizational models. More widespread implementation of BI will require many different interventions (efforts, actions, initiatives, etc.) at different interlinked levels, from implementation interventions targeting individual health professionals' knowledge, skills, attitudes and behaviours concerning alcohol issues, BI and behaviour change counselling to efforts at the organizational and societal levels that influence the conditions for delivering BI as part of routine health care.
Pyloric gland metaplasia and pouchitis in patients with ileal pouch‐anal anastomoses
Authors: KARIV R. , PLESEC T. P. , GAFFNEY K. , LIAN L. , FAZIO V. W. , REMZI F. H. , LOPEZ R. , GOLDBLUM J. R. , SHEN B. 
Published: January 2010

Aliment Pharmacol Ther 31, 862–873SummaryBackground  Diagnosis and management of chronic antibiotic‐refractory pouchitis and Crohn’s disease of the pouch can be challenging. Pyloric gland metaplasia is a histological feature indicative of chronic mucosal inflammation. Its value in diagnosis and prognosis of pouch disorders has not been investigated.Aim  To assess the prevalence, diagnostic and prognostic value, and risk factors of pyloric gland metaplasia in pouch patients.Methods  Patients were identified from our prospectively maintained Pouchitis Database. Pouch biopsy specimens were re‐reviewed for pyloric gland metaplasia and other histological features. Two cohorts of patients were studied: a historical cohort (n = 111) and the second, a validation cohort (n = 100). Univariate and multivariate analyses were performed to assess risk factors for pyloric gland metaplasia.Results  The prevalence of pyloric gland metaplasia in the historical cohort and validation cohort was 45 (40.1%) and 24 (24.0%), respectively. The sensitivity and specificity of pyloric gland metaplasia for the diagnosis of chronic antibiotic‐refractory pouchitis or Crohn’s disease were 70.7% and 92.5%, respectively, for the first cohort and 39.0% and 86.4%, respectively, for the 2nd validation cohort. In multivariate analysis of the first cohort, patients with refractory pouchitis or Crohn’s disease were 28 times (95% CI, 7.3–107.1) more likely to have pyloric gland metaplasia than those with a normal pouch or irritable pouch syndrome. The factor of refractory pouchitis or Crohn’s disease remained in the model for the 2nd validation cohort with odds ratio of 4.58 (95% CI, 1.6–13.4).Conclusions  Pyloric gland metaplasia is associated with diagnosis of chronic antibiotic‐refractory pouchitis or Crohn’s disease of the pouch and appears to be a specific marker for both disease entities.
More food, less habitat: how necromass and leaf litter decomposition combine to regulate a litter ant community
Authors: SHIK JONATHAN Z. , KASPARI MICHAEL 
Published: January 2010

1. In brown food webs of the forest floor, necromass (e.g. insect carcasses and frass) falling from the canopy feeds both microbes and ants, with the former decomposing the homes of the latter. In a tropical litter ant community, we added necromass to 1 m2 plots, testing if it added as a net food (increasing ant colony growth and recruitment) or destroyer of habitat (by decomposing leaf litter).2. Maximum, but not mean, colony growth rates were higher on +food plots. However, neither average colony size, nor density was higher on +food plots. In contrast, +food plots saw diminished availability of leaf litter and higher microbial decomposition of cellulose, a main component of the organic substrate that comprises litter habitat.3. Furthermore, necromass acted as a limiting resource to the ant community only when nest sites were supplemented on +food plots in a second experiment. Many of these +food +nest plots were colonised by the weedy species Wasmannia auropunctata.4. Combined, these results support the more food–less habitat hypothesis and highlight the importance of embedding studies of litter ant ecology within broader decomposer food web dynamics.
Differential regulation of toll‐like receptor‐2, toll‐like receptor‐4, CD16 and human leucocyte antigen‐DR on peripheral blood monocytes during mild and severe dengue fever
Authors: Azeredo Elzinandes L. , Neves‐Souza Patrícia C. , Alvarenga Allan R. , Reis Sônia R. N. I. , Torrentes‐Carvalho Amanda , Zagne Sonia‐Maris O. , Nogueira Rita M. R. , Oliveira‐Pinto Luzia M. , Kubelka Claire F. 
Published: January 2010

SummaryDengue fever (DF), a public health problem in tropical countries, may present severe clinical manifestations as result of increased vascular permeability and coagulation disorders. Dengue virus (DENV), detected in peripheral monocytes during acute disease and in in vitro infection, leads to cytokine production, indicating that virus–target cell interactions are relevant to pathogenesis. Here we investigated the in vitro and in vivo activation of human peripheral monocytes after DENV infection. The numbers of CD14+ monocytes expressing the adhesion molecule intercellular adhesion molecule 1 (ICAM‐1) were significantly increased during acute DF. A reduced number of CD14+ human leucocyte antigen (HLA)‐DR+ monocytes was observed in patients with severe dengue when compared to those with mild dengue and controls; CD14+ monocytes expressing toll‐like receptor (TLR)2 and TLR4 were increased in peripheral blood from dengue patients with mild disease, but in vitro DENV‐2 infection up‐regulated only TLR2. Increased numbers of CD14+ CD16+ activated monocytes were found after in vitro and in vivo DENV‐2 infection. The CD14high CD16+ monocyte subset was significantly expanded in mild dengue, but not in severe dengue. Increased plasma levels of tumour necrosis factor‐α (TNF‐α), interferon‐γ (IFN‐γ) and interleukin (IL)‐18 in dengue patients were inversely associated with CD14high CD16+, indicating that these cells might be involved in controlling exacerbated inflammatory responses, probably by IL‐10 production. We showed here, for the first time, phenotypic changes on peripheral monocytes that were characteristic of cell activation. A sequential monocyte‐activation model is proposed in which DENV infection triggers TLR2/4 expression and inflammatory cytokine production, leading eventually to haemorrhagic manifestations, thrombocytopenia, coagulation disorders, plasmatic leakage and shock development, but may also produce factors that act in order to control both intense immunoactivation and virus replication.
Cutaneous melanoma in New Zealand: 2000–2004
Authors: Liang Jennifer J. C. , Robinson Elizabeth , Martin Richard C. W. 
Published: January 2010

AbstractBackground:  In 2004, we published data on the trends in New Zealand (NZ) cutaneous melanoma (CM) for the period 1995–1999. The present report documents the trends in the next period from 2000 to 2004.Method:  Data were obtained from the New Zealand Cancer Registry by way of a computerized search of CM ICD‐10 (172) codes from 2000 to 2004. Only one registration per person was made to avoid including patients with metastatic melanoma. The exclusion criteria were: incorrect or absent data; benign naevi; and melanoma in situ. Incidence rates were age standardised to the Segi world population.Results:  The total study population was 8262 patients. There was no increase found in the overall incidence rate over the time period, but men had a statistically higher overall incidence rate (P= 0.0002) and thicker CMs (P= 0.003) compared with women. This gender difference was particularly marked in those patients aged greater than 59 years. Breslow thickness increased from 0.7 to 0.8 mm. The incidence rates varied quite significantly among District Health Boards, with Taranaki having the highest rate (70.3/100 000/year) and Southland had the lowest rate (20.1/100 000). Overall, NZ had a CM incidence rate of 41.2/100 000/year).Conclusion:  The current study confirmed that NZ has the highest overall CM incidence rate in the world. Elderly men (>59 years old) have the highest risk of developing melanoma. The increase in melanoma thickness with its associated higher mortality risk is of grave concern.
Dynamics of marine bacterial and phytoplankton populations using multiplex liquid bead array technology
Authors: Mayali Xavier , Palenik Brian , Burton Ronald S. 
Published: January 2010

SummaryHeterotrophic bacteria and phytoplankton dominate the biomass and play major roles in the biogeochemical cycles of the surface ocean. Here, we designed and tested a fast, high‐throughput and multiplexed hybridization‐based assay to detect populations of marine heterotrophic bacteria and phytoplankton based on their small subunit ribosomal DNA sequences. The assay is based on established liquid bead array technology, an approach that is gaining acceptance in biomedical research but remains underutilized in ecology. End‐labelled PCR products are hybridized to taxon‐specific oligonucleotide probes attached to fluorescently coded beads followed by flow cytometric detection. We used ribosomal DNA environmental clone libraries (a total of 450 clones) and cultured isolates to design and test 26 bacterial and 10 eukaryotic probes specific to various ribotypes and genera of heterotrophic bacteria and eukaryotic phytoplankton. Pure environmental clones or cultures were used as controls and demonstrated specificity of the probes to their target taxa. The quantitative nature of the assay was demonstrated by a significant relationship between the number of target molecules and fluorescence signal. Clone library sequencing and bead array fluorescence from the same sample provided consistent results. We then applied the assay to a 37‐day time series of coastal surface seawater samples from the Southern California Bight to examine the temporal dynamics of microbial communities on the scale of days to weeks. As expected, several bacterial phylotypes were positively correlated with total bacterial abundances and chlorophyllaconcentrations, but others were negatively correlated. Bacterial taxa belonging to the same broad taxonomic groups did not necessarily correlate with one another, confirming recent results suggesting that inferring ecological role from broad taxonomic identity may not always be accurate.
Stimulating the anaerobic degradation of aromatic hydrocarbons in contaminated sediments by providing an electrode as the electron acceptor
Authors: Zhang Tian , Gannon Sarah M. , Nevin Kelly P. , Franks Ashley E. , Lovley Derek R. 
Published: January 2010

SummaryThe possibility that electrodes might serve as an electron acceptor to simulate the degradation of aromatic hydrocarbons in anaerobic contaminated sediments was investigated. Initial studies with Geobacter metallireducens demonstrated that although toluene was rapidly adsorbed onto the graphite electrodes it was rapidly oxidized to carbon dioxide with the electrode serving as the sole electron acceptor. Providing graphite electrodes as an electron acceptor in hydrocarbon‐contaminated sediments significantly stimulated the removal of added toluene and benzene. Rates of toluene and benzene removal accelerated with continued additions of toluene and benzene. [14C]‐Toluene and [14C]‐benzene were quantitatively recovered as [14C]‐CO2, demonstrating that even though the graphite adsorbed toluene and benzene they were degraded. Introducing an electrode as an electron acceptor also accelerated the loss of added naphthalene and [14C]‐naphthalene was converted to [14C]‐CO2. The results suggest that graphite electrodes can serve as an electron acceptor for the degradation of aromatic hydrocarbon contaminants in sediments, co‐localizing the contaminants, the degradative organisms and the electron acceptor. Once in position, they provide a permanent, low‐maintenance source of electron acceptor. Thus, graphite electrodes may offer an attractive alternative for enhancing contaminant degradation in anoxic environments.
Effect of the herbicide glyphosate on glyphosate‐tolerant maize rhizobacterial communities: a comparison with pre‐emergency applied herbicide consisting of a combination of acetochlor and terbuthylazine
Authors: Barriuso Jorge , Marín Silvia , Mellado Rafael P. 
Published: January 2010

SummaryA comparison was made of the effect of glyphosate (Roundup®Plus), a post‐emergency applied herbicide, and of Harness®GTZ, a pre‐emergency applied herbicide, on the rhizobacterial communities of genetically modified NK603 glyphosate‐tolerant maize. The potential effect was monitored by direct amplification, cloning and sequencing of soil DNA encoding 16S rRNA, rhizobacterial DNA hybridization to commercially available genome‐wide microarrays from the soil bacterium Streptomyces coelicolor, and high‐throughput DNA pyrosequencing of the bacterial DNA coding for 16S rRNA hypervariable V6 region. The results obtained strongly suggest that both herbicides do in fact affect the maize rhizobacterial communities, glyphosate being, to a great extent, the environmentally less aggressive herbicide.