bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staging of prostate cancer
Authors: Cheng Liang , Montironi Rodolfo , Bostwick David G , Lopez‐Beltran Antonio , Berney Daniel M 
Published: December 2011

Cheng L, Montironi R, Bostwick D G, Lopez‐Beltran A & Berney D M  (2012) Histopathology 60, 87–117  Staging of prostate cancerProstatic carcinoma (PCa) is a significant cause of cancer morbidity and mortality worldwide. Accurate staging is critical for prognosis assessment and treatment planning for PCa. Despite the large volume of clinical activity and research, the challenge to define the most appropriate and clinically relevant staging system remains. The pathologically complex and uncertain clinical course of prostate cancer further complicates the design of staging classification and a substaging system suitable for individualized care. This review will focus on recent progress and controversial issues related to prostate cancer staging. The 2010 revision of the American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) tumour, node and metastasis (TNM) system is the most widely used staging system at this time. Despite general acceptance of the system as a whole, there is controversy and uncertainty about its application, particularly for T2 subclassification. The three‐tiered T2 classification system for organ‐confined prostate cancer is superfluous, considering the biology and anatomy of PCa. A tumour size‐based substaging system may be considered in the future TNM subclassification of pT2 cancer. Lymph node status is one of the most important prognostic factors for prostate cancer. Nevertheless, clinical outcomes in patients with positive lymph nodes are variable. Identification of patients at the greatest risk of systemic progression helps in the selection of appropriate therapy. The data suggest that the inherent aggressiveness of metastatic prostate cancer is closely linked to the tumour volume of lymph node metastasis. We recommend that a future TNM staging system should consider subclassification of node‐positive cancer on the basis of nodal cancer volume, using the diameter of the largest nodal metastasis and/or the number of positive nodes.
Follicular cholangitis and pancreatitis – clinicopathological features and differential diagnosis of an under‐recognized entity
Authors: Zen Yoh , Ishikawa Akira , Ogiso Seiji , Heaton Nigel , Portmann Bernard 
Published: December 2011

Zen Y, Ishikawa A, Ogiso S, Heaton N & Portmann B  (2012) Histopathology 60, 261–269  Follicular cholangitis and pancreatitis – clinicopathological features and differential diagnosis of an under‐recognized entityAims:  Biliary and pancreatic ductal systems can be involved in several lymphoplasmacytic inflammatory conditions, including primary sclerosing cholangitis, immunoglobulin G (IgG) 4‐related cholangitis and autoimmune pancreatitis. Here in we describe an unusual pancreatocholangitis whose features suggest a distinct disease entity.Methods and results:  The study group consists of five adult patients, three with predominantly hilar bile duct stricture and two with a bulky pancreatic head. Four patients were treated surgically for suspected malignancy and one patient underwent liver transplantation with a clinical diagnosis of primary sclerosing cholangitis. Histological examination revealed extensive lymphoplasmacytic inflammation centred on large biliary or pancreatic ducts. Many lymphoid follicles with germinal centres were noted around the affected ducts. Whipple specimens from two patients with a pancreatic head mass showed similar follicular inflammation histologically around bile ducts. In contrast to autoimmune pancreatitis, diffuse infiltration of IgG4+ plasma cells, granulocytic epithelial lesions and obliterative phlebitis were not identified. The postoperative course was uneventful, without evidence of recurrence (follow‐up period 17–65 months).Conclusions:  This study suggests that a disease entity which can be named follicular cholangitis and pancreatitis exists and may be under‐recognized. The disease mainly affects the hilar bile ducts and pancreatic head in adults.
Elder mistreatment in a rural area in Egypt
Authors: Abdel Rahman Tomader T , El Gaafary Maha M 
Published: December 2011

Aim:  Mistreatment of the elderly is a hidden problem frequently cloaked under the shroud of family secrecy. The aim of the present study was to determine the extent of mistreatment of older people living at their homes in the rural area of Mansoura city, Dakahlia governorate, Egypt.Methods:  The present cross‐sectional study was carried out on 1106 respondents, 518 men (mean age 67.6 ± 6.3 years) and 588 women (mean age 68.5 ± 8.4 years), who answered face‐to‐face survey questionnaires. The questionnaires used were; Questionnaire to elicit elder abuse, Actual abuse tool, Elder Assessment Instrument, Risk of abuse tool, Katz index and Geriatric depression scale 15 items.Results:  Of the respondents, 43.7% reported mistreatment by family members. The predominant type of reported mistreatment was neglect (42.4%) followed by physical abuse (5.7%), psychological abuse (5.1%) and financial abuse (3.8%).Conclusions:  The independent risk factors for overall mistreatment of the elderly were older age, insufficient pension and caregiver other than spouse. Although being dependent, the number of children being three or less and caregiver other than spouse were significant independent attributes for “neglect” as a form of elder mistreatment. Geriatr Gerontol Int 2012; 12: 532–537.
Safety of ESWL in elderly: Evaluation of independent predictors and comorbidity on stone‐free rate and complications
Authors: Polat Fazlı , Yeşil Süleyman , Ak Esat , Farahvash Amirali , Karaoğlan Üstünol , Biri Hasan , Bozkırlı İbrahim 
Published: December 2011

Aim:  Urinary stone disease affects people of all ages. With its satisfactory efficacy ranges in all age groups and lack of side‐effects, extracorporeal shock wave lithotripsy (ESWL) has become the preferred treatment modality for uncomplicated renal and proximal calculi ≤20 mm. In the present study, we aimed to assess the safety and efficacy of the ESWL treatment in elderly patients.Methods:  A retrospective study was carried out on patients aged over 65 years who underwent shock wave lithotripsy at our Department from 2009 to 2011, with a Siemens Lithostar electromagnetic shockwave lithotripter. A total of 231 patients (157 males, 74 females) out of 1694 (13.6%) were studied. The patients were divided into two groups (group 1 = 65–70; group 2 >70). The effect of age and other possible predicting factors (sex, stone localization and stone size) were investigated. Concomitant diseases and related complications were also evaluated.Results:  An overall stone‐free rate (SFR) of 82.2% was found. The influence of sex on SFR was non‐significant. There was no significant difference when comparing SFR between the age groups. When patients were divided into those with renal and ureteral stones, the SFR were 94.4% and 67.6% (P < 0.01), respectively. The SFR of the stone size groups, ≤10 mm and >10 mm were 80% and 84.4%, respectively. Comorbidity was present in 148 patients. Complications were noted in 56 of 231 patients. Of 56 patients, 43 had minor complications and 13 major complications.Conclusion:  ESWL seems to be an effective first‐line treatment choice for urinary stones in elderly patients with careful patient selection and personalized preparation. Geriatr Gerontol Int 2012; 12: 413–417.
Early computed tomography signs as early predictors of hemorrhagic transformation under heparinization in patients with cardiogenic embolism
Authors: Terao Takeshi , Mishina Masahiro , Takumi Ichiro , Komaba Yuichi , Mizunari Takayuki , Kobayashi Shiro , Yoshida Daizo , Teramoto Akira 
Published: December 2011

Aim:  Early computed tomography (CT) signs are crucial to predict the onset of hemorrhagic transformation (HT) and are preventive to avoid a fatal hematoma after thrombolysis. In the present study, we retrospectively reviewed the clinical records of patients receiving heparinization to investigate the correlation between early CT signs and the frequency of HT.Methods:  We reviewed 96 patients with cardiogenic cerebral embolism. These patients were admitted within 24 h of the onset and were subsequently given 5000–15 000 units of heparin per day for 3 days. Owing to CT on admission, early CT changes were evaluated. Patient characteristics were also estimated, including evidence of hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease and history of smoking. The probability of hemorrhagic transformation, or good outcome and independence was assessed by backward stepwise logistic regression analysis based on the maximum likelihood ratio.Results:  Higher baseline National Institutes of Health Stroke Scale (NIHSS) score, early CT signs and absence of hyperlipidemia diversely correlated with the occurrence of HT. Also, the presence or absence of early CT signs was significantly related to HT classification (χ2‐test; P < 0.05). It was statistically significant that a higher baseline NIHSS score (OR 8.51; 95% CI 3.11–27.75) affected the outcome without showing a significant relationship to early CT signs.Conclusions:  Presence of early CT signs correlated more strongly with HT than with the interval from symptom onset to hospital arrival. We might extend the therapeutic time for thrombolytic therapy, only if the early CT sign does not appear. Geriatr Gerontol Int 2012; 12: 418–424.
Interactions of household composition and required care level with functional and cognitive status among disabled Japanese elderly living in a suburban apartment complex
Authors: Murayama Hiroshi , Nishinaga Masanori , Sugawara Ikuko , Goto Jun , Hirose Yuichi , Senuma Tomohiro , Shinkai Shoji , Akiyama Hiroko , Tsuji Tetsuo , Kamata Minoru 
Published: December 2011

Aim:  In the forthcoming super‐aging society, the appropriate assessment of functional and cognitive conditions of disabled elderly people will become increasingly significant in providing care services. Care level and household composition would be key factors to assess function. There might also be an interaction between the two factors with the function. The present study examined the associations of household composition and care level with functional and cognitive status among the disabled elderly living in a suburban apartment complex with a high rate of aged residents (39% in 2009).Methods:  Participants were 190 disabled elderly persons aged 65 years and over who lived in the apartment complex. Cross‐sectional data were collected between May 2009 and August 2010, including care level, household composition, basic activities of daily living (BADL), instrumental activities of daily living (IADL) and the independence level in relation to cognitive status. Lower scores meant less independence in BADL and IADL, and as determined by the cognitive/independence scale.Results:  Approximately half of the participants lived alone. Generalized linear model procedure showed significant interactions with the BADL score and cognitive/independence scale between household composition and care level. Scores for BADL and the cognitive/independence scale in groups receiving a higher care level were lower; however, the slope of the trend for the elderly living alone was more gradual than for the elderly living with others.Conclusion:  It is important for health‐care providers to assess in detail the status of the disabled elderly considering both their household composition and care level in planning and providing assistance for them. Geriatr Gerontol Int 2012; 12: 538–546.
Clustering of multiple healthy lifestyles among older Korean adults living in the community
Authors: Lee Yunhwan , Back Joung Hwan , Kim Jinhee , Byeon Haewon , Kim Seihee , Ryu Mikyung 
Published: December 2011

Aim:  Despite the predictive value of combined healthy lifestyles in maintaining physical and cognitive functioning in late life, little is known about the clustering patterns of healthy lifestyle behaviors in older people. The aim of the present study was to examine the prevalence, clustering and population characteristics of adherence to multiple health behaviors in community‐dwelling older Korean adults.Methods:  The study population consisted of a nationally representative sample of 4165 Korean adults aged 65 years and older in 2006. Healthy lifestyles, defined as adherence to recommended guidelines, included non‐smoking, no heavy drinking, physical activity and healthy weight. Combinations of behavioral patterns and prevalence odds ratios for pairwise clusters were analyzed. Multinomial logistic regression was used to identify demographic and health‐related characteristics associated with the number of adherence to guideline recommendations.Results:  Those who adhered to all four guideline recommendations constituted the minority (11.7%). More women than men engaged in a higher number of healthy lifestyles. Clustering was more pronounced in men for whom no heavy alcohol drinking and physical activity centered around non‐smoking. In women, clustering patterns were less obvious. Men, those with low levels of education, income and wealth, and the functionally impaired were less likely to adhere to multiple healthy lifestyles.Conclusion:  Clustering of healthy lifestyles, especially among older men, supports the potential benefit of a multiple behavior change approach. Health promotion efforts should target the socially disadvantaged and functionally compromised segment of the older population presenting low adherence to recommended behaviors. Geriatr Gerontol Int 2012; 12: 515–523.
Alternative Living Arrangements for Older Persons
Authors: Barry John R. 
Published: December 2011

Billings, G. Alternatives to Nursing Home Care: An Update. Aging, 1982, Nos. 325–326, 2–11.Brill, R.S. New York City Home Care Project: A Coordinated Health and Social Service Approach. Aging, 1982, Nos. 325–326, 12–15.Gray, P.J. State Experiences with Long‐term Care. Aging, 1982, Nos. 325–326, 28–33.Sager, A. Improving the Provision of Long‐term Care. Aging, 1982, Nos. 325–326; 16–27.
Cerebellar theta burst stimulation impairs eyeblink classical conditioning
Authors: Hoffland Britt S. , Bologna Matteo , Kassavetis Panagiotis , Teo James T. H. , Rothwell John C. , Yeo Christopher H. , van de Warrenburg Bart P. , Edwards Mark J. 
Published: December 2011

Key points
Theta burst stimulation (TBS) protocols of repetitive transcranial magnetic stimulation (rTMS) have after‐effects on excitability of motor areas thought to be due to LTP‐ and LTD‐like processes at cortical synapses. TBS protocols have significant advantages over other rTMS techniques in time and intensities used.
Eyeblink classical conditioning (EBCC) is a form of associative motor learning in which paired presentation of a conditioned (CS) and unconditioned stimulus (US) leads to the production of a conditioned eyeblink response (CR). EBCC, with its heavy dependence on cerebellar function, is an ideal protocol with which to assess and potentially quantify the possible influence of TBS on the cerebellum.
We show that cerebellar TBS has clear effects on EBCC in humans, providing evidence that TBS can influence cerebellar function despite the low intensities of stimulation used and the anatomical constraints of the posterior fossa.
Acute stress induces down‐regulation of large‐conductance Ca2+‐activated potassium channels in the lateral amygdala
Authors: Guo Yan‐yan , Liu Shui‐bing , Cui Guang‐Bin , Ma Lan , Feng Bin , Xing Jiang‐hao , Yang Qi , Li Xiao‐qiang , Wu Yu‐mei , Xiong Li‐ze , Zhang Weiqi , Zhao Ming‐gao 
Published: December 2011

Key points
Stress can lead to the development of behavioural disorders associated with cognitive impairments, depression and anxiety.
Large‐conductance Ca2+‐activated potassium channels (BKCa) are highly expressed in the brain. Here we found that acute stress induced a significant reduction in BKCa channel expression in the amygdala of mice, which accompanied anxiety‐like behaviours.
Activation of BKCa channels in the amygdala could reverse the stress‐induced anxiety‐like behaviours. This research may help us understand the underlying mechanisms of anxiety‐like behaviour induced by acute stress.
American College of Cardiology/American Heart Association/European Society of Cardiology/World Heart Federation Universal Definition of Myocardial Infarction Classification System and the Risk of Cardiovascular Death
Authors: Bonaca Marc P. , Wiviott Stephen D. , Braunwald Eugene , Murphy Sabina A. , Ruff Christian T. , Antman Elliott M. , Morrow David A. 
Published: December 2011

Background—
The availability of more sensitive biomarkers of myonecrosis and a new classification system from the universal definition of myocardial infarction (MI) have led to evolution of the classification of MI. The prognostic implications of MI defined in the current era have not been well described.

Methods and Results—

We investigated the association between new or recurrent MI by subtype according to the European Society of Cardiology/American College of Cardiology/American Heart Association/World Health Federation Task Force for the Redefinition of MI Classification System and the risk of cardiovascular death among 13 608 patients with acute coronary syndrome in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel–Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38). The adjusted risk of cardiovascular death was evaluated by landmark analysis starting at the time of the MI through 180 days after the event. Patients who experienced an MI during follow-up had a higher risk of cardiovascular death at 6 months than patients without an MI (6.5% versus 1.3%,
P
<0.001). This higher risk was present across all subtypes of MI, including type 4a (peri–percutaneous coronary intervention, 3.2%;
P
<0.001) and type 4b (stent thrombosis, 15.4%;
P
<0.001). After adjustment for important clinical covariates, the occurrence of any MI was associated with a 5-fold higher risk of death at 6 months (95% confidence interval 3.8–7.1), with similarly increased risk across subtypes.

Conclusions—
MI is associated with a significantly increased risk of cardiovascular death, with a consistent relationship across all types as defined by the universal classification system. These findings underscore the clinical relevance of these events and the importance of therapies aimed at preventing MI.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00097591.
Long-Term Cardiovascular Mortality After Procedure-Related or Spontaneous Myocardial Infarction in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome
Authors: Damman Peter , Wallentin Lars , Fox Keith A.A. , Windhausen Fons , Hirsch Alexander , Clayton Tim , Pocock Stuart J. , Lagerqvist Bo , Tijssen Jan G.P. , de Winter Robbert J. 
Published: December 2011

Background—
The present study was designed to investigate the long-term prognostic impact of procedure-related and spontaneous myocardial infarction (MI) on cardiovascular mortality in patients with non–ST-elevation acute coronary syndrome.

Methods and Results—

Five-year follow-up after procedure-related or spontaneous MI was investigated in the individual patient pooled data set of the FRISC-II (Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Randomized Intervention Trial of Unstable Angina 3) non–ST-elevation acute coronary syndrome trials. The principal outcome was cardiovascular death up to 5 years of follow-up. Cumulative event rates were estimated by the Kaplan-Meier method; hazard ratios were calculated with time-dependent Cox proportional hazards models. Adjustments were made for the variables associated with long-term outcomes. Among the 5467 patients, 212 experienced a procedure-related MI within 6 months after enrollment. A spontaneous MI occurred in 236 patients within 6 months. The cumulative cardiovascular death rate was 5.2% in patients who had a procedure-related MI, comparable to that for patients without a procedure-related MI (hazard ratio 0.66; 95% confidence interval, 0.36–1.20,
P
=0.17). In patients who had a spontaneous MI within 6 months, the cumulative cardiovascular death rate was 22.2%, higher than for patients without a spontaneous MI (hazard ratio 4.52; 95% confidence interval, 3.37–6.06,
P
<0.001). These hazard ratios did not change materially after risk adjustments.

Conclusions—
Five-year follow-up of patients with non–ST-elevation acute coronary syndrome from the 3 trials showed no association between a procedure-related MI and long-term cardiovascular mortality. In contrast, there was a substantial increase in long-term mortality after a spontaneous MI.

Clinical Trial Registration—

URL:
http://www.controlled-trials.com/ISRCTN82153174
(ICTUS);
http://www.controlled-trials.com/ISRCTN07752711
(RITA-3).
Near Infrared Spectroscopy for the Detection of Desaturations in Vulnerable Ischemic Brain Tissue
Authors: Aries Marcel J.H. , Coumou Adriaan D. , Elting Jan Willem J. , van der Harst Joep J. , Kremer Berry P.H. , Vroomen Patrick C.A.J. 
Published: December 2011

Background and Purpose—
There is uncertainty whether bilateral near infrared spectroscopy (NIRS) can be used for monitoring of patients with acute stroke.

Methods—
The NIRS responsiveness to systemic and stroke-related changes was studied overnight by assessing the effects of brief peripheral arterial oxygenation and mean arterial pressure alterations in the affected versus nonaffected hemisphere in 9 patients with acute stroke.

Results—

Significantly more NIRS drops were registered in the affected compared with the nonaffected hemisphere (477 drops versus 184,
P
<0.001). In the affected hemispheres, nearly all peripheral arterial oxygenation drops (n=128; 96%) were detected by NIRS; in the nonaffected hemispheres only 23% (n=30;
P
=0.17). Only a few mean arterial pressure drops were followed by a significant NIRS drop. This was however significantly different between both hemispheres (32% versus 13%,
P
=0.01).

Conclusions—
This pilot study found good responsiveness of NIRS signal to systemic and stroke-related changes at the bedside but requires confirmation in a larger sample.
Aspiration Pneumonia Following Severe Traumatic Brain Injury: Prevalence and Risk Factors for Long-Term Mortality
Authors: Howle Alison A. , Nott Melissa T. , Baguley Ian J. 
Published: December 2011

AbstractDysphagia and aspiration pneumonia are prevalent but infrequently studied complications following severe traumatic brain injury (TBI). Aspiration pneumonia is responsible for a significant number of long-term deaths in this population, however, the reported number of deaths attributed to aspiration pneumonia may be inaccurate. This multicentre inception cohort (n= 2545) study analysed consecutive discharges from 3 metropolitan inpatient brain injury rehabilitation units from January 1990 to October 2007 following inpatient rehabilitation following primary TBI. Subject data was linked to national death registries to determine cause of death where relevant. This study aimed to (a) evaluate the prevalence of aspiration pneumonia, percutaneous endoscopic gastrostomy (PEG) insertion and dysphagia following TBI, (b) identify the number of deaths ascribed to aspiration pneumonia, and (c) characterise associated risk factors for long-term aspiration pneumonia related deaths compared to all other causes of death. In-hospital PEG insertion occurred in 18.4% of the sample, two thirds of whom remained dysphagic at discharge. In-hospital aspiration pneumonia was recorded in 3.6% of the sample. Postdischarge, people with TBI were 79 times more likely to die from aspiration pneumonia than the general population. Risks were higher for subjects discharged to a nursing home, with severe ongoing functional disability, dysphagia at discharge, in those who had experienced in-hospital aspiration pneumonia or required PEG insertion. Early identification and risk management of dysphagia and aspiration pneumonia in TBI nursing home populations may maximise these individuals' quality and length of life.