bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Pneumocystis jirovecii pneumonia diagnosed by polymerase chain reaction in patients without human immunodeficiency virus infection
Authors: HARDAK EMILIA , NEUBERGER AMI , YIGLA MORDECHAI , BERGER GIDON , FINKELSTEIN RENATO , SPRECHER HANNAH , OREN ILANA 
Published: March 2012

ABSTRACTBackground and objective:  Pneumonia caused by Pneumocystis jirovecii (PCP) in patients without human immunodeficiency virus (HIV) infection is associated with high mortality. The diagnosis of PCP at our institution is based on detection of DNA using a polymerase chain reaction (PCR) assay. The aim of this study was to describe the clinical manifestations, outcomes and factors associated with mortality due to PCP, as diagnosed by PCR, in patients without HIV infection.Methods:  Over a 6‐year period, all HIV‐negative immunocompromised patients suspected of having an opportunistic pulmonary infection underwent diagnostic bronchoscopy. A multigene PCR assay that detects Pneumocystis jirovecii DNA was used for the diagnosis of PCP. Patients were considered to have PCP if they had underlying immunodeficiency, compatible signs and symptoms, abnormal radiological findings, and Pneumocystis jirovecii DNA was detected in a bronchoalveolar lavage fluid sample. Data was collected retrospectively.Results:  PCP was diagnosed in 58 patients. The underlying conditions included haematological malignancies (60.3%), solid tumours (17.2%) and immunosuppressive treatment (22.4%). The most common clinical features in patients with PCP were fever (94.6%), dyspnoea (67.2%) and cough (36.2%). The overall in‐hospital mortality was 17.2% (10/58). Mortality was associated with co‐infections, high lactate dehydrogenase levels, female gender, and higher pneumonia severity index and acute physiology and chronic health evaluation III scores.Conclusions:  In this study, the mortality of HIV‐negative patients with PCP was low compared with previous reports. We hypothesize that this finding resulted from the increased sensitivity of a PCR‐based assay, as compared with traditional methods, for the diagnosis of PCP in HIV‐negative patients.
Fulminant hepatitis A infection in second trimester of pregnancy requiring living‐donor liver transplantation
Authors: Simsek Yavuz , Isik Burak , Karaer Abdullah , Celik Onder , Kutlu Ramazan , Aydin Nasuhi Engin , Yilmaz Sezai 
Published: March 2012

AbstractWe present an 18‐year‐old pregnant woman who was referred to our emergency clinic as a case of acute hepatic failure and hepatic encephalopathy. Laboratory tests showed abnormal liver function tests and serological workup was consistent with acute hepatitis A infection. Ultrasonography revealed a single live fetus with fetal biometry compatible with 18 gestational weeks. The patient underwent a highly urgent liver transplantation using a right lobe graft from her husband. Histological examination of the explanted liver showed acute, lymphocyte‐rich, diffuse necrotizing hepatitis, consistent with acute necrotizing hepatitis A. After the operation her allograft function gradually recovered. Her follow‐up obstetrics ultrasound revealed a male fetus with severely decreased amniotic fluid. The patient was informed about the poor prognosis of her pregnancy and the pregnancy was terminated by vaginal misoprostol induction. She has maintained a good general condition and liver function for 4 months postoperatively, up to the present time.
Case report and review of delayed‐interval delivery for dichorionic, diamniotic twins with normal development
Authors: Kaneko Masatoki , Kawagoe Yasuyuki , Oonishi Junji , Yamada Naoshi , Sameshima Hiroshi , Ikenoue Tsuyomu 
Published: March 2012

AbstractWe report a case of delayed‐interval delivery of a dichorionic, diamniotic twin pregnancy with the survival of both twins. The patient presented at 22 weeks and 1 day of gestation with vaginal bleeding and preterm labor. Five days later, the first twin was born. The second twin remained in utero. The management consisted of careful monitoring of both maternal and fetal status. Nine days later, the second twin was delivered vaginally. Both twins received full resuscitation and immediate life‐support intervention; at 7 years of age both twins exhibited normal development.
Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: Randomized controlled trial
Authors: Kittiwatanakul Wichai , Weerakiet Sawaek 
Published: March 2012

AbstractAim:  The aim of this study was to compare the efficacy of modified electric vacuum aspiration (mEVA) and sharp curettage (SC) for treatment of incomplete abortion.Material and Methods:  A randomized controlled trial was conducted between 1 March 2005 and 15 December 2009. Ninety‐four women with incomplete abortion were randomly allocated into two groups, group A (n = 47) underwent mEVA and group B (n = 47) underwent SC. The procedures were performed using the paracervical block with 20 mL of lidocaine. Successful management and complication were assessed. Successful management was defined as complete uterine evacuation with no need for the second surgical procedure.Results:  There were differences in women characteristics between groups. The successful rate of management was 100% for both groups. However, the operative time and estimated blood loss were less in the mEVA group than in the SC group. Severe pain was significantly less prevalent in group A than group B. Suspected endometritis was found in two (4.3%) patients in each group.Conclusions:  The efficacy of mEVA was the same as that of SC in successful management of incomplete abortion, but pain was experienced more often in the SC group.
Primary adenomyoma of the fallopian tube mimicking tubal malignant tumor
Authors: Etoh Tomomaro , Watanabe Yoh , Imaoka Izumi , Murakami Takamichi , Hoshiai Hiroshi 
Published: March 2012

AbstractWe report a rare case of adenomyoma localized only in the left fallopian tube mimicking tubal malignant tumor. A 45‐year‐old woman presented with mild pelvic pain, dysmenorrhea and left adnexal mass. Magnetic resonance imaging showed a solid tumor, suspected primary cancer of the fallopian tube, and serum carbohydrate antigen 125 was elevated to 72 U/mL (normal; 0–35). At surgery, the tumor was revealed as a left fallopian tube tumor without torsion. Postoperative histopathology showed that the tumor included bundle‐like growing non‐atypical leiomyoma cells and ectopic normal endometrium accompanied with endometrial stroma and we diagnosed primary adenomyoma of the left fallopian tube. Adenomyoma localized only in the fallopian tube is a rare entity and it can occur only in the fallopian tube.
Follow‐up of women with gestational diabetes in the Tehran Lipid and Glucose Study (TLGS): A population‐based cohort study
Authors: Ramezani Tehrani Fahimeh , Hashemi Somayeh , Hasheminia Mitra , Azizi Freidoon 
Published: March 2012

AbstractAim:  Women with gestational diabetes (GDM) are at increased risk of developing type 2 diabetes mellitus (T2DM), but there is disagreement regarding this conversion rate or its cardiovascular consequences. We investigated the metabolic and cardiovascular consequences of women with GDM in a population‐based cohort study.Material and Methods:  Three groups of women were selected from the Tehran Lipid and Glucose Study (TLGS) and followed up for an average 9 years: women with prior history of GDM (n = 29); women with history of macrosomia or stillbirth without GDM (MC‐ST) (n = 570), and age‐ and BMI‐matched controls (n = 628). The incidence of T2DM, hypertension (HTN) and dyslipidemia were compared between these groups. Statistical significance was set at P < 0.05.Results:  During the 9‐year follow‐up, T2DM was diagnosed in 27.3% of women with GDM in comparison to 9.5% among the control group (P < 0/001); 7.4% of the MC‐ST group versus 8.9% of control group developed T2DM during the study follow‐up (P = 0/03). There was no significant difference in the incidence of HTN or dyslipidemia between these groups (P > 0/05).Conclusion:  Women with a history of GDM are at higher risk for developing T2DM later in life. The timely recognition of GDM may provide a ‘teachable moment’ during which women could be motivated to implement lifestyle modifications to reduce their T2DM risk.
Abdominal radical trachelectomy for treatment of deep infiltrating endometriosis of the cervix
Authors: Rodolakis Alexandros , Akrivos Nikolaos , Haidopoulos Dimitrios , Kyritsis Nikolaos , Sotiropoulou Maria , Thomakos Nikolaos , Biliatis Ioannis , Simou Maria , Antsaklis Aris 
Published: March 2012

AbstractSurgical management of deep infiltrating endometriosis can be very challenging even for experienced gynecologists. Radical procedures like bowel resection and nephrectomy have been reported for treatment of the disease. Our aim is to report abdominal radical trachelectomy for treatment of deep infiltrating endometriosis of the cervix causing obstructive uropathy and diminished kidney function. We present a 38‐year‐old woman who was treated in our department for cervical endometriosis involving the vagina and left parametrium. Abdominal radical trachelectomy, insertion of a pig‐tail catheter in the left ureter and end‐to‐end anastomosis of the uterus with the vagina was performed to remove the endometriotic lesion. Cooperation between gynecologists, urologists and nephrologists enabled fertility preservation as well as improvement of renal function. Deep infiltrating endometriosis is a complex disease that requires a multidisciplinary approach. Abdominal radical trachelectomy for cervical lesions seems feasible in this setting and helps preserve fertility.
Different median levels of serum triple markers in the second trimester of pregnancy in a Thai Ethnic Group
Authors: Wanapirak Chanane , Sirichotiyakul Supatra , Luewan Suchaya , Yanase Yuri , Traisrisilp Kuntharee , Tongsong Theera 
Published: March 2012

AbstractAim:  The aim of the present study was to establish Thai‐specific reference ranges of triple markers for fetal Down syndrome as a function of gestational age as well as weight correction models and to compare the false positive rates when using Thai‐specific model relative to Caucasian‐specific model.Material and Methods:  A total of 993 normal Thai pregnant women were determined for mid‐trimester serum levels of alpha‐fetoprotein (AFP), free‐beta human chorionic gonadotropin (hCG), and unconjugated estriol (uE3), using DefiaXpress system (Perkin Elmer, Waltham, MA, USA).Results:  The models of Thai‐specific medians for AFP, b‐hCG, and uE3, as well as the models for weight correction were derived and the normal reference ranges were constructed. The best fitted equation for AFP, b‐hCG and uE3 are as follows: predicted median = 2.675 × 10(0.153 × GA in week), r = 0.979; 10(−0.717 + 57.487/GA in week), r = 0.991; and 10(5.678–69.346/GAinweek), r = 0.997, respectively. The models were properly applied to another group of 302 Thai women, signifying that they were reliable models. The weight‐adjusted gestation‐specific medians derived from Caucasian models were significantly higher than those based on Thai models and the false positive rate could be reduced from 10 to 7.1% when Thai models were applied.Conclusion:  Thai reference ranges of triple screen markers as a function of gestational age as well as weight correction models have been established. The Caucasian reference range, even after weight correction, gives a positive rate that is much higher than that it should be, strongly suggesting the need for ethnicity‐specific medians.
Prenatal diagnosis of a 22q11 deletion in a second‐trimester fetus with conotruncal anomaly, absent thymus and meningomyelocele: Kousseff syndrome
Authors: Canda Mehmet Tunc , Demir Namik , Bal Filiz Uyar , Doganay Latife , Sezer Orcun 
Published: March 2012

AbstractA 30‐year‐old nulliparous woman was seen for a detailed ultrasound scan at 20 weeks of gestation. The scan revealed a male fetus with truncus arteriosus, membranous ventricular septal defect, absent thymus and sacral meningomyelocele. A 46,XY karyotype with a 22q11 deletion was detected. The parents chose to terminate the pregnancy. The pathological autopsy showed normal facial structures, minimal ventricular dilatation in the brain and a sacral meningomyelocele. Overlapping toes and a left claw‐hand were also noted. An aplastic thymus with absent parathyroid glands was detected. The cardiac examination was consistent with the ultrasound diagnosis. The parental karyotypes were both normal. Kousseff syndrome is caused by a chromosome 22q11 deletion. It includes sacral meningomyelocele and conotruncal heart defects, unlike DiGeorge syndrome. Obstetricians should consider this a not so rare entity when they detect conotruncal abnormalities and a meningomyelocele as part of a 22q11.2 deletion syndrome.
Effect of lipopolysaccharide on the production of prostaglandin E2 and inhibition of uterine contractions by nitric oxide in pregnant inducible nitric oxide synthase knockout mice
Authors: Takahashi Hidenori , Okawa Toshiaki , Asano Kimisato , Fujimori Keiya 
Published: March 2012

AbstractAim:  The aim of the present study was to evaluate the effect of lipopolysaccharide (LPS) on the production of prostaglandin E2 (PGE2) and inhibition by nitric oxide (NO) of spontaneous contractions of uterine rings from pregnant inducible isoform of nitric oxide synthase knockout (iNOS KO) mice.Material and Methods:  iNOS KO and wild‐type mice were sacrificed 6 h after intraperitoneal (i.p.) administration of LPS on day 14 of gestation. Uterine rings were equilibrated in Krebs‐Henseleit solution for isometric tension recording. In part of the uterine rings, placental tissues were left attached. The bathing solution was analyzed for PGE2 by radioimmunoassay. Changes in spontaneous contractions in response to cumulative concentrations of L‐arginine, diethylamine/nitric oxide (DEA/NO), and 8‐bromo‐cyclic guanosine monophosphate (8‐br‐cGMP) were determined.Results:  Treatment with LPS increased PGE2 production by uterine rings from wild‐type and iNOS‐KO mice. DEA/NO and 8‐br‐cGMP inhibited spontaneous contractions in uterine rings in the absence or presence of placenta, in both LPS‐treated and LPS‐untreated animals. LPS treatment attenuated maximal inhibition induced by the agents, both in the absence and presence of placental tissues in iNOS KO and wild‐type mice.Conclusion:  LPS induces PG production in mice myometrium that is not dependent on the integrity of iNOS, while LPS could induce pathophysiological iNOS obstruct uterine quiescence by physiological iNOS. Infection affects uterine contractile activity through PG production, as well as through placental and genetic factors. NO may be a double‐edged sword in pregnant mice myometrium.
Calciuria and preeclampsia: A case–control study
Authors: Gasnier Rose , Valério Edimarlei G. , Vettorazzi Janete , Barros Elvino G. , Martins‐Costa Sérgio H. , Ramos José Geraldo L. 
Published: March 2012

AbstractAim:  Calciuria has been reported to decrease in preeclampsia. We compared calciuria among groups of normal, hypertensive and preeclamptic pregnant women, and assessed its correlation with the severity of the disease.Material and Methods:  We conducted a case–control study of mild and severe preeclampsia, chronic hypertension, and normal pregnancy, with 14 patients in each group. The groups were analyzed by one‐way anova (variance analysis) for symmetrical distribution and Kruskal–Wallis test for asymmetrical distribution when comparing quantitative variables, and by crossed tables when comparing qualitative variables.Results:  There were statistically significant differences between the groups when comparing severe preeclampsia with chronic hypertension, and severe preeclampsia with the control group (P < 0.0001). The calciuria medians were 81.5 mg/24 h for severe preeclampsia, 118 mg/24 h for mild preeclampsia, 226 mg/24 h for chronic hypertension, and 272 mg/24 h for the control group. In a ROC (receiver operating characteristic) curve analysis, the best cutoff point for preeclampsia diagnosis was 167 mg/24 h, with a sensitivity of 75% and a specificity of 85%. The outcomes were more severe as the level of calciuria dropped.Conclusion:  Measurement of calciuria can differentiate between severe preeclampsia and chronic hypertension, and hypocalciuria is also a marker for disease severity.
Stand type is more important than red wood ant abundance for the structure of ground‐dwelling arthropod assemblages in managed boreal forests
Authors: Neuvonen Seppo , Saikkonen Teemu , Sundström Liselotte , Punttila Pekka , Risch Anita C. , Domisch Timo , Niemelä Pekka , Kilpeläinen Jouni , Ohashi Mizue , Finér Leena 
Published: March 2012

The relationships between red wood ants (Formica rufagroup) and other ground‐dwelling arthropods were studied in young managed forests stands in Eastern Finland. The main objectives were: (i) to test the influence of stand type (dominant tree species; age: sapling versus pole stage) and numbers of red wood ants on the occurrence of other ground‐dwelling arthropods and (ii) to study the occurrence of red wood ants versus other arthropods on a distance gradient from ant mounds. We used pitfall traps set in 5–14‐year‐old sapling stands and 30–45‐year‐old pole‐stage stands of Scots pine (Pinus sylvestrisL.) and birch (Betulaspp.) forests.Pitfall trap catches of red wood ants did not vary significantly between the forest stand types, although some groups of other arthropods showed clear responses to stand type (e.g. catches of other Formicinae and Gnaphosidae were higher in sapling stands than in pole‐stage stands). The number of red wood ants clearly explained less of the variation in assemblages of other ground‐dwelling arthropods than the forest stand type.Red wood ant numbers decreased significantly with distance from the mounds, but the other ground‐dwelling arthropods were insensitive to this gradient or even showed a preference for proximity to ant mounds and high ant activity.The results obtained in the present study suggest that wood ants do not have strong effects on several other ground‐dwelling arthropod groups in young managed forests other than in the immediate vicinity of their mounds.
The quorum sensing diversity within and between ecotypes of Bacillus subtilis
Authors: Stefanic Polonca , Decorosi Francesca , Viti Carlo , Petito Janine , Cohan Frederick M. , Mandic‐Mulec Ines 
Published: March 2012

SummaryEcological sociobiology is an emerging field that aims to frame social evolution in terms of ecological adaptation. Here we explore the ecological context for evolution of quorum sensing diversity in bacteria, where social communication is limited to members of the same quorum sensing type (pherotype). We sampled isolates of Bacillus subtilis from soil on a microgeographical scale and identified three ecologically distinct phylogenetic groups (ecotypes) and three pherotypes. Each pherotype was strongly associated with a different ecotype, suggesting that it is usually not adaptive for one ecotype to ‘listen’ to the signalling of another. Each ecotype, however, contained one or more minority pherotypes shared with the other B. subtilis ecotypes and with more distantly related species taxa. The pherotype diversity within ecotypes is consistent with two models: first, a pherotype cycling model, whereby minority pherotypes enter a population through horizontal genetic transfer and increase in frequency through cheating the social interaction; and second, an occasional advantage model, such that when two ecotypes are each below their quorum densities, they may benefit from listening to one another. This is the first survey of pherotype diversity in relation to ecotypes and it will be interesting to further test the hypotheses raised and supported here, and to explore other bacterial systems for the role of ecological divergence in fostering pherotype diversity.
Serrated polyp detection rate during screening colonoscopy
Authors: Liang J. , Kalady M. F. , Appau K. , Church J. 
Published: March 2012

AbstractAim  The adenoma detection rate is an important quality indicator for colonoscopy, but recently, serrated polyps of the large bowel have been recognized as important premalignant lesions. As they are often more difficult to see than adenomas, the detection rate of serrated polyps is set to become a more stringent indicator of quality in colonoscopy than adenoma detection rate. Here we aim to provide preliminary data on serrated polyp detection.Method  This is a retrospective review of prospectively collected data. Colonoscopies were stratified by one of six colorectal surgeons, each of whom had performed more than 1000 colonoscopies. Exams were separated by indication and the number of patients with at least one adenoma or one serrated polyp recorded. Time of withdrawal in normal examinations was noted.Results  Eighteen thousand and three colonoscopies were included. Average completion rate was 96.3 ± 1.2%. Mean serrated detection rate for all examinations was 20.6 ± 4.8% and for screening examinations only was 13.9 ± 5.0%. Corresponding means for adenoma detection were 31.5 ± 6.7% and 20.7 ± 4.1%, respectively. Simple regression of overall adenoma detection rate versus overall serrated detection rate was not significant (R = 0.571, P = 0.237), but was significant for screening exams (R = 0.854, P = 0.031). There was a strong relationship between time of withdrawal and serrated detection rate (screening, R = 0.908, P = 0.012; overall, R = 0.956, P = 0.003).Conclusion  Taking time to withdraw the colonoscope is essential for maximum detection of serrated polyps. The ability to find adenomas does not necessarily correlate with an ability to find serrated polyps.
Increased lymph node harvest in patients operated on for right‐sided colon cancer: a population‐based study
Authors: Bernhoff R. , Holm T. , Sjövall A. , Granath F. , Ekbom A. , Martling A. 
Published: March 2012

AbstractAim  In recent decades, the focus has been on the treatment of rectal cancer with improved surgical techniques. This has resulted in improved results for patients with rectal cancer. Recently, the focus has shifted to colon cancer surgery with the introduction of preoperative staging, new surgical techniques, quality control and enhanced recovery programmes. The change in operative techniques has been most pronounced for patients with tumours on the right side of the colon, with more extensive resections and proximal ligations of the vessels. The aim of this study was to assess the number of analysed lymph nodes and the metastatic index (MI) in patients operated on for right‐sided colon cancer in the Stockholm area between 1996 and 2009.Method  All patients operated on for cancer of the right colon between January 1996 and December 2009 were divided into three groups based on the year in which they were operated (period 1, 1996–1999; period 2, 2000–2004; and period 3, 2005–2009). The number of lymph nodes and lymph node status were analysed.Results  In total, 3536 patients were operated on for right‐sided colon cancer during the study period. There was a significantly lower proportion of emergency operations in the third time period. The mean number of lymph nodes examined increased significantly during the overall study period (seven in period 1, 11 in period 2 and 18 in period 3; P < 0.001). A significant drop in MI was seen during the third time period (0.25, compared with 0.40 in period 1 and 0.40 in period 2; P < 0.001).Conclusion  During the study period there was an increase in the number of analysed lymph nodes and a decrease in MI after right‐sided hemicolectomies. Further investigations are needed to evaluate the potential impact on short‐term and long‐term outcome.