bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guideline concordant venous ulcer care predicts healing in a tertiary care Veterans Affairs Medical Center
Authors: Olson Jonathan M. , Raugi Gregory J. , Nguyen Viet Q. , Yu Onchee , Reiber Gayle E. 
Published: September 2009

ABSTRACTThis study describes the impact of 80% adherence to guideline concordant care for compression therapy, moist wound‐healing environment, and debridement on venous ulcer outcomes. The retrospective cohort design included patients from a tertiary care Veterans Affairs Medical Center from October 2003 to September 2007. During this 5‐year interval, 155 patients with 400 venous ulcers met study inclusion. A majority of ulcers (n=362) healed, with an average time to healing of 18.1 weeks (range 2–209 weeks, median 10.4 weeks). From the multivariate Poisson regression, the likelihood of ulcer healing increased when compression therapy was provided during at least 80% of visits (relative risk [RR], 1.93; 95% confidence interval [CI], 1.27–2.92) or when a moist wound‐healing environment was provided during at least 80% of visits (RR, 1.63; 95% CI, 1.09–2.42). Debridement alone was not significantly associated with ulcer healing (RR, 1.0; 95% CI, 0.61–1.64). Patients who received all three treatments during at least 80% of their visits were more likely to heal than those who received < 80% treatment (RR, 2.52; 95% CI, 1.53–4.16). Guideline concordant venous ulcer care was significantly associated with venous ulcer healing, when provided at 80% or more of patient visits.
A multicenter clinical trial of recombinant human GM‐CSF hydrogel for the treatment of deep second‐degree burns
Authors: Zhang Liping , Chen Jiong , Han Chunmao 
Published: September 2009

ABSTRACTWound healing is a complex and dynamic biological process. The efficacy and safety of a recombinant human granulocyte‐macrophage colony‐stimulating factor (rhGM‐CSF) hydrogel to promote deep‐second‐degree burn wound healing is evaluated in this study. In this multicenter, randomized, double‐blind, and placebo‐controlled clinical trial, 90 patients with deep second‐degree burns were randomly assigned into two groups. Complete healing time and percentage of wound healing at different time points were observed and side effects were recorded. A statistically significant difference was noted at each time point (p<0.01). No side effects were observed. These results suggest that rhGM‐CSF hydrogel can significantly accelerate deep second‐degree burn wound healing and is considered to be safe.
Homeostasis of the epidermal barrier layer: A theory of how occlusion reduces hypertrophic scarring
Authors: O'Shaughnessy Kristina D. , De La Garza Mauricio , Roy Nakshatra K. , Mustoe Thomas A. 
Published: September 2009

ABSTRACTThe mechanism of hypertrophic scar reduction using silicone gel sheeting remains elusive. We hypothesize that the decrease in scar formation is due to occlusion and homeostasis of the barrier layer. Using an established model of hypertrophic scarring, rabbits were divided into four groups and scars were tape‐stripped or occluded with Kelocote, Cavilon, or Indermil, with each rabbit serving as its own internal control. All wounds were harvested on day 28 and examined histologically to measure the scar elevation index (SEI), epithelial thickness, and cellularity. Immunohistochemistry fluorescence was used to quantify inflammation in the dermis. Transepidermal water loss (TEWL) was measured for each occlusive agent and tape stripping. Ultrastructural analysis was performed by electron microscopy. Kelocote, Cavilon, and Indermil all significantly decreased SEI when compared with controls. Each of the occlusive treatments was shown to decrease TEWL while tape stripping increased TEWL. Tape stripping significantly increased the SEI, epithelial thickness, and cellularity. Immunostaining for macrophages showed increased density of inflammatory cells in the tape‐stripped scars. Under electron microscopy, the tape‐stripped wounds displayed extensive inflammation and keratinocyte damage. Both unwounded skin and occlusion‐treated scars did not display these characteristics. In conclusion, hypertrophic scarring was reduced regardless of occlusive method used. Furthermore, repeated disruption of the permeability barrier by tape stripping led to an increase in scarring. Ultrastructural analysis suggests that occluded wounds may be in an advanced state of wound repair. Occlusion may mediate its effects through establishing homeostasis of the epidermal barrier layer.
Accelerated closure of skin wounds in mice deficient in the homeobox gene Msx2
Authors: Yeh Jennifer , Green Lydia M. , Jiang Ting‐Xin , Plikus Maksim , Huang Eunice , Chang Richard N. , Hughes Michael W. , Chuong Cheng‐Ming , Tuan Tai‐Lan 
Published: September 2009

ABSTRACTDifferences in cellular competence offer an explanation for the differences in the healing capacity of tissues of various ages and conditions. The homeobox family of genes plays key roles in governing cellular competence. Of these, we hypothesize that Msx2 is a strong candidate regulator of competence in skin wound healing because it is expressed in the skin during fetal development in the stage of scarless healing, affects postnatal digit regeneration, and is reexpressed transiently during postnatal skin wound repair. To address whether Msx2 affects cellular competence in injury repair, 3 mm full‐thickness excisional wounds were created on the back of C.Cg‐Msx2tm1Rilm/Mmcd (Msx2 null) mice and the healing pattern was compared with that of the wild type mice. The results show that Msx2 null mice exhibited faster wound closure with accelerated reepithelialization plus earlier appearance of keratin markers for differentiation and an increased level of smooth muscle actin and tenascin in the granulation tissue. In vitro, keratinocytes of Msx2 null mice exhibit increased cell migration and the fibroblasts show stronger collagen gel contraction. Thus, our results suggest that Msx2 regulates the cellular competence of keratinocytes and fibroblasts in skin injury repair.
HaCaT keratinocytes in co‐culture with Staphylococcus aureus can be protected from bacterial damage by polihexanide
Authors: Wiegand Cornelia , Abel Martin , Ruth Peter , Hipler Uta‐Christina 
Published: September 2009

ABSTRACTWound healing is compromised by critical colonization and infection with bacteria. Hence, antimicrobial agents are used clinically to decrease the bacterial load and promote wound healing. Polihexanide (PHMB) has been found to be effective against a broad spectrum of micro‐organisms and is increasingly utilized in rinsing solutions or in combination with wound dressings because of its good biocompatibility. In the present study, a co‐culture of human keratinocytes and Staphylococcus aureus was established to serve as an in vitro model for infected wounds. Incubation of keratinocytes with increasing concentrations of S. aureus led to a dose‐dependent decline of cell viability and proliferation. Lactate dehydrogenase release and interleukin‐8 liberation were found to be elevated under these conditions. Polihexanide dose‐dependently was able to protect keratinocytes from bacterial damage and re‐establish normal human cell proliferation in vitro. Furthermore, a dressing consisting of biocellulose derived from Acetobacter xylinum with the addition of polihexanide was adept to safeguard keratinocytes against S. aureus. In conclusion, the co‐culture system presented embodies a valuable tool as a model system for infected cells in a non‐healing wound. Furthermore, the results obtained support the favorable function of polihexanide in the treatment of infected chronic wounds.
Nonconvulsive status epilepticus and coma
Authors: Bauer Gerhard , Trinka Eugen 
Published: September 2009

SummaryNonconvulsive status epilepticus (NCSE) in a comatose patient cannot be diagnosed without electroencephalography (EEG). In many advanced coma stages, the EEG exhibits continuous or periodic EEG abnormalities, but their causal role in coma remains unclear in many cases. To date there is no consensus on whether to treat NCSE in a comatose patient in order to improve the outcome or to retract from treatment, as these EEG patterns might reflect the end stages of a dying brain. On the basis of EEG, NCSE in comatose patients may be classified as generalized or lateralized. This review aims to summarize the ongoing debate of NCSE and coma and to critically reassess the available literature on coma with epileptiform EEG pattern and its prognostic and therapeutic implications. The authors suggest distinguishing NCSE proper and comatose NCSE, which includes coma with continuous lateralized discharges or generalized epileptiform discharges (coma‐LED, coma‐GED). Although NCSE proper is accompanied by clinical symptoms suggestive of status epilepticus and mild impairment of consciousness, such as in absence status or complex focal status epilepticus, coma‐LED and coma‐GED represent deep coma of various etiology without any clinical motor signs of status epilepticus but with characteristic epileptiform EEG pattern. Hence coma‐LED and coma‐GED can be diagnosed with EEG only. Subtle or stuporous status epilepticus and epilepsia partialis continua–like symptoms in severe acute central nervous system (CNS) disorders represent the borderland in this biologic continuum between NCSE proper and comatose NCSE (coma‐LED/GED). This pragmatic differentiation could act as a starting point to solve terminologic and factual confusion.
Placebo‐corrected efficacy of modern antiepileptic drugs for refractory epilepsy: Systematic review and meta‐analysis
Authors: Beyenburg Stefan , Stavem Knut , Schmidt Dieter 
Published: September 2009

SummaryAlthough adjunctive treatment with modern antiepileptic drugs (AEDs) is standard care in refractory epilepsy, it is unclear how much of the effect can be attributed directly to the AEDs and how much to the beneficial changes seen with placebo. Therefore, we performed a systematic review and meta‐analysis of the evidence to determine the placebo‐corrected net efficacy of adjunctive treatment with modern AEDs on the market for refractory epilepsy. Of 317 potentially eligible articles reviewed in full text, 124 (39%) fulfilled eligibility criteria. After excluding 69 publications, 55 publications of 54 studies in 11,106 adults and children with refractory epilepsy form the basis of evidence. The overall weighted pooled‐risk difference in favor of AEDs over placebo for seizure‐freedom in the total sample of adults and children was 6% [95% confidence interval (CI) 4–8, z = 6.47, p < 0.001] and 21% (95% CI 19–24, z = 17.13, p < 0.001) for 50% seizure reduction. Although the presence of moderate heterogeneity may reduce the validity of the results and limit generalizations from the findings, we conclude that the placebo‐corrected efficacy of adjunctive treatment with modern AEDs is disappointingly small and suggest that better strategies of finding drugs are needed for refractory epilepsy, which is a major public health problem.
Extent of initial injury determines language lateralization in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE‐HS)
Authors: Rathore Chaturbhuj , George Annamma , Kesavadas Chandrasekharan , Sankara Sarma P. , Radhakrishnan Kurupath 
Published: September 2009

SummaryPurpose:  To assess the prevalence and attributes of atypical language lateralization (ALL) in patients with left mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE‐HS).Methods:  We recruited consecutive patients with left MTLE‐HS, who had undergone resective surgery and had pathologically proven HS. Based on the Wada test, language lateralization was classified into typical (left hemispheric) or atypical (right hemispheric or codominant). We assessed the attributes of patients with ALL using univariate and multivariate analyses.Results:  Of 124 patients with left MTLE‐HS, 23 (18.5%) had ALL. ALL occurred more frequently in patients with severe initial precipitating injury (IPI), early onset of epilepsy, and a short latent period between IPI and onset of habitual seizures. ALL was more common in patients with bitemporal and extratemporal interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) and extratemporal changes on magnetic resonance imaging (MRI). On multivariate analyses, the age at onset of habitual seizures <6 years, atypical IPI, nonunilateral temporal IEDs, and extratemporal MRI abnormalities independently predicted ALL. The likelihood of ALL was very low (∼1%) when all of these four risk factors were absent, whereas it was very high (>95%), if any three or all four of them were present.Conclusions:  ALL occurs in one‐fifth of patients with left MTLE‐HS. ALL is more frequent in those with structural or functional extrahippocampal involvement and early onset of epilepsy interrupting the development of normal language networks. Because ALL is uncommon in those with damage/dysfunction restricted to the hippocampus, the hippocampus itself may have only a limited role in determining language lateralization.
Topiramate concentrations in neonates treated with prolonged whole body hypothermia for hypoxic ischemic encephalopathy
Authors: Filippi Luca , La Marca Giancarlo , Fiorini Patrizio , Poggi Chiara , Cavallaro Giacomo , Malvagia Sabrina , Pellegrini‐Giampietro Domenico E. , Guerrini Renzo 
Published: September 2009

SummaryPurpose:  Therapeutic hypothermia reduces mortality and neurologic impairment in neonates with hypoxic–ischemic encephalopathy. Topiramate exerts a neuroprotective effect in asphyxiated neonatal animal models. However, no studies have investigated the association of hypothermia and topiramate, because topiramate pharmacokinetics during hypothermia and the optimal administration schedule are unknown. The influence of hypothermia on topiramate pharmacokinetics was evaluated in asphyxiated neonates treated with prolonged whole‐body hypothermia and topiramate.Methods:  Thirteen term newborns were treated with mild or deep whole body hypothermia for 72 h; all received oral topiramate, 5 mg/kg once a day for the first 3 days of life, and seven had concomitant phenobarbital treatment. Topiramate concentrations were measured on serial dried blood spots.Results:  Topiramate concentrations were within the reference range in 11 of 13 newborns, whereas concentrations exceeded the upper limit in 2 of 13, both newborns on deep hypothermia. Topiramate concentrations reached a virtual steady state in nine newborns, for whom pharmacokinetic parameters were calculated. Values of topiramate maximal and minimal concentration, half‐life, average concentration, and area under the time—concentration curve resulted in considerably higher values than those reported in normothermic infants. With respect to normothermic infants, time of maximal concentration was mildly delayed and apparent total body clearance was lower, suggesting slower absorption and elimination. Pharmacokinetic parameters did not differ significantly between infants on deep versus mild hypothermia and in those on topiramate monotherapy versus add‐on phenobarbital.Conclusion:  Most neonates on prolonged hypothermia treated with topiramate 5 mg/kg once a day exhibited drug concentrations within the reference range for the entire treatment duration.
Different Mechanisms Underlying Consecutive, Postoperative Atrial TachyArrhythmias in a Fontan Patient
Authors: DE GROOT NATASJA M.S. , BLOM NICO , VD WALL ERNST E. , SCHALIJ MARTIN J. 
Published: September 2009

Introduction:

Atrial tachyarrhythmias (AT) frequently develop later after a Fontan operation and can be successfully treated by ablative therapy. However, new arrhythmias often develop.
Methods and Results:

Consecutive AT emerging in a Fontan patient were ablated using three‐dimensional electro‐anatomical mapping. During a 6‐year period, nine different AT were ablated, including intraatrial reentrant AT (N = 5), focal AT (N = 3), and focal atrial fibrillation (N = 1) originating from distinct right atrial sites.
Conclusion:

In a Fontan patient, successive AT can be caused by different mechanisms. These AT are most likely the result of progressive atrial cardiomyopathy and can be treated by catheter ablation.
The role of microRNAs in normal and malignant hematopoiesis
Authors: Vasilatou Diamantina , Papageorgiou Sotirios , Pappa Vassiliki , Papageorgiou Efstathios , Dervenoulas John 
Published: September 2009

AbstractMicroRNAs are small non‐coding RNAs that act at the post‐transcriptional level, regulating protein expression by repressing translation or destabilizing mRNA target. Because of their discovery, microRNAs have been associated with almost every normal cell function, including proliferation, differentiation and apoptosis. Several lines of evidence suggest that they have an important role in normal hematopoiesis as exemplified by the role of mir‐155 and mir‐150 in the differentiation of B and T lymphocytes, the suppressive role of mir‐221 and mir‐222 in erythroid differentiation, the inhibitory effect of mir‐181 on hematopoietic differentiation and the induction of myeloid differentiation by mir‐223. Moreover, they play a role both as oncogenes, probably by a variety of mechanisms, namely through elimination of tumor suppressor proteins, or as tumor suppressor genes by targeting oncogenic mRNAs. Their aberrant expression has been associated with solid tumors and hematopoietic malignancies as suggested by the frequent deletion of mir‐15a and mir‐16‐1 in chronic lymphocytic leukemia, the increased levels of mir‐155 in diffuse large B‐cell lymphomas and the increased levels of mir‐181 in acute myeloid leukemia M1 and M2. The purpose of this review is to summarize current knowledge on the role of microRNAs in normal hematopoiesis and hematopoietic malignancies and, moreover, to highlight their role as potential therapeutic tools.
Elevated serum parathormone levels are associated with myocardial iron overload in patients with β‐thalassaemia major
Authors: Dimitriadou Meropi , Christoforidis Athanasios , Economou Marina , Tsatra Ioanna , Vlachaki Efthimia , Fidani Liana , Katzos George , Athanassiou‐Metaxa Miranda 
Published: September 2009

AbstractObjectives:  Despite advances in conventional treatment, iron‐induced cardiomyopathy is still the most frequent cause of death among patients with β‐thalassaemia major. Recent studies have correlated increased myocardial iron content to decreased levels of vitamin D in thalassaemic patients. The aim of this study was to measure parathormone (PTH) and metabolites of vitamin D and consequently to investigate whether these parameters predispose to myocardial iron overload in patients with β‐thalassaemia major.Methods:  In 62 patients (29 M and 33 F, mean age: 22.79 ± 6.18 yr) with β‐thalassaemia major levels of intact parathormone (iPTH) and vitamin D metabolites [25(ΟH)D3 and 1,25(ΟH)2D3] were measured in serum. Additionally, estimation of myocardial iron content was performed by magnetic resonance imaging, whereas mean serum ferritin concentrations were calculated for 1 yr prior to the study.Results:  Results showed markedly decreased levels of serum 25(OH)D3 in 37 patients (60%), whereas 7 patients (11%) had borderline 25(OH)D3 levels (between 50 and 75 nmol/L). Serum iPTH levels were significantly higher in patients having increased myocardial iron compared to those having normal myocardial iron (44.04 ± 22.09 pg/mL vs. 31.39 ± 14.30 pg/mL, P = 0.017). Multivariant regression analysis identified PTH levels as the major predictor of increased myocardial iron.
Adjuvant topical therapy with a cannabinoid receptor agonist in facial postherpetic neuralgia
Authors: Phan Ngoc Quan , Siepmann Dorothee , Gralow Ingrid , Ständer Sonja 
Published: September 2009

Summary Background: Postherpetic neuralgia is a frequent adverse event in herpes zoster patients and difficult to treat. Conventional analgetic therapy often fails to reduce the burning pain transmitted by unmyelinated nerve fibers. These nerves express cannabinoid receptors which exert a role in modulation of nociceptive symptoms. Therefore, topical therapy with cannabinoid receptor agonist seems likely to suppress local burning pain. Patients and methods: In an open‐labeled trial, 8 patients with facial postherpetic neuralgia received a cream containing the cannabinoid receptor agonist N‐palmitoylethanolamine. The course of symptoms was scored with the visual analog scale. Results: 5 of 8 patients (62.5 %) experienced a mean pain reduction of 87.8 %. Therapy was tolerated by all patients. No unpleasant sensations or adverse events occurred. Conclusions: Topical cannabinoid receptor agonists are an effective and well‐tolerated adjuvant therapy option in postherpetic neuralgia.
Fitting orbits to tidal streams with proper motions
Authors: Eyre Andy , Binney James 
Published: September 2009

Abstract
The Galaxy's stellar halo seems to be a tangle of disrupted systems that have been tidally stretched out into streams. Each stream approximately delineates an orbit in the Galactic force-field. In the first paper in this series, we showed that all six phase-space coordinates of each point on an orbit can be reconstructed from the orbit's path across the sky and measurements of the line-of-sight velocity along the orbit. In this paper, we complement this finding by showing that the orbit can also be reconstructed if we know proper motions along the orbit rather than the radial velocities. We also show that accurate proper motions of stream stars would enable distances to be determined to points on the stream that are independent of any assumption about the Galaxy's gravitational potential. Such ‘Galactic parallaxes’ would be as fundamental as conventional trigonometric parallaxes, but measurable to distances ∼70 times further.
Can magnetic fields be detected during the inspiral of binary neutron stars?
Authors: Giacomazzo Bruno , Rezzolla Luciano , Baiotti Luca 
Published: September 2009

Abstract
Using accurate and fully general-relativistic simulations we assess the effect that magnetic fields have on the gravitational-wave emission produced during the inspiral and merger of magnetized neutron stars. In particular, we show that magnetic fields have an impact after the merger, because they are amplified by a Kelvin–Helmholtz instability, but also during the inspiral, most likely because the magnetic tension reduces the stellar tidal deformation for extremely large initial magnetic fields, B0≳ 1017G. We quantify the influence of magnetic fields by computing the overlap, , between the waveforms produced during the inspiral by magnetized and unmagnetized binaries. We find that for any realistic magnetic field strength B0≲ 1014G the overlap during the inspiral is and is quite insensitive to the mass of the neutron stars. Only for unrealistically large magnetic fields like B0≃ 1017G the overlap does decrease noticeably, becoming at our resolutions for stars with baryon masses Mb≃ 1.4/1.6M⊙, respectively. Because neutron stars are expected to merge with magnetic fields ∼108–1010G and because present detectors are sensitive to , we conclude that it is very unlikely that the present detectors will be able to discern the presence of magnetic fields during the inspiral of neutron stars.