bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echinacea purpurea Significantly Induces Cytochrome P450 3A Activity but Does Not Alter Lopinavir‐Ritonavir Exposure in Healthy Subjects
Authors: Penzak Scott R. , Robertson Sarah M. , Hunt Jennifer D. , Chairez Cheryl , Malati Christine Y. , Alfaro Raul M. , Stevenson James M. , Kovacs Joseph A. 
Published: July 2010

Study Objective. To determine the influence of Echinacea purpurea on the pharmacokinetics of lopinavir‐ritonavir and on cytochrome P450 (CYP)3A and P‐glycoprotein activity by using the probe substrates midazolam and fexofenadine, respectively.Design. Open‐label, single‐sequence pharmacokinetic study.Setting. Outpatient clinic in a federal government research center.Subjects. Thirteen healthy volunteers (eight men, five women).Intervention. Subjects received lopinavir 400 mg‐ritonavir 100 mg twice/day with meals for 29.5 days. On day 16, subjects received E. purpurea 500 mg 3 times/day for 28 days: 14 days in combination with lopinavir‐ritonavir and 14 days ofE. purpureaalone. In order to assess CYP3A and P‐glycoprotein activity, subjects received single oral doses of midazolam 8mg and fexofenadine 120 mg, respectively, before and after the 28 days of E. purpurea.Measurements and Main Results. On days 15 and 30 of lopinavir‐ritonavir administration (before and after E. purpurea administration, respectively), serial blood samples were collected over 12 hours to determine lopinavir and ritonavir concentrations and subsequent pharmacokinetic parameters by using noncompartmental methods. Neither lopinavir nor ritonavir pharmacokinetics were significantly altered by 14 days of E. purpurea coadministration. The post‐echinacea:pre‐echinacea geometric mean ratios (GMRs) for lopinavir area under the concentration‐time curve (AUC) from 0–12 hours and for maximum concentration were 0.96 (90% confidence interval [CI] 0.83–1.10, p=0.82) and 1.00 (90% CI 0.88–1.12, p=0.72), respectively. Conversely, GMRs for midazolam AUC from time zero extrapolated to infinity and oral clearance were 0.73 (90% CI 0.61–0.85, p=0.008) and 1.37 (90% CI 1.10–1.63, p=0.02), respectively. Fexofenadine pharmacokinetics did not significantly differ before and after E. purpurea administration (p>0.05).Conclusion. Echinacea purpureainduced CYP3A activity but did not alter lopinavir concentrations, most likely duetothe presenceofthe potent CYP3A inhibitor, ritonavir. Echinacea purpureais unlikely to alter the pharmacokinetics of ritonavir‐boosted protease inhibitors but may cause modest decreases in plasma concentrations of other CYP3A substrates.
Serum Alanine Aminotransferase Elevation During 10 Days of Acetaminophen Use in Nondrinkers
Authors: Heard Kennon J. , Green Jody L. , Dart Richard C. 
Published: July 2010

Study Objective. To describe the changes in serum alanine aminotransferase (ALT) levels in nondrinkers receiving acetaminophen for 10 days.Design. Prospective, open‐label study.Setting. Outpatient clinical research center.Patients. Twenty‐four healthy volunteers who reported an average alcohol consumption of less than one drink/day for the 30 days preceding study enrollment.Intervention. Patients were administered acetaminophen 4 g/day for 10 days (study days 1–10).Measurements and Main Results. Serum ALT level, total bilirubin level, and international normalized ratio (INR) were measured on study days 0, 4, 7, 9, 11, and 14. Median ALT level increased from 24 U/L on day 0 to 39 U/L on day 7, and remained elevated through day 11 (39 U/L); these increases were statistically significant (p=0.0002). Median ALT level began to trend down by day 14 (35 U/L). Fourteen subjects (58%) had ALT levels above the upper limit of normal; the largest elevation was 3.8 times the upper limit of normal (day 7). No increases in INR or total bilirubin level were noted during the study, and no subject developed symptoms of liver injury (e.g., abdominal pain, jaundice).Conclusion. Daily use of acetaminophen at the maximum dose of 4 g/day for 10 days caused asymptomatic ALT level elevations in subjects who do not consume alcohol. The clinical implication of these elevations remains unclear. Future studies should evaluate ALT changes and their clinical effects when acetaminophen is given for long periods of time.
Associations Between Matrix Metalloproteinase‐8 and ‐14 and Myeloperoxidase in Gingival Crevicular Fluid From Subjects With Progressive Chronic Periodontitis: A Longitudinal Study
Authors: Hernández M. , Gamonal J. , Tervahartiala T. , Mäntylä P. , Rivera O. , Dezerega A. , Dutzan N. , Sorsa T. 
Published: July 2010

Background: Matrix metalloproteinase (MMP)‐8 is a central mediator in chronic periodontitis. MMP‐8 can be activated by the cooperative action of other MMPs such as MMP‐14, reactive oxygen species, and microbial proteases. The aim of this study is to associate the levels, molecular forms, isoenzyme distribution, and degree of activation of MMP‐8 and ‐14, myeloperoxidase (MPO), and tissue inhibitor of MMP (TIMP)‐1 in gingival crevicular fluid (GCF) from patients with progressive periodontitis at baseline and after periodontal therapy.Methods: In this longitudinal study, GCF samples from active (n = 25) and inactive (n = 25) sites of subjects with periodontitis were screened at baseline for GCF levels of MMP‐8 by immunofluorometric assay, of MMP‐14 by specific activity assay, and of MPO and TIMP‐1 by enzyme‐linked immunosorbent assay. MMP‐8 and MPO were also measured after periodontal treatment. Molecular forms were determined by immuno‐Western blot analyses and subjected to densitometric scanning and statistical analyses.Results: High MMP‐8 and MPO levels and a strong MPO/MMP‐8 positive correlation were found in active and inactive sites at baseline. After treatment, decreases in MPO and MMP‐8 were seen, except for active sites in which MMP‐8 differences were not significant (P <0.05).Conclusions: We present initial data that show that GCF levels and associations between MPO and MMP‐8 are related to progression episodes and treatment responses in patients with chronic periodontitis. Our results suggest an interaction between the MPO oxidative pathway and MMP‐8 activation, and this cascade might be useful as a potential biomarker for treatment outcomes.
Histologic Analysis of Healing After Tooth Extraction With Ridge Preservation Using Mineralized Human Bone Allograft
Authors: Beck Tina M. , Mealey Brian L. 
Published: July 2010

Background: Ridge preservation was developed as a therapy to prevent severe bone resorption after tooth extraction. The purpose of this study is to determine if there is any difference in the amount of new bone formation ≈3 months after extraction and ridge preservation compared to that after ≈6 months.Methods: Minimally traumatic extraction with ridge preservation using mineralized human bone allograft was performed at 38 single‐rooted tooth sites in 33 subjects. Sixteen sites healed for an average of 14 weeks (early healing), whereas 22 sites were allowed to heal for an average of 27 weeks (delayed healing) before harvesting bone core samples. Histomorphometric analysis was performed to determine the percent of new bone formation, residual graft particles, and connective tissue/non‐mineralized structures for each site.Results: All specimens showed evidence of new bone formation, with most of the residual graft particles surrounded intimately by woven bone. No statistically significant differences in the amount of newly formed bone or residual graft particles were found between the two groups. Overall, the early healing group demonstrated a mean of 45.8% new bone, 14.6% residual graft material, and 39.6% connective tissue/non‐mineralized tissue. The delayed healing group showed mean values of 45%, 13.5%, and 41.3%, respectively.Conclusion: The results of this study suggest that waiting ≈6 months after tooth extraction and ridge preservation using mineralized bone allograft does not provide a greater amount of new bone formation or less residual bone particles compared to that after only ≈3 months.
Risk Assessment of Lingual Plate Perforation in Posterior Mandibular Region: A Virtual Implant Placement Study Using Cone‐Beam Computed Tomography
Authors: Chan Hsun‐Liang , Benavides Erika , Yeh Chu‐Yuan , Fu Jia‐Hui , Rudek Ivan E. , Wang Hom‐Lay 
Published: July 2010

Background: Lingual plate perforation at the time of implant placement in posterior mandible is a potential surgical complication, and presence of a lingual concavity is considered a risk factor. Little is known about the spatial relationship between implant and lingual plate. The role of lingual concavity in the risk of lingual perforation has not yet been fully studied. This computer‐simulated study investigates the incidence of lingual plate perforation in edentulous mandibular first molar region and the risk of perforation in the area of lingual concavity.Methods: One hundred and three qualified cone‐beam computed tomography scans were selected from the database. Implants of various dimensions were virtually placed into the area using computer software. The distance between implant tip and lingual plate was measured using a digital caliper. Incidence of lingual plate perforation and proximity of the implant tip to lingual plate were measured for three types of cross‐sectional mandibular morphology.Results: One hundred and three cone‐beam computed tomography scans with 118 sites were available for analysis. The intraexaminer and interexaminer agreements were 0.93 and 0.89, respectively. The predicted incidence of lingual plate perforation was 1.1% to 1.2%. Most implants, which were within 1 mm from lingual plate, occurred in sites with lingual concavity (type‐U ridge).Conclusions: This study demonstrates a novel experimental design by which the spatial relation between implant and lingual plate in mandibular first molar region is investigated. Incidence of lingual plate perforation during implant placement is predicted to be 1.1% to 1.2% and it will most likely happen in type‐U ridge.
Clinical and Experimental Pancreatic Islet Transplantation to Striated Muscle
Authors: Christoffersson Gustaf , Henriksnäs Johanna , Johansson Lars , Rolny Charlotte , Ahlström Håkan , Caballero-Corbalan José , Segersvärd Ralf , Permert Johan , Korsgren Olle , Carlsson Per-Ola , Phillipson Mia 
Published: July 2010

OBJECTIVE
Curing type 1 diabetes by transplanting pancreatic islets into the liver is associated with poor long-term outcome and graft failure at least partly due to inadequate graft revascularization. The aim of the current study was to evaluate striated muscle as a potential angiogenic site for islet transplantation.

RESEARCH DESIGN AND METHODS
The current study presents a new experimental model that is found to be applicable to clinical islet transplantation. Islets were implanted into striated muscle and intraislet vascular density and blood flow were visualized with intravital and confocal microscopy in mice and by magnetic resonance imaging in three autotransplanted pancreatectomized patients. Mice were rendered neutropenic by repeated injections of Gr-1 antibody, and diabetes was induced by alloxan treatment.

RESULTS
Contrary to liver-engrafted islets, islets transplanted to mouse muscle were revascularized with vessel densities and blood flow entirely comparable with those of islets within intact pancreas. Initiation of islet revascularization at the muscular site was dependent on neutrophils, and the function of islets transplanted to muscle was proven by curing diabetic mice. The experimental data were confirmed in autotransplanted patients where higher plasma volumes were measured in islets engrafted in forearm muscle compared with adjacent muscle tissue through high-resolution magnetic resonance imaging.

CONCLUSIONS
This study presents a novel paradigm in islet transplantation whereby recruited neutrophils are crucial for the functionally restored intraislet blood perfusion following transplantation to striated muscle under experimental and clinical situations.
Paraquaternionic CR-submanifolds of paraquaternionic Kähler manifolds and semi-Riemannian submersions
Authors: Ianuş Stere , Marchiafava Stefano , Vîlcu Gabriel 
Published: July 2010

AbstractIn this paper we introduce paraquaternionic CR-submanifolds of almost paraquaternionic hermitian manifolds and state some basic results on their differential geometry. We also study a class of semi-Riemannian submersions from paraquaternionic CR-submanifolds of paraquaternionic Kähler manifolds.
Mathematical programming via the least-squares method
Authors: Übi Evald 
Published: July 2010

AbstractThe least-squares method is used to obtain a stable algorithm for a system of linear inequalities as well as linear and nonlinear programming. For these problems the solution with minimal norm for a system of linear inequalities is found by solving the non-negative least-squares (NNLS) problem. Approximate and exact solutions of these problems are discussed. Attention is mainly paid to finding the initial solution to an LP problem. For this purpose an NNLS problem is formulated, enabling finding the initial solution to the primal or dual problem, which may turn out to be optimal. The presented methods are primarily suitable for ill-conditioned and degenerate problems, as well as for LP problems for which the initial solution is not known. The algorithms are illustrated using some test problems.
Cancer-Related Fatigue and Rehabilitation: A Randomized Controlled Multicenter Trial Comparing Physical Training Combined With Cognitive-Behavioral Therapy With Physical Training Only and With No Intervention
Authors: van Weert Ellen , May Anne M. , Korstjens Irene , Post Wendy J. , van der Schans Cees P. , van den Borne Bart , Mesters Ilse , Ros Wynand J.G. , Hoekstra-Weebers Josette E.H.M. 
Published: July 2010

Background
Research suggests that cancer rehabilitation reduces fatigue in survivors of cancer. To date, it is unclear what type of rehabilitation is most beneficial.

Objective
This randomized controlled trial compared the effect on cancer-related fatigue of physical training combined with cognitive behavioral therapy with physical training alone and with no intervention.

Design
In this multicenter randomized controlled trial, 147 survivors of cancer were randomly assigned to a group that received physical training combined with cognitive-behavioral therapy (PT+CBT group, n=76) or to a group that received physical training alone (PT group, n=71). In addition, a nonintervention control group (WLC group) consisting of 62 survivors of cancer who were on the waiting lists of rehabilitation centers elsewhere was included.

Setting
The study was conducted at 4 rehabilitation centers in the Netherlands.

Patients
All patients were survivors of cancer.

Intervention
Physical training consisting of 2 hours of individual training and group sports took place twice weekly, and cognitive-behavioral therapy took place once weekly for 2 hours.

Measurements
Fatigue was assessed with the Multidimensional Fatigue Inventory before and immediately after intervention (12 weeks after enrollment). The WLC group completed questionnaires at the same time points.

Results
Baseline fatigue did not differ significantly among the 3 groups. Over time, levels of fatigue significantly decreased in all domains in all groups, except in mental fatigue in the WLC group. Analyses of variance of postintervention fatigue showed statistically significant group effects on general fatigue, on physical and mental fatigue, and on reduced activation but not on reduced motivation. Compared with the WLC group, the PT group reported significantly greater decline in 4 domains of fatigue, whereas the PT+CBT group reported significantly greater decline in physical fatigue only. No significant differences in decline in fatigue were found between the PT+CBT and PT groups.

Conclusions
Physical training combined with cognitive-behavioral therapy and physical training alone had significant and beneficial effects on fatigue compared with no intervention. Physical training was equally effective as or more effective than physical training combined with cognitive-behavioral therapy in reducing cancer-related fatigue, suggesting that cognitive-behavioral therapy did not have additional beneficial effects beyond the benefits of physical training.
Impact of International Subarachnoid Aneurysm Trial results on treatment of ruptured intracranial aneurysms in the United States
Authors: Qureshi Adnan I. , Vazquez Gabriela , Tariq Nauman , Suri M. Fareed K. , Lakshminarayan Kamakshi , Lanzino Giuseppe 
Published: July 2010

Object
The utilization of endovascular treatment for ruptured intracranial aneurysms is expected to change since the publication of the International Subarachnoid Aneurysm Trial (ISAT) in 2002. The authors performed this analysis to determine the impact of ISAT results on treatment selection for ruptured intracranial aneurysms and associated in-hospital outcomes using nationally representative data.

Methods
We determined the national estimates of treatments used for ruptured intracranial aneurysms and associated in-hospital outcomes, length of stay, mortality, and cost incurred using the Nationwide Inpatient Survey (NIS) data. The NIS is the largest all-payer inpatient care database in the US and contains data from 986 hospitals approximating a 20% stratified sample of US hospitals. All the variables pertaining to hospitalization were compared between 2000–2002 and 2004–2006, and in-hospital outcomes were analyzed using multivariate analysis.

Results
In the 3-year periods prior to and after the ISAT, there were 70,637 and 77,352 admissions for ruptured intracranial aneurysms, respectively. There was a significant increase in endovascular treatment after publication of the ISAT (trend test, p < 0.0001) The in-hospital mortality for ruptured intracranial aneurysm admissions decreased from 27% to 24% (odds ratio [OR] 0.89, 95% CI 0.83–0.96, p = 0.003) after the publication of the ISAT. The cost of hospitalization after adjusting for procedures practices was not significantly higher after the publication of the ISAT ($21,437 vs $22,817, p < 0.89), but cost of hospitalization was higher in the post-ISAT period for patients undergoing endovascular procedure.

Conclusions
The results of the ISAT have been associated with a prominent change in practice patterns related to the treatment of ruptured aneurysms. The cost of hospitalization has increased and the mortality has decreased, presumably due to a larger proportion of patients receiving any treatment and endovascular treatment.
Port Site and Intraperitoneal Infiltration of Local Anesthetics in Reduction of Postoperative Pain after Laparoscopic Cholecystectomy
Authors: Alam Mohammad Shaha , Hoque Hasnat Waheedul , Saifullah Mohammad , Ali Md Omar 
Published: July 2010

Laparoscopic cholecystectomy is now the gold standard technique for the treatment of gallstones disease. Although pain after laparoscopic cholecystectomy is less intense than after open cholecystectomy, some patients still experience considerable discomfort during the first 24 to 72 postoperative hours. The aim of this study is to evaluate the effect of intraperitoneal and port site instillation of local anaesthetics on pain relief in early postoperative period following laparoscopic cholecystectomy. Fifty patients undergoing elective laparoscopic cholecystectomy were consecutively included in this study and sample was divided into two groups. Following removal of gallbladder, Group A received 20 ml of 0.25% bupivacaine instilled in the right sub diaphragmatic space and 20 ml of 0.25% bupivacaine in divided doses at the trocar sites. The evaluation of postoperative pain was done at fixed time interval according to the numerical verbal scale and the dosage of narcotic analgesics consumed was also recorded. Mean pain scores at 6 hours and at 12 hours after surgery were 6.02 and 4.72 respectively, in the bupivacaine group compared with 8.44 and 6.08 respectively in the control group (p= <0.001 and <0.001). However, pain scores at 24 hours and 48 hours postoperatively and incidence of shoulder tip pain did not differ significantly between the two groups. The mean total narcotic analgesics used in study group was 1.91 as compared to 2.50 in the control group respectively and was found to be statistically significant (p= <0.001). Infiltration of bupivacaine in to port site and intraperitoneal space is simple, inexpensive and effective technique to minimize early postoperative pain and can be practiced for elective laparoscopic cholecystectomy. DOI: 10.3329/medtoday.v22i1.5601 Medicine Today Vol.22(1) 2010. 24-28
Peripheral Blood B Cell Subset Skewing Is Associated with Altered Cell Cycling and Intrinsic Resistance to Apoptosis and Reflects a State of Immune Activation in Chronic Hepatitis C Virus Infection
Authors: Sugalski Julia M. , Rodriguez Benigno , Moir Susan , Anthony Donald D. 
Published: July 2010

Abstract
Chronic hepatitis C virus (HCV) infection is associated with B cell activation, although underlying mechanisms are unclear. To investigate B cell regulation during HCV infection, we measured bulk B cell CpG and Staphylococcus aureus Cowan-induced IgG Ab-secreting cell (ASC) frequency, HCV and tetanus-specific ASC frequency, BCR- and CD40L-dependent CD80/CD86 expression, and activation of memory CD4 cells. Immature transitional, naive, resting memory, mature activated, tissue-like memory, and plasma B cell subset frequencies, cell cycling, and intrinsic apoptosis were quantified. We observed intact or enhanced tetanus-specific and total IgG ASC frequency, serum IgG, BCR- and CD40L-dependent CD80/CD86 expression, and CD40L-dependent bulk B cell activation of memory CD4 cells in HCV infection. HCV-specific ASCs were observed in HCV-infected but not control subjects, although frequencies were lower compared with tetanus-specific cells. Immature transitional and mature activated B cell subset frequencies were increased in HCV-infected subjects, with immature transitional frequency associated with liver inflammation and serum B cell-activating factor. Mature activated B cells less commonly expressed Ki67, more commonly expressed Bcl2, and were more intrinsically resistant to apoptosis, whereas immature transitional B cells more commonly expressed Ki67, the latter associated with plasma HCV level. Taken together, these results indicate that in the setting of chronic HCV infection, a state of activation results in B cell subset skewing that is likely the result of alterations in homeostasis, cell cycling, and intrinsic resistance to apoptosis and that results in an overall intact or enhanced B cell response to BCR and CD40L.
Clinical Patterns and Hematological Spectrum in Autoimmune Hemolytic Anemia
Authors: Alwar Vanamala , M. Shanthala Devi A , S. Sitalakshmi , K. Karuna R 
Published: July 2010

ABSTRACT
Background: Autoimmune hemolytic anemia (AIHA) results from red cell destruction due to circulating autoantibodies against red cell membrane antigens. They are classified etiologically into primary and secondary AIHAs. A positive direct antiglobulin test (DAT) is the hallmark of diagnosis for AIHA.
Methods and Results: One hundred and seventy-five AIHA cases diagnosed based on positive DAT were included in the study. The cases showed a female predilection (M: F = 1:2.2) and a peak incidence in the third decade. Forty cases were found to be due to primary AIHA, while a majority (n = 135) had AIHA secondary to other causes. The primary AIHA cases had severe anemia at presentation (65%) and more often showed a blood picture indicative of hemolysis (48%). Forty-five percent of primary AIHAs showed positivity for both DAT and indirect antiglobulin test (IAT). Connective tissue disorders were the most common associated etiology in secondary AIHA (n = 63).
Conclusion: AIHAs have a female predilection and commonly present with symptoms of anemia. AIHA secondary to other diseases (especially connective tissue disorders) is more common. Primary AIHAs presented with severe anemia and laboratory evidence of marked hemolysis.