bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of parity on maternal and neonatal outcomes in twin gestations
Authors: HANNOUN ANTOINE , USTA IHAB M. , AWWAD JOHNNY , MOUKALLED DARINE , YAHYA FADI , JURDI AMIN , NASSAR ANWAR H. 
Published: May 2011

AbstractObjective. To compare maternal and neonatal outcomes of twin gestations in nulliparous and multiparous women. Design. Retrospective analysis of maternal and neonatal records. Setting. American University of Beirut Medical Center, a referral university‐affiliated hospital. Population. Pregnant women who delivered twin gestations beyond 24 weeks from 1990 to 2004. Methods. The data collected were analyzed using Student's paired t‐test or χ2test. Logistic regression analysis was used to study the effect of multiple variables on preterm delivery. Main Outcome Measure. Preterm birth rate. Results. Nulliparas (n=333) were more likely to be younger (28.1±5.4 vs. 30.0±5.2years; p<0.001) and the pregnancy a product of assisted reproductive technology (23.1 vs. 4.5%; p<0.001) compared with multiparas (n=508). They were at significantly increased risk of preterm delivery (54.4 vs. 45.1%; p=0.009) at lower gestational age (35.6±3.2 vs. 36.2±3.0 weeks; p=0.004). They had longer first and second stages of labor and a higher cesarean delivery rate (61.3 vs. 44.9%; p<0.001). Except for a higher intensive care nursery admission rate and longer nursery stay for twins of nulliparas, all neonatal morbidities were comparable. On multiple logistic regression analysis, multiparity (relative risk 0.70, 95% confidence interval 0.51–0.97) and growth restriction (relative risk 0.16, 95% confidence interval 0.12–0.22) were protective, while discordance (relative risk 2.24, 95% confidence interval 1.40–3.60) was a predictor of preterm delivery. Conclusions. Nulliparous women with twin gestations are at significantly higher risk for preterm delivery and cesarean delivery compared with multiparous women. Although this was not translated into higher perinatal mortality, these women should be monitored closely and counseled regarding these risks and their attendant morbidity.
Skin alterations due to illegal drug abuse
Authors: Fink Bianca , Landthaler Michael , Hafner Christian 
Published: May 2011

SummaryDrug abuse is associated with a wide variety of skin alterations. Being aware of the typical signs and symptoms of the drug addicts’ skin is of special importance to dermatologists, even though dermatologists are commonly not involved in the treatment of these patients. There is yet a chance for dermatologists to identify drug abusers early by to some extent specific cutaneous signs and after exclusion of several other etiological factors, so that this will lead to further treatment through the respective specialists. The objective of this paper is to draw particular attention to typical skin lesions and diseases which may be associated with drug abuse.
Research in practice: Antimicrobial peptides of the skin
Authors: Gläser Regine 
Published: May 2011

SummaryAntimicrobial peptides represent evolutionary ancient molecules whose importance became evident within the last years. These highly effective peptides protect the skin and other epithelia against infection and form a fast acting “chemical barrier” also regulating the normal flora of the skin and mucosa. In the Department of Dermatology, University Hospital Kiel, various antimicrobial peptides have been discovered, characterized and investigated in healthy persons as well as in different skin diseases. Everyday clinical observations formed the background for several interesting hypotheses and findings.
Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers
Authors: Malmberg Kerstin , Edbom Tobias , Wargelius Hanna‐Linn , Larsson Jan‐Olov 
Published: May 2011

AbstractAim:  To study the coexistence of subthreshold diagnoses of both attention deficit hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBD) with other symptoms of child and adolescent psychiatric disorders as well as risk behaviours associated with smoking, alcohol and drug use.Methods:  A population‐based sample of twins including 177 girls and 135 boys was interviewed using the Swedish version of Kiddie‐SADS Present and Lifetime Version (K‐SADS‐PL). Subthreshold diagnoses were compiled based on the ADHD and DBD criteria, where each criterion was assessed as ‘possible’ or ‘certain’ according to K‐SADS‐PL. The odds ratios (OR) between the subthreshold diagnoses and each of the screening questions in K‐SADS‐PL were calculated.Results:  Subthreshold diagnoses of ADHD and DBD coexisted with the screening questions concerning depression, mania, panic attack, phobias, anorexia nervosa, motor tics and posttraumatic stress disorder (PTSD) in girls. In boys, these subthreshold diagnoses coexisted with symptoms of depression and PTSD. For both boys and girls, smoking and high alcohol consumption contributed to a high OR with regard to ADHD and DBD.Conclusion:  Subthreshold diagnoses of ADHD and DBD were risk factors for several other psychiatric symptoms as well as smoking and high alcohol consumption. Thus, a broad clinical assessment is needed for adolescents with such preliminary diagnoses.
Identification of mitogen‐activated protein/extracellular signal‐responsive kinase kinase 2 as a novel partner of the scaffolding protein human homolog of disc‐large
Authors: Maïga Oumou , Philippe Monique , Kotelevets Larissa , Chastre Eric , Benadda Samira , Pidard Dominique , Vranckx Roger , Walch Laurence 
Published: May 2011

Human disc‐large homolog (hDlg), also known as synapse‐associated protein 97, is a scaffold protein, a member of the membrane‐associated guanylate kinase family, implicated in neuronal synapses and epithelial–epithelial cell junctions whose expression and function remains poorly characterized in most tissues, particularly in the vasculature. In human vascular tissues, hDlg is highly expressed in smooth muscle cells (VSMCs). Using the yeast two‐hybrid system to screen a human aorta cDNA library, we identified mitogen‐activated protein/extracellular signal‐responsive kinase (ERK) kinase (MEK)2, a member of the ERK cascade, as an hDlg binding partner. Site‐directed mutagenesis showed a major involvement of the PSD‐95, disc‐large, ZO‐1 domain‐2 of hDlg and the C‐terminal sequence RTAV of MEK2 in this interaction. Coimmunoprecipitation assays in both human VSMCs and human embryonic kidney 293 cells, demonstrated that endogenous hDlg physically interacts with MEK2 but not with MEK1. Confocal microscopy suggested a colocalization of the two proteins at the inner layer of the plasma membrane of confluent human embryonic kidney 293 cells, and in a perinuclear area in human VSMCs. Additionally, hDlg also associates with the endoplasmic reticulum and microtubules in these latter cells. Taken together, these findings allow us to hypothesize that hDlg acts as a MEK2‐specific scaffold protein for the ERK signaling pathway, and may improve our understanding of how scaffold proteins, such as hDlg, differentially tune MEK1/MEK2 signaling and cell responses.Structured digital abstract
hDlg
and MEK2 colocalize by fluorescence microscopy (View Interaction 1, 2, 3)
hDlg
physically interacts with MEK2 by two hybrid (View Interaction 1, 2, 3)
hDlg
physically interacts with MEK2 by anti bait coimmunoprecipitation (View Interaction 1, 2)
MEK2
physically interacts with hDlg by anti bait coimmunoprecipitation (View Interaction 1, 2)
Reducing expression of NAD+ synthesizing enzyme NMNAT1 does not affect the rate of Wallerian degeneration
Authors: Conforti Laura , Janeckova Lucie , Wagner Diana , Mazzola Francesca , Cialabrini Lucia , Di Stefano Michele , Orsomando Giuseppe , Magni Giulio , Bendotti Caterina , Smyth Neil , Coleman Michael 
Published: May 2011

NAD+ synthesizing enzyme NMNAT1 constitutes most of the sequence of neuroprotective protein WldS, which delays axon degeneration by 10‐fold. NMNAT1 activity is necessary but not sufficient for WldS neuroprotection in mice and 70 amino acids at the N‐terminus of WldS, derived from polyubiquitination factor Ube4b, enhance axon protection by NMNAT1. NMNAT1 activity can confer neuroprotection when redistributed outside the nucleus or when highly overexpressed in vitro and partially in Drosophila. However, the role of endogenous NMNAT1 in normal axon maintenance and in Wallerian degeneration has not been elucidated yet. To address this question we disrupted the Nmnat1 locus by gene targeting. Homozygous Nmnat1 knockout mice do not survive to birth, indicating that extranuclear NMNAT isoforms cannot compensate for its loss. Heterozygous Nmnat1 knockout mice develop normally and do not show spontaneous neurodegeneration or axon pathology. Wallerian degeneration after sciatic nerve lesion is neither accelerated nor delayed in these mice, consistent with the proposal that other endogenous NMNAT isoforms play a principal role in Wallerian degeneration.EnzymesNMNAT (EC 2.7.7.1)
Self‐thinning and Tree Competition in Savannas
Authors: Sea William B. , Hanan Niall P. 
Published: May 2011

ABSTRACTThis paper examines the feasibility of applying self‐thinning concepts to savannas and how competition with herbaceous vegetation may modify self‐thinning patterns among woody plants in these ecosystems. Competition among woody plants has seldom been invoked as a major explanation for the persistence of herbaceous vegetation in mixed tree–grass ecosystems. On the contrary, the primary resource‐based explanations for tree–grass coexistence are based on tree–grass competition (niche‐separation) that assumes that trees are inferior competitors unless deeper rooting depths provide them exclusive access to water. Alternative nonresource‐based hypotheses postulate that trees are the better competitors, but that tree populations are suppressed by mortality related to fire, herbivores, and other disturbances. If self‐thinning of woody plants can be detected in savannas, stronger evidence for resource‐limitation and competitive interactions among woody plants would suggest that the primary models of savannas need to be adjusted. We present data from savanna sites in South Africa to suggest that self‐thinning among woody plants can be detected in low‐disturbance situations, while also showing signs that juvenile trees, more so than adults, are suppressed when growing with herbaceous vegetation in these ecosystems. This finding we suggest is evidence for size‐asymmetric competition in savannas.
Theoretical Basis of Pathogenic Substance Removal During Plasmapheresis
Authors: Hanafusa Norio 
Published: May 2011

AbstractThis article explains theoretical considerations of prescribing plasmapheresis. It is important to consider several factors in prescribing apheresis: (i) the properties of pathogenic substances, such as molecular weight, distribution volume, compartment, and production rate; (ii) therapeutic conditions such as the processed plasma volume and the frequency of processing; and (iii) the patient's condition, such as active bleeding or infection. A substance's molecular weight determines whether it can be removed using a particular membrane filter. Substances with a small distribution volume and low production rate are removed. Consequently, the processed volume per total plasma volume is related to the single‐session efficacy. Nevertheless, even frequent therapy cannot reduce the total pool of a substance within the body if movement from outside the vessels is slow. Active bleeding or infection might be exacerbated by modalities other than simple plasma exchange with fresh plasma supplementation because such therapies cannot replenish substances other than albumin.
Natural History of Mineral and Bone Disorders After Living‐Donor Kidney Transplantation: A One‐Year Prospective Observational Study
Authors: Kawarazaki Hiroo , Shibagaki Yugo , Fukumoto Seiji , Kido Ryo , Ando Katsuyuki , Nakajima Ichiro , Fuchinoue Shohei , Fujita Toshiro , Fukagawa Masafumi , Teraoka Satoshi 
Published: May 2011

AbstractMineral and bone disorders (MBD), including hypercalcemia and hypophosphatemia, are common complications after renal transplantation; however, the natural course of these disorders has not been well documented, and the pathogenesis of persistent post‐transplant MBD still remains elusive. This study was carried out to show the natural history of mineral metabolism in recipients after living‐donor kidney transplantation and also to clarify post‐transplant risk factors of persistent hypercalcemia and/or hypophosphatemia at 12 months after transplantation. Living‐donor kidney transplant recipients (N = 34) at Tokyo Women's Medical University were prospectively and consecutively recruited. Parameters of MBD, including intact parathyroid hormone and full‐length fibroblast growth factor 23, were followed. Serum calcium levels increased until the fourth week post‐transplantation, after which it reached a plateau; and serum phosphate decreased substantially at one week post‐kidney transplantation, but recovered to the reference level at two months. Fibroblast growth factor 23 gradually decreased to comparable levels for renal function, while hyperparathyroidism persisted for 12 months after transplantation. Multivariate linear regression analysis revealed that intact parathyroid hormone was the best correlating factor with both hypercalcemia and persistent hypophosphatemia at 12 months. This study suggests the need for testing of other interventions used for treatment of hyperparathyroidism which may help to offer better management of MBD after kidney transplantation.
Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators
Authors: Weichel Derek 
Published: May 2011

AbstractRural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities.Methods: All hospitals in 5 states located in communities that met the criteria for a rural town according to the Rural Urban Commuting Area codes were included. A survey with topics including community and hospital demographics, orthopedic surgical workforce and demand, surgical services, and the perceived benefit of orthopedic services was sent to the hospital administrators.Results: Of the 223 rural hospitals surveyed, 145 completed the survey. Of those completing the survey, 30% had at least one full‐time orthopedic surgeon, 25% did not provide any orthopedic surgical services, 65% never had an orthopedic surgeon on ER call, 33% were recruiting an orthopedic surgeon, 52% stated that it is more difficult to recruit an orthopedic surgeon vs a general surgeon, and 71% of the administrators acknowledged a need for additional orthopedic surgical services in their community. For those hospitals that did not have a full‐time orthopedic surgeon, members of those communities traveled a mean distance of 55 miles for emergency orthopedic surgical care as reported by the hospital administrators.Conclusions: There are many rural communities that have limited access to orthopedic surgical services. While many of the rural hospital administrators feel that there is a need for additional orthopedic surgical services in their communities, it is difficult to recruit orthopedic surgeons to these areas.
Echocardiogram Utilization Among Rural and Urban Veterans
Authors: Okrah Kingston , Vaughan‐Sarrazin Mary , Kaboli Peter , Cram Peter 
Published: May 2011

AbstractPurpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance.Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was categorized as residing in urban, rural or highly rural areas using RUCA codes. Poisson regression was used to compare echocardiography utilization rates among veterans residing in each area after adjusting for demographics, comorbidities, clustering of patients within VA networks and distance to the nearest VA medical center offering echocardiography.Findings: Our study included 22.7 million veterans of whom 1.3 million (5.7%) received at least 1 echocardiogram. Of echocardiography recipients, 69.2% lived in urban, 22.0% in rural and 8.8% in highly rural areas. In analyses adjusting for patient demographics, comorbidities, and clustering, utilization of echocardiography was modestly lower for highly rural and rural veterans compared with urban veterans (42.0 vs 40.1 vs 43.1 echocardiograms per 1,000 VA users per year for highly rural, rural and urban, respectively; P < .001). After further adjusting for distance, echocardiography utilization was somewhat higher for veterans in highly rural and rural areas than it was for urban areas (44.9 vs 41.8 vs 40.8 for highly rural, rural and urban, respectively; P < .001).Conclusions: Echocardiography utilization among rural and highly rural veterans was marginally lower than for urban veterans, but these differences can be accounted for by the greater distance of more rural veterans from facilities offering echocardiograms.
Genetic Analysis of Hyperpolarization‐Activated Cyclic Nucleotide‐Gated Cation Channels in Sudden Unexpected Death in Epilepsy Cases
Authors: Tu Emily , Waterhouse Louise , Duflou Johan , Bagnall Richard D. , Semsarian Christopher 
Published: May 2011

AbstractSudden unexpected death in epilepsy (SUDEP) is the most common epilepsy‐related cause of death, yet the cause is unknown. Our previous studies suggest a role for arrhythmia‐related ion channel genes in the pathogenesis of SUDEP. Hyperpolarization‐activated cyclic nucleotide‐gated cation (HCN1–4) channels are ion channels involved in generating spontaneous rhythmic activity in cardiac pacemaker and neuronal cells. This study sought to determine the role of pathogenic DNA variants in the HCN1–4 genes in a large SUDEP cohort collected from 1993 to 2009. Post‐mortem DNA samples were amplified and analyzed for each HCN exon. Genetic analysis in 48 SUDEP cases (age range 12–82 years) identified six novel and three previously reported nonsynonymous (amino acid changing) variants in HCN1 (n = 1), HCN2 (n = 2), HCN3 (n = 2) and HCN4 (n = 4). The Phe738Cys and Pro802Ser variants in HCN2, and Gly973Arg in HCN4 were absent in control alleles and affecting highly conserved residues in the carboxyl‐cytoplasmic tail region. Our results support a pathogenic link between the heart and brain in SUDEP, mediated by the HCN neuro‐cardiac ion channel genes.
Analysis of the Pressure‐Flow Study in Weak Detrusor Patients with Benign Prostatic Hypertrophy
Authors: TANABE Tomoaki , ISHIZUKA Osamu , ICHINO Midori , OGAWA Teruyuki , IMAMURA Tetsuya , KURIZAKI Yoshiki , IIJIMA Kazuyoshi , NISHIZAWA Osamu 
Published: May 2011

Objective: Pressure‐flow study is a method used to evaluate the degree of bladder outlet obstruction and the strength of detrusor contractility during voiding. However, whether or not the operation for benign prostate hyperplasia should be avoided in detrusor underactivity patients remains controversial. To address this, we performed a retrospective analysis of our pressure‐flow study data for benign prostate hyperplasia patients. We especially focused on the backgrounds of patients with weak detrusor contractility.Methods: Patients (n = 288; average age, 71.5 years) who underwent pressure‐flow study to evaluate operative indications between February 2001 and April 2010 were included in this study. We analyzed the relationships between background factors and detrusor contraction strength according to Schäfer's nomogram.Results: Patients with weak detrusor contractility had poor flow (5.81 mL/sec) and low voided volume (141.2 mL) compared to patients with normal (8.77 mL/sec, 202.0 mL) or strong (8.97 mL/sec, 178.3 mL) detrusor contractility. Twenty‐six of 74 weak detrusor patients underwent prostate operation. The operated group had high obstruction grade (3.35, P < 0.001), but a low rate of detrusor overactivity (19.2%, P < 0.05), compared to the non‐operated group (2.16, 41.7%). The operated group also had high urinary retention rate (38.5%) compared to the non‐operation group (18.8%).Conclusion: We performed prostate surgery in patients who had episodes of urinary retention, with outlet obstruction, and with no detrusor overactivity, even in those with weak detrusor contractility. The operation may not be contraindicated for these patients. Pressure‐flow study is an important tool to ensure adequate informed consent.
White‐Coat Effect on Systemic Blood Pressure in Retired Racing Greyhounds
Authors: Marino C.L. , Cober R.E. , Iazbik M.C. , Couto C.G. 
Published: May 2011

Background:Greyhounds are known to have a higher systemic arterial blood pressure (BP) than non‐Greyhound dogs.Objectives:The purpose of this study was to determine whether the high systemic BP was because of the white‐coat effect.Animals:Twenty‐two healthy retired racing Greyhounds (RRG) enrolled in a blood donation program.Materials/Methods:We prospectively measured systemic BP in 3 environments: in the hospital by the investigator (Hosp), in the home by the investigator (H/I), and in the home by the owner (H/O). Five serial measurements of systolic, diastolic, and mean arterial pressures (SAP, DAP, MAP) as well as heart rate (HR) were measured by an oscillometric method on the distal forelimb and distal hind limb in all 3 environments.Results:There was a significant difference for SAP, MAP, and HR between the Hosp and both H/I and H/O (P< .001); there were no significant differences for any of the parameters between the H/I and H/O environments. HR, but not SAP, MAP, or DAP (P< .05) decreased in RRG with multiple hospital visits for blood donation before this study. The hind limb SAP was significantly higher than the forelimb SAP (P< .05).Conclusions and Clinical Importance:We conclude that the high SAP, MAP, and HR seen in the hospital setting are likely because of a white‐coat effect. Furthermore, consideration should be given to defining the parameters of normal BP in RRG according to the environment in which they are obtained.