bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nomogram for predicting upgrading in patients with low‐ and intermediate‐grade prostate cancer in the era of extended prostate sampling
Authors: Moussa Ayman S. , Kattan Michael W. , Berglund Ryan , Yu Changhong , Fareed Khaled , Jones J. Stephen 
Published: August 2009

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2bOBJECTIVETo develop a nomogram to predict the probability that the pathological Gleason sum (GS) will be higher than that indicated by the biopsy, suggesting a higher risk for the patient presumed to be at low risk, as a substantial proportion of patients with low and intermediate grade on biopsy are upgraded on interpretation of the radical prostatectomy (RP) specimens, but a similar clarification of accurate Gleason scoring is not available in patients with no surgical histology.PATIENTS AND METHODSThe study included 1017 patients who had RP after biopsy showing GS 6 and 7 (3 + 4) from 2000 to 2007. Nomogram predictor variables included age, race, digital rectal examination, prostate‐specific antigen (PSA) level, number of cores taken, number of positive cores, maximum percentage cancer in any core, number of previous biopsies, prostate volume, clinical stage, high‐grade prostatic intraepithelial neoplasia, atypical small acinar proliferation, inflammation and perineural invasion. We calculated the nomogram‐predicted probability in each patient. The area under the receiver operating characteristic curve was calculated as a measure of discrimination, and the calibration was assessed graphically.RESULTSThe mean age of the patients was 60 years, the mean PSA level 6.62 ng/mL; 336 patients were upgraded (33%), 623 remained the same (61.3%) and 58 were downgraded (5.7%). A nomogram for predicting the possibility of upgrading was constructed that had a concordance index of 0.68. The nomogram was well calibrated.CONCLUSIONSOur nomogram for predicting upgrading provides important additional information for deciding on treatment to both the urologist and the patient with low‐ and intermediate‐grade prostate cancer. It might prove useful when the possibility of a more aggressive Gleason variant can change the management, and is especially meaningful when management options other than surgery are selected based on the inability to recognize the true pathological actual GS.
Factors associated with low and high voiding frequency in children with diurnal urinary incontinence
Authors: Von Gontard Alexander , Heron Jon , Joinson Carol 
Published: August 2009

Study Type – Prognosis (cohort) Level of Evidence 2aOBJECTIVETo investigate, in a population‐based study, the association of urinary voiding frequency and daytime wetting or diurnal urinary incontinence (UI) in children aged 6.5 years, to test the hypothesis that children with high or low voiding frequency have increased somatic and psychological risks.SUBJECTS AND METHODSParticipants were a cohort of >8000 children enrolled in the population‐based Avon Longitudinal Study of Parents and Children, a prospective longitudinal study of an original birth cohort of nearly 14 000 children. Parents completed postal questionnaires asking about diurnal UI, voiding frequency and associated somatic and behavioural signs and symptoms.RESULTSIn all, 10.4% of children had diurnal UI. Children with diurnal UI had significantly more gastrointestinal, urinary and psychological symptoms than the controls. Of the children with diurnal UI, 35.7% had a voiding frequency of <5 voids/day, 61.5% 5–9 voids/day and 2.8%≥ 10 voids/day. High voiding frequency was more common in boys, children with frequent diurnal UI and those with combined diurnal and night‐time UI, and also in children with nocturia, urgency, hyperactivity and conduct problems. Children with a low voiding frequency needed to be reminded to go to the toilet more often. Fecal incontinence, constipation, stomach ‘aches’, ‘choosy’ eating and urinary tract infections were not associated with voiding frequency.CONCLUSIONSVoiding frequency is an important symptom in children with diurnal UI. The children with high voiding frequencies are especially at risk for associated somatic and behavioural problems.
Inhibition of bladder tumour growth by histone deacetylase inhibitor
Authors: Ozawa Akira , Tanji Nozomu , Kikugawa Tadahiko , Sasaki Toyokazu , Yanagihara Yutaka , Miura Noriyoshi , Yokoyama Masayoshi 
Published: August 2009

OBJECTIVETo examine the expression profile of histone deacetylase (HDAC)‐1 and explore its potential role in the development of bladder cancer, using valproic acid (VPA), a HDAC inhibitor, which reduces tumour growth and metastasis formation in animal models.MATERIALS AND METHODSThe study comprised clinical samples from patients with urinary bladder cancer, mouse urinary bladder tissue specimens, and two human urinary bladder cancer cell lines (HT‐1376 and 5637). HDAC1 mRNA and protein expression were examined using real‐time reverse transcription‐polymerase chain reaction and immunohistochemical methods. Female C3H/He mice were given VPA (0, 250, 500 and 750 mg/kg body weight, intraperitoneal, every day) from the start or 4 weeks after 0.05%N‐butyl‐N‐(4‐hydroxybutyl)‐nitrosamine (BBN) treatment, and were humanely killed and sampled at 8 and 12 weeks.RESULTSA significantly higher level of HDAC1 mRNA was expressed in human urinary bladder cancer specimens. The immunohistochemical study showed that HDAC1 was expressed in the cytoplasm and nucleus in the specimens. BBN treatment increased HDAC1 mRNA expression in the urinary bladder. VPA administration seemed to delay the incidences of BBN‐induced mouse urinary bladder tumour, possibly through p21WAF1 protein expression.CONCLUSIONThese results indicate that HDAC might be an effective molecular target for cancer therapy.
Capsular involvement in patients undergoing partial nephrectomy for localized renal cell carcinoma: an adverse pathological finding?
Authors: Rouach Yannick , Delongchamps Nicolas , Timsit Marc‐Olivier , Verkarre Virginie , Fontaine Eric , Peyromaure Mickael , Mejean Arnaud 
Published: August 2009

Study Type – Prognosis (case series) Level of Evidence 4OBJECTIVETo evaluate the prognostic impact of capsular involvement (CaI) in patients treated exclusively with partial nephrectomy (PN) for localized renal cell carcinoma (RCC), as in these patients CaI was recently reported as an adverse prognostic factor.PATIENTS AND METHODSWe retrospectively reviewed the medical records of patients treated with PN for a sporadic and localized RCC (pT1‐pT2N0M0) in our institution between 1985 and 2005. Univariate and multivariate analysis using a Cox proportional‐hazards regression analysis were conducted to identify significant predictors of oncological outcome for several clinical and pathological factors, i.e. imperative indication, histological type, Fuhrman grade, tumour size, T stage, CaI, and surgical margins. Disease‐free and ‐specific survival rates of patients with CaI and no evidence of CaI were compared using the log‐rank test.RESULTSIn all, 305 patients had a PN for localized RCC, of whom 22 (7.2%) had CaI in the PN specimen. The median (range) follow‐up was 6 (1.5–23) years. Multivariate statistical analysis showed that imperative indication for PN and high‐grade RCC were independently associated with worse disease‐free and ‐specific survival, whereas CaI had no prognostic value. Disease‐free and ‐specific survival in patients with and without CaI were not significantly different at 5 and 10 years.CONCLUSIONSIn a contemporary series of patients exclusively treated with PN for localized RCC, CaI was not predictive of disease recurrence and disease‐specific mortality. These results do not support the use of any change in postoperative management in patients with CaI after PN.
Long‐term outcome of ureterosigmoidostomy: an analysis of patients with >10 years of follow‐up
Authors: Tollefson Matthew K. , Elliott Daniel S. , Zincke Horst , Frank Igor 
Published: August 2009

Study Type – Therapy (case series)Level of Evidence 4OBJECTIVETo examine our long‐term experience with ureterosigmoidostomy (USS) to evaluate its potential applicability in the treatment of benign and malignant conditions of the urinary bladder, as USS has been largely disregarded recently, secondary to concerns of long‐term complications, but has had a resurgence of interest due to its potential applicability to newer minimally invasive surgical techniques.PATIENTS AND METHODSWe identified 51 patients who had USS from 1956 to 2006 at our institution and with >10 years of follow‐up. The patients were followed retrospectively by a chart review. Patient data were analysed in a multifaceted fashion, paying particular attention to metabolic abnormalities, early (≤30 days) and late (>30 days) complication rates, continence rates, imaging changes, and the rate of repeat surgical intervention.RESULTSThe median (range) follow‐up was 15.7 (10.0–45.4) years and the median age at surgery was 58.8 (0.4–79.0) years; 40 (79%) patients had the procedure for malignancy and 11 (22%) for benign disease. Six patients (12%) had at least one early complication, including one wound dehiscence and one pulmonary embolus. In all, 22 patients (43%) had at least one late complication, with anastomotic stricture being the most common (11/51, 22%). This was followed by recurrent pyelonephritis in eight patients (16%), stones in five (10%), chronic renal insufficiency in three (6%) and severe intractable acidosis in two (4%). A repeat surgical intervention was required in 19 (37%) patients. In all, 94% (48) reported complete continence. No patient developed colonic malignancy during the course of this study.CONCLUSIONSUSS is associated with long‐term complications. While this complication rate might not be acceptable for all patients, some might be willing to undergo the procedure as the primary method of urinary diversion. When designing newer minimally invasive techniques for the treatment of benign and malignant conditions of the bladder, consideration could be given to USS as a form of urinary diversion in highly selected patients.
Will Sub‐Prime be a Twin Crisis for the United States?
Authors: Dooley Michael P. , Folkerts‐Landau David , Garber Peter M. 
Published: August 2009

AbstractWe identify incentives generated by the Bretton Woods II system that may have contributed to the sub‐prime liquidity crisis now working its way through the international monetary system. We then evaluate the persistent conjecture that the liquidity crisis is or will become a balance of payments crisis for the United States. Given that it happens, the additional costs associated with a sudden stop of net capital flows to the United States could be quite substantial. But we observe that emerging market governments have continued to acquire US assets even as yields have fallen, and the incentives for continuing to do so remain strong. Moreover, the Bretton Woods II system, which has clearly been the most resilient of the forces driving current markets, continues to generate low real interest rates in industrial countries and growth in emerging markets that will help limit the damage from the liquidity crisis.
What is Driving Reserve Accumulation? A Dynamic Panel Data Approach
Authors: Bastourre Diego , Carrera Jorge , Ibarlucia Javier 
Published: August 2009

AbstractForeign reserve accumulation is a widespread phenomenon of recent years, particularly among emerging economies. Using a panel of 136 countries for the period 1973–2003, we demonstrate the need of using both a dynamic specification of the reserve demand equation and the system GMM estimator. These improvements change the results found by previous studies. Openness, regional imitation, persistence, an inverted U‐shaped relationship between reserves and income level, and financial deregulation are the factors driving reserve hoardings. In contrast, reserves yield, and both trade and financial volatility are not statistically significant. Surprisingly, we find that countries with flexible exchange rate regimes have higher ratios of reserves to GDP. This result is robust to alternative exchange rate regime classifications.
Can International Productivity Differences Alone Account for the US Current Account Deficits?
Authors: Chakraborty Suparna , Dekle Robert 
Published: August 2009

AbstractAn influential explanation for the recent rise in the US current account deficit is the boom in US productivity. As US productivity surged in the mid‐1990s, capital was attracted to the US to take advantage of the higher real returns. Using a two‐country general‐equilibrium model, this paper quantitatively shows that the gap in productivity growth between the US and the “rest of the world” cannot explain the US current account deficits, especially in the 1980s and the 2000s. This is because on a GDP‐weighted basis, the “rest of the world” actually had higher productivity growth during these periods, and standard macroeconomic models would predict an outflow of funds from the US to the rest of the world, and a consequent US current account surplus. We show that changes in global financial integration can help explain this anomaly in US current account behavior.
Hoarding of International Reserves: Mrs Machlup's Wardrobe and the Joneses
Authors: Cheung Yin‐Wong , Qian Xingwang 
Published: August 2009

AbstractMotivated by the observed international reserve hoarding behavior in the post‐1997 crisis period, we explore the Mrs Machlup's Wardrobe hypothesis and the related keeping up with the Joneses argument. It is conceived that, in addition to psychological reasons, holding a relatively high level of international reserves reduces the vulnerability to speculative attacks and promotes growth. A stylized model is constructed to illustrate this type of hoarding behavior. The relevance of the keeping up with the Joneses effect is examined using a few plausible empirical specifications and data from 10 East Asian economies. Panel‐based regression results are suggestive of the presence of the Joneses effect, especially in the post‐1997 crisis period.
Emergency department utilization among HIV‐infected patients in a multisite multistate study*
Authors: Josephs JS , Fleishman JA , Korthuis PT , Moore RD , Gebo KA ,   for the HIV Research Network
Published: August 2009

ObjectiveThe aim of this study was to examine Emergency Department (ED) utilization and clinical and sociodemographic correlates of ED use among HIV‐infected patients.MethodsDuring 2003, 951 patients participated in face‐to‐face interviews at 14 HIV clinics in the HIV Research Network. Respondents reported the number of ED visits in the preceding 6 months. Using logistic regression, we identified factors associated with visiting the ED in the last 6 months and admission to the hospital from the ED.ResultsThirty‐two per cent of respondents reported at least one ED visit in the last 6 months. In multivariate analysis, any ED use was associated with Medicaid insurance, high levels of pain (the third or fourth quartile), more than seven primary care visits in the last 6 months, current or former illicit drug use, social alcohol use and female gender.Of those who used ED services, 39% reported at least one admission to the hospital. Patients with pain in the highest quartile reported increased admission rates from the ED as did those who made six or seven primary care visits, or more than seven primary care visits vs. three or fewer.ConclusionsThe likelihood of visiting the ED has not diminished since the advent of highly active antiretroviral therapy (HAART). More ED visits are to treat illnesses not related to HIV or injuries than to treat direct sequelae of HIV infection. With the growing prevalence of people living with HIV infection, the numbers of HIV‐infected patients visiting the ED may increase, and ED providers need to understand potential complications produced by HIV disease.
Kaempferol protects against rat striatal degeneration induced by 3‐nitropropionic acid
Authors: Lagoa Ricardo , Lopez‐Sanchez Carmen , Samhan‐Arias Alejandro K. , Gañan Carlos M. , Garcia‐Martinez Virginio , Gutierrez‐Merino Carlos 
Published: August 2009

Abstract3‐Nitropropionic acid (NPA) produces degeneration of striatum and some neurological disturbances characteristic of Huntington’s disease in rodents and primates. We have shown that the flavonoid kaempferol largely reduced striatal damage induced by cerebral ischaemia‐reperfusion in rats (Lopez‐Sanchez et al. 2007). In this work, we report that intraperitoneal (i.p.) administration of kaempferol affords an efficient protection against NPA‐induced neurodegeneration in Wistar rats. We studied the effects of daily i.p. injections of 7, 14 and 21 mg of kaempferol/kg body weight during the NPA‐treatment (25 mg/kg body weight/12 h i.p., for 5 days) on the neurological deficits, degeneration of rat striatum and oxidative stress markers. Intraperitoneal injections of 14–21 mg of kaempferol/kg body weight largely attenuated motor deficit and delayed mortality. The higher dose of kaempferol prevented the appearance of NPA‐induced striatal lesions up to the end of treatment, as revealed by haematoxylin‐eosin and TUNEL staining, and also NPA‐induced oxidative stress, because it blocked the fall of reduced glutathione and the increase of protein nitrotyrosines in NPA‐treated rats. It was found that striatal degeneration was associated with calpains activation and a large inactivation of creatine kinase, which were also prevented when the higher doses of kaempferol were administered.
Involvement of glutamate in retinal protection against ischemia/reperfusion damage induced by post‐conditioning
Authors: Fernandez Diego C. , Chianelli Mónica S. , Rosenstein Ruth E. 
Published: August 2009

AbstractRetinal ischemia could provoke blindness and there is no effective treatment against retinal ischemic damage. Brief intermittent ischemia applied during the onset of reperfusion (i.e., post‐conditioning) protects the retina from ischemia/reperfusion injury. Multiple evidences support that glutamate is implicated in retinal ischemic damage. We investigated the involvement of glutamate clearance in post‐conditioning‐induced protection. For this purpose, ischemia was induced by increasing intra‐ocular pressure for 40 min, and 5 min after reperfusion, animals underwent seven cycles of 1 min/1 min ischemia/reperfusion. One, three, or seven days after ischemia, animals were subjected to electroretinography and histological analysis. The functional and histological protection induced by post‐conditioning was evident at 7 (but not 1 or 3) days post‐ischemia. An increase in Müller cell glial fibrillary acidic protein (GFAP) levels was observed at 1, 3, and 7 days after ischemia, whereas post‐conditioning reduced GFAP levels of Müller cells at 3 and 7 days post‐ischemia. Three days after ischemia, a significant decrease in glutamate uptake and glutamine synthetase activity was observed, whereas post‐conditioning reversed the effect of ischemia. The intravitreal injection of supraphysiological levels of glutamate mimicked electroretinographic and histological alterations provoked by ischemia, which were abrogated by post‐conditioning. These results support the involvement of glutamate in retinal protection against ischemia/reperfusion damage induced by post‐conditioning.
Docosahexaenoic acid promotes hippocampal neuronal development and synaptic function
Authors: Cao Dehua , Kevala Karl , Kim Jeffrey , Moon Hyun‐Seuk , Jun Sang Beom , Lovinger David , Kim Hee‐Yong 
Published: August 2009

AbstractDocosahexaenoic acid (DHA, 22:6n‐3), the major polyunsaturated fatty acid accumulated in the brain during development, has been implicated in learning and memory, but underlying cellular mechanisms are not clearly understood. Here, we demonstrate that DHA significantly affects hippocampal neuronal development and synaptic function in developing hippocampi. In embryonic neuronal cultures, DHA supplementation uniquely promoted neurite growth, synapsin puncta formation and synaptic protein expression, particularly synapsins and glutamate receptors. In DHA‐supplemented neurons, spontaneous synaptic activity was significantly increased, mostly because of enhanced glutamatergic synaptic activity. Conversely, hippocampal neurons from DHA‐depleted fetuses showed inhibited neurite growth and synaptogenesis. Furthermore, n‐3 fatty acid deprivation during development resulted in marked decreases of synapsins and glutamate receptor subunits in the hippocampi of 18‐day‐old pups with concomitant impairment of long‐term potentiation, a cellular mechanism underlying learning and memory. While levels of synapsins and NMDA receptor subunit NR2A were decreased in most hippocampal regions, NR2A expression was particularly reduced in CA3, suggesting possible role of DHA in CA3‐NMDA receptor‐dependent learning and memory processes. The DHA‐induced neurite growth, synaptogenesis, synapsin, and glutamate receptor expression, and glutamatergic synaptic function may represent important cellular aspects supporting the hippocampus‐related cognitive function improved by DHA.
Combined therapy in the treatment of hypertension
Authors: Escobar Carlos , Barrios Vivencio 
Published: August 2009

AbstractThe majority of patients with hypertension need at least two antihypertensive agents to achieve blood pressure (BP) objectives. As current European guidelines for the treatment of arterial hypertension recommend, combined therapy is required when monotherapy fails and as a first‐line treatment in certain situations, such as subjects at high or very high cardiovascular risk, markedly elevated BP values, or when lower targets are required (<130/80 mmHg). The advantages of combined therapy are well known and include an earlier and higher antihypertensive efficacy because of complementary mechanisms of action, and a lower incidence of side effects due to the possible compensatory responses and, in many cases, the lower doses used. In the present study, available evidence about the efficacy and tolerability of combined therapy for the treatment of hypertension is updated.
Mossy fiber sprouting interacts with sodium channel mutations to increase dentate gyrus excitability
Authors: Thomas Evan A. , Reid Christopher A. , Petrou Steven 
Published: August 2009

SummaryPurpose:  Idiopathic epilepsy is caused by the complex interaction of genetic and environmental factors. The purpose of this study was to use computational approaches to explore the interaction between changes in sodium channel availability caused by mutations and mossy fiber sprouting.Methods:  We used a previously published biophysically realistic computer model of dentate gyrus neurons and networks. A sensitivity analysis probed the effects of typical mutation‐like changes in either single‐ or multiple‐gating parameters. Isolated neuron models were stimulated with current injections, and networks were stimulated with perforant path synaptic input. The gene–environment interaction was studied by including mossy fiber sprouting into these networks.Results:  Single neuron responses to current injections were complex, with increased sodium channel availability paradoxically reducing firing rates. In the absence of mossy fiber sprouting, control networks showed strong accommodation supporting the role of the dentate gyrus as a gate. Availability changes alone were not able to drive the networks into ictal states, even though they reduced the effectiveness of the dentate gyrus gate. Interestingly, the presence of electrophysiologic changes substantially increased the ability of mossy fiber sprouting to induce ictal activity.Conclusion:  (1) Increased sodium channel availability does not necessarily lead to increased firing rates, (2) network excitability is most sensitive to changes in steady state activation of sodium channels, (3) mutation‐induced changes in availability reduce the effectiveness of the dentate gyrus gate, and (4) mutations interact strongly with structural network changes to allow ictal‐like activity in the dentate gyrus.