bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of distal subungual onychomycosis with a topical preparation of urea, propylene glycol and lactic acid: results of a 24‐week, double‐blind, placebo‐controlled study
Authors: Emtestam L. , Kaaman T. , Rensfeldt K. 
Published: June 2012

SummaryOnychomycosis is difficult to cure as this requires eradication of the primary infection and protection of new areas of growth from reinfection. A new topical treatment (K101) has been developed. The aim of this study was to assess the efficacy, safety and tolerability of K101 treatment of distal subungual onychomycosis. This was a 24‐week (plus 2‐week washout), multicentre, randomised, double‐blind, placebo‐controlled study in 493 patients with distal subungual onychomycosis (K101, n = 346; placebo, n = 147), stratified according to degree of nail involvement. More patients with ≤50% nail involvement achieved the primary endpoint (mycological cure after 26 weeks) in the K101 group (27.2%) than placebo (10.4%; P = 0.0012). Proportions for patients with 51–75% involvement were 19.1% for K101 and 7.0% for placebo (not significant). More patients applying K101 than placebo judged that their condition had improved from week 2 (P = 0.0148) to week 24 (P = 0.0004). No safety issues were identified. K101 provides early visible improvements in nail appearance and a clinically meaningful antifungal activity.
Seminal Plasma Proteins as Modulators of the Sperm Function and Their Application in Sperm Biotechnologies
Authors: Caballero I , Parrilla I , Almiñana C , del Olmo D , Roca J , Martínez EA , Vázquez JM 
Published: June 2012

ContentsSeminal plasma (SP) is known to play an important role in mammalian fertilization. However, the variability found in its composition among species, males and even fractions of the same ejaculate has made difficult to completely understand its effect in sperm function. Proteins are one of the major SP components that modulate sperm functionality. During the last years, intensive work has been performed to characterize the role of these proteins. They have been found to influence sperm capacitation, formation of the oviductal sperm reservoir and sperm–oocyte interaction. Sperm biotechnologies, such as sperm cryopreservation and flow cytometric sex‐sorting, that involve a substantial dilution of the SP are detrimental to sperm quality. Attempts to improve the outcome of these biotechnologies include the restoration of SP, which has produced contradictory results. To overcome this variability, different research groups have proposed the application of isolated SP proteins. Herein, we will review the current knowledge in the role of the major SP proteins as modulators of sperm functionality. Furthermore, we will discuss the possible applications of the SP proteins in sperm cryopreservation and flow cytometric sex‐sorting.
Ovarian Ultrasonography in the Mare
Authors: Miro J 
Published: June 2012

ContentsUltrasonography has become indispensable in the control of equine reproduction. Mare ovary layers are inverted with respect to other species, with the follicles and corpus luteum found inside the ovary; only large follicles protrude from the organ’s surface. This renders the making of diagnoses via rectal palpation of the ovaries very difficult. Ultrasound imaging, however, provides another avenue of examination. Since its first use in 1980, the diagnostic potential of ultrasonography has greatly improved. Colour Doppler ultrasonography can even asses blood flow, allowing for much better monitoring of ovarian activity. This study discusses the use of ultrasound, and in particular colour Doppler ultrasonography, in the monitoring of mare ovarian function and disease.
Brain accumulation of amyloid β protein visualized by positron emission tomography and BF‐227 in Alzheimer's disease patients with or without diabetes mellitus
Authors: Tomita Naoki , Furukawa Katsutoshi , Okamura Nobuyuki , Tashiro Manabu , Une Kaori , Furumoto Shozo , Iwata Ren , Yanai Kazuhiko , Kudo Yukitsuka , Arai Hiroyuki 
Published: June 2012

Aim:  Although diabetes mellitus (DM) is considered to be one of the most consistent risks for developing dementia, it is not known if the pathology in dementia patients with DM is similar to or distinct from typical pathological features of Alzheimer's disease (AD). To discover the mechanism of developing dementia in AD patients with DM in a living state, we studied the distribution of amyloid β (Αβ) protein of diabetic AD patients.Methods:  To evaluate the accumulation of Aβ, we examined 14 normal controls, four diabetic patients with AD and 11 non‐diabetic patients with AD by positron emission tomography (PET) using BF‐227, a currently developed Aβ tracer.Results:  The analysis of PET images among the three groups showed an abundant aggregated Aβ accumulation in the cerebral cortex of both AD patients with and without DM. The extent and distributions of BF‐227 accumulation in diabetic AD patients were not significantly different from these of non‐diabetic AD patients.Conclusion:  These results suggest that the degree and extent of Aβ deposition is not significantly different between AD with DM and AD alone. Geriatr Gerontol Int 2013; 13: 215–221.
Impact of pharmacy outreach services on blood pressure management in the elderly community of Hong Kong
Authors: Lee Vivian WY , Yi Pang Tin , Kong Kathy WY , Chan Peter KH , Kwok Fanny LM 
Published: June 2012

Aim:  To investigate the impact of the Pharmacy Outreach Service (POS) on blood pressure (BP) and disease knowledge among community‐dwelling elderly patients with hypertension, and to evaluate the sustainability of such impact of POS.Methods:  A prospective open‐labeled study of elderly adults (aged ≥65 years) with hypertension (BP ≥140/90 mmHg for non‐diabetics and ≥130/80 mmHg for diabetics) was carried out at seven elderly community centers from July 2008 to March 2010. Pharmacists provided BP monitoring, medication review and disease knowledge assessment. The target BP was <140/90 mmHg for non‐diabetics and <130/80 mmHg for diabetics. The primary outcome was BP change, whereas the secondary outcome was the change of disease knowledge of hypertension. All outcomes were compared between baseline and the last visit. For POS 2008/09 participants, BP was compared between values obtained during POS 2008/09 and 2009/10.Results:  A total of 97 participants were recruited. Systolic BP reduced significantly from 152.38 ± 18.80 mmHg to 147.04 ± 20.72 mmHg (P = 0.021), and diastolic BP reduced from 73.84 ± 11.36 mmHg to 71.03 ± 10.97 mmHg (P = 0.010). Cumulative reductions in mean systolic BP and diastolic BP throughout the 2‐year study period were 21.39 ± 24.72 mmHg and 9.88 ± 13.48 mmHg, respectively (P < 0.001). A 12% increase in the at‐goal rate was observed in new participants recruited in 2009 (P = 0.039). Disease knowledge of hypertension improved significantly (P < 0.005), particularly in areas that included the definition of hypertension, diet and lifestyle modification.Conclusions:  The POS might improve blood pressure control, hypertension and diabetes knowledge in elderly adults with hypertension in Hong Kong. The effect on blood pressure improvement was sustainable. Geriatr Gerontol Int 2013; 13: 175–181.
Early prediction of adverse events in enhanced recovery based upon the host systemic inflammatory response
Authors: Lane J. C. , Wright S. , Burch J. , Kennedy R. H. , Jenkins J. T. 
Published: June 2012

AbstractAim  Early identification of patients experiencing postoperative complications is imperative for successful management. C‐reactive protein (CRP) is a nonspecific marker of inflammation used in many specialties to monitor patient condition. The role of CRP measurement early in the elective postoperative colorectal patient is unclear, particularly in the context of enhanced recovery (ERAS).Methods  Five hundred and thirty‐three consecutive patients who underwent elective colorectal surgery between October 2008 and October 2010 within an established ERAS programme were studied. Patients were separated into a development group of 265 patients and a validation group of 268 patients by chronological order. CRP and white cell count were added to a prospectively maintained ERAS database. The primary outcome of the study was all adverse events (including infective complications, postoperative organ dysfunction and prolonged length of stay) during the initial hospital admission. Significant predictors for adverse events on univariate analysis were submitted to multivariate regression analysis and the resulting model applied to the validation group. The validity and predictive accuracy of the regression model was assessed using receiver operating characteristic curve/area under the curve (AUC) analysis.Results  CRP levels > 150 mg/l on postoperative day 2 and a rising CRP on day 3 were independently associated with all adverse events during the hospital admission. A weighted model was applied to the validation group yielding an AUC of 0.65 (95% CI 0.58–0.73) indicating, at best, modest discrimination and predictive accuracy for adverse events.Conclusion  Measurement of CRP in patients after elective colorectal surgery in the first few days after surgery within ERAS can assist in identifying those at risk of adverse events and a prolonged hospital stay. A CRP value of > 150 mg/l on day 2 and a rising CRP on day 3 should alert the surgeon to an increased likelihood of such events.
Does the incidence of unexpected malignancy in ‘benign’ rectal neoplasms undergoing trans‐anal endoscopic microsurgery vary according to lesion morphology?
Authors: Dash I. , Walter C. J. , Wheeler J. M. D. , Borley N. R. 
Published: June 2012

AbstractAim  Mucosectomy by trans‐anal endoscopic microsurgery (TEMS) allows safe and effective excision of benign rectal lesions. Preoperative endoscopic, clinical and ultrasonographic assessment aims to select benign lesions whilst avoiding inappropriate mucosectomy in lesions with malignancy. This study examines the relationship between lesion morphology and accurate benign preoperative classification of rectal lesions undergoing TEMS.Method  Primary lesions preoperatively assessed as benign were identified from a prospective TEMS database. Operative specimen morphology was independently classified by two blinded investigators, using photographs, into flat‐sessile, exophytic or mixed morphology. The accuracy of the preoperative assessment by rectal ultrasonography was compared with the results of histological examination of the excised specimen (χ2 and Fisher’s exact tests).Results  Of 167 lesions with adequate data, the morphological classification showed 60 flat‐sessile, 56 mixed morphology and 51 exophytic tumours, of which 5, 7 and 9, respectively, contained unexpected malignancy (P = 0.48). Accurate preoperative assessment of a lesion as benign occurred in 89% of flat‐sessile and mixed morphology (n = 55 and 49, respectively) and in 70% of exophytic lesions (n = 36) (P = 0.01). Only the exophytic group contained patients in whom preoperative endoscopic and ultrasonographic staging could not be confidently made (uTx). Histology demonstrated six of the seven uTx cases to be benign.Conclusion  In this study exophytic polyps were less likely to be accurately classified as benign using preoperative ultrasonography/endoscopy when compared with flat‐sessile or mixed morphology polyps.
Associations between surrogate measures of insulin resistance and waist circumference, cardiovascular risk and the metabolic syndrome across Hispanic and non‐Hispanic white populations
Authors: Martínez‐Larrad M. T. , Lorenzo C. , González‐Villalpando C. , Gabriel R. , Haffner S. M. , Serrano‐Ríos M. 
Published: June 2012

AbstractAims  We evaluated the relations between surrogate indices of insulin resistance and waist circumference, metabolic syndrome and coronary heart disease risk across Hispanic and non‐Hispanic white populations.Methods  The study was a cross‐sectional analysis of participants without diabetes in the San Antonio Heart Study, Mexico City Diabetes Study and Spanish Insulin Resistance Study. We evaluated commonly used indices of insulin resistance, including homeostasis model assessment, McAuley’s index, Gutt’s insulin sensitivity index, Avignon’s insulin sensitivity index and the Stumvoll index with and without demographics, the modified Matsuda index and the product of the triglycerides and glucose index. The metabolic syndrome was defined by American Heart Association/National Heart, Lung, and Blood Institute criteria and coronary heart disease risk by Framingham risk scores.Results  The Stumvoll index with demographics and the Avignon’s insulin sensitivity index had the strongest correlations with waist circumference across populations. The triglycerides and glucose and McAuley’s indices had the most robust correlations with Framingham risk score. The triglycerides and glucose index had the greatest ability to detect individuals with the metabolic syndrome and ≥ 10% coronary heart disease risk. Some indices display significant variability in the strength of the relationship with adiposity and coronary heart disease risk across populations.Conclusions  There are significant differences between insulin resistance indices regarding the ability to detect the metabolic syndrome and coronary heart disease risk across populations. Studies may need to consider the index of insulin resistance that best suits the objectives.
Zurich Fabry study – prevalence of Fabry disease in young patients with first cryptogenic ischaemic stroke or TIA
Authors: Sarikaya H. , Yilmaz M. , Michael N. , Miserez A. R. , Steinmann B. , Baumgartner R. W. 
Published: June 2012

Background and purposeThe etiology of stroke in young patients remains undetermined in up to half of the cases. Data on prevalence of Fabry disease (FD) in young people with cryptogenic ischaemic stroke are limited and controversial. We aimed to evaluate the frequency of unrecognized FD in a cohort of stroke patients at a tertiary stroke center.MethodsPatients suffering from first cryptogenic ischaemic stroke or transient ischaemic attack (TIA) at the age of 18–55 years were screened for the presence of FD. We measured the serum activity of α‐galactosidase (α‐GAL) in all patients. In addition, sequencing of α‐GAL gene was performed in men with low enzyme activity and in all women.ResultsBetween January, 2006, and October, 2009, we recruited 150 patients (102 men, 48 women) with a mean age of 43 ± 9 years at symptom onset (135 ischaemic stroke, 15 TIA). The α‐GAL activity was low in nine patients (6%; six men and three women). Genetic sequencing in six men with low enzyme activity and all 48 women detected no α‐GAL gene mutation.ConclusionOur study suggests that the yield of screening for FD in patients with first cryptogenic ischaemic stroke or TIA is very low. Further large‐scale studies are needed to investigate the importance of FD amongst patients with recurrent cryptogenic strokes.
Early seizures in first‐ever acute stroke patients in India: incidence, predictive factors and impact on early outcome
Authors: Goswami R. P. , Karmakar P. S. , Ghosh A. 
Published: June 2012

Background and purposeStroke‐associated early seizures (ES) often complicate the initial course of acute stroke. This study intended to estimate the rate of and the predictive factors for ES and the impact of ES on the clinical outcome in patients with first‐ever acute stroke.Materials and methodsConsecutive patients with first‐ever acute stroke admitted in the Department of Medicine from June 2010 to December 2011 were prospectively included. ES were defined as seizures occurring within 7 days from acute stroke. Patients with history of epilepsy, transient ischaemic attack, subarachnoid haemorrhage and cerebral venous thrombosis were excluded. Clinical outcomes were measured under the subheadings of mortality and disability at discharge, according to modified Rankin score.ResultsOf the 441 (56.92% male patients, median age 55 years, 49.43% had haemorrhagic stroke) patients, 79 (17.91%, 95% confidence interval (CI): 14.61–21.78%) suffered from ES. At discharge, 37.64% were disabled, and 19.5% were dead. In multivariate analysis, alcoholism, NIHSS at admission, haemorrhagic stroke and cortical location were significant predictors of ES. Thirty‐day mortality was predicted by NIHSS at admission [hazard ratio (HR): 1.14, 95% CI: 1.11–1.18, P < 0.001], history of hypertension (HR: 3.79, 95% CI: 2.1–6.85, P < 0.001), history of alcoholism (HR: 2.43, 95% CI: 1.49–3.95, P < 0.001) and early seizure (HR: 2.58, 95% CI: 1.54–4.34, P = 0.001).ConclusionsEarly seizures occurred in about 18% acute stroke patients. Alcoholism, haemorrhagic stroke, cortical and severe strokes predict development of ES. ES are an independent important risk factor for early mortality.
Evaluating an anxiety group for people with learning disabilities using a mixed methodology
Authors: Marwood Hayley , Hewitt Olivia 
Published: June 2012

Accessible Summary
We held an anxiety group for people with learning disabilities
The group ran for 6 weeks and eight people came
After the group, we found out if people felt better. We did this by asking them what was good about the group and asking them to fill out questionnaires.

SummaryThe effectiveness of group therapy for people with learning disabilities and anxiety management issues is reviewed. People with learning disabilities face increased levels of psychological distress compared to the general population, yet are often faced with a lack of social support and poor coping techniques to manage their distress. A 6‐week cognitive behavioural therapy (CBT) anxiety management group was delivered to eight adults with a mild learning disability by a trainee psychologist and an assistant psychologist. Participants' ages ranged from 17 to 73 years. All participants lived in the local community. Not all participants had a specific anxiety diagnosis, but all required anxiety management input. A mixed methodology using quantitative and qualitative analysis of group outcomes was used. The outcomes from this group suggest that the intervention was successful in treating anxiety for people with learning disabilities. Measures included the Quality of Life Scale, the Glasgow Anxiety Scale and the Health of the Nation Outcome Scale–Learning Disability Version. Interpretative Phenomenological Analysis (IPA) was also used. Data from interviews were coded and analysed thematically. The main themes that emerged included group versus individual input, helpful aspects of the group, talking in front of other people, group composition (including age differences), support partners, and written materials. The outcomes for this group suggest that the intervention was successful in treating anxiety for people with learning disabilities. Practical applications of group therapies for these clients are considered, and recommendations for future groups made. Quantitative and qualitative evaluation methods are compared.
Phylogenetic relationships among superfamilies of Cicadomorpha (Hemiptera: Auchenorrhyncha) inferred from the wing base structure
Authors: YOSHIZAWA Kazunori , WAGATSUMA Mutsumi 
Published: June 2012

AbstractThe infraorder Cicadomorpha is a monophyletic group of the order Hemiptera, suborder Auchenorrhyncha, and is composed of three superfamilies: Cercopoidea (spittle bugs), Cicadoidea (cicadas) and Membracoidea (leafhoppers and treehoppers). Phylogenetic relationships among the superfamilies have been highly controversial morphologically and molecularly, but recent molecular phylogenetic analyses provided support for Cercopoidea + Cicadoidea. In this study, we examined morphology of the wing base structure in Cicadomorpha and tested the previous phylogenetic hypotheses using the characters selected from the wing base. As a result, a sister‐group relationship between Cicadoidea and Cercopoidea was supported by three synapomorphies (presence of a projection posterior to the anterior notal wing process, presence of a novel notal process anterior to the posterior notal wing process, presence of a novel sclerite between the distal median plate and the base of anal vein). The present study provides the first unambiguous and prominent morphological support for Cicadoidea + Cercopoidea.
Red Blood Cell Transfusion Risks in Patients with End‐Stage Renal Disease
Authors: Tanhehco Yvette C. , Berns Jeffrey S. 
Published: June 2012

AbstractPrior to the introduction of recombinant human erythropoietin (EPO), red blood cell (RBC) transfusions were frequently required when iron and anabolic steroids failed to improve the clinical symptoms of anemia associated with hemoglobin (Hb) levels that were commonly less than 7 g/dl. After the approval of EPO in the United States in 1989, the Hb levels of patients on hemodialysis dramatically improved and the need for RBC transfusions decreased significantly. The need for RBC transfusion remains for patients who require an immediate increase in their RBC mass due to symptomatic anemia and is likely to increase due to changes in the management of anemia in dialysis patients resulting from clinical trials data, regulatory changes, and new reimbursement policies for EPO. The safety of the blood supply has greatly improved over the last few decades, and the risk of transfusion‐transmitted diseases has now been dramatically reduced. Noninfectious complications of transfusion currently cause the majority of morbidity and mortality associated with transfusion in the United States. Transfusion also brings a risk of alloimmunization, a particular concern for dialysis patients waiting for kidney transplantation. Knowledge of the risks of RBC transfusions will help clinicians better assess the risks and benefits of transfusing patients with ESRD. This article reviews the modern day infectious and noninfectious risks of allogeneic RBC transfusions.
Determination of Bone Architecture and Strength in Men and Women with Stage 5 Chronic Kidney Disease
Authors: West Sarah L. , Jamal Sophie A. 
Published: June 2012

AbstractFractures are common in men and women with dialysis‐dependent chronic kidney disease (stage 5D CKD) and are associated with substantial morbidity and mortality. The clinical utility of dual energy X‐ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), noninvasive measures of bone mass and architecture that reflect fracture risk in healthy men and women, is uncertain in patients with stage 5D CKD. This review will outline the epidemiology and etiology of fractures and will summarize the published data that describe the association between fractures, bone mass, and bone strength in stage 5D CKD. Fracture risk assessment in stage 5D CKD is complicated as the etiology of fractures is multifactorial and includes impairments in bone quantity and quality. Cross‐sectional data suggest that bone density by DXA is lower among stage 5D CKD patients with fractures compared with those without, and that this may be particularly true at cortical sites. However, DXA does not capture bone microarchitecture and cannot differentiate between cortical and trabecular bone. Some, but not all studies, that measure cortical and trabecular bone by pQCT in stage 5D CKD, demonstrate a preferential decrease in cortical bone; however, these studies are limited by small sample sizes and cross‐sectional study design. No studies have reported on longitudinal relationships between bone architecture, strength, and incident fractures in patients with stage 5D CKD. Further research is needed to identify noninvasive measures of bone strength that can be used for fracture risk assessment in stage 5D CKD.