bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe implementation of thrombolysis in stroke‐monitoring study in Italy
Authors: Lorenzano S. , Ahmed N. , Rosselli A. , Marcello N. , Inzitari D. , Sterzi R. , Wahlgren N. , Prencipe M. , Toni D. 
Published: June 2009

Background and purpose:  The safe implementation of thrombolysis in stroke‐monitoring (SITS‐MOST) study was an unique opportunity to test in Italy, where only few centres were expert in thrombolytic treatment before, safety and efficacy of i.v. alteplase within 3 h of ischaemic stroke outside the setting of clinical trials.Methods:  In Italy to participate in the study the clinical centres had to possess organizational and structural characteristics certified by Regional Health Authorities.Results:  Seventy‐one centres were activated, 56 (79%) treated patients of which 41 (73%) had never used thrombolysis before the study. Globally, 586 patients were included. Baseline median National Institute of Health Stroke Scale of Italian patients was 13 vs. 12 in other European centres (P = 0.0001). Symptomatic intracerebral haemorrhage as per the NINDS/Cochrane definition, mortality and independence (modified Rankin Scale 0–2) rates at 3 months occurred respectively in 6.7% (95% CI: 4.8–9.1), 11.7% (9.2–14.6) and 51.6% (47.4–55.7) of Italian patients compared with 7.3% (6.7–8.0) (P = 0.56), 11.2% (10.4–12.1) (P = 0.75) and 55.1% (53.8–56.4) (P = 0.09) in the European patients and in 8.6% (40/65; 6.3–11.6), 17.3% (14.1–21.1) and 50.1% (44.5–54.7) of the patients treated in the pooled randomized controlled trials.Conclusions:  The SITS‐MOST study showed that in Italy i.v. alteplase is safe and effective in routine clinical use also in non‐expert centres.
Elevated cerebrospinal fluid adiponectin and adipsin levels in patients with multiple sclerosis: a Finnish co‐twin study
Authors: Hietaharju A. , Kuusisto H. , Nieminen R. , Vuolteenaho K. , Elovaara I. , Moilanen E. 
Published: June 2009

Background and purpose:  The aim of this study was to investigate the levels of three adipocytokines: leptin, adiponectin and adipsin, in serum and cerebrospinal fluid (CSF) of twins discordant for multiple sclerosis (MS). Adipose tissue is an important component connecting immune system and several tissues and organs including CNS. Fat cells produce adipocytokines, which seem to have a role in various autoimmune disorders including MS.Methods:  Plasma samples were collected from twelve twins and CSF samples from four twins discordant for MS. The concentrations of interleukine (IL)‐6, adiponectin, adipsin and leptin in plasma and CSF samples were determined by enzyme immuno assay.Results:  A significant difference was seen in the adipocytokine levels in CSF samples. Twins with MS had higher concentrations of adiponectin (P = 0.039) and adipsin (P = 0.039), than their asymptomatic co‐twins.Conclusion:  As adiponectin and adipsin levels in CSF did not correlate with their levels in plasma, it seems that there could be a secondary intrathecal synthesis of these adipocytokines in MS.
One‐year MRI scan predicts clinical response to interferon beta in multiple sclerosis
Authors: Prosperini L. , Gallo V. , Petsas N. , Borriello G. , Pozzilli C. 
Published: June 2009

Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment.Methods:  All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single‐centre, prospective and post‐marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed‐up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of ≥1 point in the Expanded Disability Status Scale (EDSS) during the follow‐up period.Results:  Out of 454 RR‐MS patients starting IFNB therapy, data coming from 394 patients with a mean follow‐up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow‐up. Less than 1/3 (30.4%) of the patients satisfied the criterion of ‘poor responders’. Patients presenting new lesions on T2‐weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow‐up period (HR 16.8, 95% CI 7.6–37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10‐fold increase for each new lesion.Conclusions:  Developing new T2‐hyperintense lesions during IFNB treatment was the best predictor of long‐term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
Ischaemic posterior circulation stroke in State of Qatar
Authors: Akhtar N. , Kamran S. I. , Deleu D. , D’Souza A. , Miyares F. , ElSotouhy A. , Al‐Hail H. , Mesraoua B. , Own A. , Salem K. , Kamha A. , Osman Y. 
Published: June 2009

Background:  Ischaemic stroke features may show regional differences. Posterior circulation stroke (PCS) is of special interest, as symptomatology, course and outcome are usually different and complex. No significant studies or registries have reported on the characteristics and outcomes of PCS in our region.Methods:  We prospectively collected data of 116 patients with PCS admitted from 2005 through 2008 in the only stroke admitting hospital in Qatar. Demographics, risk factors, clinical signs/symptoms, pattern of presentation, aetiology, imaging features, complications and outcome at discharge and follow‐up were recorded.Results:  Mean age was 53 years with 25% aged ≤45, 85% were males. Demographically 47% were Arabs and 51% of South‐Asian origin. Mean duration from onset to presentation was 29 h. Major risk factors were obesity (66%) and hypertension (61%). Minimal or fluctuating symptoms were present in 64%, while 9% had maximal deficit at onset. Thirty nine per cent had lesions in proximal territory and 23% in multiple territories. Around 41% had no occlusion, 16% had vertebro‐basilar, 16% vertebral, 8% basilar occlusion. Etiologically 53% patients had large artery disease, 16% small vessel disease, and 17% cardioembolism. Seventy per cent of patients were discharged home, while 10% expired. Modified Rankin score (mRS) at discharge was ≤2 in 53% and ≥4 in 13% patients. At 30‐day follow‐up, 68% had mRS of ≤2. Ninety‐day survival status showed 89% alive with mRS ≤ 2 in 73%.Conclusion:  The aetiology and lesion topography of PCS in this heterogeneous population differs from the pattern observed in other populations.
Adjustment of treatment increases quality of life in patients with epilepsy: a randomized controlled pragmatic trial
Authors: Uijl S. G. , Uiterwaal C. S. P. M. , Aldenkamp A. P. , Carpay J. A. , Doelman J. C. , Keizer K. , Vecht C. J. , De Krom M. C. T. F. M. , Van Donselaar C. A. 
Published: June 2009

Background and purpose:  Complaints about side‐effects of antiepileptic drugs (AEDs) may be overlooked in clinical practice. We assessed the value and risks of an active intervention policy for reported complaints in a randomized controlled pragmatic trial.Methods:  This randomized controlled pragmatic trial included 111 adults treated for epilepsy in seven general hospitals. They were considered well‐managed by their treating physician, but reported moderate to severe complaints on a questionnaire (SIDAED, assessing SIDe effects in AED treatment). The intervention was adjustment of AED treatment (53 patients), either reduction of dose or switch of AED, versus continuation of treatment unchanged (58 control patients) during 7 months. Primary outcomes were quality of life (Qolie‐10) and complaints score. Secondary outcome measures were the occurrence of seizures or adverse events.Results:  After 7 months, the relative risk (RR) for improvement in quality of life was 1.80 (1.04–3.12) for the intervention group compared to control and the RR of decrease in complaints was 1.34 (0.88–2.05). In 58% of patients randomized to adjustment, the medication had indeed been changed.Discussion:  In conclusion, despite a possible risk of seizure recurrence, adjustment of drug treatment in well‐managed patients with epilepsy, who report considerable complaints, improves the quality of life.
The impact of lifestyles and food knowledge on the food patterns of German children
Authors: Von Normann Konstantin 
Published: June 2009

AbstractThe German youth is relatively well informed about healthy eating, but does not act in accordance with this knowledge. It is also known from empirical studies that there is an association between lifestyles, food knowledge and the eating patterns of older teenagers. However, is there a similar correlation in regard to younger children? This article shows results of a study addressing this issue by empirically investigating leisure time activities, food intake and food knowledge.The study conducted with 907 children, on average 12 years old, out of an urban region in northwest Germany using a written questionnaire, implies that food patterns and food knowledge have to be improved because they are – on average – only marginally acceptable. On this level, they are not in line with a healthy future.For the first time in Germany, food patterns and food knowledge of seventh grade pupils were analysed in relation to their lifestyles. The study revealed four lifestyles. One family‐oriented lifestyle and three non‐family oriented lifestyles: outdoor and sociable youth, culture‐oriented youth, and multimedia kids. The family‐oriented lifestyle influences the children's food patterns in a positive way; the three found non‐family‐oriented lifestyles lead to less preferable food patterns.The results imply that there is a phase of unhealthy food patterns at the beginning of the second life decade, which seems to be linked to the detachment from the parents and the gained independency, expressed by the first self‐chosen lifestyles.As lifestyles have such a vital influence on healthy eating, and family is no longer the place where children get their everyday competencies, school has to enable pupils to make healthier food and lifestyle choices.
Ease of reading of mandatory information on Canadian food product labels
Authors: Mackey Mary Alton , Metz Marilyn 
Published: June 2009

AbstractFood product labels present individual product information, safety, nutrition, electronic inventory, container and environmental information, in various formats, languages and images. Some information is mandatory; much is promotional. The food label is an essential tool for regulators of safe food handling, nutrition policy and fair competition. Mandatory information on food labels in Canada is required to be presented in both English and French, readily discernable, prominently displayed and legible. This study examines the ease of finding and reading of mandatory label components on selected Canadian food products. A validated typographical scoring system assessed the lists of ingredients on a purposive sample of 100 food labels representing foods in all groups in Canada's Food Guide. Seven percent of the ingredient lists were easy to read; 26% were difficult to read and 67% were very difficult to read. Well‐educated resourceful readers in consumer focus groups examined food labels for key elements that influence ease of finding and reading information. Focus groups and typographical scoring identified: colour contrast, case, print style, print size, space between the lines, reverse print, organization, justification, type of surface, hyphenation and print reproduction as factors that affect ease of reading. Print that curves around a container, lack of paragraphing or point form organization make reading difficult; text blocks at right angles to each other make comparisons difficult; separation of the nutrition facts table from the list of ingredients makes decision making tedious. Inadequate spacing between lines of print creates problems for readers of English and exacerbates problems for readers of French. Words placed over illustrations, busy backgrounds or watermarks increase reading difficulty. Hazard statements, instructions and storage information imbedded in other information without added space or appropriate heading is difficult to find and read. Canadian consumers echo consumers in 28 European countries who find label information difficult to find and to read and want clear guidelines/regulations on the placement and the typography of mandatory food label components
Gum chewing stimulates early return of bowel motility after caesarean section
Authors: Abd‐El‐Maeboud KHI , Ibrahim MI , Shalaby DAA , Fikry MF 
Published: June 2009

Objective  To evaluate the efficacy and safety of postoperative gum chewing on the recovery of bowel motility after caesarean section.Design  A randomised controlled study.Setting  Faculty of Medicine, Ain Shams University, Egypt.Population  A total of 200 pregnant women delivered by elective caesarean section (CS) under general anaesthesia.Methods  Women were randomised into two groups; group A (93 women) who received one stick of sugarless gum for 15 minutes every 2 hours after surgery, and group B (107 women) had traditional management (oral intake of clear fluids allowed after passage of flatus and regular diet with the passage of bowel movement).Main outcome measures  Time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement and length of hospital stay.Results  The mean duration of surgery was longer in group A (41.3 ± 7.5 versus 38.4 ± 8.1 minutes, P < 0.05). The mean postoperative time interval to first hearing of normal intestinal sounds (10.9 ± 2.7 versus 15.6 ± 3.7 hours), passage of flatus (17.9 ± 4.6 versus 24.4 ± 7.1 hours), defecation (21.1 ± 4.7 versus 30 ± 8.2 hours) and discharge from the hospital (40.8 ± 10.6 versus 50.5 ± 8.9 hours) were significantly shorter in group A (P < 0.001). Severe ileus occurred only in one woman belonging to group B. All patients in group A tolerated gum chewing beginning on the first postoperative day.Conclusion  Gum chewing after CS is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stay; with potential impact on reducing the overall healthcare costs in case of routine implementation.
The HDAC inhibitor, sodium butyrate, stimulates neurogenesis in the ischemic brain
Authors: Kim Hyeon Ju , Leeds Peter , Chuang De‐Maw 
Published: June 2009

AbstractIn the healthy adult brain, neurogenesis normally occurs in the subventricular zone (SVZ) and hippocampal dentate gyrus (DG). Cerebral ischemia enhances neurogenesis in neurogenic and non‐neurogenic regions of the ischemic brain of adult rodents. This study demonstrated that post‐insult treatment with a histone deacetylase inhibitor, sodium butyrate (SB), stimulated the incorporation of bromo‐2′‐deoxyuridine (BrdU) in the SVZ, DG, striatum, and frontal cortex in the ischemic brain of rats subjected to permanent cerebral ischemia. SB treatment also increased the number of cells expressing polysialic acid–neural cell adhesion molecule, nestin, glial fibrillary acidic protein, phospho‐cAMP response element‐binding protein (CREB), and brain‐derived neurotrophic factor (BDNF) in various brain regions after cerebral ischemia. Furthermore, extensive co‐localization of BrdU and polysialic acid–neural cell adhesion molecule was observed in multiple regions after ischemia, and SB treatment up‐regulated protein levels of BDNF, phospho‐CREB, and glial fibrillary acidic protein. Intraventricular injection of K252a, a tyrosine kinase B receptor antagonist, markedly reduced SB‐induced cell proliferation detected by BrdU and Ki67 in the ipsilateral SVZ, DG, and other brain regions, blocked SB‐induced nestin expression and CREB activation, and attenuated the long‐lasting behavioral benefits of SB. Together, these results suggest that histone deacetylase inhibitor‐induced cell proliferation, migration and differentiation require BDNF–tyrosine kinase B signaling and may contribute to long‐term beneficial effects of SB after ischemic injury.
Circadian regulation of ion channels and their functions
Authors: Ko Gladys Y.‐P. , Shi Liheng , Ko Michael L. 
Published: June 2009

AbstractIon channels are the gatekeepers to neuronal excitability. Retinal neurons of vertebrates and invertebrates, neurons of the suprachiasmatic nucleus (SCN) of vertebrates, and pinealocytes of non‐mammalian vertebrates display daily rhythms in their activities. The interlocking transcription–translation feedback loops with specific post‐translational modulations within individual cells form the molecular clock, the basic mechanism that maintains the autonomic ∼24‐h rhythm. The molecular clock regulates downstream output signaling pathways that further modulate activities of various ion channels. Ultimately, it is the circadian regulation of ion channel properties that govern excitability and behavior output of these neurons. In this review, we focus on the recent development of research in circadian neurobiology mainly from 1980 forward. We will emphasize the circadian regulation of various ion channels, including cGMP‐gated cation channels, various voltage‐gated calcium and potassium channels, Na+/K+‐ATPase, and a long‐opening cation channel. The cellular mechanisms underlying the circadian regulation of these ion channels and their functions in various tissues and organisms will also be discussed. Despite the magnitude of chronobiological studies in recent years, the circadian regulation of ion channels still remains largely unexplored. Through more investigation and understanding of the circadian regulation of ion channels, the future development of therapeutic strategies for the treatment of sleep disorders, cardiovascular diseases, and other illnesses linked to circadian misalignment will benefit.
Endoscopic posterior nasal neurectomy: an alternative to Vidian neurectomy
Authors: Kanaya T. , Kikawada T. 
Published: June 2009

SummaryAlthough Vidian neurectomy is very effective as a means of alleviating symptoms of chronic rhinitis (allergic rhinitis and vasomotor rhinitis), it is presently seldom used because of a high incidence of complications such as disturbed lacrimal secretion and sensory disorders of the cheek and gum. In 1997, Kikawada succeeded in endoscopically cutting the posterior nasal nerve (a ramus of the Vidian nerve) at the level of the sphenopalatine foramen under clear vision. This technique has since been improved into one that allows safe and rapid completion of the operation using a bipolar device. This new technique of endoscopic posterior nasal neurectomy with a bipolar device will be presented in this paper.
Quality‐of‐life prediction after various therapeutic interventions
Authors: Mandai T. 
Published: June 2009

SummaryWe believe that this century will be the century of quality of life (QOL). Both medical prediction and QOL prediction are indispensable in clinical practice. Therefore, we investigated how to predict QOL outcomes after various therapeutic interventions using our customized questionnaire. Seventy‐four cataractus patients treated with day surgery (S1), 106 undergoing renal transplantation (S2), 30 with pacemaker treatment (S3), and 36 elderly persons supported by government‐mandatory nursing/healthcare service for persons aged >65 years (S4) participated in this study. Our self‐administered questionnaires and the Life Satisfaction Index (LSI) were at first compared. Pearson's correlation coefficients between our questionnaires and LSI were S1, r=0.92 (P<0.05); S2, r=0.69 (P<0.01); and S3, r=0.87 (P<0.01). Cronbach's α coefficients of our questionnaires were high enough for acceptance for clinical use. Our questionnaires contained 11 (S1), 11 (S2), 9 (S3), and 12 (S4) main factors and the cumulative contributions were 0.82, 0.77, 0.85, and 0.81, respectively. Whereas all patients whose baseline QOL was low before interventions exhibited improved total QOL after interventions, most patients whose total QOL was high before interventions underwent impaired total QOL thereafter. Divergent points were identified for QOL improvement or deterioration after therapeutic interventions according to each disorder investigated. Significant negative correlations were noted between baseline QOL and QOL changes. Our QOL prediction theory may be helpful when discussing interventions with individual patients in a range of therapeutic settings.
Can antenatal education influence how women push in labour?
Authors: PHIPPS Hala , CHARLTON Sarah , DIETZ Hans Peter 
Published: June 2009

Background:  Antenatal education on the physiology of second stage of labour and effective pushing has not been studied in the literature. Anecdotal observation seems to indicate that some nulliparous women are (at least initially) unable to push effectively. A large proportion seem to reflexly contract the levator ani muscle when asked to push which may have the effect of slowing the progress of labour.Aims:  To test the effectiveness of structured antenatal education for pushing in the second stage of labour versus normal care and its impact on delivery outcome.Methods: One hundred nulliparous women between 35 and 37 weeks gestation were randomised. Intervention: Two 15‐min structured education sessions, one week apart, utilising observation of the perineum and a vaginal examination to teach correct technique for relaxing the levator ani muscle and effective pushing.Results:  In both groups, 31 of 50 women (62%) delivered vaginally. Instrumental delivery and caesarean section rates did not differ between the two groups (P = 0.78, relative risk = 1). The mean duration of active second stage for the control group was 53.96 min compared with 57.26 min for the intervention group. This difference of 3.3 min was not statistically significant (P = 0.56). Knowledge of women in the intervention group was increased and the majority of women found the educational sessions helpful.Conclusion:  Antenatal teaching to ensure effective maternal pushing in labour did not result in altered obstetric outcomes relative to the control group. However, there was a measurable qualitative effect from the intervention in that women clearly felt the education sessions to be helpful.
Characteristics and practices of birth centres in Australia
Authors: LAWS Paula J. , LIM Carylyn , TRACY Sally , SULLIVAN Elizabeth A. 
Published: June 2009

Background: Around 2% of women who give birth in Australia each year give birth in a birth centre. There is currently no standard definition of a birth centre in Australia.Aims: This study aimed to locate all birth centres nationally, describe their characteristics and procedures, and develop a definition.Methods: Surveys were sent to 23 birth centres. Questions included: types of procedures, equipment and pain relief available, staffing, funding, philosophies, physical characteristics and transfer procedures. Of the birth centres, 19 satisfied the inclusion criteria and 16 completed surveys.Results: Three constructs of a birth centre were identified. A ‘commitment to normality of pregnancy and birth’ was most commonly reported as the most important philosophy (44%). The predominant model of care was group practice/caseload midwifery (63%).Thirteen birth centres were located within/attached to a hospital, two were on a hospital campus and one was freestanding. The distance to the nearest labour ward ranged from 2 m to 15 km. Reported intrapartum transfer rates ranged from 7% to 29%. Thirteen centres had a special care nursery or neonatal intensive care unit onsite, or both.Eight centres undertook artificial rupture of membranes for induction of labour, while two administered oxytocin or prostaglandins. All centres offered nitrous oxide and local anaesthetic. Twelve centres had systemic opioids available and one offered pudendal analgesia. Fetal monitoring was used in all birth centres. Only three centres conducted instrumental deliveries, while 15 performed episiotomies.Conclusion: Birth centres vary in their philosophies, characteristics and service delivery.