bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventricular tachycardia during hyperthermic intraperitoneal chemotherapy
Authors: Thix C. A. , Königsrainer I. , Kind R. , Wied P. , Schroeder T. H. 
Published: September 2009

SummaryCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is used for selected gastrointestinal carcinomas. We report a case of ventricular tachycardia during HIPEC with cisplatin that persisted as long as the chemotherapy solution remained in the intra‐abdominal cavity. We hypothesise that high plasma levels of cisplatin with concomitant low magnesium levels caused the arrhythmia.
Oblique sub‐costal transversus abdominis plane (TAP) catheters: an alternative to epidural analgesia after upper abdominal surgery
Authors: Niraj G. , Kelkar A. , Fox A. J. 
Published: September 2009

SummaryThe authors present three cases where catheters placed in the oblique sub‐costal transversus abdominis plane provided prolonged analgesia after upper abdominal surgery. Patient 1 was admitted with severe sepsis following major hepatobiliary surgery. Bilateral catheters facilitated weaning from mechanical ventilation and provided adequate analgesia for 4 days. Patient 2 underwent emergency laparotomy for intestinal obstruction having refused consent for epidural analgesia. The transversus abdominis plane catheters provided a significant opioid sparing effect. A unilateral catheter offered rescue analgesia in patient 3 when the epidural catheter was displaced. We put forward a case for oblique sub‐costal transversus abdominis plane catheters as an alternative to epidural analgesia after upper abdominal surgery.
Tracheal intubation with restricted access: a randomised comparison of the Pentax‐Airway Scope and Macintosh laryngoscope in a manikin
Authors: Asai T. 
Published: September 2009

SummaryTen anaesthetists assessed the ease of tracheal intubation (time to see the glottis, to intubate the trachea and to ventilate), using the Pentax Airway Scope and Macintosh laryngoscope in a manikin, in three simulated circumstances of restricted laryngoscopy: (1) the patient lying supine on the ground; (2) the patient lying supine on the ground with the head close to a wall; (3) the patient confined to a car driver’s seat. For the Pentax Airway Scope, intubation was successful (within 2 min) in all three circumstances. For the Macintosh laryngoscope, intubation was successful in all cases in circumstance (1), eight in circumstance (2), and five in circumstance (3). In circumstances (2) and (3), the Pentax Airway Scope needed significantly shorter time to see the vocal cords (median [95% confidence interval] for difference: 4.5 [0.5–9.5] s in circumstance (2), and 12.5 [7.0–32.5] s in circumstance (3)), shorter time to intubate (median [95% confidence interval] for difference: 21.0 [5.5–38.5] s in circumstance (2), and 40.5 [17.5–64.0] s in circumstance (3)), and shorter time to ventilate the lungs (median [95% confidence interval] for difference: 18. 3 [4.5–36.0] s in circumstance (2), and 47.5 [16.0–84.5] s in circumstance (3)). These results indicate that, in situations where access to the patient’s head is restricted, the Pentax Airway Scope is more effective than the Macintosh laryngoscope.
The effect of flexion on the level of termination of the dural sac in paediatric patients
Authors: Koo B‐N. , Hong J‐Y. , Kim J. E. , Kil H. K. 
Published: September 2009

SummaryAlthough the anatomy of the spinal cord and its associated structures have been well defined, the effects of body position relevant to neuraxial blockade have not been elucidated. This study was designed to determine the effect of body position on the end of the dural sac in children. After induction of anaesthesia, ultrasound examination was performed to evaluate the location of the dural sac end in the lateral position with a straight back and knee, and in the lateral position with the knees, legs, and neck flexed. The level of the end of the dural sac was determined in relation to the vertebrae. Our data demonstrate that the dural sac shifts significantly cephalad in the lateral flexed position used for neuraxial blockade (p < 0.001). These results suggest that the safety margin to avoid dural puncture during hiatal or S2‐3 approach for caudal block can be increased in younger children.
Rise in antiobesity drug prescribing for children and adolescents in the UK: a population‐based study
Authors: Viner Russell M. , Hsia Yingfen , Neubert Antje , Wong Ian C. K. 
Published: September 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The antiobesity drugs sibutramine and orlistat are not licensed for use in children and adolescents in the UK or USA.• Clinical trials suggest antiobesity drugs are effective and well‐tolerated in obese adolescents. WHAT THIS STUDY ADDS • Prescribing of unlicensed antiobesity drugs in children and adolescents has increased significantly in the past 8 years.• Most prescribed antiobesity drugs in children and adolescents are rapidly discontinued before patients can see clinical benefit, suggesting they are poorly tolerated or poorly efficacious.AIMS The international childhood obesity epidemic has driven increased use of unlicensed antiobesity drugs, whose efficacy and safety are poorly studied in children and adolescents. We investigated the use of unlicensed antiobesity drugs (orlistat, sibutramine and rimonabant) in children and adolescents (0–18 years) in the UK.METHODS Population‐based prescribing data from the UK General Practice Research Database between 1 January 1999 and 31 December 2006.RESULTS A total of 452 subjects received 1334 prescriptions during the study period. The annual prevalence of antiobesity drug prescriptions rose significantly from 0.006 per 1000 [95% confidence interval (CI) 0.0007, 0.0113] in 1999 to 0.091 per 1000 (95% CI 0.07, 0.11) in 2006, a 15‐fold increase, with similar increases seen in both genders. The majority of prescriptions were made to those ≥14 years old, although 25 prescriptions were made for children <12 years old. Orlistat accounted for 78.4% of all prescriptions; only one patient was prescribed rimonabant. However, approximately 45% of the patients ceased orlistat and 25% ceased sibutramine after only 1 month. The estimated mean treatment durations for orlistat and sibutramine were 3 and 4 months, respectively.CONCLUSIONS Prescribing of unlicensed antiobesity drugs in children and adolescents has dramatically increased in the past 8 years. The majority are rapidly discontinued before patients can see weight benefit, suggesting they are poorly tolerated or poorly efficacious when used in the general population. Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed.
Relationship between blood alcohol concentration on admission and outcome in dimethoate organophosphorus self‐poisoning
Authors: Eddleston Michael , Gunnell David , Von Meyer Ludwig , Eyer Peter 
Published: September 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Acute alcohol intoxication often complicates acute organophosphorus pesticide poisoning.• No data are available on how alcohol intoxication affects outcome in acute organophosphorus pesticide poisoning.• In particular, the relationships between plasma alcohol concentration and plasma organophosphorus concentration or outcome are unclear. WHAT THIS STUDY ADDS • Alcohol co‐ingestion is associated with higher concentrations of the organophosphorus insecticide dimethoate, probably due to larger ingestions.• The higher concentrations of dimethoate found with alcohol co‐ingestion increase the risk of death in dimethoate poisoning. There was no detectable effect of the alcohol itself on outcome.• Efforts to reduce deaths from insecticide self‐poisoning may benefit from concurrent efforts to reduce alcohol consumption.AIMS Many patients acutely poisoned with organophosphorus insecticides have co‐ingested alcohol. Although clinical experience suggests that this makes management more difficult, the relationship between plasma concentration of alcohol and insecticide is unknown. We aimed to determine whether acute intoxication results in ingestion of larger quantities of insecticide in dimethoate self‐poisoning and a worse clinical outcome.METHODS We set up a prospective study of acute dimethoate self‐poisoning in Sri Lankan district hospitals. An admission plasma sample was analysed to identify the ingested insecticide; in patients with detectable dimethoate, plasma alcohol was measured.RESULTS Plasma from 37 of 72 (51.4%) dimethoate‐poisoned patients had detectable alcohol {median concentration 1.10 g l−1[110 mg dl−1][interquartile range (IQR) 0.78–1.65]} a median of 3 h post ingestion. The median plasma dimethoate concentration was higher in patients who had ingested alcohol [479 µmol l−1 (IQR 268–701) vs. 145 µmol l−1 (IQR 25–337); P < 0.001]. Plasma dimethoate concentration was positively correlated with plasma alcohol (Spearman's ρ= 0.34; P= 0.0032). The median alcohol concentration was higher in the 21 patients who died compared with survivors (0.94 vs. 0.0 g l−1, P= 0.018). Risk of death was greater amongst individuals who consumed alcohol [odds ratio (OR) 4.3, 95% confidence interval (CI) 1.2, 16.4]; this risk was abolished by controlling for dimethoate concentration (OR 0.3, 95% CI 0.0, 8.8), indicating that deaths were not due to the direct toxic effects of alcohol.CONCLUSIONS Alcohol co‐ingestion is associated with higher plasma concentrations of dimethoate and increased risk of death. Larger studies are required to assess this finding's generalizability, since efforts to reduce deaths from self‐poisoning may benefit from concurrent efforts to reduce alcohol consumption.
Effect of efavirenz on high‐density lipoprotein antioxidant properties in HIV‐infected patients
Authors: Pereira S. A. , Batuca J. R. , Caixas U. , Branco T. , Delgado‐Alves J. , Germano I. , Lampreia F. , Monteiro E. C. 
Published: September 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • In previous work, we showed a long‐term and concentration‐dependent beneficial effect of the non‐nucleoside reverse transcriptase inhibitor efavirenz (EFV) on high‐density lipoproteins (HDL) in human immunodeficiency virus (HIV)‐infected patients.• Furthermore, it has been suggested that instead of the current practice of only measuring HDL‐chelesterol values, the evaluation of HDL function, namely its antioxidant properties, might be an improved tool for identifying subjects at increased risk for cardiovascular events.• Paraoxonase‐1 (PON‐1) is an enzyme associated with HDL that is responsible for HDL antioxidant function. WHAT THIS STUDY ADDS • In the present work, we studied the effect of EFV on the activity of PON‐1 and showed, for the first time, that EFV‐based antiretroviral therapy is associated with a better antioxidant function, i.e. with a higher PON‐1 activity.AIMS A long‐term and concentration‐dependent beneficial effect of efavirenz (EFV) on cholesterol associated with high‐density lipoprotein (HDL‐c) in human immunodeficiency virus (HIV)‐infected patients has been documented. Furthermore, it has been suggested that, instead of the current practice of only measuring HDL‐c values, the evaluation of HDL quality might be an improved tool for identifying subjects at increased risk of cardiovascular events. Paraoxonase‐1 (PON‐1) is an enzyme associated with HDL that is involved in the onset of cardiovascular disease and responsible for HDL antioxidant function. The aim of the present study was to investigate the effect of EFV on the circulating activity of PON‐1 in HIV‐infected patients.METHODS The patients included were adults with a documented HIV‐1 infection, nontreated or treated with antiretroviral regimens including EFV 600 mg once daily as first therapeutic regimen for at least 3 months. The influence of treatment with EFV, HDL‐c and CD4 cell count on PON‐1 activity was analysed.RESULTS HIV‐infected White patients treated with EFV had higher PON‐1 activity [77.35 U l−1 (65.66, 89.04)] (P < 0.05) and higher PON‐1 activity : HDL‐c ratio [1.88 (1.49, 2.28)] (P < 0.01) than untreated patients. PON‐1 activity was higher in Black patients (P < 0.001) and in patients with a CD4 cell count >500 cells ml−1 (P= 0.0120).CONCLUSIONS EFV‐based antiretroviral regimens are associated with HDL particles with a better antioxidant function, i.e. with a higher PON‐1 activity. The PON‐1 activity of Black patients is higher than that found in Whites regardless of treatment. Ethnicity should be taken into consideration when studying drug effects on PON‐1 activity.
Common community acquired infections and subsequent risk of chronic lymphocytic leukaemia
Authors: Anderson Lesley A. , Landgren Ola , Engels Eric A. 
Published: September 2009

SummaryEmerging evidence supports a role for immune‐related factors in the causation of chronic lymphocytic leukaemia (CLL). Using the population‐based U.S. Surveillance Epidemiology and End Results‐Medicare database, 10 171 elderly CLL patients and 122 531 frequency‐matched controls were identified in order to evaluate several community acquired infections associated with subsequent CLL risk. Odds ratios (ORs) were adjusted for gender, age, race, calendar year and number of physician claims. CLL risk was increased following Medicare claims for sinusitis (OR = 1·11; 95% CI = 1·05–1·17), pharyngitis (OR = 1·15; 1·08–1·22), bronchitis (OR = 1·14; 1·08–1·19), pneumonia (OR = 1·17; 1·11–1·24), influenza (OR = 1·10; 1·01–1·19), cellulitis (OR = 1·08; 1·02–1·14) and herpes zoster (OR = 1·26; 1·15–1·37). Associations with pneumonia and cellulitis remained significant when the 5‐year period before diagnosis/control selection was excluded. CLL risk increased with increasing severity/frequency of pneumonia (P = 0·005), cellulitis (P < 0·001) and herpes zoster (P < 0·001). Our findings suggest that common infections may play a role in CLL aetiology. Alternatively, the associations might reflect an underlying immune disturbance present several years prior to CLL diagnosis.
Multiple isoforms of PAX5 are expressed in both lymphomas and normal B‐cells
Authors: Arseneau Jean‐René , Laflamme Mark , Lewis Stephen M. , Maïcas Emmanuel , Ouellette Rodney J. 
Published: September 2009

SummaryThe transcription factor Pax5 plays a critical role in B cell development. It has been shown that alternative splicing of its gene (PAX5) produces several distinct transcripts that modify the amino acid sequence of the putative Pax5 proteins. Subsequent studies have attempted to correlate the expression of PAX5 isoforms with certain B‐cell lymphomas, the conclusions of which suggest that altered isoform expression is involved in lymphomagenesis. However, in the absence of definitive data for PAX5 isoform expression patterns in normal B cells it is difficult to confirm whether aberrant isoform expression can indeed be correlated with disease. Using a high‐resolution method of analysis of reverse transcription polymerase chain reaction products, we sought to analyse the expression of the different PAX5 isoforms in normal B‐cells as well as a number of B‐cell lymphoma and chronic lymphocytic leukaemia cases. It was found that multiple PAX5 isoforms were expressed in both normal and malignant B cells. Immunodetection and polysomal RNA analyses also confirmed that the different PAX5 mRNAs were translated into their corresponding proteins. No consistent deregulation of PAX5 isoform expression was observed in B‐cell lymphomas, but rather, complex isoform expression patterns were found in normal B cell as well as B‐cell lymphoma and CLL cases.
Omega-3 polyunsaturated fatty acids ameliorate the severity of ileitis in the senescence accelerated mice (SAM)P1/Yit mice model
Authors: Matsunaga H , Hokari R , Kurihara C , Okada Y , Takebayashi K , Okudaira K , Watanabe C , Komoto S , Nakamura M , Tsuzuki Y , Kawaguchi A , Nagao S , Miura S 
Published: September 2009

Summary
Clinical studies using omega-3 polyunsaturated fatty acids (ω3-PUFA) to Crohn's disease (CD) are conflicting. Beneficial effects of dietary ω3-PUFA intake in various experimental inflammatory bowel disease (IBD) models have been reported. However, animal models of large intestinal inflammation have been used in all previous studies, and the effect of ω3 fat in an animal model of small intestinal inflammation has not been reported. We hypothesized that the effects of ω3 fat are different between large and small intestine. The aim of this study was to determine whether the direct effect of ω3 fat is beneficial for small intestinal inflammation. Senescence accelerated mice (SAM)P1/Yit mice showed remarkable inflammation of the terminal ileum spontaneously. The numbers of F4/80-positive monocyte–macrophage cells as well as β7-integrin-positive lymphocytes in the intestinal mucosa were increased significantly compared with those in the control mice (AKR-J mice). The area of mucosal addressin cell adhesion molecule-1 (MAdCAM-1)-positive vessels was also increased. The degree of expression levels of monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6 and interferon (IFN)-γ mRNA were increased significantly compared with those in the control mice. The feeding of two different kinds of ω3 fat (fish-oil-rich and perilla-oil-rich diets) for 16 weeks to SAMP1/Yit mice ameliorated inflammation of the terminal ileum significantly. In both the ω3-fat-rich diet groups, enhanced infiltration of F4/80-positive monocytes/macrophages in intestinal mucosa of SAMP1/Yit mice cells and the increased levels of MCP-1, IL-6 and IFN-γ mRNA expression were ameliorated significantly compared with those in the control diet group. The results suggest that ω3 fat is beneficial for small intestinal inflammation by inhibition of monocyte recruitment to inflamed intestinal mucosa.
Spatial scale and the diversity of macroinvertebrates in a Neotropical catchment
Authors: LIGEIRO RAPHAEL , MELO ADRIANO S. , CALLISTO MARCOS 
Published: September 2009

Summary1. Lotic ecosystems can be studied on several spatial scales, and usually show high heterogeneity at all of them in terms of biological and environmental characteristics. Understanding and predicting the taxonomic composition of biological communities is challenging and compounded by the problem of scale. Additive diversity partitioning is a tool that can show the diversity that occurs at different scales.2. We evaluated the spatial distribution of benthic macroinvertebrates in a tropical headwater catchment (S.E. Brazil) during the dry season and compared alpha and beta diversities at the scales of stream segments, reaches, riffles and microhabitats (substratum types: gravels, stones and leaf litter). We used family richness as our estimate of diversity. Sampling was hierarchical, and included three stream segments, two stream reaches per segment, three riffles per reach, three microhabitats per riffle and three Surber sample units per microhabitat.3. Classification analysis of the 53 families found revealed groups formed in terms of stream segment and microhabitat, but not in terms of stream reaches and riffles. Separate partition analyses for each microhabitat showed that litter supported lower alpha diversity (28%) than did stones (36%) or gravel (42%). In all cases, alpha diversity at the microhabitat scale was lower than expected under a null model that assumed no aggregation of the fauna.4. Beta diversity among patches of the microhabitats in riffles depended on substratum type. It was lower than expected in litter, similar in stone and higher in gravel. Beta diversities among riffles and among reaches were as expected under the null model. On the other hand, beta diversity observed was higher than expected at the scale of stream segments for all microhabitat types.5.  We conclude that efficient diversity inventories should concentrate sampling in different microhabitats and stream sites. In the present study, sampling restricted to stream segments and substratum types (i.e. excluding riffles and stream reaches) would produce around 75% of all observed families using 17% of the sampling effort employed. This finding indicates that intensive sampling (many riffles and reaches) in few stream segments does not result in efficient assessment of diversity in a region.
Regionalisation of chemical variability in European mountain lakes
Authors: CAMARERO LLUÍS , ROGORA MICHELA , MOSELLO ROSARIO , ANDERSON NICHOLAS J. , BARBIERI ALBERTO , BOTEV IVAN , KERNAN MARTIN , KOPÁČEK JIŘÍ , KORHOLA ATTE , LOTTER ANDRÉ F. , MURI GREGOR , POSTOLACHE CARMEN , STUCHLÍK EVŽEN , THIES HANSJÖRG , WRIGHT RICHARD F. 
Published: September 2009

Summary1. We carried out a coordinated survey of mountain lakes covering the main ranges across Europe (including Greenland), sampling 379 lakes above the local tree line in 2000. The objectives were to identify the main sources of chemical variability in mountain lakes, define a chemical classification of lakes, and develop tools to extrapolate our results to regional lake populations through an empirical regionalisation or upscaling of chemical properties.2. We investigated the main causes of chemical variability using factor analysis (FA) and empirical relationships between chemistry and several environmental variables. Weathering, sea salt inputs, atmospheric deposition of N and S, and biological activity in soils of the catchment were identified as the major drivers of lake chemistry.3. We tested discriminant analysis (DA) to predict the lake chemistry. It was possible to use the lithology of the catchments to predict the range of Ca2+ and SO42− into which a lake of unknown chemistry will decrease. Lakes with lower SO42− concentrations have little geologically derived S, and better reflect the variations in atmospheric S loading. The influence of marine aerosols on lakewater chemistry could also be predicted from the minimum distance to the sea and altitude of the lakes.4. The most remarkable result of FA was to reveal a factor correlated to DOC (positively) and NO3− (negatively). This inverse relationship might be the result either of independent processes active in the catchment soils and acting in an opposite sense, or a direct interaction, e.g. limitation of denitrification by DOC availability. Such a relationship has been reported in the recent literature in many sites and at all scales, appearing to be a global pattern that could reflect the link between the C and N cycles.5. The concentration of NO3− is determined by both atmospheric N deposition and the processing capacity of the catchments (i.e. N uptake by plants and soil microbes). The fraction of the variability in NO3− because of atmospheric deposition is captured by an independent factor in the FA. This is the only factor showing a clear pattern when mapped over Europe, indicating lower N deposition in the northernmost areas.6. A classification has been derived which takes into account all the major chemical features of the mountain lakes in Europe. FA provided the criteria to establish the most important factors influencing lake water chemistry, define classes within them, and classify the surveyed lakes into each class. DA can be used as a tool to scale up the classification to unsurveyed lakes, regarding sensitivity to acidification, marine influence and sources of S.