bluuebunny/crossref_metadata_2025_split huggingface dataset:
Granule Exocytosis Contributes to Priming and Activation of the Human Neutrophil Respiratory Burst
Authors: Uriarte Silvia M. , Rane Madhavi J. , Luerman Gregory C. , Barati Michelle T. , Ward Richard A. , Nauseef William M. , McLeish Kenneth R. 
Published: June 2011

Abstract
The role of exocytosis in the human neutrophil respiratory burst was determined using a fusion protein (TAT–SNAP-23) containing the HIV transactivator of transcription (TAT) cell-penetrating sequence and the N-terminal SNARE domain of synaptosome-associated protein-23 (SNAP-23). This agent inhibited stimulated exocytosis of secretory vesicles and gelatinase and specific granules but not azurophil granules. GST pulldown showed that TAT–SNAP-23 bound to the combination of vesicle-associated membrane protein-2 and syntaxin-4 but not to either individually. TAT–SNAP-23 reduced phagocytosis-stimulated hydrogen peroxide production by 60% without affecting phagocytosis or generation of HOCl within phagosomes. TAT–SNAP-23 had no effect on fMLF-stimulated superoxide release but significantly inhibited priming of this response by TNF-α and platelet-activating factor. Pretreatment with TAT–SNAP-23 inhibited the increase in plasma membrane expression of gp91phox in TNF-α–primed neutrophils, whereas TNF-α activation of ERK1/2 and p38 MAPK was not affected. The data demonstrate that neutrophil granule exocytosis contributes to phagocytosis-induced respiratory burst activity and plays a critical role in priming of the respiratory burst by increasing expression of membrane components of the NADPH oxidase.
Alternative Pathway Activation of Complement by Shiga Toxin Promotes Exuberant C3a Formation That Triggers Microvascular Thrombosis
Authors: Morigi Marina , Galbusera Miriam , Gastoldi Sara , Locatelli Monica , Buelli Simona , Pezzotta Anna , Pagani Chiara , Noris Marina , Gobbi Marco , Stravalaci Matteo , Rottoli Daniela , Tedesco Francesco , Remuzzi Giuseppe , Zoja Carlamaria 
Published: June 2011

Abstract
Shiga toxin (Stx)-producing E.coli O157:H7 has become a global threat to public health; it is a primary cause of diarrhea-associated hemolytic uremic syndrome (HUS), a disorder of thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure with thrombi occluding renal microcirculation. In this study, we explored whether Stx triggers complement-dependent microvascular thrombosis in in vitro and in vivo experimental settings of HUS. Stx induced on human microvascular endothelial cell surface the expression of P-selectin, which bound and activated C3 via the alternative pathway, leading to thrombus formation under flow. In the search for mechanisms linking complement activation and thrombosis, we found that exuberant complement activation in response to Stx generated an increased amount of C3a that caused further endothelial P-selectin expression, thrombomodulin (TM) loss, and thrombus formation. In a murine model of HUS obtained by coinjection of Stx2 and LPS and characterized by thrombocytopenia and renal dysfunction, upregulation of glomerular endothelial P-selectin was associated with C3 and fibrin(ogen) deposits, platelet clumps, and reduced TM expression. Treatment with anti–P-selectin Ab limited glomerular C3 accumulation. Factor B-deficient mice after Stx2/LPS exhibited less thrombocytopenia and were protected against glomerular abnormalities and renal function impairment, indicating the involvement of complement activation via the alternative pathway in the glomerular thrombotic process in HUS mice. The functional role of C3a was documented by data showing that glomerular fibrin(ogen), platelet clumps, and TM loss were markedly decreased in HUS mice receiving C3aR antagonist. These results identify Stx-induced complement activation, via P-selectin, as a key mechanism of C3a-dependent microvascular thrombosis in diarrhea-associated HUS.
Enforcing Quality Metrics over Equipment Utilization Rates as Means to Reduce Centers for Medicare and Medicaid Services Imaging Costs and Improve Quality of Care
Authors: Sura Amit , Ho Alexander 
Published: May 2011

Radiology has been the focus of efforts to reduce inefficiencies while attempting to lower medical costs. The 2010 Medicare Physician Fee Schedule has reduced Centers for Medicare and Medicaid Services’ (CMS) reimbursements related to the technical component of imaging services. By increasing the utilization rate, the cost of equipment spreads over more studies, thus lowering the payments per procedure. Is it beneficial for CMS to focus on equipment utilization as a cost-cutting measure? Can greater financial and quality of care rewards be made by improving metrics like appropriateness criteria and pre-authorization?
On examining quality metrics, such as appropriateness criteria and pre-authorization, promising results have ensued. The development and enforcement of appropriateness criteria lowers overutilization of studies without requiring unattainable fixed rates. Pre-authorization educates ordering physicians as to when imaging is indicated.
Social Support and Hope among Egyptian Women with Breast Cancer after Mastectomy
Authors: Denewer Adel , Farouk Omar , Mostafa We'am , Elshamy Karima 
Published: May 2011

Introduction Breast cancer is the most common cancer among Egyptian women. We report the unique assessment of hope and social support outcomes of women with breast cancer after mastectomy in Egyptian community. Patients and methods Between July 2009 and June 2010, three hundred and one women with newly diagnosed breast cancer joined this study. Socio-demographic data including patient's age, level of education, occupation, social status, and residence were collected by means of structured interviews based on special questionnaires. These questionnaires were designed to measure hope and social support. Results Age ranged from 21 to 88 years (median = 45.8 years and SD ± 13.3). A low degree of hope was reported in 103 patients (34.2%), a moderate degree in 109 patients (36.2%), and a high degree in 89 patients (29.6%). A low degree of social support was reported in 119 patients (39.5%), a moderate degree in 101 patients (33.6%), and a high degree in 81 patients (26.9%). Conclusions Social support is related to many psychological factors, which can be quantitatively analyzed and it can predict hope. However, there were no significant differences between the socio-demographic variables (age, educational levels, residence and martial status) and social support, hope, and their sub-components among Egyptian women with breast cancer.
An Unusual Case of Hypercalcemia Associated with Graves’ Disease and Vitamin D Deficiency
Authors: Korytnaya Evgenia , Rao Nagashree Gundu , Mayrin Jane V. 
Published: May 2011

Objective To present a case of hypercalcemia associated with thyrotoxicosis in a patient with vitamin D deficiency and review biochemical changes during the course of treatment. Methods We report a case, describe the changes in serum calcium, phosphorus, parathyroid hormone in Graves’ disease and concomitant Vitamin D deficiency. We compare our findings to those reported in literature. Results Our patient had hypercalcemia secondary to thyrotoxicosis alone, which was confirmed by low parathyroid hormone level and resolution of hypercalcemia with treatment of thyrotoxicosis. The case was complicated by a concomitant vitamin D deficiency. Serum calcium elevation in patients with thyrotoxicosis occurs secondary to hyperthyroidism alone or due to concurrent hyperparathyroidism. Hypercalcemia from thyrotoxicosis is usually asymptomatic and is related to bone resorption. Vitamin D deficiency can be seen in patients with thyrotoxicosis because of accelerated metabolism, poor intestinal absorption and increased demand during bone restoration phase. Coexistence of hypercalcemia and Vitamin D deficiency in patients with thyrotoxicosis is rare, but possible, and 25-hydroxyvitamin D levels should be checked. The definite treatment for hypercalcemia in thyrotoxicosis is correction of thyroid function. Conclusion Hypercalcemia in thyrotoxicosis should be distinguished from concomitant hyperparathyroidism and confirmed by resolution of hypercalcemia with control of thyrotoxicosis. Patients with hypercalcemia and thyrotoxicosis may also have vitamin D deficiency and 25-OH Vitamin D levels should be checked.
On the Existence of the Graded Exponent for Finite Dimensional ℤp-graded Algebras
Authors: Di Vincenzo Onofrio M. , Nardozza Vincenzo 
Published: May 2011

AbstractLet F be an algebraically closed field of characteristic zero, and let A be an associative unitary F-algebra graded by a group of prime order. We prove that if A is finite dimensional then the graded exponent of A exists and is an integer.
Symptoms of Oral Submucosal Fibrosis: Our Experience with Intralesional Injection Treatment
Authors: Dhond PV , Yadav Rajesh , Mittal Mudit , Kant Shashi 
Published: May 2011

ABSTRACTObjectiveThis study evaluates the symptoms and effects of peroral intralesional injections in relieving the symptoms of oral submucosal fibrosis (OSMF) in our clinical settings.Study designRetrospective clinical review at a primary care hospital of 32 patients with extensive OSMF who underwent peroral intralesional injections of steroid, hyaluronidase, placentrex and lignocaine performed in office setting.ResultsThe main symptoms were change in color of buccal mucosa, trismus, burning mouth, vesicles in oral cavity. All patients experienced considerable improvement in their symptoms over a duration of 2 to 6 weeks.ConclusionsThough, a large number of Indian population is suffering and seeking treatment for OSMF, unfortunately not much has been done in this area. It is difficult to find studies on peroral intralesional injection technique. When there is lack of reliable evidence of oral submucosal fibrosis treatment, the old technique of peroral intralesion shots of steroid, hyaluronidase, placentrex in lignocaine is safe and effective in resolving the symptoms associated with OSMF. The therapy is very cost effective and also reduces the need of surgery.
Polymorphous Low-grade Adenocarcinoma of the Palate: Report of a Case and Review of Literature
Authors: Gupta Siddharth , Kumar C Anand , Raghav Namita 
Published: May 2011

ABSTRACTPolymorphous low-grade adenocarcinoma (PLGA) is a malignancy arising predominantly from minor salivary glands. PLGAs account for 10% of all tumors and 25% of all malignancies of the minor salivary glands. It has been frequently described as occurring in hard or soft palate minor salivary glands; some cases being described in the tongue and in major salivary glands. We report a case of PLGA of the palate extending into the maxillary sinus and nasal cavity diagnosed on the basis of histopathology and treated by subtotal maxillectomy. The review of literature concerning clinical, histological and immunohistochemical features, as well as the proper management concerning this tumor is included.
Primary Small Cell Carcinoma of Nasal Cavity Presenting as Unilateral Blindness
Authors: Chauhan Ashutosh , Chakarborty NC , Nath Pramod , Ganguly Manomoy 
Published: May 2011

ABSTRACTPrimary sinonasal small cell carcinomas are extremely rare lesions. We present a case of 29-year-old male patient, who initially presented with recurrent right sided nasal obstruction and occasional epistaxis, but came to medical attention when he developed progressive deterioration of vision in ipsilateral eye. Radiological examination showed a tumor with epicenter in right nasal cavity with extensive local infiltration. The histopathology picture and immunohistochemistry profile of the tumor showed it to be a primary small cell neuroendocrine tumor. Extensive imaging studies revealed no other site of primary. He was treated with induction chemotherapy followed by concomitant chemoradiotherapy. Complete clinical response was seen and the patient has been disease free since last 20 months. The report discusses the diagnostic criteria which differentiates this extremely rare but aggressive tumor from a much more common and more indolent tumor, esthesioneuroblastoma.
Spontaneous Small Bowel Perforations in Patients Receiving Radiotherapy or Chemotherapy for Advanced Head and Neck Cancer
Authors: Sidramesh Muttagi , Chaturvedi Pankaj 
Published: May 2011

ABSTRACTGastroduodenal perforations are known to occur due to various causes. However, such problems involving small bowel and manifesting spontaneously, especially in a head and neck cancer patient, undergoing chemoradiation has never been described in the literature. We report three cases of head and neck cancer that were undergoing treatment (one case curative and two cases palliative), during which small bowel perforation manifested requiring urgent surgical intervention. We seek to highlight this problem, so as to ascertain the possible mechanisms of its causation, identify a group of patients at risk, evolve possible preventive strategies and facilitate earlier diagnosis and treatment.
Pediatric Infraorbital Nerve Schwannoma: A Rare Clinical Entity
Authors: Raviraj GA , Rony Thomas , Dhanraj GA , Rao Vishal US 
Published: May 2011

ABSTRACTThis report elaborates a rare case of infraorbital nerve Schwannoma in an 8-year-old boy who presented with the recurrent progressively increasing swelling over the right cheek following initial treatment. The mass was excised surgically via a facial approach. Infraorbital nerve sheath tumors occurring in the pediatric age are rare and can be often mistaken for infectious causes in this age group. Surgery remains the mainstay of treatment in these tumors. Early diagnosis and prompt surgical treatment can serve to minimize the treatment related morbidity arising from multiple interventions while avoiding undue apprehension. Pediatric infraorbital schwannomas, although a rare entity, should be considered in the differential diagnosis of long standing pediatric facial swellings.
To Assess the Effectiveness of Self-Instructional Module on Knowledge regarding Effect of Massage Therapy in Reducing Labor Pain
Authors: Raddi Sudha A , Kaur Simer Preet 
Published: June 2011

ABSTRACT

Objectives
To assess the knowledge of 3rd year GNM students regarding effect of massage therapy in reducing labor pain before and after the implementation of self-instructional module. To evaluate the effect of self-instructional module in enhancing the knowledge of 3rd year GNM students regarding the effect of massage therapy in reducing labor pain and to compare the knowledge of samples regarding the effect of massage therapy in reducing labor pain in relation to selected demographic variables (age at 12th std. education, medium of 12th std. education, percentage of 1st and 2nd year GNM exam, number of attempts, location of house and mother education).

Methods
The research approach for the study was that of an evaluative one with one group pre- and post-test design. The sample size considered for the study was 50 general nursing and midwifery students. The sampling technique used for the study was convenience sampling, which is a type of nonprobability sampling. The tool used for gathering relevant data was a structured questionnaire on knowledge of effect of massage therapy in reducing labor pain.

Results
Analysis of data was done on the basis of objectives and hypotheses. Data analysis of level of knowledge revealed that during pretest, no student had highly adequate knowledge of effect of massage therapy on labor pain, 9 (18%) had moderately adequate knowledge, while 41(82%) had inadequate knowledge. It was worth noting during post-test, where no student had inadequate knowledge and majority of 50 (100%) had highly adequate knowledge. While assessing the effectiveness of the structured instructional module on effect of massage therapy on labor pain, the pre-test and post-test data analysis by using Wilcoxon signed rank test revealed the mean post-test score (27.88 ± 1.27) was higher than the mean pre-test score (13.14 ± 2.93). Since the calculated z-value was 6.16 and p-value was 0.00, thus proving that p < 0.05 (data was analyzed using SPSS software).

Conclusions
Based on the analyses, the following inference was drawn. There was evident increase in the knowledge scores in all the areas included in the study after the administration of self-instructional module. Thus, it was inferred that the structured teaching program was effective and while the knowledge gain score is commendable, there is still room for improvement.
Pruritic Urticarial Papules and Plaques of Pregnancy Developing in a Gravida having Overt Diabetes with Hypothyroidism, Pre-eclampsia and Anemia
Authors: Munikrishna M , Shashidhar B 
Published: June 2011

ABSTRACT
Specific dermatoses of pregnancy refer to a group of skin diseases that are encountered predominantly during or immediately following pregnancy. This is a case report of pruritic urticarial papules and plaques of pregnancy developing in a 29-year-old lady primigravida lady is associated with overt diabetes with hypothyroidism, pre-eclampsia and anemia. The diagnosis of PUPPP is a clinical one, as the histopathology is often nonspecific and the direct immunofluorescence is negative. She responded to treatment with antipruritic topical medication, topical steroid and oral antihistamine. Prompt and effective management is very important in decreasing maternal and fetal mortality and morbidity when we come across a pregnant mother with multiple problems.
Successful Outcome following Antepartum Amnioinfusion in Pregnancy Complicated with Severe Oligohydramnios with APLA Syndrome
Authors: Kumar Sunesh , Karmakar Debjyoti , Singla Shilpa , Singh Neeta , Roy Kallol K 
Published: June 2011

ABSTRACT

Objective
This case was reported to highlight an alternative form of management for patients, including amnioinfusion as one of the tools in an uncommon setting.

Methods
Transabdominal amnioinfusion was done in the patient at 24 weeks for severe oligohydramnios without PPROM. At 26 weeks she was found to be APLAS. Patient was also started on enoxaparin and low dose aspirin.

Results
Pregnancy continued till 36 weeks with delivery of healthy fetus.

Conclusion
Our excellent outcome for the patient having marked oligohydramnios with amnioinfusion along with LMWH clearly underlines the place for such procedures in selected cases.
Ethics in Obstetric Ultrasound: The Past 25 Years in Perspective
Authors: McCullough Laurence B , Chervenak Frank A 
Published: May 2011

ABSTRACTEthics is an essential component of obstetric ultrasound, an area in which the authors have collaborated for the past 25 years. The authors describe their collaboration. They then present one of the core ethical concepts of obstetric ultrasound: The ethical concept of the fetus as a patient. Next, they present one of the clearest clinical applications of ethics to obstetric ultrasound: Autonomy-enhancing strategies. The authors hope that these two paradigms will convince the reader that ethics is an essential dimension of obstetric ultrasound and stimulate further interest.
Fetal Brain Function: Lessons Learned and Future Challenges of 4D Sonography
Authors: Kadic Aida Salihagic , Predojevic Maja 
Published: May 2011

ABSTRACT
Maturation of the central nervous system (CNS) is reflected in fetal behavior. Modern technology, such as four-dimensional (4D) sonography improved assessment of fetal behavior in all three trimesters of pregnancy. After summing our own experiences and experiences of the leading authors in the field of fetal and neonatal neurology, new prenatal screening test for assessment of fetal behavior has been suggested. Test was named Kurjak antenatal neurodevelopmental test (KANET). Up to now results of KANET are encouraging and they have been published in several prominent journals. Nevertheless, potential of KANET in the assessment of integrity of the fetal central nervous system needs to be confirmed by studies that are in progress in several world university centers.
Analysis of Quality of Nuchal Translucency Measurements
Authors: Echevarria Mónica , Comas Carmen , Serra Bernat , Rodríguez Ignacio , Sabrià Joan 
Published: May 2011

ABSTRACT

Objective
Quantitative analysis of the quality of nuchal translucency (NT) measurements.

Methods
This is a retrospective single-center study. NT was measured according to the Fetal Medicine Foundation (FMF) criteria by 20 trained obstetricians (October 2003-November 2009). The performance of NT measurements was analyzed with regard to several quality control standards. Accuracy according to experience, professional profile, crown-rump length (CRL) values and FMF certification was statistically tested.

Results
A total of 14,978 NT measurements were assessed. (1) The mean operator-specific median NT-MoM values was 0.98. (2) Mean percentage of cases >95th and <5th percentiles were 5.0 and 4.2% respectively. (3) Logarithmic mean and SD of the NT-MoM values were 0.00 and 0.13 respectively. (4) The DR for trisomy 21 at screening time was 90.7% for a FPR of 6.7% for standard screening strategy. (5) According to cumulative SUM (CUSUM) figures, the performance was more acceptable in FMF-certified operators. Operator experience, exclusive dedication to FM, FMF certification and a range of CRL values > 60 mm had a statistical impact improving these standards.

Conclusion
Overall quality standards show optimal NT measurements in our unit. Experience a dedicated profile to fetal medicine ultrasound, CRL over 60 mm and FMF certification has a significant positive impact on the quality standards.
Integrated Screening for Chromosomal Anomalies: Strategies in Developing Countries
Authors: Rao Jai Prakash 
Published: May 2011

ABSTRACT
Ultrasound screening has advantages over maternal serum screening. These include confirmation of embryo viability, accurate assessment of gestational age, early diagnosis of multiple pregnancies and identification of chorionicity, the detection of major structural abnormalities, major defects of the heart and great arteries, skeletal dysplasias and genetic syndrome and measurement of NT thickness in assessing the risk for Down's syndrome. Nuchal translucency (NT) has emerged as the most sensitive ultrasound marker for detection of chromosomal anomalies in the first trimester. However, the use of ultrasound in routine screening still faces problems with reliability and quality control. Combination of maternal age, NT and first and biochemical second-trimester markers is known as the integrated test. A major goal of screening tests is to achieve high detection rate and low false-positive rate at a low cost. The integrated test best meets these criteria. It could achieve a detection rate of 85% for a false-positive rate of 1.2%. It has a much better positive predictive value and, therefore, fewer amniocentesis and fewer losses of normal fetuses. Only screen-positive cases could be taken for invasive testing.
Ductus Venosus: A Love Story of 14 Years
Authors: Montenegro Nuno , Matias Alexandra 
Published: May 2011

ABSTRACT
Ductus venosus is a tiny vessel with a central role in fetal circulation. Combining B-mode with color and pulsed Doppler is feasible to identify this vessel and evaluate the blood flow waveform at 11 to 13 weeks. The higher prevalence of abnormal A-wave in fetuses with abnormal karyotype and/or cardiac defects turned DV evaluation into a useful marker for chromosomal abnormalities and cardiopathies. Even when combined with nuchal translucency (NT) or biochemical markers, DV blood flow evaluation contributes to an increase in sensitivity and reduces false-positive rate. Abnormal ductal flow is also related to a worse fetal and perinatal outcome. In monochorionic twin pregnancies, in addition to NT measurement at 11 to 14 weeks, the Doppler assessment of DV blood flow increases relevantly the performance of screening for those at higher risk of developing twin-to-twin transfusion syndrome. This story of 14 years surely contributed to change the way first trimester screening is being implemented.