bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sacrococcygeal teratoma: The 13‐year experience of a tertiary paediatric centre
Authors: Ho Kok On , Soundappan Sannappa V , Walker Karen , Badawi Nadia 
Published: May 2011

Aim:  To describe the management, morbidity and mortality of infants admitted to a tertiary paediatric hospital in New South Wales, Australia with a diagnosis of sacrococcygeal teratoma (SCT).Methods:  All neonates admitted to the neonatal intensive care unit with a SCT between January 1996 and December 2008 were included in this retrospective review. Data collected included maternal and neonatal demographics, time of diagnosis, tumour characteristics, surgical treatment, operative complications and outcomes.Results:  Seventeen infants with a diagnosis of SCT were included in the study. Of these infants, the majority (70%) were born at term, and eight had a prenatal diagnosis made during the second trimester. Associated anomalies were detected in seven infants (41.8%), with renal anomalies being the most common. Tumour histology included mature (50%, n= 8), yolk sac tumour (18.75%, n= 3), immature (6.25%, n= 1) and mature with mixed elements (25%, n= 4). Recurrent disease occurred in two infants within 4–18 months of the primary resection, with one infant suffering a second recurrence. Only one child died prior to surgery, giving a survival rate of 94%, and mean age at follow‐up was 32 months. Long‐term sequelae found in four babies included revision of scar, vesicoureteric reflux, post‐surgical neurogenic bladder and osteotomy for hip dysplasia.Conclusions:  The overall survival of neonatal SCT is high. While this is a small series, our results are consistent with the literature. Important components of management include timely diagnosis, multidisciplinary planning, long‐term follow‐up and intervention for functional sequelae.
Exhaled air dispersion and removal is influenced by isolation room size and ventilation settings during oxygen delivery via nasal cannula
Authors: HUI DAVID S. , CHOW BENNY K. , CHU LEO , NG SUSANNA S. , LAI SIK‐TO , GIN TONY , CHAN MATTHEW T.V. 
Published: May 2011

ABSTRACTBackground and objective:  We compared the exhaled air dispersion distances during oxygen delivery via nasal cannula to a human‐patient simulator (HPS) in two different isolation rooms.Methods:  Airflow was marked with intrapulmonary smoke for visualization. Oxygen flow was gradually increased from 1 to 5 L/min, with the HPS sitting at 45°. The leakage jet plume was revealed by laser light‐sheet and images captured by high‐definition video. Smoke concentration in the plume was estimated from the light scattered by smoke particles. The experiments were conducted at a double‐door, negative pressure isolation room with a dimension of 4.1 × 5.1 × 2.6 m, pressure of −7.4 Pa and 16 air exchanges/h (ACH) (room A). Results were compared with experiments repeated in a smaller isolation room with a dimension of 2.7 × 4.2 × 2.4 m, pressure of −5 Pa and 12 ACH (room B).Results:  Room A: an exhalation jet spread almost horizontally outward from the nostrils of the HPS to 0.66 m and 1 m towards the end of bed when oxygen flow was increased from 1 to 5 L/min respectively. Room B: there was interaction between the downward ceiling ventilation current and the exhaled air from the HPS, leading to deflection of exhaled smoke towards the head of the HPS at an oxygen flow rate of 1 L/min. As oxygen flow was increased gradually to 5 L/min, more room contamination with smoke was noted.Conclusions:  Substantial exposure to exhaled air occurs within 1 m towards the end of the bed from patients receiving oxygen via nasal cannula. Room dimension and air exchange rate are important factors in preventing contamination in isolation rooms.
Plasma neutrophil elastase correlates with pulmonary vascular permeability: A prospective observational study in patients with pneumonia
Authors: TAGAMI TAKASHI , KUSHIMOTO SHIGEKI , TOSA RYOICHI , OMURA MARIKO , YONEZAWA KOHEI , AKIYAMA GO , HIRAMA HISAO , YOKOTA HIROYUKI 
Published: May 2011

ABSTRACTBackground and objective:  Little is known about plasma neutrophil elastase (PNE) levels in patients with community‐acquired pneumonia (CAP) requiring treatment in the intensive care unit (ICU) or high care unit (HCU). In addition, the influence of PNE on pulmonary vascular permeability in a clinical setting has not been investigated. The aims of this study were (i) to investigate PNE levels in patients with CAP and (ii) to explore the relationship between PNE and pulmonary vascular permeability.Methods:  Fourteen consecutive CAP patients who were admitted to the HCU (n = 8) or ICU (n = 6) were prospectively investigated over a 6‐month period. A group of eight patients with hydrostatic pulmonary oedema without CAP served as a control group (CG). PNE levels were measured at regular intervals. The pulmonary vascular permeability index (PVPI) was monitored in all ICU and CG patients, using the PiCCO system.Results:  PNE levels were higher in the CAP patients (132 (84–261) ng/mL) than in the CG patients (77 (64–107) ng/mL) (P = 0.04), and were highest in the ICU patients (186 (75–466) ng/mL). The PVPI was higher in the ICU patients (2.85 (1.90–4.00)) than in the CG patients (1.15 (0.75–2.35)) (P = 0.02). PNE levels correlated with PVPI in the ICU patients (r = 0.81, P < 0.001) but there was no correlation among the CG patients (r = 0.14, P = 0.73).Conclusions:  Patients with severe CAP had high levels of PNE, which was closely correlated with PVPI. PNE may be involved in the pathogenesis of severe pneumonia.
A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis
Authors: AGARWAL RITESH , PAUL ABINASH S. , AGGARWAL ASHUTOSH N. , GUPTA DHEERAJ , JINDAL SURINDER K. 
Published: May 2011

ABSTRACTBackground and objective:  Talc is an effective and widely used agent for chemical pleurodesis. However, limited availability and high cost hamper the routine use of talc in resource poor countries. In this study, we compared the efficacy and safety of iodopovidone with that of cosmetic talc, for chemical pleurodesis.Methods:  Patients with recurrent pleural effusions and/or spontaneous pneumothorax were prospectively randomized to undergo pleurodesis with cosmetic talc (5 g) or iodopovidone (20 mL of a 10% solution) by tube thoracostomy. The cosmetic talc was pretested for impurities (asbestos‐free) and particle size (20–60 µm), using energy dispersive analysis by X‐ray and scanning electron microscopy. The success rate (complete or partial), time to pleurodesis and safety of these two agents was compared.Results:  Pleurodesis was performed in 73 patients (39 with iodopovidone, 34 with cosmetic talc; 56 men, 17 women; mean age 51.7 years; 38 pleural effusions, 35 pneumothoraces). A complete response was obtained in all patients with pneumothorax in both the iodopovidone and talc groups. Among patients with pleural effusions, a complete response was observed in 16/19 and 15/19 patients in the iodopovidone and talc groups, respectively. A partial response was observed in two additional patients from each group. The time to pleurodesis was similar in the two groups. Minor side‐effects (fever, chest pain) were observed with similar frequencies in the two groups. None of the patients experienced hypotension or ARDS.Conclusions:  Iodopovidone and cosmetic talc are equally efficacious and safe agents for chemical pleurodesis.
Serum KL‐6 and surfactant protein D in children with 2009 pandemic H1N1 influenza infection
Authors: Nishida Satoko , Fukazawa Ryuji , Imai Takehide , Takeda Sachiyo , Hayakawa Jun , Takeuchi Hodaka , Shimizu Kiwako , Kawakami Yasuhiko , Takase Masato 
Published: May 2011

AbstractBackground:  A global pandemic influenza A (H1N1) outbreak occurred in 2009. Rapid progress of respiratory distress is one of the characteristic features of pandemic influenza A (H1N1) infection. The physiologic mechanism causing hypoxia in pandemic influenza A (H1N1) infection, however, has not been elucidated.Methods:  The serum levels of KL‐6 and surfactant protein D (SP‐D) were evaluated in 21 cases of pandemic influenza A (H1N1) infection associated with chest radiographic abnormality in order to estimate alveolar involvement. The clinical features were also analyzed.Results:  All of the patients had high fever, and rapidly progressed to respiratory distress within several days of disease onset. Despite mild radiographic abnormality in these patients, dyspnea was severe and they had low blood oxygen saturation levels. Many of the patients had a history of allergic diseases including asthma. Serum KL‐6 and SP‐D levels on admission were 191 ± 69 U/mL and 32.6 ± 18.9 ng/mL, respectively. These two levels were still below the upper normal limit 1 week later. There were no clear relationships between specific clinical symptoms and KL‐6 or SP‐D levels. All patients were treated with oseltamivir and/or zanamivir, and improved without mechanical ventilation management.Conclusion:  KL‐6 and SP‐D elevation were not significant in pandemic influenza A (H1N1) infection associated with chest radiographic abnormality. In pandemic influenza A (H1N1) infection, alveolar involvement was estimated to be little, and severe respiratory distress was probably caused by obstruction of peripheral bronchi.
Comparing the effects of intrauterine progestin system and oral progestin on health‐related quality of life and Kupperman index in hormone replacement therapy
Authors: Pirimoglu Zehra Meltem , Ozyapi Ayse Gul , Kars Bulent , Buyukbayrak Esra Esim , Solak Yakup , Karsidag Ayse Yasemin Karageyim , Unal Orhan , Turan Mehmet Cem 
Published: May 2011

AbstractAim:  The aim of this study was to compare the effects of intrauterine‐system‐releasing 20 µg daily of levonorgestrel (LNG IUS) plus 1 mg 17 beta‐estradiol daily, orally with combined oral pill containing 1 mg 17 beta‐estradiol/2 mg drospirenone daily as hormone replacement therapy, on health‐related quality of life (HRQoL) and climacteric symptoms in postmenopausal women.Materials and Methods:  A 6‐month prospective clinical trial was conducted at the Department of Obstetrics and Gynecology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. Ninety postmenopausal women were accepted to be part of the study. The Euro Quality of Life‐5 Dimensions (EQ‐5D) and Euro Quality of Life Visual Analogue Scale (EQ VAS) indexes for HRQoL and Kupperman indexes were compared between two groups of patients.Results:  Kupperman indexes of both treatment groups decreased gradually over 6 months, but indexes decreased significantly more in the group with intrauterine‐system‐releasing 20 µg daily of levonorgestrel. Elevations were observed in EQ‐5D indexes and VAS values of both groups. EQ VAS values significantly increased in the group on intrauterine progestogen system. Similar changes were observed in the EQ‐5D indexes of both groups.Conclusion:  A hormone replacement therapy regimen that includes an intrauterine progestin system decreased climacteric symptoms and increased HRQoL in postmenopausal women during a follow‐up period of 6 months. The extent of the relief of symptoms was greater in this group than in women receiving oral combined hormone replacement therapy. It seems therefore that the intrauterine progestin system could represent a method of choice for endometrial suppression in women using estrogen replacement therapy with distinct advantages over systemically administered progestogens, which have been the subject of considerable debate as reported in the recent literature.
Prenatal diagnosis and management of vasa previa: A 6‐year review
Authors: Kanda Eriko , Matsuda Yoshio , Kamitomo Masato , Maeda Takatsugu , Mihara Keiko , Hatae Masayuki 
Published: May 2011

AbstractAim:  To evaluate the methods of screening and prenatal diagnosis of vasa previa.Material and Methods:  We reviewed cases of vasa previa in our hospital between January 2002 and December 2007. During this period, we visualized the site of cord insertion using transabdominal ultrasonography and observed the internal os using gray‐scale transvaginal ultrasonography. A diagnosis of vasa previa was confirmed by transvaginal color Doppler imaging.Results:  We encountered 10 cases of vasa previa among 5131 deliveries. All cases had one or more known risk factors. In all of the four cases that underwent screening in the second trimester (i.e. between 20 and 25 weeks of gestation), the diagnosis was correct. Routine ultrasonography detected in only three of the other six cases of vasa previa that were referred to our hospital after 26 weeks of gestation. Of the other three cases referred after 26 weeks of gestation, in two cases vasa previa was detected by detailed examination using color Doppler transvaginal ultrasonography after fetal heart rate monitoring detected the presence of non‐reassuring fetal status; in the remaining case, we were unable to make an antenatal diagnosis. Non‐reassuring fetal status was seen on fetal heart rate monitoring in four of the five detected cases complicated by preterm labor.Conclusion:  We consider that the best timing of antenatal screening for vasa previa is the second trimester. Non‐reassuring fetal heart rate pattern without other possible causes warrants detailed examination of vasa previa.
Isolated broad ligament leiomyomatosis
Authors: Huang Kuan‐Gen , Adlan Aizura‐Syafinaz , Lee Chyi‐Long , Lertvikool Srithean 
Published: May 2011

AbstractLeiomyomas of an extrauterine nature are rare and often present a more challenging diagnosis process for the clinician. Our patient presented with lower abdominal pain associated with menorrhagia over a period of 6 months. Laparoscopic surgery revealed a right‐sided broad ligament myoma consisting of multiple soft and diffused fibroids, of more than 400 in total. The myomas were enucleated and completely removed by laparoscopic surgery with minimal blood loss. Histopathological examination and analysis revealed the multiple nodules to be benign leiomyomatosis. The finding of isolated broad ligament leiomyomatosis rates this case as a unique kind of leiomyoma.
T‐cell receptor beta polymorphism is not associated with endometriosis
Authors: Tripputi Pasquale , Bignotto Monica , Cigognini Daniela , Bianchi Stefano , Fedele Luigi 
Published: May 2011

AbstractAim:  We carried out an association study between T‐cell receptor beta polymorphism (TCRB) and endometriosis to investigate the difference in allelic frequency. Polymorphisms in T‐cell receptor genes can provide important information for the study of the immune response and autoimmune diseases; indeed, rs1800907, a very common single nucleotide polymorphism (SNP) of the TCRB, has been extensively studied in autoimmune diseases in the 1990s using Southern blot analysis and more recently polymerase chain reaction (PCR) and sequencing. An autoimmune etiology for endometriosis has been strongly suggested for the presence of antibodies against endometrium, high rates of autoimmune disorders and associated atopic diseases.Material and Methods:  We investigated 70 patients with endometriosis and 120 controls. DNA of patients and controls was studied by PCR followed by restriction digestion and sequencing to determine genotype and presence of linkage disequilibrium (LD). Statistical analysis was carried out using STATA Routine GENHW (StataCorp, College Station, TX, USA) for estimation of Hardy–Weinberg equilibrium and test power calculation. The difference of allele distribution between patients and controls was calculated according to Pearson's and Fisher's tests. Test power for the estimation of linkage disequilibrium is low (0.16).Results:  We performed an association study of the SNP rs1800907 of TCRB between 70 patients with endometriosis and 120 controls, and did not find any significant difference (χ2 = 0.27 and P = 0.87). Fisher's test confirmed a P‐value of 0.872.Conclusion:  Our study does not suggest an evidential and major involvement of TCRB in the pathogenesis of endometriosis in an Italian population in a small case control study.
Hospital Competition and Quality with Regulated Prices*
Authors: Brekke Kurt R. , Siciliani Luigi , Straume Odd Rune 
Published: May 2011

AbstractWe analyse the effect of competition on quality in hospital markets with regulated prices, considering the effect of both introducing competition (monopoly versus competition) and increasing competition through either lower transportation costs (increased substitutability) or a higher number of hospitals. With semi‐altruistic providers and a fairly general cost structure, we show that the relationship between competition and quality is generally ambiguous. In contrast to the received body of theoretical literature, this is consistent with, and potentially explains, the mixed empirical evidence.
Unemployment and Right‐wing Extremist Crime*
Authors: Falk Armin , Kuhn Andreas , Zweimüller Josef 
Published: May 2011

AbstractIt is frequently argued that unemployment plays a crucial role in the occurrence of right‐wing extremist crimes (RECs). We test this hypothesis empirically using data from Germany. We find that right‐wing criminal activities occur more frequently when unemployment is high. The substantial difference in the numbers of RECs occurring in the East and West German states can mostly be attributed to differences in unemployment. This finding reinforces the importance of unemployment as an explanatory factor for RECs, and it questions explanations based solely on the different socialization in former communist East Germany and the liberal West German states.
Natural Resource Booms and Inequality: Theory and Evidence*
Authors: Goderis Benedikt , Malone Samuel W. 
Published: May 2011

AbstractWe develop a theory, in the context of a two‐sector growth model in which learning‐by‐doing drives growth, to explain the time path of income inequality following natural resource booms in resource‐rich countries. Under the condition of a relatively unskilled labor intensive non‐traded sector, inequality falls immediately after a boom, and then increases steadily over time until the initial impact of the boom disappears. Using data for 90 countries between 1965 and 1999, we find evidence in support of the theory, especially for oil and mineral booms. We also find that uncertainty about future commodity prices increases long‐run inequality.
Safety and efficacy of raltegravir in patients with HIV‐1 and hepatitis B and/or C virus coinfection
Authors: Rockstroh JK , Teppler H , Zhao J , Sklar P , Harvey CM , Strohmaier KM , Leavitt RY , Nguyen B‐YT 
Published: May 2011

ObjectiveThe aim was to examine the long‐term safety and efficacy of raltegravir in patients with HIV‐1 and hepatitis B virus (HBV) and/or hepatitis C virus (HCV) coinfection in three double‐blind, randomized, controlled Phase III studies.MethodsIn STARTMRK, treatment‐naïve patients received raltegravir 400 mg twice a day (bid) or efavirenz 600 mg at bedtime, both with tenofovir/emtricitabine. In BENCHMRK‐1 and ‐2, highly treatment‐experienced patients with multi‐drug resistant virus and prior treatment failure received raltegravir 400 mg bid or placebo, both with optimized background therapy. Patients with chronic HBV and/or HCV coinfection were enrolled if baseline liver function tests were ≤5 times the upper limit of normal. HBV infection was defined as HBV surface antigen positivity for all studies; HCV infection was defined as HCV RNA positivity for STARTMRK and HCV antibody positivity for BENCHMRK.ResultsHepatitis coinfection was present in 6% (34 of 563) of treatment‐naïve patients (4% HBV only, 2% HCV only and 0.2% HBV+HCV) and 16% (114 of 699) of treatment‐experienced patients (6% HBV only, 9% HCV only and 1% HBV+HCV). The incidence of drug‐related adverse events was similar in raltegravir recipients with and without hepatitis coinfection in both STARTMRK (50 vs. 47%) and BENCHMRK (34 vs. 38.5%). Grade 2–4 liver enzyme elevations were more frequent in coinfected vs. monoinfected patients, but were not different between the raltegravir and control groups. At week 96, the proportion of raltegravir recipients with HIV RNA <50 HIV‐1 RNA copies/mL was similar between coinfected and monoinfected patients (93 vs. 90% in STARTMRK; 63 vs. 61% in BENCHMRK).ConclusionRaltegravir was generally well tolerated and efficacious up to 96 weeks in HIV‐infected patients with HBV/HCV coinfection.
Sustained swimming increases the mineral content and osteocyte density of salmon vertebral bone
Authors: Totland Geir K. , Fjelldal Per Gunnar , Kryvi Harald , Løkka Guro , Wargelius Anna , Sagstad Anita , Hansen Tom , Grotmol Sindre 
Published: May 2011

AbstractThis study addresses the effects of increased mechanical load on the vertebral bone of post‐smolt Atlantic salmon by forcing them to swim at controlled speeds. The fish swam continuously in four circular tanks for 9 weeks, two groups at 0.47 body lengths (bl) × s−1 (non‐exercised group) and two groups at 2 bl × s−1 (exercised group), which is just below the limit for maximum sustained swimming speed in this species. Qualitative data concerning the vertebral structure were obtained from histology and electron microscopy, and quantitative data were based on histomorphometry, high‐resolution X‐ray micro‐computed tomography images and analysis of bone mineral content, while the mechanical properties were tested by compression. Our key findings are that the bone matrix secreted during sustained swimming had significantly higher mineral content and mechanical strength, while no effect was detected on bone in vivo architecture. mRNA levels for two mineralization‐related genes bgp and alp were significantly upregulated in the exercised fish, indicating promotion of mineralization. The osteocyte density of the lamellar bone of the amphicoel was also significantly higher in the exercised than non‐exercised fish, while the osteocyte density in the cancellous bone was similar in the two groups. The vertebral osteocytes did not form a functional syncytium, which shows that salmon vertebral bone responds to mechanical loading in the absence of an extensive connecting syncytial network of osteocytic cell processes as found in mammals, indicating the existence of a different mechanosensing mechanism. The adaptive response to increased load is thus probably mediated by osteoblasts or bone lining cells, a system in which signal detection and response may be co‐located. This study offers new insight into the teleost bone biology, and may have implications for maintaining acceptable welfare for farmed salmon.