bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality of Tuberculosis in Very Old People
Authors: Salvadó Meritxell , Garcia‐Vidal Carolina , Vázquez Pilar , Riera Montserrat , Rodríguez‐Carballeira Mónica , Martínez‐Lacasa Javier , Cuchi Eva , Garau Javier 
Published: January 2010

OBJECTIVES: To describe the clinical characteristics and outcomes of tuberculosis (TB) in elderly people.DESIGN: Observational analysis of a prospective cohort of adults with TB (1995–2004). A case–control study to determine attributable mortality to TB in very old people was done.RESULTS: Of 319 patients with TB, 109 (34.2%) were aged 65 and older. The older group was more likely to have comorbidities (1.4% vs 0.4%; P<.001), extrapulmonary and disseminated TB (50.4% vs 26.1%; P<.001), toxicity (22% vs 9.8%; P=.006), and 30‐day mortality (18.3% vs 1.6%; P<.001). When patients aged 65 to 79 were compared with those aged 80 and older, only differences in TB‐related mortality were detected (9.8% vs 44.4%; P=.01). In the attributable mortality analysis, 30‐day and 6‐month mortality were higher in very old patients with TB than in controls without TB (41.7% vs 11.1%, P=.005; 45.8% and 19.4%, P=.01, respectively). No differences in mortality were shown when excluding patients with postmortem TB diagnosis or those who died within the first 72 hours of diagnosis.CONCLUSION: Older people with TB had a higher frequency of atypical features, more adverse drug reactions, and greater TB‐related mortality than younger people. Data suggest that very old patients with TB have higher mortality, but if diagnosed early and adequately treated, very old patients with TB do not have greater mortality than those without.
Fatal Trichosporon fungemia in patients with hematologic malignancies
Authors: Suzuki Kei , Nakase Kazunori , Kyo Taiichi , Kohara Tadahiro , Sugawara Yumiko , Shibazaki Tetsunori , Oka Kouji , Tsukada Tetsuya , Katayama Naoyuki 
Published: January 2010

Abstract Objective: Invasive Trichosporon infection has been increasingly recognized in patients with hematologic malignancies. Our study aims to clarify the clinical characteristics of this disease and factors influencing patient prognosis. Patients and methods: We retrospectively analyzed 33 cases of Trichosporon fungemia (TF) in patients with hematologic malignancies treated at our collaborating five hospitals in Japan between 1992 and 2007. Results: The majority of these patients had acute leukemia (82%), neutropenia (85%), and a history of intensive chemotherapy (91%). TF occurred as a breakthrough infection during antifungal therapy in 30 patients (91%), 18 of whom were receiving micafungin. The surveillance cultures of most patients were negative for Trichosporon. Only a few patients exhibited elevated levels of 1,3‐β‐d‐glucan before positive blood culture. Twenty‐five patients (76%) died of this infection. The resolution of infection was associated with neutrophil recovery (P = 0.0001), absence of hyperglycemia (P = 0.023), and azole inclusive therapy (P = 0.031). Survival was significantly longer in patients receiving antifungal therapies containing azole than in those who did not receive azole (P = 0.0034). Conclusions: At present, the diagnosis of invasive trichosporonosis depends on blood culture studies, and the mortality of this disease is high; however, azole therapy and control of blood glucose level, together with hematopoietic recovery could help in improving the clinical outcome. When we use antifungals lacking anti‐Trichosporon activity, sufficient care should be taken to prevent the development of breakthrough trichosporonosis.
THP‐COP regimen for the treatment of peripheral T‐cell lymphoma and adult T‐cell leukemia/lymphoma: a multicenter phase II study
Authors: Takamatsu Yasushi , Suzumiya Junji , Utsunomiya Atae , Maeda Koichi , Matsuoka Hitoshi , Suzushima Hitoshi , Tsukada Junichi , Shibata Keisuke , Tamura Kazuo ,   the Kyushu Hematology Organization for Treatment Study Group (K‐HOT)
Published: January 2010

Abstract Objective: The efficacy of pirarubicin (THP)‐COP was previously compared with cyclophophamide + doxorubicin + vincristine + prednisolone (CHOP) in elderly patients with lymphoma. The subset analysis showed that T‐cell lymphoma had a significantly better response with THP‐COP, whereas no such difference was observed in B‐cell lymphoma. The aim of this study is to confirm the efficacy of THP‐COP in the treatment of T‐cell lymphoma. Methods: We underwent a multicenter phase II study of THP‐COP as a first‐line treatment for T‐cell lymphoma. The overall response rate, survival period, and toxicity were analyzed. Results: Fifty‐three patients were enrolled in this study. Seventeen patients had peripheral T‐cell lymphoma (PTCL), including nine of PTCL not otherwise specified (PTCL‐NOS) and eight of angioimmunoblastic T‐cell lymphoma (AITL). Thirty‐six patients had adult T‐cell leukemia/lymphoma (ATLL), including 20 of acute type and 16 of lymphoma type. A treatment response was obtained in 35 (66%) patients, including 17 (32%) complete responses. Median overall survival (OS) and progression‐free survival (PFS) times were 14.3 months and 5.2 months, respectively. Patients with ATLL showed a tendency to obtain low response rate (61% vs. 77%, P = 0.27) and had a significantly inferior OS (13.3 vs. 28.6 months, P = 0.04) and PFS (4.6 vs. 8.1 months, P = 0.01) in comparison with PTCL. Grade 3 to 4 neutropenia, anemia, and thrombocytopenia occurred in 72%, 34%, and 58% of the patients, respectively. Febrile neutropenia was observed in 51% and grade 3 non‐hematological toxicities in 2–9% of the patients. Conclusion: The efficacy of THP‐COP is equivalent to that of CHOP for the first‐line therapy in T‐cell lymphoma.
Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*
Authors: Royer Derek J. , George James N. , Terrell Deirdra R. 
Published: January 2010

AbstractBackground:  Thrombocytopenia is a well‐recognized adverse effect of many drugs. However, the association of thrombocytopenia with complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages has been rarely described, except for reports of thrombocytopenia caused by quinine‐containing beverages.Objectives:  To systematically identify all published reports of thrombocytopenia associated with these substances and to assess the evidence supporting their causal association with thrombocytopenia.Methods:  Eleven databases were searched to identify relevant published reports. A priori criteria were defined for article selection and assessment. Each selected article was independently assessed by the three authors to document the presence of the criteria and determine the level of evidence for a causal association of the reported substance with thrombocytopenia.Results:  Twenty‐seven articles were identified that reported the occurrence of thrombocytopenia with 25 substances (other than quinine). However, only six articles describing five substances (cow’s milk, cranberry juice, Jui [Chinese herbal tea], Lupinus termis bean, and tahini [pulped sesame seeds]) reported clinical data supporting definite evidence of a causal association with thrombocytopenia. Four articles provided probable evidence for four additional substances, and five articles provided possible evidence for five additional substances. In the remaining articles, the association with thrombocytopenia was unlikely or the articles were excluded from review.Conclusions:  Reports of thrombocytopenia describing definite or probable evidence for an association of a complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages are rare. Whether the occurrence of thrombocytopenia with these substances is uncommon or unrecognized is unknown.
What’s New in Sex Therapy (CME)
Authors: Althof Stanley E. 
Published: January 2010

ABSTRACTIntroduction“Is there anything new in sex therapy?” Has the field of sex therapy been stagnating and failing to develop new treatments? Clearly, the important pharmaceutical advances of the past 11 years have overshadowed the developments in the field of sex therapy.AimThe goal of this manuscript is to call attention to the recent innovations in the field of sex therapy.MethodReview of the literature.ResultsThere are four candidates to consider: (i) combination medical and psychological therapy; (ii) the technique of mindfulness for women with complaints of arousal disorder and low sexual desire; (iii) Internet sexual therapy and; and (iv) reconceptualization of genital pain and psychological interventions for women with these complaints. This article reviews the literature in these areas and offers commentary regarding the benefits and limitations of the research. Finally, future directions for research in these four areas are discussed.ConclusionsPsychological innovation and intervention remains a vital aspect in the field of sexual medicine. New methods continue to be developed and appraised and the methodology, design, and sophistication of sex therapy outcome research have significantly advanced.
Priapism: Pathogenesis, Epidemiology, and Management
Authors: Broderick Gregory A. , Kadioglu Ates , Bivalacqua Trinity J. , Ghanem Hussein , Nehra Ajay , Shamloul Rany 
Published: January 2010

ABSTRACT

Introduction
Priapism describes a persistent erection arising from dysfunction of mechanisms regulating penile tumescence, rigidity, and flaccidity. A correct diagnosis of priapism is a matter of urgency requiring identification of underlying hemodynamics.

Aims
To define the types of priapism, address its pathogenesis and epidemiology, and develop an evidence-based guideline for effective management.

Methods
Six experts from four countries developed a consensus document on priapism; this document was presented for peer review and debate in a public forum and revisions were made based on recommendations of chairpersons to the International Consultation on Sexual Medicine. This report focuses on guidelines written over the past decade and reviews the priapism literature from 2003 to 2009. Although the literature is predominantly case series, recent reports have more detailed methodology including duration of priapism, etiology of priapism, and erectile function outcomes.

Main Outcome Measures
Consensus recommendations were based on evidence-based literature, best medical practices, and bench research.

Results
Basic science supporting current concepts in the pathophysiology of priapism, and clinical research supporting the most effective treatment strategies are summarized in this review.

Conclusions
Prompt diagnosis and appropriate management of priapism are necessary to spare patients ineffective interventions and maximize erectile function outcomes. Future research is needed to understand corporal smooth muscle pathology associated with genetic and acquired conditions resulting in ischemic priapism. Better understanding of molecular mechanisms involved in the pathogenesis of stuttering ischemic priapism will offer new avenues for medical intervention. Documenting erectile function outcomes based on duration of ischemic priapism, time to interventions, and types of interventions is needed to establish evidence-based guidance. In contrast, pathogenesis of nonischemic priapism is understood, and largely attributable to trauma. Better documentation of onset of high-flow priapism in relation to time of injury, and response to conservative management vs. angiogroaphic or surgical interventions is needed to establish evidence-based guidance.
Implants, Mechanical Devices, and Vascular Surgery for Erectile Dysfunction
Authors: Hellstrom Wayne J.G. , Montague Drogo K. , Moncada Ignacio , Carson Culley , Minhas Suks , Faria Geraldo , Krishnamurti Sudhakar 
Published: January 2010

ABSTRACT

Introduction
The field of erectile dysfunction (ED) is evolving and there is a need for state-of-the-art information in the area of treatment.

Aim
To develop an evidence-based, state-of-the-art consensus report on the treatment of erectile dysfunction by implants, mechanical devices, and vascular surgery.

Methods
To provide state-of-the-art knowledge concerning treatment of erectile dysfunction by implant, mechanical device, and vascular surgery, representing the opinions of 7 experts from 5 countries developed in a consensus process over a 2-year period.

Main Outcome Measure
Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate.

Results
The inflatable penile prosthesis (IPP) is indicated for the treatment of organic erectile dysfunction after failure or rejection of other treatment options. Comparisons between the IPP and other forms of ED therapy generally reveal a higher satisfaction rate in men with ED who chose the prosthesis. Organic ED responds well to vacuum erection device (VED) therapy, especially among men with a suboptimal response to intracavernosal pharmacotherapy. After radical prostatectomy, VED therapy combined with phosphodiesterase type 5 therapy improved sexual satisfaction in patients dissatisfied with VED alone. Penile revascularization surgery seems most successful in young men with absence of venous leakage and isolated stenosis of the internal pudendal artery following perineal or pelvic trauma. Currently, surgery to limit venous leakage is not recommended.

Conclusions
It is important for the future of the field that patients be made aware of all treatment options for erectile dysfunction in order to make an informed decision. The treating physician should be aware of the patient’s medical and sexual history in helping to guide the decision. More research is needed in the area of revascularization surgery, in particular, venous outflow surgery.
Standards for Clinical Trials in Sexual Dysfunction in Women: Research Designs and Outcomes Assessment
Authors: Clayton Anita H. , Dennerstein Lorraine , Fisher William A. , Kingsberg Sheryl A. , Perelman Michael A. , Pyke Robert E. 
Published: January 2010

ABSTRACTIntroductionClinical trial design in female sexual dysfunction (FSD) is an evolving science, with some areas of controversy.AimTo develop an evidence-based, expert consensus-report on design of FSD clinical research.MethodsLiterature review including the Food and Drug Administration (FDA) clinical trial guidelines with critique by six experts from three countries, modified after public presentation and debate.Main Outcome MeasureExpert opinion and recommendations were based on grading of evidence based literature, internal committee dialogue, open presentation, and debate.ResultsDesign of clinical research for regulatory approval is driven by FDA guidelines. Diagnostic and Statistical Manual-IV definitions and consideration of comorbidity of sexual disorders may complicate patient selection and outcomes. Measures for study end points include satisfying sexual events utilizing a daily diary, sexual distress, and patient-reported outcomes measures of the construct under study. Currently, trial duration is recommended to be 6 months for efficacy trials to allow for modification of behavioral adaptations to changes in desire. Important issues include safety assessments, generalizability, having a representative study population, stratification by reproductive status, partner assessment, contextual and interpersonal factors, symptom duration and severity, management of placebo response, and drug dosing. Statistical analysis should include assessment of change from baseline to end point between study drug and placebo, determination of statistically significant change vs. clinically meaningful effects, linear mapping of all measures of the same construct, and determination of responders and remitters.ConclusionsFuture trials should include clear population definitions, direct and indirect measures of the specific FSD construct, and procedures to allow generalizability of diagnosis and treatment to the target population.
Plasma protein electrophoresis ofTrachemys scriptaandIguana iguana
Authors: Giménez Mercè , Saco Yolanda , Pato Raquel , Busquets Alex , Martorell Jaime M. , Bassols Anna 
Published: January 2010

Background:Protein electrophoresis is widely applied in veterinary medicine, but is not used often in reptiles, in part because of lack of reference values.Objective:The goals of this study were to compare plasma protein profiles obtained by cellulose acetate electrophoresis (CAE) and agarose gel electrophoresis (AGE), measure precision and examine interference by sample hemolysis, and establish preliminary reference intervals for 2 reptile species.Methods:Heparinized plasma samples from healthy and diseased adult femaleIguana iguana(n=40) andTrachemys scripta(n=60) were analyzed by CAE and AGE. Total protein concentration was measured by the biuret method. Electrophoresis results were compared using Bland–Altman plots and Passing–Bablok regression analysis. Precision and the effects of sample hemolysis were determined. Results from clinically healthy animals were used to determine reference intervals.Results:Five protein fractions were identified in both species, with bisalbuminemia observed in 23/40 iguanas. High correlation was observed between the 2 methods for all fractions, with few proportional and systematic errors. Coefficients of variation were lower using AGE vs CAE and forI. iguanavsT. scripta. Two additional bands were observed in hemolyzed samples fromT. scripta; 1 additional band was observed forI. iguana. Minimum and maximum values were reported for healthyI. iguana(n=14) andT. scripta(n=22).Conclusions:Although both methods are acceptable, the performance of AGE was slightly better than that of CAE for analysis of plasma from reptiles. Furthermore, reptile electrophoretic patterns should be interpreted based on the method used, the species analyzed, and the quality of the plasma sample.
Serum IgG Concentrations after Intravenous Serum Transfusion in a Randomized Clinical Trial in Dairy Calves with Inadequate Transfer of Colostral Immunoglobulins
Authors: Chigerwe M. , Tyler J.W. 
Published: January 2010

Background:Plasma transfusions have been used clinically in the management of neonates with failure of passive transfer. No studies have evaluated the effect of IV serum transfusions on serum IgG concentrations in dairy calves with inadequate transfer of passive immunity.Hypothesis:A commercially available serum product will increase serum immunoglobulin concentration in calves with inadequate transfer of colostral immunoglobulins.Animals:Thirty‐two Jersey and Jersey‐Holstein cross calves with inadequate colostral transfer of immunoglobulins (serum total protein <5.0 g/L).Methods:Thirty‐two calves were randomly assigned to either control (n = 15) or treated (n = 17) groups. Treated calves received 0.5 L of a pooled serum product IV. Serum IgG concentrations before and after serum transfusion were determined by radial immunodiffusion.Results:Serum protein concentrations increased from time 0 to 72 hours in both control and transfused calves and the difference was significant between the control and treatment groups (P< .001). Mean pre‐ and posttreatment serum IgG concentrations in control and transfused calves did not differ significantly. Median serum IgG concentrations decreased from 0 to 72 hours by 70 mg/dL in control calves and increased over the same time interval in transfused calves by 210 mg/dL. The difference was significant between groups (P< .001). The percentage of calves that had failure of immunoglobulin transfer 72 hours after serum transfusion was 82.4%.Conclusions and Clinical Importance:Serum administration at the dosage reported did not provide adequate serum IgG concentrations in neonatal calves with inadequate transfer of colostral immunoglobulins.
GacA-Controlled Activation of Promoters for Small RNA Genes in
Pseudomonas fluorescens
Authors: Humair Bérénice , Wackwitz Birgit , Haas Dieter 
Published: January 2010

ABSTRACT

The Gac/Rsm signal transduction pathway positively regulates secondary metabolism, production of extracellular enzymes, and biocontrol properties of
Pseudomonas fluorescens
CHA0 via the expression of three noncoding small RNAs, termed RsmX, RsmY, and RsmZ. The architecture and function of the
rsmY
and
rsmZ
promoters were studied
in vivo
. A conserved palindromic upstream activating sequence (UAS) was found to be necessary but not sufficient for
rsmY
and
rsmZ
expression and for activation by the response regulator GacA. A poorly conserved linker region located between the UAS and the −10 promoter sequence was also essential for GacA-dependent
rsmY
and
rsmZ
expression, suggesting a need for auxiliary transcription factors. One such factor involved in the activation of the
rsmZ
promoter was identified as the PsrA protein, previously recognized as an activator of the
rpoS
gene and a repressor of fatty acid degradation. Furthermore, the integration host factor (IHF) protein was found to bind with high affinity to the
rsmZ
promoter region
in vitro
, suggesting that DNA bending contributes to the regulated expression of
rsmZ
. In an
rsmXYZ
triple mutant, the expression of
rsmY
and
rsmZ
was elevated above that found in the wild type. This negative feedback loop appears to involve the translational regulators RsmA and RsmE, whose activity is antagonized by RsmXYZ, and several hypothetical DNA-binding proteins. This highly complex network controls the expression of the three small RNAs in response to cell physiology and cell population densities.
Automated Quantification and Sizing of Unbranched Filamentous Cyanobacteria by Model-Based Object-Oriented Image Analysis
Authors: Zeder Michael , Van den Wyngaert Silke , Köster Oliver , Felder Kathrin M. , Pernthaler Jakob 
Published: January 2010

ABSTRACT

Quantification and sizing of filamentous cyanobacteria in environmental samples or cultures are time-consuming and are often performed by using manual or semiautomated microscopic analysis. Automation of conventional image analysis is difficult because filaments may exhibit great variations in length and patchy autofluorescence. Moreover, individual filaments frequently cross each other in microscopic preparations, as deduced by modeling. This paper describes a novel approach based on object-oriented image analysis to simultaneously determine (i) filament number, (ii) individual filament lengths, and (iii) the cumulative filament length of unbranched cyanobacterial morphotypes in fluorescent microscope images in a fully automated high-throughput manner. Special emphasis was placed on correct detection of overlapping objects by image analysis and on appropriate coverage of filament length distribution by using large composite images. The method was validated with a data set for
Planktothrix rubescens
from field samples and was compared with manual filament tracing, the line intercept method, and the Utermöhl counting approach. The computer program described allows batch processing of large images from any appropriate source and annotation of detected filaments. It requires no user interaction, is available free, and thus might be a useful tool for basic research and drinking water quality control.