bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic aspects of pathological gambling: a complex disorder with shared genetic vulnerabilities
Authors: Lobo Daniela S. S. , Kennedy James L. 
Published: August 2009

ABSTRACTAims  To summarize and discuss findings from genetic studies conducted on pathological gambling (PG).Methods  Searches were conducted on PubMed and PsychInfo databases using the keywords: ‘gambling and genes’, ‘gambling and family’ and ‘gambling and genetics’, yielding 18 original research articles investigating the genetics of PG.Results  Twin studies using the Vietnam Era Twin Registry have found that: (i) the heritability of PG is estimated to be 50–60%; (ii) PG and subclinical PG are a continuum of the same disorder; (iii) PG shares genetic vulnerability factors with antisocial behaviours, alcohol dependence and major depressive disorder; (iv) genetic factors underlie the association between exposure to traumatic life‐events and PG. Molecular genetic investigations on PG are at an early stage and published studies have reported associations with genes involved in the brain's reward and impulse control systems.Conclusions  Despite the paucity of studies in this area, published studies have provided considerable evidence of the influence of genetic factors on PG and its complex interaction with other psychiatric disorders and environmental factors. The next step would be to investigate the association and interaction of these variables in larger molecular genetic studies with subphenotypes that underlie PG. Results from family and genetic investigations corroborate further the importance of understanding the biological underpinnings of PG in the development of more specific treatment and prevention strategies.
Tetraplegia following parathyroidectomy in two long‐term haemodialysis patients
Authors: Mercieri M. , Paolini S. , Mercieri A. , De Blasi R. A. , Palmisani S. , Pinto G. , Arcioni R. 
Published: August 2009

SummaryWe report two cases of postoperative iatrogenic tetraparesis, which occurred in different hospitals after surgery for parathyroidectomy. Both patients were on long‐term haemodialysis. The prolonged neck extension usually required by this procedure was probably the main factor involved in the genesis of the spinal cord injury. Spinal abnormalities associated with chronic renal failure may have made these patients more vulnerable. In our opinion, it is advisable to investigate thoroughly any sign of spinal stenosis in patients who undergo any procedure requiring significant neck extension, particularly if on long‐term haemodialysis.
Thrombotic thrombocytopenic purpura following transurethral resection of the prostate
Authors: Benington S. R. , McKillop A. , Macartney I. , Burns S. 
Published: August 2009

SummaryA 65‐year old man developed anaemia, profound thrombocytopenia and acute renal failure 2 days after transurethral resection of the prostate. Based on the clinical picture and blood film evidence of microangiopathic haemolysis, thrombotic thrombocytopenic purpura was diagnosed. The patient was treated with a course of plasma exchange, renal replacement therapy and methylprednisolone and made a good recovery. Thrombotic thrombocytopenic purpura is an uncommon cause of haematological and renal abnormalities in the postoperative period. It has a high mortality if untreated, and should be considered in the differential diagnosis of any postoperative patient with a low platelet count and anaemia, since prompt investigation and treatment is life‐saving.
Simulation as a tool to improve the safety of pre‐hospital anaesthesia – a pilot study*
Authors: Batchelder A. J. , Steel A. , Mackenzie R. , Hormis A. P. , Daniels T. S. , Holding N. 
Published: August 2009

SummaryWe conducted a pilot study of the effects of simulation as a tool for teaching doctor‐paramedic teams to deliver pre‐hospital anaesthesia safely. Participants undertook a course including 43 full immersion, high‐fidelity simulations. Twenty videos taken from day 4 and days 9/10 of the course were reviewed by a panel of experienced pre‐hospital practitioners. Participants’ performance at the beginning and the end of the course was compared. The total time from arrival to inflation of the tracheal tube cuff was longer on days 9/10 than on day 4 (mean (SD) 14 min 52 s (2 min 6 s) vs 11 min 28 s (1 min 54 s), respectively; p = 0.005), while the number of safety critical events per simulation were fewer (median (IQR [range]) 1.0 (0–1.8 [0–2]) vs 3.5 (1.5–4.8 [0–8], respectively; p = 0.011). Crew resource management behaviours also improved in later simulations. On a personal training needs analysis, participants reported increased confidence after the course.
The effect of the European Clinical Trials Directive on published drug research in anaesthesia
Authors: Walker E. , Hankins M. C. , White S. M. 
Published: August 2009

SummaryThe clinical indications for anaesthetic drugs are developed through peer‐reviewed publication of clinical trials. We performed a bibliometric analysis of all human research papers reported in nine general anaesthesia journals over 6 years (n = 6489), to determine any effects of the 2004 European Clinical Trials Directive on reported drug research in anaesthesia originating from Europe and the United Kingdom. We found 89% studies involved patients and 11% volunteers. Of 3234 (50%) drug studies, 96% were phase IV (post‐marketing) trials. Worldwide, the number of research papers fell by 3.6% (p < 0.004) in the 3 years following introduction of the European Clinical Trials Directive (5% Europe, 18% United Kingdom), and drug research papers fell by 12% (p < 0.001; 15% Europe, 29% United Kingdom). The introduction of the Clinical Trials Directive has therefore coincided with a decline in European drug research, particularly that originating from the United Kingdom. We suggest a number of measures researchers could take in response, and we propose a simplification of the application process for phase IV clinical trials, emphasising patient risk assessment.
Kinematical characteristics of the factorized velocity model
Authors: Stovas Alexey 
Published: August 2009

ABSTRACTThe factorized velocity model that incorporates both vertical heterogeneity and constant anisotropy is one of the complicated analytical models used in seismic data processing and interpretation. In this paper, I derive the analytic equations for offset, traveltime and relative geometrical spreading for the quasi‐compressional (qP‐) waves that can be used for modelling and inversion of the traveltime parameters. I show that the presence of anelliptic anisotropy usually dominates over the vertical heterogeneity with respect to the non‐hyperbolicity of the factorized velocity model.
Behavioural disturbance in people with Down's syndrome and dementia
Authors: Prasher V. P. , Filer A. 
Published: August 2009

AbstractBehavioural disturbance associated with dementia in people with Down's syndrome has not been fully researched. This study investigated such problems in demented Downs’ syndrome subjects and non‐demented Down's syndrome controls. Changes in mood, difficulty with communication, gait deterioration, loss of self‐care skills, sleep disturbance, day‐time wandering and urinary incontinence were found to be associated with dementia. Problems giving the greatest cause for concern to carers were restlessness, loss of communication skills, urinary incontinence and wandering. Care provision specifically focused on management of behavioural disturbance in individuals who develop dementia is recommended.
Histrionic personality disorder as pseudo‐learning disability
Authors: Cooper S.‐A. , Collacott R. A. 
Published: August 2009

AbstractThe case of a 20‐year‐old woman with a histrionic personality disorder is described. She claims to have a mild learning disability, and indeed, is receiving special college education for people with learning disabilities and has a specialist learning disability social worker, despite being of above average intelligence. Aetiologically, her persona is viewed as a psychological defence, rather than a deliberate attennpt at deception. A process of ‘institutionalization’ appears to have occurred and compounded the problems with further regression. Psychiatrists and professionals in allied disciplines should not accept that a person has a learning disability purely because that person tells you that he or she has one.
Transvestism in a person with learning disabilities presenting with behavioural problems
Authors: Thomas P. R. , DeAlwis K. 
Published: August 2009

AbstractA case of transvestism is reported in a 47‐year‐old man with learning disabilities. He had developed encephalitis in childhood, which had resulted in moderate learning disabilities and epilepsy, and had been living in institutions from the age of six. He did not have any chance to express his sexual desire and this frustration manifested as aggressive behaviour. Recently, he moved to a community home and his deviant sexual behaviour became apparent. Management of his problems Involves organizing a behavioural programme linking his cross dressing with aggressive behaviour.
Increasing parathyroid hormone concentrations in untreated primary hyperparathyroidism
Authors: RUDNICKI M. , TRANSBøL I. 
Published: August 2009

Twenty‐four patients with mild to moderate primary hyperparathyroidism were followed for an average of 2.45 years with serial determinations of serum ionized calcium and intact parathyroid hormone (PTH). For the entire group serum ionized calcium remained stable, whereas serum PTH increased significantly. Eleven patients (group 1) demonstrated a significant increase in PTH with time. The remaining 13 patients formed group 2. Comparison of the changes (%) in each subgroup showed a small but significant increase in serum ionized calcium of 2.6% with time in group 1, while serum PTH increased by 78%. In group 2 serum ionized calcium remained stable whereas PTH increased modestly by 22%. Serum concentrations of creatinine were stable throughout the follow‐up period in both groups.Despite the greater precision of serum ionized calcium, measurements of intact PTH are evidently more sensitive than measurements of serum ionized calcium for the detection of progression in primary hyperparathyroidism.
Patients with persistent elevation of aminotransferases: investigation with ultrasonography, radionucleide imaging and liver biopsy
Authors: HULTCRANTZ R. , GABRIELSSON N. 
Published: August 2009

Abstract. Eighty‐three patients, submitted for investigation of the liver due to persistently elevated activities of serum aminotransferases were included in a study in order to compare the relative merits of liver biopsy, ultrasound and radionucleide imaging.From the liver biopsy it was found that 45 patients had fatty liver, 14 had cirrhosis and 11 had chronic inflammation, 3 had haemochromatosis and 10 had unspecific changes or normal findings.An investigation with ultrasound yielded pathological findings in 65% of the patients. The sensitivity was highest in patients with fatty liver (82%) and more than 10% fat in the liver always resulted in increased echogeneicity. Alterations in the liver due to cirrhosis and chronic inflammation were detected with ultrasound in only 50% and 57% of the cases, respectively.Radionucleide imaging was positive in 44% of the patients with fatty liver, 64% of those with cirrhosis and 21% of the patients with chronic inflammation. It was only possible to distinguish fatty liver from cirrhosis in those patients who had an increase in the size of the spleen (four patients).The study demonstrates that in patients with a persistent elevation of serum aminotransferases ultrasound has a high sensitivity for detecting more than 10% fat in the liver. However, both the ultrasound and a liver scintigram had a rather low sensitivity and a very low specificity for making a diagnosis for this group of patients. With the aid of a liver biopsy it was possible to establish a diagnosis in 90% of the patients.
Sex differences in essential hypertension
Authors: OS I. , KJELDSEN S. E. , NORDBY G. , EIDE I. , LANDE K. , HJERMANN I. , WESTHEIM A. 
Published: August 2009

Abstract. A group of 41‐year‐old hypertensive men (n = 35, blood pressure (BP) 149.9 ± 2.1/ 98.9 ± 1.1 mmHg, mean ± SEM) who had never received treatment for their condition were compared with hypertensive women of the same age (n = 18, BP 155.9 ± 4.3/ 98.1 ± 1.6 mmHg) with comparable body mass index (BMI. 25.9 ± 0.5 vs. 24.9 ± 4.5 kg m−2) who, also, had never received treatment. The lipid profile was more atherogenic in the men, with lower HDL cholesterol (1.21 ± 0.04 vs. 1.38 ± 0.06 mmol l−1 P = 0.04), higher total cholesterol (6.04 ± 0.14 vs. 5.54 ± 0.18 mmol l−1. P = 0.04) and triglycerides (1.80 ± 0.16 vs. 0.96 ± 0.10 mmol l−1, P < 0.001). The hypertensive men had higher haemoglobin (P < 0.001) and haematocrit. Plasma catecholamines were inversely related to BMI in the women only (r = −0.52, P < 0.05 for both noradrenaline and adrenaline). Women with BMI above 25 kg m−2 had significantly lower arterial plasma adrenaline and noradrenaline than those with BMI below 25 kg m−2 (28 ± 5 vs. 78 ± 16 pg ml−1, P < 0.01 and 101 ± 17 vs. 206 ± 33 pg ml−1, P < 0.01 respectively). A negative curvelinear relationship appeared between arterial adrenaline and insulin (r = 0.49, P= 0.05).These results suggest a male propensity for athero‐thrombogenic risk factors in otherwise comparable hypertensive subjects. A close relationship between metabolic risk factors within the normal range seems to exist even in hypertensive women. The decreased sympathetic activity at rest in the obese hypertensive women indicates different pathophysiological mechanism for hypertension in lean and obese. Decreased sympathetic activity and thus reduced energy expenditure, promotes a risk for weight gain, and could explain the inverse relationship between insulin and adrenaline.
Elevated level of erythropoietin in congestive heart failure Relationship to renal perfusion and plasma renin
Authors: JENSEN J. D. , EISKJÆR H. , BAGGER J. P. , PEDERSEN E. B. 
Published: August 2009

Abstract. Background. In animal experiments reduction of renal perfusion can stimulate erythropoietin production. The relationship between renal haemodynamics and erythropoietin production is unknown in congestive heart failure.Objective. The aim was to study the relationship between serum erythropoietin and renal haemodynamics, plasma renin activity and haematocrit in patients with congestive heart failure and in healthy control subjects.Patients and methods. Serum erythropoietin, renal plasma flow, glomerular filtration rate and plasma renin activity were determined in 14 patients with acyanotic congestive heart failure, and 36 healthy controls.Results. Serum erythropoietin was significantly elevated in congestive heart failure 26.6 U l−1 (median) compared with controls 17.0 U l−1 despite a normal haematocrit, and increased with the severity of congestive heart failure (New York Heart Association class II: 17 U l−1 [n = 4]; class III: 30 U l−1 [n = 5]; class IV: 45 U l−1 [n = 5]). Significant inverse correlations between serum erythropoietin and renal plasma flow (r = −0.60, P < 0.03), and between serum erythropoietin and glomerular filtration rate, were found in congestive heart failure but not in the control subjects. A significant positive correlation (r = 0.71, P < 0.03) was demonstrated between serum erythropoietin and plasma renin activity in congestive heart failure.Conclusion. A severe reduction in renal perfusion in congestive heart failure appears to cause an increase in serum erythropoietin.
Different effects of two methods of low‐density lipoprotein apheresis on the coagulation and fibrinolytic systems3
Authors: KNISEL W. , DI NICUOLO A. , PFOHL M. , MÜLLER H. , RISLER T. , EGGSTEIN M. , SEIFRIED E. 
Published: August 2009

Abstract. Objective. Immunoadsorption (IMA) and dextran sulfate adsorption (DSA) are two methods for selective extracorporeal elimination of low‐density lipoproteins which are known as LDL apheresis. Their influence on haemostasis until now is widely unknown.Design. The effects of both LDL apheresis procedures on the coagulation and fibrinolytic systems were compared amongst five patients treated with IMA and four patients who received a DSA therapy.Subjects. All patients with severe heterozygous familial hypercholesterolaemia were participants in a long‐term LDL apheresis programme with treatments every 1–2 weeks.Intervention. Combined anticoagulation with heparin and citrate in IMA, and also heparin exclusively in DSA were used for the extracorporeal circulation.Measures. Blood samples were taken immediately before and after a single LDL apheresis and five times during the weekly interval until the next therapy.Results. DSA had a significantly greater effect on standard clotting tests than IMA at the end of plasma therapy despite identical dosages of heparin. DSA caused a considerable reduction of the coagulation factors V, VIII:C, vWF:Ag, XI, XII, and prekallikrein by 48–99% at the end of apheresis treatment whereas only factor VIII:C showed a marked decrease of 72% after IMA. All abnormalities of the global coagulation tests and of most clotting factors were restored 1 day after treatment in both procedures followed by a moderate rebound phenomenon of single coagulation factors during the next few days in IMA‐treated patients.Conclusion. DSA exerts a more profound effect on the coagulation system than IMA by a substantial co‐elimination of various clotting factors in addition to the desired removal of atherogenic lipoproteins.
Haematocrit: a predictor of cardiovascular mortality ?
Authors: ERIKSSEN G. , THAULOW E. , SANDVIK L. , STORMORKEN H. , ERIKSSEN J. 
Published: August 2009

Abstract.Objectives. The main purpose of the study was to assess a possible association between haematocrit (Hct) and long‐term cardiovascular disease (CVD) mortality.Design. An extensive examination programme was carried out in 2014 men, defined as apparently healthy, during the period 1972 to 1975, including Hct measurements in a 25% random subsample. Sequential, cause‐specific mortality was followed prospectively over a period of 16 years.Setting. The survey was conducted at Medical Department B, Rikshospitalet, Oslo, Norway.Subjects. The participants represented 86% of all eligible apparently healthy men working in five preselected companies in Oslo.Interventions. No intervention was given by the study group during follow‐up.Main outcome measures. Complete, cause‐specific mortality figures after 8–16 years were obtained from the Norwegian Central Bureau of Statistics.Results. Hct measures were obtained in 488 men (24.2%). Mean Hct was 47.2% (sd2.9%). After correcting for differences in age, plasma cholesterol, systolic blood pressure, erythrocyte sedimentation rate and smoking habits (Cox proportional hazards model), an increase in Hct by 2 SDS was associated with an increase in CVD mortality by a factor ranging between 2.9 at 10, and 1.9 at 16 years (P< 0.05). A similar increased risk was observed earlier during follow‐up but the number of deaths was too small for meaningful statistical analysis. No association was found between Hct and non‐CVD mortality.Conclusions. Our data show that increased Hct is associated with an increased risk of dying from CVD—independent of conventional CVD risk factors.
Unusual thrombotic‐like retinopathy (Coats' disease) associated with congenital plasminogen deficiency type I
Authors: PATRASSI GIOVANNI M. , SARTORI M. T. , PIERMAROCCHI S. , VIERO M. , BOERI G. , GIROLAMI A. 
Published: August 2009

Abstract. A new kindred with heterozygous plasminogen deficiency type I is described. The proband, a 17‐year‐old male, showed a peculiar thrombotic‐like retinal picture compatible with Coats' disease. Extensive coagulation studies revealed decreased levels of both plasminogen activity and antigen to about 50% of normal values. Five out of 13 family members from the paternal side showed the same fibrinolytic defect. In two cases, a history of recurrent phlebites of the lower limbs was present. One unaffected patient also had a superficial phlebites at a young age; her plasminogen levels were shown to be within normal limits, but a long‐standing oestroprogestinic intake could have influenced and normalized the results. No other family member showed retinal abnormality.This is the first case of hypoplasminogenaemia associated with Coats' disease. A possible role of the fibrinolytic defect in the pathogenesis of this unusual retinopathy is suggested. Finally, the occurrence of thrombotic manifestations in other affected family members supports the opinion that plasminogen deficiency should be considered as a potential risk factor for thrombosis.
Antivenom treatment in Vipera berus envenoming—report of 30 cases
Authors: Karlson‐Stiber C. , Persson H. 
Published: August 2009

Abstract. Objectives. To assess efficacy and safety of two equine F(ab')2 antivenoms currently used to treat envenoming by European vipers.Design. Retrospective case review study.Setting. Case records collected by the Swedish Poison Information Centre concerning patients treated in Swedish hospitals for bites by the common European adder, Vipera berus.Subjects. Patients presenting with V. berus envenoming treated with antivenom (n = 30) and two groups of patients not given antivenom (n = 16 and n = 38).Main outcome measures. Clinical course and time in hospital were retrospectively studied and compared in patients treated or not treated with antivenom.Results. There was a significantly lower incidence of extensive oedema (23 vs. 88%) and anaemia (10 vs. 50%) in the antivenom‐treated group, and the hospital stay was shorter (median: 3 vs. 6 days). Antivenom treatment also resulted in prompt clinical improvement in the acute phase. Adverse effects consisting of urticaria and serum sickness occurred in 10% of the patients given antivenom.Conclusions. Antivenom treatment was associated with a reduced morbidity in severe V. berus envenoming. However, the occurrence of allergic side‐effects is not negligible with this type of antivenom.
Can laboratory testing improve screening strategies for deep vein thrombosis at an emergency unit?
Authors: Hansson P.‐O. , Eriksson H. , Eriksson E. , Jagenburg R. , Lukes P. , Risberg B. 
Published: August 2009

Abstract. Objectives. To study various markers of blood coagulation and fibrinolysis in relation to the extension of deep vein thrombosis (DVT), and to compare the diagnostic usefulness of these markers as screening tests for excluding DVT.Design. A clinical study of patients admitted to an emergency unit.Setting. Östra Hospital, Göteborg, Sweden.Subjects. One hundred and five patients with a clinical suspicion of DVT.Main outcome measures. Phlebography was used as the reference method for a diagnosis of DVT. Small distal thromboses as well as large proximal thromboses were included. Plasma D‐dimer as well as other markers of coagulation and fibrinolysis were analysed.Results. Twenty‐eight proximal and 20 distal DVTs were found. Plasma D‐dimers (one ELISA and two latex assays), fibrin monomer, prothrombin fragment 1 + 2 (F1+2), thrombin‐antithrombin III complex (TAT) and the t‐PA‐PAI‐1 complex were all significantly correlated to the extension of DVT, whilst fibronectin, tissue‐type plasminogen activator (t‐PA), single‐chain urokinase‐type plasminogen activator (scu‐PA) and plasminogen activator inhibitor 1 (PAI‐1) were not. The sensitivity was 94% for the D‐dimer ELISA and one of the latex methods (latex‐B), at a specificity of 60% and 68%, respectively. The negative predictive value was 92% for ELISA and 93% for latex‐B, and both assays showed a negative predictive value of 100% for proximal DVTs. Fibrin monomer, F1+2, TAT, D‐dimer (latex‐S) and the t‐PA‐PAI‐1 complex all showed lower negative predictive values (88, 84, 79, 78 and 65% respectively).Conclusions. Sensitivity and negative predictive values for a latex assay (D‐dimer latex‐B) was similar to that of a D‐dimer ELISA. With a sensitivity of 94% (100% for proximal DVTs) such a latex assay may be included in a screening strategy for DVT at an emergency unit. However, the safety of such an approach has to be tested in other prospective studies.