bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency department use by nonagenarian patients
Authors: Iwata Mitsunaga , Kuzuya Masafumi , Kitagawa Yoshimi , Iguchi Akihisa 
Published: February 2006

Background:  In accord with the rapid growth of the nonagenarian population, their emergency departments (ED) visits are increasing. The aim of our study was to examine ED use by nonagenarian patients and their dispositions.Method:  We analyzed 275 consecutive ED visits of nonagenarian patients in Japan during 1 year. Demographic data, chief complaint, diagnosis, categories of urgency, and disposition following the ED visit were recorded. A 1‐year follow up was conducted on all discharged nonagenarian patients.Results:  A total of 199 patients made 275 visits. Of these patients, 56.4% were transferred by ambulance, 15.6% were classified as emergency, and 65.1% led to hospitalization. Fever, fall, altered mental status, anorexia, focal neurological deficits and general fatigue accounted for 72% of the reasons for ED visits, and 43% of their ED visits resulted in a diagnosis of pneumonia, stroke, head trauma or hip fracture. In hospitalized patients, the mean length of stay was 23.4 days. Most of the patients had geriatric problems such as disability (78%), comorbidity (86%) and polypharmacy (82%). The in‐hospital mortality of the 179 hospitalized patients was 19.6% (35/179). Eighty‐six percent of alive patients were discharged to long‐term care facilities (124/144). The total 1‐year mortality of the 199 patients who visited the ED accounted for 49.2% (98/199).Conclusion:  Nonagenarians’ ED visits were associated with prolonged admissions, postdischarge institutionalizations, and high risk of in‐hospital and postdischarge death. Their ED visits seemed to be a major transition in their own life.
Relation of age and smoking to serum levels of total testosterone and dehydroepiandrosterone sulfate in aged men
Authors: Mizushima Yutaka , Mizuno Hiroshi , Urata Yukitomo 
Published: February 2006

Background:  Hormonal factors have been extensively investigated in the area of geriatric medicine in the search for potential anti‐aging agents or useful biomarkers for senescence in men. However, inconsistent results have been published so far concerning the relation of anthropometric and life‐style factors to endocrine factors. To confirm the relationships between epidemiological parameters and sex hormone levels, we examined the relation of age and smoking to serum levels of total testosterone (T) and dehydroepiandrosterone sulfate (DHEA) in aged men.Methods:  The subjects included men aged 50–74 years, 40 current smokers and 27 never smokers. Serum levels of T and DHEA were assayed with a radioimmunoassay kit.Results:  Serum T did not decrease with age, and was significantly higher in smokers than for non‐smokers. Serum DHEA decreased with age more sharply in non‐smokers than for smokers.Conclusion:  These data suggest that serum DHEA decreases with aging, but serum T does not, and that serum levels of these hormones are influenced by cigarette smoking.
Oral condition and health status of people aged 80–85 years
Authors: Hashimoto Masanori , Yamanaka Katsumi , Shimosato Tukasa , Furuzawa Hiroshi , Tanaka Hikaru , Kato Hiroshi , Ozawa Akira , Sakai Takeshi , Noguchi Toshihide 
Published: February 2006

Objectives:  To clarify the relationship between oral condition and health status, particularly bone mineral density (BMD), in the elderly aged 80 years or more.Methods:  We examined the oral conditions and health status of two groups. One was elderly who lived at home and had at least 20 teeth at the age of 80 (8020 elderly). The other group consisted of elderly people residing in long‐term care facilities (institutionalized elderly). The oral conditions we examined were the number of teeth, masticatory ability, occlusal force, stimulated salivary flow rate, saliva buffer ability, community periodontal index (CPI) and salivary occult blood test. The health status indicators we examined were BMD, grip strength, height, weight and body mass index (BMI).Results:  The number of teeth, stimulated salivary flow rate, masticatory ability, and occlusal force in the 8020 elderly were significantly higher than in the institutionalized elderly. BMD, grip strength, height, weight and BMI in these 8020 elderly were also significantly higher than in the institutionalized elderly. Masticatory ability and occlusal force in the institutionalized elderly with high BMD (high BMD group) were significantly higher than in the institutionalized elderly with low BMD (low BMD group). Grip strength, height and weight in the high BMD group were higher than in the low BMD group.Conclusions:  The 8020 elderly had good oral condition and health status compared to the institutionalized elderly. There may be a relationship between number of teeth and BMD in elderly aged 80–84.
Polypoid prolapsing mucosal folds with diverticulosis and colonic muco‐submucosal elongated polyps
Authors: Kanazawa Nobuo , Kawahara Yuichi , Kasahara Ichirou , Higuchi Yoshiki , Arai Tomio , Kuroiwa Kojiro 
Published: February 2006

Background:  In 1991, Kelly first reported the presence of red or brown mucosal protrusions or polyps associated with diverticular disease and described this syndrome as ‘polypoid prolapsing mucosal folds in diverticular disease.’ In 1994, Matake et al. independently reported several long mucosal intraluminal protrusions as ‘colonic muco‐submucosal elongated polyps.’ The purpose of the present study is to address the relationship between the two syndromes.Methods:  We performed a careful review of the published work on the clinicopathological features of these syndromes.Results:  The clinical symptoms associated with these two syndromes do not differ notably. Because of the mucosal redundancy of the colonic mucosa, the excessive propulsive power of peristalsis may play an important role in generating both types of polyps. Neither ‘polypoid prolapsing mucosal folds in diverticular disease’ nor ‘colonic muco‐submucosal elongated polyps’ fit into any of the conventional classifications, and their histological characteristics are similar. In addition, we describe the diagnosis and clinical management at our institution of an emergent case of polypoid prolapsing mucosal folds in diverticular disease.Conclusion:  In light of their similar etiology and pathology, we propose that these conditions are different manifestations of the same entity. Unifying these two classifications into one makes the diagnosis of either type of polyp less onerous for clinicians, endoscopists and pathologists. As a consequence, it is likely that more cases will be diagnosed and reported. The accumulation of more cases will lead to deeper understanding and further clinicopathological characterization of diverticular polyps.
Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderly
Authors: Arai Hidenori , Takechi Hajime , Wada Taizo , Ishine Masayuki , Wakatsuki Yoshio , Horiuchi Hisanori , Murayama Toshinori , Yokode Masayuki , Tanaka Makoto , Kita Toru , Matsubayashi Kozo , Kume Noriaki 
Published: February 2006

Background:  To determine the utility of various serum markers for assessment of cognitive and mental functions in the elderly, we performed a Comprehensive Geriatric Assessment (CGA) in the out‐patient clinic in Kyoto University Hospital.Methods:  We measured serum levels of dehydroepiandrosterone (DHEA), DHEA‐S, malondialdehyde low‐density lipoproteins (MDA‐LDL), and high‐sensitivity C‐reactive protein (hs‐CRP) in 145 patients to find the association of these markers with activities of daily living (ADL), cognitive impairment and depressive symptoms.Results:  We found that the levels of hs‐CRP were significantly higher in patients with lower scores in Mini‐Mental State Examination (MMSE) and Kohs block design test, and higher scores in the button test, indicating that hs‐CRP may be associated with the cognitive function in elderly patients. We also found that the levels of DHEA‐S were lower in patients with higher scores (9 or over) on the Geriatric Depression Scale‐15 (GDS), indicating that DHEA‐S may be associated with depressive mode in elderly patients. Total cholesterol, high‐density cholesterol (HDL‐C), or albumin were not statistically different in each group studied.Conclusions:  Thus, our data indicate that measuring hs‐CRP and DHEA‐S would be helpful to assess the cognitive function and depressive symptoms in elderly patients.
Application of artificial neural network for predicting plain strain fracture toughness using tensile test results
Authors: KANG J. Y. , CHOI B. I. , LEE H. J. 
Published: February 2006

ABSTRACTA back‐propagation neural network was applied to predicting the KIC values using tensile material data and investigating the effects of crack plane orientation and temperature. The 595 KIC data of structural steels were used for training and testing the neural network model. In the trained neural network model, yield stress has relatively the most effect on KIC value among tensile material properties and KIC value was more sensitive to KIC test temperature than to crack plane orientation valid in the range of material data covered in this study. The performance of the trained artificial neural network (ANN) was evaluated by comparing output of the ANN with results of a conventional least squares fit to an assumed shape. The conventional linear or nonlinear least squares fitting methods gave very poor fitting results but the results predicted by the trained neural network were considerably satisfactory. This study shows that the neural network can be a good tool to predict KIC values according to the variation of the temperature and the crack plane orientation using tensile test results.
First aid for obstetric haemorrhage: the pilot study of the non‐pneumatic anti‐shock garment in Egypt
Authors: Miller S , Hamza S , Bray EH , Lester F , Nada K , Gibson R , Fathalla M , Mourad M , Fathy A , Turan JM , Dau KQ , Nasshar I , Elshair I , Hensleigh P 
Published: February 2006

Objective  To compare the effect of non‐pneumatic anti‐shock garment (NASG) on blood loss from obstetric haemorrhage with standard management of obstetric haemorrhage.Design  Observational study of consecutive obstetric haemorrhage cases before and after introduction of the NASG.Setting  Four tertiary care maternity facilities in Egypt.Sample  The sample consisted of women with obstetric haemorrhage and signs of shock and the entry criteria were: >750 mL of blood loss and either pulse of >100 beats per minute or systolic blood pressure of <100 mmHg. A total of 158 women were in the preintervention group and 206 in the postintervention group.Methods  All the women with haemorrhage meeting the eligibility criteria were treated according to the standard protocol for 4 months (May–August 2004); blood loss was measured and recorded. The NASG was then introduced, and all the women meeting the eligibility criteria were treated according to the standard haemorrhage protocol plus the NASG for 4 months (September–December 2004).Main outcome measures  Measured blood loss collected in a closed‐end, graduated, plastic, under buttocks collection drape.Results  Median measured blood loss in the drape following study entry was 50% lower in those treated with the NASG (250 versus 500 mL, P < 0.001). There was also a non‐statistically significant decrease in morbidity and mortality.Conclusions  This is the first comparative study of the NASG with a standard obstetric haemorrhage treatment protocol. The NASG shows promise for management of obstetric haemorrhage, particularly in lower resource settings. Larger studies will be needed to determine if the NASG contributes to statistically significant decreases in morbidity and mortality.
Nifedipine inhibits picrotoxin‐induced seizure activity: further evidence on the involvement of L‐type calcium channel blockers in epilepsy
Authors: Otoom Sameer , Hasan Zuhair 
Published: February 2006

AbstractA large body of evidence supports the role of L‐type calcium channels in epileptogenesis. The aim of the present study was to study the efficacy of the specific L‐type calcium channel blocker nifedipine on seizure activity induced by picrotoxin (PTX). Adult female Sprague–Dawley rats were used in these experiments. The intraperitoneal administration of nifedipine (5 mg/kg) did not significantly alter the latency to onset of clonic seizure induced by intraperitoneal injection of PTX (4 mg/kg). Higher doses of the drug (10 and 20 mg/kg) significantly increased the latency of onset of clonic seizure in a dose‐dependent manner. Nifedipine (10 mg/kg) did not reduce the incidence of clonic seizures in the animals injected with PTX, but inhibited tonic seizure and the progression of clonic seizures into maximal tonic seizures in four of eight of the animals. The drug (20 mg/kg) inhibited clonic seizure in four of six of the animals and abolished minimal or maximal tonic seizures in all the animals. In conclusion, our study provides further evidence on the antiepileptic effect of L‐type calcium channel blocker nifedipine by showing its protective effect on seizure activity induced by PTX.
Cardioprotection of cariporide evaluated by plasma myoglobin and troponin I in myocardial infarction in pigs
Authors: Létienne Robert , Bel Lydia , Bessac Anne‐Marie , Denais Delphine , Degryse Anne‐Dominique , John Gareth W. , Le Grand Bruno 
Published: February 2006

AbstractThe cardioprotective effects of cariporide were investigated against myoglobin and troponin I elevation in a model of myocardial infarction in pig, and the possible relationship between these markers and myocardial infarct size. The left circumflex coronary artery was ligated for 60‐min and then reperfused for 48‐h. Plasma levels of myoglobin and troponin I were quantified during reperfusion. Vehicle or cariporide (2.5 mg/kg) were administered i.v. before ischaemia and infused throughout ischaemia and for the beginning of reperfusion. In vehicle‐treated pigs, the infarct size represented 26% ± 3% of the area at risk. Cariporide significantly decreased the infarct size by 66% ± 9%, and significantly reduced plasma levels of myoglobin and troponin I. A strongly correlated linear relationship between myocardial necrosis and plasma levels of myoglobin (R = 0.966, P < 0.0001) or troponin I (R = 0.855, P < 0.0001) was clearly identified. In conclusion, in our porcine model of myocardial infarction, even with small infarcts (in the presence of cariporide), plasma levels of myoglobin and troponin I are predictive of the presence of necrosis and its extent.
Effect of rofecoxib, a cyclo‐oxygenase‐2 inhibitor, on various biochemical parameters of brain associated with pentylenetetrazol‐induced chemical kindling in mice
Authors: Dhir Ashish , Naidu Pattipati S. , Kulkarni Shrinivas K. 
Published: February 2006

AbstractCyclo‐oxygenase (COX) has been reported to play a significant role in neurodegeneration and other brain‐related disorders. Recent studies have reported that COX plays a significant role in the pathophysiology of brain‐related disorders and COX‐2 inhibitors could be useful drug therapy in neurodegenerative disorders. The aim of the present study was to explore the possible role of COX and the effect of COX‐2 inhibitor, rofecoxib in epilepsy. In the present study, kindling was induced in mice by chronic administration of a subconvulsive dose of pentylenetetrazol (PTZ, 40 mg/kg, i.p.) on every other day for a period of 15 days. Rofecoxib was administered orally daily 45 min before either PTZ or vehicle. The kindling score was recorded after PTZ administration. Seizure severity was measured according to a prevalidated scoring scale. Biochemical estimations were performed on the day 16 of PTZ treatment (24 h after the last dose of PTZ). Chronic treatment with selective COX‐2 inhibitor, rofecoxib (2.0 and 5.0 mg/kg, p.o.) for 15 days showed significant decrease in PTZ‐induced kindling score. Biochemical analysis showed that chronic treatment with PTZ significantly increased lipid peroxidation, nitrite levels (NO levels), and myeloperoxidase levels and decreased the reduced glutathione levels in brain homogenate. Chronic treatment with rofecoxib, a selective COX‐2 inhibitor, significantly reversed the PTZ‐induced kindling score as well as various biochemical alterations suggesting the use of COX‐2 inhibitor rofecoxib in epilepsy. In conclusion, results of the present study suggested that COX‐2 plays an important role in the pathophysiology of PTZ‐induced kindling in mice and rofecoxib is protective against various biochemical alterations against PTZ‐induced kindling in mice.
Distribution of calcineurin activity in blood cell fractions and impact of tacrolimus inhibition
Authors: Blanchet Benoit , Hulin Anne , Ghaleh Bijan , Giraudier Stéphane , Jouault Hélène , Astier Alain 
Published: February 2006

AbstractThe aim of this study was to investigate calcineurin (PP2B) activity in different blood cell fractions and its inhibition by tacrolimus. Basal PP2B activity was measured in each blood cellular fraction collected from healthy volunteers. The inhibition profile of PP2B activity was explored in isolated peripheral blood mononuclear cells (PBMC) and platelets exposed directly to tacrolimus and in PBMC and platelets isolated from whole blood previously exposed to tacrolimus. Constrasting with red blood cells (30%) and platelets (25%), PBMC represented only 8.7% of PP2B activity of unfractionated whole blood. After tacrolimus exposure of isolated PBMC and platelets, the concentration of tacrolimus required to inhibit 50% of PP2B acti‐vity (EC50) in PBMC was significantly lower than in platelets (0.26 ng/mL vs. 0.83 ng/mL, P < 0.001). EC50 values were similar in PBMC and platelets isolated from whole blood previously exposed to tacrolimus (7.69 ng/mL vs. 7.42 ng/mL, respectively). These results suggest PBMC is a very suitable matrix for PP2B measurement in monitoring transplant recipients but clinical studies are necessary to solve clearly this issue.
A field trial to evaluate the pollution potential to ground and surface waters from woodchip corrals for overwintering livestock outdoors
Authors: Vinten A. J. A. , Donnelly S. , Ball B. C. , Crawford C. E. , Ritchie R. M. , Parker J. P. 
Published: February 2006

AbstractOutwintering beef cattle on woodchip corrals offers stock management, economic and welfare benefits when compared with overwintering in open fields or indoors. A trial was set up on a loamy sand over sand soil to evaluate the pollution risks from corrals and the effect of design features (size and depth of woodchips, stocking density, and feeding on or off the corral). Plastic‐lined drainage trenches at 9–10 m spacing under the woodchips allowed sampling of the leachate. Sampling of the soil to 3.6 m below the corral allowed evaluation of pollutant mitigation during vadose zone transport. Mean corral leachate pollutant concentrations were 443–1056 mg NH4‐N L−1, 372–1078 mg dissolved organic carbon (DOC) L−1, 3–13 mg NO3‐N L−1, 8 × 104–1.0 × 106Escherichia coli 100 mL−1 and 2.8 × 102–1.4 × 103 faecal enterococci 100 mL−1. Little influence of design features could be observed. DOC, NH4 and (in most cases) E. coli and faecal enterococci concentrations decreased 102–103 fold when compared with corral leachate during transport to 3.6 m but there were some cores where faecal enterococci concentrations remained high throughout the profile. Travel times of pollutants (39–113 days) were estimated assuming vertical percolation, piston displacement at field moisture content and no adsorption. This allowed decay/die‐off kinetics in the soil to be estimated (0.009–0.044 day−1 for DOC, 0.014–0.045 day−1 for E. coli and 0–0.022 day−1 for faecal enterococci). The mean [NO3‐N] in pore water from the soil cores (n = 3 per corral) ranged from 114 ± 52 to 404 ± 54 mg NO3‐N L−1, when compared with 59 ± 15 mg NO3‐N L−1 from a field overwintering area and 47 ± 40 mg NO3‐N L−1 under a permanent feeding area. However, modelling suggested that denitrification losses in the soil profile increased with stocking density so nitrate leaching losses per animal may be smaller under corrals than for other overwintering methods. Nitrous oxide, carbon dioxide and methane fluxes (measured on one occasion from one corral) were 5–110 g N ha−1 day−1, 3–23 kg C ha−1 day−1, and 5–340 g C ha−1 day−1 respectively. Ammonia content of air extracted from above the woodchips was 0.7–3.5 mg NH4‐N m−3.
Implementation of peripheral blood CD34 analyses to initiate leukapheresis: marked reduction in resource utilization
Authors: Meehan Kenneth R. , Hill John M. , Patchett Linda , Webber Susan M. , Wu Jillian , Ely Pamela , Szczepiorkowski Zbigniew M. 
Published: February 2006

BACKGROUND:  Analysis of the peripheral blood (PB) C34 value may determine the optimal time to initiate leukapheresis.STUDY DESIGN AND METHODS:  After selecting a threshold PB CD34 value of five CD34 + cells per µL to initiate leukapheresis procedure, a prospective analysis of 50 consecutive patients was initiated to identify the optimal time to initiate leukapheresis and its impact on costs and resource utilization. Clinical decisions were made to commence or to postpone leukapheresis with this PB CD34 threshold number. Based on PB CD34 values for each patient, the number of leukapheresis procedures, postponed or canceled, the number of CD34+ cells per kg, and the total number of cells collected were identified. Costs of mobilization were obtained from the hospital cost accounting system.RESULTS:  In 13 months, 50 patients with a hematologic disorder underwent mobilization. There were 34 cancellations or postponements of collections due to a low PB CD34 value in 13 patients. By use of our identified costs per initial collection, this resulted in a savings of $67,660.CONCLUSIONS:  This prospective study defines how the implementation of the PB CD34 value results in costs savings. A low PB CD34 value canceled or postponed a significant number of leukapheresis procedures, resulting in a substantial cost savings. Use of the PB CD34 value should be the standard of care during mobilization and peripheral blood progenitor cell collection.
The Politics of Vulnerability: Constructing Local Performance Regimes for Homeland Security
Authors: Clarke Susan E. , Chenoweth Erica 
Published: February 2006

AbstractParadoxically, the greater the national security threats, the more important the role of local policy in the United States. In this article we examine homeland security initiatives—particularly the tension between risk and vulnerability—and the governance dilemmas they pose for local communities. In contrast to the usual emphasis on coordination and capacity, we argue for conceptualizing local imperatives attendant to homeland security as collective action problems requiring the construction of local performance regimes. Performance regimes must engage three challenges: (1) to enlist diverse stakeholders around a collective local security goal despite varying perceptions of its immediacy; (2) to persuade participants to sustain their involvement in the face of competing demands, and (3) to create a durable coalition around performance goals necessary for reducing local vulnerability. Using these analytic categories casts local homeland security issues in strategic terms; it also encourages comparisons of local governance arrangements to respond to risk and vulnerability.