bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consequences of Increased Rigidity in Palatal Implants for Snoring: A Randomized Controlled Study
Authors: Skjøstad Ketil W. , Kari Stene Brit , Norgård Ståle 
Published: January 2006

OBJECTIVESPalatal implants have seen an increased role in the treatment of snoring. In this study, we evaluate the safety and possible treatment effect of adding further stiffness to the palate through the use of a more rigid implant.STUDY DESIGNRandomized double‐blind study of 20 patients with primary snoring. Three polyethylene teralphate implants were placed in the soft palate with the patient under local anesthesia. Ten patients received regular implants (rigidity 1.0) and 10 patients received stiffer implants (rigidity 1.8). The patients and their bed partners were followed for 6 months with questionnaires and office visits. A sleep study was performed preoperatively and at the last follow‐up.RESULTSFour of the 10 patients with stiffer implants had 5 partial extrusions in the observation period. There was a nonsignificant reduction in snoring intensity from 8.1 to 6.1 evaluated by the bed partner on a visual analogue scale in this group. No extrusions were seen in the group with regular implants. This group showed a significant reduction in snoring intensity from 7.7 to 4.7. No other major adverse events were observed.CONCLUSIONS AND SIGNIFICANCERigid implants cause short time extrusions with loss of treatment effect. Regular implants reduce palatal snoring intensity with high patient and bed partner satisfaction.EBM rating: A‐1b
Experience of First Deployed Otolaryngology Team in Operation Iraqi Freedom: The Changing Face of Combat Injuries
Authors: Brennan Joseph 
Published: January 2006

OBJECTIVESIn September, 2004, an Air Force otolaryngology team was deployed to Iraq as a member of the multispecialty head and neck team, which had historically consisted of neurosurgery, ophthalmology, and oral surgery. We examined our operative and outpatient experience to determine if otolaryngology would be a critical component of this new head and neck team.STUDY DESIGN AND SETTINGBetween September 7, 2004, and January 22, 2005, we collected data on all otolaryngology operative procedures and outpatient visits at the Air Force Theater Hospital at Balad Air Base, Iraq.RESULTSOne hundred fifty‐nine patients underwent 257 operative procedures with the 3 most common procedures being complex facial laceration repair, tracheostomy, and neck exploration for penetrating neck trauma. In the otolaryngology clinic, we examined and treated 529 patients from throughout the Middle East.CONCLUSIONSThe otolaryngology team proved to be a critical component of the Air Force multispecialty head and neck team.EBM rating: C‐4
Endoscopically Directed Middle Meatal Cultures Versus Maxillary Sinus Taps in Acute Bacterial Maxillary Rhinosinusitis: A Meta‐Analysis
Authors: Benninger Michael S. , Payne Spencer C. , Ferguson Berrylin J. , Hadley James A. , Ahmad Nadir 
Published: January 2006

OBJECTIVESThe aim of this study was to verify the correlation of endoscopically directed middle meatal (EDMM) cultures with maxillary sinus tap and culture (MST) in acute bacterial rhinosinusitis (ABRS).STUDY DESIGN AND METHODSMeta‐analysis of the previous literature, unpublished data, and a prospective trial supported by the Sinus & Allergy Health Partnership. EDMM and MST cultures were obtained and their results compared. Inclusion for both the unpublished and prospective trial as well as prior published literature in the meta‐analysis required the studies to compare EDMM versus MST in the acute setting of bacterial rhinosinusitis with both symptomatic and radiologic evidence of ABRS.RESULTSThree articles and 1 national presentation were identified for inclusion. Additional data from unpublished studies and the prospective trial were combined. The pooled data consisted of 126 patients with 131 culture pairs. For known pathogenic bacteria for ABRS and in comparison to MST, EDMM had a sensitivity of 80.9%, a specificity of 90.5%, a positive predictive value of 82.6%, a negative predictive value of 89.4%, and an overall accuracy of 87.0% (95% confidence interval, 81.3%‐92.8%); 70.5% (12/17) of false positive culture pairs were of known pathogens for ABRS that would not be expected to be contaminants.CONCLUSIONS AND SIGNIFICANCEThis meta‐analysis shows that EDMM is a highly sensitive and accurate culture method for acute ABRS and may be more sensitive than MST given the presence of pathogenic bacteria not found on antral lavage. EDMM is a viable, and possibly preferred, culture method for determining antimicrobial efficacy and bacterial resistance patterns.EBM rating: A‐1a
Helicobacter Pylori and Laryngopharyngeal Reflux in Chronic Rhinosinusitis
Authors: Borges Dinis Paulo , Subtil João 
Published: January 2006

OBJECTIVESInvestigation of the potential role of several laryngopharyngeal reflux contents in sinus disease.STUDY DESIGN AND SETTINGA controlled cohort analysis of Helicobacter pylori, pepsin and pepsinogen I in inflamed and non‐inflamed sinonasal tissue. Fifteen patients, selected for surgery due to chronic medically refractory rhinosinusitis, had their pathologic sinus tissue analyzed for polymerase chain reaction detection of H. pylori DNA and assayed for pepsin and pepsinogen I tissue concentration levels. A control group of 5 patients undergoing surgery for anatomic sinonasal abnormalities provided non‐inflammatory mucosa specimens for comparison.RESULTSH. pylori was found scattered in inflamed and non‐inflamed mucosa, whereas sinonasal tissue pepsin/pepsinogen never rose above blood levels in both groups.CONCLUSIONSEvidence of intra‐operative peptic reflux into the sinuses was not found. As H. pylori was similarly encountered in healthy and diseased sinus mucosa, it seemingly fails to support a pathogenic role for this organism in the sinuses.EBM rating: B‐2b
Effect of Nitric Oxide and Peroxynitrite on Mucociliary Transport Function of Experimental Otitis Media
Authors: Jeon Eun‐ju , Park Yong‐Soo , Kyun Lee Seung , Yeo Sang‐Won , Park Shi Nae , Chang Ki‐Hong 
Published: January 2006

OBJECTIVESTo determine the role of nitric oxide (NO) and peroxynitrite on mucociliary activity in experimental otitis media with effusion (OME).STUDY DESIGN AND SETTINGTwenty guinea pigs were divided into 1 control and 3 experimental groups; lipopolysaccharide (LPS), NG‐nitro‐L‐arginine methyl ester (L‐NAME), and uric acid (UA) groups. Ten ears were used in each group. OME was induced by transtympanic injection of LPS in experimental groups. Twenty‐four hours after the transtympanic injection, dye transfer time (DTT) was measured and the temporal bone was taken for histopathologic examination. Expression of peroxynitrite was determined by immunohistochemical stain for 3‐nitrotyrosine (3‐NT).RESULTSDye transfer time was significantly delayed in LPS group compared to control group; by contrast it was significantly reduced in L‐NAME or UA treated groups (P < 0.01). Histopathologic examination showed reduced inflammation and mucosal thickening in the treatment groups when compared to LPS group. These findings, however, were not statistically significant. Immunoreactivity to 3‐NT was intense in LPS group and decreased in the treatment groups (P < 0.05).CONCLUSIONSIt is suggested that LPS induced mucociliary dysfunction in the middle ear by NO and peroxynitrite‐mediated pathways.
Opening Plugged Tympanostomy Tubes: Effect of Biofilm Formation
Authors: Mehta Ajay J. , Lee James C. , Stevens Gary R. , Antonelli Patrick J. 
Published: January 2006

OBJECTIVESTo determine if the presence of a bacterial biofilm impacts the rate of clearing of mucoid plugs from tympanostomy tubes (TTs).STUDY DESIGN AND SETTINGEx vivo model. Stainless steel Reuter Bobbin TTs (n = 18) were placed in growth medium with Pseudomonas aeruginosa and Streptococcus pneumoniae for 12 days to promote biofilm formation. Tympanostomy tubes (n = 18) placed in growth medium, without bacteria, for 12 days served as controls. Biofilm formation was assessed by scanning electron microscopy. All TTs were filled with middle ear mucus and allowed to dry, thereby forming a plug. TTs were placed in a model ear chamber, covered with ofloxacin otic solution, and the time to clear each plug was recorded.RESULTSBiofilm formation was consistently encountered on TTs exposed to bacteria but in no TTs in the control group. There was a significant effect of the biofilm on plug clearance, favoring TTs without a biofilm (P = 0.0333). Although there was no significant difference in the proportion of unplugged TTs (P = 0.264), TTs with a biofilm did not clear plugs as rapidly as TTs without a biofilm (P = 0.0416).CONCLUSIONSThe presence of a biofilm may slow the time to clear mucoid TT plugs, but it does not seem to affect the overall proportion of TTs that are unplugged.
Post‐Tonsillectomy Morbidity and Quality of Life in Pediatric Patients with Obstructive Tonsils and Adenoid: Microdebrider vs Electrocautery
Authors: Derkay Craig S. , Darrow David H. , Welch Camille , Sinacori John T. 
Published: January 2006

OBJECTIVESTo prospectively compare outcomes in children over age 2 with obstructive adenotonsillar hypertrophy when tonsillectomy is performed utilizing an intracapsular microdebrider technique versus low‐wattage electrocautery technique.STUDY DESIGN AND SETTINGProspective, single‐blind, randomized controlled trial at a tertiary care children's hospital.RESULTSAmong the 300 children, those treated with the microdebrider resumed normal activity faster, with a median recovery of 2.5 days, and stopped taking pain medication sooner, with the median time to the last dose of 4 days. The microdebrider group were 3 times more likely to no longer need pain medications at 3 days postoperatively and 2.5 times less likely to be still needing pain medication 7 days postoperatively. They were twice as likely to be at a normal activity level by 3 days postoperatively and were less likely to still not have attained normal activity and normal diet after 7 days. There was no difference between groups in median days to return to normal diet (3.0 to 3.5 days). At 1‐month follow‐up, children in the microdebrider group were 5 times more likely to have residual tonsil tissue.CONCLUSIONSIntracapsular tonsillectomy in children with obstructive adenotonsillar hypertrophy results in improved peri‐operative outcomes. Residual tonsil tissue is more common with use of the microdebrider; however, the incidence of future obstruction or infection is unknown.EBM rating: A‐1b
A Trial of High‐Dose, Short‐Course Levofloxacin for the Treatment of Acute Bacterial Sinusitis
Authors: Poole Michael , Anon Jack , Paglia Margaret , Xiang Jim , Khashab Mohammed , Kahn James 
Published: January 2006

OBJECTIVESCompare two dosage strengths of levofloxacin in the treatment of acute bacterial sinusitis.STUDY DESIGN AND SETTINGMulticenter clinical trial comparing levofloxacin 750 mg for 5 days vs levofloxacin 500 mg for 10 days.RESULTSSinus fluid samples were obtained by antral puncture (59.2%) or by sinus endoscopy (40.8%). Among microbiologically evaluable patients, 91.4% (139/152) of patients receiving levofloxacin 750 mg achieved clinical success vs 88.6% (132/149) of patients receiving levofloxacin 500 mg (95% CI −10.0, 4.2). Clinical success rates by pathogen were above 90% in both treatment groups for the 3 typical pathogens of acute sinusitis:Streptococcus pneumoniae, Haemophilus influenzae, andMoraxella catarrhalis. The safety profile of the 2 dosage strengths was similar.CONCLUSIONLevofloxacin 750 mg for 5 days is noninferior to levofloxacin 500 mg for 10 days.SIGNIFICANCELevofloxacin 750 mg for 5 days represents a safe and effective treatment regimen for acute bacterial sinusitis.EBM rating: A‐1b
THE FRENCH ARMY, 1624–1914: FROM THE KING'S TO THE PEOPLE'S
Authors: HOPKIN DAVID 
Published: January 2006

Richelieu's army: war government and society in France, 1624–1642. By David Parrott. Cambridge: Cambridge University Press, 2001. Pp. xxiv+599. ISBN 0-521-79209-6. £65.00.The dynastic state and the army under Louis XIV: royal service and private interest, 1661–1701. By Guy Rowlands. Cambridge: Cambridge University Press, 2002. Pp. xxiv+404. ISBN 0-521-64124-1. £55.00.The French army, 1750–1820: careers, talent, merit. By Rafe Blaufarb. Manchester: Manchester University Press, 2002. Pp. xii+227. ISBN 0-7190-6262-4. £45.00.The people in arms: military myth and national mobilization since the French Revolution. Edited by Daniel Moran and Arthur Waldron. Cambridge: Cambridge University Press, 2003. Pp. xi+268. ISBN 0-521-81432. £50.00.From revolutionaries to citizens: antimilitarism in France, 1870–1914. By Paul B. Miller. Durham, NC, and London: Duke University Press, 2002. Pp. xiii+277. ISBN 0-8223-2766-X. £13.95.Although all the books under review are military histories, international conflict is not their central concern. They are not primarily campaign histories, nor studies of strategic or tactical innovations, nor biographies of great commanders. If they help to answer the military historian's traditional question – how is military might created and used on the battlefield – then they do so indirectly, through an exploration of how the state marshalled its resources for war, particularly in terms of manpower. This is not just a question of emphasis, or of filling in gaps in the historiography; these books mount a sustained critique on the explanatory models favoured by military historians. Military history, David Parrott suggests, too readily falls into a ‘whiggish trap’: a series of clear-sighted war leaders grasp the potential of technology in achieving the state's foreign policy objectives; technological shifts drive changes in the size and organization of armies, and consequently in the development of the state. And thus was the modern world of large, complex, disciplined organizations made. In contrast, we are offered here a selection of error-prone war leaders, constrained at every turn by the social, political, and financial realities of their day, who were intent not on ‘progress’ but on manipulating the system of which they themselves were a part, and as much for their own ends as for those of the state they served.
Heterotrimeric G‐proteins: a short history
Authors: Milligan Graeme , Kostenis Evi 
Published: January 2006

Some 865 genes in man encode G‐protein‐coupled receptors (GPCRs). The heterotrimeric guanine nucleotide‐binding proteins (G‐proteins) function to transduce signals from this vast panoply of receptors to effector systems including ion channels and enzymes that alter the rate of production, release or degradation of intracellular second messengers. However, it was not until the 1970s that the existence of such transducing proteins was even seriously suggested. Combinations of bacterial toxins that mediate their effects via covalent modification of the α‐subunit of certain G‐proteins and mutant cell lines that fail to generate cyclic AMP in response to agonists because they either fail to express or express a malfunctional G‐protein allowed their identification and purification. Subsequent to initial cloning efforts, cloning by homology has defined the human G‐proteins to derive from 35 genes, 16 encoding α‐subunits, five β and 14 γ. All function as guanine nucleotide exchange on–off switches and are mechanistically similar to other proteins that are enzymic GTPases. Although not readily accepted initially, it is now well established that β/γ complexes mediate as least as many functions as the α‐subunits. The generation of chimeras between different α‐subunits defined the role of different sections of the primary/secondary sequence and crystal structures and cocrystals with interacting proteins have given detailed understanding of their molecular structure and basis of function. Finally, further modifications of such chimeras have generated a range of G‐protein α‐subunits with greater promiscuity to interact across GPCR classes and initiated the use of such modified G‐proteins in drug discovery programmes.British Journal of Pharmacology (2006) 147, S46–S55. doi:10.1038/sj.bjp.0706405
Histamine and its receptors
Authors: Parsons Mike E , Ganellin C Robin 
Published: January 2006

This article reviews the development of our knowledge of the actions of histamine which have taken place during the course of the 20th century. Histamine has been shown to have a key physiological role in the control of gastric acid secretion and a pathophysiological role in a range of allergic disorders. The synthesis of, and pharmacological studies on, selective agonists and antagonists has established the existence of four types of histamine receptor and histamine receptor antagonists have found very important therapeutic applications. Thus, in the 1940s, H1‐receptor antagonists (‘the antihistamines’) yielded and still provide valuable treatment for allergic conditions such as hay fever and rhinitis. In the late 1970s and 1980s, H2‐receptor antagonists (in the discovery of which the two authors were personally involved) revolutionised the treatment of peptic ulcer and other gastric acid‐related diseases. The H3‐receptor antagonists, although available since 1987, have been slower to find a therapeutic role. However, the discovery of nonimidazole derivatives such as brain‐penetrating H3antagonists has provided drugs that are in early‐phase clinical trials, possibly for application in obesity, and a variety of central nervous system disorders, such as memory, learning deficits and epilepsy. Finally, the most recently (1999) discovered H4receptor promises the potential to provide drugs acting on the immunological system with possible applications in asthma and inflammation.British Journal of Pharmacology(2006)147, S127–S135. doi:10.1038/sj.bjp.0706440
Molecular targets underlying general anaesthesia
Authors: Franks Nicholas P 
Published: January 2006

The discovery of general anaesthesia, over 150 years ago, revolutionised medicine. The ability to render a patient unconscious and insensible to pain made modern surgery possible and general anaesthetics have become both indispensible as well as one of the most widely used class of drugs. Their extraordinary chemical diversity, ranging from simple chemically inert gases to complex barbiturates, has baffled pharmacologists, and ideas about how they might work have been equally diverse. Until relatively recently, thinking was dominated by the notion that anaesthetics acted ‘nonspecifically’ by dissolving in the lipid bilayer portions of nerve membranes. While this simple idea could account for the chemical diversity of general anaesthetics, it has proven to be false and it is now generally accepted that anaesthetics act by binding directly to sensitive target proteins. For certain intravenous anaesthetics, such as propofol and etomidate, the target has been identified as the GABAA receptor, with particular subunits playing a crucial role. For the less potent inhalational agents, the picture is less clear, although a relatively small number of targets have been identified as being the most likely candidates. In this review, I will describe the work that led up to the identification of the GABAA receptor as the key target for etomidate and propofol and contrast this with current progress that has been made in identifying the relevant targets for other anaesthetics, particularly the inhalational agents.British Journal of Pharmacology (2006) 147, S72–S81. doi:10.1038/sj.bjp.0706441
The discovery of nitric oxide and its role in vascular biology
Authors: Moncada S , Higgs E A 
Published: January 2006

Nitric oxide (NO) is a relative newcomer to pharmacology, as the paper which initiated the field was published only 25 years ago. Nevertheless its impact is such that to date more than 31,000 papers have been published with NO in the title and more than 65,000 refer to it in some way. The identification of NO with endothelium‐derived relaxing factor and the discovery of its synthesis from L‐arginine led to the realisation that the L‐arginine: NO pathway is widespread and plays a variety of physiological roles. These include the maintenance of vascular tone, neurotransmitter function in both the central and peripheral nervous systems, and mediation of cellular defence. In addition, NO interacts with mitochondrial systems to regulate cell respiration and to augment the generation of reactive oxygen species, thus triggering mechanisms of cell survival or death. This review will focus on the role of NO in the cardiovascular system where, in addition to maintaining a vasodilator tone, it inhibits platelet aggregation and adhesion and modulates smooth muscle cell proliferation. NO has been implicated in a number of cardiovascular diseases and virtually every risk factor for these appears to be associated with a reduction in endothelial generation of NO. Reduced basal NO synthesis or action leads to vasoconstriction, elevated blood pressure and thrombus formation. By contrast, overproduction of NO leads to vasodilatation, hypotension, vascular leakage, and disruption of cell metabolism. Appropriate pharmacological or molecular biological manipulation of the generation of NO will doubtless prove beneficial in such conditions.British Journal of Pharmacology (2006) 147, S193–S201. doi:10.1038/sj.bjp.0706458
Monoamine oxidase: isoforms and inhibitors in Parkinson's disease and depressive illness
Authors: Youdim Moussa B H , Bakhle Y S 
Published: January 2006

A few years after the foundation of the British Pharmacological Society, monoamine oxidase (MAO) was recognized as an enzyme of crucial interest to pharmacologists because it catalyzed the major inactivation pathway for the catecholamine neurotransmitters, noradrenaline, adrenaline and dopamine (and, later, 5‐hydroxytryptamine, as well). Within the next decade, the therapeutic value of inhibitors of MAO in the treatment of depressive illness was established. Although this first clinical use exposed serious side effects, pharmacological interest in, and investigation of, MAO continued, resulting in the characterization of two isoforms, MAO‐A and ‐B, and isoform‐selective inhibitors. Selective inhibitors of MAO‐B have found a therapeutic role in the treatment of Parkinson's disease and further developments have provided reversible inhibitors of MAO‐A, which offer antidepressant activity without the serious side effects of the earlier inhibitors. Clinical observation and subsequent pharmacological analysis have also generated the concept of neuroprotection, reflecting the possibility of slowing, halting and maybe reversing, neurodegeneration in Parkinson's or Alzheimer's diseases. Increased levels of oxidative stress in the brain may be critical for the initiation and progress of neurodegeneration and selective inhibition of brain MAO could contribute importantly to lowering such stress. There are complex interactions between free iron levels in brain and MAO, which may have practical outcomes for depressive disorders. These aspects of MAO and its inhibition and some indication of how this important area of pharmacology and therapeutics might develop in the future are summarized in this review.British Journal of Pharmacology (2006) 147, S287–S296. doi:10.1038/sj.bjp.0706464