bluuebunny/crossref_metadata_2025_split huggingface dataset:
18F-Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Adrenocortical Tumors: A Prospective Study in 77 Operated Patients
Authors: Groussin Lionel , Bonardel Gérald , Silvéra Stéphane , Tissier Frédérique , Coste Joël , Abiven Gwenaelle , Libé Rossella , Bienvenu Marie , Alberini Jean-Louis , Salenave Sylvie , Bouchard Philippe , Bertherat Jérôme , Dousset Bertrand , Legmann Paul , Richard Bruno , Foehrenbach Hervé , Bertagna Xavier , Tenenbaum Florence 
Published: February 2009

Abstract
Context: Most adrenal incidentalomas are nonfunctioning adrenocortical adenomas (ACAs). Adrenocortical carcinomas (ACCs) are rare but should be recognized at an early stage.
Objective: The objective of the study was to evaluate the usefulness of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) to predict malignancy in patients without a previous history of cancer.
Design: This was a prospective, multicenter study from 2001 to 2006.
Setting: The study was conducted at a network of seven university hospitals in Paris.
Patients: Seventy-seven patients were included. All underwent surgery because of hypersecretory and/or growing benign lesions (n = 18), obvious ACCs (n = 21), or radiologically indeterminate lesions (n = 38).
Main Outcome Measure: The degree of 18F-FDG PET uptake [maximum standardized uptake value (maxSUV)] was related to the pathological findings serving as a reference, and its diagnostic value was compared with that of computerized tomography (CT) scan.
Results: Pathology eventually diagnosed 43 ACAs, 22 ACCs, and 12 nonadrenocortical lesions. Using a cutoff value above 1.45 for adrenal to liver maxSUV ratio, the sensitivity and specificity to distinguish ACAs from ACCs were, respectively, 1.00 (95% confidence interval 0.85–1.00) and 0.88 (95% confidence interval 0.75–0.96). Among the 38 indeterminate lesions at CT scan, we could analyze a subgroup of 16 adrenocortical tumors with high unenhanced density (&gt;10 HU) and an inappropriate washout: 18F-FDG PET correctly predicted the benignity in 13 of 15 ACAs.
Conclusions: In a multidisciplinary team approach, 18F-FDG PET helps to manage suspicious CT scan lesions. An adrenal to liver maxSUV ratio less than 1.45 is highly predictive of a benign lesion.
Association of High Iodine Intake with the T1799A BRAF Mutation in Papillary Thyroid Cancer
Authors: Guan Haixia , Ji Meiju , Bao Rong , Yu Hongyu , Wang Yangang , Hou Peng , Zhang Yong , Shan Zhongyan , Teng Weiping , Xing Mingzhao 
Published: February 2009

Abstract
Context: Epidemiological studies have indicated that high iodine intake might be a risk factor for papillary thyroid cancer (PTC), which commonly harbors the oncogenic T1799A BRAF mutation.
Objective: The objective of the study was to investigate the relationship between BRAF mutation in PTC and iodine intake in patients.
Subjects and Methods: We analyzed and compared the prevalences of the T1799A BRAF mutation in classical PTC of 1032 patients from five regions in China that uniquely harbor different iodine contents in natural drinking water, ranging from normal (10–21 μg/liter) to high (104–287 μg/liter). The BRAF mutation was identified by direct DNA sequencing.
Results: The prevalence of BRAF mutation was significantly higher in any of the regions with high iodine content than any of the regions with normal iodine content. Overall, BRAF mutation was found in 387 of 559 PTC with high iodine content (69%) vs. 252 of 473 PTC with normal iodine content (53%), with an odds ratio of 1.97 (95% confidence interval 1.53–2.55) for the association of BRAF mutation with high iodine content (P &lt; 0.0001). In addition, clinicopathological correlation analysis, the largest one of its type ever, showed that BRAF mutation was significantly associated with extrathyroidal invasion, lymph node metastasis, and advanced tumor stages of PTC.
Conclusions: High iodine intake seems to be a significant risk factor for the occurrence of BRAF mutation in thyroid gland and may therefore be a risk factor for the development of PTC. This large study also confirmed the association of BRAF mutation with poorer clinicopathological outcomes of PTC.
Bupropion as a Possible Treatment Option for Restless Legs Syndrome
Authors: Lee Jennifer J , Erdos Joseph , Wilkosz Meghan F , LaPlante Renee , Wagoner Brenda 
Published: February 2009

Objective: To describe a case of restless legs syndrome (RLS) successfully managed with bupropion. Case Summary: A 45-year-old female presented to a Veterans Affairs primary care clinic with a history of chronic insomnia. Her complicated history of treatment failure to sedative–hypnotic agents, continued sleep disturbances, and complaints of intolerable leg sensations fostered collaboration between a psychiatrist and pharmacist to identify effective treatment. Further review of her medical history and subjective complaints led to a diagnosis of RLS. Based on this new diagnosis, she was prescribed several Food and Drug Administration–approved and alternative agents recommended for the management of RLS. Unfortunately, each medication resulted in a variety of intolerable adverse effects, limiting the list of treatment options. Although not widely used for RLS, bupropion XL (Wellbutrin XL) 150 mg daily was initiated, resulting in resolution of RLS within 3 days. Discussion: RLS can be an extremely disabling disorder and affects many people. For most patients, dopamine agonists are the treatment of choice for symptomatic relief. However, for patients unable to tolerate this drug class, small trials and case reports have identified alternative agents. This case supports findings from other cases suggesting a beneficial response with bupropion for the management of RLS. Conclusion: Bupropion may be a treatment option for patients who have RLS and are unable to tolerate dopamine agonists.
Increase in Tiagabine Serum Concentration with Coadministration of Gemfibrozil
Authors: Burstein Aaron H , Boudreau Eilis A , Theodore William H 
Published: February 2009

Objective: To report a case of possible acute tiagabine toxicity secondary to administration of gemfibrozil. Case Summary: A 39-year-old male was taking tiagabine 16 mg orally 3 times per day and carbamazepine 500 mg orally twice per day for complex partial seizures secondary to mesial temporal sclerosis. He was found to have type IV hypertriglyceridemia and was prescribed gemfibrozil. Because he reported severe confusion and altered consciousness shortly after a single 600-mg dose of gemfibrozil, he was admitted for controlled challenge with that drug. A single 300-mg dose of gemfibrozil resulted in lightheadedness and led to a 59% and 75% increase in total tiagabine serum concentrations at 2 and 5 hours, respectively, without significant change in baseline carbamazepine concentrations. Discussion: This is the first report of an interaction between the widely used antihyperlipidemic drug gemfibrozil and tiagabine. Since tiagabine, which was originally developed as an antiepileptic medication, is now being used widely for a variety of other indications such as anxiety and depression, there is an increased risk for clinically significant interactions with gemfibrozil. Conclusions: Increased total and unbound tiagabine concentrations following a single 300-mg dose of gemfibrozil and reproduction of clinical symptoms with gemfibrozil rechallenge suggests the toxicity our patient experienced was due to a pharmacokinetic drug interaction. Use of the Horn Drug interaction Probability Scale showed a probable interaction between gemfibrozil and tiagabine.
Probability of Rash Related to Gabapentin Therapy in a Child
Authors: Gijsen Violette MGJ , Wildt Saskia N de , Ito Shinya 
Published: February 2009

Objective: To describe a child who developed a skin reaction during gabapentin therapy and discuss how we evaluated the probability of an adverse drug reaction. Case Summary: An 8-year-old boy with a neurodegenerative disease of unknown origin and an epilepsy disorder developed an urticarial rash and irritability 10 and 4 days, respectively, after the start of gabapentin 20 mg/kg 3 times a day for epilepsy control. Otherwise, the child was well; no changes in other medication or diet had recently been made. After gabapentin discontinuation and administration of one dose of methylprednisolone 10 mg/kg intravenously and diphenhydramine 1 mg/kg every 4 hours via gastric tube, the rash disappeared over 3 weeks. Discussion: In contrast to other antiepileptic drugs, skin reactions to gabapentin are considered uncommon. In adults, reported prevalence of rash possibly related to gabapentin range from 1% to 10%. A postmarketing surveillance study reported gabapentin treatment failure as a consequence of rash in 0.4% of 3000 patients. The product monograph does not mention rash in children. In our patient, assessment using an objective causality scale revealed that the rash was probably caused by gabapentin. Conclusions: This case, and limited literature data, suggest that gabapentin may cause rash that is severe enough to necessitate discontinuation in a small percentage of children. Further research is needed to determine the actual incidence and severity of gabapentin-related rash in this population.
Clinical Predictors of Chemotherapy-Induced Nausea and Vomiting in Breast Cancer Patients Receiving Adjuvant Doxorubicin and Cyclophosphamide
Authors: Shih Vivianne , Wan Hee Siew , Chan Alexandre 
Published: February 2009

Background: Patients with breast cancer often receive emetogenic anthracycline–based chemotherapy as part of their treatment. Chemotherapy-induced nausea and vomiting (CINV) has been commonly reported as one of the distressing adverse effects among patients with cancer. Despite the advent of newer antiemetics and better understanding of the CINV pathophysiology, total eradication of CINV has yet to be achieved. Objective: To assess the incidence of nausea and vomiting in patients who have breast cancer and are receiving adjuvant doxorubicin and cyclophosphamide (AC) bolus chemotherapy, ascertain patients’ risk factors affecting CINV response, and study patient adherence to delayed antiemetics. Methods: This was a single-institution, prospective, observational study conducted at an outpatient cancer center in Singapore from December 2006 to December 2007. Clinical events such as CINV were collated using a standardized diary. Use of rescue antiemetics and unscheduled clinic visits due to CINV were documented. Results: Of a total of 108 participants, 16 patients were lost to follow-up and 1 provided incomplete information; thus, 91 patients were included in the analysis. Delayed antiemetics were given according to the institution's guideline and only 9 (9.9%) patients received aprepitant. Neither acute nor delayed vomiting was reported by a majority of patients and only 4 (4.4%) experienced grade 3 vomiting. The incidence of severe nausea was highest on day 3 of chemotherapy and affected 14.3% of patients. Anxiety and history of chemotherapy-induced nausea were associated with both acute and delayed nausea, and history of motion sickness was associated with delayed vomiting. Approximately 65% of patients were adherent to their prescribed delayed antiemetics. Conclusions: Most of our patients adhered to their antiemetics and tolerated AC chemotherapy reasonably well, without vomiting; yet nausea persisted. To improve CINV control, clinicians must actively communicate with patients to facilitate accurate assessment of risk factors and CINV response and to encourage adherence to delayed antiemetics.
Evaluation of the Modified Diet in Renal Disease Equation for Calculation of Carboplatin Dose
Authors: Shord Stacy S , Bressler Linda R , Radhakrishnan Latha , Chen Ningyu , Villano J Lee 
Published: February 2009

Background: Serum creatinine (SCr)-based formulas are used to estimate glomerular filtration rate (GFR) when calculating a dosage for carboplatin using the Calvert equation, but these formulas often underestimate measured GFR. The Modified Diet in Renal Disease (MDRD) equation appears to be a more accurate estimate of GFR in patients with chronic kidney disease, but this equation has not been studied extensively in patients with cancer. Objective: To determine the absolute difference between the dose of carboplatin administered (traditional SCr-based formulas used to estimate GFR) and the dose calculated using the MDRD equation to estimate GFR and compare the frequencies of thrombocytopenia, neutropenia, and dosage modifications between subjects in whom the difference in dose was 20% or more (divergent) or less than 20% (nondivergent). Methods: A retrospective analysis was conducted using data from patients who received carboplatin. Inclusion criteria were receipt of at least 2 doses of carboplatin, either as monotherapy or combination therapy, and documentation of desired area under the concentration-time curve (AUC). Patients were excluded if the baseline values needed to estimate GFR using the MDRD equation were not available. The absolute difference between the dose of carboplatin administered and that calculated using the MDRD equation was determined and, from this comparison, the subjects were divided into 2 groups (divergent vs nondivergent). Results: The medical records of 186 adults who received more than 2 doses of carboplatin were included in the analysis. The doses were divergent in 89 (48%) patients. The mean target AUC values were 5.3 mg/mUmin and 5.1 mg/mL/min in the divergent and nondivergent groups, respectively, and most patients received cytotoxic regimens with a relatively low risk of febrile neutropenia. The frequencies of neutropenia, thrombocytopenia, and dosage modifications were similar between the 2 groups. Use of the MDRD equation to calculate the carboplatin dosage did not appear to result in a change in the frequency of myelosuppression or the need for dose modifications compared with traditional SCr-based formulas. Conclusions: The traditional SCr-based formulas for the calculation of carboplatin dosage should be used to estimate carboplatin dose until more data become available regarding the use of the MDRD equation in this population.
Comparison of 2002–2006 OPTAMA Programs for US Hospitals: Focus on Gram-Negative Resistance
Authors: Crandon Jared L , Kuti Joseph L , Jones Ronald N , Nicolau David P 
Published: February 2009

Background: Resistance among gram-negative bacteria is increasing within the US. Objective: To determine pharmacodynamic target attainment rates for 10 antimicrobials against selected gram-negative bacilli and compare these results with previous Optimizing Pharmacodynamic Target Attainment Using the MYSTIC Antibiogram (OPTAMA) assessments. Methods: A 5000-patient Monte Carlo simulation using data from population pharmacokinetic studies was employed to estimate the pharmacokinetic profiles for standard and/or prolonged infusion (PI) regimens of cefepime, ceftazidime, ceftriaxone, ciprofloxacin, ertapenem, imipenem, levofloxacin, meropenem, piperacillin–tazobactam, and tigecycline. Minimum inhibitory concentration data were obtained from intensive care units of 15 US hospitals participating in the 2006 MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) study for 640 Escherichia coli, 618 Klebsiella spp., and 606 Pseudomonas aeruginosa isolates. Cumulative fraction of response (CFR) was calculated using pharmacodynamic targets for each antibiotic and compared with results from the 2002 and 2004 OPTAMA studies. Results: Against E. coli, CFRs greater than 92% were maintained for all regimens except the fluoroquinolones (CFR range 69.4–72%), which showed a 7% decrease compared with 2004. The presence of Klebsiella spp. producing KPC-type carbapenemases with associated multidrug resistance resulted in a 7% or greater drop in CFR of standard regimens relative to 2004. Despite these resistant phenotypes, high-dose PI regimens (2 g every 8 hours as 3-hour PI) of cefepime and meropenem achieved CFRs of 97% and 95.8%, respectively. Excluding 3 KPC-harboring hospitals resulted in CFR increases to greater than 98% for carbapenems and cefepime and greater than 88% for all other agents tested, except tigecycline. Against P. aeruginosa, the fluoroquinolones had the lowest CFR (55.8–63.9%), followed by imipenem (74.6-80.4%). The most predictable activity was seen with cefepime 2 g every 12 hours or higher (>90%), ceftazidime 2 g every 8 hours (97.9%), and meropenem 1-2 g every 8 hours (86.7–92.6%). Use of PI for piperacillin-tazobactam and meropenem increased CFRs by 6% and 4%, respectively, over standard infusions. Conclusions: Relative to previous years, an increase in resistance was noted among gram-negative bacilli to common antibiotics, resulting in disproportionate decreases in pharmacodynamic target attainment. The use of PI for β-lactams may help to overcome these decreases.
Irinotecan in Cancer Patients with End-Stage Renal Failure
Authors: Czock David , Rasche Franz Maximilian , Boesler Benjamin , Shipkova Maria , Keller Frieder 
Published: February 2009

Objective: To observe and report on the pharmacokinetics of irinotecan in a patient with end-stage renal failure (ESRF) who was undergoing hemodialysis. Case Summary: A 64-year-old man with metastatic colorectal cancer who was on hemodialysis was treated with Irinotecan 50 mg/m2 weekly for 3 weeks, followed by 1 week with no treatment. As the drug was well tolerated, the dosage was increased to 80 mg/m2 after 2 cycles. Diagnostic testing of a hepatic lesion after 2 and 6 treatment cycles showed stable disease. The carcinoembryonic antigen value decreased to 40% of its pretreatment level. Pharmacokinetically, our patient had a lower apparent clearance and a higher maximum concentration of the active metabolite SN-38 (130 L/h/m2, maximum concentration 0.4 μg/L per mg of irinotecan) compared with published values from patients with normal renal function. Removal of irinotecan and its metabolites by hemodialysis was negligible. Discussion: The reason for the unexpectedly low clearance of SN-38 in our patient remains unclear. We speculate that inhibition of the OATP1B1 transporter by uremic toxins could be an explanation. Such a mechanism would explain excessive irinotecan toxicity, as reported in previous case reports of patients undergoing hemodialysis. Conclusions: We conclude that approximately two-thirds of the standard weekly irinotecan dosage regimen should be considered in patients with ESRF.
Checklist of benthic marine algae and cyanobacteria of northern Portugal
Authors: Araújo Rita , Bárbara Ignacio , Tibaldo Marta , Berecibar Estibaliz , Tapia Pilar Díaz , Pereira Rui , Santos Rui , Pinto Isabel Sousa 
Published: February 2009

Abstract
The northern Portuguese coast is a biogeographic transition zone where many macroalgal species have their distribution limits; it is thus a particularly interesting region for investigating species distribution shifts. An updated and complete list of species for this region is not available in spite of its baseline importance for comparative studies with past and present data. Based on new records, literature references, and herbarium data, we provide an updated checklist of the benthic marine algae of the northern Portuguese coast. This checklist includes 346 species: 26 Cyanobacteria, 200 Rhodophyta, 70 Ochrophyta, and 50 Chlorophyta. From these, 21 species are new records for the Portuguese coast (Lyngbya aestuarii, Lyngbya semiplena, Microcoleus acutirostris, Myxosarcina gloeocapsoides, Aiolocolax pulchella, Antithamnion densum, Antithamnion villosum, Antithamnionella spirographidis, Dasya sessilis, Furcellaria lumbricalis, Neosiphonia harveyi, Porphyrostromium boryanum, Chorda filum, Dictyopteris ambigua, Sphacelaria rigidula, Undaria pinnatifida, Vaucheria coronata, Vaucheria velutina, Ulothrix implexa, Ulva scandinavica, and Umbraulva olivascens) and 33 were recorded for the first time in the north of Portugal. Alien species have increased in number and extended their distribution range over the last 10 years in the study area. Distribution shifts of northern cold water species with southern distribution limit in the north of Portugal were not consistent among species.
Haptophytes of the Nervión River estuary, northern Spain
Authors: Seoane Sergio , Eikrem Wenche , Arluzea Jon , Orive Emma 
Published: February 2009

Abstract
The meso-macrotidal Nervión River estuary in northern Spain was sampled monthly from March to September 2002 and 2003 to study species composition and abundance of haptophytes in the phytoplankton. From natural samples and uni-algal cultures, 17 haptophyte species were identified using light and electron microscopy. The species were found across a wide range of temperatures and salinities. The most frequently occurring haptophytes in the estuary were species of the genus Chrysochromulina; however, Isochrysis galbana reached highest abundances. Chrysochromulina lanceolata and Phaeocystis globosa were occasionally present at high abundances. Another bloom-forming species, Prymnesium parvum, was recorded only once. Of the genera identified, eight species belonged to Chrysochromulina, two to Prymnesium and the rest of the genera were represented by one species only. The majority of the species were recorded for the first time in the Cantabrian Sea and one of them for the first time in the Atlantic Ocean.
Sinophysis verruculosasp. nov. (Dinophysiales, Dinophyceae), a new sand-dwelling dinoflagellate from South Brittany, northwestern France
Authors: Chomérat Nicolas , Loir Maurice , Nézan Elisabeth 
Published: February 2009

AbstractA new species of a marine sand-dwelling dinoflagellate in the genusSinophysisis described from South Brittany, France using both light and scanning electron microscopy. Cells ofSinophysis verruculosasp. nov. are oval to subcircular, slightly bulging dorsally and flattened laterally, with no chloroplasts, ranging from 52.2 to 57.8 μm in length, and 43.2 to 51.0 μm in width. The epitheca is small and tilted back to the dorsal part of the cell. At least three major plates and smaller platelets form the epitheca, but the exact number cannot be ascertained due to their reduced size and the presence of a projection hiding the sutures. Four cingular and four hypothecal plates, two large lateral and two small ventral plates are present. The sulcus is bordered by lists supported by hypothecal plates and extends less than two-thirds of the total length of the hypotheca. The most distinctive feature ofS. verruculosais the minute verrucose ornamentation covering the thecal surface, which contrasts with the smooth and areolate ornamentation of temperate and tropical species, respectively.
High concentrations of haptocorrin interfere with routine measurement of cobalamins in human serum and milk. A problem and its solution
Authors: Lildballe Dorte L. , Hardlei Tore F. , Allen Lindsay H. , Nexo Ebba 
Published: February 2009

Abstract: Human milk and occasional serum samples contain high concentrations of unsaturated haptocorrin, which influence accurate measurement of cobalamins.: Cobalamins in serum samples spiked with increasing amounts of unsaturated haptocorrin were measured employing the Centaur, Cobas and Architect analysers. Cobinamide-coated EAH sepharose was employed for pretreatment of the samples. Human milk samples were collected from 24 healthy mothers. Haptocorrin was measured by ELISA.: The measured concentration of cobalamins either increased (Centaur analyser) or decreased (Architect, Cobas analysers) significantly for haptocorrin >10 nM, and was 220%, 52% or 45% of the expected values in a serum sample containing 50 nM haptocorrin. Following pretreatment with cobinamide-sepharose, the expected cobalamin concentration was obtained (Centaur). The milk samples contained 4.5–180 nM haptocorrin. In samples containing >10 nM haptocorrin (n=19), the median concentration of cobalamins decreased from 1.3 nM to 0.67 nM after pretreatment with cobinamide-sepharose.: Haptocorrin in concentrations above 10 nM influences measurement of cobalamins giving rise to falsely elevated or decreased results. Removal of unsaturated haptocorrin by pretreatment with cobinamide-sepharose solves the problem.Clin Chem Lab Med 2009;47:182–7.