bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tegaserod Use in Children: A Single‐center Experience
Authors: Liem Olivia , Mousa Hayat M , Benninga Marc A , Di Lorenzo Carlo 
Published: March 2009

ABSTRACTBackground:Tegaserod is increasingly prescribed by pediatric gastroenterologists even though there are few published data concerning its use in children. The aim of this study was to describe the authors' experience with tegaserod in children.Patients and Methods: Patients treated with tegaserod from 2004 through 2006 were included in this study. Defecation and fecal incontinence frequency and global assessment of relief of symptoms were assessed.Results:Seventy‐two patients (44 girls) ranging in age from 1.1 to 18.3 years constitute the patient sample of this report. The median age was 10 years and the median follow‐up after initiation of tegaserod treatment was 11.3 months (range 2.3–45.2 months). Indications to prescribe tegaserod were constipation (58%) and a variety of other conditions including functional dyspepsia or inflammatory bowel disease (42%). Defecation frequency increased after tegaserod use (1 vs 7/week, P < 0.001) and presence of fecal incontinence decreased (47% vs 23%, P < 0.001) in the constipation group. Parents rated relief of constipation as moderate or significant in 71% of cases in the constipation group. In the group with other indications to start tegaserod therapy, moderate or significant relief of abdominal pain and bloating was noted in 64% and 68% of patients, respectively. The median dose of tegaserod prescribed was 0.22 mg · kg−1 · day−1 (range 0.05–0.87 mg · kg−1 · day−1). Adverse events were observed in 32% of the patients. The most common side effects were self‐limiting diarrhea (20%) and abdominal pain (8%). Only one patient discontinued tegaserod because of side effects; this patient experienced pain at his cecostomy site.Conclusions:Tegaserod seems to relieve a variety of functional gastrointestinal symptoms in children. Further randomized controlled studies are needed to support the specific pediatric target of prescribing tegaserod.
Simvastatin Restores Ischemic Preconditioning in the Presence of Hyperglycemia through a Nitric Oxide–mediated Mechanism
Authors: Gu Weidong , Kehl Franz , Krolikowski John G. , Pagel Paul S. , Warltier David C. , Kersten Judy R. 
Published: March 2009

Background
A growing body of evidence indicates that statins decrease perioperative cardiovascular risk and that these drugs may be particularly efficacious in diabetes. Diabetes and hyperglycemia abolish the cardioprotective effects of ischemic preconditioning (IPC). The authors tested the hypothesis that simvastatin restores the beneficial effects of IPC during hyperglycemia through a nitric oxide-mediated mechanism.

Methods
Myocardial infarct size was measured in dogs (n = 76) subjected to coronary artery occlusion and reperfusion in the presence or absence of hyperglycemia (300 mg/dl) with or without IPC in separate groups. Additional dogs received simvastatin (20 mg orally daily for 3 days) in the presence or absence of IPC and hyperglycemia. Other dogs were pretreated with N-nitro-l-arginine methyl ester (30 mg intracoronary) with or without IPC, hyperglycemia, and simvastatin.

Results
Ischemic preconditioning significantly (P < 0.05) reduced infarct size (n = 7, 7 +/- 2%) as compared with control (n = 7, 29 +/- 3%). Hyperglycemia (n = 7), simvastatin (n = 7), N-nitro-l-arginine methyl ester alone (n = 7), and simvastatin with hyperglycemia (n = 6) did not alter infarct size. Hyperglycemia (n = 7, 24 +/- 2%), but not N-nitro-l-arginine methyl ester (n = 5, 10 +/- 1%), blocked the protective effects of IPC. Simvastatin restored the protective effects of IPC in the presence of hyperglycemia (n = 7, 14 +/- 1%), and this beneficial action was blocked by N-nitro-l-arginine methyl ester (n = 7, 29 +/- 4%).

Conclusions
The results indicate that simvastatin restored the cardioprotective effects of IPC during hyperglycemia by nitric oxide-mediated signaling. The results also suggest that enhanced cardioprotective signaling could be a mechanism for statin-induced decreases in perioperative cardiovascular risk.
Postoperative Bleeding in Cardiac Surgery
Authors: Iribarren Jose L. , Jimenez Juan J. , Hernández Domingo , Brouard Maitane , Riverol Debora , Lorente Leonardo , de La Llana Ramiro , Nassar Ibrahim , Perez Rosalia , Martinez Rafael , Mora Maria L. 
Published: March 2009

Background
Plasminogen activator inhibitor 1 (PAI-1) attenuates the conversion of plasminogen to plasmin. Polymorphisms of the PAI-1 gene are associated with varying PAI-1 levels and risk of prothrombotic events in nonsurgical patients. The purpose of this study, a secondary analysis of a clinical trial, was to investigate whether PAI-1 genotype affects the efficacy of tranexamic acid (TA) in reducing postoperative chest tube blood loss of patients undergoing cardiopulmonary bypass.

Methods
Fifty patients were classified according to PAI-1 genotype (4G/4G, 4G/5G, or 5G/5G). Twenty-four received 2 g TA before and after cardiopulmonary bypass, whereas 26 received placebo. The authors recorded data related to coagulation, fibrinolysis, and bleeding before surgery, at admission to the intensive care unit (0 h), and 4 and 24 h later.

Results
In patients not receiving TA, those with the 5G/5G genotype had significantly higher chest tube blood loss and transfusion requirements compared with patients with the other genotypes at all time points. Patients with the 5G/5G genotype receiving TA showed significantly lower blood loss compared with the placebo group. There were no significant differences in blood loss or transfusion requirements between patients with the 4G/4G genotype when TA was used.

Conclusions
Plasminogen activator inhibitor-1 5G/5G homozygotes who did not receive TA showed significantly greater postoperative bleeding than patients with other PAI-1 genotypes. 5G/5G homozygotes who received TA showed the greatest blood-sparing benefit.
Age-related Attenuation of Isoflurane Preconditioning in Human Atrial Cardiomyocytes
Authors: Mio Yasushi , Bienengraeber Martin W. , Marinovic Jasna , Gutterman David D. , Rakic Mladen , Bosnjak Zeljko J. , Stadnicka Anna 
Published: March 2009

Background
Clinical trials suggest that anesthetic-induced preconditioning (APC) produces cardioprotection in humans, but the mechanisms of APC and significance of aging for APC in humans are not well understood. Here, the impact of age on the role of two major effectors of APC, mitochondria and sarcolemmal adenosine triphosphate-sensitive potassium (sarcKATP) channels, in preconditioning of the human atrial myocardium were investigated.

Methods
Right atrial appendages were obtained from adult patients undergoing cardiac surgery and assigned to mid-aged (MA) and old-aged (OA) groups. APC was induced by isoflurane in isolated myocardium and isolated cardiomyocytes. Mitochondrial oxygen consumption measurements, myocyte survival testing, and patch clamp techniques were used to investigate mitochondrial respiratory function and sarcKATP channel activity.

Results
After in vitro APC with isoflurane, the respiratory function of isolated mitochondria was better preserved after hypoxia-reoxygenation stress in MA than in OA. In isolated intact myocytes, APC significantly decreased oxidative stress-induced cell death in MA but not in OA, and isoflurane protection from cell death was attenuated by the sarcKATP channel inhibitor HMR-1098. Further, the properties of single sarcKATP channels were similar in MA and OA, and isoflurane sensitivity of pinacidil-activated whole cell KATP current was no different between MA and OA myocytes.

Conclusion
Anesthetic-induced preconditioning with isoflurane decreases stress-induced cell death and preserves mitochondrial respiratory function to a greater degree in MA than in OA myocytes; however, sarcKATP channel activity is not differentially affected by isoflurane. Therefore, effectiveness of APC in humans may decrease with advancing age partly because of altered mitochondrial function of myocardial cells.
Neuromuscular Involvement in Nephrogenic Systemic Fibrosis
Authors: Keyrouz Salah , Rudnicki Stacy A 
Published: March 2009

ABSTRACT

Introduction:
Nephrogenic fibrosing dermopathy causes fibrotic skin changes in the setting of renal failure. Although this condition was initially felt to be limited to the skin, recent studies have described widespread involvement, and the term nephrogenic systemic fibrosis (NSF) has been suggested.

Objective:
To describe the clinical, electrophysiologic, and pathologic findings in three NSF patients with neuromuscular involvement.

Methods:
Case report.

Results:
Three patients developed progressive hardening of the skin and underlying fascia and muscles. Strength was difficult to assess because of limited joint mobility. electromyography/nerve conduction studies suggested involvement of both nerve and muscle. Muscle biopsy demonstrated primarily myopathic changes with variable fibrosis.

Conclusion:
Neuromuscular involvement occurs in NSF and may be difficult to appreciate clinically because of joint and skin fibrosis.
Neuromuscular Features in the Camera-Marugo-Cohen Syndrome
Authors: Ohkoshi Norio , Matsuno-Yoshida Sayoko , Watanabe Masahiko , Tamaoka Akira 
Published: March 2009

ABSTRACT

We describe the case of a 24-year-old Japanese man suffering from obesity, mental retardation, muscle weakness, camptodactyly, syndactyly, and a urinary tract cleft. His muscle weakness, which was slightly distally dominant in the extremities, was almost static and showed slow progression for several years. He had normal blood chromosomes (46, XY) and showed normal levels of sex hormones. A needle electromyographic examination of the upper- and lower-limb muscles revealed a reinnervation pattern with large-amplitude, long-duration motor unit potentials. A muscle biopsy also showed denervation and reinnervation patterns, with small-group atrophy and type grouping, with numerous small, angulated fibers. Our findings suggest that these neuromuscular features of the Camera-Marugo-Cohen syndrome are caused by neurogenic changes rather than myogenic changes.
A Comparison of the Effectiveness of Intravenous Immunoglobulin and Plasma Exchange as Preoperative Therapy of Myasthenia Gravis
Authors: Jensen Paul , Bril Vera 
Published: March 2009

ABSTRACT

Objectives:
Immunomodulation with plasma exchange is effective in preparing patients for thymectomy. Newer forms of immunomodulation, such as intravenous immunomodulation, require evaluation in this clinical setting.

Methods:
We conducted a retrospective chart review to determine if plasma exchange and intravenous immunoglobulin had comparable effectiveness in the preoperative preparation of patients with myasthenia gravis.

Results and Conclusions:
The results show that intravenous immunoglobulin may have comparable efficacy in the preoperative preparation of patients with myasthenia gravis and that this therapy is a reasonable alternative to plasma exchange in this clinical setting.
Correction of Progressive Hearing Loss in Superior Canal Dehiscence Syndrome
Authors: Wilkinson Eric P. , Liu Gene C. , Friedman Rick A. 
Published: March 2009

AbstractA 44‐year‐old woman presented with typical vestibular symptoms of superior semicircular canal dehiscence syndrome (SSCDS). In addition, the patient experienced a rapidly progressive mixed hearing loss in the affected ear prior to surgical intervention that was unresponsive to oral steroid administration. Following middle fossa craniotomy with repair of the dehiscence, the patient's mixed hearing loss resolved to normal levels with no air‐bone gap. In this report, we discuss the possible etiology of this rapidly progressive hearing loss and its implications on the differential diagnosis of patients with new onset mixed hearing losses. We also contrast the index case of progressive mixed loss with the more frequent conductive hearing loss seen in SSCDS.
Fatigue Improvement Following Endoscopic Sinus Surgery: A Systematic Review and Meta‐Analysis
Authors: Chester Alexander C. , Sindwani Raj , Smith Timothy L. , Bhattacharyya Neil 
Published: March 2009

AbstractBackground: Fatigue is a common symptom of chronic rhinosinusitis (CRS), yet the response of fatigue to endoscopic sinus surgery (ESS) has not been systematically evaluated.Methods: Studies published in any language were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional Web‐based sources (from 1980–2007); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Studies consisting of more than 10 adult patients analyzing the response of fatigue, vitality, energy, or malaise following ESS were included. Two authors independently evaluated studies for inclusion, rated the methods, and summarized relevant data using a standardized protocol.Results: Using within‐subject comparisons, 28 identified observational studies noted substantial improvement in fatigue after ESS. A subgroup analysis of 11 studies measuring outcomes using the 36‐Item Short Form Health Survey (SF‐36) demonstrated a moderate‐sized combined effect of 0.47 (95% confidence interval, 0.38–0.56; I2 = 0%), corresponding to a mean ± standard deviation improvement of 9.7 ± 3.4 units on the SF‐36 vitality domain scores. In studies measuring outcomes using symptom rating scores, the preoperative severity scores and improvement after surgery for fatigue were similar to the respective values for other pooled CRS symptoms.Conclusions: All 28 studies described substantial improvement in fatigue following ESS based on presurgery and postsurgery comparisons. A subgroup analysis of 11 studies reporting results by the SF‐36 vitality domain scores demonstrated a moderate‐sized combined effect. Preoperative fatigue severity scores and improvement noted after surgery were similar to the respective values for other pooled CRS symptoms.
New Horizons in the Pathogenesis of Gastrointestinal Neuromuscular Disease
Authors: Knowles Charles H 
Published: March 2009

ABSTRACTThe term “gastrointestinal neuromuscular disease” can be interpreted variably and encompasses a spectrum of paediatric and adult conditions including achalasia, pseudoobstruction, idiopathic constipation, irritable bowel syndrome, megacolon, and Hirschsprung disease. Although progress has been made in the understanding of the pathophysiology of some conditions, the aetiopathogenesis has been elucidated only in the rare minority. This review critically considers the available evidence for possible pathogenic mechanisms in these disorders.
Disorders of Interstitial Cells of Cajal
Authors: Burns Alan J 
Published: March 2009

ABSTRACTInterstitial cells of Cajal (ICCs) have, in the past 2 decades, been recognised as important elements in the regulation of gastrointestinal motility. Specifically, they have been shown to be critical for the generation and propagation of electrical slow waves that regulate the phasic contractile activity of gastrointestinal smooth muscle, and for mediating neurotransmission from enteric motor neurons to smooth muscle cells. These different functional roles are carried out by different phenotypic classes of ICC that have discrete distributions within the tunica muscularis. Identifying the functional roles of ICC within the gut has been facilitated by studying mutant mice deficient in ICC, either as a consequence of loss of the tyrosine kinase receptor, Kit, or its ligand, stem cell factor, both of which are necessary for normal ICC development. In humans, under certain pathophysiological conditions, loss or defects in ICC networks appear to play a role in the generation of certain motility disorders. Alterations in ICC distribution have been reported in conditions such as achalasia, chronic intestinal pseudoobstruction, Hirschsprung disease, inflammatory bowel diseases, and slow transit constipation. Molecular and genetic techniques are helping researchers to determine whether defects in ICC networks are the cause of motility disorders, or whether the disrupted ICC networks are a consequence of gut dysfunction.
Treatment and Outcome of Intestinal Failure Secondary to Enteric Neuromuscular Disease
Authors: Hill Susan 
Published: March 2009

ABSTRACTThe clinical management of intestinal pseudoobstructive syndromes has, in the broadest of terms, 2 management strategies: optimisation of underlying gastrointestinal motor and absorptive function and, when this is inadequate, adequate nutritional support using enteral and intravenous nutrition to restore and maintain a good nutritional state and growth. With such support, a 10‐year survival rate of >80% can be achieved in the most severely affected individuals without recourse to intestinal transplantation.
Key Role of Aldosterone and Pericryptal Myofibroblast Growth in Colonic Permeability
Authors: Cristià Esther , Moretó Miquel , Naftalin Richard J 
Published: March 2009

ABSTRACTWhen sodium intake diminishes, both the kidney and distal colon contribute directly to sodium homeostasis. In response to a diet with low amounts of sodium, the body hormonal profile changes to produce different effects on crypt‐colon permeability and absorption and in the pericryptal sheath surrounding distal colonic crypts. This adaptation produces an increase in Na+ absorption, a decreased crypt‐wall permeability, and an activation of the growth of pericryptal myofibroblasts. The separate roles of the 2 main hormones implicated in the process, aldosterone and angiotensin II, until now have been unclear. Experiments conducted on adrenalectomized rats on low‐ and high‐sodium diets, implanted with osmotic pumps perfusing either aldosterone or angiotensin II, allow us to discriminate between the effects of these hormones. In the distal colon, aldosterone acts as a trophic agent on the myofibroblasts layer and is the key hormone controlling colonic permeability, but angiotensin II alone has no discernable direct role in the process.
Medium‐term Outcome of Endoluminal Gastroplication With the EndoCinch Device in Children
Authors: Thomson Mike , Antao Brice , Hall Sharon , Afzal Nadeem , Hurlstone Paul , Swain C Paul , Fritscher‐Ravens Annette 
Published: March 2009

ABSTRACTObjective:Endoluminal gastroplication (EG) is emerging as a minimally invasive procedure for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to evaluate the medium‐term outcomes after EG in a pediatric patient population.Patients and Methods:Seventeen children with a median age of 12.4 years (range 6.1–15.9 years) with GERD underwent EG using a flexible endoscopic sewing device (EndoCinch) over a period of 3 years. Three plications were placed in the gastric tissue below the lower esophageal sphincter. Drug dose requirement, pH measurements, symptom severity and frequency, and validated Quality of Life in Reflux and Dyspepsia (QOLRAD) scores were compared before EG and 1 and 3 years after EG. Statistical analysis was performed using a Wilcoxon rank‐sum test and P < 0.05 was the threshold for significance.Results:All patients showed an immediate posttreatment improvement in symptom severity, symptom frequency, and quality of life scores. Completed 1‐ and 3‐year data were obtained from 16 patients. Four cases (25%) required a repeat procedure as a result of recurrence of symptoms after 2 to 24 months. Fourteen patients (88%) at 1 year and 9 patients (56%) at 3 years remained without a need for any antireflux medication. A sustained improvement in heartburn (P = 0.004), regurgitation (P = 0.017), and vomiting (P = 0.018) was seen at 3 years. The total QOLRAD score (maximum of 175) improved from a median of 87 (range 69–142) to 156 (range 111–175) at 1 year (P < 0.0001) and 153.5 (range 55–174) at 3 years (P = 0.002).Conclusions:EG is an effective and safe procedure in children. It is a viable option for the treatment of GERD refractory to or dependent on antireflux medications.
Enteral Erythropoietin and Iron Stimulate Erythropoiesis in Suckling Rats
Authors: Kling Pamela J , Willeitner Andrea , Dvorak Bohuslav , Blohowiak Sharon E 
Published: March 2009

ABSTRACTObjectives:A primary objective was to evaluate whether addition of enteral iron supplementation will facilitate a systemic erythropoietic effect when feeding erythropoietin (Epo) to suckling rats. A secondary objective was to confirm that iron does not alter the previous finding that enteral Epo exerts local trophic effects on the small intestine.Methods:Four‐day‐old Sprague‐Dawley rats underwent gastrostomy and were fed a cow's milk–based rat milk substitute for 8 days. We studied rats fed rat milk substitute alone (control), enteral Epo 425 U · kg−1· day−1, and enteral Epo 1700 U · kg−1· day−1, and the effects of oral iron sulfate (Fe) therapy (6 mg · kg−1· day−1). Blood was collected to measure hemoglobin (Hb), reticulocytes, red cell indices, and zinc protoporphyrin/heme. To confirm previous work describing trophic effects of enteral Epo on the intestine, duodenal villous height was measured.Results:Hb levels in control (84 ± 1 g/L) were similar to Epo 425 (87 ± 1 g/L). Hb levels in control+Fe (97 ± 1 g/L), Epo 425+Fe (97 ± 1 g/L), and Epo 1700 (94 ± 1 g/L) were higher than control,P< 0.001, but mean Hb level in Epo 1700+Fe was higher (105 ± 1 g/L) than the other groups,P< 0.003. Mean cell volume was higher in rats receiving iron supplementation, compared with those without iron,P< 0.005. Duodenal villous height was taller in Epo 1700+Fe compared with control + Fe,P< 0.01.Conclusions:If combined with sufficient iron supplementation, high‐dose Epo artificially fed to suckling rats exerted a systemic erythropoietic effect in addition to the previously reported local trophic effects.
Neonatal Sublingual Vaccination with Salmonella Proteins and Adjuvant Cholera Toxin or CpG Oligodeoxynucleotides Induces Mucosal and Systemic Immunity in Mice
Authors: Huang Ching‐Feng , Wang Chih‐Chien , Wu Tzee‐Chung , Wu Keh‐Gong , Lee Chin‐Cheng , Peng Ho‐Jen 
Published: March 2009

ABSTRACTObjectives:Salmonella enteritidis is one of the most common enteric pathogens that cause acute gastroenteritis. A vaccine that can induce systemic and mucosal immune responses by a simple, noninvasive pathway and provide protection against this mucosal pathogen is needed.Materials and Methods:Newborn BALB/c mice were sublingually vaccinated daily for the first 3 days with sonicated Salmonella proteins (SSP) only, or SSP combined with adjuvant CpG or cholera toxin (CT). A booster vaccination was given 7 weeks after the last treatment. Serum and saliva antibody responses, cytokine profiles of spleen cells, survival rate, and intestinal morphology after live S enteritidis challenge were investigated.Results:Saliva‐specific secretory IgA (SIgA) antibody responses were markedly enhanced by neonatal sublingual vaccination with SSP together with adjuvant CpG or CT. Whereas vaccination with SSP and CpG enhanced spleen cell interferon‐γ production and serum‐specific IgG2a antibody responses, vaccination with SSP and CT increased spleen cell interleukin (IL)‐4, IL‐5, IL‐6, and interferon‐γ production and serum‐specific IgG1 and IgG2a antibody responses. Vaccination with SSP and CpG or CT protected against intestinal necrosis and was associated with a higher survival rate after oral challenge with live S enteritidis. The vaccinated mice with higher specific IgG and saliva‐specific secretory IgA antibody levels had a better survival rate.Conclusions:Neonatal sublingual vaccination with adjuvant CpG or CT can induce both mucosal and systemic immunity and may play a crucial role in protection against enteric pathogens.