bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fusarium
Infections in Immunocompromised Patients
Authors: Nucci Marcio , Anaissie Elias 
Published: October 2007

SUMMARY

Fusarium
species cause a broad spectrum of infections in humans, including superficial, locally invasive, and disseminated infections. The clinical form of fusariosis depends largely on the immune status of the host and the portal of entry, with superficial and localized disease occurring mostly in immunocompetent patients and invasive and disseminated disease affecting immunocompromised patients. Risk factors for severe fusariosis include prolonged neutropenia and T-cell immunodeficiency, especially in hematopoietic stem cell transplant recipients with severe graft-versus-host disease. The most frequent presentation of disseminated fusariosis is a combination of characteristic cutaneous lesions and positive blood cultures, with or without lung or sinus involvement. The prognosis is poor and is determined largely by degree of immunosuppression and extent of infection, with virtually a 100% death rate among persistently neutropenic patients with disseminated disease. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy. Treatment options include the lipid formulations of amphotericin B, voriconazole, and posaconazole. Prevention of fusarial infection among high-risk patients should be considered.
Clinical Significance of Human Immunodeficiency Virus Type 1 Replication Fitness
Authors: Dykes Carrie , Demeter Lisa M. 
Published: October 2007

SUMMARYThe relative fitness of a variant, according to population genetics theory, is that variant's relative contribution to successive generations. Most drug-resistant human immunodeficiency virus type 1 (HIV-1) variants have reduced replication fitness, but at least some of these deficits can be compensated for by the accumulation of second-site mutations. HIV-1 replication fitness also appears to influence the likelihood of a drug-resistant mutant emerging during treatment failure and is postulated to influence clinical outcomes. A variety of assays are available to measure HIV-1 replication fitness in cell culture; however, there is no agreement regarding which assays best correlate with clinical outcomes. A major limitation is that there is no high-throughput assay that incorporates an internal reference strain as a control and utilizes intact virus isolates. Some retrospective studies have demonstrated statistically significant correlations between HIV-1 replication fitness and clinical outcomes in some patient populations. However, different studies disagree as to which clinical outcomes are most closely associated with fitness. This may be in part due to assay design, sample size limitations, and differences in patient populations. In addition, the strength of the correlations between fitness and clinical outcomes is modest, suggesting that, at present, it would be difficult to utilize these assays for clinical management.
Artificial playing surface increases the injury risk in pivoting indoor sports: a prospective one-season follow-up study in Finnish female floorball
Authors: Pasanen K , Parkkari J , Rossi L , Kannus P 
Published: October 2007

Objectives:To compare the injury risk in pivoting indoor sports between two different surfaces: artificial floors and wooden floors.Methods:Female players (n = 331) from 26 top-level Finnish floorball teams were followed for one competitive season (6 months). All traumatic game related time-loss injuries were recorded. Injury incidences were calculated as the number of injuries per 1000 game hours for both surfaces. Incidence rate ratios (IRRs) were obtained from Poisson regression models.Results:Over the competitive season, 62 traumatic injuries occurred during the games. The injury incidence per 1000 playing hours was 59.9 (95% CI 43.2 to 83.0) on artificial floors and 26.8 (95% CI 18.2 to 39.3) on wooden floors, the adjusted IRR being twofold higher (IRR = 2.1; 95% CI 1.2 to 3.5, p = 0.005) on artificial floors than wooden floors. The risk for non-contact injuries (adjusted IRR = 12.5; 95% CI 2.9 to 54.9, p = 0.001) and severe injuries (adjusted IRR = 3.3; 95% CI 0.9 to 10.9, p = 0.052) was especially high when playing on artificial floors.Conclusions:The study attested that the risk of traumatic injury in pivoting indoor sports is higher when playing on artificial floors than wooden floors. The higher shoe–surface friction on the former surface is likely to explain the higher injury risk.
Cardiopulmonary exercise testing and its application
Authors: Albouaini Khaled , Egred Mohaned , Alahmar Albert , Wright David Justin 
Published: October 2007

Abstract
Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure.
Suicide-associated comorbidity among US males and females: a multiple cause-of-death analysis
Authors: Rockett Ian R H , Wang Shuhui , Lian Yinjuan , Stack Steven 
Published: October 2007

Objective:To describe physical and mental comorbidity among male and female suicides in the US. This research replicates a seminal Australian study, which permits inference on comparative cause-of-death data quality.Design and setting:National cross-sectional study of suicides and unintentional injury decedents (comparison group) using Multiple Cause of Death (MCOD) public use files for 1999–2003.Main outcome measures:Prevalence of medical conditions; relative odds of suicide-associated comorbidity.Results:For 14% of male suicides and 19% of female suicides, comorbidity was shown on their death certificates. Respective prevalences for mental and physical comorbidity were 7.2% and 7.1% for males and 10.0% and 9.3% for females. Mean numbers of psychopathologies mentioned were virtually identical for male and female suicides (1.22 and 1.21) for whom comorbidity was registered. Mean mentions of physical disease were lower for male suicides: 1.64 vs 1.77. Multiple medical conditions were registered for 4% of male suicides and 6% of female suicides. Suicides manifested excess comorbidity for depression and mood disorders (adjusted odds ratio (AOR) = 34.6, 95% CI = 32.41 to 36.92), schizophrenia (AOR = 2.5, 95% CI = 2.16 to 2.88), and cancer (AOR = 2.1, 95% CI = 1.93 to 2.19), but unexpectedly no excess comorbidity for HIV.Conclusions:The US system of death certification appears to be less fastidious than the Australian system. Although comorbidity patterns were very similar, only half as much psychopathology was reported for US suicides as for Australian suicides. A questionable deficit of comorbid physical disease was also documented for US suicides. Findings have important implications for medical training, as well as for suicide surveillance, policy, and prevention.
Intracluster correlation coefficient in multicenter childhood trauma studies
Authors: Roudsari Bahman , Fowler Raymond , Nathens Avery 
Published: October 2007

Objective:To calculate the intracluster correlation coefficient (ICC) for emergency department (ED) shock rate, early trauma death (ie, death during the first 24 h after arrival at hospital), and in-hospital trauma death rate for multicenter childhood injuries.Methods:The National Trauma Data Bank (5th revision), the largest multicenter trauma registry in the US, was used. Data from 80 trauma centers were used to calculate the ICC for in-hospital trauma death rate. Thirty three states provided data for calculation of the ICC for ED shock and early trauma death rate.Results:From 2000 to 2004, 13% of the 952 242 patients in the National Trauma Data Bank were <15 years old. Approximately 17 000 of these children had injuries with an injury severity score >15, of whom 84% (14 095 subjects) were hospitalized at 80 level I or II trauma centers in 33 states. The ICCs for ED shock rate, early trauma death rate, and in-hospital death rate were 0.005 (95% CI 0.000 to 0.010), 0.014 (95% CI 0.004 to 0.024), and 0.023 (95% CI 0.013 to 0.033), respectively. These ICCs were calculated for boys and girls and also for blunt and penetrating injuries.Conclusion:Clustered childhood trauma studies that aim to compare different aspects of pre-hospital and hospital trauma care should incorporate these ICCs for sample calculation. When cluster randomized clinical trials are mounted, if sample sizes are calculated without adjustment for ICC, then the planned trial is likely to be seriously underpowered.
Prevention of motor-vehicle deaths by changing vehicle factors
Authors: Robertson Leon S 
Published: October 2007

Objective:To estimate the effect of changing vehicle factors to reduce mortality in a comprehensive study.Design/methods:Odds of death in the United States during 2000–2005 were analyzed, involving specific makes and models of 1999–2005 model year cars, minivans, and sport utility vehicles using logistic regression after selection of factors to be included by examination of least-squares correlations of vehicle factors to maximize independence of predictors. Based on the regression coefficients, percentages of deaths preventable by changes in selected factors were calculated. Correlations of vehicle characteristics to environmental and behavioral risk factors were also examined to assess any potential confounding.Results:Deaths in the studied vehicles would have been 42% lower had all had electronic stability control (ESC) systems. Improved crashworthiness as measured by offset frontal and side crash tests would have produced an additional 28% reduction, and static stability improvement would have reduced the deaths 11%. Although weight–power that reduces fuel economy is associated with lower risk to drivers, it increases risk of deaths to pedestrians and bicyclists but has an overall minor effect compared to the other factors.Conclusion:A large majority of motor-vehicle-related fatalities could be avoided by universal adoption of the most effective technologies.
Child drowning deaths in Xiamen city and suburbs, People’s Republic of China, 2001–5
Authors: Fang Ya , Dai Long , Jaung Michael S , Chen Xiaoxuan , Yu Songlin , Xiang Huiyun 
Published: October 2007

Background:Risk-factor research and prevention programs targeting drowning deaths in children have been well developed in industrialized countries, but little research has been undertaken in developing countries where the majority of drowning deaths occur. We conducted an epidemiological study to describe the sociodemographic characteristics, drowning circumstances, and medical service in drowning deaths of children in Xiamen city and suburbs, People’s Republic of China.Material and methods:Drowning deaths in 1–14-year-old children between 2001 and 2005 were identified using death certificates. Parents of each case were interviewed face to face about the sociodemographics of the family and child, the drowning event, and medical care received. Mortalities were calculated using census data for urban and rural areas, and Poisson regression was used to evaluate confounding effects and interactions of several major risk factors for drowning death.Results:Of 67 drowning deaths identified, 52 (77.6%) were males. A higher proportion of deaths were in children aged 5–9 years (40.3%) and 10–14 years (40.3%). The drowning mortality per 100 000 population was 5.84 in rural areas and 0.75 in urban areas. Drowning events occurred most commonly during the summer months (56.7% from June to August), during the hours of 13:00–17:59 (62.7%), and in natural or man-made bodies of water (eg, ponds, ditches, construction sites, and wells). None of the children were proficient swimmers, the majority of drowning events (88.1%) occurred in the absence of adult supervision, and 86.6% children died at the scene without any medical care. Results from muiltivariable Poisson regression analysis indicated that 10–14-year-old boys were at the highest risk of drowning deaths in this area.Discussion and conclusions:Drowning deaths in children in Xiamen city and suburbs follow trends that are markedly different from patterns observed in other countries. Different prevention strategies may be required for preventing child drowning deaths in Xiamen and other developing regions.
Hypoxia-inducible factor-1α expression correlates with focal macrophage infiltration, angiogenesis and unfavourable prognosis in urothelial carcinoma
Authors: Chai C-Y , Chen W-T , Hung W-C , Kang W-Y , Huang Y-C , Su Y-C , Yang C-H 
Published: October 2007

Background:Hypoxia inducible factor (HIF)-1α is a critical regulatory protein of cellular response to hypoxia and is closely related to angiogenic process.Aims:To explore the potential role and the prognostic value of HIF-1α in urothelial carcinoma (UC).Methods:Clinicopathological and follow-up data on 99 UC cases were reviewed and immunostained for HIF-1α, CD68, vascular endothelial growth factor (VEGF) and CD34 antigen. Tumour-associated macrophage (TAM) counts and HIF-1α expression were compared with clinicopathologic characteristics, overall survival (OS) and disease-free survival rates (DFS).Results:High expression of HIF-1α was detected in 55 of 99 (55.6%) tumours. HIF-1α expression was correlated with tumour size, histological grade, tumour invasiveness and recurrence. VEGF and microvessel density (MVD) demonstrated their positive correlation with HIF-1α overexpression, supporting the correlation of HIF-1α up-regulation with tumour angiogenesis. Higher TAM infiltration was identified in high expression of HIF-1α cases rather than HIF-1α low expression cases (p = 0.002). Kaplan–Meier analysis found that HIF-1α overexpression and high TAM count was only associated with worse DFS (p = 0.009, p = 0.023) but was not associated with OS (p = 0.696, p = 0.141). Multivariate analyses indicated only tumour size (p = 0.038) to be an independently significant prognostic factor for OS, in addition, HIF-1α expression (p = 0.011), as well as histological grade (p = 0.038), and MVD (p = 0.004), to be independently significant prognostic factors for DFS.Conclusions:Our results indicate that HIF-1α is a key regulator of the angiogenic cascade. We show that HIF-1α is an independent prognostic factor for disease-free survival.
A detailed morphologic and immunohistochemical comparison of pre- and postmenopausal endometriosis
Authors: Cumiskey J , Whyte P , Kelehan P , Gibbons D 
Published: October 2007

Background:Endometriosis depends on oestrogenic stimulation for its continued growth, accounting for its prevalence during reproductive years. There is doubt among clinicians regarding its existence in postmenopausal women in the absence of exogenous or endogenous sex hormones. We postulated that endometriosis occurring in postmenopausal women would show a different morphologic and immunohistochemical profile to the disease occurring in premenopausal women.Methods:We reviewed the most recent 100 cases of endometriosis in our department plus all cases occurring in women aged ⩾50 dating back to 1999. Cases were divided into <50 (n = 91), 50–59 (8) and ⩾60 (6), and analysed for extent of disease, proportions of epithelium and stroma, and amount of haemorrhage. Immunohistochemistry for oestrogen receptor (OR), progesterone receptor (PR) and CD10 was performed and analysed on all cases aged ⩾50 and on controls <50.Results:There was statistically less disease in older women when cases occurring in the cervix and in scars were excluded (p = 0.0191). There was no statistical difference in the proportions of epithelium or stroma, but there was a statistical difference in the amount of haemorrhage (p = 0.0154) with older women showing less haemorrhage. There was no significant difference in immunohistochemical profile.Conclusions:Endometriosis does occur in postmenopausal women but is less common, is present in smaller volumes, and is less active. It has the same immunohistochemical profile as the disease occurring in premenopausal women and we infer from this that it has the potential to reactivate given the appropriate stimulation.
Light and electron microscopy characteristics of the muscle of patients withSURF1gene mutations associated with Leigh disease
Authors: Pronicki M , Matyja E , Piekutowska-Abramczuk D , Szymańska-Dębińska T , Karkucińska-Więckowska A , Karczmarewicz E , Grajkowska W , Kmieć T , Popowska E , Sykut-Cegielska J 
Published: October 2007

Aims:Leigh syndrome (LS) is characterised by almost identical brain changes despite considerable causal heterogeneity.SURF1gene mutations are among the most frequent causes of LS. Although deficiency of cytochromecoxidase (COX) is a typical feature of the muscle in SURF1-deficient LS, other abnormalities have been rarely described. The aim of the present work is to assess the skeletal muscle morphology coexisting withSURF1mutations from our own research and in the literature.Methods:Muscle samples from 21 patients who fulfilled the criteria of LS andSURF1mutations (14 homozygotes and 7 heterozygotes of c.841delCT) were examined by light and electron microscopy.Results:Diffuse decreased activity or total deficit of COX was revealed histochemically in all examined muscles. No ragged red fibres (RRFs) were seen. Lipid accumulation and fibre size variability were found in 14 and 9 specimens, respectively. Ultrastructural assessment showed several mitochondrial abnormalities, lipid deposits, myofibrillar disorganisation and other minor changes. In five cases no ultrastructural changes were found. Apart from slight correlation between lipid accumulation shown by histochemical and ultrastructural techniques, no other correlations were revealed between parameters investigated, especially between severity of morphological changes and the patient’s age at the biopsy.Conclusion:Histological and histochemical features of muscle of genetically homogenous SURF1-deficient LS were reproducible in detection of COX deficit. Minor muscle changes were not commonly present. Also, ultrastructural abnormalities were not a consistent feature. It should be emphasised that SURF1-deficient muscle assessed in the light and electron microscopy panel may be interpreted as normal if COX staining is not employed.
Effect of storage and postage on recovery and quantitation of bacteria in sputum samples
Authors: Pye A , Hill S L , Bharadwa P , Stockley R A 
Published: October 2007

Aims:The aims of the study were to compare bacterial recovery following storage of sputum samples at 20°C room temperature and 4°C (refrigerated) for 24 h, and to determine the effect of postage on viable bacterial numbers.Methods:A total of 38 individual sputum samples from clinically stable patients with bronchiectasis were split into three equal aliquots and quantitative bacterial culture was performed (i) immediately, (ii) following storage at 4°C for 24 h or (iii) following storage at 20°C for 24 h. A further 42 sputum samples were split into two equal aliquots and quantitative bacterial culture was performed either immediately or following postage back to the laboratory by first-class mail from an outside location.Results:The predominant organism could still be recovered following storage at 4°C and 20°C, but viable numbers were significantly reduced following storage at 4°C (p<0.004) by at least an order of magnitude (10-fold) in 24% of samples stored at 4°C compared with only 8% stored at 20°C. Posting samples back to the laboratory did not affect the recovery of bacterial species and there was no difference in viable numbers isolated.Conclusions:The results suggest that storage at room temperature is preferable to refrigeration as it retains the species isolated and the viable number. The data also confirm that sputum samples can be posted to the laboratory from patients in the community without affecting qualitative or quantitative results.
Relevance and limits of the principle of “equivalence of care” in prison medicine
Authors: Niveau Gérard 
Published: October 2007

The principle of “equivalence of care” in prison medicine is a principle by which prison health services are obliged to provide prisoners with care of a quality equivalent to that provided for the general public in the same country. It is cited in numerous national and international directives and recommendations.The principle of equivalence is extremely relevant from the point of view of normative ethics but requires adaptation from the point of view of applied ethics. From a clinical point of view, the principle of equivalence is often insufficient to take account of the adaptations necessary for the organization of care in a correctional setting. The principle of equivalence is cost-effective in general, but has to be overstepped to ensure the humane management of certain special cases.
Interacting effects of particulate pollution and cold temperature on cardiorespiratory mortality in Scotland
Authors: Carder M , McNamee R , Beverland I , Elton R , Van Tongeren M , Cohen G R , Boyd J , MacNee W , Agius R M 
Published: October 2007

Objectives:To determine whether the effect of black smoke on cardiorespiratory mortality is modified by cold temperatures.Methods:Poisson regression models were used to investigate the relationship between lagged black smoke concentration and daily mortality, and whether the effect of black smoke on mortality was modified by cold temperature for three Scottish cities from January 1981 to December 2001.Main results:For all-cause respiratory and non-cardiorespiratory mortality, there was a significant association between mortality and lagged black smoke concentration. Generally the maximum black smoke effect occurred at lag 0, although these estimates were not statistically significant. A 10 μgm−3increase in the daily mean black smoke concentration on any given day was associated with a 1.68% (95% CI 0.72 to 2.65) increase in all-cause mortality and a 0.43% (95% CI −0.97 to 1.86), 5.36% (95% CI 2.93 to 7.84) and 2.13% (95% CI 0.82 to 3.47) increase in cardiovascular, respiratory and non-cardiorespiratory mortality, respectively, over the ensuing 30-day period. The effect of black smoke on mortality did not vary significantly between seasons (cool and warm periods). For all-cause, cardiovascular and non-cardiorespiratory mortality the inclusion of interaction terms did not improve the models, although for all-cause and non-cardiorespiratory mortality there was a suggestion for interaction between temperature and recent black smoke exposure.Conclusions:The results of this study suggested a greater effect of black smoke on mortality at low temperatures. Since extremes of cold and particulate pollution may coexist, for example during temperature inversion, these results may have important public health implications.