bluuebunny/crossref_metadata_2025_split huggingface dataset:
PHOSPHORUS METABOLISM AND MANAGEMENT IN CHRONIC KIDNEY DISEASE: New Developments in the Management of Hyperphosphatemia in Chronic Kidney Disease
Authors: McIntyre Christopher W. 
Published: July 2007

AbstractHyperphosphatemia is a characteristic complication of significant chronic kidney disease. Elevated serum phosphorous is associated with reduced survival. Hyperphosphatemia has long been recognized as predisposing to uremic bone disease and disorders of parathyroid function. Furthermore, elevated serum phosphate has been implicated particularly in the development of cardiovascular structural and functional abnormalities.Given the limitations of restricting phosphate in the diet and the inadequate removal by conventional dialysis regimes, nephrologists rely on the use of additional medications to control serum levels (currently oral phosphate binders).This review focuses on new agents and therapeutic approaches dealing with hyperphosphatemia in chronic kidney disease, that are not currently licensed and available in routine clinical practise. This article attempts to review therapies under development and considers additional effects that the next generation of agents may bring over and above those already within the therapeutic armamentarium.
Classification of Complications Associated with Hemodialysis Vascular Access Procedures: A Position Statement from the American Society of Diagnostic and Interventional Nephrology
Authors: Vesely Thomas M. , Beathard Gerald , Ash Stephen , Hoggard Jeffrey , Schon Donald ,   for the ASDIN Clinical Practice Committee
Published: July 2007

AbstractA procedure‐related complication is an unanticipated adverse event that requires therapy. In order to analyze frequency and severity of complications in the process of quality assurance, it is useful to have a classification of complications, indicating the type and severity. The Clinical Practice Committee of American Society of Diagnostic and Interventional Nephrology has developed a Classification of Complications relating to Hemodialysis Vascular Access Procedures, based on the system first proposed by Beathard in 2006. In this system, the “type” refers to the procedure being performed or vessel entered, and the “grade” is based on the intensity of medical care needed to address the complication. This publication describes 10 Types and 4 Grades of complications.
The use of infliximab in dermatology
Authors: Rott Silja , Mrowietz Ulrich 
Published: July 2007

SummaryAutoimmune diseases like Crohn's disease, rheumatoid arthritis (RA) and psoriasis are often difficult to treat due to complex underlying immunologic pathways. Tumor necrosis factor (TNFα) is an important proinflammatory cytokine that seems to play an important role in the pathogenesis of these diseases. After the approval of a variety of drugs which block the biological activity of TNFα, new therapeutic options were available and especially infliximab became widely used.TNFα, as a member of the proinflammatory cytokine family, is a major cytokine in different inflammatory dermatological diseases such as cutaneous vasculitis, lupus erythematosus, eczema or psoriasis. Therefore infliximab has been used in a variety of inflammatory dermatoses lately, sometimes with great success. Several case reports showing new indications for a successful use of TNFα‐inhibitors in dermatology have been published and will be reviewed in the following article. Nevertheless, infliximab is not approved for these indications at the moment and has to be considered as off‐label use.
Ultrasonography in dermatology
Authors: Dill‐Müller Dorothee , Maschke Jan 
Published: July 2007

SummaryUltrasonography is an essential tool for most medical specialties; training in its use is required for dermatology residency programs in Germany. Ultrasonography is a versatile, painless, low‐risk, non‐invasive procedure which can be done anywhere and easily repeated; it provides real‐time visual information about benign and malignant processes in the skin and subcutis. Highfrequency sonography with 20 MHz scanners is well‐established for measuring the thickness of the skin or its tumors and assessing inflammatory skin disorders. Mid‐frequency sonography with 7.5‐15 MHz sounds is widely used in dermatologic oncology, both for pre‐operative staging and follow‐up of melanoma patients. The interpretation of sonographic images such as borders of lesions, echogenicity, artifacts and vascular patterns with duplex color sonography requires structured education and intensive training. The wide variety of diagnostic information provided by sonography underlines its essential position in certified skin cancer centers.
Effects of dietary nitrate on oxygen cost during exercise
Authors: Larsen F. J. , Weitzberg E. , Lundberg J. O. , Ekblom B. 
Published: July 2007

AbstractAim:  Nitric oxide (NO), synthesized from l‐arginine by NO synthases, plays a role in adaptation to physical exercise by modulating blood flow, muscular contraction and glucose uptake and in the control of cellular respiration. Recent studies show that NO can be formed in vivo also from the reduction of inorganic nitrate (NO3−) and nitrite (NO2−). The diet constitutes a major source of nitrate, and vegetables are particularly rich in this anion. The aim of this study was to investigate if dietary nitrate had any effect on metabolic and circulatory parameters during exercise.Method:  In a randomized double‐blind placebo‐controlled crossover study, we tested the effect of dietary nitrate on physiological and metabolic parameters during exercise. Nine healthy young well‐trained men performed submaximal and maximal work tests on a cycle ergometer after two separate 3‐day periods of dietary supplementation with sodium nitrate (0.1 mmol kg−1 day−1) or an equal amount of sodium chloride (placebo).Results:  The oxygen cost at submaximal exercise was reduced after nitrate supplementation compared with placebo. On an average Vo2 decreased from 2.98 ± 0.57 during CON to 2.82 ± 0.58 L min−1 during NIT (P < 0.02) over the four lowest submaximal work rates. Gross efficiency increased from 19.7 ± 1.6 during CON to 21.1 ± 1.3% during NIT (P < 0.01) over the four lowest work rates. There was no difference in heart rate, lactate [Hla], ventilation (VE), VE/Vo2 or respiratory exchange ratio between nitrate and placebo during any of the submaximal work rates.Conclusion:  We conclude that dietary nitrate supplementation, in an amount achievable through a diet rich in vegetables, results in a lower oxygen demand during submaximal work. This highly surprising effect occurred without an accompanying increase in lactate concentration, indicating that the energy production had become more efficient. The mechanism of action needs to be clarified but a likely first step is the in vivo reduction of dietary nitrate into bioactive nitrogen oxides including nitrite and NO.
Control of the triceps surae during the postural sway of quiet standing
Authors: Tokuno C. D. , Carpenter M. G. , Thorstensson A. , Garland S. J. , Cresswell A. G. 
Published: July 2007

AbstractAim:  The present study investigated how the triceps surae are controlled at the spinal level during the naturally occurring postural sway of quiet standing.Methods:  Subjects stood on a force platform as electrical stimuli were applied to the posterior tibial nerve when the center of pressure (COP) was either 1.6 standard deviations anterior (COPant) or posterior (COPpost) to the mean baseline COP signal. Peak‐to‐peak amplitudes of the H‐reflex and M‐wave from the soleus (SOL) and medial gastrocnemius (MG) muscles were recorded to assess the efficacy of the Ia pathway.Results:  A significant increase in the Hmax : Mmax ratio for both the SOL (12 ± 6%) and MG (23 ± 6%) was observed during the COPant as compared to the COPpost condition. The source of the modulation between COP conditions cannot be determined from this study. However, the observed changes in the synaptic efficacy of the Ia pathway are unlikely to be simply a result of an altered level of background electromyographic activity in the triceps surae. This was indicated by the lack of differences observed in the Hmax : Mmax ratio when subjects stood without postural sway (via the use of a tilt table) at two levels of background activity.Conclusions:  It is suggested that the phase‐dependent modulation of the triceps surae H‐reflexes during the postural sway of quiet standing functions to maintain upright stance and may explain the results from previous studies, which, until now, had not taken the influence of postural sway on the H‐reflex into consideration.
Molecular and functional expression of anion exchangers in cultured normal human nasal epithelial cells
Authors: Shin J.‐H. , Son E. J. , Lee H. S. , Kim S. J. , Kim K. , Choi J. Y. , Lee M. G. , Yoon J.‐H. 
Published: July 2007

AbstractAims:  Anions have an important role in the regulation of airway surface liquid (ASL) volume, viscosity and pH. However, functional localization and regulation of anion exchangers (AEs) have not been clearly described. The aim of this study was to investigate the regulation of AE mRNA expression level in accordance with mucociliary differentiation and the functional expression of AEs cultured normal human nasal epithelial (NHNE) cells.Methods:  Nasal mucosal specimens from three patients are obtained and serially cultured cells are subjected to morphological examinations, RT‐PCR, Western blot analysis and immunocytochemistry. AE activity is assessed by pHi measurements.Results:  Expression of ciliated cells on the apical membrane and expression of MUC5AC, a marker of mucous differentiation, increased with time. AE2 and SLC26A4 mRNA expression decreased as mucociliary differentiation progressed, and AE4, SLC26A7 and SLC26A8 mRNA expression increased on the 14th and 28th day after confluence. Accordingly, AE4 protein expression also progressively increased. AE activity in 100 mm K+ buffer solutions was nearly twofold higher than that in 5 mm K+ buffer solutions. Moreover, only luminal AE activity increased about fourfold over the control in the presence of 5 μm forskolin. In the presence of 100 μm adenosine‐5′‐triphosphate (ATP) which evokes intracellular calcium signalling through activation of purinergic receptors, only luminal AE activity was again significantly increased. On the other hand, 500 μm 4,4′‐diisothiocyanostilbene‐2,2′‐disulfonic acid (DIDS), an inhibitor of most SLC4 and SLC26AE isoforms, nearly abolished AE activity in both luminal and basolateral membranes. We found that AE activity was affected by intracellular cAMP and calcium signalling in the luminal membrane and was DIDS‐sensitive in both membranes of cultured NHNE cells.Conclusion:  Our findings through molecular and functional studies using cultured NHNE cells suggest that AEs may have an important role in the regulation of ASL.
Reduced sarcoplasmic reticulum content of releasable Ca2+ in rat soleus muscle fibres after eccentric contractions
Authors: Nielsen J. S. , Sahlin K. , Ørtenblad N. 
Published: July 2007

AbstractAim:  The purpose was to evaluate the effects of fatiguing eccentric contractions (EC) on calcium (Ca2+) handling properties in mammalian type I muscles. We hypothesized that EC reduces both endogenous sarcoplasmic reticulum (SR) content of releasable Ca2+ (eSRCa2+) and myofibrillar Ca2+ sensitivity.Methods:  Isolated rat soleus muscles performed 30 EC bouts. Single fibres were isolated from the muscle and after mechanical removal of sarcolemma used to measure eSRCa2+, rate of SR Ca2+ loading and myofibrillar Ca2+ sensitivity.Results:  Following EC maximal force in whole muscle was reduced by 30% and 16/100 Hz force ratio by 33%. The eSRCa2+ in fibres from non‐stimulated muscles was 45 ± 5% of the maximal loading capacity. After EC, eSRCa2+ per fibre CSA decreased by 38% (P = 0.05), and the maximal capacity of SR Ca2+ loading was depressed by 32%. There were no effects of EC on either myofibrillar Ca2+ sensitivity, maximal Ca2+ activated force per cross‐sectional area and rate of SR Ca2+ loading, or in SR vesicle Ca2+ uptake and release.Conclusions:  We conclude that EC reduces endogenous SR content of releasable Ca2+ but that myofibrillar Ca2+ sensitivity and SR vesicle Ca2+ kinetics remain unchanged. The present data suggest that the long‐lasting fatigue induced by EC, which was more pronounced at low frequencies (low frequency fatigue), is caused by reduced Ca2+ release occurring secondary to reduced SR content of releasable Ca2+.
Use of a Bioluminescent
Pseudomonas aeruginosa
Strain within an In Vitro Microbiological System, as a Model of Wound Infection, To Assess the Antimicrobial Efficacy of Wound Dressings by Monitoring Light Production
Authors: Thorn R. M. S. , Nelson S. M. , Greenman J. 
Published: July 2007

ABSTRACT

A bioluminescent
Pseudomonas aeruginosa
was incorporated into an in vitro static diffusion method to determine whether light output could be used as a measure of wound dressing efficacy. A significant linear correlation was observed between viable counts and bioluminescence during exponential growth in planktonic culture (
r
2
= 0.969). Exponential-phase cells were used to inoculate cellulose discs for integration into an in vitro wound model that incorporated a reservoir of serum. A significant linear correlation was found between bioluminescence (photon counts monitored by a low-light camera) and viable counts in this growth environment (
r
2
= 0.982). Three antimicrobial wound dressings were applied to the surface of freshly prepared sample discs within the wound model, and the kill kinetics were codetermined by photon and viable counts. Quantifiable kill rates gave the same order of efficacy for the three wound dressings using both types of measurement, and a significant linear correlation was shown between photon and viable counts (
r
2
= 0.873) within this killing environment. Under all defined conditions, a significant linear correlation between bioluminescence and viable counts was shown but the actual slope of the correlation was different, depending on the physicochemical environment of the cells. Hence, significantly more light per cell (
P
< 0.0001) was produced when cells in discs were exposed to a killing environment compared to a growing environment. As long as defined conditions are employed, the resulting linear correlation enables the state of the system to be continually monitored without disturbance, allowing more immediate and accurate calculations of kill rates without the need for viable counting.
Population Pharmacokinetics of Micafungin in Pediatric Patients and Implications for Antifungal Dosing
Authors: Hope William W. , Seibel Nita L. , Schwartz Cindy L. , Arrieta Antonio , Flynn Patricia , Shad Aziza , Albano Edythe , Keirns James J. , Buell Donald N. , Gumbo Tawanda , Drusano George L. , Walsh Thomas J. 
Published: July 2007

ABSTRACT

The echinocandins potentially have an important role in treatment of infections caused by
Candida
spp. and
Aspergillus
spp. in immunocompromised children. However, there are no population pharmacokinetic models of the echinocandins for pediatric patients. The safety and descriptive pharmacokinetics of micafungin in children were recently reported. However, a population pharmacokinetic model in children is needed in order to accurately determine the dosage of micafungin that produces an equivalent magnitude of drug exposure to that observed in adults. In order to explore the effect of weight on micafungin pharmacokinetics, a standard two-compartment pharmacokinetic model, a linear model, and an allometric power model were developed. For all three models, the fit to the data was excellent, with comparable measures of precision and bias. However, the superior log-likelihood value of the allometric power model suggested that it best reflected the data and was therefore chosen for a more detailed analysis of the magnitude and pattern of drug exposure which develop following the administration of micafungin. The allometric power model suggested that clearance in smaller children is higher than that predicted on the basis of weight alone. Consequently, a degree of dosage increase is required in smaller children to ensure comparable levels of drug exposure to those observed in larger children and adults. The allometric power model developed in this study enables identification of pediatric dosage regimens of micafungin which, based upon Monte Carlo simulations, result in equivalent drug exposures to those observed in adults, for which antifungal efficacy has been established.
Doxycycline versus Azithromycin for Treatment of Leptospirosis and Scrub Typhus
Authors: Phimda Kriangsak , Hoontrakul Siriwan , Suttinont Chuanpit , Chareonwat Sompong , Losuwanaluk Kitti , Chueasuwanchai Sunee , Chierakul Wirongrong , Suwancharoen Duangjai , Silpasakorn Saowaluk , Saisongkorh Watcharee , Peacock Sharon J. , Day Nicholas P. J. , Suputtamongkol Yupin 
Published: July 2007

ABSTRACT

Leptospirosis and scrub typhus are important causes of acute fever in Southeast Asia. Options for empirical therapy include doxycycline and azithromycin, but it is unclear whether their efficacies are equivalent. We conducted a multicenter, open, randomized controlled trial with adult patients presenting with acute fever (<15 days), without an obvious focus of infection, at four hospitals in Thailand between July 2003 and January 2005. Patients were randomly allocated to receive either a 7-day course of doxycycline or a 3-day course of azithromycin. The cure rate, fever clearance time, and adverse drug events were compared between the two study groups. A total of 296 patients were enrolled in the study. The cause of acute fever was determined for 151 patients (51%): 69 patients (23.3%) had leptospirosis; 57 patients (19.3%) had scrub typhus; 14 patients (4.7%) had murine typhus; and 11 patients (3.7%) had evidence of both leptospirosis and a rickettsial infection. The efficacy of azithromycin was not inferior to that of doxycycline for the treatment of both leptospirosis and scrub typhus, with comparable fever clearance times in the two treatment arms. Adverse events occurred more frequently in the doxycycline group than in the azithromycin group (27.6% and 10.6%, respectively;
P
= 0.02). In conclusion, doxycycline is an affordable and effective choice for the treatment of both leptospirosis and scrub typhus. Azithromycin was better tolerated than doxycycline but is more expensive and less readily available.
Salmonella
Pathogenicity Island 4-Mediated Adhesion Is Coregulated with Invasion Genes in
Salmonella enterica
Authors: Gerlach Roman G. , Jäckel Daniela , Geymeier Nina , Hensel Michael 
Published: July 2007

ABSTRACT

Salmonella
pathogenicity island 4 (SPI4) encodes a type I secretion system and the cognate substrate protein, SiiE. We have recently demonstrated that SiiE is a giant nonfimbrial adhesin involved in the adhesion of
Salmonella enterica
serovar Typhimurium to polarized epithelial cells. We also observed that under in vitro culture conditions, the synthesis and secretion of SiiE coincided with the activation of
Salmonella
invasion genes. These observations prompted us to investigate the regulation of SPI4 genes in detail. A novel approach for the generation of reporter gene fusions was employed to generate single-copy chromosomal fusions to various genes within SPI4, and the expression of these fusions was investigated. We analyzed the regulation of SPI4 genes and the roles of various regulatory systems for SPI4 expression. Our data show that the expression of SPI4 genes is coregulated with SPI1 invasion genes by the global regulator SirA. Expression of a SPI4 gene was also reduced in the absence of HilA, the central local regulator of SPI1 gene expression. Both SirA and HilA functions were required for the secretion of SiiE and the SPI4-mediated adhesion. Our data demonstrate that SPI4-mediated adhesion, as well as SPI1-mediated invasion, are tightly coregulated by the same regulatory circuits and induced under similar environmental conditions.
Global Effects of the Cell-to-Cell Signaling Molecules Autoinducer-2, Autoinducer-3, and Epinephrine in a
luxS
Mutant of Enterohemorrhagic
Escherichia coli
Authors: Kendall Melissa M. , Rasko David A. , Sperandio Vanessa 
Published: July 2007

ABSTRACT

Intrakingdom cell-to-cell communication and interkingdom cell-to-cell communication play essential roles in the virulence of enterohemorrhagic
Escherichia coli
(EHEC). Four signals, autoinducer 2 (AI-2), AI-3, and the human hormones epinephrine and norepinephrine, are important in this communication. The effect of these signaling compounds on the transcriptome of EHEC was examined in this study. We demonstrated that the
luxS
mutation affects primarily central metabolic genes in both pathogenic and nonpathogenic strains of
E. coli
and that addition of exogenous AI-2 does not fully restore the expression profile in a
luxS
-deficient strain lacking the ability to synthesize AI-2. Addition of AI-3 or epinephrine increased expression of the locus of enterocyte effacement regulon, which is known to play a pivotal role in EHEC virulence. Moreover, when epinephrine was added to the culture medium, the greatest number of gene alterations was observed. These alterations included a greater proportion of alterations in EHEC genes than in MG1655 genes, suggesting that epinephrine may be a global virulence signal. Detailed examination with real-time reverse transcriptase PCR (RT-PCR) confirmed the increases in virulence gene expression with addition of AI-3 and epinephrine. Additional studies with real-time RT-PCR examining the EHEC secreted effectors and putative fimbrial gene expression showed a variable expression profile, indicating that there is differential regulation of the secreted molecules. This study began to examine the global signaling networks in EHEC and revealed expression profiles that are signal and pathogen specific.
Noncapsulated Toxinogenic
Bacillus anthracis
Presents a Specific Growth and Dissemination Pattern in Naive and Protective Antigen-Immune Mice
Authors: Glomski Ian J. , Corre Jean-Philippe , Mock Michèle , Goossens Pierre L. 
Published: July 2007

ABSTRACT

Bacillus anthracis
is a spore-forming bacterium that causes anthrax.
B. anthracis
has three major virulence factors, namely, lethal toxin, edema toxin, and a poly-γ-
d
-glutamic acid capsule. The toxins modulate host immune responses, and the capsule inhibits phagocytosis. With the goal of increasing safety, decreasing security concerns, and taking advantage of mammalian genetic tools and reagents, mouse models of
B. anthracis
infection have been developed using attenuated bacteria that produce toxins but no capsule. While these models have been useful in studying both toxinogenic infections and antitoxin vaccine efficacy, we questioned whether eliminating the capsule changed bacterial growth and dissemination characteristics. Thus, the progression of infection by toxinogenic noncapsulated
B. anthracis
was analyzed and compared to that by previously reported nontoxinogenic capsulated bacteria, using in vivo bioluminescence imaging. The influence of immunization with the toxin component protective antigen (PA) on the development of infection was also examined. The toxinogenic noncapsulated bacteria were initially confined to the cutaneous site of infection. Bacteria then progressed to the draining lymph nodes and, finally, late in the infection, to the lungs, kidneys, and frequently the gastrointestinal tract. There was minimal colonization of the spleen. PA immunization reduced bacterial growth from the outset and limited infection to the site of inoculation. These in vivo observations show that dissemination by toxinogenic noncapsulated strains differs markedly from that by nontoxinogenic capsulated strains. Additionally, PA immunization counters bacterial growth and dissemination in vivo from the onset of infection.