bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is major depressive disorder a metabolic encephalopathy?
Authors: Harvey Brian H 
Published: April 2008

AbstractMetabolic encephalopathy is an acute disturbance in cellular metabolism in the brain evoked by conditions of hypoxia, hypoglycaemia, oxidative stress and/or inflammation. It usually develops acutely or subacutely and is reversible if the systemic disorder is treated. If left untreated, however, metabolic encephalopathy may result in secondary structural damage to the brain. Most encephalopathies are present with neuropsychiatric symptoms, one in particular being depression. However, mood disorders are often co‐morbid with cardiovascular, liver, kidney and endocrine disorders, while increasing evidence concurs that depression involves inflammatory and neurodegenerative processes. This would suggest that metabolic disturbances resembling encephalopathy may underscore the basic neuropathology of depression at a far deeper level than currently realized. Viewing depression as a form of encephalopathy, and exploiting knowledge gleaned from our understanding of the neurochemistry and treatment of metabolic encephalopathy, may assist in our understanding of the neurobiology of depression, but also in realizing new ideas in the pharmacotherapy of mood disorders. Copyright © 2008 John Wiley & Sons, Ltd.
Degradation of biorefractory furaltadone in aqueous solution by ozonation
Authors: Bao Nan , Sun Jian , Wei Zhen‐Tao , Ma Dong , Liu Feng , Wang Jin 
Published: April 2008

AbstractBACKGROUND: Furaltadone (FD), a nitrofuran derivative, is a highly effective chemotherapeutic drug. In China the FD wastewater discharged by the pharmaceutical industry is high in organics and biorefractory compounds. The objective of this study was to investigate the degradation mechanism of FD in aqueous solution by ozone oxidation. Preliminary results on the reaction mechanism were obtained using three different spectral analysis techniques.RESULTS: The ozonation mechanism was significantly affected by the pH value. At low pH values the primary reaction is direct oxidation of ozone, an incomplete oxidisation, which can only destroy the FD molecule's conjugated structure. At high pH values the major reaction changes to hydroxyl radical oxidation. FD can be rapidly oxidised into CO2, H2O, NH3, NO$_{3}^{-}$, HCHO, oxalic acid and other aliphatic acids of low molecular weight, which can be entirely mineralised by continued ozonation.CONCLUSION: The pH value significantly influences the mode of FD ozonation. The present experiment suggests a potentially useful pretreatment method for conventional biological treatment of wastewater containing FD. Copyright © 2008 Society of Chemical Industry
Not the usual cardiac rhythm device infection: A fastidious pathogen with several teaching points
Authors: Cawley Peter J. , Ravindrin Bipin K. , Poole Jeanne E. 
Published: April 2008

AbstractBecause cardiac device infections may include fastidious pathogens, extended incubation of blood cultures is suggested. A patient with an infection of a right ventricular lead implantable cardioverter defibrillator (ICD) system is described. The device was implanted 6 months earlier. The pathogen was identified as Haemophilus parainfluenzae, which was cultured within 72 hours and was presumably from a respiratory tract infection. Extended incubation was not necessary to culture this fastidious pathogen. Two large retrospective studies suggest that prolonged incubation for fastidious organisms is generally not necessary because of advances in culture media and automated blood culture systems. Journal of Hospital Medicine 2008;3:173–175. © 2007 Society of Hospital Medicine.
Fate of patients with obstructive jaundice
Authors: Björnsson Einar , Gustafsson Jonas , Borkman Jakob , Kilander Anders 
Published: April 2008

AbstractBACKGROUND/OBJECTIVE:Systematic data are limited on the etiology and prognosis of unselected patients with obstructive jaundice (OJ). We aimed to review the clinical features, etiology, and prognosis of patients with OJ.METHODS:All adult patients with bilirubin ≥ 5.85 mg/dL (100 μmol/L) at a university hospital in Sweden in 2003–2004 were identified. Medical records from patients with OJ were reviewed.RESULTS:Seven hundred and forty‐nine patients were identified, of whom 241 (32%) had OJ (median age 71 years, 129 women). No one was lost to follow‐up. The biliary obstruction of 154 patients (64%) was a result of a malignancy: 69 patients (46%) had pancreatic cancer, 44 (29%) had cholangiocarcinoma (CC), 5 (3%) had papilla vateri cancers, and 36 patients (23%) had other malignancies. Of the 87 patients with a benign obstruction, 57 (65%) had choledocholithiasis, 7 (8%) had biliary strictures, 6% had PSC, and the obstruction of 16 patients (20.7%) had other causes. A total of 115 of the 242 patients (48%) had abdominal pain associated with jaundice, whereas 52% had painless jaundice. Thirty‐four percent of patients with a malignant obstruction had abdominal pain versus 71% of patients with a benign obstruction (P < .05). At the end of follow‐up, only 5% (8 patients) with a malignant obstruction were alive versus 78% with a benign obstruction.CONCLUSIONS:Obstructive jaundice was the cause of the severe jaundice of one third of patients. Most cases of OJ were a result of a malignancy, which carried a very poor prognosis, with a 2‐year mortality rate of 95%. Journal of Hospital Medicine 2008;3:117–123. © 2008 Society of Hospital Medicine.
Diagnostic and treatment delays in recurrent clostridium difficile–associated disease
Authors: Scheurer Danielle 
Published: April 2008

AbstractBACKGROUND:Because Clostridium difficile–associated disease (CDAD) is primarily an inpatient issue, hospitalists are at the forefront of the timely diagnosis and treatment of patients with this disease.DESIGN:The study was a retrospective cohort of all inpatients with CDAD at Brigham and Women's Hospital from 1997 to 2004 in order to determine the time to diagnosis and treatment in initial and recurrent episodes of disease.RESULTS:The mean time to sampling, between 2.09 and 2.24 days, was not significantly different between initial and recurrent CDAD hospital episodes. The mean time to treatment (from symptoms and sampling) was shorter in recurrent episodes but was still 2.5 days.CONCLUSIONS:Patients with recurrent disease were more likely to be treated earlier but not diagnosed earlier than those with initial disease. Because both groups had significant diagnostic and treatment delays, this is an area in which hospitalists can have a major impact on patient care. Journal of Hospital Medicine 2008;3:156–159. © 2008 Society of Hospital Medicine.
Effect of a hospitalist–care coordinator team on a nonteaching hospitalist service
Authors: O'Leary Kevin J. , Lindquist Lee A. , Colone Marcia A. , Haviley Corinne , Thompson Jason A. , Baker David W. 
Published: April 2008

AbstractBACKGROUND:Although many hospitalists work with clinical coordinators, few studies have evaluated their impact.OBJECTIVE:The purpose of the study was to evaluate the impact of a hospitalist–care coordinator team on hospitalist work experience, patient satisfaction, and hospital efficiency.DESIGN AND PARTICIPANTS:During each of 12 weeks, hospitalists on a nonteaching hospitalist service were randomly assigned to work with a hospitalist care coordinator (HCC) or to work independently.MEASUREMENTS:Each week hospitalists completed a survey to assess their satisfaction and perceived work efficiency. Patient satisfaction with hospital discharge was assessed by telephone interviews. Hospital efficiency was analyzed with multivariate linear regression using log‐transformed length of stay (LOS) and cost as dependent variables.RESULTS:The 356 patients cared for by hospitalist–HCC teams were similar to 337 patients cared for by control hospitalists. Twenty‐eight of 31 hospitalists (90%) who worked with an HCC responded that the HCC improved their efficiency and job satisfaction. Seventy‐one of 196 eligible patients (36%) completed the postdischarge interview. The mean ratings of overall satisfaction with hospital discharge on a scale of 10 were similarly high in both groups (8.57 vs. 8.37; P = .94). In multivariate regression analyses, LOS was 0.28 days shorter and cost was $585.62 lower for patients cared for by hospitalist–HCC teams; however, these results were not statistically significant (P = .17 and .15, respectively).CONCLUSIONS:Hospitalists working in a team approach with an HCC reported improved efficiency and job satisfaction compared with hospitalists working independently. These findings are important in light of growing concerns about hospitalist workload and job satisfaction. Journal of Hospital Medicine 2008;3:103–109. © 2008 Society of Hospital Medicine.
Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit
Authors: Carroll Christopher L. , Krieger Diane , Campbell Margaret , Fisher Daniel G. , Comeau Leonard L. , Zucker Aaron R. 
Published: April 2008

AbstractBACKGROUND:Dexmedetomidine is a potentially useful sedative for hospitalized children, but there is little published data regarding its safety, dosage, or efficacy.OBJECTIVE:To report our experience with dexmedetomidine for the sedation of hospitalized children.DESIGN:Retrospective case series.SETTING:Pediatric ICU of a university‐affiliated children's hospital.PATIENTS:We retrospectively examined data from the medical records of all children who received dexmedetomidine for sedation between December 2003 and October 2005.INTERVENTION:None.RESULTS:Dexmedetomidine was administered 74 times to 60 children (median age 1.5 years, range 0.1–17.2 years). The most common indications for ICU admission were respiratory distress/failure (53%), status–postcorrective cardiac surgery (19%), and other postoperative patients (18%). In 53% of cases dexmedetomidine was used to supplement ongoing sedation judged inadequatem and in 41% of cases it was used as a bridge to extubation while other sedatives were weaned or discontinued. Among all the children, the median dose to maintain adequate sedation was 0.7 μg/kg per hour (range 0.2–2.5 μg/kg per hour), with a median duration of therapy of 23 hours (range 3–451 hours). Most children (80%) experienced no adverse effects from the sedation, with hypotension (9%), hypertension (8%), and bradycardia (3%) the most common adverse events. For 93% of children who experienced a side effect, it resolved either without treatment or by withholding the infusion.CONCLUSIONS:In this cohort of children hospitalized in the ICU, dexmedetomidine appeared to be effective and to have few adverse effects. Dexmedetomidine may have a potentially useful role to play in sedating hospitalized children. Journal of Hospital Medicine 2008;3:142–147. © 2008 Society of Hospital Medicine.
Potentially inappropriate medication use in hospitalized elders
Authors: Rothberg Michael B. , Pekow Penelope S. , Liu Fengjuan , Korc‐Grodzicki Beatriz , Brennan Maura J. , Bellantonio Sandra , Heelon Mark , Lindenauer Peter K. 
Published: April 2008

AbstractBACKGROUND:Prescribing of potentially harmful medications has not been well documented in hospitals.OBJECTIVE:The objective of the study was to determine the rate of and factors associated with potentially inappropriate medication (PIM) prescribing in a large inpatient sample.DESIGN:The study was a retrospective cohort of the period between September 1, 2002, and June 30, 2005. We used multivariable logistic regression to identify patient, physician, and hospital characteristics associated with PIM prescribing.SETTING:The study collected data from 384 US hospitals.PATIENTS:The sample was composed of patients aged ≥65 years admitted with 1 or more of 7 common medical diagnoses.MEASUREMENTS:The percentage of patients prescribed PIMs as defined using a modified Beers list was measured. Multivariable‐adjusted odds ratios for PIM use were computed.RESULTS:Of the 493,971 patients, 49% received at least 1 PIM, and 6% received 3 or more, most commonly promethazine, diphenhydramine, and propoxyphene. Patient, physician, and hospital characteristics were all associated with PIM use. Patients with myocardial infarction or heart failure were most likely (61% and 52% vs. 46% for pneumonia), men (47% vs. 49% for women) and those in managed care plans (44% vs. 49% for other plans) were less likely, and patients ≥85 years were least likely (42% vs. 53% for patients aged 65–74 years) to receive PIMs (P < .0001 for all comparisons). For high‐severity PIMs, internists and hospitalists had similar prescribing rates (33%), cardiologists had a higher rate (48%), and geriatricians had the lowest rate (24%). The proportion of elders receiving PIMs ranged from 34% in the Northeast to 55% in the South, and variation at the individual hospital level was extreme. At 7 hospitals, PIMs were never prescribed.CONCLUSIONS:Wide variation in the use of PIMs is associated with hospital and physician characteristics. Care may be improved by minimizing this non‐patient‐centered variation. Journal of Hospital Medicine 2008;3:91–102. © 2008 Society of Hospital Medicine.
Innovative approaches to increase deep vein thrombosis prophylaxis rate resulting in a decrease in hospital‐acquired deep vein thrombosis at a tertiary‐care teaching hospital
Authors: Bullock‐Palmer Renee P. , Weiss Steven , Hyman Charles 
Published: April 2008

AbstractBACKGROUND AND OBJECTIVE:Hospital‐acquired venous thromboembolic events (VTEs) in medically ill patients account for a significant percentage of in‐hospital mortality. Unfractionated heparin and low‐molecular‐weight heparin have been shown to be effective in the prevention of VTEs. However, use of these medications for thromboprophylaxis remains suboptimal. The objective of this article is to report the impact of a continuous quality improvement project on adherence with DVT prophylaxis guidelines and on the subsequent incidence of hospital‐acquired DVT in medical patients at a teaching hospital between 2002 and 2005.METHODS:In November 2002, Kings County Hospital Center Department of Medicine embarked on a project to increase the rate of thromboprophylaxis use. Quality improvement strategies included an active, multifaceted, layered combination of provider education, provider reminders with decision support, and audit with feedback.RESULTS:The DVT prophylaxis rate on the general medicine house‐staff service increased from a baseline of 63% in 2002 to 96% in 2005. The number of hospital‐acquired DVTs decreased from a baseline of 14 in 2002 to 1 in 2005. The hospital‐acquired DVT rate fell significantly, from 2.6 per 1000 discharges in 2002 (95% CI 1.5–4.4) to 0.2 per 1000 discharges in 2005 (95% CI 0.0–1.1), P = .007.CONCLUSIONS:A layered combination of provider education, provider reminders with decision support, and audit with feedback increased the DVT prophylaxis rate and decreased the rate of hospital‐acquired DVTs in the medicine department at a tertiary‐care hospital center. Journal of Hospital Medicine 2008;3:148–155. © 2008 Society of Hospital Medicine.
The larval stages of the sea urchin, Strongylocentrotus purpuratus
Authors: Smith M. Meighan , Cruz Smith Luisa , Cameron, R. Andrew , Urry Lisa A. 
Published: April 2008

AbstractThe adult body plan of Strongylocentrotus purpuratus is established within the imaginal rudiment during the larval stages. To facilitate the study of these stages, we have defined a larval staging scheme, which consists of seven stages: Stage I, four‐arm stage; Stage II, eight‐arm stage; Stage III, vestibular invagination stage; Stage IV, rudiment initiation stage; Stage V, pentagonal disc stage; Stage VI, advanced rudiment stage; and Stage VI, tube‐foot protrusion stage. Each stage is characterized by significant morphological features observed for the first time at that stage. This scheme is intended as a guide for determining the degree of larval development, and for identifying larval and adult structures. Larval anatomy was visualized using light and confocal microscopy as required on living material, whole mount fixed specimens, and serial sections. Antibody staining to localize specific gene products was also used. Detailed analysis of these data has furthered our understanding of the morphogenesis of the rudiment, and has suggested provocative questions regarding the molecular basis for these events. We intend this work to be of use to investigators studying gene expression and morphogenesis in postembryonic larvae. J. Morphol., 2008. © 2008 Wiley‐Liss, Inc.
Investigation of hatching and early post‐embryonic life of freshwater crayfish by in vitro culture, behavioral analysis, and light and electron microscopy
Authors: Vogt Günter 
Published: April 2008

AbstractThe late embryonic and early post‐embryonic life period of freshwater crayfish, which is the main time period of organogenesis, is poorly investigated because of the protective brooding behavior of crayfish mothers. A combination of in vitro culture, behavioral observations, and microscopic investigations of organs involved in hatching, attachment, exploration of the environment, and searching and processing of food yielded deeper insights in this important period of life. Experiments were performed with the robust parthenogenetic marbled crayfish. The following results were obtained: (1) Marbled crayfish can be raised in simple in vitro systems from 80% embryonic development to juvenile Stage 4 with up to 100% survival; (2) Hatching is prepared by chemical weakening of the egg shell and completed by levering actions of the hatchling's appendages; (3) The telson thread, a safety line that keeps the hatchling secured to the mother, is formed by secretions from the telson and the detaching inner layer of the egg case; (4) Molting Stage‐1 juveniles are secured by an anal thread that results from delayed molting of the hindgut; (5) Active attachment of the hatchlings to the maternal pleopods with their 1st pereiopods is achieved by an innate fixed action pattern; (6) In vitro, juveniles are motile from Stage 2 despite incomplete development of their balance controlling statocysts. Movement pattern and social behavior vary greatly among individuals; and (7) Feeding starts in Stage 3, when the mouthparts and the gastric mill are fully developed. Onset of feeding is innate and does not require maternal contributions. In vitro culture of the isogenic marbled crayfish is recommended for broader use in research because it enables not only time and stage‐specific sampling but also precisely timed experimental manipulations. J. Morphol., 2008. © 2008 Wiley‐Liss, Inc.
Activation of microglia by endotoxin suppresses the secretion of glial cell line–derived neurotrophic factor (GDNF) through the action of protein kinase Cα (PKCα) and mitogen‐activated protein kinases (MAPKS)
Authors: Matsushita Yuichi , Nakajima Kazuyuki , Tohyama Yoko , Kurihara Tadashi , Kohsaka Shinichi 
Published: April 2008

AbstractThe ability of microglia to produce/secrete glial cell line–derived neurotrophic factor (GDNF) in vitro was examined. Immunoblotting analysis revealed that nonstimulated microglia release limited amounts of GDNF with molecular sizes of 14 and 17 kDa. However, the secreted amounts significantly decreased when the microglia were activated with the endotoxin lipopolysaccharide (LPS). Comparison of the amounts of GDNF in the cells and the conditioned medium between the nonstimulated microglia and LPS‐stimulated microglia clarified that the secretion of GDNF, but not its production, is strongly suppressed when the microglia are activated with LPS. The inhibitor experiments suggested that the GDNF secretion is depressed by a signaling cascade associated with protein kinase C alpha (PKCα) and/or mitogen‐activated protein kinases (MAPKs). As expected from the above results, a PKC activator suppressed the secretion of GDNF in nonstimulated microglia. Taken together, these results demonstrated that microglia have the ability to produce and secrete GDNF in vitro, and that the secretion is suppressed by stimulation with endotoxin, probably due to a signaling mechanism involving PKCα and/or MAPKs. © 2008 Wiley‐Liss, Inc.
Dynamics of the inflammatory response after murine spinal cord injury revealed by flow cytometry
Authors: Stirling David P. , Yong V. Wee 
Published: April 2008

AbstractSpinal cord injury (SCI) triggers a robust inflammatory response that contributes in part to the secondary degeneration of spared tissue. Here, we use flow cytometry to quantify the inflammatory response after SCI. Besides its objective evaluation, flow cytometry allows for levels of particular markers to be documented that further aid in the identification of cellular subsets. Analyses of blood from SCI mice for CD45 (common leukocyte antigen), CD11b (complement receptor‐3), Gr‐1 (neutrophil/monocyte marker), and CD3 (T‐cell marker) revealed a marked increase in circulating neutrophils (CD45high:Gr‐1high) at 12 hr compared with controls. Monocyte density in blood increased at 24 hr, and in contrast, lymphocyte numbers were significantly decreased. Mirroring the early increase in neutrophils within the blood, flow analysis of the spinal cord lesion site revealed a significant (P < 0.01) and maintained increase in blood‐derived leukocytes (CD45high:CD11bhigh) from 12 to 96 hr compared with sham‐injured and naive controls. Importantly, this technique clearly distinguishes blood‐derived neutrophils (CD45:Gr‐1high:F4/80negative) and monocyte/macrophages (CD45high) from resident microglia (CD45low) and revealed that the majority of the blood‐derived infiltrate were neutrophils. Our results highlight an assumed, but previously uncharacterized, marked and transient increase in leukocyte populations in blood early after SCI followed by the orchestrated invasion of neutrophils and monocytes into the injured cord. In contrast to mobilization of neutrophils, SCI induces lymphopenia that may contribute negatively to the overall outcome after spinal cord trauma. © 2008 Wiley‐Liss, Inc.
Calcium receptor expression and function in oligodendrocyte commitment and lineage progression: Potential impact on reduced myelin basic protein in CaR‐null mice
Authors: Chattopadhyay Naibedya , Espinosa‐Jeffrey Araceli , Tfelt‐Hansen Jacob , Yano Shozo , Bandyopadhyay Sanghamitra , Brown Edward M. , de Vellis Jean 
Published: April 2008

AbstractOligodendrocytes develop from oligodendrocyte progenitor cells (OPCs), which in turn arise from a subset of neuroepithelial precursor cells during midneurogenesis. Development of the oligodendrocyte lineage involves a plethora of cell‐intrinsic and ‐extrinsic signals. A cell surface calcium‐sensing receptor (CaR) has been shown to be functionally expressed in immature oligodendrocytes. Here, we investigated the expression and function of the CaR during oligodendrocyte development. We show that the order of CaR mRNA expression as assessed by quantitative polymerase chain reaction is mature oligodendrocyte > neuron > astrocyte. We next determined the rank order of CaR expression on inducing specification of neural stem cells to the neuronal, oligodendroglial, or astrocytic lineages and found that the relative levels of CaR mRNA expression are OPC > neuron > astrocytes. CaR mRNA expression in cells at various stages of development along the oligodendrocyte lineage revealed that its expression is robustly up‐regulated during the OPC stage and remains high until the premyelinating stage, decreasing thereafter by severalfold in the mature oligodendrocyte. In OPCs, high Ca2+ acting via the CaR promotes cellular proliferation. We further observed that high Ca2+ stimulates the mRNA levels of myelin basic protein in preoligodendrocytes, which is also CaR mediated. Finally, myelin basic protein levels were significantly reduced in the cerebellum of CaR‐null mice during development. Our results show that CaR expression is up‐regulated when neural stem cells are specified to the oligodendrocyte lineage and that activation of the receptor results in OPC expansion and differentiation. We conclude that the CaR may be a novel regulator of oligodendroglial development and function. © 2008 Wiley‐Liss, Inc.