bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the Identification of Patients at Risk of Postoperative Renal Failure after Cardiac Surgery
Authors: Wijeysundera Duminda N. , Karkouti Keyvan , Beattie W Scott , Rao Vivek , Ivanov Joan 
Published: December 2005

Background
Preoperative renal insufficiency is an important predictor of the need for postoperative renal replacement therapy (RRT). Serum creatinine (sCr) has a limited ability to identify patients with preoperative renal insufficiency because it varies with age, sex, and muscle mass. Calculated creatinine clearance (CrCl) is an alternative measure of renal function that may allow better estimation of renal reserve.

Methods
Data were prospectively collected for consecutive patients who underwent cardiac surgery requiring cardiopulmonary bypass at a tertiary care center. The relation between CrCl (Cockcroft-Gault equation) and RRT was initially described using descriptive statistics, logistic regression, and receiver operating curve analysis. Based on these analyses, preoperative renal insufficiency was defined as CrCl of 60 ml/min or less. Preoperative renal function was classified as moderate insufficiency (sCr > 133 microM), mild insufficiency (100 microM < sCr < or = 133 microM), occult insufficiency (sCr < or = 100 microM and CrCl < or = 60 ml/min), or normal function (sCr < or = 100 microM and CrCl > 60 ml/min). The independent association of preoperative renal function with RRT was subsequently determined using multiple logistic regression.

Results
Of the 10,751 patients in the sample, 137 (1.2%) required postoperative RRT. Approximately 13% of patients with normal sCr had occult renal insufficiency. Occult renal insufficiency was independently associated with RRT (odds ratio, 2.80; 95% confidence interval, 1.39-5.33). The magnitude of this risk was similar to patients with mild renal insufficiency (P = 0.73).

Conclusions
The inclusion of a simple CrCl-based criterion in preoperative assessments may improve identification of patients at risk of needing postoperative RRT.
Statistical Prediction of the Type of Gastric Aspiration Lung Injury Based on Early Cytokine/Chemokine Profiles
Authors: Hutson Alan D. , Davidson Bruce A. , Raghavendran Krishnan , Chess Patricia R. , Tait Alan R. , Holm Bruce A. , Notter Robert H. , Knight Paul R. 
Published: December 2005

Background
Unwitnessed gastric aspiration can be a diagnostic dilemma, and early discrimination of different forms may help to identify individuals with increased risk of development of severe clinical acute lung injury or acute respiratory distress syndrome. The authors hypothesized that inflammatory mediator profiles could be used to help diagnose different types of gastric aspiration.

Methods
Diagnostic modeling using a newly modified receiver operator characteristic approach was applied to recently published data from our laboratory on lavaged inflammatory mediators from rodents given intratracheal normal saline, hydrochloric acid, small nonacidified gastric particles, or a combination of acid and small gastric particles. Multiple animal groups and postaspiration times of injury were analyzed to gauge the applicability of the predictive approach: rats (6 and 24 h), C57/BL6 wild-type mice (5 and 24 h), and transgenic mice on the same background deficient in the gene for monocyte chemoattractant protein 1 (MCP-1 [-/-] mice; 5 and 24 h).

Results
Overall, the four types of aspiration were correctly discriminated in 85 of 96 rats (89%), 72 of 78 wild-type mice (92%), and 59 of 73 MCP-1 (-/-) mice (81%) by models that used a maximum of only two mediators. The severe "two-hit" aspirate of the combination of acid and small gastric particles was correctly predicted in 21 of 24 rats, 23 of 23 wild-type mice, and 21 of 21 MCP-1 (-/-) mice. Specific best-fit mediators or mediator pairs varied with aspirate type, animal type, and time of injury. Cytokines and chemokines that best predicted the combination of acid and small gastric particles were cytokine-induced neutrophil chemoattractant 1 (6 h) and MCP-1 (24 h) in rats, tumor necrosis factor alpha/macrophage inflammatory protein 2 (5 h) and tumor necrosis factor alpha/MCP-1 (24 h) in wild-type mice, and tumor necrosis factor alpha/macrophage inflammatory protein 2 (5 h) and tumor necrosis factor alpha/keratinocyte-derived cytokine (24 h) in MCP-1 (-/-) mice.

Conclusions
These results support the potential feasibility of developing predictive models that use focused measurements of inflammatory mediators to help diagnose severe clinical forms of unwitnessed gastric aspiration, such as the combination of acid and small gastric particles, that may have a high risk of progression to acute lung injury/acute respiratory distress syndrome.
Excitatory and Inhibitory Actions of Isoflurane on the Cholinergic Ascending Arousal System of the Rat
Authors: Dong Hai-long , Fukuda Satoru , Murata Eri , Higuchi Takashi 
Published: December 2005

Background
The cholinergic arousal systems are known to critically regulate the state of consciousness. The aim of this study was to determine the effect of isoflurane on the inhibitory or excitatory neurotransmitters efflux in important nuclei within the cholinergic arousal system using in vivo intracerebral microdialysis.

Methods
The efflux of glutamate, gamma-aminobutyric acid (GABA), or acetylcholine in the posterior hypothalamus (PH), the basal forebrain (BF), and the somatosensory cortex (S1BF) of rats was detected using intracerebral microdialysis under an awake condition and at 0.5-2.0 minimum alveolar concentration (MAC) isoflurane anesthesia. The intrabasalis perfusion of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and N-methyl-D-aspartate on the cortical acetylcholine effluxes was also examined under both conditions.

Results
Isoflurane had no influence on the glutamate and GABA efflux in the PH, whereas in the BF, it dose-dependently increased glutamate efflux and decreased GABA efflux. A transient increase in glutamate efflux at 1.0 MAC and a decrease in GABA at 0.5-1.5 MAC were observed in the S1BF. Isoflurane dose-dependently decreased acetylcholine efflux in the S1BF. Perfusion of the BF with AMPA increased acetylcholine efflux in the S1BF with electroencephalographic activation during 0.75 MAC isoflurane anesthesia, suggesting an inhibitory action of isoflurane on AMPA receptors in the BF. However, N-methyl-D-aspartate had no effect on these parameters.

Conclusion
Isoflurane induces both excitatory and inhibitory actions in the cholinergic arousal system. The predominant inhibitory action of isoflurane over its excitatory action at the BF would result in the decrease in the acetylcholine efflux in the S1BF.
Cyclooxygenase-2 Induction after Oral Surgery Does Not Entirely Account for Analgesia after Selective Blockade of Cyclooxygenase 2 in the Preoperative Period
Authors: Fornai Matteo , Colucci Rocchina , Graziani Filippo , Cei Silvia , Antonioli Luca , Tonelli Matteo , Vassalle Cristina , Blandizzi Corrado , Gabriele Mario , Del Tacca Mario 
Published: December 2005

Background
The administration of selective cyclooxygenase-2 inhibitors before surgery is regarded as an innovative option to manage postoperative pain. This study was designed to (1) examine the efficacy of preoperative cyclooxygenase-2 blockade on postoperative oral pain and (2) compare pain intensity with prostaglandin E2 (PGE2) production and cyclooxygenase isoform (cyclooxygenase-1, cyclooxygenase-2) messenger RNA (mRNA) expression at the surgical site during the postoperative period.

Methods
Sixty patients with impacted lower third molars were randomly allocated to three single-dose treatment groups--placebo, 50 mg rofecoxib, or 550 mg naproxen--1 h before extraction. Pain intensity was evaluated with categorical and visual analog scales every 30 min from 90 to 240 min after surgery. At these times, PGE2 production in the alveolar socket was also evaluated. Cyclooxygenase-1 and cyclooxygenase-2 mRNA expression was examined by reverse-transcription polymerase chain reaction in gingival specimens collected during tooth removal and 240 min after surgery.

Results
Pain intensity and PGE2 production in the placebo group increased throughout the observation period. Naproxen prevented pain and decreased PGE2 release at all time points. Rofecoxib reduced PGE2 production versus placebo from 150 min onward, while inducing analgesia through the whole observation period. mRNA assay in gingival specimens collected at tooth extraction revealed cyclooxygenase-1 expression, whereas cyclooxygenase 2 was undetectable. At the end of observation, cyclooxygenase-1 mRNA expression was unchanged, whereas cyclooxygenase-2 mRNA was significantly induced.

Conclusions
This study indicates that preoperative administration of a selective cyclooxygenase-2 inhibitor ensures effective control of postoperative pain. It is suggested that the selective blockade of inducible cyclooxygenase 2 at the surgical site does not entirely account for the analgesic action occurring in the postoperative period.
Treatment of acute infectious diarrhoea in infants and children with a mixture of three Lactobacillus rhamnosus strains – a randomized, double‐blind, placebo‐controlled trial
Authors: SZYMAŃSKI H. , PEJCZ J. , JAWIEŃ M. , CHMIELARCZYK A. , STRUS M. , HECZKO P. B. 
Published: December 2005

SummaryBackground  Multiple studies document that probiotics are effective in treating infectious diarrhoea in children. Lactobacillus rhamnosus GG is the most extensively studied but effectiveness of other strains has been poorly examined.Aim  To determine whether L. rhamnosus strains (573L/1; 573L/2; 573L/3) (Lakcid L, Biomed, Lublin, Poland) would be effective in shortening infectious diarrhoea.Methods  In a randomized, double‐blind, placebo‐controlled trial, 87 children (age range: 2 months to 6 years) with infectious diarrhoea were administered Lakcid L at a dose 1.2 × 1010 CFU or placebo, twice daily, for 5 days. Primary outcome measure was the duration of diarrhoea. Secondary measures were duration of parenteral rehydration, adverse events, and gastrointestinal tract colonization by administered strains.Results  In an intention to treat analysis of 87 children, the mean duration of diarrhoea in the treated group: 84 ± 56 h; placebo: 96 ± 72 h (P = 0.36). In rotavirus infection: 76 ± 35 h vs. 115 ± 67 h (P = 0.03), respectively. Duration of parenteral rehydration: 15 ± 14 h vs. 38 ± 33 h (P = 0.006). Gut colonization by administered strains was 80% and 41% at five and 14 days, respectively. No adverse events were noted.Conclusions  Administration of L. rhamnosus strains shortens the duration of rotaviral diarrhoea in children but not of diarrhoea of any aetiology. Intervention shortens the time of intravenous rehydration.
Review article: drug therapy for non‐alcoholic fatty liver disease
Authors: COMAR K. M. , STERLING R. K. 
Published: December 2005

SummaryNon‐alcoholic fatty liver disease represents a spectrum of liver diseases, characterized mainly by macrovesicular steatosis in the absence of significant alcohol ingestion. Non‐alcoholic fatty liver disease includes both non‐alcoholic fatty liver and non‐alcoholic steatohepatitis.Non‐alcoholic steatohepatitis once considered a benign process is now known to lead to progressive fibrosis and cirrhosis. Histologically indistinguishable from alcoholic liver disease, the exact aetiology of non‐alcoholic fatty liver disease remains unknown, but the fundamental pathophysiological process appears to be insulin resistance and oxidative stress related to the metabolic syndrome.Therapy has focused on risk factors, weight reduction and pharmacological intervention. Promising pharmacological treatments have been demonstrated with antioxidants, insulin sensitizers, hepatoprotectants and lipid‐lowering agents. However, without larger randomized studies, no pharmacological treatments can be recommended at this time.
A study of 4‐ and 7‐day triple therapy with rabeprazole, high‐dose levofloxacin and tinidazole rescue treatment for Helicobacter pylori eradication
Authors: GIANNINI E. G. , BILARDI C. , DULBECCO P. , MAMONE M. , SANTI M. L. , TESTA R. , MANSI C. , SAVARINO V. 
Published: December 2005

SummaryBackground  Helicobacter pylori treatment failure is becoming an emergent problem in clinical practice. Shorter treatment duration should improve compliance to therapy and keep an acceptable H. pylori eradication rate.Aims  To evaluate the efficacy of two rabeprazole, high‐dose levofloxacin and tinidazole‐based regimens as ‘rescue’ treatment for H. pylori eradication in an open‐label, randomized, pilot study carried out in a clinical practice setting.Methods  Eighty‐five consecutive patients who have previously failed at least one H. pylori eradication attempt were randomized to receive rabeprazole (20 mg, b.d.), levofloxacin (500 mg, b.d.) and tinidazole (500 mg, b.d.) either for 4 (4‐day RLT, n = 42) or 7 days (7‐day RLT, n = 43). Cure of H. pylori infection was assessed by means of 13C‐urea breath test.Results  The 7‐day RLT achieved 84% (95% CI: 69–93%) and 86% (95% CI: 72–95%) eradication rates in intention‐to‐treat and per‐protocol analyses respectively. The shorter treatment obtained an 83% (95% CI: 69–93%) eradication rate in both intention‐to‐treat and per‐protocol analysis. Both regimens were well tolerated, although patients who received the 4‐day RLT reported fewer side‐effects.Conclusions  In patients who have previously failed at least one H. pylori eradication attempt, both 4‐ and 7‐day rabeprazole, high‐dose levofloxacin, tinidazole‐based regimens are effective in curing the infection in more than 80% of patients.
Effect of desloratadine on epithelial cell granulocyte‐macrophage colony‐stimulating factor secretion and eosinophil survival
Authors: Mullol J. , Roca‐Ferrer J. , Alobid I. , Pujols L. , Valero A. , Xaubet A. , Bernal‐Sprekelsen M. , Picado C. 
Published: December 2005

SummaryBackground
Second‐generation antihistamines are H1 receptor antagonists and may have additional anti‐inflammatory effects.Objective
The aims of the study were to evaluate the effect of desloratadine (DL) on cytokine secretion by epithelial cells from both nasal mucosa (NM) and polyps (NP), and on eosinophil survival primed by epithelial cell secretions.Methods
Epithelial cells were cultured and stimulated with fetal bovine serum (FBS), IL‐1β or TNF‐α with and without DL for 24 h. Culture supernatant cytokines concentration were measured by ELISA. Peripheral blood eosinophils were incubated with human epithelial cell conditioned media (HECM) and DL. Eosinophil survival was assessed by Trypan blue dye exclusion. Results are expressed as mean±SEM of cytokine concentration (pg/mL) or eosinophil survival index (%).Results
FBS increased granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), vascular endothelial growth factor (VEGF), IL‐6, IL‐8, and TGF‐β1 secretion in epithelial cell cultures from both NM and NP. Only GM‐CSF secretion was significantly (P<0.05) inhibited by a dose‐response of DL compared with positive controls, in both NM (10−5 m: 125±36 pg/mL, 10−6 m: 95±22 pg/mL vs. control: 256±91 pg/mL, n=6) and NP (10−5 m: 80±29 pg/mL, 10−6 m: 109±45 pg/mL vs. control: 333±212 pg/mL, n=6). DL also showed an inhibitory effect on HECM‐induced eosinophil survival from both NM and NP. At 72 h, DL significantly (P<0.01) inhibited eosinophil survival induced by HECM from NM (10−5 m: 19.9±5.5%, n=9; 10−6 m: 28.7±7.7%, n=9) and NP (10−5 m: 6.2±2.8%, n=11) compared with HECM alone (NM: 42.1±7.3%; NP: 45.3±8.1%).Conclusion
The inhibitory effects of DL on epithelial cell GM‐CSF secretion and on eosinophil survival induced by epithelial cell secretions, suggest that this H1 antagonist may regulate eosinophil inflammation in upper airways.
Adenoidectomy and/or tonsillectomy in childhood is not associated with atopic disease later in life
Authors: van Hattum E. S. , Balemans W. A. F. , Rovers M. M. , Zielhuis G. A. , Schilder A. G. M. , van der Ent C. K. 
Published: December 2005

SummaryObjective
To investigate the association between adenoidectomy and/or tonsillectomy in childhood and asthma, allergic rhinitis (AR), and eczema in adolescence.Methods
Longitudinal birth cohort study of 1328 members born in the city of Nijmegen. Information on ear–nose–throat surgery was documented at 2, 4, and 8 years of age. In 1055 cohort members the incidence of asthma, AR, and eczema at 21 years of age was determined using the International Study of Asthma and Allergic disease in Childhood Core Questionnaire. To analyse the association between adenoidectomy and/or tonsillectomy in childhood and asthma, AR, and eczema at age 21 years, relative risks (RR) were calculated.Results
Six hundred and ninety‐three (66%) members completed the questionnaire at age 21 years, of whom 104 (15%) had undergone adenoidectomy and/or tonsillectomy and 262 (38%) reported atopic disease. Children who underwent adenoidectomy and/or tonsillectomy before the age of 8 years were not more likely to develop asthma, AR, or eczema at the age of 21 years than children who did not; RR 0.93 (95% confidence limits (CL) 0.52–1.64), RR 0.94 (CL 0.68–1.30), and RR 1.00 (CL 0.59–1.68), respectively.Conclusions
Our data show no association between adenoidectomy and/or tonsillectomy in childhood and the incidence of atopic disease in young adults.
Identification ofLeishmania donovaniantigens stimulating cellular immune responses in exposed immune individuals
Authors: Tripathi P , Ray S , Sunder S , Dube A , Naik S 
Published: December 2005

SummaryHuman visceral leishmaniasis (VL), also known as kala azar (KA) in India, is a systemic progressive disease caused by Leishmania donovani. In VL, Th1 responses correlate with recovery from and resistance to disease and resolution of infection results in lifelong immunity against the disease. However, recent data suggest an important role for interleukin (IL)-10 in maintaining the resistant state. We evaluated whole cell extract (WE) and 11 antigenic fractions [F1–F11, molecular weight (MW) range of 139–24·2 kDa] from L. donovani (2001 strain, a fresh field isolate from Bihar), for their ability to induce in vitro T cell proliferation and production of interferon (IFN)-γ, interleukin (IL)-12, IL-10 and IL-4 by peripheral blood mononuclear cells (PBMCs) of exposed immune individuals (14 patients with history of VL, 10 household endemic contacts) and 20 non-endemic healthy controls. Twenty-one of 24 exposed individuals and no healthy controls showed proliferative response to WE. Whole-extract activated IFN-γ, IL-12, IL-10 levels were higher in the exposed group than in controls; IL-4 was not detectable in any of the samples. Among 21 responders to WE, frequent proliferative responses were seen to fractions F1–F4 (MW &gt; 64·2 kDa) and none to fractions F5–F11; fractions F1–F11 stimulated comparable levels of IFN-γ and IL-12 while IL-10 levels were higher in response to F5–F11 compared to F1–F4. These data demonstrate the presence of immunostimulatory antigens in the high MW fractions of whole L. donovani antigen. However, these fractions do not stimulate a Th1 response and produce variable amounts of IFN-γ and the regulatory cytokine, IL-10. Hence, these high MW immunostimulatory fractions need to be evaluated in greater depth for their possible role as protective antigens.
A sampling protocol to detect latent infections in potato tubers
Authors: Battilani P. , Sanguineti M.C. , Saccardi A. , Pasqua di Bisceglie D. , Traversa F. , Mazzucchi U. 
Published: December 2005

A sampling protocol for detecting latent infections in potato tubers stored in bins, based on the preparation of standard samples of 200 tubers, was tested for reliability. Bins of tubers were manually distributed in windrows and 1% of tubers were replaced with painted tubers, simulating tubers with latent infections. The painted tubers were distributed in windrows with clustered, regular and random distribution. Tubers were harvested and transferred to bins. Each bin was considered to be divided into layers 15 cm in depth, and 20 tubers were collected along an X‐shaped sampling path of each bin layer. A simulated sampling approach was applied to obtain 10 bulk samples (200 tubers) for each kind of tuber distribution. The number of marked tubers, the mean percentage and the standard deviation of the bulk samples of each group was computed. The results confirmed that the sampling design adopted in this study ensured preparation of representative bulk samples. In fact, marked tubers were effectively detected; the observed mean percentages of marked tubers were acceptable in value, even though an overestimate of the true percentage was generally obtained. The percentage of marked tubers was underestimated in 50% of cases when considering a regular distribution of marked tubers. However, it was never underestimated when considering the clustered distribution, which is most representative of the situation for tubers with latent infections.
Arterial stiffening and cardiac hypertrophy in a new rat model of type 2 diabetes
Authors: Chang K.‐C. , Tseng C.‐D. , Chou T.‐F. , Cho Y.‐L. , Chi T.‐C. , Su M.‐J. , Tseng Y.‐Z. 
Published: December 2005

AbstractBackground  We determined the effects of NIDDM on haemodynamic parameters describing arterial wall elasticity and cardiac hypertrophy in rats administered streptozotocin (STZ) and nicotinamide (NA), using the aortic impedance analysis.Methods  Male Wistar rats at 2 months were administered intraperitoneally 180 mg kg−1 of NA, 30 min before an intravenous injection of 50 mg kg−1 STZ, to induce type 2 diabetes. The STZ‐NA rats were divided into two groups, 4 weeks and 8 weeks after induction of diabetes, and compared with untreated age‐matched controls. Pulsatile aortic pressure and flow signals were measured by a high‐fidelity pressure sensor and electromagnetic flow probe, respectively, and were then subjected to Fourier transformation for the analysis of aortic input impedance.Results  In each diabetic group, the experimental syndrome was characterized by a moderate and stable hyperglycaemia and a relative deficiency of insulin secretion. However, the 8‐week but not the 4‐week STZ‐NA diabetic rats showed a decrease in cardiac output in the absence of any significant changes in mean aortic pressure, having increased total peripheral resistance. The diabetic syndrome at 8 weeks also contributed to an increase in aortic characteristic impedance, from 1·49 ± 0·33 (mean ± SD) to 1·95 ± 0·28 mmHg s mL−1 (P < 0·05), suggesting a detriment to the aortic distensibility in NIDDM. Meanwhile, the STZ‐NA diabetic animals after 8 weeks had an increased wave reflection factor (0·46 ± 0·09 vs. 0·61 ± 0·13, P < 0·05) and decreased wave transit time (25·8 ± 3·8 vs. 20·6 ± 2·8 ms, P < 0·05). Ratio of the left ventricular weight to body weight was also enhanced in the 8‐week STZ‐NA diabetic rats.Conclusion  The heavy intensity with early return of the pulse wave reflection may augment systolic load of the left ventricle coupled to the arterial system, leading to cardiac hypertrophy in the rats at 8 weeks after following STZ and NA administration.