bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid-lowering and skin vascular responses in patients with hypercholesterolaemia and peripheral arterial obstructive disease
Authors: Khan Faisel , Litchfield Stuart J , Stonebridge Peter A , Belch Jill JF 
Published: January 2007

Elevated blood cholesterol is a major risk factor for atherosclerosis. Recent studies show that lowering cholesterol reduces the risk of vascular disease, but the precise mechanisms for vascular improvement are not fully understood. Furthermore, it is not known whether the beneficial effects of cholesterol lowering extend to the skin microvasculature. In this unrandomized, open design study, we used iontophoresis and laser Doppler flowmetry to examine forearm skin perfusion in hypercholesterolaemic patients with PAOD before and after cholesterol-lowering therapy with fluvastatin. Endothelium-dependent and -independent vasodilatation were measured following skin iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), respectively. Before cholesterol-lowering, vascular responses to ACh and SNP were reduced significantly in patients compared with responses in control subjects (p, 0.001 and p, 0.05, ANOVA, respectively). Fluvastatin therapy (40 mg/day) for 24 weeks significantly reduced total cholesterol (7.3 6 0.3 to 6.0 6 0.2 mmol/l, p, 0.001) and LDL cholesterol (5.4 6 0.5 to 4.2 6 0.4 mmol/l, p, 0.01). Vasodilatation to SNP was significantly improved at week 24 (p, 0.05). In patients with hypercholesterolaemia and PAOD, cholesterol-lowering with statin therapy significantly improved endothelium-independent vascular responses to SNP in skin microvessels. The application of the non-invasive techniques of iontophoresis and laser Doppler flowmetry may provide useful markers for the assessment of microvascular function in this group of patients.
Pathological fractures of the extremities
Authors: Cool Paul , Grimer Rob 
Published: January 2007

Pathological fractures of the appendicular skeleton due to tumours are relatively uncommon. Patients who are older than 50 years are most likely to have a metastasis, while patients who are younger than 20 are more likely to have a primary bone neoplasm. In all fractures, but especially those that present after minimal trauma, one should have a high index of suspicion that the fracture might be pathological. Correct diagnosis prior to treatment is essential and we have constructed a protocol for this. In the assessment of these tumours a multidisciplinary assessment with radiologist, pathologist, oncologist and orthopaedic surgeon, is essential. The patient will require both oncological and surgical treatment. The aims of surgical treatment are firstly to stabilize the fracture with a construct that will outlive the patient and second to improve the patient’s mobility and to relieve pain. Advances in oncological treatment have prolonged the survival of patients with primary and metastatic bone disease. This puts increasing strains on the surgical construct, therefore the choice of surgical reconstruction needs to be carefully considered. We outline the assessment of a patient who presents with a pathological fracture in three phases and describe a treatment protocol.
Current consensus and controversies in major burns management
Authors: Judkins Keith 
Published: January 2007

Most doctors in Britain receive some training in the care of the burned patient, if not as an undergraduate then as part of training in accident and emergency medicine or in the Advanced Trauma Life Support (ATLS®) course. Because major burn injury presents infrequently to the average district hospital, most of this training is rusty by the time it is needed. Further, most have little opportunity to catch up with developments in this very specialized area of trauma medicine. This paper aims to address some of these shortcomings by describing recent advances in burn care and highlighting areas of current debate. The fluids used for resuscitation, improved options for treatment, the status of ongoing discussions about treatment facilities and the state of the art in managing smoke inhalation are reviewed. Some pointers to the future and to avenues for research are suggested.
Non-operative management of solid organ trauma in children
Authors: Powis MR , Cord-Udy C , Walsh M 
Published: January 2007

Trauma is the commonest cause of mortality in infancy and childhood. Injuries from blunt trauma predominate, with multisystem injury, the rule. Blunt abdominal injury represents the third commonest cause of death from injury in this age group. Initial management of the child combines assessment and resuscitation. If the child’s condition is stable then the injured organ should be definitively identified, usually by computerized tomography. Over 90% of children who are stable at this point can be managed conservatively, with a period of observation on an intensive care unit, followed by bed rest on a general ward. Instability at any point requires further resuscitation, reassessment and if necessary laparotomy. Repeated clinical assessment and radiological investigation are used to guide further management, mobilization and the return to normal activities.
Brain monitoring in severe head injury: a practical guide
Authors: Mathew P , Gentleman D , Bullock MR 
Published: January 2007

There is, as yet, no specific therapy available for post-traumatic brain damage; the treatment of head injury is therefore aimed at limitation of secondary damage at the cellular, whole organ and systemic level. The purpose of monitoring the injured brain is twofold: 1. to obtain a better understanding of the mechanisms by which pathophysiological processes further damage the injured brain 2. to continuously detect potentially harmful influences and allow them to be reversed before damage is done. In this review, we provide a general overview of mechanisms of brain damage due to high intracranial pressure (ICP) and discuss the following ‘brain specific’ haemodynamic monitoring techniques: • ICP/CPP (cerebral perfusion pressure) monitoring; • jugular vein saturation (SjO2) monitoring; • cerebral oxygen monitoring (PtiO2) and near infra-red spectroscopy (NIRS); • brain temperature monitoring; • cerebral blood flow (CBF) monitoring; and • transcranial Doppler. We also discuss the role of functional techniques such as electroencephalogram (EEG) and evoked potential monitoring. This article gives an overview of the techniques currently available in a rapidly expanding field within neuro-intensive care, mainly for the interest of trauma surgeons, intensivists, and others with a practical need to understand the monitoring of the injured brain.
When to ventilate
Authors: Wright Sue 
Published: January 2007

Within the setting of trauma, there are many indications for intubation and ventilation, but the ultimate aims are always the same. These are to ensure airway patency and security, provide an acceptable level of arterial oxygenation at the lowest possible inspired oxygen concentration, control arterial carbon dioxide tension and optimize pulmonary and systemic blood flow. The clinical situation, developing trends, and the experience of the individual concerned will all influence the decision to intubate and ventilate the patient who has suffered trauma. This paper considers the ‘rule-of-thumb’ indications for intubation in the emergency room and discusses the factors which may influence their interpretation.
Medical care in civil disorder
Authors: Cocks Robert A 
Published: January 2007

Civil disorder may be defined in widely differing terms, depending largely on the political and legal system prevailing in a given country. The way in which the authorities manage disorder has important implications for both internal stability and the country’s international image, and to a great extent the number of injuries will also depend on the effectiveness of this management. For the police, ambulance service and hospitals, civil disorder will often necessitate the invocation of their respective major incident plans. Since the response requirements may be very different from other disasters, such plans need to address civil disorder specifically. This paper reviews the various wounding agents that may be used by participants in civil disorder, and by security forces in their response. The issues of personal safety for emergency service staff are reviewed, and the organizational aspects of medical care emphasized.
The Mycobacterium marinum mel2 locus displays similarity to bacterial bioluminescence systems and plays a role in defense against reactive oxygen and nitrogen species
Authors: Subbian Selvakumar , Mehta Parmod K , Cirillo Suat LG , Cirillo Jeffrey D 
Published: January 2007

Abstract

Background
Mycobacteria have developed a number of pathways that provide partial protection against both reactive oxygen species (ROS) and reactive nitrogen species (RNS). We recently identified a locus in Mycobacterium marinum, mel2, that plays a role during infection of macrophages. The molecular mechanism of mel2 action is not well understood.

Results
To better understand the role of the M. marinum mel2 locus, we examined these genes for conserved motifs in silico. Striking similarities were observed between the mel2 locus and loci that encode bioluminescence in other bacterial species. Since bioluminescence systems can play a role in resistance to oxidative stress, we postulated that the mel2 locus might be important for mycobacterial resistance to ROS and RNS. We found that an M. marinum mutant in the first gene in this putative operon, melF, confers increased susceptibility to both ROS and RNS. This mutant is more susceptible to ROS and RNS together than either reactive species alone.

Conclusion
These observations support a role for the M. marinum mel2 locus in resistance to oxidative stress and provide additional evidence that bioluminescence systems may have evolved from oxidative defense mechanisms.
Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation: A case report
Authors: Baijal Noopur , Sahni Mohit , Verma Neeraj , Kumar Amit , Parkhe Nittin , Puliyel Jacob M 
Published: January 2007

Abstract

Background
Documentation of superfoetation is extremely rare in humans., The younger foetus has invariably been small for gestational age (estimated from the date of the last menstrual bleed) in all the cases reported in the literature. We report a case where the younger twin was of appropriate size for gestation.

Case Presentation
The first of twins was of 32 weeks gestation and the baby was of appropriate size and development for the gestational age. The second twin was of 36 weeks gestation. Gestational age was estimated with the New Ballard score, x-ray of the lower limbs, dental age on x-ray, and ophthalmic examination.

Conclusion
Bleeding on implantation of the first foetus probably helped demarcate the two pregnancies. Dental age and the New Ballard score can be used to diagnose superfoetation in discordant twins, when detailed first trimester ultra-sound data is not available.
Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study
Authors: Ballerini Andrea , Boccalon Roberto M , Boncompagni Giancarlo , Casacchia Massimo , Margari Francesco , Minervini Lina , Righi Roberto , Russo Federico , Salteri Andrea , Frediani Sonia , Rossi Andrea , Scatigna Marco ,   the PERSEO study group
Published: January 2007

Abstract

Background
Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management).

Method
Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO – Psychiatric EmeRgency Study and EpidemiOlogy).

Results
253 FPA aged <= 40 were identified among 2521 patients admitted to Italian SPDCs over the 5-month study period. About half of FPA patients showed an aggressive behavior as defined by a Modified Overt Aggression Scale (MOAS) score greater than 0 Vs 46% of non-FPA patients (p = 0.3651). The most common was verbal aggression, while about 20% of FPA patients actually engaged in physical aggression against other people. 74% of FPA patients had no diagnosis at admission, while 40% had received a previous psychopharmacological treatment, mainly benzodiazepines and antidepressants. During SPDC stay, diagnosis was established in 96% of FPA patients and a pharmacological therapy was prescribed to 95% of them, mainly benzodiazepines, antipsychotics and mood stabilizers.

Conclusion
Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved significantly from admission to discharge both for FPA and non-FPA patients.
Impact of immigration on the cost of emergency visits in Barcelona (Spain)
Authors: Cots Francesc , Castells Xavier , García Oscar , Riu Marta , Felipe Aida , Vall Oriol 
Published: January 2007

Abstract
Background
The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population.

Methods
Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect.

Results
With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults.

Conclusion
Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity.
Identification of novel immunogens in Pasteurella multocida
Authors: Al-Hasani Keith , Boyce John , McCarl Victoria P , Bottomley Stephen , Wilkie Ian , Adler Ben 
Published: January 2007

Abstract

P. multocida is a Gram-negative pathogen responsible for causing diseases in animals of economic significance to livestock industries throughout the world. Current vaccines include bacterins, which provide only limited protection against homologous serotypes. Therefore there is a need for more effective vaccines to control diseases caused by P. multocida. As a step towards developing vaccines against fowl cholera, a genomics based approach was applied for the identification of novel immunogens.

Results

Bioinformatics analysis of the P. multocida genome predicted 129 proteins as secreted, located in the outer membrane, or lipoproteins. 105 of the genes encoding these proteins were cloned and recombinant protein expressed in Escherichia coli. Polyclonal serum from P. multocida-infected chickens reacted with a subset of these proteins.

Conclusion

These data show the range of bacterial immunogens recognized by the chicken immune system, including 6 novel immunoreactive proteins.
Synthesis and biologic properties of hydrophilic sapphyrins, a new class of tumor-selective inhibitors of gene expression
Authors: Wang Zhong , Lecane Philip S , Thiemann Patricia , Fan Qing , Cortez Cecilia , Ma Xuan , Tonev Danielle , Miles Dale , Naumovski Louie , Miller Richard A , Magda Darren , Cho Dong-Gyu , Sessler Jonathan L , Pike Brian L , Yeligar Samantha M , Karaman Mazen W , Hacia Joseph G 
Published: January 2007

Abstract

Background
Sapphyrin analogues and related porphyrin-like species have attracted attention as anticancer agents due to their selective localization in various cancers, including hematologic malignancies, relative to surrounding tissues. Sapphyrins are electron affinic compounds that generate high yields of singlet oxygen formation. Although initially explored in the context of photodynamic therapy, sapphyrins have intrinsic anticancer activity that is independent of their photosensitizing properties. However, the mechanisms for their anticancer activity have not been fully elucidated.

Results
We have prepared a series of hydrophilic sapphyrins and evaluated their effect on proliferation, uptake, and cell death in adherent human lung (A549) and prostate (PC3) cancer cell lines and in an A549 xenograft tumor model. PCI-2050, the sapphyrin derivative with the highest in vitro growth inhibitory activity, significantly lowered 5-bromo-2'-deoxyuridine incorporation in S-phase A549 cells by 60% within eight hours and increased levels of reactive oxygen species within four hours. The growth inhibition pattern of PCI-2050 in the National Cancer Institute 60 cell line screen correlated most closely using the COMPARE algorithm with known transcriptional or translational inhibitors. Gene expression analyses conducted on A549 plateau phase cultures treated with PCI-2050 uncovered wide-spread decreases in mRNA levels, which especially affected short-lived transcripts. Intriguingly, PCI-2050 increased the levels of transcripts involved in RNA processing and trafficking, transcriptional regulation, and chromatin remodeling. We propose that these changes reflect the activation of cellular processes aimed at countering the observed wide-spread reductions in transcript levels. In our A549 xenograft model, the two lead compounds, PCI-2050 and PCI-2022, showed similar tumor distributions despite differences in plasma and kidney level profiles. This provides a possible explanation for the better tolerance of PCI-2022 relative to PCI-2050.

Conclusion
Hydrophilic sapphyrins were found to display promise as novel agents that localize to tumors, generate oxidative stress, and inhibit gene expression.
Interleukin-18 regulates pathological intraocular neovascularization
Authors: Qiao Hong , Sonoda Koh-Hei , Ikeda Yasuhiro , Yoshimura Takeru , Hijioka Kuniaki , Jo Young-Joon , Sassa Yukio , Tsutsumi-Miyahara Chikako , Hata Yasuaki , Akira Shizuo , Ishibashi Tatsuro 
Published: January 2007

AbstractRecently, the proinflammatory cytokine IL-18 has been shown to have a role in angiogenesis. This study aimed to elucidate its role in abnormal neovascularization (NV) in an oxygen-induced retinopathy (OIR) mouse model of the retinopathy seen in human premature newborns. IL-18 was constitutively expressed in the retina in C57BL/6 mice, but expression transiently dropped on Day 17 after birth in mice exposed to 75% oxygen for 5 days between Days 7 and 12. Coincident with the IL-18 reduction in oxygen-treated mice, vascular endothelial growth factor was expressed in the retina, and OIR developed. By Day 24, NV in the retina had regressed to normal levels. By contrast, IL-18 knockout mice, exposed to elevated oxygen concentrations, developed more severe OIR on Day 17, and it is important that this persisted until Day 24. This suggested that IL-18 negatively regulated retinal NV. To investigate this further, we administrated recombinant IL-18 to C57BL/6 mice during the development of OIR but found no significant inhibition of retinopathy. However, when IL-18-binding protein was administered during the OIR recovery phase to neutralize endogenous IL-18, OIR was still apparent on Day 24. We therefore concluded that IL-18 regulates pathogenic retinal NV by promoting its regression rather than inhibiting its development. This suggests some useful, new approaches to treating retinopathy in humans.
Simple Method for Haplotyping the Poly(TG) Repeat in Individuals Carrying the IVS8 5T Allele in the CFTR Gene
Authors: Mantovani Vilma , Garagnani Paolo , Selva Paola , Rossi Cesare , Ferrari Simona , Cenci Marinella , Calza Nilla , Cerreta Vincenzo , Luiselli Donata , Romeo Giovanni 
Published: January 2007

AbstractBackground: The 5T allele of the polyT tract located within intron 8 of the cystic fibrosis transmembrane conductance regulator (CFTR) gene is a variant that in trans with a severe CFTR mutation can result in normal phenotype, congenital bilateral absence of vas deferens (CBAVD), or mild cystic fibrosis. The 5T allele has been associated with the skipping of exon 9, a process that seems to be influenced by an adjacent 9–13TG tandem repeat. The 12- or 13TG repeats are often associated with an abnormal phenotype. We present here a single-step method for direct haplotyping of the TG repeats in 5T carriers.Method: The method is based on a single-step PCR, using a fluorescently labeled forward primer and a reverse allele-specific primer matching the 5T allele. We validated the test in 30 control samples of known 5T-poly(TG) haplotype and then used this method to evaluate 57 clinical samples.Results: The expected TG genotypes were obtained for all 5T control samples, and no nonspecific amplification of either the 7T or 9T alleles was detected. In our 5T-positive collection 9 of 9 (100%) CBAVD patients, 6 of 12 (50.0%) chronic pancreatitis patients, and 12 of 36 (33.3%) individuals undergoing assisted reproduction showed 5T-12TG haplotype.Conclusions: Our method is an accurate, specific, and simple tool to characterize the 5T poly(TG) haplotype. Our results confirm the high frequency of 5T-12TG in CBAVD patients and do not preclude a potential effect also in pancreatitis. This assay can be useful in assessment of the disease risk in 5T carriers.