bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can cocaine use be evaluated through analysis of wastewater? A nation‐wide approach conducted in Belgium
Authors: Van Nuijs Alexander L. N. , Pecceu Bert , Theunis Laetitia , Dubois Nathalie , Charlier Corinne , Jorens Philippe G. , Bervoets Lieven , Blust Ronny , Meulemans Herman , Neels Hugo , Covaci Adrian 
Published: March 2009

ABSTRACTAims  Cocaine is the second most‐used illicit drug world‐wide and its consumption is increasing significantly, especially in western Europe. Until now, the annual prevalence has been estimated indirectly by means of interviews. A recently introduced and direct nation‐wide approach based on measurements of the major urinary excreted metabolite of cocaine, benzoylecgonine, in wastewater is proposed.Design  Wastewater samples from 41 wastewater treatment plants (WWTPs) in Belgium, covering approximately 3 700 000 residents, were collected. Each WWTP was sampled on Wednesdays and Sundays during two sampling campaigns in 2007–08. Samples were analysed for cocaine (COC) and its metabolites, benzoylecgonine (BE) and ecgonine methylester (EME) by a validated procedure based on liquid chromatography coupled with tandem mass spectrometry. Concentrations of BE were used to calculate cocaine consumption (g/day per 1000 inhabitants) for each WWTP region and for both sampling campaigns (g/year per 1000 inhabitants).Findings  Weekend days showed significantly higher cocaine consumption compared with weekdays. The highest cocaine consumption was observed for WWTPs receiving wastewater from large cities, such as Antwerp, Brussels and Charleroi. Results were extrapolated for the total Belgian population and an estimation of a yearly prevalence of cocaine use was made based on various assumptions. An amount of 1.88 tonnes (t) per year [standard error (SE) 0.05 t] cocaine is consumed in Belgium, corresponding to a yearly prevalence of 0.80% (SE 0.02%) for the Belgian population aged 15–64 years. This result is in agreement with an earlier reported estimate of the Belgian prevalence of cocaine use conducted through socio‐epidemiological studies (0.9% for people aged 15–64 years).Conclusions  Wastewater analysis is a promising tool to evaluate cocaine consumption at both local and national scale. This rapid and direct estimation of the prevalence of cocaine use in Belgium corresponds with socio‐epidemiological data. However, the strategy needs to be refined further to allow a more exact calculation of cocaine consumption from concentrations of BE in wastewater.
Twelve‐Step affiliation and 3‐year substance use outcomes among adolescents: social support and religious service attendance as potential mediators
Authors: Chi Felicia W. , Kaskutas Lee A. , Sterling Stacy , Campbell Cynthia I. , Weisner Constance 
Published: March 2009

ABSTRACTAims  Twelve‐Step affiliation among adolescents is little understood. We examined 12‐Step affiliation and its association with substance use outcomes 3 years post‐treatment intake among adolescents seeking chemical dependency (CD) treatment in a private, managed‐care health plan. We also examined the effects of social support and religious service attendance on the relationship.Design  We analyzed data for 357 adolescents, aged 13–18, who entered treatment at four Kaiser Permanente Northern California CD programs between March 2000 and May 2002 and completed both baseline and 3‐year follow‐up interviews.Measures  Measures at follow‐up included alcohol and drug use, 12‐Step affiliation, social support and frequency of religious service attendance.Findings  At 3 years, 68 adolescents (19%) reported attending any 12‐Step meetings, and 49 (14%) reported involvement in at least one of seven 12‐Step activities, in the previous 6 months. Multivariate logistic regression analyses indicated that after controlling individual and treatment factors, 12‐Step attendance at 1 year was marginally significant, while 12‐Step attendance at 3 years was associated with both alcohol and drug abstinence at 3 years [odds ratio (OR) 2.58, P < 0.05 and OR 2.53, P < 0.05, respectively]. Similarly, 12‐Step activity involvement was associated significantly with 30‐day alcohol and drug abstinence. There are possible mediating effects of social support and religious service attendance on the relationship between post‐treatment 12‐Step affiliation and 3‐year outcomes.Conclusions  The findings suggest the importance of 12‐Step affiliation in maintaining long‐term recovery, and help to understand the mechanism through which it works among adolescents.
Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users
Authors: Scott Christy K , Dennis Michael L. 
Published: March 2009

ABSTRACTAims  Post‐discharge monitoring and early reintervention have become standard practice when managing numerous chronic conditions. These two experiments tested the effectiveness of recovery management checkup (RMC) protocols for adult chronic substance users.Intervention  RMC included quarterly monitoring; motivational interviewing to provide personalized feedback and to resolve ambivalence about substance use; treatment linkage, engagement and retention protocols to increase the amount of treatment received.Participants and setting  Recruited from sequential addiction treatment admissions, participants in the two experiments were, on average, 36 and 38 years of age, mainly female (59% versus 46%), African American (85% versus 80%) and met past‐year criteria for dependence (87% versus 76%).Design  Participants in both experiments were assigned randomly to the RMC or control condition and interviewed quarterly for 2 years.Measurement  The Global Appraisal of Individual Needs (GAIN) was the main assessment instrument.Findings  RMC participant outcomes were better than control participants in both experiments. Effect sizes were larger in the second experiment in terms of reducing days to readmission (Cohen's d = 0.41 versus d = 0.22), successive quarters in the community using substances (d = −0.32 versus −0.19), past‐month symptoms of abuse/dependence (d = −0.23 versus −0.02) and increasing the days of abstinence over 2 years (d = +0.29 versus 0.04).Conclusion  RMC, which provided ongoing monitoring and linkage, is feasible to conduct and is effective for adults with chronic substance dependence.
Individual trajectories of substance use in lesbian, gay and bisexual youth and heterosexual youth
Authors: Marshal Michael P. , Friedman Mark S. , Stall Ron , Thompson Amanda L. 
Published: March 2009

ABSTRACTAims Several decades of research have shown that lesbian, gay and bisexual (LGB) adults are at high risk for substance use and substance use disorders, and a recent meta‐analysis shows that these disparities most probably begin in adolescence; however, no studies to date have examined longitudinal growth in substance use in LGB youth and heterosexual youth to determine if they follow different trajectories into young adulthood. The primary aims of this paper were to estimate individual trajectories of substance use in youth and examine differences between self‐identified LGB and heterosexual subsamples.Method A school‐based, longitudinal study of health‐related behaviors of adolescents and their outcomes in young adulthood was used to test our hypotheses (The National Longitudinal Study of Adolescent Health). Participants were included if they were interviewed at all three waves and were not missing information regarding self‐identified sexual orientation (n = 10 670).Results Latent curve models (LCMs) showed that LGB identity was associated significantly with individual variability in substance use intercepts and slopes, above and beyond age, race and gender. Self‐identified LGB youth reported higher initial rates of substance use and on average their substance use increased over time more rapidly than did substance use by heterosexual youth. Two other indicators of sexual orientation (same‐sex romantic attraction and same‐sex sexual behavior) were also associated with substance use trajectories, and differential results were found for youth who identified as ‘mostly heterosexual’ and bisexual compared with youth who identified as completely heterosexual or homosexual.Conclusions Sexual orientation is an important risk marker for growth in adolescent substance use, and the disparity between LGB and heterosexual adolescents increases as they transition into young adulthood. More research is needed in order to examine: causal mechanisms, protective factors, important age‐related trends (using a cohort‐sequential design), the influence of gay‐related developmental milestones, curvilinear effects over time and long‐term health outcomes.
Pre‐oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation
Authors: McClelland S. H. , Bogod D. G. , Hardman J. G. 
Published: March 2009

SummaryUsing the Nottingham Physiology Simulator, we investigated the effects on pre‐oxygenation and apnoea during rapid sequence induction of labour, obesity, sepsis, pre‐eclampsia, maternal haemorrhage and multiple pregnancy in term pregnancy. Pre‐oxygenation with 100% oxygen was followed by simulated rapid sequence induction when end‐tidal nitrogen tension was less than 1 kPa, and apnoea. Labour, morbid obesity and sepsis accelerated pre‐oxygenation and de‐oxygenation during apnoea. Fastest pre‐oxygenation was in labour, with 95% of the maximum change in expired oxygen tension occurring in 47 s, compared to 97 s in a standard pregnant subject. The labouring subject with a body mass index of 50 kg.m−2 demonstrated the fastest desaturation, the time taken to fall to an arterial saturation < 90% being 98 s, compared to 292 s in a standard pregnant subject. Pre‐eclampsia prolonged pre‐oxygenation and tolerance to apnoea. Maternal haemorrhage and multiple pregnancy had minor effects. Our results inform the risk‐benefit comparison of the anaesthetic options for Caesarean section.
A meta‐analysis of the utility of C‐reactive protein in predicting early, intermediate‐term and long term mortality and major adverse cardiac events in vascular surgical patients
Authors: Padayachee L. , Rodseth R. N. , Biccard B. M. 
Published: March 2009

SummaryWe conducted a meta‐analysis of the utility of pre‐operative C reactive protein (CRP) in predicting early (< 30 days), intermediate (30–180 days) and long term (> 180 days) mortality and major adverse cardiac events (MACE; cardiac mortality and nonfatal myocardial infarction (MI) combined) following vascular surgery. Of 291 studies identified, ten prospective patient cohorts were identified. A pre‐operative CRP > 3 mg.l−1 was not associated with 30‐day all‐cause mortality, cardiac mortality, nonfatal myocardial infarction or MACE. Intermediate‐term all‐cause mortality, cardiac death and MACE showed a trend to a worse outcome (odds ratio (OR) 9.07, 95% confidence interval (CI) 0.86–96.28, p = 0.07; OR 8.71, 95% CI 0.5–153.1, p = 0.14 and OR 2.81, 95% CI 0.78–5.18, p = 0.15 respectively). Long term all cause mortality (OR 2.40, 95% CI 1.15–5.02, p = 0.02), cardiac death (OR 5.66, 95% CI 1.71–18.73, p = 0.005) and MACE (OR 2.76, 95% CI 1.38–5.55, p = 0.004) were significantly increased.
Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation
Authors: El Masry A. , Mukhtar A. M. , El Sherbeny A. M. , Fathy M. , El‐Meteini M. 
Published: March 2009

SummaryCentral venous catheterisation is commonly performed during major surgery and intensive care, and it would be useful if central venous oxygen saturation could function as a surrogate for mixed venous oxygen saturation. We studied 50 patients undergoing living related liver transplantation. Blood samples were taken simultaneously from central venous and pulmonary artery catheters at nine time points during the pre‐anhepatic, anhepatic, and postanhepatic phases. Four hundred and fifty sets of measurement were obtained. There was a good correlation between central venous oxygen saturation and mixed venous oxygen saturation. The mean (SD) difference (95% limit of agreement) was lowest at the first time point (1.06 (0.65)%, −1.94% to 2.7%) and then increased throughout the study but remained acceptable. The change in mixed venous oxygen and central venous oxygen saturations occurred mostly in parallel and as a result changes in mixed venous oxygen saturation were reflected adequately in the change in central venous oxygen saturation. The correlation between mixed venous oxygen saturation and cardiac output was poor.
A simple fibreoptic assisted laryngoscope for paediatric difficult intubation: a manikin study*
Authors: Komiya K. , Inagawa G. , Nakamura K. , Kikuchi T. , Fujimoto J. , Sugawara Y. , Goto T. 
Published: March 2009

SummaryThe fibreoptic assisted laryngoscope is a new airway device. We compared the fibreoptic assisted laryngoscope with the Bullard laryngoscope, Macintosh laryngoscope and fibreoptic bronchoscope in a manikin with a simulated Cormack and Lehane Grade 4 laryngoscopic view. Eighteen anaesthetists intubated the manikin’s trachea using these devices and the success rate of intubation was measured. They were then asked to rate the subjective difficulty of intubation. The success rate (95% confidence interval) was 100% (94.6–100) with the fibreoptic assisted laryngoscope, 88.9% (80.5–97.3) using the Bullard laryngoscope, 37.0% (24.1–49.9) with the Macintosh laryngoscope, and 22.2% (11.1–33.3) using the fibreoptic bronchoscope. Tracheal intubation using the fibreoptic assisted laryngoscope or Bullard laryngoscope is easier than that using the Macintosh laryngoscope or fibreoptic bronchoscope by subjective difficulty score. All of the intubations were successful with the fibreoptic assisted laryngoscope without practice. These results suggest that fibreoptic assisted laryngoscope may be a useful tool for paediatric difficult intubation.
Tracheal tube fixation: the effect on depth of insertion of midline fixation compared to the angle of the mouth*
Authors: Sharma K. , Varshney M. , Kumar R. 
Published: March 2009

SummaryFollowing successful placement of a tracheal tube (TT), it is frequently moved from the midline to the angle of the mouth. This study investigates the tracheal tube tip position in the two fixation positions in 200 adult patients. Following tracheal intubation, a fibreoptic bronchoscope (FOB) was introduced through a swivel connector and the distances from the swivel connector to the lips, carina, tip of TT and the crico‐tracheal membrane were measured with the TT in the midline and at the right angle of the mouth. The mean (SD) TT tip to carinal distance decreased from 3.60 (1.50) cm to 2.28 (1.55) cm in female patients, and 5.04 (1.43) cm to 3.69 (1.65) cm in male patients on moving the tracheal tube to the angle of the mouth. We conclude that there is a significant movement of the tracheal tube towards the carina on moving the TT from midline to angle of mouth and the depth of insertion of the tube should be adjusted accordingly.
A new instrument for pain assessment in the immediate postoperative period*
Authors: Machata A. M. , Kabon B. , Willschke H. , Fäßler K. , Gustorff B. , Marhofer P. , Curatolo M. 
Published: March 2009

SummaryPerceptual‐cognitive impairment after general anaesthesia may affect the ability to reliably report pain severity with the standard visual analog scale (VAS). To minimise these limitations, we developed ‘PAULA the PAIN‐METER®’ (PAULA): it has five coloured emoticon faces on the forefront, it is twice as long as a standard VAS scale, and patients use a slider to mark their pain experience. Forty‐eight postoperative patients rated descriptive pain terms on PAULA and on a standard VAS immediately after admission and before discharge from the postanaesthesia care unit. Visual acuity was determined before both assessments. The values obtained with PAULA showed less variance than those obtained with the standard VAS, even at the first assessment, where only 23% of the patients had regained their visual acuity. Furthermore, the deviations of the absolute VAS values in individual patients for each descriptive pain term were significantly smaller with PAULA than with the standard VAS.
Refractory thrombotic thrombocytopenic purpura following influenza vaccination
Authors: Dias P. J. , Gopal S. 
Published: March 2009

SummaryThrombotic thrombocytopenic purpura (TTP) is characterised by the systemic microvascular aggregation of platelets causing ischaemia of the brain and other organs. We describe the case of a 54 year‐old man who presented with neurological signs, fever, severe thrombocytopenia, microangiopathic haemolytic anaemia and renal failure 5 days after receiving an influenza vaccination. He was diagnosed with acute refractory TTP caused by autoantibody‐mediated ADAMTS‐13 deficiency. He required stabilisation on the critical care unit before being successfully treated with 3 l plasma exchanges for 21 days and rituximab (MabThera®) at a dose of 375 mg.m−2, given weekly for a total of 4 weeks. Vaccination is an important part of preventative medicine and reduces morbidity and mortality. Only in a few rare cases has vaccination been associated with autoimmune pathology. We could find only one similar case report of thrombotic thrombocytopenic purpura following influenza vaccination. In addition to plasma exchange, rituximab appears to be effective and well tolerated in the treatment of refractory thrombotic thrombocytopenic purpura.
Chronic transfusion practice for children with sickle cell anaemia and stroke
Authors: Aygun Banu , McMurray Marsha A. , Schultz William H. , Kwiatkowski Janet L. , Hilliard Lee , Alvarez Ofelia , Heeney Matthew , Kalinyak Karen , Lee Margaret T. , Miller Scott , Helms Ronald W. , Ware Russell E. ,   for the SWiTCH Trial Investigators
Published: March 2009

SummaryChronic transfusions to maintain haemoglobin S (HbS) ≤30% are the mainstay of treatment for children with sickle cell anaemia (SCA) and previous stroke. This HbS target is often hard to maintain, however, and values achieved in current practice are unknown. In preparation for the Phase III Stroke With Transfusions Changing to Hydroxyurea (SWiTCH) trial, we collected data on 295 children with SCA and stroke who received transfusions at 23 institutions. The overall average pre‐transfusion %HbS was 35 ± 11% (institutional range 22–51%). Receiving scheduled transfusions on time was the most predictive variable for maintaining HbS at the ≤30% goal.
NF‐κB promotes iNOS and VEGF expression in salivary gland adenoid cystic carcinoma cells and enhances endothelial cell motility in vitro
Authors: Zhang Jiali , Peng Bin 
Published: March 2009

AbstractTumour cell‐derived angiogenic‐related factors and endothelial cell mobility are essential for neovascularization and haematogenous metastasis of adenoid cystic carcinoma (ACC) of the human salivary glands. Our previous study demonstrated that vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), and nuclear factor kappaB (NF‐κB) staining correlated with ACC microvessel density. However, there still remains a lack of direct evidence to clarify the function of liposaccharide‐induced NF‐κB activity in ACC angiogenesis.Objectives:  This study aimed to demonstrate the function of liposaccharide‐induced NF‐κB signalling pathway (which would be relevant to angiogenesis) of ACC cell lines.Materials and methods: A PCMV‐IκBαM vector transfection assay was performed to inhibit NF‐κB activity. Constitutive and liposaccharide‐induced NF‐κB activity, along with VEGF and iNOS expression, was detected by electrophoretic mobility shift assays, reverse transcription–polymerase chain reaction and Western blot assay. Tumour cell‐derived NO2− was evaluated by a nitrite determination assay, and endothelial cell mobility was investigated by endothelial cell proliferation, migration and tube formation assays.Results: We demonstrated that regulation of VEGF and iNOS expression utilized the NF‐κB signalling pathway in ACC cell lines. In the constitutive and liposaccharide‐induced condition, NF‐κB activity was blocked by phosphorylation‐defective IκBα. Accordingly, mRNA and protein expression of VEGF and iNOS were significantly decreased, with a great drop in endogenous NO2−. Furthermore, supernatant from ACC‐2/IkBaM and ACC‐M/IkBaM cells resulted in much lower endothelial cell mobility than that from ACC‐2 and ACC‐M cells.Conclusions: Our results suggest that NF‐κB promotes iNOS and VEGF expression in salivary gland ACC cells and enhances endothelial cell motility in vitro.
Generation of mice by transplantation of an adult spermatogonial cell line after cryopreservation
Authors: Yuan Zhe , Hou Ruoyu , Wu Ji 
Published: March 2009

AbstractObjectives: The key to fertility in adult males is production of mature spermatogenic cells. Spermatogonial stem cells (SSC) have the dual capacity of self‐renewal and of differentiation into mature sperm. SSC transplantation may provide potential treatment for specific male infertilities. However, until now, there has been no evidence of offspring produced by transplantation of adult SSC line cells in humans or other mammals.Materials and methods: A new line of SSCs from adult C57BL/6 mouse was established by using magnetic‐activated cell sorting. The cell line was characterized by immunocytochemistry, karyotype analysis and telomeric repeat amplification protocol (TRAP) telomerase activity assay. Spermatogenic function was examined by allograft into germ cell‐ablated recipient mice.Results: For more than 14 months with more than 65 maintenance passages, the cell line showed a normal karyotype (40, XY) and high telomerase activity. It represented a Thy‐1+, Oct4+, SSEA‐1‐, c‐kit‐ (99 ± 1%) cell subpopulation. We cryopreserved these SSCs and successfully produced normal offspring after transplanting them into testes of busulphan‐sterilized mice.Conclusions: We established and long‐term maintained an adult SSC line with normal spermatogenic function, without the need of genetic modification; thus, this study provides a model system for basic research and clinical application.
Analysis of human mammary fibroadenoma by Ki‐67 index in the follicular and luteal phases of menstrual cycle
Authors: Rego M. F. , Navarrete M. A. L. H. , Facina G. , Falzoni R. , Silva R. , Baracat E. C. , Nazario A. C. P. 
Published: March 2009

Abstract.Objectives:  Fibroadenoma is the most common benign mammary condition among women aged 35 or younger. Expression of Ki‐67 antigen has been used to compare proliferative activity of mammary fibroadenoma epithelium in the follicular and luteal phases of the menstrual cycle.Materials and methods:  Ninety eumenorrheic women were selected for tumour excision; they were assigned to either of the two groups, according to their phase of menstrual cycle. At the end of the study, 75 patients with 87 masses were evaluated by epithelial cell Ki‐67 expression, blind (no information given concerning group to which any lesion belonged).Results:  Both groups were found to be homogeneous relative to age, menarche, body mass index, previous gestation, parity, breastfeeding, number of fibroadenomas, family history of breast cancer and tabagism. Median tumour size was 2.0 cm and no relationship between proliferative activity and nodule diameter was observed. No typical pattern was observed in the expression of Ki‐67 in distinct nodules of the same patient. Average values for expression of Ki‐67 (per 1000 epithelial cells) in follicular and luteal phases were 27.88 and 37.88, respectively (P = 0.116).Conclusion:  Our findings revealed that proliferative activities in the mammary fibroadenoma epithelium did not present a statistically significant difference in the follicular and luteal phases. The present study contributes to clarifying that fibroadenoma is a neoplasm and does not undergo any change in the proliferative activity during the menstrual cycle.