bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Ischemic Pain in Patients Suffering from Peripheral Vasculopathy with Transdermal Buprenorphine Plus Epidural Morphine with Ropivacaine vs. Epidural Morphine with Ropivacaine
Authors: Aurilio Caterina , Pace Maria Caterina , Passavanti Maria Beatrice , Paladini Antonella , Maisto Massimo , Iannotti Mario , Pota Vincenzo , D’amora Eleonora , Sansone Pasquale , Barbarisi Manlio 
Published: October 2008

AbstractAim:  This study compared the efficacy and safety of buprenorphine transdermal delivery system with peridural infusion of morphine and ropivacaine to peridural infusion alone for the control of ischemic pain in patients suffering from peripheral vasculopathy.Methods:  Eighty‐six patients were randomized into two groups. In the first group, a buprenorphine patch 35 µg/hour TTDS (transtec transdermal device plus ropivacaine and morphine) was applied, and a peridural infusion of ropivacaine/morphine (200 mg + 2 mg) was established. In the second group, ropivacaine and morphine analgesia was obtained using a peridural infusion and a placebo patch. The primary efficacy parameter was the visual analog scale score for pain. Secondary parameters of efficacy were the short‐form McGill Pain Questionnaire scores and a score for pain interference with sleep obtained from patient diaries evaluated every week for a period of 4 weeks.Results:  Subjects in the TTDS group reported a reduction in pain, increased sleep, and a lower incidence of side effects compared with the control group.Conclusion:  Transdermal buprenorphine use resulted in significant pain relief with excellent patient satisfaction, which may translate into improvement in mood and quality of life.
Evidence‐Based Outcomes in Pain Research and Clinical Practice
Authors: Gatchel Robert J. , Theodore Brian R. 
Published: October 2008

AbstractThe growing emphasis on evidence‐based medicine dictates that reliable, evidence‐based outcomes be utilized in documenting response to treatment, as well as determining the treatment efficacy and cost‐effectiveness of different treatment modalities. The biopsychosocial model conceptualizes pain as a complex multifactorial interaction of biological, psychological, and social components that play a role in the development, exacerbation, and perpetuation of pain. As a result, outcomes relevant to pain management are necessarily complex and multifactorial in nature. Two broad categories of evidence‐based outcomes relevant to pain management are discussed: patient‐reported outcomes and objective outcomes. Patient‐reported outcomes are discussed within the context of pain measures, health‐related quality of life, and psychological constructs. Objective outcomes are discussed within the context of healthcare utilization and occupational status. The discussion within each section highlights the unique constructs measured by each category of outcome measure and highlights their consistency with current evidence‐based guidelines and knowledge from pain research.
Management and Interpretation of Data Obtained from Clinical Trials in Pain Management
Authors: Theodore Brian R. , Gatchel Robert J. 
Published: October 2008

AbstractConducting a clinical trial involves various stages of planning and implementation. The three major components involved in clinical trials are the management of data, the quality control to ensure data integrity, and the interpretation of the data at the conclusion of the trial. Although each process is distinct and involves different levels of effort and knowledge to implement, all processes are intimately linked. Data management techniques include the process of data entry and the implementation of an organized, comprehensive approach to quality control. Some guidelines for quality control screening are recommended to address various common issues related to clinical data, such as missing data, invalid cases, subject “outliers,” and violation of distributional assumptions relevant to statistical analyses. In order to aid in interpreting the data, conditions that need to be met to make causal inferences are discussed. Taking into account baseline characteristics of the patient sample is also discussed as an extension to maintaining the internal validity of the study. Additionally, some common threats to statistical conclusion validity, including Type I error inflation and the problem of overpowered tests, are highlighted. Finally, the concept of the effect size as an important complement to statistical significance and how the various types of effect size measures can be interpreted within the context of a clinical trial are discussed.
Vasovagal Reactions and Other Complications of Cervical vs. Lumbar Translaminar Epidural Steroid Injections
Authors: Trentman Terrence L. , Rosenfeld David M. , Seamans David P. , Hentz Joseph G. , Stanek James P. 
Published: October 2008

AbstractObjective:  To document the per patient rate of vasovagal reactions and other complications of cervical vs. lumbar translaminar epidural steroid injections.Background:  Anecdotal observations at our institution suggested that vasovagal reactions are much more common during cervical epidural steroid injections than lumbar injections, and more frequent than previously reported.Methods:  Records of 249 patients undergoing their first cervical epidural steroid injection were reviewed for vasovagal reactions and other adverse events. For comparison, a first lumbar epidural steroid injection performed by the same staff physician was matched to each cervical procedure and reviewed for complications.Results:  The incidence of vasovagal reaction was 7 points more common (P < 0.001, 95% confidence interval 0.04–0.12) in the cervical group (8%) than in the lumbar group (1%). This correlates to an additional vasovagal reaction for every 14 patients who were treated with cervical injection in comparison with those treated with lumbar injection.Discussion:  The risk of vasovagal reaction is significantly higher for cervical translaminar epidural steroid injections than for lumbar injections. The risk of vasovagal reaction remained higher for cervical injection even when adjusting for differences between the two populations. The higher rate of cervical vasovagal reactions may result from a combination of anxiety, the prone position with neck flexed, head drapes, and stimulus from a neck procedure.Conclusion:  Increased vigilance for patients undergoing translaminar cervical epidural steroid injections may be warranted. Clinicians may choose to consider these results when counseling patients regarding risk and the need for conscious sedation during the procedure.
Tramadol Added to Bupivacaine Does Not Prolong Analgesia of Continuous Psoas Compartment Block
Authors: Kumar Mukesh , Batra Yatindra Kumar , Panda Nidhi Bidyut , Rajeev Subramanyam , Nagi Onkar Nath 
Published: October 2008

AbstractThe primary aim of our study was to evaluate the quality and duration of analgesia when tramadol was added to 0.25% bupivacaine for continuous psoas compartment block (CPCB) using visual analog pain scores. Thirty patients were prospectively randomized into two equal groups (n = 15). Visual analog scale pain score was not significantly different between the groups during the 48‐hour follow‐up period. Rescue analgesic consumption, nausea and vomiting, and the satisfaction scores were comparable between the groups (P > 0.05). Success with catheter placement adjacent to the lumbar plexus was 100%, and none of the patients developed any catheter‐related complications. In conclusion, tramadol does not provide a clinically significant analgesic action as an adjunct to 0.25% bupivacaine for CPCB.
Incidence of social phobia and identification of its risk indicators: a model for prevention
Authors: Acarturk C. , Smit F. , De Graaf R. , Van Straten A. , Ten Have M. , Cuijpers P. 
Published: October 2008

Objective:  This study seeks to examine the incidence of social phobia in the general population and to establish a number of risk indicators.Method:  Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population based prospective study (n = 7076). A sample of adults aged 18–64 years (n = 5618) were re‐interviewed 1 year later using Composite International Diagnostic Interview (CIDI).Results:  The 12‐month incidence of DSM‐III‐R social phobia was 1.0%. Low education, low mastery, low self‐esteem, emotional neglect in childhood and ongoing difficulties were found to be risk indicators. After including other mental disorders as risk indicators in the model, the incidence was found to be more common among those with low mastery, major depression, subthreshold social phobia, emotional neglect, negative life events, and low education.Conclusion:  The incidence of social phobia can be predicted relatively well with psychosocial variables and comorbidity.
Bone formation at recombinant human bone morphogenetic protein‐2‐coated titanium implants in the posterior mandible (Type II bone) in dogs
Authors: Wikesjö Ulf M. E. , Xiropaidis Andreas V. , Qahash Mohammed , Lim Won Hee , Sorensen Rachel G. , Rohrer Michael D. , Wozney John M. , Hall Jan 
Published: October 2008

AbstractBackground: Conventional oral/maxillofacial implants reach osseointegration over several months during which the titanium fixtures interact with alveolar bone. The objective of this study was to determine if adsorbing recombinant human bone morphogenetic protein‐2 (rhBMP‐2) onto a titanium porous oxide (TPO) implant surface might enhance or accelerate local bone formation and support osseointegration in a large animal oral/maxillofacial orthotopic model.Material and Methods: Endosseous implants with a TPO surface were installed into the edentulated posterior mandible in eight adult Hound Labrador mongrel dogs. The implant surface had been adsorbed with rhBMP‐2 at 0.2 or 4.0 mg/ml. TPO implants without rhBMP‐2 served as control. Treatments were randomized between jaw quadrants. Mucosal flaps were advanced and sutured leaving the implants submerged. Clinical and radiographic evaluations were made immediately post‐surgery, at day 10 (suture removal), and week 4 and 8 post‐surgery. The animals received fluorescent bone markers at week 3, 4, and at week 8 post‐surgery, when they were euthanized for histologic analysis.Results: TPO implants coated with rhBMP‐2 exhibited dose‐dependent bone remodelling including immediate resorption and formation of implant adjacent bone, and early establishment of clinically relevant osseointegration. The resulting bone–implant contact, although clinically respectable, appeared significantly lower for rhBMP‐2‐coated implants compared with the control [rhBMP‐2 (0.2 mg/ml) 43.3±10.8%versus 71.7±7.8%, p<0.02; rhBMP‐2 (4.0 mg/ml) 35.4±10.6%versus 68.2±11.0%, p<0.03].Conclusions: rhBMP‐2 adsorbed onto TPO implant surfaces initiates dose‐dependent peri‐implant bone re‐modelling resulting in the formation of normal, physiologic bone and clinically relevant osseointegration within 8 weeks.
Is there equity in oral healthcare utilization: experience after achieving Universal Coverage
Authors: Somkotra Tewarit , Detsomboonrat Palinee 
Published: October 2008

Abstract –  Objectives:  To assess the socioeconomic‐related (in)equality and horizontal (in)equity in oral healthcare utilization among Thai adults after Universal Coverage (UC) policy implemented nationwide, and to decompose the source of inequality in utilization. Further, to identify the determinants that effect to out‐of‐pocket payments for oral healthcare.Methods:  Using the data of 32748, Thai adults aged 15 years and over from nationally representative Health and Welfare Survey and Socio‐Economic Survey in 2006. This study employs concentration index (CI) and horizontal inequity index (HI) to measure the socioeconomic‐related inequality and horizontal inequity in oral healthcare utilization, respectively. Further, employing decomposition method to identify the sources of inequality comprising of a contribution of income, need determinants (i.e. self‐assessed oral health, demographic characteristics), non‐need determinants (i.e.working status, educational level attainment, type of insurance entitlement, geographic characteristics and marital status) and residual term. Two‐part model is used to determine the factors effect to out‐of‐pocket payments for oral healthcare.Results:  There are the pro‐rich inequality and inequity in oral healthcare utilization among Thais as indicated by significantly positive values of CI (=0.199) and HI (=0.206). The poor are more likely to access and utilize services at subsidized public facility particularly community hospital, as opposed to the better‐off who tend to utilize services at private facility. Income and non‐need determinants principally contribute to the pro‐poor in public sector utilization, unlike pro‐rich in private sector utilization. Need factors account for most of the pro‐poor utilization. Type of treatment obtained and insurance used in the last visit are the substantial determinants effect to incurring out‐of‐pocket payments for oral healthcare.Conclusion:  Notwithstanding the UC policy implementation made impressive strides toward improving of welfare coverage and an increase in accessibility of health services among Thais, inequality and inequity in oral healthcare utilization persist even when the country achieved universal coverage. Decomposition analyses demonstrate the association of each determinant to inequality in utilization which provides information for policy amendment to achieve the goal of equity in healthcare system.
Sequential effects of photodynamic treatment of basal cell carcinoma
Authors: Prignano Francesca , Lotti Torello , Spallanzani Adelina , Berti Samantha , De Giorgi Vincenzo , Moretti Silvia 
Published: October 2008

Background:  Photodynamic therapy (PDT) of superficial basal cell carcinoma (SBCC) acts as a biological response modifier or killing target cells, but sequential biological effects have not been reported in depth in humans.Methods:  In 15 patients with SBCC treated with aminolevulinic acid (ALA)‐PDT, inflammatory infiltrate, apoptosis phenomena and tumor‐derived molecules were investigated on biopsies at baseline, and after 15 min and 4, 24, 48 and 72 h, by immunohistochemistry and ultrastructure.Results:  Early apoptosis of keratinocytes was already observed at 15 min, while late apoptotic markers were maximally found at 24 h. Baseline mast cells tended to slightly increase up to 72 h; polymorphonuclear phagocytes significantly increased at 4 h but decreased at 24/48/72 h; on the contrary, lymphocytes and macrophages gradually increased starting at baseline. At baseline, SBCC cells expressed stem cell factor in all cases, and granulocyte‐monocyte colony‐stimulating factor, basic fibroblastic growth factor, interleukin (IL)‐8 and vascular endothelial growth factor in most cases. IL‐6 and monocyte chemoattractant protein‐1 were poorly expressed, and transforming growth factor‐beta was absent.Conclusions:  We show a clear time‐dependent profile of apoptotic markers and inflammatory infiltrate composition in SBCC after ALA‐PDT. SBCC cells express cytokines and chemotactic molecules that are likely related to the recruitment of inflammatory cells.
Concordant overexpression of phosphorylated ATF2 and STAT3 in extramammary Paget’s disease
Authors: Chen Si‐Yuan , Takeuchi Satoshi , Moroi Yoichi , Hayashida Sayaka , Kido Makiko , Tomoeda Hiroto , Uenotsuchi Takeshi , Tu Ya‐Ting , Furue Masutaka , Urabe Kazunori 
Published: October 2008

Background:  Activating transcription factor 2 (ATF2) and signal transducer and activator of transcription 3 (STAT3) play important roles in the pathogenesis of various tumors, but ATF2 expression/activation and the relationship with STAT3 activation have not yet been investigated in extramammary Paget’s disease (EMPD).Objective:  To investigate potential contributions of ATF2 and STAT3 pathways to the pathogenesis of EMPD.Method:  Paraffin‐embedded 45 EMPD specimens (43 primary EMPD and 2 nodal metastases) were subjected to immunohistochemical staining for ATF2, phosphorylated (p)‐ATF2 and p‐STAT3.Results:  P‐ATF2 expression in advanced EMPD, non‐invasive EMPD and normal skin (NS) controls were 97.9 ± 1.8%, 82.0 ± 23.4% and 45.8 ± 3.2%, respectively, and p‐STAT3 expression in advanced EMPD, non‐invasive EMPD and NS were 97.0 ± 2.9%, 83.2 ± 23.3% and 50.1 ± 6.7%, respectively. P‐ATF2 and p‐STAT3 expressions in EMPD were significantly higher than those in NS, indicating a possible contribution of these pathways to the tumor development. P‐ATF2 and p‐STAT3 expressions in advanced EMPD were significantly higher than those in non‐invasive EMPD, possibly indicating that these pathways might also contribute to the tumor invasion and/or metastasis. We also found an exceptionally high positive correlation between p‐ATF2 and p‐STAT3 expressions in EMPD.Conclusions:  P‐ATF2 and p‐STAT3 are concordantly overexpressed in EMPD and their expressions may possibly be associated with the tumor stage.
Expression and bioactivities of endothelin‐1 in gingiva during cyclosporine A treatment
Authors: Chin Y‐T. , Tu H‐P. , Chen Y‐T. , Dai N‐T. , Shen E‐C. , Chiang C‐Y. , Fu M. M‐J. , Fu E. 
Published: October 2008

Background and Objective: This study aimed to evaluate the expression and bioactivities of endothelin‐1 (ET‐1) in gingiva during cyclosporine A (CsA) treatment.Material and Methods: After establishing edentulous ridges, experimental rats were fed 30 mg/kg/day CsA while control animals received mineral oil for 4 weeks, after which a reverse transcription‐polymerase chain reaction (RT‐PCR) and/or immunohistochemistry was used to examine the expression of ET‐1, its receptors, proliferating cell nuclear antigen (PCNA) and inducible nitric oxide synthase (iNOS) in gingivae. The roles of the endothelin receptors A and B (ETAand ETB) in CsA‐enhanced expression of PCNA and iNOS were examined in cultured human gingival fibroblasts pretreated with receptor antagonists, by immunocytochemistry and RT‐PCR, respectively.Results: The mRNA expression of ET‐1, ETAand ETB, as well as of PCNA and iNOS, was significantly greater in edentulous gingiva that received CsA compared with control gingiva. Immunohistochemistry revealed more cells positively stained for ET‐1 and its receptors in the tissues of CsA‐treated rats than in those of control rats. In fibroblast cultures, enhanced mRNA expression of ET‐1, ETAand ETBwas observed after CsA treatment at the concentrations of 10 and 100 ng/mL. Cyclosporine A‐enhanced PCNA expression was somewhat reduced by blockade of ETA, but not ETB, whereas iNOS expression was somewhat reduced by blockade of ETB.Conclusion: Based on the present findings, we suggest that: (1) CsA upregulates the gingival expression of ET‐1 and its receptors; and (2) ETAand ETBhave different bioactivities, ETAbeing involved in cell proliferation and ETBbeing associated with iNOS expression.
Effects of heparin‐binding epidermal growth factor‐like growth factor on cell repopulation and signal transduction in periodontal ligament cells after scratch wounding in vitro
Authors: Lee J. S. , Kim J. M. , Hong E. K. , Kim S.‐O. , Yoo Y.‐J. , Cha J.‐H. 
Published: October 2008

Background and Objective:  A growing amount of attention has been placed on periodontal regeneration and wound healing for periodontal therapy. This study was conducted in an effort to determine the effects of heparin‐binding epidermal growth factor‐like growth factor on cell repopulation and signal transduction in periodontal ligament cells after scratch wounding in vitro.Material and Methods:  Human periodontal ligament cells were acquired from explant tissue of human healthy periodontal ligament. After the wounding of periodontal ligament cells, the change in expression of heparin‐binding epidermal growth factor‐like growth factor and epidermal growth factor receptors 1–4 mRNA was assessed. The effects of heparin‐binding epidermal growth factor‐like growth factor on periodontal ligament cell proliferation and repopulation were assessed in vitro via the 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay and by photographing the injuries, respectively. Extracellular signal‐regulated kinase (Erk)1/2, p38 and Akt phosphorylation was characterized via western blotting.Results:  Scratch wounding resulted in a significant up‐regulation of heparin‐binding epidermal growth factor‐like growth factor mRNA expression, whereas wounding had no effect on the expression levels of epidermal growth factor receptors 1–4. Interestingly, no expression of epidermal growth factor receptors 2 and 4 was detectable prior to or after wounding. Heparin‐binding epidermal growth factor‐like growth factor treatment promoted the proliferation and repopulation of periodontal ligament cells. The scratch wounding also stimulated the phosphorylation of Erk1/2 and p38, but not of Akt, in periodontal ligament cells, and heparin‐binding epidermal growth factor‐like growth factor treatment applied after wounding amplified and extended the activations of Erk1/2 and p38, but not of Akt. Furthermore, Erk1/2 inhibition blocked the process of cell repopulation induced by heparin‐binding epidermal growth factor‐like growth factor, whereas the inhibition of p38 delayed the process.Conclusion:  These results indicate that heparin‐binding epidermal growth factor‐like growth factor may constitute a critical factor in the wound healing of human periodontal ligament cells by a mechanism that requires the activation of Erk1/2 via specific interaction with epidermal growth factor receptor 1.
Elevation of collagen type I in fibroblast–keratinocyte cocultures emphasizes the decisive role of fibroblasts in the manifestation of the phenotype of cyclosporin A‐induced gingival overgrowth
Authors: Dannewitz B. , Tomakidi P. , Syagailo Y. , Kohl A. , Staehle H. J. , Eickholz P. , Komposch G. , Steinberg T. 
Published: October 2008

Background and Objective: Collagen type I elevation in cyclosporin A‐induced gingival overgrowth supports evidence that gingival fibroblasts play a decisive role in the manifestation of the phenotype. To analyze the role of gingival fibroblasts under morein vivo‐like conditions, we evaluated the effect of cyclosporin A on collagen type I gene and protein expression in gingival overgrowth‐derived gingival fibroblasts established as cocultures with gingival keratinocytes as well as in matched gingival fibroblast monolayers.Material and methods: Monolayers and cocultures of primary gingival fibroblasts were treated with cyclosporin A for 6 and 72 h. The expression of collagen type I mRNA was analyzed by quantitative real time polymerase chain reaction, while expression and secretion of collagen type I protein was analyzed by indirect immunofluorescence and western blotting.Results: Compared with controls, significant elevation of collagen type I mRNA was restricted to cocultures after 6 and 72 h of treatment with cyclosporin A. In keratinocytes, collagen type I remained undetectable. In monolayers and cocultures, indirect immunofluorescence showed a slightly higher level of collagen type I protein in gingival fibroblasts in response to stimulation with cyclosporin A. Semiquantitative detection of collagen type I by western blotting demonstrated a nonsignificant increase for cell extracts in monolayers and cocultures. For secreted collagen type I, western blot analysis of the supernatants revealed elevated protein levels in cultures stimulated with cyclosporin A. Compared with the corresponding monolayers, the stimulatory effect of cyclosporin A on protein secretion was significant only in coculture.Conclusion: Our results indicate that collagen type I is a target of cyclosporin A and that gingival fibroblasts are decisive for the manifestation of the gingival overgrowth‐phenotype. Furthermore, the results suggest that cocultures of gingival overgrowth‐derived gingival fibroblasts and gingival keratinocytes permit analysis of cyclosporin A‐induced effects under morein vivo‐like conditions.