bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management Guidelines for Children with Idiopathic Generalized Epilepsy
Authors: Camfield Carol , Camfield Peter 
Published: November 2005

Summary:  Most idiopathic generalized epilepsy (IGE) begins in childhood. Clinicians face many important management decisions for these children; however the existing literature provides little scientific guidance. Time of Diagnosis: At the time of presentation, it is unclear how accurately IGE seizures and syndromes are diagnosed and how consistent are the EEG correlates. Investigations beyond EEG are of uncertain value but probably are not needed. Selection of an initial antiepileptic drug (AED) is not based on any adequately powered, blinded, randomized comparative trials; however, reasonable evidence supports the use of valproic acid (VPA), lamotrigine and ethosuccimide as initial treatment for childhood absence epilepsy (CAE). Many large case series suggest the value of VPA for juvenile myoclonic epilepsy (JME) but the relative value of other, newer AEDs has not been established. First years of treatment: Once AED treatment is started, it is difficult to establish that absence seizures are completely controlled and the importance of interictal spike‐wave discharge remains uncertain. The value of restrictions on the child's activities has not been well studied; however serious accidents appear to be a justifiable concern in children with uncontrolled absence. Assessing the risk from photosensitivity in JME is challenging. Length of treatment: The optimal length of treatment for IGE is unclear. There is a high rate of remission in CAE when AEDs are discontinued after 1–2 years of seizure freedom; however, long‐term remission in CAE occurs in only 65%. It is usually assumed that treatment for JME is life long, although about 10% appear to have permanent remission in adolescence. Discontinuing AED treatment in JME requires a very individual risk assessment. Preparation for adult life: Long‐term social outcome for children with CAE is often unsatisfactory even if the epilepsy remits. The reasons are unclear and successful interventions have not been described. Long‐term social outcome for JME has not been adequately described. Conclusions: Further research is needed to justify the direction of many of the necessary management decisions in the diagnosis and treatment of IGE syndromes.
Influence of Sarcopenia on the Development of Physical Disability: The Cardiovascular Health Study
Authors: Janssen Ian 
Published: November 2005

OBJECTIVES: To examine the temporal relationship between sarcopenia and disability in elderly men and women.DESIGN: Cardiovascular Health Study, a longitudinal study of cardiovascular disease and its risk factors in older people.SETTING: Four U.S. communities.PARTICIPANTS: Five thousand thirty‐six men and women aged 65 and older.MEASUREMENTS: Whole‐body skeletal muscle mass was measured at baseline, and subjects were classified as having normal muscle mass, moderate sarcopenia, or severe sarcopenia based on previously established thresholds. Disability was measured via questionnaire at baseline in up to eight annual follow‐up examinations. The cross‐sectional relationship between sarcopenia and prevalent disability at baseline was examined using logistic regression models. The longitudinal relation between sarcopenia and incident disability over 8 years of follow‐up was examined using Cox proportional hazards models.RESULTS: At baseline, the likelihood of disability was 79% greater in those with severe sarcopenia (P<.001) but was not significantly greater in those with moderate sarcopenia (P=.38) than in those with normal muscle mass. During the 8‐year follow‐up, the risk of developing disability was 27% greater in those with severe sarcopenia (P=.006) but was not statistically greater in those with moderate sarcopenia (P=.23) than in those with normal muscle mass.CONCLUSION: Severe sarcopenia was a modest independent risk factor for the development of physical disability. The effect of sarcopenia on disability was considerably smaller in the longitudinal analysis than in the cross‐sectional analysis.
Measures of Adiposity and Risk of Breast Cancer in Older Postmenopausal Women
Authors: Krebs Erin E. , Taylor Brent C. , Cauley Jane A. , Stone Katie L. , Bowman Paula J. , Ensrud Kristine E. 
Published: November 2005

OBJECTIVES: To determine whether higher adiposity is associated with greater breast cancer risk in older postmenopausal women.DESIGN: Prospective cohort study with mean follow‐up of 11.3 years.SETTING: Four U.S. clinical centers.PARTICIPANTS: Seven thousand five hundred twenty‐three women (mean age 73.5) enrolled in the Study of Osteoporotic Fractures.MEASUREMENTS: Weight, height, and waist and hip circumference were measured at baseline. Body composition was determined using bioelectrical impedance. Risk factor information was obtained by interview and questionnaire. Bone mineral density was measured using dual energy x‐ray absorptiometry. The outcome was incident invasive breast cancer, confirmed using medical records.RESULTS: After adjustment for multiple risk factors, including bone density, women in the uppermost quartiles of weight, weight gain since age 25, body mass index, waist circumference, and percentage of body fat had higher breast cancer rates than women in the first quartiles of each measure. For example, breast cancer rates were 49% higher for women in the uppermost quartile of weight (hazard ratio (HR)=1.49, 95% confidence interval (CI)=1.05–2.10), 64% higher for women in the top quartile of weight gain since age 25 (HR=1.64, 95% CI=1.15–2.34), and 58% higher for women in the top quartile of percentage of body fat (HR=1.58, 95% CI=1.11–2.23) than for women in the lowest quartile of each measure. The associations between adiposity measures and breast cancer rates were not altered when the analyses were limited to very elderly women (≥70).CONCLUSION: Higher adiposity is an independent risk factor for breast cancer in elderly women.
Simvastatin Causes Changes in Affective Processes in Elderly Volunteers
Authors: Morales Knashawn , Wittink Marsha , Datto Catherine , DiFilippo Suzanne , Cary Mark , TenHave Thomas , Katz Ira R. 
Published: November 2005

OBJECTIVES: To test for simvastatin‐induced changes in affect and affective processes in elderly volunteers.DESIGN: Randomized, clinical trial.SETTING: The Geriatric Behavioral Psychopharmacology Laboratory at the University of Pennsylvania.PARTICIPANTS: Eighty older volunteers, average age 70, with high normal/mildly elevated serum cholesterol.INTERVENTION: Simvastatin up to 20 mg/d or placebo for 15 weeks.MEASUREMENTS: Daily diary records of positive and negative affects and of events and biweekly measures of depressive symptoms. Affect ratings were obtained using the Lawton positive and negative affect scales; independent raters coded the valences of events.RESULTS: Thirty‐one of 39 subjects assigned to placebo and 33 of 41 receiving simvastatin completed the study. During biweekly assessments, four subjects on simvastatin and one on placebo experienced depressive symptoms, as manifest by Center for Epidemiological Studies Depression scale scores greater than 16 (exact P=.36). Diary data demonstrated significant effects on affective processes. For positive affect, there was a significant medication‐by‐time interaction that reflected decreases in positive affect in subjects receiving simvastatin, greatest in those patients whose final total cholesterol levels were below 148 mg/dL. For negative affect, there were significant medication‐by‐event, and medication‐by‐event‐by‐time interactions, reflecting a time‐limited increase in the apparent effect of negative events.CONCLUSION: Simvastatin has statistically significant effects on affect and affective processes in elderly volunteers. The decrease in positive affect may be significant clinically and relevant to the quality of life of many patients.
Treatment delay and response rate in first episode psychosis
Authors: Wunderink A. , Nienhuis F. J. , Sytema S. , Wiersma D. 
Published: November 2005

Objective:  There is no consistent evidence of long duration of untreated psychosis (DUP) predicting long time to response (TTR) in first psychosis. This study aims to investigate the predictors of DUP and TTR in a first episode patient population.Method:  An epidemiologically representative sample of 157 non‐affective first psychotic episode patients was interviewed and followed‐up for at least half a year.Results:  The mean DUP was 46 weeks, the median 31 days. Long DUP was associated with being unemployed before treatment and male gender. Short DUP, having a job, and living with a partner before treatment predicted early response.Conclusion:  Early intervention likely improves short‐term treatment response in first episode psychosis. The best strategy to reduce DUP probably is to direct attention to the substantial number of patients who do not engage in regular treatment.
Low Erythrocyte Complement Receptor Type 1 (CR1, CD35) Expression in Preeclamptic Gestations
Authors: Feinberg Bruce B. , Jack Richard M. , Mok Samuel C. , Anderson Deborah J. 
Published: November 2005

ProblemErythrocyte complement receptor type 1 (E‐CR1) is the main immune complex clearance mechanism in humans. Decreased E‐CR1 expression is noted in certain inflammatory disorders. Recent evidence implicates inflammation in the pathogenesis of preeclampsia. We investigated whether E‐CR1 is decreased in preeclampsia.Method of studyE‐CR1 protein expression was quantified by radioimmunoassay. Plasma concentration of soluble CR1 was quantified using a specific enzyme linked immunosorbent assay. Quantitative genotypes were evaluated by HindIII restriction fragment length polymorphism analysis.ResultsE‐CR1 expression was reduced in patients with preeclampsia. Lack of neoantigen expression (indicative of enzymatic cleavage of CR1) or elevated plasma‐soluble CR1 was evidence against an acquired loss of E‐CR1. Genotype analysis revealed a higher frequency of a CR1 allele associated with low E‐CR1 expression in preeclampsia when compared with normal pregnant controls.ConclusionsE‐CR1 expression is decreased in preeclamptic patients and levels correlate with severity of disease. This condition may have a genetic basis in some patients.
Antisperm Vaccine for Contraception
Authors: Naz Rajesh K. 
Published: November 2005

ProblemThis study is a review of antisperm contraceptive vaccine (CV) development with the main focus on research going on in our laboratory.Method of studyVarious methods of proteomics and genomics, hybridoma technology, substractive libraries, differential display method, and phage display technology were used to obtain sperm‐specific genes and proteins. The present study will primarily focus on the sequences obtained by using the phage display technology and their role in CV development and human immunoinfertility.ResultFour novel peptides, delineated by using the phage display technology, were found to be involved in human immunoinfertility. The vaccine based on one of these peptides, designated as YLP12, caused a reversible contraception in female mice.ConclusionsThe vaccine targeting sperm is a feasible and exciting approach to contraception. The phage display technology is a powerful tool to delineate sperm‐specific peptide sequences that can be used for the CV development and in the diagnosis and treatment of infertility mediated through antisperm antibodies.
Pre‐eclampsia is not Associated with Changes in the Levels of Regulatory T Cells in Peripheral Blood
Authors: Paeschke Steffen , Chen Frank , Horn Nadja , Fotopoulou Christina , Zambon‐Bertoja Annarosa , Sollwedel Andre , Zenclussen Maria Laura , Casalis Pablo Ariel , Dudenhausen Joachim W. , Volk Hans‐Dieter , Zenclussen Ana Claudia 
Published: November 2005

ProblemThe acceptance of the semi‐allogeneic fetus within the maternal environment requires tolerance mechanisms not fully characterized yet. Normal pregnancy is known to be associated with a Th2 profile. Furthermore, regulatory T cells (Tregs) were proposed to regulate the Th2/Th1 balance at early stages of pregnancy. Treg may avoid the shift to a Th1 profile, thus preventing miscarriage. Accordingly, spontaneous abortion is characterized by a Th1 dominance and diminished levels of Treg. The major aim of the present work was to investigate if pre‐eclampsia, a late immunological complication of pregnancy, is characterized by similar hallmarks.Method of studyWe measured the surface antigens CD4, CD25, CD8 and CTLA4 in peripheral blood from patients suffering from pre‐eclampsia (n = 8) and age‐matched patients undergoing normal pregnancies (n = 9) by four‐color flow cytometry.ResultsWe were not able to find any significant differences in the levels of CD4+, CD25+, CD8+, CTLA4, CD4+/CD25+, CD4+/CD25bright, CD4+/CTLA4, CD25+/CTLA4, CD4+/CD25+/CTLA4, CD8+/CD25+, CD8+/CTLA4 or CD8+/CD25+/CTLA4 cell subsets.ConclusionsOur data confirm comparable number of Tregs during pre‐eclampsia and normal pregnancy in peripheral blood. Other regulatory mechanisms might be involved during late pregnancy.
A Review of Trafficking and Activation of Uterine Natural Killer Cells
Authors: van den Heuvel Marianne J. , Xie Xuemei , Tayade Chandrakant , Peralta Crystal , Fang Yuan , Leonard Sean , Paffaro Valdemar A. , Sheikhi Abdol K. , Murrant Coral , Anne Croy Barbara 
Published: November 2005

ProblemEnrichment of uterine natural killer (uNK) cells occurs during pregnancy in many species. However, functions of uNK cells and regulation of their uterine homing are not fully defined. In mice and women, uNK cells contribute to angiogenesis, a role reviewed here and now addressed in a mammal with an alternative placental type.Methods of studyTo address lymphocyte functions, RNA from murine or porcine endometrium and lymphocytes purified from endometrium were analyzed using real‐time or reverse transcription PCR. To address homing potential, human blood CD56+ lymphocytes were evaluated using both RNA and functional adhesion to endothelium presented under shear force in frozen sections of gestation day 7 C57Bl/6J implantation sites. Women were serially sampled over a menstrual cycle or a clinical preparatory cycle for embryo transfer.ResultsActivation of murine uNK cells is associated with much greater increases in transcription for Eomes than for T‐bet (Tbx21). Lymphocytes from normal porcine implantation sites transcribe vascular endothelial growth factor, placental growth factor, interferon‐gamma and hypoxia‐inducible factor (HIF)‐1α. In fertile women, increases in L‐selectin‐ and α4‐integrin‐mediated interactions between CD56+ cells and endothelium occur at luteinizing hormone (LH) surge (cycling women) to oocyte pick up or embryo transfer, then return to pre‐LH levels.ConclusionsUterine lymphocytes may universally promote pregnancy‐associated endometrial angiogenesis. Recruitment of uNK precursor cells from blood appears to occur in a window promoted by rising plasma estrogen and LH and limited by rising progesterone.
How we do it: ‘The oral tube area method’: a new method for self‐assessment of nasal resistance
Authors: Pontoppidan J.M. 
Published: November 2005

Keypoints• Breathing orally through a tube, 20 subjects compared their sensation of air resistance in the tube with their sensation of resistance breathing through the nose.• By changing the internal cross‐sectional area in the tube the subjects could choose an oral tube area where they felt the same resistance in the tube as in the nose.• Expressed by the chosen oral tube area we had a measurement of the nasal resistance.• The method can measure changes in nasal resistance.• The method is inexpensive and easy to perform.
How we do it: Transnasal fibreoptic oesophagoscopy
Authors: McPartlin D.W. , Nouraei S.A.R. , Tatla T. , Howard D.J. , Sandhu G.S. 
Published: November 2005

Keypoints• Transnasal fibreoptic oesophagoscopy (TFO) allows the upper aerodigestive tract, from the nasal vestibule to the gastric cardia to be examined in the outpatients department without sedation.• This permits patients with symptoms of upper aerodigestive pathology to be investigated at the initial consultation without the need for inpatient endoscopy or swallow studies.• The technique is easily learned, and is statistically comparable with standard flexible nasoendoscopy in respect of procedural pain and discomfort.• It is highly cost‐efficient, paying for itself within 1 year, and thereafter leading to cost savings of over 80%.• Its role can be expanded to encompass investigating patients with potentially malignant disease processes, as well as outpatients ‘panendoscopy’ and biopsy, and a number of therapeutic interventions.
How we do it: The role of trans‐nasal flexible laryngo‐oesophagoscopy (TNFLO) in ENT: one year's experience in a head and neck orientated practice in the UK
Authors: Price T. , Sharma A. , Snelling J. , Bennett A.M.D. , Qayyum A. , Bradnam T. , Montgomery P. 
Published: November 2005

Keypoints• Transnasal flexible laryngo‐oesophagoscopy (TNFLO) is a safe and well‐tolerated procedure that may be performed in a procedure room in the outpatient or day‐case/main theatre setting.• It requires a local anaesthetic and no sedation.• It may be used to histologically diagnose or exclude pathology from the nose to the gastro‐oesophageal junction.• It provides a ‘one stop’ diagnosis service, reducing diagnostic delays, the need for endoscopy under general anaesthesia, barium swallows and follow‐up outpatient appointments.• Therapeutic procedures such as vocal cord medialization, endolaryngeal laser surgery, insertion of speech prostheses and foreign body removal may be performed without general anaesthesia.
Endoscopic sphenopalatine artery ligation – when, why and how to do it. An on‐line video tutorial
Authors: Loughran S. , Hilmi O. , McGarry G.W. 
Published: November 2005

Keypoints• Endoscopic ligation of the sphenopalatine artery (ESPAL) has recently become the treatment of choice for refractory epistaxis. This paper reviews the background, indications and potential complications of ESPAL.• The main focus of this article is an online video tutorial on the anatomy and surgical technique of ESPAL. Web links lead to video clips of operative steps and therefore this paper should be read in front of a computer with access to the internet.• To study the techniques the links detailed below should be followed. (For computers running realplayer software the .wmv extension in each of these links should be replaced with the .rm extension.)• Incision, http://www.nhsgg.org.uk/content/streams/Figure3.wmv• Flap elevation, http://www.nhsgg.org.uk/content/streams/Figure4.wmv• Pedicle location, http://www.nhsgg.org.uk/content/streams/Figure5.wmv• Clip application, http://www.nhsgg.org.uk/content/streams/Figure6.wmv
Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients
Authors: Aarstad A.K.H. , Aarstad H.J. , Bru E. , Olofsson J. 
Published: November 2005

Objectives:  To study self‐reported coping style by the COPE questionnaire and the association to tumour node distant metastasis (TNM) stage, received treatment and health‐related quality of life (HRQoL) in a population of successfully treated head and neck squamous cell carcinoma (HNSCC) patients.Design:  Disease free HNSCC patients were interviewed during a regular outpatient visit to the Department.Setting:  All patients <80 years who had been diagnosed with HNSCC, in Western Norway, in the period from 1992 to 1997 and who were disease free in the year 2000 were included.Main outcome measures:  The HNSCC patients were studied by the European organization for research and treatment of cancer quality of life (QoL) questionnaire and by the COPE questionnaire from which coping styles profiles were extracted. Clinical and socio‐demographic variables were also gathered.Results:  Level of problem focused coping style was associated with the T stage and whether or not the patient was given neck radiotherapy. An avoidance‐focused coping style was generally associated with lowered HRQoL. Employment of emotional focused coping was associated with low HRQoL among the patients treated with surgery only, and associated with increased HRQoL among patients treated with radiation therapy only. The associations between HRQoL and coping style levels were stronger for HRQoL indexes reflecting cognitive/emotional function than for HRQoL indexes reflecting physical function.Conclusions:  In former HNSCC patients, level of problem focused coping style was associated with the T stage and if given neck radiotherapy. Level of avoidance coping was inversely associated with the HRQoL, and level of emotional coping was associated with HRQoL in a complex manner.
Haemophilus ducreyi
Targets Src Family Protein Tyrosine Kinases To Inhibit Phagocytic Signaling
Authors: Mock Jason R. , Vakevainen Merja , Deng Kaiping , Latimer Jo L. , Young Jennifer A. , van Oers Nicolai S. C. , Greenberg Steven , Hansen Eric J. 
Published: November 2005

ABSTRACT

Haemophilus ducreyi
, the etiologic agent of the sexually transmitted disease chancroid, has been shown to inhibit phagocytosis of both itself and secondary targets in vitro. Immunodepletion of LspA proteins from
H. ducreyi
culture supernatant fluid abolished this inhibitory effect, indicating that the LspA proteins are necessary for the inhibition of phagocytosis by
H. ducreyi
. Fluorescence microscopy revealed that macrophages incubated with wild-type
H. ducreyi
, but not with a
lspA1 lspA2
mutant, were unable to complete development of the phagocytic cup around immunoglobulin G-opsonized targets. Examination of the phosphotyrosine protein profiles of these two sets of macrophages showed that those incubated with wild-type
H. ducreyi
had greatly reduced phosphorylation levels of proteins in the 50-to-60-kDa range. Subsequent experiments revealed reductions in the catalytic activities of both Lyn and Hck, two members of the Src family of protein tyrosine kinases that are known to be involved in the proximal signaling steps of Fcγ receptor-mediated phagocytosis. Additional experiments confirmed reductions in the levels of both active Lyn and active Hck in three different immune cell lines, but not in HeLa cells, exposed to wild-type
H. ducreyi
. This is the first example of a bacte-rial pathogen that suppresses Src family protein tyrosine kinase activity to subvert phagocytic signaling in hostcells.
Reduction of Astrogliosis by Early Treatment of Pneumococcal Meningitis Measured by Simultaneous Imaging, In Vivo, of the Pathogen and Host Response
Authors: Kadurugamuwa Jagath L. , Modi Kshitij , Coquoz Olivier , Rice Brad , Smith Steven , Contag Pamela R. , Purchio Tony 
Published: November 2005

ABSTRACT

We developed a method for simultaneous in vivo biophotonic monitoring of pneumococcal meningitis and the accompanying neuronal injury in live transgenic mice.
Streptococcus pneumoniae
engineered for bioluminescence (
lux
) was used for direct visualization of disease progression and antibiotic treatment in a mouse model of meningitis. The host response was monitored in transgenic mice containing an inducible firefly luciferase (
luc
) reporter gene under transcriptional control of the mouse glial fibrillary acidic protein (GFAP) promoter. Based on the different spectra of light emission and substrate requirements for
lux
and
luc
, we were able to separately monitor the two reporters using a highly sensitive in vivo imaging system. The level of neuronal damage and recovery following antibiotic treatment was dependent on the time of treatment. This model has potential for simultaneous multiparameter monitoring and testing of therapies that target the pathogen or host response to prevent neuronal injury and recovery.