bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of carotid duplex imaging in carotid screening programmes – an overview
Authors: Saleem Muhammad A , Sadat Umar , Walsh Stewart R , Young Victoria E , Gillard Jonathan H , Cooper David G , Gaunt Michael E 
Published: July 2008

Abstract

Background
Stroke is the third most common cause of death in the UK and the largest single cause of severe disability. Each year more than 110,000 people in England suffer from a stroke which costs the National Health Service (NHS) over GBP2.8 billion. Thus, it is imperative that patients at risk be screened for underlying carotid artery atherosclerosis.

Aim
To assess the role of carotid ultrasound in different carotid screening programmes.

Methods
A literature overview was carried out by using PubMed search engine, to identify different carotid screening programmes that had used ultrasound scan as a screening tool.

Results
It appears that the carotid ultrasound is an effective method for screening carotid artery disease in community as it effectively predicts the presence of stenosis with high accuracy. There is a need for primary care to recommend high risk patients for regular screening, to reduce stroke and transient ischemic attack (TIA) related morbidity and mortality.

Conclusion
Screening programmes using carotid ultrasonography contribute to public health awareness and promotion which in long term could potentially benefit in disease prevention and essentially promote better standards of healthcare.
Prognostic factors for lymph node metastasis from advanced squamous cell carcinoma of the skin of the trunk and extremities
Authors: de Lima Vazquez Vinicius , Sachetto Teoclito , Perpetuo Natalia Martins , Carvalho Andre Lopes 
Published: July 2008

Abstract

Background
Squamous cell carcinoma (SCC) of the skin of the trunk and extremities may present lymph node metastasis with difficult disease control and poor survival. The purpose of this study was to identify risk factors for lymph node metastasis and outcome.

Patients/Methods
Retrospective review of 57 patients with locally advanced SCC of the trunk and extremities was performed and several clinical variables including age, gender, ethnicity, previously injured skin (burns, scars, ulcers and others), patient origin (rural or urban), anatomic site and treatment were studied.

Results
Fifteen patients presented with previous skin lesions. Thirty-six were classified as T3 tumors and 21 as T4; 46 were N0, and 11, N1. Eleven N0 patients presented lymph node metastasis during follow up. Univariate analysis identified previous skin lesions (ulcers and scars) as risk factor for lymph node metastasis (p = 0.047). Better survival was demonstrated for T3 (p = 0.018) classification. N0 patients who presented lymph node metastasis during follow up (submitted to lymphadenectomy) had similar survival to patients without lymph node recurrence (p = 0.219).

Conclusion
Local advanced tumors are at risk of lymph node metastasis. Increased risk is associated to previous lesions at tumor site. T4 classification have worse prognosis. Lymph node recurrences in N0 patients, once treated, did not affect survival. For these patients, we propose close follow up and prompt treatment of lymph node metastasis. These results do not support indication for elective lymphadenectomy or sentinel node mapping. Further prospective studies must address this issue.
Helicobacter pylori and gastroesophageal reflux disease
Authors: Grande Michele , Cadeddu Federica , Villa Massimo , Attinà Grazia Maria , Muzi Marco Gallinella , Nigro Casimiro , Rulli Francesco , Farinon Attilio M 
Published: July 2008

AbstractBackgroundThe nature of the relationship betweenHelicobacter pyloriand reflux oesophagitis is still not clear. To investigate the correlation between Helicobacter pylori infection and GERD taking into account endoscopic, pH-metric and histopathological data.MethodsBetween January 2001 and January 2003 a prospective study was performed in 146 patients with GERD in order to determine the prevalence of Helicobacter pylori infection at gastric mucosa; further the value of the De Meester score endoscopic, manometric and pH-metric parameters, i.e. reflux episodes, pathological reflux episodes and extent of oesophageal acid exposure, of the patients with and withoutHelicobacter pyloriinfection were studied and statistically compared. Finally, univariate analysis of the above mentioned data were performed in order to evaluate the statistical correlation with reflux esophagitis.ResultsThere were no statistically significant differences between the two groups, HP infected and HP negative patients, regarding age, gender and type of symptoms. There was no statistical difference between the two groups regarding severity of symptoms and manometric parameters. The value of the De Meester score and the ph-metric parameters were similar in both groups. On univariate analysis, we observed that hiatal hernia (p = 0,01), LES size (p = 0,05), oesophageal wave length (p = 0,01) and pathological reflux number (p = 0,05) were significantly related to the presence of reflux oesophagitis.ConclusionBased on these findings, it seems that there is no significant evidence for an important role forH. pyloriinfection in the development of GERD and erosive esophagitis. Nevertheless, current data do not provide sufficient evidence to define the relationship between HP and GERD. Further assessments in prospective large studies are warranted.
Next Generation of Immunotherapy for Melanoma
Authors: Kirkwood John M. , Tarhini Ahmad A. , Panelli Monica C. , Moschos Stergios J. , Zarour Hassane M. , Butterfield Lisa H. , Gogas Helen J. 
Published: July 2008

PurposeImmunotherapy has a long history with striking but limited success in patients with melanoma. To date, interleukin-2 and interferon-alfa2b are the only approved immunotherapeutic agents for melanoma in the United States.DesignTumor evasion of host immune responses, and strategies for overcoming tumor-induced immunosuppression are reviewed. Several novel immunotherapies currently in worldwide phase III clinical testing for melanoma are discussed.ResultsThe limitations of immunotherapy for melanoma stem from tumor-induced mechanisms of immune evasion that render the host tolerant of tumor antigens. For example, melanoma inhibits the maturation of antigen-presenting cells, preventing full T-cell activation and downregulating the effector antitumor immune response. New immunotherapies targeting critical regulatory elements of the immune system may overcome tolerance and promote a more effective antitumor immune response. These include monoclonal antibodies that block the cytotoxic T lymphocyte-associated antigen 4 (CTLA4) and toll-like receptor 9 (TLR9) agonists. Blockade of CTLA4 prevents inhibitory signals that downregulate T-cell activation. TLR9 agonists stimulate dendritic cell maturation and ultimately induce a more effective immune response. These approaches have been shown to stimulate acute immune activation with concomitant appearance of transient adverse events mediated by the immune system. The pattern and duration of immune responses associated with these new modalities differ from those associated with cytokines and cytotoxic agents. In addition, vaccines are being developed that may ultimately target melanoma either alone or in combination with these immunomodulatory therapies.ConclusionThe successes of cytokine and interferon therapy of melanoma, coupled with an array of new approaches, are generating new enthusiasm for the immunotherapy of melanoma.
The Extracellular Domain of the Growth Hormone Receptor Interacts with Coactivator Activator to Promote Cell Proliferation
Authors: Conway-Campbell Becky L. , Brooks Andrew J. , Robinson Philip J. , Perani Michela , Waters Michael J. 
Published: July 2008

AbstractThe presence of GH receptor (GHR) in the cell nucleus correlates with cell division, and targeting the GHR to the nucleus results in constitutive proliferation and transformation because of increased sensitivity to autocrine GH. Here we have sought additional mechanisms that might account for the enhanced proliferation seen with nuclear GHR, commencing with a yeast two-hybrid (Y2H) screen for interactors with the extracellular domain of the GHR [GH-binding protein (GHBP)]. We find that the GHBP is a transcriptional activator in yeast and mammalian cells, and this activity resides in the lower cytokine receptor module. Activity is dependent on S226, the conserved serine of the cytokine receptor consensus WSXWS box. By using parallel GHBP affinity columns and tandem mass spectrometry of tryptic digests of proteins bound to wild-type GHBP and S226A columns, we identified proteins that bind to the transcriptionally active GHBP. These include a nucleoporin and two transcriptional regulators, notably the coactivator activator (CoAA), which is also an RNA binding splicing protein. Binding of CoAA to the GHBP was confirmed by glutathione S-transferase pulldown and coimmunoprecipitation, and shown to be GH dependent in pro-B Ba/F3 cells. Importantly, stable expression of CoAA in Ba/F3 cells resulted in an increased maximum proliferation in response to GH, but not IL-3. Because CoAA overexpression has been identified in many cancers and its stable expression promotes cell proliferation and cell transformation in NIH-3T3 cells, we suggest CoAA contributes to the proliferative actions of nuclear GHR by the hormone-dependent recruitment of this powerful coactivator to the GHR.
Smoking cessation support in community pharmacies: is the association of smoking and eye disease an additional tool to increase uptake?
Authors: Thornton Judith , Torun Perihan , Edwards Richard , Harrison Annie , Kelly Simon P , Harrison Roger A , Verma Arpana 
Published: July 2008

Abstract

Objective
Community pharmacists have a central role in provision of smoking-cessation support. Evidence is growing that tobacco smoking is associated with development and progression of several potentially blinding eye diseases. As part of an ongoing programme of raising awareness of this link, we investigated whether community pharmacists are aware of this association and incorporate relevant advice into their smoking-cessation guidance.

Setting
Two-thousand and eighty community pharmacists in north west England, UK.

Method
A postal self-completion questionnaire asked pharmacists about their current practice with regard to smoking habits of their clients. Data were extracted and entered onto a database for statistical analyses.

Key findings
The response rate was 50.5%; 685 (65.2%) pharmacists asked clients about smoking habits; the most common situation was when clients complained of respiratory symptoms. Of these pharmacists, 52.7% always/usually recommended that smokers should stop and 37.2% always/usually assessed motivation to succeed. Help provided by pharmacists included brief advice on smoking cessation, leaflets, more structured support, referral to smoking-cessation services, and nicotine replacement therapies. The most common reason why pharmacists did not ask about smoking was lack of time (83.1%); 52.0% were aware of the causal association of smoking with eye disease, and 19.8% of those who asked about smoking habits mentioned this association when discussing smoking cessation.

Conclusion
Our study shows that community pharmacists are actively involved in smoking cessation. Many pharmacists are aware of the causal association between smoking and eye disease, but few are actively counselling patients about the eye heath risks of smoking. Community pharmacists could include this information in their advice to clients who smoke, as an additional means to promote smoking cessation.
Comparison of three systems of classification in predicting the outcome of diabetic foot ulcers in a Brazilian population
Authors: Parisi Maria Cândida R , Zantut-Wittmann Denise E , Pavin Elizabeth J , Machado Helymar , Nery Márcia , Jeffcoate William J 
Published: July 2008

ObjectiveThe aim was to compare three ulcer classification systems as predictors of the outcome of diabetic foot ulcers: the Wagner, the University of Texas (UT) and the size (area, depth), sepsis, arteriopathy, denervation system (S(AD)SAD) systems in a specialist clinic in Brazil.MethodsUlcer area, depth, appearance, infection and associated ischaemia and neuropathy were recorded in a consecutive series of 94 subjects. A novel score, the S(AD)SAD score, was derived from the sum of individual items of the S(AD)SAD system, and was evaluated. Follow-up was for at least 6 months. The primary outcome measure was the incidence of healing.ResultsMean age was 57.6 years; 57 (60.6%) were male. Forty-eight ulcers (51.1%) healed without surgery; 11 (12.2%) subjects underwent minor amputation. Significant differences in terms of healing were observed for depth (P=0.002), infection (P=0.006) and denervation (P=0.002) using the S(AD)SAD system, for UT grade (P=0.002) and stage (P=0.032) and for Wagner grades (P=0.002). Ulcers with an S(AD)SAD score of ≤9 (total possible 15) were 7.6 times more likely to heal than scores ≥10 (P<0.001).ConclusionsAll three systems predicted ulcer outcome. The S(AD)SAD score of ulcer severity could represent a useful addition to routine clinical practice. The association between outcome and ulcer depth confirms earlier reports. The association with infection was stronger than that reported from the centres in Europe or North America. The very strong association with neuropathy has only previously been observed in Tanzania. Studies designed to compare the outcome in different countries should adopt systems of classification, which are valid for the populations studied.
Relationships between serum IGF1 levels, blood pressure, and glucose tolerance: an observational, exploratory study in 404 subjects
Authors: Colao Annamaria , Di Somma Carolina , Cascella Teresa , Pivonello Rosario , Vitale Giovanni , Grasso Ludovica F S , Lombardi Gaetano , Savastano Silvia 
Published: July 2008

BackgroundIn the general population, low IGF1 has been associated with higher prevalence of cardiovascular disease and mortality.ObjectiveTo investigate the relationships between IGF1 levels, blood pressure (BP), and glucose tolerance (GT).SubjectsFour-hundred and four subjects (200 men aged 18–80 years). Exclusion criteria: personal history of pituitary or cardiovascular diseases; previous or current treatments with drugs interfering with BP, GT, or lipids, corticosteroids (>2 weeks), estrogens, or testosterone (>12 weeks); smoking of >15 cigarettes/day and alcohol abuse (>3 glasses of wine/day).ResultsTwo hundred and ninety-six had normal BP (73.3%), 86 had mild (21.3%), and 22 had severe (5.4%) hypertension; 322 had normal GT (NGT (79.7%)), 53 had impaired glucose tolerance (IGT (13.1%)), 29 had diabetes mellitus (7.2%). Normotensive subjects had significantly higher IGF1 levels (0.11±0.94 SDS) than those with mild (−0.62±1.16 SDS, P<0.0001) or severe (−1.01±1.07 SDS, P<0.0001) hypertension. IGF1 SDS (t=−3.41, P=0.001) independently predicted systolic and diastolic BP (t=−2.77, P=0.006) values. NGT subjects had significantly higher IGF1 levels (0.13±0.90 SDS) than those with IGT (−0.86±1.14 SDS, P<0.0001) or diabetes mellitus (−1.31±1.13 SDS, P<0.0001). IGF1 SDS independently predicted fasting glucose (t=−3.49, P=0.0005) and homeostatic model assessment (HOMA)-R (t=−2.15, P=0.033) but not insulin (t=−1.92, P=0.055) and HOMA-β (t=−0.19, P=0.85).ConclusionIGF1 levels in the low normal range are associated with hypertension and diabetes in subjects without pituitary and cardiovascular diseases.
The usefulness of 99mTc-sestaMIBI thyroid scan in the differential diagnosis and management of amiodarone-induced thyrotoxicosis
Authors: Piga M , Cocco M C , Serra A , Boi F , Loy M , Mariotti S 
Published: July 2008

BackgroundAmiodarone-induced thyrotoxicosis (AIT) is caused by excessive hormone synthesis and release (AIT I) or a destructive process (AIT II). This differentiation has important therapeutic implications.PurposeTo evaluate 99mTc-sestaMIBI (MIBI) thyroid scintigraphy in addition to other diagnostic tools in the diagnosis and management of AIT.Subjects and methodsThyroid and 99mTc-MIBI scintigraphies were performed in 20 consecutive AIT patients, along with a series of biochemical and instrumental investigations (measurement of thyrotrophin, free thyroid hormones and thyroid autoantibodies; thyroid colour-flow Doppler sonography (CFDS) and thyroid radioiodine uptake (RAIU)).ResultsOn the basis of instrumental and laboratory data (excluding thyroid 99mTc-MIBI scintigraphy) and follow-up, AIT patients could be subdivided into six with AIT I, ten with AIT II and four with indefinite forms of AIT (AIT Ind). 99mTc-MIBI uptake results were normal/increased in all the six patients with AIT I and absent in all the ten patients with AIT II. The remaining four patients with AIT Ind showed low, patchy and persistent uptake in two cases and in the other two evident MIBI uptake followed by a rapid washout. MIBI scintigraphy was superior to all other diagnostic tools, including CFDS (suggestive of AIT I in three patients with AIT II and of AIT II in three with AIT Ind) and RAIU, which was measurable in all patients with AIT I, and also in four out of the ten with AIT II.ConclusionThyroid MIBI scintigraphy may be proposed as an easy and highly effective tool for the differential diagnosis of different forms of AIT.
Long-acting octreotide treatment causes a sustained decrease in ghrelin concentrations but does not affect weight, behaviour and appetite in subjects with Prader–Willi syndrome
Authors: De Waele Kathleen , Ishkanian Stacey L , Bogarin Roberto , Miranda Charmaine A , Ghatei Mohammad A , Bloom Stephen R , Pacaud Danièle , Chanoine Jean-Pierre 
Published: July 2008

ObjectiveGhrelin is secreted primarily by the stomach and circulates as both acylated and desacyl ghrelin. Acylated (but not desacyl) ghrelin stimulates appetite. Both concentrations are elevated in Prader–Willi syndrome (PWS), suggesting that ghrelin may contribute to hyperphagia and overweight in these subjects. We evaluated whether long-acting octreotide (Oct) decreases acylated and desacyl ghrelin concentrations, body mass, appetite and compulsive behaviour towards food in adolescents with PWS.DesignA 56-week prospective, randomized, cross-over trial.MethodsNine subjects with PWS (age 14.6 (10.8–18.9) years, body mass index (BMI) Z-score +1.9 (0.6–3.0)) received either Oct (30 mg) or saline i.m. every 4 weeks for 16 weeks and were switched over to the other treatment after a 24-week washout period.ResultsEight subjects completed the study. Oct caused a decrease in both acylated (−53%) and desacyl (−54%) fasting ghrelin concentrations (P<0.05) but did not significantly affect BMI. Oct had no significant effect on peptide YY concentrations, appetite or compulsive behaviour towards food. Oct caused a decrease in insulin-like growth factor-I concentrations, an increase in HbA1c and transient elevation of blood glucose in two subjects. Three subjects developed gallstones.ConclusionsOct treatment caused a prolonged decrease in ghrelin concentrations in adolescents with PWS but did not improve body mass or appetite. Future intervention studies aiming at clarifying the role of ghrelin in PWS should focus on the administration of specific inhibitors of ghrelin secretion or ghrelin receptor activity that do not interfere with other appetite-regulating peptides.
Biomechanical analysis of cranial settling after transoral odontoidectomy
Authors: Naderi Sait , Crawford Neil R. , Melton M. Stephen , Sonntag Volker K. H. , Dickman Curtis A. 
Published: July 2008

The authors conducted a biomechancial study to determine whether C-1 ring integrity is important in maintaining normal occiput-C-2 separation, specifically when the anterior arch is transected to provide access to the dens during an odontoidectomy procedure.
Six human cadaveric occiput-C3 specimens were loaded under axial compression, and the bilateral horizontal separation of the C-1 lateral masses and the vertical compression of the occiput relative to C-2 were recorded. Specimens were first studied after odontoidectomy without C-1 ring transection, then after C-1 anterior arch transection, and finally after C-1 lamina transection.
With applied compressive load corresponding to three times the weight of the head, the C-1 ring spread horizontally 1.57 ± 0.30 mm more when the anterior arch of C-1 was transected than when left intact, resulting in 0.74 ± 0.44 mm collapse in the occiput-C-2 vertical separation. After laminar transection, the C-1 ring spread 6.55 ± 2.29 mm more than when it was intact. The resultant vertical separation was a 3.37 ± 1.89-mm collapse in the occiput-C-2. All changes in C-1 spreading and the occiput-C-2 collapse were statistically significant (p < 0.05, paired Student's t-tests). The C-1 ring continuity prevents horizontal spreading caused by the wedging of C-1 between the occiput and C-2 and thus prevents cranial settling. Therefore, to prevent the subsequent development of disease related to cranial settling, the authors recommend that the surgeon resect part of C-1 only if necessary during odontoidectomy.
Use of EPR Spectroscopy to Study Macromolecular Structure and Function
Authors: Biswas Roopa , KÜhne Henriette , Brudvig Gary W. , Gopalan Venkat 
Published: July 2008

Electron paramagnetic resonance (EPR) spectroscopy is now part of the armory available to probe the structural aspects of proteins, nucleic acids and protein–nucleic acid complexes. Since the mobility of a spin label covalently attached to a macromolecule is influenced by its microenvironment, analysis of the EPR spectra of site-specifically incorporated spin labels (probes) provides a powerful tool for investigating structure–function correlates in biological macromolecules. This technique has become readily amenable to address various problems in biology in large measure due to the advent of techniques like site-directed mutagenesis, which enables site-specific substitution of cysteine residues in proteins, and the commercial availability of thiol-specific spin-labeling reagents (Figure 1)1. In addition to the underlying principle and the experimental strategy, several recent applications are discussed in this review.
Kinetic modeling of light limitation and sulfur deprivation effects in the induction of hydrogen production with Chlamydomonas reinhardtii: Part I. Model development and parameter identification
Authors: Fouchard Swanny , Pruvost Jérémy , Degrenne Benoit , Titica Mariana , Legrand Jack 
Published: July 2008

AbstractChlamydomonas reinhardtii is a green microalga capable of turning its metabolism towards H2 production under specific conditions. However this H2 production, narrowly linked to the photosynthetic process, results from complex metabolic reactions highly dependent on the environmental conditions of the cells. A kinetic model has been developed to relate culture evolution from standard photosynthetic growth to H2 producing cells. It represents transition in sulfur‐deprived conditions, known to lead to H2 production in Chlamydomonas reinhardtii, and the two main processes then induced which are an over‐accumulation of intracellular starch and a progressive reduction of PSII activity for anoxia achievement. Because these phenomena are directly linked to the photosynthetic growth, two kinetic models were associated, the first (one) introducing light dependency (Haldane type model associated to a radiative light transfer model), the second (one) making growth a function of available sulfur amount under extracellular and intracellular forms (Droop formulation). The model parameters identification was realized from experimental data obtained with especially designed experiments and a sensitivity analysis of the model to its parameters was also conducted. Model behavior was finally studied showing interdependency between light transfer conditions, photosynthetic growth, sulfate uptake, photosynthetic activity and O2 release, during transition from oxygenic growth to anoxic H2 production conditions. Biotechnol. Bioeng. 2009;102: 232–245. © 2008 Wiley Periodicals, Inc.