bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial contamination of nebulizers in the home treatment of cystic fibrosis
Authors: Blau H. , Mussaffi H. , Mei Zahav M. , Prais D. , Livne M. , Czitron B. M. , Cohen H. A. 
Published: October 2006

AbstractBackground Home nebulizers are in widespread use in cystic fibrosis (CF) and other chronic pulmonary diseases. Bacterial contamination may be a source of respiratory tract colonization.Objectives To investigate microbial contamination of home nebulizers in CF patients, compare with sputum cultures and relate to cleaning practices.Methods A total of 29 home nebulizers of CF patients were cultured. Families were interviewed regarding cleaning routines and patients had sputum cultures for bacteria and fungi.Results In total, 19/29 (65%) nebulizers were contaminated: 18 reservoir cups, 14 mouthpieces and five filters. Pseudomonas spp. were isolated from 10 nebulizers (35%) and all 10 had Pseudomonas aeruginosa airway infection although without genetic typing we could not be sure this was the same bacteria as that from their nebulizer unit. An additional 7/29 had Pseudomonas aeruginosa airway infection without a contaminated nebulizer (P = 0.001). No nebulizers were contaminated with Aspergillus. Only 4/19 contaminated nebulizers (22%) had been cleaned after every use, compared with seven of the 10 (70%) uncontaminated nebulizers (P = 0.017). Only 7/19 patients with contaminated nebulizers (37%) and 5/10 with clean nebulizers (50%) recalled receiving cleaning instructions (not significant).Conclusions Home nebulizers are frequently contaminated, particularly when cleaning instructions are inadequate, and may be a source of airway infection or reinfection especially following contamination from a patient chronically colonized with P. aeruginosa. Simple oral and written cleaning instructions should be offered.
Social perception of the development of disabled children
Authors: Castañeto M. V. , Willemsen E. W. 
Published: October 2006

AbstractBackground  This experiment extends our study of perception of the disabled from the realm of personality into child development to determine if our results, which reveal prejudice against disabled adults, apply to perceptions of a toddler’s development.Methods  Participants watched a video of either a disabled or a non‐disabled toddler in sessions conducted by either a disabled or a non‐disabled experimenter. Participants rated the target using the Achenbach Caregiver‐Teacher Report Form for ages 1.5–5 years twice: first, each participant imagined being the caregiver of the toddler at age 4 years (self‐rating), and then the participant envisioned how a typical childcare provider would rate the target (other‐rating).Results  Data revealed an interaction between the experimenter’s disability and the source of ratings. For the disabled experimenter, participants thought that ‘others’ would perceive more behavioural problems than they themselves do. For the non‐disabled experimenter, participants rated the disabled target more pessimistically in both the self‐ and other‐ratings.Conclusion  As we found in our first study of disabled adults, our current results reveal subtle prejudice against disabled children.
Mechanisms of osteoporosis in spinal cord injury
Authors: Jiang Sheng‐Dan , Jiang Lei‐Sheng , Dai Li‐Yang 
Published: October 2006

SummaryOsteoporosis is a known complication of spinal cord injury (SCI), but its mechanism remains unknown. The pathogenesis of osteoporosis after SCI is generally considered disuse. However, although unloading is an important factor in the pathogenesis of osteoporosis after SCI, neural lesion and hormonal changes also seem to be involved in this process. Innervation and neuropeptides play an important role in normal bone remodelling. SCI results in denervation of the sublesional bones and the neural lesion itself may play a pivotal role in the development of osteoporosis after SCI. Although upper limbs are normally loaded and innervated, bone loss also occurs in the upper extremities in patients with paraplegia, indicating that hormonal changes may be associated with osteoporosis after SCI. SCI‐mediated hormonal changes may contribute to osteoporosis after SCI by different mechanisms: (1) increased renal elimination and reduced intestinal absorption of calcium leading to a negative calcium balance; (2) vitamin D deficiency plays a role in the pathogenesis of SCI‐induced osteoporosis; (3) SCI antagonizes gonadal function and inhibits the osteoanabolic action of sex steroids; (4) hyperleptinaemia after SCI may contribute to the development of osteoporosis; (5) pituitary suppression of TSH may be another contributory factor to bone loss after SCI; and (6) bone loss after SCI may be caused directly, at least in part, by insulin resistance and IGFs. Thus, oversupply of osteoclasts relative to the requirement for bone resorption and/or undersupply of osteoblasts relative to the requirement for cavity repair results in bone loss after SCI. Mechanisms for the osteoporosis following SCI include a range of systems, and osteoporosis after SCI should not be simply considered as disuse osteoporosis. Unloading, neural lesion and hormonal changes after SCI result in severe bone loss. The aim of this review is to improve understanding with regard to the mechanisms of osteoporosis after SCI. The understanding of the pathogenesis of osteoporosis after SCI can help in the consideration of new treatment strategies. Because bone resorption after SCI is very high, intravenous bisphosphonates and denosumab should be considered for the treatment of osteoporosis after SCI.
Workshop cluster 1+γδ T‐cell receptor+ T cells from calves express high levels of interferon‐γ in response to stimulation with interleukin‐12 and ‐18
Authors: Price Sally J. , Sopp Paul , Howard Christopher J. , Hope Jayne C. 
Published: October 2006

Summaryγδ T‐cell receptor+ T lymphocytes are an important element of the innate immune system. Early production of interferon (IFN)‐γ by γδ T cells may have a role in linking innate and adaptive immune responses and contribute to T helper‐1 bias. We investigated the role of cytokines in the activation and induction of IFN‐γ secretion by bovine workshop cluster 1+ (WC1+) γδ T cells. The effects of culture with interleukin (IL)‐12, IL‐18, IL‐15 and IL‐2 were investigated; these cytokines are known to influence murine and human γδ T cells. We report that bovine WC1+γδ T cells are synergistically stimulated by IL‐12 and IL‐18 to secrete large quantities of IFN‐γ. Neonatal calves were shown to have significantly higher numbers of circulating WC1+γδ T cells than adult animals. In addition, the response of peripheral blood WC1+γδ T cells was significantly higher in neonatal calves compared with adult animals. However, in adult animals the response of lymph node WC1+γδ T cells to IL‐12/IL‐18 was more pronounced than that of peripheral blood WC1+γδ T cells. We hypothesize that the induction of IFN‐γ secretion from WC1+γδ T cells by IL‐12 and IL‐18 is likely to be an important element of the innate response to pathogens such as Mycobacterium bovis. The high numbers of WC1+γδ T cells in neonatal calves, and their inherent ability to respond to inflammatory cytokines, could be a key factor in the enhanced responses seen in calves to BCG vaccination.
Toll‐like receptor interactions: tolerance of MyD88‐dependent cytokines but enhancement of MyD88‐independent interferon‐β production
Authors: Broad Andrea , Kirby John A. , Jones David E. J. ,   Applied Immunology and Transplantation Research Group
Published: October 2006

SummaryToll‐like receptors (TLRs) signal through two main pathways: a myeloid differentiation factor (MyD)88‐dependent pathway that acts via nuclear factor κB (NF‐κB) to induce proinflammatory cytokines such as tumour necrosis factor‐α (TNF‐α) and a MyD88‐independent pathway that acts via type I interferons to increase the expression of interferon‐inducible genes. Repeated signalling through TLR4 and a number of other TLRs has been reported to result in a reduction in the subsequent proinflammatory cytokine response, a phenomenon known as TLR tolerance. In this study we have shown that, whilst NF‐κB activation and production of TNF‐α and interleukin‐12 by murine RAW264.7 and J774.2 cells in response to stimulation by TLR4, ‐5, ‐7 or ‐9, was reduced by prior stimulation with TLR4, ‐5, ‐7 or ‐9 ligands, the primary stimulation of TLR3, which does not use the MyD88 pathway, did not reduce the TNF‐α or interleukin‐12 responses to subsequent TLR stimulation. The response to TLR3 stimulation was not diminished by prior TLR ligand exposure. Furthermore, the production of interferon‐β (IFN‐β) following stimulation of TLR3 or ‐4, which is MyD88‐independent, was increased by prior activation of TLR4, ‐5, ‐7 or ‐9. In contrast, TLR9 ligand‐induced IFN‐β production, which is MyD88‐dependent, was tolerized by prior TLR stimulation. These results are consistent with differential regulation of MyD88‐dependent and MyD88‐independent cytokine production following serial activation of TLRs.
Avoidance of solid food in weight losing older patients with Parkinson's disease
Authors: Lorefält Birgitta , Granérus Ann‐Katherine , Unosson Mitra 
Published: October 2006

Aim.  The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process.Background.  Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease.Design.  The design was a longitudinal prospective study.Methods.  Twenty‐six free‐living Parkinson's disease patients and 26 age‐ and sex‐matched controls were investigated twice, with one‐year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation.Results.  In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age.Conclusion.  Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage.Relevance to clinical practice.  Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.
Calcineurin inhibitor‐free immunosuppression in dual kidney transplantation from elderly donors
Authors: Furian Lucrezia , Baldan Nicola , Margani Giuseppe , Ekser Burcin , Silvestre Cristina , Marchini Francesco , Bonfante Luciana , Rossi Barbara , Valente Maria Luisa , Rigotti Paolo 
Published: October 2006

Abstract:  Background:  Kidneys from expanded‐criteria donors may be particularly susceptible to calcineurin inhibitor (CI)‐mediated vasoconstriction and nephrotoxicity. In the early post‐transplant phase, using CI may prolong ischemic injury and, in the long term, chronic CI nephrotoxicity is an even greater concern. To avoid the acute and chronic consequences of CI in kidneys from marginal donors, CI‐free protocols have been introduced for maintenance immunosuppressive therapy. A CI‐free protocol of anti‐thymocyte globulin (ATG) induction, sirolimus, mycophenolate mofetil (MMF) and steroids has been adopted at our center in recipients of dual kidney transplantation (DKT) from elderly donors (EDs).Methods:  Dual kidney transplantations performed since April 2003 on CI‐free immunosuppression (group 1 = 31) were compared with earlier DKTs in recipients treated with CI‐based therapy (group 2 = 25), retrospectively analyzing patient and graft survival, surgical and medical complications, rejection episodes and renal function.Results:  No deaths occurred after a mean follow‐up of 10.1 ± 7.6 (group 1) and 48.2 ± 17.4 months (group 2). Graft loss occurred in one patient in group 1 (bilateral renal vein thrombosis) and in three patients in group 2 (one primary non‐function [PNF], one chronic rejection, one Kaposi's sarcoma). The incidence of acute rejection was 19% in group 1 and 16% in group 2. Delayed graft function (DGF) was recorded in 16% and 48%, respectively. Renal function was better in group 1, with a mean S‐Cr of 135 ± 48 vs. 210 ± 141 μmol/L at one month and 116 ± 30 vs. 149 ± 49 μmol/L at six months.Conclusions:  After DKT from EDs, a CI‐free immunosuppressive regimen including ATG induction, sirolimus, MMF and steroids affords excellent results, with a lower DGF rate and a better renal function.
Non‐Hodgkin lymphoma and skin cancer: A dangerous combination
Authors: Otley Clark C 
Published: October 2006

SUMMARYThere is a significant association between non‐Hodgkin lymphoma, including chronic lymphocytic leukaemia, and both melanoma and non‐melanoma skin cancer. This review highlights the existing data on the phenomenon of accelerated skin cancer in patients with non‐Hodgkin lymphoma and specifically chronic lymphocytic leukaemia. The outcomes of patients with non‐Hodgkin lymphoma (including chronic lymphocytic leukaemia) and non‐melanoma skin cancer are worse than in patients without concomitant lymphoreticular malignancy, as shown by increased rates of local recurrence, regional metastasis and death. Pathogenic factors may be common between non‐Hodgkin lymphoma and chronic lymphocytic leukaemia and skin cancer. The treatment of skin cancer in patients with non‐Hodgkin lymphoma must factor in the worse prognosis and adapt standard therapeutic approaches to minimize the risk of metastasis and death. Preventive strategies and early detection are paramount in this high‐risk population.
Muir–Torre syndrome: Diagnostic and screening guidelines
Authors: Jones Brad , Oh Carol , Mangold Elisabeth , Egan Conleth A 
Published: October 2006

SUMMARYA 65‐year‐old man presented with a history of multiple skin coloured papules on his face that were asymptomatic. He had an adenocarcinoma resected from his proximal colon 12 years prior to presentation as well as a family history of colon cancer on the maternal side. Diagnostic biopsies showed the lesions to be sebaceous adenomas and epitheliomas and the diagnosis of Muir–Torre syndrome was made. The sebaceous tumour tissue showed microsatellite instability and immunohistochemical staining indicated diminished expression in the DNA mismatch–repair protein complex MSH2/MSH6. Genetic analysis showed a germline mutation in the MSH2 gene confirming the diagnosis of Muir–Torre syndrome. The patient and his first‐degree relatives have been referred for genetic counselling and screening. We review the diagnostic criteria in this syndrome and review the recommended screening guidelines.
Primary cutaneous diffuse leiomyosarcoma with desmoplasia
Authors: Choy Carolyn , Cooper Alan , Kossard Steven 
Published: October 2006

SUMMARYA 65‐year‐old man presented with an indurated plaque over his left cheek and left neck. An initial punch biopsy of skin showing increased smooth muscle bundles was consistent with a diagnosis of smooth muscle hamartoma. A second incisional skin biopsy revealed a well‐differentiated smooth muscle proliferation invading into the dermis and subcutaneous fat in a diffusely infiltrative pattern and with a desmoplastic component, suggesting a diagnosis of desmoplastic leiomyosarcoma. Resection of the tumour confirmed the presence of a cytologically low grade leiomyosarcoma with an insidious infiltrative growth pattern. This rare pattern of diffuse leiomyosarcoma is important to recognize as the histological features are subtle and may potentially constitute a pitfall in histological diagnosis in a small biopsy specimen. In addition, our case illustrates overlapping morphology between diffuse and desmoplastic types of leiomyosarcoma.
A comparative study between electron microscopy and immunofluorescence mapping in the diagnosis of epidermolysis bullosa
Authors: Yiasemides Eleni , Walton Judie , Marr Penelope , Villanueva Elmer V. , Murrell Dédée F. 
Published: October 2006

INTRODUCTION: The classification of epidermolysis bullosa (EB) into 3 main subtypes has been based on electron microscopy (EM) that is able to directly visualize and quantify specific ultrastructural features. Immunofluorescence antigenic mapping (IFM) is a technique that determines the precise level of skin cleavage by determining the site of binding of a series of antibodies. To date, no study has compared the accuracy of these two techniques in diagnosing the major types of EB.METHODS: A prospective cohort of 33 patients thought to have EB on clinical grounds had both EM and IFM. The sensitivity and specificity of EM and IFM were calculated using the genetic results as the ‘gold standard’. Statistical analysis involved the determination of positive and negative predictive values, accuracies, positive and negative likelihood ratios and post‐test probabilities of the IFM and EM diagnosis being correct compared to genetic diagnosis.RESULTS: 30/33 cases had a positive EB diagnosis. TEM subclassified EB into its three major forms in 24/30 cases (80%) and IFM in 29/30 cases (97%). Overall, TEM sensitivities and specificities when compared to genetic results were 71% and 81%, respectively. IFM sensitivities and specificities when compared to genetic results were 97% and 100% respectively. If a patient tested positive for EB by IFM, the likelihood ratio of having a particular type of EB was consistently greater than 20 against the reference standard (compared to a likelihood ratio less than 10 for TEM).CONCLUSION: These findings dispute the contention that EM and IFM are equally accurate and sensitive as diagnostic tests for the classification of the major types of EB. The results indicate that the diagnosis of EB is improved (sometimes substantially) by the use of IFM compared to TEM.
A molecular phylogeny of Planorboidea (Gastropoda, Pulmonata): insights from enhanced taxon sampling
Authors: Albrecht Christian , Kuhn Kerstin , Streit Bruno 
Published: October 2006

Planorbid gastropods are the most diverse group of limnic pulmonates, with both discoidal and highspired taxa. Phylogenetic relationships among these genera are confused and controversial. In particular, the monophyly of the limpet‐like taxa (traditionally Ancylidae) is disputed. Even recent molecular studies have concluded that substantially more work is necessary to solve the remaining issues concerning intergeneric phylogenetic relationships and higher taxa systematics. Planorbid snails are of great significance for humans as several members of this group are intermediate hosts of blood flukes (schistosomes) causing a chronic disease, schistosomiasis. We used the two independent molecular markers COI and 18S (concatenated dataset of 2837 nucleotide bp) to infer phylogenetic relationships of 26 genera (27 species) of Planorboidea, represented mostly by type species from mainly topotypical populations. With the majority of the taxa discussed not having been studied previously, this study attempted to test several hypotheses on planorbid phylogenetic relationships using Bayesian inference techniques. The monophyly of Planorboidea (= ‘Ancyloplanorbidae’) is strongly suggested on the basis of our extensive molecular analysis. Besides a distinct Burnupia clade, two major clades were recovered that correspond to family level taxa (traditional Bulinidae and Planorbidae). Considerable rearrangements of suprageneric taxa are evident from the phylogeny inferred. Therefore, the only clades recognized by current classifications and supported by our analysis are Planorbini and Segmentinini. The present study found that Ancylidae as traditionally understood, i.e. covering most freshwater limpet gastropods, is paraphyletic, as the genera of Burnupia and Protancylus have been shown to lie phylogenetically outside the Ancylini. Chromosome numbers and levels of polyploidy are discussed in the light of the new phylogeny. An earlier theory of shell shape evolution, i.e. that of patelliform taxa being most advanced, was not supported by this study; a limpet‐shaped taxon is most basal within Planorboidea. Although many taxa still remain to be studied, our results will hopefully contribute towards a better understanding of this very important group of freshwater organisms. Some taxonomic implications are discussed.
Outpatient dermatology major surgery: a 1‐year experience in a Spanish tertiary hospital
Authors: Fernández‐Jorge B , Peña‐Penabad C , Vieira V , Paradela S , Rodríguez‐Lozano J , Fernández‐Entralgo A , García‐Silva J , Fonseca E 
Published: October 2006

AbstractIntroduction  The constant increase in the incidence of skin cancer together with the requirement for maximum exploitation of available medical resources has meant that dermatological major surgery on an outpatient basis has greatly increased in recent years.Objective  This article reviews the practice of dermatological surgery in an outpatient setting over a 1‐year period. Its purpose is to analyse the number of surgical procedures, the type of cutaneous processes treated and the kind of surgical intervention and anaesthesia used. We also assessed the percentage of cancellations, postsurgical hospital admission and postsurgical complications. Clinicopathological correlation and complete tumour removal were also evaluated.Material and methods  Our clinical experience of major surgery of outpatients at the dermatology department of the Hospital Juan Canalejo in A Coruña (Spain), analysing 565 patients in a non‐randomized pilot study running from January to December 2003, is presented.Results  Six hundred and forty‐four surgical procedures were performed on a total of 565 patients. The three main cutaneous processes treated were basal cell carcinoma (240), squamous cell carcinoma (117) and melanoma (77). The most frequent type of procedure was direct closure (346), followed by exeresis and flap (133) and partial‐ or full‐thickness skin graft (29), nail apparatus surgery (56) and lip surgery (33). Twelve patients were admitted to hospital after surgery owing to the complexity of their operations or to complications arising during surgery. Five hundred and fifty‐three patients were discharged after being kept under observation for a few hours. Seventeen patients (3%) suffered complications following surgery, which consisted of partial implant failure (six cases), infection of the surgical wound (six cases), intense pain (four cases) and haemorrhage (one case). There was a good clinicopathological correlation in 90.78% of non‐melanoma skin cancers, of which 92.03% were completely removed.Conclusions  Medium and high complexity operations for dermatological processes, traditionally performed on hospitalized patients, can be conducted on an outpatient basis. This allows hospitalization costs and waiting lists to be reduced and affords the possibility of achieving better morbidity rates and medical care than in the standard hospital setting.