bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystatin‐C, Renal Function, and Incidence of Hip Fracture in Postmenopausal Women
Authors: LaCroix Andrea Z. , Lee Jennifer S. , Wu LieLing , Cauley Jane A. , Shlipak Michael G. , Ott Susan M. , Robbins John , Curb J. David , Leboff Meryl , Bauer Douglas C. , Jackson Rebecca D. , Kooperberg Charles L. , Cummings Steven R. 
Published: July 2008

OBJECTIVES: To evaluate the association between chronic kidney disease and incident hip fracture using serum cystatin‐C as a biomarker of renal function calculated without reference to muscle mass.DESIGN: Case‐control study nested within a prospective study.SETTING: The Women's Health Initiative Observational Study conducted at 40 U.S. clinical centers.PARTICIPANTS: From 93,676 women aged 50 to 79 followed for an average of 7 years, 397 incident hip fracture cases and 397 matched controls were studied.MEASUREMENTS: Cystatin‐C levels were measured on baseline serum using a particle‐enhanced immunonepholometric assay. Estimated glomerular filtration rates (eGFRcys‐c) were calculated using a validated equation and categorized into three groups (≥90.0 mL/min per 1.73 m2, 60.0–89.9 mL/min per 1.73 m2, and <60.0 mL/min per 1.73 m2 indicating chronic kidney disease Stages 3 to 4).RESULTS: The odds ratio (OR) for hip fracture was 2.50 (95% confidence interval (CI)=1.32–4.72) for eGFRcys‐c less than 60 mL/min per 1.73 m2 compared with Stages 0 to 1, after adjustment for body mass, parental hip fracture, smoking, alcohol consumption, and physical function. No association was observed for eGFRcys‐c of 60 to 90 mL/min per 1.73 m2 (OR=1.04, 95% CI=0.66–1.64). Additional adjustment for poor health status, hemoglobin, serum 25‐hydroxy vitamin D, and bone metabolism markers did not affect these associations. Adjustment for plasma homocysteine reduced the OR for eGFRcys‐c less than 60 mL/min per 1.73 m2 to 1.83 (95% CI=0.93–3.61).CONCLUSION: Women with eGFRcys‐c levels less than 60 mL/min per 1.73 m2 have a substantially greater risk of hip fracture. Effects of renal function on homocysteine levels may partially mediate, or accompany, this association.
Health Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes
Authors: Tinetti Mary E. , McAvay Gail J. , Fried Terri R. , Allore Heather G. , Salmon JoAnna C. , Foody Joanne M. , Bianco Luann , Ginter Sandra , Fraenkel Liana 
Published: July 2008

OBJECTIVES: To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall‐ and medication symptom‐related outcomes.DESIGN: Interview.SETTING: Community.PARTICIPANTS: One hundred twenty‐three cognitively intact persons aged 70 and older with hypertension and fall risk.MEASUREMENTS: Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome.RESULTS: Sixty‐two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P=.02), unsteadiness (P=.02), functional dependency (P=.04), lower cognition (P=.02) and depressive symptoms (P=.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics.CONCLUSION: Interindividual variability in the face of competing outcomes supports individualizing decision‐making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals.
Olfaction and the 5‐Year Incidence of Cognitive Impairment in an Epidemiological Study of Older Adults
Authors: Schubert Carla R. , Carmichael Lakeesha L. , Murphy Claire , Klein Barbara E. K. , Klein Ronald , Cruickshanks Karen J. 
Published: July 2008

OBJECTIVES: To determine whether odor identification ability is associated with the 5‐year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and whether olfactory impairment contributes to the prediction of cognitive decline.DESIGN: Population‐based longitudinal study.SETTING: Beaver Dam, Wisconsin.PARTICIPANTS: One thousand nine hundred twenty participants in the Epidemiology of Hearing Loss Study (mean age 66.9).MEASUREMENTS: Olfaction was measured using the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini‐Mental State Examination (MMSE) score of less than 24 or reported diagnosis of dementia or Alzheimer's disease (AD) at follow‐up in participants with a MMSE score of 24 or greater and no diagnosis of dementia or AD at baseline.RESULTS: There was a significant association between olfactory impairment at baseline and 5‐year incidence of cognitive impairment (odds ratio (OR)=6.62, 95% confidence interval (CI)=4.36–10.05). The association remained significant after adjusting for possible confounders (OR=3.72, 95% CI=2.31–5.99). The positive predictive value of the SDOIT was 15.9%, the negative predictive value was 97.2%, the sensitivity was 55.1%, and the specificity was 84.4% for 5‐year incidence of cognitive impairment.CONCLUSION: Olfactory impairment at baseline was strongly associated with 5‐year incidence of cognitive impairment as measured using the MMSE. Odor identification testing may be useful in high‐risk settings, but not in the general population, to identify patients at risk for cognitive decline.
Results, Rhetoric, and Randomized Trials: The Case of Donepezil
Authors: Gilstad John R. , Finucane Thomas E. 
Published: July 2008

Whether donepezil provides meaningful benefit to patients with Alzheimer's disease (AD) is controversial, but drug sales annually total billions of dollars. A review of data from published randomized clinical trials (RCTs) found rhetorical patterns that may encourage use of this drug.To create a reproducible observation, the sentences occurring at five specific text sites in all 18 RCTs of donepezil for AD were tabulated, as were study design, sources of financial support, and outcomes that could be compared between trials.Rhetoric in the 13 vendor‐supported trials (15 publications) was strongly positive. Three early trials used the motif “efficacious (or effective) … treating … symptoms” four times. “Well‐tolerated and efficacious” or an equivalent motif appeared 11 times in five RCTs. Nine RCTs referred 15 times to previously proven effectiveness. Seven trials encourage off‐label use, for “early” cognitive impairment, severe dementia in advance of the Food and Drug Administration labeling change, or behavioral symptoms. These rhetorical motifs and themes appeared only in the vendor‐supported trials. Trials without vendor support described the drug's effects as “small” or absent; two emphasized the need for better treatments. RCT results were highly consistent in all trials; the small differences do not explain differences in rhetoric.At these text sites in the primary research literature on donepezil for AD, uniformly positive rhetoric is present in all vendor‐supported RCTs. Reference to the limited benefit of donepezil is confined to RCTs without vendor support. Data in the trials are highly consistent. This observation generates the hypothesis that rhetoric in vendor‐supported published RCTs may promote vendors' products.
Evaluation of the transfusion safety of blood products and determination of plasma concentrations of acitretin and etretinate in patients receiving transfusions
Authors: Park Hyung‐Doo , Kim Hye‐Kyung , Kim Jong‐Won , Kim Dae‐Won , Lee Joo‐Heung , Huh Wooseong , Youn Jai‐Il , Kim Hyung‐Gun , Kim Yoon‐Gyoon , Kim Myung‐Hwa , Lee Soo‐Youn 
Published: July 2008

BACKGROUND: Acitretin and etretinate are potentially teratogenic. Many people taking acitretin for psoriasis have donated blood during the deferral period in Korea. Therefore, many of the blood products from these donors treated with acitretin have been circulated in Korea.STUDY DESIGN AND METHODS: A high‐performance liquid chromatography system (HP 1050, Agilent Technologies) was used to measure the drug concentrations in five blood products and in patients. Sixty patients taking acitretin were enrolled to determine their plasma drug levels. Forty‐one female patients were recruited to investigate the residual plasma levels of acitretin and etretinate in relation to their teratogenicity. We calculated the elimination rate of acitretin and etretinate during the manufacturing process.RESULTS: Sixty individuals taking acitretin expressed variable acitretin (<2.0‐206.8 ng/mL) and etretinate levels (<2.0‐9.1 ng/mL). All patients that had a transfusion had concentrations of acitretin and etretinate lower than the lower limit of quantification (LLOQ; 2 ng/mL). The concentrations of acitretin and etretinate in five blood products were less than the LLOQ. Approximately 98.84 percent (log value, 1.94) of the acitretin and 99.93 percent (log value, 3.14) of the etretinate was eliminated during the manufacturing process of albumin. More than 99.99 percent (log values, 5.95‐15.76) of acitretin and etretinate was eliminated during the manufacturing processing of immunoglobulin and blood coagulation factors.CONCLUSIONS: We confirmed the effective manufacturing processing of various blood products. We also demonstrated that individuals receiving transfusions with blood products originating from donors treated with acitretin were not at risk for significant exposure to the acitretin and etretinate.
Bacterial contamination of whole blood–derived platelets: the introduction of sample diversion and prestorage pooling with culture testing in the American Red Cross
Authors: Benjamin Richard J. , Kline Linda , Dy Beth A. , Kennedy Jean , Pisciotto Patricia , Sapatnekar Suneeti , Mercado Rachel , Eder Anne F. 
Published: July 2008

BACKGROUND: Bacterial sepsis following whole blood–derived platelet (WBP) transfusion has remained a substantial patient risk, primarily due to a lack of practical and effective means to limit or detect bacterial contamination. We describe the risk of reported septic reactions to WBPs and the introduction of prestorage‐pooled whole blood–derived platelets (PSPs) collected using initial sample diversion and cultured for bacterial contamination.STUDY DESIGN AND METHODS: Product qualification and quality control (QC) testing with the Acrodose PL system (Pall Medical) were evaluated in four regional blood centers. Bacterial contamination risk was assessed by review of reported septic transfusion reactions to WBPs and by aerobic QC culture of leukoreduced PSPs utilizing automated microbial detection system cultures (BacT/ALERT 3D, bioMérieux).RESULTS: Before implementing PSPs (January 2003‐December 2006), we distributed 2,535,043 WBP units and received 20 reports of septic reactions including 2 fatalities (7.9 per million [1:126,752] reactions and 0.79 per million [1:1,267,522] fatalities). In October 2006, PSPs were effectively implemented with a product qualification success rate of 99.6 percent and a mean yield of 4.0 × 1011 platelets (PLTs) per pool. Whole blood collection sets with sample diversion technology were introduced during the operational trial and decreased the rate of confirmed‐positive bacterial culture of PSPs from 2111 (1:474) to 965 (1:1036) per million (odds ratio, 0.46; 95% confidence interval, 0.22‐0.95). No septic reactions to PSPs were reported (25,936 PSP units distributed).CONCLUSION: Sample diversion and bacterial culture are effective methods to reduce bacterial risk with WBP transfusion. Bacterial contamination of PSPs was assessed at 5.8‐fold our current rate for apheresis PLTs utilizing comparable culture protocols.
Proteomic characterization of freeze‐dried human plasma: providing treatment of bleeding disorders without the need for a cold chain
Authors: Steil Leif , Thiele Thomas , Hammer Elke , Bux Jürgen , Kalus Monika , Völker Uwe , Greinacher Andreas 
Published: July 2008

BACKGROUND: Transfusion of human plasma is a basic treatment for severe coagulopathies, especially in major bleeding. The required logistics to provide plasma is challenging because of the need to maintain a cold chain. This disadvantage could be overcome by lyophilized plasma. However, it is unknown to what extent lyophilization alters plasma proteins. Quantitative proteomic technologies were applied to monitor protein changes during production of lyophilized, solvent/detergent (S/D)‐treated plasma.MATERIALS AND METHODS: The impact of S/D treatment and lyophilization on the plasma proteome was evaluated by differential in‐gel electrophoresis (2D‐DIGE), and proteins were characterized by mass spectrometry. Clotting factor activities were determined in lyophilized S/D‐treated plasma after 24 months of storage at room temperature.RESULTS: By 2D‐DIGE, 600 individual protein spots were compared. Lyophilization did not change any of the 600 spots, whereas pathogen inactivation caused significant changes of 38 spots including α1‐antitrypsin, α1‐antichymotrypsin, and α2‐antiplasmin. Clotting factor activities remained stable over 24 months of storage.CONCLUSION: Lyophilization of human plasma neither alters its protein composition nor impairs its clotting capacity. It does not require cost‐intensive logistics for storage and transport and can be quickly reconstituted. It is suggested that lyophilized, pathogen‐inactivated plasma is an attractive option to provide the most important basic treatment for severe coagulopathies in areas without cold chain and to provide plasma with reduced time delay in emergency situations.
Cyclooxygenase in normal human tissues – is COX‐1 really a constitutive isoform, and COX‐2 an inducible isoform?
Authors: Zidar Nina , Odar Katarina , Glavac Damjan , Jerse Maja , Zupanc Tomaz , Stajer Dusan 
Published: July 2008

AbstractCyclooxygenase (COX) is a key enzyme in prostanoid synthesis. It exists in two isoforms, COX‐1 and COX‐2. COX‐1 is referred to as a ‘constitutive isoform’, and is considered to be expressed in most tissues under basal conditions. In contrast, COX‐2 is referred to as an ‘inducible isoform’, which is believed to be undetectable in most normal tissues, but can be up‐regulated during various conditions, many of them pathological. Even though the role of COX in homeostasis and disease in now well appreciated, controversial information is available concerning the distribution of COX isoforms in normal human tissues. There is mounting evidence that it is much more complex than generally believed. Our aim was therefore to analyse the expression and distribution of COX isoforms in normal human tissues, using immunohistochemistry, Western blotting and real‐time RT‐PCR. Autopsy samples from 20 healthy trauma victims and samples from 48 biopsy surgical specimens were included. COX‐1 was found in blood vessels, interstitial cells, smooth muscle cells, platelets and mesothelial cells. In contrast, COX‐2 was found predominantly in the parenchymal cells of many tissues, with few exceptions, for example the heart. Our results confirm the hypothesis that the distribution of COX isoforms in healthy tissues is much more complex than generally believed. This and previous studies indicate that both isoforms, not only COX‐1, are present in many normal human tissues, and that both isoforms, not only COX‐2, are up‐regulated in various pathological conditions. We may have to revise the concept of ‘constitutive’ and ‘inducible’ COX isoforms.
ORIGINAL ARTICLE: IL‐6 as a Regulatory Factor of the Humoral Response During Pregnancy
Authors: Dubinsky Valeria , Junovich Gisela , Gentile Teresa , Gutiérrez Gabriela 
Published: July 2008

Problem  Regulatory factors seem to be essential to achieve transition from implantation window to placental vascularization. A novel function of interleukin (IL)‐6 in the promotion of Th2 differentiation and inhibition of Th1 polarization has been demonstrated. Considering that Th2 response promotes antibody synthesis, we postulate that IL‐6 could be modulating the quality of this response during pregnancy by increasing the proportion of blocking asymmetric antibodies.Method of study  We investigated expression of blocking‐asymmetric‐IgG during pregnancy of CBA/J × DBA/2 abortion model treated with IL‐6, with regards to CBA/J × BALB/c. We also determined asymmetric‐IgG production in IL‐6‐deficient pregnant mice.Results  We found that IL‐6 treatment increased asymmetric‐IgG in multiparous placentas from abortion combination whereas diminished abortion rate. Moreover, asymmetric‐IgG proportion was diminished in sera from IL‐6‐deficient pregnant mice.Conclusion  Modulation of asymmetric antibody synthesis could be another mechanism implicated in the beneficial effect of IL‐6 in prevention of murine recurrent abortion.
Peri‐Implant Bone Organization under Immediate Loading Conditions: Collagen Fiber Orientation and Mineral Density Analyses in the Minipig Model
Authors: Traini Tonino , Neugebauer Jörg , Thams Ulf , Zöller Joachim E. , Caputi Sergio , Piattelli Adriano 
Published: July 2008

ABSTRACTBackground: Mechanical properties of bones are greatly influenced by percentages of organic and mineral constituents. Nevertheless, information about mineralization level on a microscopic scale and collagen fiber organization in peri‐implant bone after immediate loading is scarce.Purpose: The aim of this work was to analyze and compare the degree of mineralization and collagen fiber orientation in alveolar bone (AB) and peri‐implant bone of immediately loaded (IL) and unloaded (NL) implants.Materials and Methods: A total of 25 dental implants of 3.8 mm in diameter and 11 mm in length were used in the present study. In five minipigs, three premolars and the first molar were removed from the left side of the mandible. Three months later, five implants for each animal were inserted. Four implants were loaded immediately with a fixed restoration, while one implant was left unloaded. After a 4‐month healing period, all implants were retrieved. Circularly polarized light and scanning electron microscope with backscattered electron imaging were used to analyze both peri‐implant and AB retrieved 5 mm from the implant.Results: The bone/implant contact ratio (BIC %) was 77.8 ± 5.9% for the IL implants and 78.0 ± 5.8% for the NL implants; the difference was not statistically significant (p = 0.554). In the peri‐implant bone, the area related to transverse collagen fibers was 112,453 ± 4,605 pixels for IL implants and 87,256 ± 2,428 pixels for NL implants. In the AB, the area related to transverse collagen fibers was 172,340 ± 3,892 pixels. The difference between groups was statistically significant (p < .001). The degree of mineralization of peri‐implant bone was 137 ± 19 gray level for IL implants and 115 ± 24 gray level for NL implants, while in the AB, the degree of mineralization was 125 ± 26 gray level. This difference was statistically significant (p < .001).Conclusion: In this study, it was found that IL and NL implants showed the same degree of osseointegration. The bone matrix around IL implants had a higher quantity of transverse collagen fibers and presented a higher level of mineralization.
Bacterial Colonization of Oral Implants from Nondental Sources
Authors: Emrani Jinus , Chee Winston , Slots Jørgen 
Published: July 2008

ABSTRACTImplants showing signs of peri‐implantitis harbor a microbiota similar to that of periodontitis‐affected teeth. This case report describes the subgingival microbiota of a 45‐year‐old female with advanced periodontitis before and after complete edentulation and reconstruction with dental implants. A 3‐month healing period post extraction passed before implants were placed using a two‐stage submerged implant protocol. At 4‐ to 6‐month recall visits after definitive prosthetic reconstruction, some implant sites showed bleeding on probing and localized mucositis. Microbiological culture of three inflamed peri‐implant sites showed an almost identical spectrum of pathogens, including Porphyromonas gingivalis, Tannerella forsythia, and other major pathogenic bacteria characteristic of aggressive periodontitis. As natural teeth were absent for 8 months, this case report suggests that periodontal pathogens can be retained for a prolonged period of time in nondental sites, from where they can later colonize and compromise the health of dental implants. The therapeutic implications of this finding are discussed.
Clinical Outcome of Overdenture Treatment on Two Nonsubmerged and Nonsplinted Astra Tech Microthread™ Implants
Authors: De Bruyn Hugo , Besseler Jos , Raes Filiep , Vaneker Marianne 
Published: July 2008

ABSTRACTBackground: The use of two implants for mandibular overdenture stabilization improves the patients' comfort and well‐being. This treatment could be more cost‐effective if surgery and prosthetic treatment could be performed by one clinician in the normal setting of a dental clinic.Purpose: The aim of this retrospective clinical study was to describe implant success, restorative outcome, and the patients' opinion of mandibular overdenture treatment on two early‐loaded, nonsplinted Astra Tech TiOblast Microthread™ (Astra Tech Dental, Mölndal, Sweden) implants.Materials and Methods: Thirty‐seven consecutive patients treated with implant‐supported mandibular overdentures were invited for a clinical examination. Implant survival, marginal bone level, quality of implant and prosthetic treatment, and the patients' opinion by means of questionnaires were scored.Results: Thirty‐four patients attended the examination. Two implants were lost in one patient and the failure rate for the total group of patients was 3%. As 8 of the 33 remaining patients were still in the provisional loading stage, they were not included in the final clinical and radiographic examination. Based on 25 patients and 50 implants with a mean follow‐up of 18.8 months (range 4–33), implant positioning and occlusion/articulation scored perfect in 74 to 80% of the cases. Retention of the dentures was rated perfect in 80%, but 20% needed minor activation of the attachments, 20% showed signs of abrasion, and 20% had already been repaired. The average marginal bone level was 0.8 mm below the reference point. The mean pocket depth was 2.1 mm, and 54% of the peri‐implant tissues were free of bleeding. The patients were appreciative of the work carried out by their dentist and they indicated a significant improvement in their well‐being and quality of life.Conclusions: It can be concluded that the Astra Tech implant system was successfully used by the general dentist both surgically and prosthetically with minimal implant failures and prosthetic complications and that this led to high levels of patient appreciation and overall satisfaction.