bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reevaluation of Gray and White Matter Injury after Spinal Cord Ischemia in Rabbits
Authors: Kurita Naoko , Kawaguchi Masahiko , Kakimoto Meiko , Yamamoto Yuri , Inoue Satoki , Nakamura Mitsutoshi , Konishi Noboru , Patel Piyush M. , Furuya Hitoshi 
Published: July 2006

Background
Although gray matter injury has been well characterized, the available data on white matter injury after spinal cord ischemia (SCI) in rabbits are limited. The current study was conducted to investigate the evolution of ischemia induced injury to gray and white matter and to correlate this damage to hind-limb motor function in rabbits subjected to SCI.

Methods
Thirty-eight rabbits were randomly assigned to 24-h, 4-day, or 14-day reperfusion groups or a sham group (n = 9 or 10 per group). SCI was induced by occlusion of the infrarenal aorta for 16 min. Hind-limb motor function was assessed using the Tarlov scale (0 = paraplegia, 4 = normal). The gray matter damage was assessed on the basis of the number of normal neurons in the anterior spinal cord. White matter damage was assessed on the basis of the extent of vacuolation and accumulation of amyloid precursor protein immunoreactivity.

Results
Tarlov scores gradually decreased and reached a nadir 14 days after reperfusion. There were no significant differences in the number of normal neurons among the 24-h, 4-day, and 14-day groups. The extent of vacuolation, expressed as a percent of total white matter area, was significantly greater in the 4-day and 14-day groups in comparison with the sham group. By contrast, there was no difference in vacuolation between the sham and 24-h groups. Amyloid precursor protein immunoreactivity was greater in the 4-day and 14-day groups.

Conclusion
The results in the current study show that SCI induced white matter injury as well as gray matter injury in a rabbit model of SCI. The time course for 14 days after reperfusion may differ among the gray and white matter damages and hind-limb motor function in rabbits subjected to SCI.
Gabapentin Increases a Tonic Inhibitory Conductance in Hippocampal Pyramidal Neurons
Authors: Cheng Victor Y. , Bonin Robert P. , Chiu Mary W. , Newell J Glen , MacDonald John F. , Orser Beverley A. 
Published: July 2006

Background
The mechanisms underlying the therapeutic actions of gabapentin remain poorly understood. The chemical structure and behavioral properties of gabapentin strongly suggest actions on inhibitory neurotransmission mediated by gamma-aminobutyric acid (GABA); however, gabapentin does not directly modulate GABAA or GABAB receptors. Two distinct forms of GABAergic inhibition occur in the brain: postsynaptic conductance and a persistent tonic inhibitory conductance primarily generated by extrasynaptic GABAA receptors. The aim of this study was to determine whether gabapentin increased the tonic conductance in hippocampal neurons in vitro. As a positive control, the effects of vigabatrin, which irreversibly inhibits GABA transaminase, were also examined.

Methods
GABAA receptors in hippocampal neurons from embryonic mice were studied using whole cell patch clamp recordings. Miniature inhibitory postsynaptic currents and the tonic current were recorded from cultured neurons that were treated for 36-48 h with gabapentin, vigabatrin, or gabapentin and vigabatrin. To determine whether gabapentin increased the expression of GABAA receptors, Western blots were stained with antibodies selective for alpha1, alpha2, and alpha5 subunits.

Results
GABAA receptors were insensitive to the acute application of gabapentin, whereas chronic treatment increased the amplitude of the tonic current threefold (EC50 = 209 microm) but did not influence miniature inhibitory postsynaptic currents. Vigabatrin increased the tonic conductance, and the maximally effective concentration did not occlude the actions of gabapentin, which suggests that these compounds act by different mechanisms. Neither gabapentin nor vigabatrin increased the expression of GABAA receptors in the neurons.

Conclusions
Gabapentin increases a tonic inhibitory conductance in mammalian neurons. High-affinity GABAA receptors that generate the tonic conductance may detect small increases in the ambient concentration of neurotransmitter caused by gabapentin.
Modifying the Baricity of Local Anesthetics for Spinal Anesthesia by Temperature Adjustment
Authors: Heller Axel R. , Zimmermann Katrin , Seele Kristin , Rössel Thomas , Koch Thea , Litz Rainer J. 
Published: July 2006

Background
Although local anesthetics (LAs) are hyperbaric at room temperature, density drops within minutes after administration into the subarachnoid space. LAs become hypobaric and therefore may cranially ascend during spinal anesthesia in an uncontrolled manner. The authors hypothesized that temperature and density of LA solutions have a nonlinear relation that may be described by a polynomial equation, and that conversion of this equation may provide the temperature at which individual LAs are isobaric.

Methods
Density of cerebrospinal fluid was measured using a vibrating tube densitometer. Temperature-dependent density data were obtained from all LAs commonly used for spinal anesthesia, at least in triplicate at 5 degrees, 20 degrees, 30 degrees, and 37 degrees C. The hypothesis was tested by fitting the obtained data into polynomial mathematical models allowing calculations of substance-specific isobaric temperatures.

Results
Cerebrospinal fluid at 37 degrees C had a density of 1.000646 +/- 0.000086 g/ml. Three groups of local anesthetics with similar temperature (T, degrees C)-dependent density (rho) characteristics were identified: articaine and mepivacaine, rho1(T) = 1.008-5.36 E-06 T2 (heavy LAs, isobaric at body temperature); L-bupivacaine, rho2(T) = 1.007-5.46 E-06 T2 (intermediate LA, less hypobaric than saline); bupivacaine, ropivacaine, prilocaine, and lidocaine, rho3(T) = 1.0063-5.0 E-06 T (light LAs, more hypobaric than saline). Isobaric temperatures (degrees C) were as follows: 5 mg/ml bupivacaine, 35.1; 5 mg/ml L-bupivacaine, 37.0; 5 mg/ml ropivacaine, 35.1; 20 mg/ml articaine, 39.4.

Conclusion
Sophisticated measurements and mathematic models now allow calculation of the ideal injection temperature of LAs and, thus, even better control of LA distribution within the cerebrospinal fluid. The given formulae allow the adaptation on subpopulations with varying cerebrospinal fluid density.
Statistical Process Control as a Tool for Monitoring Nonoperative Time
Authors: Seim Andreas , Andersen Bjørn , Sandberg Warren S. 
Published: July 2006

Background
Administrators need simple tools to quickly identify even small changes in the performance of perioperative systems. This applies both to established systems and to impact assessments of deliberate perioperative system design changes.

Methods
Statistical process control was originally developed to detect nonrandom variation in manufacturing processes by continuous comparison to previous performance. The authors applied the technique to assess the nonoperative time performance between successive cases for same surgeon following themselves in a redesigned operating room. This operating room specifically implemented a new patient care pathway that improves throughput by reducing the nonoperative time. The authors tested how quickly statistical process control detected reductions in nonoperative time. They also tested the ability of statistical process control to detect successively smaller performance changes and investigated its utility for longitudinal process monitoring.

Results
Statistical process control detected a clear reduction in nonoperative time after the new operating room had been used for only 2 days. The method could detect nonoperative time changes of between 5 and 10 min per case for a single operating room within one fiscal quarter. Nonoperative time for the new process was globally stable over the 31 months analyzed, but late in the analysis period, the authors detected small performance decrements, mostly attributable to factors external to the new operating room.

Conclusions
Statistical process control is useful for detecting changes in perioperative system performance, represented in this study by nonoperative time. The technique is able to detect changes quickly and to detect small changes over time.
The 13carbon urea breath test for the diagnosis of Helicobacter pylori infection in subjects with atrophic gastritis: evaluation in a primary care setting
Authors: KORSTANJE A. , VAN EEDEN S. , OFFERHAUS G. J. A. , SABBE L. J. M. , DEN HARTOG G. , BIEMOND I. , LAMERS C. B. H. W. 
Published: July 2006

SummaryBackground 13Carbon urea breath testing is reliable to detect current infection with Helicobacter pylori but has been reported to be of limited value in selected patients with atrophic body gastritis or acid‐lowering medication.AimTo evaluate the accuracy of 13carbon urea breath testing for H. pylori detection in 20 asymptomatic patients with histologically confirmed atrophic body gastritis in a primary care setting.Methods 13Carbon urea breath testing and serology were compared with H. pylori culture of a corpus biopsy as reference test.ResultsAll tests were in agreement in 12 patients, being all positive in six and all negative in six. One patient was positive for serology and culture but negative for 13carbon urea breath testing, five patients had only positive serology and two patients had only positive 13carbon urea breath testing. 13Carbon urea breath testing showed an accuracy with culture of 85% and anti‐H. pylori serology with culture of 75%. 13Carbon urea breath testing carried out in patients with positive serology showed an accuracy of 92%. Receiver operating characteristic curve analysis of 13carbon urea breath testing shows optimal discrimination at the prescribed cut‐off value.Conclusions 13Carbon urea breath testing can be used as diagnostic H. pylori test in asymptomatic patients with atrophic body gastritis, preferably in addition to serology, to select subjects for anti‐H. pylori therapy.
Proton pump inhibitor therapy is a risk factor for Clostridium difficile‐associated diarrhoea
Authors: YEARSLEY K. A. , GILBY L. J. , RAMADAS A. V. , KUBIAK E. M. , FONE D. L. , ALLISON M. C. 
Published: July 2006

SummaryBackgroundInhibition of gastric acid removes a defence against ingested bacteria and spores, increasing the risk of some forms of gastroenteritis. Previous studies investigating a possible link between acid suppression therapy and Clostridium difficile‐associated diarrhoea have reported conflicting results.AimTo investigate whether acid suppression therapy is associated with an increased risk of C. difficile‐associated diarrhoea.MethodsProspective case–control study of 155 consecutive in‐patients with C. difficile‐associated diarrhoea.ResultsAntibiotics had been received by 143 (92%) of the C. difficile‐associated diarrhoea group and 76 (50%) of the controls during the preceding 3 months. Among those receiving antibiotics, 59 (41%) of the C. difficile‐associated diarrhoea group had also received acid suppression, compared with 21 (28%) of controls (OR 1.84, CI 1.01, 3.36, χ2 = 4.0, P = 0.046). Among the entire C. difficile‐associated diarrhoea group 64 (41%) had received acid suppression compared with 40 (26%) of controls (OR 1.99, CI 1.19, 3.31, χ2 = 7.9, P = 0.005). Logistic regression analyses found that C. difficile‐associated diarrhoea was independently associated with: antibiotic use (OR 13.1, 95% CI: 6.6, 26.1); acid suppression therapy (OR 1.90, 95% CI: 1.10, 3.29); and female sex (OR 1.79, 95% CI: 1.06, 3.04).ConclusionsThe risk of C. difficile‐associated diarrhoea in hospitalized patients receiving antibiotics may be compounded by exposure to proton pump inhibitor therapy.
Clinical outcome in upper gastrointestinal bleeding complicating low‐dose aspirin and antithrombotic drugs
Authors: TAHA A. S. , ANGERSON W. J. , KNILL‐JONES R. P. , BLATCHFORD O. 
Published: July 2006

SummaryBackgroundThe current risk stratification systems in upper gastrointestinal bleeding do not correct for the intake of low‐dose aspirin and other antithrombotic drugs.AimTo test the Blatchford scores in evaluating the clinical outcome in bleeders using these drugs.MethodsWe calculated the Blatchford scores in 510 bleeders, including 123 on low‐dose aspirin, 44 on other antithrombotic drugs, and 68 on non‐steroidal anti‐inflammatory drugs.ResultsThe median clinical scores distributed according to aetiological risk factors were as follows: no risk factors, 5; non‐steroidal anti‐inflammatory drugs, 8; aspirin, 7; other antithrombotics, 6; excess alcohol, 4; multiple risk factors, 7; (P = 0.003, Kruskal–Wallis test). Scores correlated positively with the duration of admission in the entire group (rs = 0.285; P < 0.001) and in those taking aspirin and antithrombotics (rs = 0.211; P = 0.029). The median scores in patients requiring the blood transfusion were 10 in the entire group and 11 in users of aspirin or antithrombotics, compared with 3 and 4, respectively, in those not transfused (P < 0.001).ConclusionsThe Blatchford scores are significantly elevated in users of non‐steroidal anti‐inflammatory drugs, low‐dose aspirin, and other antithrombotic drugs. They correlate positively with the duration of admission and the need for blood transfusion.
Rates and predictors of hepatitis C virus treatment in HCV–HIV‐coinfected subjects
Authors: BUTT A. A. , JUSTICE A. C. , SKANDERSON M. , GOOD C. , KWOH C. K. 
Published: July 2006

SummaryBackgroundTrue treatment rates and the impact of comorbidities on treatment rates for hepatitis C virus in the HCV–HIV‐coinfected subjects are unknown.AimTo quantify the rates of treatment prescription and the effect of comorbidities on hepatitis C virus treatment rates in HCV–HIV‐coinfected veterans.MethodsThe Veterans Affairs National Patient Care Database was used to identify all hepatitis C virus‐infected subjects between 1999 and 2003 using ICD‐9 codes. Demographics, comorbidities and pharmacy data were retrieved. We used logistic regression to compare the predictors of hepatitis C virus treatment in hepatitis C virus‐monoinfected and HCV–HIV‐coinfected subjects.FindingsWe identified 120 507 hepatitis C virus‐infected subjects, of which 6502 were HIV coinfected. 12% of the hepatitis C virus‐monoinfected and 7% of the ‐coinfected subjects were prescribed hepatitis C virus treatment (P < 0.0001). Those not prescribed treatment were older (48.6 years vs. 47.7 years, P = 0.007) and more likely to be black (52% vs. 32%, P < 0.0001). HIV coinfected was less likely to be prescribed hepatitis C virus treatment (OR 0.74, 95% CI: 0.67–0.82). Among the coinfected subjects, the following were associated with non‐treatment (OR, 95% CI): black race (0.45, 0.35–0.57); Hispanic race (0.56, 0.38–0.82); drug use (0.68, 0.53–0.88); anaemia (0.17, 0.11–0.26); bipolar disorder (0.63, 0.40–0.99); major depression (0.72, 0.53–0.99); mild depression (0.47, 0.35–0.62).ConclusionsA small number of HCV–HIV‐coinfected veterans are prescribed treatment for hepatitis C virus. Non‐treatment is associated with increasing age, minority race, drug use and psychiatric illness. Further studies are needed to determine the eligibility for treatment and reasons for non‐treatment for hepatitis C virus.
Evaluation of topical pharyngeal anaesthesia by benzocaine lozenge for upper endoscopy
Authors: SHAOUL R. , HIGAZE H. , LAVY A. 
Published: July 2006

SummaryBackgroundAmong the randomized controlled trials evaluating the effect of pharyngeal anaesthesia only some suggest benefit. Spray is irritating for some people and leaves bitter taste in the throat. We hypothesized that delivering the local anaesthetic as a sucking lozenge would benefit the patients in terms of decreasing anxiety and will improve procedure performance and patient tolerance.AimTo determine whether benzocaine/tyrothricin sucking lozenges with conscious sedation is superior to conscious sedation alone, with respect to procedure performance and tolerance in patients undergoing upper endoscopy.MethodsOne hundred and seventy‐four adult patients undergoing upper endoscopy with conscious sedation completed the study. They were randomized to receive sucking lozenge containing benzocaine or placebo before the procedure. Patients were asked to rate prestudy anxiety, tolerance for topical pharyngeal anaesthesia, comfort during endoscopy, degree of difficulty of intubation, postprocedure throat discomfort and willingness to undergo subsequent examinations using a 10‐cm visual analogue scale. Endoscopists were asked to estimate the ease of oesophageal intubation and procedure performance.ResultsNo significant statistical differences regarding all the points studied were found between the groups.ConclusionsTopical pharyngeal anaesthesia with benzocaine/tyrothricin lozenges with conscious sedation has no advantages over conscious sedation alone in patients undergoing upper endoscopy.
Antireflux surgery for non‐erosive and erosive reflux disease in community practice
Authors: THIBAULT R. , CORON E. , SÉBILLE V. , SACHER‐HUVELIN S. , BRULEY DES VARANNES S. , GOURNAY J. , GALMICHE J. P. 
Published: July 2006

SUMMARYBackground  Antireflux surgery has been mainly evaluated in tertiary referral centres. Data regarding post‐operative outcome in non‐erosive reflux disease are lacking.Aim  To assess long‐term outcome after antireflux surgery performed in a community practice setting.Methods  We selected consecutively 60 non‐erosive reflux disease patients and 61 erosive oesophagitis patients with symptomatic gastro‐oesophageal reflux disease. After surgery, each subject answered a validated disease‐specific health‐related quality of life questionnaire and another questionnaire focusing on symptoms, late morbidity and drug use.Results  After a 43‐month median follow‐up, an excellent outcome was reported by less than two‐thirds of patients. Quality of life scores were lower in the non‐erosive reflux disease group, especially in female patients. Non‐erosive reflux disease patients reported more daily symptoms and more reflux‐related symptoms (P = 0.04). Proton‐pump inhibitor use was higher in non‐erosive reflux disease patients (P < 0.005). Multivariate analysis identified four independent predictive factors associated with better outcome, namely male gender, abnormal preoperative acid exposure, a long duration of symptoms and surgical expertise.Conclusions  In community practice, the results of antireflux surgery are inferior to those reported by tertiary centres. Outcome seems poorer in non‐erosive reflux disease especially in female patients. Nearly one‐third of the non‐erosive reflux disease patients continue to take proton‐pump inhibitors. These results highlight the need for careful selection of patients before antireflux surgery.
Impact of Helicobacter pylori on the management of dyspepsia in primary care
Authors: BENNETT K. , FEELY J. , THORNTON O. , DOBSON M. , O'MORAIN C. A. , O'CONNOR H. J. 
Published: July 2006

SummaryBackground  It is unclear what impact Helicobacter pylori infection has had on the management of dyspepsia in primary care and to what extent published guidelines on H. pylori are implemented in routine clinical practice.Aim  To assess the impact of H. pylori infection on the management of dyspepsia in primary care.Methods  Patients referred by primary care doctors to an open‐access 13‐carbon urea breath test service over a 2‐year period for their first urea breath test were included in the study. Individual breath results were linked with data on prescribing obtained from the General Medical Services prescription database.Results  Of 805 patients, 374 (47%) had a positive urea breath test and 431 (54%) a negative urea breath test. Of positive urea breath test patients, only 245 (64%) were prescribed eradication therapy in the 3 months after the breath test and only 43% were referred back for re‐testing. In the year after the urea breath test, there was a significant fall in prescribing of antisecretory therapy which was greatest in the patients who received H. pylori therapy (P < 0.001).Conclusions  There appears to be under and inappropriate treatment of H. pylori infection in primary care, and a low rate of re‐testing after eradication, indicating that current guidelines are not well implemented in practice.
Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong
Authors: CHEUNG T.‐K. , LAI C.‐L. , WONG B. C.‐Y. , FUNG J. , YUEN M.‐F. 
Published: July 2006

SummaryBackground  Clinical features of hepatocellular carcinoma patients are changing because of screening.Aim  To examine the clinical features of hepatocellular carcinoma patients in Hong Kong and validity of different staging systems.Methods  A total of 223 Chinese patients with hepatocellular carcinoma were studied.Results  Seventy‐eight percent of hepatocellular carcinoma patients had chronic hepatitis B (43% diagnosed by screening). Hepatitis B positivity, weight loss, jaundice, encephalopathy, alpha‐fetoprotein level, portal vein thrombosis, extrahepatic metastasis, and treatment were shown to be independent factors affecting survival. Of chronic hepatitis B patients, hepatitis B virus DNA levels (P = 0.001) and portal vein thrombosis (P = 0.008) were independent factors affecting survival. Seventy‐six percent of chronic hepatitis B patients with hepatocellular carcinoma were hepatitis B e antigen negative. Screening patients had hepatocellular carcinoma detected at an earlier stage and better survival (median survival: 21 vs. 4 months, P < 0.0001). All staging systems had good stratification of survival. Prognosis and median survival generated were different when compared with the US data.Conclusions  Chronic hepatitis B was the most common cause of hepatocellular carcinoma in Hong Kong. High‐risk chronic hepatitis B patients should be followed irrespective of the hepatitis B e antigen status. Hepatitis B virus DNA levels at the time of diagnosis are an important survival predictor. Screening detected hepatocellular carcinoma at an earlier stage and prolonged survival. Staging systems should be validated in different populations.
Coming to conclusions: social workers’ perceptions of the decision‐making process in care proceedings
Authors: Beckett Chris , McKeigue Bridget , Taylor Hilary 
Published: July 2006

ABSTRACTThis study reports on an analysis of the transcripts of four focus groups involving social workers from four English social work teams working with children and families. In the groups, social workers discussed the process of coming to a decision in care proceedings (where decisions are made about the future care of a child where there are concerns about the care provided in the family of origin). It explores how social workers described themselves coming to conclusions about cases, and how they perceive the courts as doing so. Noting the need in such important proceedings both for thoroughness and for speed (for delay is likely to be harmful to children in need of a secure home), the authors consider ways in which decision‐making might be distorted or delayed and discuss the perception of the social workers that some kinds of evidence are under‐ or overvalued by the courts. The authors conclude that, while it may seem that there is a trade‐off between thoroughness and speed, this is not always the case and that factors that cause poor decision‐making can also cause delay.