bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antroduodenojejunal motor activity in untreated and treated celiac disease patients
Authors: Bassotti Gabrio , Villanacci Vincenzo , Mazzocchi Alessandro , Mariano Marina , Incardona Paolo , Clerici Carlo , Morelli Antonio 
Published: April 2007

AbstractBackground and Aim: Patients with celiac disease may present with abnormal upper gut motor activity. However, it is not known if these abnormalities persist after the introduction of a gluten‐free diet. The present study aimed to compare antroduodenojejunal motor variables recorded in untreated celiac patients with those of celiac patients given a gluten‐free diet and healthy volunteers.Methods: Eleven untreated celiac disease patients, 12 age‐ and sex‐matched celiac patients on a gluten‐free diet (at least 12 months), and 33 controls entered the study. Antroduodenojejunal motility was recorded for 6 h during fasting and for 3 h after a standard meal by means of a perfused, multiple lumen catheter.Results: More than 80% of untreated celiac patients had discrete motor abnormalities of the upper gut, in both fasting and fed recordings, compared to the other subjects. Patients on a gluten‐free diet also showed motor abnormalities, albeit to a lesser extent. In these patients histological evaluation showed the persistence of mild mucosal abnormalities.Conclusions: Upper gut motor abnormalities are frequent in patients with celiac disease, even in those on a gluten‐free diet. In the latter group, these abnormalities may suggest an incomplete adherence to the dietary regimen.
Predicting pleural effusion and ascites following extended hepatectomy in the non‐cirrhotic liver
Authors: Shimizu Yasuhiro , Sano Tsuyoshi , Yasui Kenzo 
Published: April 2007

AbstractBackground:  There are cases in which intractable pleural effusion and/or ascites appear even in the non‐cirrhotic liver following extended liver resection, making postoperative management difficult. In this study we investigated the risk factors for pleural effusion and ascites following extended hepatectomy.Methods:  Subjects were 50 patients between 1996 and 2003 who had hepatic metastasis of colorectal cancer, and who underwent extended liver resection of hemihepatectomy or greater at a time separate from the surgery for their colorectal cancer. The 50 patients were classified according to the presence or absence of pleural effusion and/or ascites, and compared for preoperative ICGR15, pre‐ and postoperative total serum protein and albumin levels, operating time, amount of blood loss, resected liver weight g/bodyweight kg (Hx ratio), intraoperative fluid replacement volume, period of surgery, operative procedure, use of serum and plasma derivatives, and use of catecholamines.Results:  In a univariate analysis of pleural effusion and ascites, the Hx ratio, period of surgery, operative procedure, use of fresh frozen plasma and use of albumin preparations were significant factors, but in a multivariate analysis only the Hx ratio was a significant independent factor. Among patients with an Hx ratio of 8 or above, many had postoperative pleural effusion and ascites.Conclusions:  The Hx ratio is a simple method for the evaluation of postoperative remnant liver function and is extremely useful as a predictive factor for pleural effusion and ascites following extended hepatectomy in the non‐cirrhotic liver.
Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non‐acetaminophen‐related fulminant hepatic failure
Authors: Miyake Yasuhiro , Iwasaki Yoshiaki , Makino Yasuhiro , Kobashi Haruhiko , Takaguchi Kouichi , Ando Masaharu , Sakaguchi Kohsaku , Shiratori Yasushi 
Published: April 2007

AbstractBackground and Aim:  Many patients continue to die due to the rapid development of cerebral edema and/or multiple organ failure prior to receiving a liver transplantation.Methods:  We investigated the prognostic factors associated with 1‐week fatal outcomes after the diagnosis of fulminant hepatic failure, which were associated with fatal outcomes prior to receiving liver transplantation, in 104 patients with non‐acetaminophen‐related fulminant hepatic failure.Results:  With a multivariate logistic regression analysis, age (>40 years), systemic inflammatory response syndrome (SIRS) and plasma prothrombin activities (≤10%) were significantly associated with fatal outcomes at 1 week after diagnosis in 104 patients. At the time of diagnosis, 50 patients (48%) were in a state of SIRS. Significant differences were observed between patients with and without SIRS regarding the period from the initial symptoms to the diagnosis of fulminant hepatic failure, hepatic coma grade, serum alanine aminotransferase level, serum creatinine level and plasma prothrombin activity. With a multivariate logistic regression analysis, age (>40 years), cause of fulminant hepatic failure (viral hepatitis), plasma prothrombin activity (≤10%) and no administration of protease inhibitor were significantly associated with the 1‐week fatal outcomes of 50 patients with SIRS.Conclusions:  Patients with SIRS exhibited hepatic failure of increased severity and SIRS may reduce the probability of receiving a liver transplantation. In order to estimate the efficacy of protease inhibitor for patients with SIRS, a prospective randomized trial is required.
Serum sodium and hydration status predict transplant‐free survival independent of MELD score in patients with cirrhosis
Authors: Mathur Sachin , Gane Edward J , McCall John L , Plank Lindsay D 
Published: April 2007

AbstractBackground and Aim:  Serum sodium may have prognostic value in addition to the model for end‐stage liver disease (MELD) score for prediction of early mortality in patients listed for liver transplant. In patients with cirrhosis, over‐hydration is a common feature but its prognostic value has not been evaluated. This study examines the independent prognostic significance of MELD, serum sodium and hydration status on long‐term survival in patients with cirrhosis.Methods:  Serum sodium and hydration (total body water as a percentage of fat‐free mass) were measured in 227 consecutive cirrhotic patients (146 male, 81 female; median age 49 years, range 19–73 years; median MELD score 13, range 6–36). Patients with hepatocellular carcinoma or listed for liver transplantation at the time of initial assessment were excluded. A competing risks Cox proportional hazards analysis was performed to evaluate the influence of MELD, sodium and hydration on risk of death or transplant.Results:  Median follow‐up was 52 (range 4–93) months. Serum sodium and hydration were each associated with reduction in time to death or transplant on univariate analysis (sodium: hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.87–0.94, P < 0.0001; hydration: HR 1.20, 95% CI 1.10–1.30, P < 0.0001). On multivariate analysis, MELD, serum sodium and hydration were independently predictive of death or transplant (MELD: HR 1.12, 95% CI 1.06–1.19, P < 0.0001; sodium: HR 0.93, 95% CI 0.87–0.99, P = 0.04; hydration: HR 1.17, 95% CI 1.02–1.33, P = 0.02).Conclusions:  In non‐waitlisted patients with cirrhosis, serum sodium is predictive of transplant or death independent of MELD score.
Hepatitis E in New Zealand
Authors: Dalton Harry R , Fellows Helen J , Gane Edward J , Wong Philip , Gerred Stephen , Schroeder Bryan , Croxson Margaret C , Garkavenko Olga 
Published: April 2007

AbstractBackground and Aim:  Locally acquired hepatitis E virus (HEV) infection has been described in a number of developed countries and is thought to be zoonotic from pigs. Little is known about hepatitis E in humans in New Zealand (NZ) but 90% of NZ pigs show evidence of HEV infection. The aim of this study was to investigate the epidemiology of hepatitis E infection in NZ by documenting HEV immunoglobulin (Ig) G seroprevalence in NZ blood donors, testing patients with unexplained hepatitis for HEV, and comparing genetic sequences of human HEV with local porcine isolates.Methods:  In total, 265 blood donors were tested for HEV IgG and 77 patients with unexplained hepatitis were tested for HEV. Viral sequences were compared with known HEV isolates including those from NZ pigs.Results:  The HEV IgG seroprevalence was 4%. HEV genotype 3 was isolated in four patients with unexplained hepatitis. Clinical and sequencing data suggest that two cases were acquired in Europe and two in NZ. All cases were in elderly patients, one of whom was asymptomatic and initially misdiagnosed as a drug reaction. The NZ‐acquired cases were most similar to HEV from Japan, and bore little sequence homology to HEV isolated from NZ pigs.Conclusions:  Hepatitis E does occur in NZ in patients who have not traveled to endemic areas and seems to affect the elderly. The seroprevalence data suggest that subclinical/unrecognized infection is common. Sequencing data suggest that some reservoir other than pigs could be the source of HEV in NZ. It is recommend that all patients with unexplained hepatitis, whatever their age or travel history, are tested for HEV.
Factors that influence the adequacy of total mesorectal excision for rectal cancer
Authors: Jeyarajah S. , Sutton C. D. , Miller A. S. , Hemingway D. 
Published: April 2007

AbstractObjective  In 1997 with the start of CRO7 trial it was agreed that adequacy of surgical resection of rectal cancer would be determined by a pathologically determined grading of the mesorectum the so called total mesorectal excision score (TME score). Scores ranged from 1–3 with 3 being a perfect specimen. The aim of this study was to investigate factors which may influence TME scores and establish if local recurrence is related to them.Method  Data on all patients undergoing resectional surgery for rectal cancer in our unit are entered prospectively onto a database. Pathology reports of those patients who underwent total mesorectal excision were examined and the TME scores added to the database. Categorical variables were analysed using the χ2 test, continuous variables using ANOVA. Statistical significance was taken as P < 0.05.Results  Between January 2000 and June 2005, 518 patients underwent surgery for adenocarcinoma of the rectum, of these, 287 patients had a total mesorectal excision for mid or lower third tumours under the care of seven colorectal surgeons. All resected specimens were scored by a Consultant GI pathologist. Two hundred and fourteen patients underwent anterior resection and 73 underwent abdomino‐perineal resection. The median age of the patients was 73 years (range 38–95 years). One hundred and ninety‐four patients were male. Seventy‐eight patients were treated with preoperative radiotherapy, 59 short course and 19 long course. TME scores were TME1 n = 30, TME2 n = 99, TME3 n = 158. Fifteen patients developed local pelvic recurrence at 2 years.Total mesorectal excision scores were not statistically influenced by Dukes’ stage, width of tumour, preoperative radiotherapy or grade of surgeon. Male patients were statistically more likely to have a TME score of 2 or 3 compared with female P = 0.04. Patients undergoing an anterior resection were statistically more likely to have a TME score of 2 or 3 compared with abdomino‐perineal resection P = 0.0001.Tumours with a circumferential resection margin (CRM) of more than 1 mm were more likely to have a TME score of 2 or 3 score (P = 0.0001). There was no relationship between TME and local recurrence (P = 0.966).Conclusion  There is no relationship between the TME score in patients undergoing resectional surgery for adenocarcinoma of the rectum and the development of local recurrence at 2 years. Other factors such as CRM involvement are more likely to have an impact on local recurrence. The factors that influence the quality of TME are the operative procedure of anterior resection, male gender and CRM positivity. There appear to be no deleterious effects on the TME score by Specialist Registrars performing the operation under Consultant supervision. While TME scores may be an index of a technical performance, they appear to have little role in predicting future outcomes.
The Euro Effect on Trade is not as Large as Commonly Thought*
Authors: Bun Maurice J. G. , Klaassen Franc J. G. M. 
Published: April 2007

AbstractExisting studies on the impact of the euro on goods trade report increments between 5% and 40%. These estimates are based on standard panel gravity models for the level of trade. We show that the residuals from these models exhibit upward trends over time for the euro countries, and that this leads to an upward bias in the estimated euro effect. To correct for that, we extend the standard model by including a time trend that may have different effects across country‐pairs. This results in an estimated euro impact of only 3%.
Intra‐individual variation in sperm tail length in murine rodents
Authors: Breed W. G. , Bauer M. , Wade R. , Thitipramote N. , Suwajarat J. , Yelland L. 
Published: April 2007

AbstractIn eutherian mammals, there are marked interspecific differences in sperm head shape and tail length. In a few species, sperm head variability occurs but intra‐individual variation in sperm tail length has rarely been investigated or commented upon. Here, we ask the question: Do murine rodent species that have variable sperm head shapes exhibit greater intra‐individual variation in sperm midpiece and total tail lengths than closely related species where little, or no, sperm head variability occurs? From three separate lineages, we selected three pairs of murine rodents, one of which has monomorphic, and the other variable, sperm head shape. These were from southern Asia the bandicoot rats Bandicota bengalensis and Bandicota indica, from southern Africa the veld rats, Aethomys chrysophilus and Aethomys ineptus and from Australia the fawn hopping mouse Notomys cervinus and the spinifex hopping mouse Notomys alexis. Cauda epididymal sperm smears were prepared and sperm midpiece and total tail lengths were determined. A linear mixed‐effects model was used to estimate intra‐individual variance. The results showed that in all three species where there are variable sperm head shapes (B. indica, A. ineptus and N. alexis), statistically significantly greater intra‐individual variability of sperm midpiece and total tail lengths occurs (P<0.0001 in all cases). These species all have relatively smaller testes mass compared with the closely related species with monomorphic sperm populations. This suggests that depressed levels of intermale sperm competition may result in the occurrence of variability in not only the divergent sperm head shape but also in the length of the midpiece as well as that of the total length of the sperm tail.
Living with your food: geckos in termitaria of Cantão
Authors: Vitt L. J. , Shepard D. B. , Caldwell J. P. , Vieira G. H. C. , França F. G. R. , Colli G. R. 
Published: April 2007

AbstractWe tested three non‐exclusive hypotheses that the lizard, Gymnodactylus carvalhoi, lives in termitaria to avoid thermal extremes, to avoid predators, or because of an abundance of food (dietary specialist). We first confirm that these geckos are restricted to termitaria in the region studied. Body temperatures (Tb) of geckos averaged below environmental temperatures during day outside of termitaria and above outside temperatures at night; Tb averaged only slightly higher than temperatures inside termitaria. We conclude that thermal constraints in Cerrado habitats lacking rocks restrict Gymnodactylus to termite nests. High frequencies of tail loss and the presence of many potential predators within termitaria suggest high encounter rates with predators, indicating that predation pressure does not restrict these geckos to termite nests. Dietary data indicate that G. carvalhoi is a termite specialist. Published data indicate that other Gymnodactylus species and populations are also termite specialists, even though several live primarily outside termitaria (in crevices and under rocks). An evolutionary history of termite specialization and low thermal requirements in the clade (Gymnodactylus) predispose them to feed on termites within the termitaria.
Proportional Feedback Stimulation for Seizure Control in Rats
Authors: Colpan Mustafa Efkan , Li Yue , Dwyer Jennifer , Mogul David Jeffrey 
Published: April 2007

Summary:  Purpose: A responsive electrical brain stimulation system using control feedback was investigated for the treatment of seizures. Methods: A proportional feedback stimulation system was designed. Penicillin‐induced episodic seizures were created in rat primary motor cortex. Both intracranial (proximal to seizure focus) and extracranial EEGs were monitored. Current stimulation was applied at the seizure focus by using the intracranial EEG as the current‐stimulus template. Different gains (H) for determining feedback stimulus amplitudes were tested. Results: The effect of feedback stimulation on seizures was initially assessed by measuring change in variance of the amplitude histogram of the intracranial EEG before and during stimulation. Mean reduction in amplitude variance during seizure activity was significant, with variance during stimulation progressively reduced as feedback gain was increased, indicating that overall suppression of seizure amplitude depended on H. Further increases in feedback gain typically produced saturating oscillations, indicating that this level of H resulted in instability. Frequency analysis of seizure and stimulation periods for each of the effective levels of H demonstrated close correlation across a large frequency domain, suggesting that the reduction in EEG seizure amplitude during feedback stimulation was possibly because of shunting of neuronal currents near electrodes as opposed to an alteration of neuronal dynamics. Although the frequency and energy responses during seizures before or during feedback stimulation remained well correlated in the delta band, this correlation progressively decreased across the theta, alpha, and beta bands. Conclusions: These results demonstrate that proportional feedback stimulation holds the promise of suppressing seizure activity. More‐complicated control algorithms for generating feedback stimulation may provide further improvements in seizure suppression.
Managing cardiovascular collapse in severe flecainide overdose without recourse to extracorporeal therapy
Authors: Devin Ruth , Garrett Peter , Anstey Chris 
Published: April 2007

AbstractFlecainide overdose can rapidly result in profound cardiovascular collapse, and is associated with a relatively high mortality. A case is described where a woman with major toxicity and high serum levels was managed without recourse to invasive modalities such as cardiopulmonary bypass or extracorporeal therapies. Hypertonic sodium bicarbonate is recognized as effective therapy for hypotension and arrhythmias. More recent case reports have concentrated on the use of cardiopulmonary bypass. In this report and other reports describing successful resuscitation, the total dose of sodium bicarbonate is conspicuously higher than in reports describing extracorporeal interventions. Sodium bicarbonate should be given early in the resuscitation, and re‐administered as frequently as required, targeting an alkaline pH and improved cardiac output, while accepting hypernatraemia. This case demonstrates the maxim that the correct dose of hypertonic sodium bicarbonate is ‘enough’. Cardiopulmonary bypass support can be considered as a salvage therapy.
Practicality, safety and accuracy of computed tomography coronary angiography in the evaluation of low TIMI‐risk score chest pain patients: A pilot study
Authors: Soon Kean H , Kelly Anne‐Maree , Cox Nicholas , MacGregor Lachlan , Chaitowitz Ivan , Bell Kevin , Lim Yean 
Published: April 2007

AbstractObjectives:  The present pilot study aimed to assess the practicality, safety and accuracy of performing CT coronary angiography (CT‐CA) in the evaluation of acute chest pain of patients with low thrombolysis in myocardial infarction (TIMI) risk scores.Methods:  The present prospective observational study was undertaken in a university teaching hospital between November 2004 and December 2005. Participants were a convenience sample of patients admitted to hospital for investigation of chest pain with TIMI risk scores <3. Consenting patients underwent CT‐CA within 48 h of presentation. Outcomes of interest were practicality (proportion of diagnostic quality scans obtained and preparation time for CT‐CA), rate of serious adverse events, and accuracy at the patient level using selective coronary angiography as the reference standard.Results:  Thirty‐four patients were recruited. Diagnostic quality scans were obtained in 26/34 or 76% of patients (four failed CT‐CA and four non‐diagnostic scans). The median CT preparation time was 1.9 h (range 0.17–4.0). No serious adverse events were found. Fourteen of those 26 patients with diagnostic CT‐CA subsequently had selective coronary angiography, of which nine were positive. The sensitivity and specificity of CT‐CA in identifying patients with significant coronary artery disease were 9/9 (100%; 95% confidence interval 72–100%) and 4/5 (80%; 95% confidence interval 28–100%), respectively.Conclusions:  The majority of acute chest pain patients with low TIMI risk scores were successfully scanned with a 16‐slice CT to produce CT‐CA studies with good diagnostic quality and accuracy. No major adverse events were found. The place of CT‐CA in diagnostic workup for chest pain remains to be defined.
Uncommon cause of cardiac arrest in the emergency department
Authors: Clarke Benjamin , Ryan Glenn , Fraser John , Francis Leo 
Published: April 2007

AbstractA previously healthy 48‐year‐old woman presented to a peripheral ED with non‐specific signs and symptoms, including vomiting, abdominal cramping, shortness of breath, tachycardia and hypertension. Despite supportive measures the patient rapidly deteriorated, resulting in a cardiac arrest during an interhospital transfer. This required aggressive resuscitation, but without success. The case represents a diagnostic dilemma in the ED regarding the diagnosis and initial management of the patient’s presentation.
Identification of Genotypically Diverse
Cryptococcus neoformans
and
Cryptococcus gattii
Isolates by Luminex xMAP Technology
Authors: Bovers M. , Diaz M. R. , Hagen F. , Spanjaard L. , Duim B. , Visser C. E. , Hoogveld H. L. , Scharringa J. , Hoepelman I. M. , Fell J. W. , Boekhout T. 
Published: April 2007

ABSTRACT

A Luminex suspension array, which had been developed for identification of
Cryptococcus neoformans
and
Cryptococcus gattii
isolates, was tested by genotyping a set of 58 mostly clinical isolates. All genotypes of
C. neoformans
and
C. gattii
were included. In addition, cerebrospinal fluid (CSF) obtained from patients with cryptococcal meningitis was used to investigate the feasibility of the technique for identification of the infecting strain. The suspension array correctly identified haploid isolates in all cases. Furthermore, hybrid isolates possessing two alleles of the Luminex probe region could be identified as hybrids. In CSF specimens, the genotype of the cryptococcal strains responsible for infection could be identified after optimization of the PCR conditions. However, further optimization of the DNA extraction protocol is needed to enhance the usability of the method in clinical practice.
Distinct Pathotypes of O113
Escherichia coli
Strains Isolated from Humans and Animals in Brazil
Authors: dos Santos L. F. , Gonçalves E. M. , Vaz T. M. I. , Irino K. , Guth B. E. C. 
Published: April 2007

ABSTRACT

Two distinct diarrheagenic
Escherichia coli
pathotypes, enteroaggregative
E. coli
(EAEC) and Shiga toxin-producing
E. coli
, were observed in association with O113 strains isolated from human and nonhuman sources in Brazil, respectively. The O113 strains from human diarrhea belonged to a diversity of serotypes, and nine (53%) of them harbored virulence traits of typical EAEC.