bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric emergency room decision‐making, social control and the ‘undeserving sick’
Authors: Lincoln Alisa 
Published: February 2006

AbstractThe influence of social factors on involuntary hospitalisation has been an important and controversial area of sociological focus for many years. Traditionally, social control theory has been used to understand disproportionate rates of involuntary hospitalisation among marginalised and powerless groups. However, dramatic changes in the social context of mental healthcare have necessitated a re‐examination of the role of social factors in involuntary hospitalisation. In this study 287 psychiatric emergency room visits were examined in order to test hypotheses for understanding social influences on disposition. Little support for the traditional social control hypothesis was found. People from marginalised groups were not disproportionately involuntarily hospitalised, but instead were disproportionately treated and released from the hospital as people's social resources were used to access care rather than to prevent hospitalisation. This study highlights the importance of the historical relevance of our theoretical understanding of the relationship between social factors and involuntary commitment.
Accounting for risk and responsibility associated with smoking among mothers of children with respiratory illness
Authors: Coxhead Lauren , Rhodes Tim 
Published: February 2006

AbstractContemporary public health discourses construct individuals as rational, responsible and knowledgeable, and thus promote a self‐controlled prudent response to risk. In the context of evidence emphasising risks to children's health associated with passive smoking, mothers of children with respiratory illness may knowingly place their children at increased risk should they continue to smoke in their presence. Drawing on an analysis of depth qualitative interview accounts with mothers who smoke and whose young child was recently admitted to hospital with respiratory illness, this study describes mothers’ constructions of risk and responsibility associated with their smoking. Three forms of accounting style were identified: ‘stories of acceptability’; ‘denial of agency’; and ‘reflections of guilt’. ‘Stories of acceptability’ either positioned the risk of passive smoking as contained and controlled to an acceptable level, or disputed the level of risk that passive smoke posed. ‘Denial of agency’ drew on discourses of addiction and shared responsibility to exonerate the mother of responsibility or blame. ‘Reflections of guilt’ were presented when contradictions arose within accounts, particularly in relation to discussions of agency and rationality in decision‐making. The study illustrates how constructions of moral responsibility, especially in relation to being a ‘good mother’, framed mothers’ accounts of smoking in the face of risk. The study concludes that far greater consideration be given to the way in which mothers rationalise their smoking to others if paediatric doctors are to foster risk reduction practices associated with passive smoking more effectively.
Axonal regeneration in adult CNS neurons – signaling molecules and pathways
Authors: Teng Felicia Yu Hsuan , Tang Bor Luen 
Published: February 2006

AbstractFailure of severed adult CNS axons to regenerate could be attributed to both a reduced intrinsic capacity to grow and an heightened susceptibility to inhibitory factors of the CNS extracellular environment. A particularly interesting and useful paradigm for investigating CNS axonal regeneration is its enhancement at the CNS branch of dorsal root ganglion (DRG) neurons after conditional lesioning of their peripheral branch. Recent reports have implicated the involvement of two well‐known signaling pathways utilizing separate transcription factors; the Cyclic AMP (cAMP) response element binding protein (CREB) and signal transducer and activator of transcription 3 (STAT3), in conditional lesioning. The former appears to be the pathway activated by neurotrophic factors and Bcl‐2, while the latter is responsible for the neurogenic effect of cytokines [such as the leukemia inhibitory factor (LIF) and interleukin‐6 (IL‐6) elevated at lesion sites]. Recent findings also augmented earlier notions that modulations of the activity of another class of cellular signaling intermediate, the conventional protein kinase C (PKC), could result in a contrasting growth response by CNS neurons to myelin‐associated inhibitors. We discuss these signaling pathways and mechanisms, in conjunction with other recent reports of regeneration enhancement and also within the context of what is known about aiding regeneration of injured CNS axons.
Is endogenous d‐serine in the rostral anterior cingulate cortex necessary for pain‐related negative affect?
Authors: Ren Wen‐Hua , Guo Ji‐Dong , Cao Hong , Wang Hua , Wang Pei‐Fen , Sha Hong , Ji Ru‐Rong , Zhao Zhi‐Qi , Zhang Yu‐Qiu 
Published: February 2006

AbstractFunctional activation of NMDA receptors requires co‐activation of glutamate‐ and glycine‐binding sites. d‐serine is considered to be an endogenous ligand for the glycine site of NMDA receptors. Using a combination of a rat formalin‐induced conditioned place avoidance (F‐CPA) behavioral model and whole‐cell patch‐clamp recording in rostral anterior cingulate cortex (rACC) slices, we examined the effects of d‐amino acid oxidase (DAAO), an endogenous d‐serine‐degrading enzyme, and 7‐chlorokynurenate (7Cl‐KYNA), an antagonist of the glycine site of NMDA receptors, on pain‐related aversion. Degradation of endogenous d‐serine with DAAO, or selective blockade of the glycine site of NMDA receptors by 7Cl‐KYNA, effectively inhibited NMDA‐evoked currents in rACC slices. Intra‐rACC injection of DAAO (0.1 U) and 7Cl‐KYNA (2 and 0.2 mm, 0.6 µL per side) 20 min before F‐CPA conditioning greatly attenuated F‐CPA scores, but did not affect formalin‐induced acute nociceptive behaviors and electric foot shock‐induced conditioned place avoidance. This study reveals for the first time that endogenous d‐serine plays a critical role in pain‐related aversion by activating the glycine site of NMDA receptors in the rACC. Furthermore, these results extend our hypothesis that activation of NMDA receptors in the rACC is necessary for the acquisition of specific pain‐related negative emotion. Thus a new and promising strategy for the prevention of chronic pain‐induced emotional disturbance might be raised.
Inflammatory signalling pathways involved in astroglial activation by unconjugated bilirubin
Authors: Fernandes Adelaide , Falcão Ana S. , Silva Rui F. M. , Gordo Ana C. , Gama Maria J. , Brito Maria A. , Brites Dora 
Published: February 2006

AbstractDuring neonatal hyperbilirubinaemia, astrocytes activated by unconjugated bilirubin (UCB) may contibute to brain toxicity through the production of cytokines. As a first step in addressing the signal transduction cascades involved in the UCB‐induced astroglial immunological response, we tested whether tumour necrosis factor (TNF)‐α receptor 1 (TNFR1), mitogen‐activated protein kinase (MAPK) and nuclear factor κB (NF‐κB) would be activated in astrocytes exposed to UCB, and examined the profile of cytokine production. Astrocyte cultures stimulated with UCB showed a rapid rise in TNFR1 protein levels, followed by activation of the MAPKs p38, Jun N‐terminal kinase1/2 and extracellular signal‐regulated kinase1/2, and NF‐κB. Interestingly, the induction of these signal effectors preceded the early up‐regulation of TNF‐α and interleukin (IL)‐1β mRNAs, and later secretion of TNF‐α, IL‐1β and IL‐6. Treatment of astrocytes with UCB also induced cell death, with levels comparable to those obtained after exposure of astrocytes to recombinant TNF‐α and IL‐1β. Moreover, loss of cell viability and cytokine secretion were reduced when the NF‐κB signal transduction pathway was inhibited, suggesting a key role for NF‐κB in the astroglial response to UCB. These results demonstrate the complexity of the molecular mechanisms involved in cell injury by UCB during hyperbilirubinaemia and provide a basis for the development of novel therapeutic strategies.
Effect of serotonin receptor 2 blockage on liver regeneration after partial hepatectomy in the rat liver
Authors: Papadimas George K. , Tzirogiannis Konstantinos N. , Panoutsopoulos Georgios I. , Demonakou Maria D. , Skaltsas Spyridon D. , Hereti Rosa I. , Papadopoulou‐Daifoti Zeta , Mykoniatis Michael G. 
Published: February 2006

Abstract: The effect of serotonin receptor 2 blockade (5‐HT2) on liver regeneration after 30–34% and 60–70% partial hepatectomy in the rat liver was investigated.Materials and methods: Male Wistar rats were subjected to 60–70% (group I) and 30–34% (group II) partial hepatectomy. Serotonin receptor 2 blockade was exerted by intraperitoneal administration of ketanserin at different doses and time points after partial hepatectomy. The rats of all groups were killed at different time points until 96 h after partial hepatectomy. The rate of liver regeneration was evaluated by the mitotic index in hematoxylin and eosin sections, the immunochemical detection of Ki67 and proliferating cell nuclear antigens, the rate of [3H]‐thymidine incorporation into hepatic DNA and liver thymidine kinase enzymatic activity.Results: Liver regeneration peaked at 24 and 32 h after partial hepatectomy in 60–70% hepatectomized rats. In 30–34% hepatectomized rats liver regeneration peaked at 60 h, whereas low rates of regenerative activity were observed between 24 and 72 h after partial hepatectomy. Ketanserin administration arrested liver regeneration only when administered at 16 h after 60–70% partial hepatectomy. Ketanserin also abrogated the observed peak of regenerative activity at 60 h in 30–34% hepatectomized rats when administered at 52 h after partial hepatectomy. All indices of liver regeneration were affected by ketanserin administration.Conclusions: Serotonin receptor 2 blockade can arrest liver regeneration only when administered close to G1/S transition point, and that while serotonin may be a cofactor for DNA synthesis, it does not play a role in initiation of liver regeneration.
The development and clinical features of splenic aneurysm associated with liver cirrhosis
Authors: Sunagozaka Hajime , Tsuji Hirokazu , Mizukoshi Eishiro , Arai Kuniaki , Kagaya Takashi , Yamashita Tatsuya , Sakai Akito , Nakamoto Yasunari , Honda Masao , Kaneko Shuichi 
Published: February 2006

Abstract: Objectives: Splenic artery aneurysm (SAA) is usually asymptomatic, but can be fatal if it ruptures. Portal hypertensive patients with varix or splenomegaly are sometimes complicated by SAA. However, there have been no large‐scale clinical studies regarding whether liver cirrhosis itself is associated with splenic aneurysm regardless of varix or splenomegaly.Methods: In the present study, we retrospectively analyzed 303 cirrhotic patients examined with arteriography. The diagnosis and characteristics of SAAs were determined, and the relation with splenic artery diameter was evaluated.Results: Nine patients (2.97%) had 12 complicated SAAs. The aneurysms, which measured 4–22 mm in diameter, were all saccular, and occurred commonly in the splenic hilum (50.0%). A correlation was noted between splenic artery diameter and aneurysm diameter (R2=0.706). Aneurysm growth was strongly associated with an increase in diameter of the splenic artery trunk (R2=0.705), which is closely related to arterial flow.Conclusions: SAA is considered a complication of cirrhosis. The increase in splenic artery diameter may result in SAA enlargement and rupture. Elective procedures should be considered based on the follow‐up of main trunk or diameter of the splenic artery in addition to SAA size, a known risk factor of aneurysmal rupture.
The effect of the metabolic syndrome, hepatic steatosis and steatohepatitis on liver fibrosis in hereditary hemochromatosis
Authors: Adams Leon A. , Angulo Paul , Abraham Susan C. , Torgerson Heidi , Brandhagen David 
Published: February 2006

Abstract: Objectives: The variability in phenotypic expression of hereditary hemochromatosis (HH) is not fully understood. We sought to examine whether the metabolic syndrome, hepatic steatosis or steatohepatitis influenced hepatic fibrosis among patients with HH and iron overload.Methods: We identified 86 patients with C282Y/C282Y or C282Y/H63D HH and iron overload (hepatic iron concentration (HIC) >2200 μg/g for males, >1600 μg/g for females). Features of the metabolic syndrome were assessed at the time of liver biopsy. Biopsies were scored by a blinded pathologist. Significant fibrosis was defined as peri‐portal fibrosis or greater.Results: The mean (±SD) age of the study population was 53±12 years and 68 (79%) were male. The median (range) values of ferritin and HIC were 1125 (253–9530) μg/l and 9963 (1926–50 887) μg/g, respectively. The metabolic syndrome was present in 23 (27%), hepatic steatosis in 43 (50%), steatohepatitis in 18 (21%) and significant fibrosis in 38 (44%). Overall, neither the metabolic syndrome nor any of its components were associated with significant fibrosis or a higher mean fibrosis stage. Hepatic steatosis but not steatohepatitis was associated with a lower fibrosis stage. C282Y/H63D compound heterozygous individuals who had glucose intolerance had more severe fibrosis compared with those without glucose intolerance (1.0±1.0 vs. 0.1±0.3, P=0.01).Conclusions: Overall, the metabolic syndrome and fatty liver were not associated with hepatic fibrosis among individuals with HH and iron overload. However, glucose intolerance may be important risk factor for the development of hepatic fibrosis in subjects with the C282Y/H63D HFE genotype.
Patterns and Predictors of Smoking Cessation in an Elderly Cohort
Authors: Whitson Heather E. , Heflin Mitchell T. , Burchett Bruce M. 
Published: February 2006

OBJECTIVES: To identify subject characteristics that predict smoking cessation and describe patterns of cessation and recidivism in a cohort of elderly smokers.DESIGN: Prospective cohort study.SETTING: Piedmont region, North Carolina.PARTICIPANTS: Five hundred seventy‐three subjects enrolled in the North Carolina Established Populations for Epidemiologic Studies of the Elderly who responded “yes” to question 179 on the baseline survey (Do you smoke cigarettes regularly now?) and survived at least 3 years, until the next in‐person follow‐up (1989/90). Subjects were classified as quitters (n=100) or nonquitters (n=473) based on subsequent smoking behavior.MEASUREMENTS: Reported smoking behavior, demographic characteristics of the smokers at baseline or subsequent interviews, 7‐year mortality.RESULTS: After controlling for all characteristics studied, subjects who quit smoking were more likely to be female (P=.03) and showed a trend toward greater likelihood of a recent cancer diagnosis (P=.11). Recidivism was observed in only 16% (19/119) of subjects who reported no smoking in 1989/90. The percentage of subjects who died during 7 years of follow‐up was 44.0% of quitters, compared with 51.6% of nonquitters. Smoking cessation was not associated with a statistically significant decrease in risk of death after controlling for other variables (odds ratio=0.78, 95% confidence interval=0.48–1.26).CONCLUSION: Smoking cessation in this elderly cohort was associated with different subject characteristics from those that predict successful cessation in younger populations, suggesting that older smokers may have unique reasons to stop smoking. Further study is needed to assess potential motives and benefits associated with smoking cessation at an advanced age.
Risk Factors for Surgical Site Infections in Older People
Authors: Kaye Keith S. , Sloane Richard , Sexton Daniel J. , Schmader Kenneth A. 
Published: February 2006

OBJECTIVES: To identify risk factors for surgical site infection (SSI) in older people and to test a priori hypotheses regarding particular variables and SSI risk.DESIGN: Case‐control study.SETTING: Duke University Medical Center and seven community hospitals in North Carolina and Virginia.PARTICIPANTS: Elderly patients (≥65) who underwent surgery between 1991 and 2002 at the study hospitals. Cases were elderly patients with SSI; controls were elderly operative patients without SSI. Infection control practitioners prospectively identified patients.MEASUREMENTS: Data were collected retrospectively. Case patients who developed SSI were compared with control patients who did not develop SSI.RESULTS: Five hundred sixty‐nine SSI cases were identified, and 589 uninfected controls were selected. In multivariate analysis, independent predictors of SSI included obesity (odds ratio (OR)=1.77, 95% confidence interval (CI)=1.34–2.32), chronic obstructive pulmonary disease (COPD) (OR=1.66, 95% CI=1.17–2.34), and a wound class classified as contaminated or dirty (OR=1.65, 95% CI=1.01–2.72). Having private insurance was associated with lower risk (OR=0.29, 95% CI=0.12–0.68).CONCLUSION: This study identified several independent predictors of SSI in older people, including comorbid conditions (COPD and obesity), perioperative variables (wound class), and socioeconomic factors (private insurance, which was associated with lower risk). The results from this study can be used to design and implement interventions for SSI prevention in high‐risk older people.
Results of Clinical Renal Transplantation in 15 Dogs Using Triple Drug Immunosuppressive Therapy
Authors: GREGORY CLARE R. , KYLES ANDREW E. , BERNSTEEN LYNDA , MEHL MARGO 
Published: February 2006

Objective— To evaluate outcome of renal transplantation in dogs administered cyclosporine, azathioprine, and prednisolone immunosuppression.Study Design— Prospective clinical study.Animals— Fifteen dogs with chronic renal failure.Results— Nine dogs died within 1 month of surgery; 5 died from complications associated with generalized thromboembolism. Three dogs survived for 6–25 months. Three dogs alive at the time of this report have survived 22–48 months; however, all 3 dogs have had bacterial infections that responded to antibiotic therapy. There was no biochemical evidence of acute allograft rejection in any dog. Perioperative use of enoxaparin may have prevented thromboembolism in 5 dogs.Conclusions— Triple drug immunosuppressive therapy used in this study prevented acute renal allograft rejection in 6 dogs that survived >4 weeks; however, immunosuppression was excessive, resulting in an unacceptable frequency of infection and other drug‐related complications. Perioperative anticoagulation therapy seem to be warranted.Clinical Relevance— Survival time and quality of life for this group of dogs was poor; however, there was no evidence of acute rejection in the dogs surviving >4 weeks. This protocol should only be used if the degree of immunosuppression is reduced, and early evidence of allograft rejection is monitored by renal biopsy or markers of lymphocyte activation.
Biomechanics of Tibial Plateau Leveling of the Canine Cruciate‐Deficient Stifle Joint: A Theoretical Model
Authors: SHAHAR RON , MILGRAM JOSHUA 
Published: February 2006

Objective—To evaluate the effect of tibial plateau leveling on the biomechanics of the canine stifle.Study Design—Analysis of a 3‐dimensional (3‐D) anatomically accurate theoretical model of the canine stifle.Methods—A 3‐D, 3‐segment mathematical model of the normal canine stifle was modified to simulate the effect of rotation of the tibial plateau during tibial plateau leveling osteotomy (TPLO). The model examined the normal stifle, the stifle with a tibial plateau angle (TPA) of 0°, and the stifle with a TPA of 5°. Analysis of the models at 10 consecutive equally spaced positions during the stance phase yielded data such as ligament forces and joint reaction forces at each position.Results—Rotation of the tibial plateau to a TPA of 0° almost eliminates forces in the cranial cruciate ligament (CCL) throughout the stance phase. Rotation to a TPA of 5° did not, however, substantially decrease the load in the CCL. Both procedures increased the load in the caudal cruciate ligament (CaCL).Conclusions—Cranial tibial thrust (CTT) is converted into caudal tibial thrust when the TPA is 0°; however, rotating the plateau to a TPA of 5° does not eliminate the CTT.Clinical Relevance—The TPLO procedure performed as currently recommended (rotating the tibial plateau to a TPA of 5°) may not eliminate the CTT, but only reduce it. Both TPLO procedures evaluated here were found to increase the load in the CaCL.
Ex Vivo Comparison of One Versus Two Distal Screws in 8 mm Model 11 Interlocking Nails Used to Stabilize Canine Distal Femoral Fractures
Authors: REEMS MICHAEL R. , PLUHAR G. ELIZABETH , WHEELER DONNA L. 
Published: February 2006

Objective—To compare the structural properties of an 8 mm model 11 interlocking nail (IN) with 2 proximal and 2 distal screws (2/2) to 2 proximal and 1 distal screws (2/1) in an unstable canine fracture model.Study Design—Ex vivo biomechanical investigation.Sample Population—Eight pairs of adult canine femurs.Methods—A simple transverse distal metaphyseal femoral fracture with a 1 cm gap was created. The unstable fracture in 1 femur was repaired with a nail with 2 distal and 2 proximal screws and the paired femur with a nail with 1 distal and 2 proximal screws. Cyclic mechanical testing in torsion was performed to assess fatigue life, peak torque, stiffness, and mode of failure.Results—All 2/1 IN‐femoral constructs, but only 2 of eight 2/2 constructs, failed before completion of 50,000 loading cycles. The 2/2 constructs had significantly greater peak torque to failure (P=.002) and longer fatigue life (P=.00003) compared with 2/1 constructs. There were no significant differences in stiffness between 2/2 and 2/1 constructs when the non‐failed constructs were compared (P>.5). All constructs failed by screw deformation.Conclusions—An 8 mm model 11 IN used for fixation of unstable canine distal femoral fractures has a longer fatigue life and is stronger under torsional loads when 2 rather than 1 distal screws are placed.Clinical Relevance—When repairing unstable canine distal femoral fractures with an IN system, 2 distal screws should be inserted to avoid catastrophic implant failure before bone healing is achieved.
Spinal Epidural Empyema in Seven Dogs
Authors: LAVELY JAMES A. , VERNAU KAREN M. , VERNAU WILLIAM , HERRGESELL ERIC J. , LECOUTEUR RICHARD A. 
Published: February 2006

Objective— To characterize the clinical signs, diagnostic and surgical findings, and outcome in dogs with spinal epidural empyema (SEE).Study Design— Retrospective study.Animals— Seven dogs.Methods— Dogs with SEE between 1992 and 2001 were identified from a computerized medical record system. Inclusion criteria were: neurologic examination, vertebral column radiographs, myelography, antimicrobial culture and susceptibility of material collected surgically from the vertebral canal, a definitive diagnosis of SEE confirmed by surgery, and microscopic examination of tissue from the vertebral canal.Results— Common signs were lethargy, fever, anorexia, apparent spinal pain, and paraparesis/plegia. Common laboratory abnormalities were peripheral neutrophilia, and neutrophilic pleocytosis in cerebrospinal fluid (CSF). Three dogs had concurrent discospondylitis and 1 of these had vertebral luxation. On myelography, extradural spinal cord compression was focal (2 dogs), multifocal (3), or diffuse (2). Bacteria were isolated not from CSF but from blood, surgical site, pleural fluid, or urine in 6 dogs. Dogs were administered antibiotics and had surgical decompression by hemilaminectomy. Five dogs improved neurologically and had a good long‐term outcome. Two dogs were euthanatized, 1 because of worsening of neurologic signs and pneumonia, and the other because of herniation of a cervical intervertebral disc 1 month postoperatively, unrelated to the SEE.Conclusion— Dogs with SEE may have a good outcome when treated by surgical decompression and antibiotic administration.Clinical Relevance— SEE should be included in a list of possible causes for dogs with fever, apparent spinal pain, and myelopathy.