bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orthopaedic surgery core curriculum: the spine
Authors: Wadey Veronica M R , Halpern Jerry , Bouchard Jacques , Dev Parvati , Olshen Richard A , Walker Decker 
Published: April 2007

AbstractObjectiveTo develop a core curriculum for orthopaedic surgery and to conduct a national survey to assess the importance of 281 items in the curriculum. Attention was focused specifically on 24 items pertaining to the curriculum that are pertinent to the spine.Study designA cross-sectional survey of a random sample of orthopaedic surgeons whose primary affiliation was non-academic, representing the provinces and territories of CanadaMethodsA questionnaire containing 281 items was developed. A random group of 131 (out of 156) orthopaedic surgeons whose primary affiliation is non-academic completed the questionnaire. The data were analysed quantitatively using average mean scores, histograms, the modified Hotelling's T2 test and the Benjimini–Hochberg procedure.Results131 of 156 (84%) orthopaedic surgeons participated, in this study. 14 of 24 items were ranked at no less than 3 out of 4 thus suggesting that 58% of the items are important or probably important to know by the end of residency (SD⩽0.07). Residents need to learn the diagnosis and principles of managing patients with common conditions of the spine.ConclusionsThe study shows, with reliable statistical evidence, that orthopaedic residents are no longer expected to be able to perform spinal fusions with proficiency on completion of residency. Is the exposure to surgical spine problems and the ability to be comfortable with operating expectations specific to the fellowship level? If so, the focus during residency or increasing accredited spine fellowships needs to be addressed to ensure that enough spine surgeons are educated to meet the future healthcare demands projected for Canada.
Management of paraproteinaemia
Authors: Cook Lucy , Macdonald Donald H C 
Published: April 2007

Abstract
A paraprotein is a monoclonal immunoglobulin or light chain present in the blood or urine; it is produced by a clonal population of mature B cells, most commonly plasma cells. In individuals aged &gt;50 years the incidence of a paraprotein is 3.2%. Plasma cell disorders can be considered as a spectrum of conditions ranging from monoclonal gammopathy of undetermined significance (MGUS), through asymptomatic, to symptomatic myeloma. MGUS is defined by a low level of paraprotein &lt;30 g/l, bone marrow plasma cells &lt;10% and the absence of myeloma related organ or tissue damage (predominantly renal, skeletal or bone marrow impairment.) MGUS requires no therapy and the overall risk of progression to myeloma is 1% per year. Myeloma remains incurable with a median survival of 3–4 years; autologous stem cell transplant can prolong survival, if appropriate. Thalidomide in combination with dexamethasone has an emerging role in the treatment of myeloma.
Chemosensitization of Cancer In vitro and In vivo by Nitric Oxide Signaling
Authors: Frederiksen Lisa J. , Sullivan Richard , Maxwell Lori R. , Macdonald-Goodfellow Shannyn K. , Adams Michael A. , Bennett Brian M. , Siemens D. Robert , Graham Charles H. 
Published: April 2007

Abstract
Purpose: Hypoxia contributes to drug resistance in solid cancers, and studies have revealed that low concentrations of nitric oxide (NO) mimetics attenuate hypoxia-induced drug resistance in tumor cells in vitro. Classic NO signaling involves activation of soluble guanylyl cyclase, generation of cyclic GMP (cGMP), and activation of cGMP-dependent protein kinase. Here, we determined whether chemosensitization by NO mimetics requires cGMP-dependent signaling and whether low concentrations of NO mimetics can chemosensitize tumors in vivo.
Experimental Design: Survival of human prostate and breast cancer cells was assessed by clonogenic assays following exposure to chemotherapeutic agents. The effect of NO mimetics on tumor chemosensitivity in vivo was determined using a mouse xenograft model of human prostate cancer. Drug efflux in vitro was assessed by measuring intracellular doxorubicin-associated fluorescence.
Results: Low concentrations of the NO mimetics glyceryl trinitrate (GTN) and isosorbide dinitrate attenuated hypoxia-induced resistance to doxorubicin and paclitaxel. Similar to hypoxia-induced drug resistance, inhibition of various components of the NO signaling pathway increased resistance to doxorubicin, whereas activation of the pathway with 8-bromo-cGMP attenuated hypoxia-induced resistance. Drug efflux was unaffected by hypoxia and inhibitors of drug efflux did not significantly attenuate hypoxia-induced chemoresistance. Compared with mice treated with doxorubicin alone, tumor growth was decreased in mice treated with doxorubicin and a transdermal GTN patch. The presence of GTN and GTN metabolites in plasma samples was confirmed by gas chromatography.
Conclusion: Tumor hypoxia induces resistance to anticancer drugs by interfering with endogenous NO signaling and reactivation of NO signaling represents a novel approach to enhance chemotherapy.
Synergism between Arsenic Trioxide and Heat Shock Protein 90 Inhibitors on Signal Transducer and Activator of Transcription Protein 3 Activity—Pharmacodynamic Drug-Drug Interaction Modeling
Authors: Wetzler Meir , Earp Justin C. , Brady Michael T. , Keng Michael K. , Jusko William J. 
Published: April 2007

Abstract
Purpose: Constitutive signal transducer and activator of transcription 3 (STAT3) activity, observed in ∼50% of acute myelogenous leukemia cases and associated with adverse treatment outcome, is down-regulated by arsenic trioxide (ATO). Heat shock protein (HSP) 90 is a molecular chaperone involved in signal transduction pathways. We hypothesized that HSP90 inhibitors will potentiate ATO effect on constitutive STAT3 activity and cell killing. One concern was that the effect of ATO and HSP90 inhibitors will result in up-regulation of HSP70, a protein known to inhibit apoptosis.
Experimental Design: We have used a semimechanistic pharmacodynamic model to characterize concentration-effect relationships of ATO and HSP90 inhibitors on constitutive STAT3 activity, HSP70 expression, and cell death in a cell line model.
Results: Pharmacodynamic interaction of ATO and three HSP90 inhibitors showed synergistic interactions in inhibiting constitutive STAT3 activity and inducing cell death, in spite of a concurrent synergistic up-regulation of HSP70.
Conclusions: These preliminary results provide a basis for studying the combined role of ATO with HSP90 inhibitors in acute myelogenous leukemia with constitutive STAT3 activity.
Unraveling the Mechanisms of Endocrine Resistance in Breast Cancer: New Therapeutic Opportunities
Authors: Massarweh Suleiman , Schiff Rachel 
Published: April 2007

Abstract
Two thirds of breast cancers express the estrogen receptor (ER), which contributes to tumor development and progression. ER-targeted therapy is therefore widely used in breast cancer to inhibit signaling through ER and disrupt breast cancer growth. This therapeutic strategy, particularly using the antiestrogen tamoxifen, is proven to increase the cure rates in early breast cancer, improve patient outcomes in advanced disease, and reduce breast cancer incidence in the prevention setting. Despite the recent integration of more powerful endocrine agents into breast cancer care, resistance to all forms of endocrine therapy remains a major problem. New insight into ER biology and progress in understanding resistance mechanisms, mediated by molecular crosstalk between ER and various growth factor signaling pathways, are generating tremendous promise for new therapeutic opportunities to target resistance and improve breast cancer disease outcomes.
Circulating Tumor Cell Analysis in Patients with Progressive Castration-Resistant Prostate Cancer
Authors: Shaffer David R. , Leversha Margaret A. , Danila Daniel C. , Lin Oscar , Gonzalez-Espinoza Rita , Gu Bin , Anand Aseem , Smith Katherine , Maslak Peter , Doyle Gerald V. , Terstappen Leon W.M.M. , Lilja Hans , Heller Glenn , Fleisher Martin , Scher Howard I. 
Published: April 2007

Abstract
Purpose: To better direct targeted therapies to the patients with tumors that express the target, there is an urgent need for blood-based assays that provide expression information on a consistent basis in real time with minimal patient discomfort. We aimed to use immunomagnetic-capture technology to isolate and analyze circulating tumor cells (CTC) from small volumes of peripheral blood of patients with advanced prostate cancer.
Experimental Design: Blood was collected from 63 patients with metastatic prostate cancer. CTCs were isolated by the Cell Search system, which uses antibodies to epithelial cell adhesion marker and immunomagnetic capture. CTCs were defined as nucleated cells positive for cytokeratins and negative for CD45. Captured cells were analyzed by immunofluorescence, Papanicolau staining, and fluorescence in situ hybridization.
Results: Most patients (65%) had 5 or more CTCs per 7.5 mL blood sample. Cell counts were consistent between laboratories (c = 0.99) and did not change significantly over 72 or 96 h of storage before processing (c = 0.99). Their identity as prostate cancer cells was confirmed by conventional cytologic analysis. Molecular profiling, including analysis of epidermal growth factor receptor (EGFR) expression, chromosome ploidy, and androgen receptor (AR) gene amplification, was possible for all prostate cancer patients with ≥5 CTCs.
Conclusions: The analysis of cancer-related alterations at the DNA and protein level from CTCs is feasible in a hospital-based clinical laboratory. The alterations observed in EGFR and AR suggest that the methodology may have a role in clinical decision making.
Influence of Echinacea purpurea (L.) Moench Extract on the Toxicity of Cadmium
Authors: ZITKEVICIUS VIRGILIJUS , SMALINSKIENE ALINA , LESAUSKAITE VAIVA , SAVICKIENE NIJOLE , SAVICKAS ARUNAS , RYSELIS STANISLOVAS , KREGZDYTE RIMA , ABDRAKHMANOV OLEG , SADAUSKIENE ILONA , IVANOV LEONID 
Published: April 2007

Abstract:
Echinacea purpurea (L.) Moench (EP) has many beneficial features, especially strengthening the immune system. Cadmium (Cd) is a ubiquitous metal and cumulative poison that may cause liver and kidney damage and the formation of neoplasia. In this article, the changes in organs and metabolism, the accumulation of various levels of Cd in tissues, and the effects of EP liquid extract on Cd‐induced changes in mice were investigated. Experiments were carried out on the white laboratory mice. Solution of different Cd and EP concentrations were given to drink and experiments were performed. The concentration of Cd in mice blood, liver, kidneys, heart, spleen, skeletal muscle was determined using an electrothermal graphite furnace atomic absorption spectrophotometer Perkin–Elmer/Zeeman 3030. Long time per os of extract of EP combined with Cd leads to a significant increase of Cd concentration in blood and investigated organs of experiment mice.
Aerogel-like Three-dimensional Gold Nanoparticle Network via Sublimation of Volatile Organic Crystals Decorated with Gold Nanoparticles
Authors: Fujiki Yuzo , Shinkai Seiji , Sada Kazuki 
Published: April 2007

Abstract
We demonstrate novel strategy to create the three-dimensional networks of the gold nanoparticle from organic crystals decorated by the gold nanoparticles via slow removal of the crystals by sublimation.
Previous Head Injury Is a Risk Factor for Subsequent Head Injury in Children: A Longitudinal Cohort Study
Authors: Swaine Bonnie R. , Tremblay Camille , Platt Robert W. , Grimard Guy , Zhang Xun , Pless I. Barry 
Published: April 2007

OBJECTIVE. The objective of this study was to determine whether children who sought care for a head injury were at greater risk of having a subsequent head injury within the following 6 and 12 months compared with children who sought care for an injury other than to the head.DESIGN/SETTING. This was a longitudinal cohort study conducted in the emergency departments of 2 Montreal (Quebec, Canada) pediatric hospitals.PARTICIPANTS. The parents of 11867 injured children aged 1 to 18 years were interviewed by telephone at 6 (n = 10315) and 12 (n = 9486) months after their child's injury to ascertain outcome (ie, subsequent head injury) and to provide information on potential risk factors (age, gender, chronic medical condition, activity level, and socioeconomic status).MAIN OUTCOME MEASURE. The outcome of interest was a head injury requiring medical attention within the following year ascertained by parental recall or physician claims data.RESULTS. A total of 245 and 386 previously head-injured children sustained a subsequent head injury within 6 and 12 months, respectively. Children who sought care for an initial head injury (n = 3599) were at higher risk of having a subsequent head injury within 6 months than children who sought care for an injury not to the head (n = 6716). The adjusted odds ratio suggested weak confounding by age, gender, and history of previous head injury. Results were consistent on the basis of physician claims data and 12-month follow-up interview data.CONCLUSIONS. These results provide evidence that having a head injury increases a child's risk of having a subsequent head injury. Although age, gender, and history of previous head injury confound the relationship, the effect remains substantial.
Preventive Health Care for Children With and Without Special Health Care Needs
Authors: Houtrow Amy J. , Kim Sue E. , Chen Alex Y. , Newacheck Paul W. 
Published: April 2007

OBJECTIVE. The objective of this study was to compare the receipt of preventive health services for children with and without special health care needs and to identify predictors of these health services for children with special health care needs using nationally representative data.
METHODS. Data from the 2002 and 2003 Medical Expenditure Panel Surveys were analyzed. A total of 18279 children aged 3 to 17 years were included in our study. The Child Preventive Health Supplement was used to identify caregiver recall of specific health screening measures and anticipatory guidance during the previous 12 months. Odds ratios were calculated for predictive factors of preventive services for children with special health care needs.
RESULTS. The prevalence of special health care needs in children aged 3 to 17 years was 21.6%. Based on caregiver reports, 87.5% of children with special health care needs had ≥1 health screening measure checked in the past year compared with 73.1% of children without special health care needs. Receipt of ≥1 topic of anticipatory guidance was reported for 69.8% of children with special health care needs compared with 55.2% of children without special health care needs. Black and Hispanic caregivers of children with special health care needs were more likely than others to report receipt of all 6 categories of anticipatory guidance measured in this study.
CONCLUSIONS. We found that caregivers of children with special health care needs were more likely to report receipt of anticipatory guidance and health screening than were caregivers of children without special health care needs. Although a majority of these caregivers reported receiving some health screening and anticipatory guidance on an annual basis, there are clear gaps in the delivery of preventive health services. This study identifies areas for improvement in the delivery of preventive health services for children with special health care needs and children in general.
Association Between Parental Depression and Children's Health Care Use
Authors: Sills Marion R. , Shetterly Susan , Xu Stanley , Magid David , Kempe Allison 
Published: April 2007

OBJECTIVE. The objective of this study was to determine the association between parental depression and pediatric health care use patterns.METHODS. We selected all children who were 0 to 17 years of age, enrolled in Kaiser Permanente of Colorado during the study period July 1997 to December 2002, and linked to at least 1 parent/subscriber who was enrolled for at least 6 months during that period. Unexposed children were selected from a pool of children whose parents did not have a depression diagnosis. Outcome measures were derived from the child's payment files and electronic medical charts and included 5 categories of use: well-child-care visits, sick visits to primary care departments, specialty clinic visits, emergency department visits, and inpatient visits. We compared the rate of use per enrollment month for these 5 categories between exposed and unexposed children within each of the 5 age strata.RESULTS. Our study population had 24391 exposed and 45274 age-matched, unexposed children. For the outcome of well-child-care visits, teenagers showed decreased rates of visits among exposed children. The rate of specialty department visits was higher in exposed children in the 4 oldest age groups. The rates of both emergency department visits and sick visits to primary care departments were higher for exposed children across all 5 age categories. The rate of inpatient visits was higher among exposed children in 2 of the 5 age groups.CONCLUSIONS. Overall, having at least 1 depressed parent is associated with greater rate of emergency department and sick visits across all age groups, greater use of inpatient and specialty services in some age groups, and a lower rate of well-child-care visits among 13- to 17-year-olds. This pattern of increased use of expensive resources and decreased use of preventive services represents one of the hidden costs of adult depression.
Twenty-Year Trends in Fatal Injuries to Very Young Children: The Persistence of Racial Disparities
Authors: Pressley Joyce C. , Barlow Barbara , Kendig Tiffany , Paneth-Pollak Rachel 
Published: April 2007

OBJECTIVE. Mortality trends across modifiable injury mechanisms may reflect how well effective injury prevention efforts are penetrating high-risk populations. This study examined all-cause, unintentional, and intentional injury–related mortality in children who were aged 0 to 4 years for evidence of and to quantify racial disparities by injury mechanism.METHODS. Injury analyses used national vital statistics data from January 1, 1981, to December 31, 2003, that were available from the Centers for Disease Control and Prevention. Rate calculations and χ2 test for trends (Mantel extension) used data that were collapsed into 3-year intervals to produce cell sizes with stable estimates. Percentage change for mortality rate ratios used the earliest (1981–1983) and the latest (2001–2003) study period for black, American Indian/Alaskan Native, and Asian/Pacific Islander children, with white children as the comparison group.RESULTS. All-cause injury rates declined during the study period, but current mortality ratios for all-cause injury remained higher in black and American Indian/Alaskan Native children and lower in Asian/Pacific Islander children compared with white children. Trend analyses within racial groups demonstrate significant improvements in all groups for unintentional but not intentional injury. Black and American Indian/Alaskan Native children had higher injury risk as a result of residential fire, suffocation, poisoning, falls, motor vehicle traffic, and firearms. Disparities narrowed for residential fire, pedestrian, and poisoning and widened for motor vehicle occupant, unspecified motor vehicle, and suffocation for black and American Indian/Alaskan Native children.CONCLUSIONS. These findings identify injury areas in which disparities narrowed, improvement occurred with maintenance or widening of disparities, and little or no progress was evident. This study further suggests specific mechanisms whereby new strategies and approaches to address areas that are recalcitrant to improvement in absolute rates and/or narrowing of disparities are needed and where increased dissemination of proven efficacious injury prevention efforts to high-risk populations are indicated.
Hepatocyte Growth Factor Levels in Gingival Crevicular Fluid in Health, Disease, and After Treatment
Authors: Nagaraja Chaitra , Pradeep A.R. 
Published: April 2007

Background: Hepatocyte growth factor (HGF) is a broad‐spectrum multifunctional cytokine with mitogenic, motogenic, morphogenic, and antiapoptotic functions in various types of cells. It is secreted by mesenchymal cells, including gingival fibroblasts, and its expression is induced by inflammatory cytokines, such as interleukin‐1 and tumor necrosis factor‐alpha, which play a potential role in periodontal destruction. Hence, the present study was carried out to assess HGF's concentration in gingival crevicular fluid (GCF) and to determine its association with periodontal disease progression.Methods: Sixty subjects (aged 29 to 39 years) were divided into three groups based on gingival index, probing depth, clinical attachment loss, and radiographic evidence of bone loss: healthy (group I), gingivitis (group II), and chronic periodontitis (group III). The fourth group consisted of the 20 subjects in group III, from whom GCF samples were collected 6 to 8 weeks after scaling and root planing (SRP). The levels of HGF were estimated using enzyme‐linked immunosorbent assay. Further, the correlation between HGF levels and clinical parameters in all groups and before and after treatment in periodontitis patients was analyzed.Results: The highest mean HGF concentration was observed for group III (26.28 ± 14.77 pg/μl), and the lowest mean concentration was observed for group I (13.99 ± 11.24 pg/μl). Following SRP, the mean HGF concentration decreased from 26.28 ± 14.77 pg/μl to 14.35 ± 13.96 pg/μl, which was statistically significant.Conclusions: HGF concentration increased proportionally with the progression of periodontal disease, and HGF concentrations showed a positive correlation with the clinical parameters, suggesting that HGF plays a key role in periodontal disease progression. Also, following non‐surgical periodontal therapy, the levels of HGF decrease significantly suggesting that HGF could be useful for monitoring the response to periodontal therapy.
Implant‐Supported Reconstruction in a Patient With Generalized Aggressive Periodontitis
Authors: Wu Aaron Yu‐Jen , Chee Winston 
Published: April 2007

Background: A 31‐year‐old female was diagnosed with generalized aggressive periodontitis based on clinical and radiographic findings. Dental implants were used to restore her dentition. The long‐term success of osseointegrated implants in periodontally healthy patients has been documented well in the literature. However, only a few cases of full‐mouth rehabilitation, using dental implants, have been reported in periodontally compromised patients, especially those who exhibited generalized aggressive periodontitis.Methods: Following extraction of all teeth except #6 through #11 in the maxilla, oral rehabilitation was accomplished with the use of implant‐supported restorations; detailed treatment planning and sequence are presented.Results: Eight implants were loaded immediately in the mandible. Six implants were placed in the posterior maxilla with a conventional two‐stage approach. The maxillary implants were loaded after a 4‐month healing period. The patient was followed for 18 months postloading in the maxilla and 24 months postloading in the mandible.Conclusion: Successful oral rehabilitation was accomplished using osseointegrated implants in a patient with generalized aggressive periodontitis.