bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of acute hypovolaemia by furosemide on tracheal transepithelial potential difference and mucus in dogs
Authors: Nakagawa N.K. , Donato-Júnior F. , Kondo C.S. , King M. , Auler-Júnior J.O.C. , Saldiva P.H.N. , Lorenzi-Filho G. 
Published: October 2004

Furosemide is a potent diuretic that affects water transfer across the respiratory epithelium, which is closely related to the transepithelial potential difference (PD). Water is a critical factor that determines mucus transport; an important lung defence mechanism that removes particles and microorganisms from the respiratory system.The aim of the present study was to investigate the acute effects of furosemide and hypovolaemia on tracheal PD and mucus properties. A total of 36 male mixed-breed dogs were submitted to anaesthesia, mechanical ventilation and haemodynamic monitoring. They were randomly assigned to three groups consisting of: a control group, a furosemide (40 mgi.v.) + hypovolaemia group, and a furosemide (40 mgi.v.) + volume replacement group. Tracheal PD and mucus samples were collected at time 0, 1 and 2 h after intervention. Mucus properties were analysed by means of a magnetic microrheometer andin vitromucociliary transportability on the frog palate.Compared to controls, furosemide decreased PD to intermediate values, and only significantly when associated with hypovolaemia (−13±5 and −8±2 mV, time 0 and 2 h, respectively).In addition to the direct effect of furosemide, these results indicate that hypovolaemia also affects ion transport in the tracheal membrane. Furosemide and hypovolemia have no acute effects on respiratory mucus properties.
Association between prenatal exposure to analgesics and risk of schizophrenia
Authors: Sørensen Holger J. , Mortensen Erik L. , Reinisch June M. , Mednick Sarnoff A. 
Published: October 2004

BackgroundDisturbances in the central nervous system originating during foetal life may increase the risk of schizophrenia.AimsTo illuminate the hypothesis that prenatal exposure to analgesics may affect foetal neurodevelopment, leading to increased risk of schizophrenia in adulthood.MethodUsing data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Central Register, we studied the relationship between prenatal exposure to analgesics and the risk of schizophrenia. The effect of prenatal exposure was adjusted for parental history of schizophrenia, second-trimester viral infections, concomitant drug treatment during pregnancy, an index of pregnancy complications, parental social status and parental age.ResultsIn a risk set of 7999 individuals, 116 cases of schizophrenia were found (1.5%). Prenatal exposure to analgesics in the second trimester was associated with an elevated risk (adjusted odds ratio 4.75, 95% CI1.9–12.0). Independent of the covariates, the effect remained statistically significant.ConclusionsIndependent of a wide range of possible confounders, a significant association between second-trimester exposure to analgesics and increased risk of schizophrenia was observed.
Factors influencing the development and amelioration of suicidal thoughts in the general population
Authors: Gunnell D. , Harbord R. , Singleton N. , Jenkins R. , Lewis G. 
Published: October 2004

BackgroundThe incidence of suicidal thoughts in the British population is unknown.AimsTo determine the factors associated with the development of, and recovery from, suicidal thoughts.MethodAn 18-month follow-up survey investigated 2404 of the adults who took part in the second National Psychiatric Morbidity Survey.ResultsThe annual incidence of suicidal thoughts was 2.3%. Incidence was highest in women and among 16- to 24-year-olds. Increased incidence was associated with not being in a stable relationship, low levels of social support and being unemployed. Fifty-seven percent of those with suicidal thoughts at baseline had recovered by the 18-month follow-up interview.ConclusionsRisk factors for suicidal thoughts are similar to those for completed suicide, although the age and gender patterning is different. Fewer than 1 in 200 people who experience suicidal thoughts go on to complete suicide. Further study into explanations for the differences in the epidemiology of suicidal thoughts and suicide is crucial to understanding the pathways (protective and precipitating) linking suicidal thoughts to completed suicide and should help inform effective prevention of suicide.
Homicide and mental illness in New Zealand, 1970–2000
Authors: Simpson Alexander I. F. , Mckenna Brian , Moskowitz Andrew , Skipworth Jeremy , Barry-Walsh Justin 
Published: October 2004

BackgroundHomicides by mentally ill persons have led to political concerns about deinstitutionalisation.AimsTo provide accurate information about the contribution of mental illness to homicide rates.MethodRetrospective study of homicide in New Zealand from 1970 to 2000, using data from government sources. ‘Mentally abnormal homicide’ perpetrators were defined as those found unfit to stand trial, not guilty by reason of insanity, convicted and sentenced to psychiatric committal, or convicted of infanticide. Group and time trends were analysed.ResultsMentally abnormal homicides constituted 8.7% of the 1498 homicides. The annual rate of such homicides was 1.3 per million population, static over the period. Total homicides increased by over 6% per year from 1970 to 1990, then declined from 1990 to 2000. The percentage of all homicides committed by the mentally abnormal group fell from 19.5%in 1970 to 5.0% in 2000. Ten percent of perpetrators had been admitted to hospital during the month before the offence; 28.6% had had no prior contact with mental health services. Victims were most commonly known to the perpetrator (74%).ConclusionsDeinstitutionalisation appears not to be associated with an increased risk of homicide by people who are mentally ill.
What attitudes do psychiatrists hold towards people with mental illness?
Authors: Kingdon David , Sharma Tonmoy , Hart Deborah ,   Deborah Hart The Schizophrenia Subgroup of The Royal College of Psychiatrists' Changing Minds Campaign
Published: October 2004

Aims and MethodTo investigate the attitudes that psychiatrists hold towards people with mental illness. Each member of the Royal College of Psychiatrists in the UK was sent a questionnaire based on previous research in this area, supplemented with relevant questions on management.Results2813 of 6524 questionnaires were returned (43%). Psychiatrists' attitudes compared favourably with those of the general population. Among other findings, they believed that the risk of dangerousness was overemphasised, that misdiagnosis of schizophrenia in Black people is common, and that polypharmacy and the use of antipsychotic medication above British National Formulary levels occurs too often.Clinical ImplicationsPsychiatrists' attitudes are substantially more favourable towards people with mental illness than those of the general population with individual, but important, exceptions. Some aspects of psychiatric management, especially of antipsychotic medication, may undermine this, however. Comparison with other groups, e.g. general practitioners, nurses and social workers, would be useful in planning how to reduce the stigmatisation of people with mental illness.
Diverse clinical and pathologic features of gastric carcinoid and the relevance of hypergastrinemia
Authors: Gough David B. , Thompson Geoffrey B. , Crotty Thomas B. , Donohue John H. , Kvols Larry K. , Carney J. Aidan , Grant Clive S. , Nagorney David M. 
Published: October 2004

AbstractThe etiology, prognosis, and optimal management of primary gastric carcinoids remain controversial. Records of 36 consecutive patients with gastric carcinoid (15 men) were reviewed retrospectively between 1975 and 1990. Follow‐up was complete in 97% of cases. Mean age at diagnosis was 58.4 years (range 24–82 years). The clinical presentations included anemia (72%), pain (69%), and carcinoid syndrome (11%). Associated autoimmune and endocrine abnormalities were common and included atrophic gastritis (67%), pernicious anemia (58%), hypothyroidism (39%), diabetes (19%), Addison's disease (6%), and hyperparathyroidism (6%). Lesions were nonantral in 78%, involving only the corpus in 42%, the fundus in 28%, and only the antrum in 8%; 42% were multiple. Urinary 5‐hydroxyindoleacetic acid (5‐HIAA) and serum gastrin levels were elevated in 17% and 50% of those tested, respectively. Histologic examination revealed that 28% of lesions were ≥2 cm, and 33% had liver metastases on presentation or developed them during follow‐up. Eight patients (22%) died of tumor with a median survival of 39 months. The presence of metastases, atypical histology, serosal involvement, and size > 2 cm were adverse prognostic factors. In patients without hypergastrinemia (n=6), 66% developed metastases, 60% had elevated 5‐HIAA, and 50% died of carcinoid tumor. In sharp contrast, those patients with hypergastrinemia and “typical” gastric carcinoids (n=15), metastases and death did not occur (p<0.003 and p < 0.005, respectively, compared with eugastrinemic patients). In the latter group (hypergastrinemia and typical histology), pernicious anemia was common (73%); solitary lesions and serosal penetration were seen comparatively less often (33% versus 100%, p<0.005 and 0% versus 33%, p<0.05, respectively); and no lesion measured > 2.0 cm compared to 66% in the group without elevated gastrin (p<0.002). No patient with hypergastrinaemia had elevated levels of 5‐HIAA. Overall survival at 5 and 10 years was 58% and 28%, respectively. Survival was 80% at 5 and 10 years in the hypergastrinemic group. Gastric carcinoid tumors that are histologically atypical, large (>2 cm), or present without elevated gastrin are potentially lethal and require aggressive therapy. In contrast, gastric carcinoids with typical histology and hypergastrinemia are rarely lethal, and conservative management with local excision and close observation is appropriate.
Radioiodine‐associated thyroid cancers
Authors: Tezelman Serdar , Grossman Richard F. , Siperstein Allan E. , Clark Orlo H. 
Published: October 2004

AbstractNumerous investigations document that exposure to low dose external therapeutic radiation leads to the development of benign and malignant thyroid neoplasms. There is consideble controversy, however, concerning whether radioactive iodine (131I) causes thyroid cancer. The aim of this investigation was to examine our experience and that in the literature related to this problem. From 1982 to March 1993 seven of 373 patients (1.9%) with thyroid cancer who were treated by one surgeon had a history of treatment with radioactive iodine for Graves' disease and toxic nodular goiter. Sixty‐five patients have previously been reported in the literature from 1957 to present. Our patients (five women, two men) ranged in age from 26 to 80 years (mean 57 years). The interval between the exposure to the internal radiation and development of cancer ranged from 3 to 29 years (mean 11.4 years), and the mean age at the time of 131I treatment was 45 years (18–76 years). The therapeutic dose of 131I was 5 to 100 mCi (mean 25.3 mCi) in our patients. Two of our patients received 131I twice. The age of patients reported in the literature at the time of 131I treatment ranged from 7 to 74 years (mean 48 years). The mean therapeutic dose of 131I was 20.6 mCi (1.25–180.0 mCi) and the latent period was documented for a mean 8.7 years (0.25–28.0 years) in these patients. Three of 29 patients in the literature received 131I twice. Fine‐needle aspiration cytology of thyroid nodules was positive for cancer in six of our patients (86%). All patients were treated by total thyroidectomy, and three of them had a modified neck dissection. Six of our seven patients had invasive papillary thyroid carcinoma (stage III disease), and the seventh patient had extensive nodal metastasis and intrathyroidal invasion. Invasion into adjacent muscle and soft tissue were found in four patients, and two had tracheal invasion. Two patients had lymph node metastases. There were no postoperative complications. One patient (14%), however developed recurrent papillary and anaplastic thyroid cancer in his left neck and mediastinum 2 years after total thyroidectomy. He had extensive pulmonary metastases and malignant pleural effusions and died 23 days after a left modified radical neck dissection. In conclusion, radioactive iodine in doses to treat Graves' disease may increase the risk of developing thyroid cancer. These cancers are discovered at a later stage and appear to be aggressive.
Thyroperoxidase immunodetection for the diagnosis of malignancy on fine‐needle aspiration of thyroid nodules
Authors: Henry Jean‐Francois , Denizot Anne , Porcelli Alberto , Villafane Marcelo , Zoro Patricia , Garcia Stéphane , De Micco Cathérine 
Published: October 2004

AbstractWe have previously demonstrated that in 95.6% of malignant thyroid tumors the enzyme thyroid peroxidase (TPO) presents antigenic changes detectable by a monoclonal antibody termed MoAb47. The aim of this study was to investigate the interest of TPO immunodetection for the diagnosis of malignancy on fine‐needle aspiration biopsy (FNAB) of thyroid nodules. The study was performed on 300 patients. Slides of FNAB aspirate were air‐dried and stained by anti‐TPO‐MoAb47. According to the percentage of TPO‐positive epithelial cells, patients were divided into two groups: benign (<80%) and malignant (<80%). In 279 cases additional slides were available for Giemsa stain and standard cytology. All the patients were operated on, and the final diagnosis was recorded as benign in 248 cases (183 macrofollicular nodules, 23 microfollicular adenomas, 18 atypical adenomas, 11 oncocytomas, 11 thyroiditis, 2 Graves' disease) and malignant in 52 cases (44 papillary carcinomas and 8 follicular carcinomas). Samples from 215 of 248 benign nodules yielded 80% to 100% TPO‐positive cells, whereas samples from all malignant tumors yielded less than 80% positive cells. The sensitivity of TPO staining for diagnosis of malignancy was thus 100%, its specificity 86.7%, and its overall accuracy 89%. With conventional cytology, sensitivity, specificity, and accuracy were 91.6%, 79.2%, and 81.0%, respectively. We conclude from this study that TPO staining with MoAb47 should become an essential adjunct in the preoperative cytologic diagnosis of thyroid nodules.
Classification of papillary cancer of the thyroid based on prognosis
Authors: Noguchi Shiro , Murakami Nobuo , Kawamoto Hitoshi 
Published: October 2004

AbstractBetween 1965 and 1988 there were 2953 patients with papillary carcinoma treated at Noguchi Thyroid Clinic. Among them 761 patients were excluded because the primary tumor was <10 mm in maximum diameter, the patient's age was >80, or the patient underwent noncurative surgery. The remaining 2192 patients, 192 men and 2000 women, were analyzed. The mean follow‐up period was 12.5 years. Total thyroidectomy, subtotal thyroidectomy, lobectomy with or without isthmectomy, and less than lobectomy were performed in 2.3%, 40.3%, 44.2%, and 13.2%, respectively. Modified radical neck dissection, partial node excision, and no node excision were performed in 77.8%, 6.4%, and 15.8%, respectively. Men and women were separately analyzed because their risk factors and prognosis were significantly different. Multivariate analysis was carried out according to Cox's regression hazard model. Independently significant factors affecting prognosis in men were aged and gross nodal metastasis; and age, gross nodal metastasis,tumor size, and number of adhered tissues or organs were the factors in women. Based on those risk factors patients were classified into three groups. For men, 65.6% were classified in the excellent group and their 10‐year survival was 98.4%; 17.2% were classified as intermediate and 17.2% as poor with survival rates of 90.1% and 74.4%, respectively. For female patients 69.6% were classified in the excellent group, 18.6% in the intermediate group, and 11.9% in the poor group with 10‐year survivals of 99.3%, 96.4%, and 88.8%, respectively.
Presymptomatic screening for medullary thyroid carcinoma in patients with multiple endocrine neoplasia type 2A
Authors: Frilling Andrea , Röher Hans‐Dietrich , John Ponder Bruce Anthony 
Published: October 2004

AbstractPresymptomatic screening of medullary thyroid carcinoma in MEN IIA families enables the early diagnosis of this tumor with its significant morbidity. Biochemical screening consists of basal and stimulated serum calcitonin evaluation. Genetic screening is based on DNA analysis using linked DNA markers. Thyroidectomy at an occult tumor stage may be curative. Calcitonin measurement was carried out in 58 apparently unaffected family members at risk and 11 MEN IIA patients. Calcitonin elevation was detected in nine individuals. All nine underwent thyroidectomy. Histologic examination confirmed medullary thyroid carcinoma in eight patients and in one case C cell hyperplasia. Postoperatively, eight patients (89%) are clinically and biochemically tumor‐free (mean follow‐up 30 months). DNA screening results in one affected family are presented. DNA analysis allowed recognition of one apparently unaffected individual at risk as a MEN IIA gene carrier. One family member at risk was found not to carry the gene and may be excluded from further screening.
CD15 (LeuM1) immunoreactivity: Prognostic factor for sporadic and hereditary medullary thyroid cancer?
Authors: Längle Friedrich , Soliman Thomas , Neuhold Nikolaus , Widhalm Gerold , Niederle Bruno , Roka Sebastian , Kaserer K. , Blauensteiner Wolfgang , Dam Karl , Clodi Martin , Flores Juan , Loidl Almute , Schwarzlmüller Bernhard , Huber Eva , Jahl Gerald , Wamprechtshammer Klaus , Roka Rudolf ,   Study Group on Multiple Endocrine Neoplasia of Austria
Published: October 2004

AbstractPatients treated for sporadic and hereditary medullary thyroid carcinoma (MTC) have varying rates of persistent disease, recurrence, and survival. The aim of this study was to correlate the immunoreactivity of the monoclonal antibody CD15 (LeuM1) to initial clinical findings and the outcome of treatment. The primary tumors of 75 patients with sporadic MTC, 7 with hereditary disease, and 3 members of MEN 2A families were studied. Of these subjects 74 (87%) showed no or little immunoreactivity (<15% positive cells; score 0) in most tumors. The remaining 13% had surgery for tumors with more than 15% cells with positive staining (score I). There was no correlation between LeuM1 immunoreactivity and sex, age, and type of MTC. There was, however, a significant correlation with the pTNM classification and UICC staging. The prognosis for patients with score 0 was significantly better than score 1 patients. CD15 immunoreactivity appears to be a predictive factor in sporadic and hereditary MTC. Lymph node dissection seems to be more successful in patients with score 0 tumors than in those with score 1 tumors. The question of reoperation in patients with recurrence of disease (especially with biochemical recurrence or persistence) should be discussed on the basis of CD15 immunoreactivity.
Clinical course of metastatic parathyroid cancer
Authors: Sandelin Kerstin , Tullgren Owe , Farnebo Lars Ove 
Published: October 2004

AbstractIn a retrospective study the clinical course of 40 patients with symptomatic persistent or recurrent parathyroid cancer was analyzed in order to assess the value of aggressive surgical intervention. Recurrence was diagnosed after a median period of 33 months (1–228 months). Twenty‐two patients had locoregional disease, whereas 14 patients had both local and distant spread. The remaining four patients had distant spread. Patients with just locoregional disease were subject to one to nine reoperative procedures. The median survival time from the last operation was 39 months (1–204 months). Eight patients then had no evidence of disease, three were hypercalemic and 9 of 11 had died of parathyroid cancer. Distant spread was demonstrated in 17 of 40 patients. Pulmonary metastases predominated (14 of 17). Surgical excision was performed in 9 of 14 cases. Of these nine, two patients had a subsequent disease‐free interval of 36+ and 72+ months, respectively. One patient was reported hypercalcemic after 84 months, whereas five patients died of cancer between 4 and 60 months after their last surgical exploration. One patient was lost to follow‐up. In all, 21 patients (53%) died of parathyroid cancer. Conspicuous nuclear atypia and frequent mitoses predominated. Image cytometric DNA analysis showed high rates for all three groups (median p90=80%, range 21–98%).
Outcome of 309 patients with metastatic differentiated thyroid carcinoma treated with radioiodine
Authors: Pacini Furio , Cetani Filomena , Miccoli Paolo , Mancusi Francesco , Ceccarelli Claudia , Lippi Francesco , Martino Enio , Pinchera Aldo 
Published: October 2004

AbstractFrom 1969 to 1990 there were 309 patients with differentiated thyroid carcinoma (241 papillary and 68 follicular) treated with radioactive iodine for functioning node metastases alone (n=191) or distant metastases (n=118) with or without node metastases. These patients represented 32.7% of 945 patients treated in our institution during the same period. Initial treatment included near‐total thyroidectomy and 131I ablation of postsurgical thyroid residue, followed by L‐thyroxine suppressive therapy. At the end of follow‐up (mean 5.8 years), 146 patients (76.4%) in the group with nodal metastases were considered cured, as assessed by clinical and laboratory evaluation including whole body scan (WBS) and serum thyroglobulin (Tg) levels; 32 patients (16.7%) had persistent disease. Loss of 131I uptake in persistent metastatic lesions occurred in five patients (2.6%), and newly developed distant metastases occurred in eight patients (4.2%). Of the patients with distant metastases, 36.4% were cured by 131I. Distant metastases from papillary carcinomas had a higher cure rate than follicular carcinomas (p<0.01). The metastases of four patients (5.2%) lost the property to take up radioiodine. Lung and bone metastases detectable by WBS but not by radiography were most likely to be cured by 131I. The overall survival at the end of follow‐up was 95.8% in patients with only lymph node metastases and 76.0% in those with distant metastases. Tumor‐related deaths were 3.6% and 23.7%, respectively. Our data indicate that 131I therapy is highly effective in the treatment of lymph node metastases from differentiated thyroid carcinoma. To a variable extent, distant metastases may also benefit from radioiodine therapy, definitive cure being much more likely during the early phase of metastatic involvement.