bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aseptic meningo-encephalitis related to dexibuprofen use in a patient with systemic lupus erythematosus: a case report with MR findings
Authors: Obermoser G , Bellmann R , Pfausler B , Schmutzhard E , Sepp N 
Published: October 2002

We report of a 22-year-old woman with systemic lupus erythematosus (SLE) who was admitted to the intensive care unit (ICU) because of obtundation and a febrile illness. These symptoms had occurred after ingestion of 16 tablets of dexibuprofen.Cerebral magnetic resonance imaging (MRI) disclosed multiple hyperintense white matter abnormalities without gadolinium enhancement. No infectious origin or signs of a lupus flare were found. Our report is the first description of MR findings in dexibuprofen-induced aseptic meningitis, which here is actually a case of meningo-encephalitis. Patients suffering from SLE show increased susceptibility to non steroidal anti-inflammatory drug (NSAID)-induced aseptic meningitis/encephalitis, an important differential diagnosis to be considered at the work-up of altered mental status.
Physical and chemical stability of methotrexate, cytarabine, and hydrocortisone in Elliott’s B Solution for intrathecal use
Authors: Trissel Lawrence A , King Krista M , Zhang Yanping , Wood Amy M 
Published: October 2002

Intrathecal administration of methotrexate sodium and cytarabine with or without hydrocortisone sodium succinate is commonly used to treat metastatic spread of malignancies to the leptomeninges. The existing stability information on these drug combinations is inadequate due to the clinical use of increased doses of the drugs, as well as a change in the formulation of Elliott’s B Solution. The purpose of this study was to evaluate the physical and chemical stability of simulated high intrathecal doses of the subject drugs in the current formulation of Elliott’s B Solution. Methotrexate sodium 6, 12, and 15 mg was combined with cytarabine 100 mg with and without hydrocortisone sodium succinate 100 mg using Elliott’s B Solution as the intrathecal vehicle. Samples were stored at 4 and 23°C and evaluated for physical and chemical stability over 48 h. No precipitation or other evidence of physical instability was observed in any sample. Measured pH was 7.2- 7.5 in the samples and was sufficient to prevent methotrexate precipitation. High-performance liquid chromatography analysis found little or no loss of methotrexate and cytarabine in any sample and hydrocortisone at 4°C. At room temperature, hydrocortisone losses of 6-8% occurred in 48 h. The high doses of methotrexate sodium and cytarabine with or without hydrocortisone sodium succinate evaluated in this study are physically and chemically stable for 48 h at 4 and 23°C in Elliott’s B Solution.
Compatibility screening of oxaliplatin during simulated Y-site administration with other drugs
Authors: Trissel Lawrence A , Saenz Christopher A , Ingram Delshalonda S , Ogundele Abayomi B 
Published: October 2002

The physical compatibility of oxaliplatin (Eloxatin, Sanofi-Synthelabo, Malvern, PA) with 58 selected other drugs during simulated Y-site injection was evaluated by visual observation, turbidity measurement, and electronic particle content assessment when appropriate. Five-milliliter samples of oxaliplatin 0.5 mg/mL in 5% dextrose injection were combined with 5 mL of 58 other drugs. The other test drugs included antineoplastics, analgesics, antihistamines, diuretics, steroids, and other supportive care drugs undiluted or diluted in 5% dextrose injection. Visual examinations were performed with the unaided eye in normal diffuse fluorescent light and using a Tyndall beam (high-intensity monodirectional light beam) to enhance visualization of small particles and low-level turbidity. The turbidity of each sample was measured as well. For samples with no visible incompatibility, the particle content was measured. Evaluation of the samples was performed initially and at 1 and 4 h after preparation. Fifty-seven of the 58 test drugs were compatible with the oxaliplatin dilution during the 4 h observation period. However, diazepam resulted in precipitation. Oxaliplatin should not be administered simultaneously with diazepam.
A Study of Bedside Ocular Ultrasonography in the Emergency Department
Authors: Blaivas Michael , Theodoro Daniel , Sierzenski Paul R. 
Published: October 2002

AbstractThe use of ocular ultrasonography for the evaluation of emergency patients has recently been described in the emergency medicine (EM) literature. There are a number of potential uses that may greatly aid the emergency physician (EP) and avoid lengthy consultation or other diagnostic tests. Objective: To examine the accuracy of bedside ultrasonography as performed by EPs for the evaluation of ocular pathology. Methods: This prospective, observational study took place in a high‐volume, suburban community hospital with an EM residency program. All patients arriving with a history of eye trauma or acute change in vision were eligible to participate in the study. A 10‐MHz linear‐array transducer was used for imaging. All imaging was performed through a closed eyelid, using water‐soluble ultrasound gel. Investigators filled out standardized data sheets and all examinations were taped for review. All ultrasound examinations were followed by orbital computed tomography or complete ophthalmologic evaluation from the ophthalmology service. Statistical analysis included sensitivity, specificity, and positive and negative predictive values. Results: Sixty‐one patients were enrolled in the study; 26 were found to have intraocular pathology on ultrasound. Of these, three had penetrating globe injuries, nine had retinal detachments, one had central retinal artery occlusion, and two had lens dislocations. The remaining pathology included vitreous hemorrhage and vitreous detachment. Emergency sonologists were in agreement with the criterion standard examination in 60 out of 61 cases. Conclusions: Emergency bedside ultrasound is highly accurate for ruling out and diagnosing ocular pathology in patients presenting to the emergency department. Further, it accurately differentiates between pathology that needs immediate ophthalmologic consultation and that which can be followed up on an outpatient basis.
American Society of Clinical Oncology Technology Assessment on the Use of Aromatase Inhibitors as Adjuvant Therapy for Women With Hormone Receptor–Positive Breast Cancer: Status Report 2002
Authors: Winer Eric P. , Hudis Clifford , Burstein Harold J. , Chlebowski Rowan T. , Ingle James N. , Edge Stephen B. , Mamounas Eleftherios P. , Gralow Julie , Goldstein Lori J. , Pritchard Kathleen I. , Braun Susan , Cobleigh Melody A. , Langer Amy S. , Perotti Judy , Powles Trevor J. , Whelan Timothy J. , Browman George P. 
Published: October 2002

OBJECTIVE: To conduct an evidence-based technology assessment to determine whether the routine use of anastrozole or any of the aromatase inhibitors in the adjuvant breast cancer setting is appropriate for broad-based conventional use in clinical practice. POTENTIAL INTERVENTIONS: Anastrozole, letrozole, and exemestane. OUTCOMES: Outcomes of interest include breast cancer incidence, breast cancer-specific survival, overall survival, and net health benefit. EVIDENCE: A comprehensive, formal literature review was conducted for relevant topics and is detailed in the text. Testimony was collected from invited experts and interested parties. The American Society of Clinical Oncology (ASCO)–prescribed technology assessment procedure was followed. BENEFITS/HARMS: The ASCO panel recognizes that a woman and her physician’s decision regarding adjuvant hormonal therapy is complex and will depend on the importance and weight attributed to information regarding both cancer and non–cancer-related risks and benefits. CONCLUSION: The panel was influenced by the compelling, extensive, and long-term data available on tamoxifen. Overall, the panel considers the results of the Arimidex (anastrozole) or Tamoxifen Alone or in Combination (ATAC) trial and the extensive supporting data to be very promising but insufficient to change the standard practice at this time (May 2002). A 5-year course of adjuvant tamoxifen remains the standard therapy for women with hormone receptor–positive breast cancer. The panel recommends that physicians discuss the available information with patients, and, in making a decision, acknowledge that treatment approaches can change over time. Individual health care providers and their patients will need to come to their own conclusions, with careful consideration of all of the available data. (Specific questions addressed by the panel are summarized in Appendix 3.) VALIDATION: The conclusions of the panel were endorsed by the ASCO Health Services Research Committee and the ASCO Board of Directors. SPONSOR: American Society of Clinical Oncology.
Lead-In Phase to Randomized Trial of Motexafin Gadolinium and Whole-Brain Radiation for Patients With Brain Metastases: Centralized Assessment of Magnetic Resonance Imaging, Neurocognitive, and Neurologic End Points
Authors: Mehta Minesh P. , Shapiro William R. , Glantz Michael J. , Patchell Roy A. , Weitzner Michael A. , Meyers Christina A. , Schultz Christopher J. , Roa Wilson H. , Leibenhaut Mark , Ford Judith , Curran Walter , Phan See , Smith Jennifer A. , Miller Richard A. , Renschler Markus F. 
Published: October 2002

PURPOSE: Motexafin gadolinium is a redox mediator that selectively targets tumor cells, is detectable by magnetic resonance imaging (MRI), and enhances the effect of radiation therapy. This lead-in phase to a randomized trial served to evaluate radiologic, neurocognitive, and neurologic progression end points and to evaluate the safety and radiologic response of motexafin gadolinium administered concurrently with 30 Gy in 10-fraction whole-brain radiation therapy for the treatment of brain metastases. PATIENTS AND METHODS: Motexafin gadolinium (5.0 mg/kg/d for 10 days) was administered before each radiation treatment in this prospective international trial. Patients were evaluated by MRI, neurologic examinations, and neurocognitive tests. Prospective criteria and centralized review procedures were established for radiologic, neurocognitive, and neurologic progression end points. RESULTS: Twenty-five patients with brain metastases from lung (52%) and breast (24%) cancer, recursive partitioning analysis class 2 (96%), and an average of 11 brain metastases were enrolled. Neurocognitive function was highly impaired at presentation. Motexafin gadolinium was well tolerated. Freedom from neurologic progression was 77% at 1 year. Median survival was 5.0 months. In 29% of patients, the cause of death was brain metastasis progression. The radiologic response rate was 68%. Motexafin gadolinium’s tumor selectivity was established with MRI. CONCLUSION: (1) Centralized neurologic progression scoring that incorporated neurocognitive tests was implemented successfully. (2) Motexafin gadolinium was well tolerated. (3) Local control, measured by radiologic response rate, neurologic progression, and death caused by progression of brain metastasis, seemed to be improved compared with historical results. A randomized phase III trial using these methods for evaluation of efficacy has just been completed.
Second Malignant Neoplasms Among Long-Term Survivors of Hodgkin’s Disease: A Population-Based Evaluation Over 25 Years
Authors: Dores Graça M. , Metayer Catherine , Curtis Rochelle E. , Lynch Charles F. , Clarke E. Aileen , Glimelius Bengt , Storm Hans , Pukkala Eero , van Leeuwen Flora E. , Holowaty Eric J. , Andersson Michael , Wiklund Tom , Joensuu Timo , van’t Veer Mars B. , Stovall Marilyn , Gospodarowicz Mary , Travis Lois B. 
Published: October 2002

PURPOSE: To quantify the relative and absolute excess risks (AER) of site-specific second cancers, in particular solid tumors, among long-term survivors of Hodgkin’s disease (HD) and to assess risks according to age at HD diagnosis, attained age, and time since initial treatment.PATIENTS AND METHODS: Data from 32,591 HD patients (1,111 25-year survivors) reported to 16 population-based cancer registries in North America and Europe (1935 to 1994) were analyzed.RESULTS: Two thousand one hundred fifty-three second cancers (observed-to-expected ratio [O/E] = 2.3; 95% confidence interval [CI] = 2.2 to 2.4), including 1,726 solid tumors (O/E = 2.0; 95% CI, 1.9 to 2.0) were reported. Cancers of the lung (observed [Obs] = 377; O/E = 2.9), digestive tract (Obs = 376; O/E = 1.7), and female breast (Obs = 234; O/E = 2.0) accounted for the largest number of subsequent malignancies. Twenty-five years after HD diagnosis, the actuarial risk of developing a solid tumor was 21.9%. The relative risk of solid neoplasms decreased with increasing age at HD diagnosis, however, patients aged 51 to 60 years at HD diagnosis sustained the highest cancer burden (AER = 79.2/10,000 patients/year). After a progressive rise in relative risk and AER of all solid tumors over time, there was an apparent downturn in risk at 25 years. Temporal trends and treatment group distribution for cancers of the esophagus, stomach, rectum, female breast, bladder, thyroid, and bone/connective tissue were suggestive of a radiogenic effect.CONCLUSION: Significantly increased risks of second cancers were observed in all HD age groups. Although significantly elevated risks of stomach, female breast, and uterine cervix cancers persisted for 25 years, an apparent decrease in relative risk and AER of solid tumors at other sites is suggested.
International Validation of a Preoperative Nomogram for Prostate Cancer Recurrence After Radical Prostatectomy
Authors: Graefen Markus , Karakiewicz Pierre I. , Cagiannos Ilias , Quinn David I. , Henshall Susan M. , Grygiel John J. , Sutherland Robert L. , Stricker Phillip D. , Klein Eric , Kupelian Patrick , Skinner Donald G. , Lieskovsky Gary , Bochner Bernard , Huland Hartwig , Hammerer Peter G. , Haese Alexander , Erbersdobler Andreas , Eastham James A. , de Kernion Jean , Cangiano Thomas , Schröder Fritz H. , Wildhagen Mark F. , van der Kwast Theo H. , Scardino Peter T. , Kattan Michael W. 
Published: October 2002

PURPOSE: We evaluated the predictive accuracy of a recently published preoperative nomogram for prostate cancer that predicts 5-year freedom from recurrence. We applied this nomogram to patients from seven different institutions spanning three continents. METHODS: Clinical data of 6,754 patients were supplied for validation, and 6,232 complete records were used. Nomogram-predicted probabilities of 60-month freedom from recurrence were compared with actual follow-up in two ways. First, areas under the receiver operating characteristic curves (AUCs) were determined for the entire data set according to several variables, including the institution where treatment was delivered. Second, nomogram classification–based risk quadrants were compared with actual Kaplan-Meier plots. RESULTS: The AUC for all institutions combined was 0.75, with individual institution AUCs ranging from 0.67 to 0.83. Nomogram predictions for each risk quadrant were similar to actual freedom from recurrence rates: predicted probabilities of 87% (low-risk group), 64% (intermediate-low–risk group), 39% (intermediate-high–risk group), and 14% (high-risk group) corresponded to actual rates of 86%, 64%, 42%, and 17%, respectively. The use of neoadjuvant therapy, variation in the prostate-specific antigen recurrence definitions between institutions, and minor differences in the way the Gleason grade was reported did not substantially affect the predictive accuracy of the nomogram. CONCLUSION: The nomogram is accurate when applied at international treatment institutions with similar patient selection and management strategies. Despite the potential for heterogeneity in patient selection and management, most predictions demonstrated high concordance with actual observations. Our results demonstrate that accurate predictions may be expected across different patient populations.
Do Biocides Select for Antibiotic Resistance?
Authors: Russell A D 
Published: October 2002

Abstract
Some similarities exist between bacterial resistance to antibiotics and to biocides, and gram-negative bacteria that have developed resistance to cationic biocides may also be insusceptible to some antibiotics. Outer membrane changes are believed to be responsible for this non-specific increase in resistance. Efflux, another important resistance mechanism, is associated with the qacA/B gene system in staphylococci that confers low-level resistance to cationic agents including chlorhexidine salts and quaternary ammonium compounds. It has been proposed that the introduction into clinical practice of Chlorhexidine and quaternary ammonium compounds has resulted in the selection of staphylococci containing qacA genes on multiresistance plasmids. A linkage between low-level resistance to triclosan and to antibiotics has recently been claimed to occur in Escherichia coli, with the bisphenol selecting for chromosomally-mediated antibiotic resistance. A key issue in many studies has been the use of biocides at concentrations significantly below those used clinically. It remains to be determined how an increase to low-level resistance to cationic biocides can be held responsible for the selection of antibiotic-resistant bacteria.
Extract of Juglandaceae regia Inhibits Growth, In-vitro Adherence, Acid Production and Aggregation of Streptococcus mutans
Authors: Jagtap A G , Karkera S G 
Published: October 2002

Abstract
Aqueous and alcoholic extracts from Juglandaceae regia, used as chewing sticks to maintain oral hygiene, were tested for their ability to inhibit the growth and some physiological functions of Streptococcus mutans.
Both the aqueous and the alcoholic extract strongly inhibited the growth, in-vitro adherence, acid production and glucan-induced aggregation of S. mutans. At a concentration of 8% w/v, the aqueous extract produced a 95% inhibition (P &lt; 0.05) of adherence of S. mutans to glass and a 40% inhibition (P &lt; 0.05) of adherence to tooth surface. The alcoholic extract at a concentration of 10% w/v produced a 95% inhibition (P &lt; 0.05) of adherence of S. mutans to glass and a 56% inhibition (P &lt; 0.05) of adherence to tooth surface. At concentrations of 2% w/v the aqueous and alcoholic extracts significantly inhibited (P &lt; 0.05) glucan-induced aggregation of S. mutans and the in-vitro salivary glycolytic reaction for up to 5 h. Bactericidal effects on S. mutans were also evident. At a concentration of 10% w/v, the zone of inhibition observed with the aqueous extract was 12 ± 0.01 mm and that observed with the alcoholic extract was 12.6 ± 0.02 mm. As the in-vitro studies had shown that both the aqueous and the alcoholic extract of J. regia, at concentrations of 10% w/v, could inhibit the growth as well as the acid-producing ability of S. mutans, they were tested at the same concentration for their activity in-vivo. Three subjects were employed. Parameters monitored were salivary bacterial count and salivary glycolysis. Mouth-rinsing with the aqueous but not the alcoholic extract significantly reduced total streptococcal counts in the salivary samples obtained up to, and including, 3 h after rinsing, compared with the counts obtained pre-rinsing or after placebo rinsing. Mouth-rinsing with the aqueous extract produced a 65%, 27% and 78% reduction (P &lt; 0.05) in the streptococcal count in the salivary samples obtained 10 min, 1 h and 3 h after rinsing, respectively. Both the aqueous and the alcoholic extract also inhibited the glycolytic reaction by the salivary bacteria for up to 90 min post-rinsing.
This study provides evidence to justify the use of J. regia sticks as an aid to maintain oral hygiene.
Stimulatory Effect of Procaine on the Growth of Several Microalgae and Cyanobacteria
Authors: Suzuki Takahiro , Ezure Toru , Yamaguchi Toyoshi , Domen Hirotaka , Ishida Masaru , Schmidt Walter 
Published: October 2002

AbstractProcaine has been used to stimulate plant growth and it has been noted that it also promotes growth of microorganisms. The effect of procaine hydrochloride concentration on the growth rates of several species of microalgae and cyanobacteria was studied under both photoautotropic and heterotrophic growth conditions. Procaine hydrochloride was added to cultures at concentrations over the range 0.01–1000 mg L−1.A stimulating effect of procaine hydrochloride on photoautotrophic growth was observed for the cyanobacteria Anabaena cylindrica and Anabaena variabilis, and for the salt-tolerant green algae Dunaliella primolecta and Dunaliella parva. During active growth in batch culture an increase in growth rate (compared with control culture without procaine hydrochloride) of about 25% was observed at 0.1 mg L−1 of procaine hydrochloride for A. cylindrica. However, procaine hydrochloride was toxic at concentrations of &gt; 10 mg L−1. Simultaneous administration of hydrolysis products of procaine, p-amino-benzoic acid and diethyl aminoethanol, in lieu of procaine hydrochloride, was as effective as procaine in stimulating growth of A. cylindrica. Heterotrophic growth of Chlorella ellipsoidea and Prototheca zopfii was not stimulated by procaine hydrochloride over the concentration range studied (0.1–10 mg L−1).The combined effects of procaine hydrochloride concentration and four other environmental factors (temperature, light intensity, CO2 concentration in the flushing gas and NaCl concentration) on growth rate of D. primolecta was modelled using both a neural network approach and a response surface method. These results indicate that procaine hydrochloride exerts different effects on the growth of microalgal and cyanobacterial cells as functions of dosage, species and culture conditions.
Brittle-Ductile Transitions in Sucrose and the Influence of Lateral Stresses During Compaction
Authors: Roberts R J , Rowe R C 
Published: October 2002

Abstract
Sucrose, in a range of particle sizes, has been compacted to investigate both the effect of brittle-ductile transition and the effect of lateral stresses on the deformation stress as measured using Heckel plots.
All particles with a diameter greater than 30 μm exhibited cracking in line with both theoretical predictions and literature data from hammer and ball milling. In addition, crack lengths in compressed particles examined microscopically were very similar to those predicted from the deformation stress, confirming the applicability of the model.