bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Cognitive Function Associated with Sleep Disordered Breathing in Older People
Authors: Cohen‐Zion Mairav , Stepnowsky Carl , Marler  , Shochat Tamar , Kripke Daniel F. , Ancoli‐Israel Sonia 
Published: February 2005

OBJECTIVES: Sleep disordered breathing (SDB) is very common in older people and is known to be associated with complaints of impaired daily functioning, including excessive daytime sleepiness and cognitive impairments. As part of a larger study on SDB and aging, it became possible to examine the relationship between SDB and cognition in older men and women.DESIGN: A population‐based longitudinal study.SETTING: In‐home interviews and home sleep recordings in the greater San Diego area.PARTICIPANTS: Community‐dwelling people age 65 and older with high risk for SDB were originally studied from 1981 through 1985 and then followed every 2 years. Data from the 46 subjects who completed Visit 3 and Visit 4 are presented.MEASUREMENTS: Subjects were interviewed in the home about their sleep and medical condition before each visit. Cognitive function was assessed using the Mini‐Mental State Examination (MMSE). Daytime sleepiness was based on self‐report. Objective sleep was recorded in the home and scored for sleep, apneas and hypopneas, and oximetry variables.RESULTS: Increases in respiratory disturbance index (RDI) (P = .036) and increases in daytime sleepiness (P = .002) were associated with decreases in cognitive performance (i.e., increases in cognitive impairment). Increases in RDI were also associated with increases in daytime sleepiness (P = .012). Change in MMSE scores was therefore regressed onto changes in RDI, daytime sleepiness, age, and education, resulting in decreases in MMSE scores being associated with increases in daytime sleepiness (P = .019) but not with changes in RDI (P = .515). There was no significant relationship between changes in oxygen saturation levels and changes in MMSE.CONCLUSIONS: The results of this study suggest that declining cognitive function is associated primarily with increases in daytime sleepiness. Although cognitive decline was also associated with increases in RDI, this association did not hold in the more inclusive model which also included variable of SDB, oximetry, sleep and subjective report. One theoretical model could suggest that any relationship between SDB and cognitive function may be mediated by the effect of SDB on daytime sleepiness. These results suggest that older patients suffering from mild to moderate SDB may benefit from the treatment of SDB, even if they are not markedly hypoxemic.
Total Body Mass, Fat Mass, Fat‐Free Mass, and Skeletal Muscle in Older People: Cross‐Sectional Differences in 60‐Year‐Old Persons
Authors: Kyle Ursula G. , Genton Laurence , Hans Didier , Karsegard Veronique L. , Michel Jean‐Pierre , Slosman Daniel O. , Pichard Claude 
Published: February 2005

OBJECTIVES: To evaluate body composition parameters, including fat‐free mass (FFM), appendicular skeletal muscle mass (ASMM), relative skeletal muscle mass (RSM) index, body cell mass (BCM), BCM index, total body potassium (TBK), fat mass, percentage fat mass (FM), and their differences between age groups and to evaluate the frequency of sarcopenia in healthy older subjectsDESIGN: Cross‐sectional, nonrandomized study.SETTING: Outpatient clinic.PARTICIPANTS: Ninety‐one healthy men and 100 healthy women age 60 and older.MEASUREMENTS: FFM, ASMM, FM, and percentage fat mass by whole‐body dual‐energy x‐ray absorptiometry; TBK, BCM, and TBK/FFM ratio by whole body potassium‐40 counter.RESULTS: All lean body mass parameters were significantly (P < .05) lower in subjects age 80 and older than in those age 70 to 79, except ASMM in women. Mean FFM was 4.2 kg (7.3%) lower in men age 80 and older than in those younger than 70 and 2.9 kg (6.8%) lower in women age 80 and older than in those younger than 70. The skeletal muscle mass, reflected by ASMM, decreased more than FFM. This suggests that nonskeletal muscle mass is proportionally preserved during aging. Forty‐five percent of men and 30% of women were sarcopenic by definition of BCM index and 11.0% of men and women by definition of RSM index.CONCLUSIONS: Significant age‐related differences exist in body composition of older men and women between age 60 and 95. The greater decrease in TBK and BCM than the decrease in FFM and skeletal muscle mass suggests changing composition of FFM with age. Lack of agreement between two independent sarcopenia indexes suggests that further refinement in the definition of a sarcopenia index is necessary.
Gait Variability in Community‐Dwelling Older Adults
Authors: Brach Jennifer S. , Berthold Robert , Craik Rebecca , VanSwearingen Jessie M. , Newman Anne B. 
Published: February 2005

OBJECTIVES: To describe gait variability at usual and fast walking speeds in community‐dwelling older adults and to describe the effects of increasing gait speed on gait variability.DESIGN: Cross‐sectional, descriptive study.SETTING: The Cardiovascular Health Study at the University of Pittsburgh.PARTICIPANTS: Ninety‐five community‐living older adults, 54 women and 41 men, age 65 and older (mean age ± standard deviation 79.4 ± 3.37).MEASUREMENTS: Gait measured at participant's usual and fast walking speed collected using an instrumented walkway. Step‐length and step‐width variability were determined using the coefficient of variation.CONCLUSIONS: Step‐length and step‐width variability have opposite associations with gait speed in older adults. Improvement in step‐length and step‐width variability with attempted acceleration might be a key factor to examine in future studies of disability risk and therapeutic interventions.
Zolpidem Use and Hip Fractures in Older People
Authors: Wang Philip S. , Bohn Rhonda L. , Glynn Robert J. , Mogun Helen , Avorn Jerry 
Published: February 2005

OBJECTIVES: The widespread use of sedative‐hypnotics in older populations makes it imperative to identify hazardous regimens that should be avoided and safer regimens that may be used preferentially by older people. Although benzodiazepines have been shown to increase fall and fracture risk, zolpidem, a nonbenzodiazepine hypnotic, has been advocated as a safer alternative.DESIGN: Case‐control study of hip fracture cases and controls in 1994.SETTING: All subjects were age 65 and older and enrolled in Medicare, and in Medicaid or the Pharmaceutical Assistance to the Aged and Disabled program of New Jersey.PARTICIPANTS: Cases (n = 1,222) were patients who underwent surgical repair of a hip fracture. They were frequency‐matched to four controls (n = 4,888) based on age and gender.MEASUREMENTS: Use of sedative‐hypnotics and other medications was assessed in the 180 days before the index event. We assessed other covariates, including demographic, clinical, and healthcare utilization variables in the prior 180 days.RESULTS: Zolpidem use was associated with a significant increased risk of hip fracture (adjusted odds ratio (AOR) 1.95; 95% confidence interval (CI) = 1.09–3.51). Other psychotropic medication classes with significantly increased risks included benzodiazepines (AOR 1.46; 95% CI = 1.21–1.76), antipsychotic medications (AOR 1.61; 95% CI = 1.29–2.01), and antidepressants (AOR 1.46; 95% CI = 1.22–1.75). In subanalyses, preferential use of zolpidem by subjects at greater risk of hip fracture did not appear to explain the apparent risk of hip fracture with zolpidem use.CONCLUSION: Use of zolpidem by older people was associated with nearly twice the risk of hip fracture, even after controlling for possible demographic and clinical confounders. Rather than being a safer alternative, zolpidem may be associated with risks that are as great as those seen with conventional benzodiazepines in older patients.
Aberrations in the mismatch repair genes and the clinical impact on oesophageal squamous carcinomas from a high incidence area in South Africa
Authors: Naidoo R , Ramburan A , Reddi A , Chetty R 
Published: February 2005

Aims:To investigate the incidence of genetic aberrations in the DNA repair genes in a cohort of oesophageal cancers.Methods:One hundred oesophagectomy samples of squamous cell carcinoma were studied. Normal and tumour DNA were isolated using a standard phenol/chloroform extraction procedure. Six recommended microsatellite loci with high informativity were analysed. The following markers were used: D2S123 (2p), D3S659 (3p), D3S1255 (3p), Bat 25 (4q), Bat 26 (2p), and Bat 40 (1p). The results were analysed using software attached to an automated DNA sequencer. The molecular data were then correlated with clinicopathological parameters.Results:The incidence of microsatellite instability and loss of heterozygosity was very low. There was no significant correlation between the clinicopathological and molecular data. However, D2S123 genetic abnormalities were seen more frequently in both moderately and well differentiated tumours than in poorly differentiated tumours (p  =  0.033). Follow up data were available for only 67 of the 100 patients. Fifty patients were alive and 17 patients had died.Conclusion:Low frequencies of genetic aberrations in these mismatch repair loci are found in squamous carcinomas of the oesophagus from a high incidence area in South Africa.
Are routine iron stains on bone marrow trephine biopsy specimens necessary?
Authors: Stuart-Smith S E , Hughes D A , Bain B J 
Published: February 2005

Aims:To determine the role of Perls’ staining in bone marrow trephine biopsy sections.Methods:The haemosiderin content of 155 Perls’ stained, formic acid decalcified trephine biopsy sections was assessed and compared with Perls’ stained aspirate samples in 105 cases and haematoxylin and eosin (H&E) stained biopsy sections in all cases.Results:An evaluable aspirate film with positive iron or at least seven negative particles was available for 105 biopsies. Only 71 of 95 cases with detectable aspirate iron had haemosiderin detectable on a Perls’ stained section. None of 10 samples with a negative aspirate had a positive trephine biopsy. Haemosiderin was positive in 101 of the 155 Perls’ stained sections, and was detectable on the H&E stained section in 71 of these cases. In five of 54 cases with negative Perls’ staining, a small amount of haemosiderin was thought to be present on H&E staining.Conclusions:Aspirate smears reflect bone marrow iron stores more reliably than formic acid decalcified trephine biopsy sections. The presence of iron in Perls’ stained aspirates in 44% of cases with negative Perls’ stained sections indicates that iron is often lost from sections during decalcification. However, 61% of cases with unassessable aspirate samples had a positive trephine biopsy Perls’ stain, contributing useful clinical information about iron status. Preparation of Perls’ stained sections only in cases in which aspirate samples are inadequate for iron assessment and no obvious haemosiderin is present in an H&E stained section could produce savings in staff time and reagent costs.
An immunohistochemical analysis to evaluate an inverse correlation between Runx2/Cbfa1 and NFκB in human osteosarcoma
Authors: Andela V B , Siddiqui F , Groman A , Rosier R N 
Published: February 2005

Background:Dominant negative inhibition of nuclear factor κB (NFκB) signalling activity in a human osteosarcoma cell line (Saos2) results in malignant reversion and the induction of the osteoblast differentiating transcription factor, Runx2/Cbfa1. This observation suggests that there is an inverse relation between a transcription factor associated with malignant progression and chemoresistance (NFκB) and an osteoblast differentiating transcription factor (Runx2/Cbfa1).Aims:To assess and correlate Runx2/Cbfa1 and NFκB (p65) immunoreactivity in human osteosarcoma.Methods:Runx2/Cbfa1 and NFκB (p65) immunoreactivity was assessed on 11 paraffin wax embedded archival specimens of human primary osteosarcoma by standard immunohistochemical methods and scored on a scale of 0–3. A Pearson correlation analysis between Runx2/Cbfa1 and NFκB (p65) scores was established.Results:Runx2/Cbfa1 was expressed constitutively in all pathology specimens of human osteosarcoma. Of note, a chondroblastic osteosarcoma showed the highest Runx2/Cbfa1 immunoreactivity. A Pearson correlation did not support an inverse correlation between Runx2/Cbfa1 and NFκB (p65) scores (r =  0.57) in human osteosarcoma.Conclusion:Runx2/Cbfa1 immunoreactivity does not inversely correlate with NFκB immunoreactivity, and thus cannot serve as an indirect measure of NFκB activity or an independent predictive or prognostic indicator.
The role of CA125 in clinical practice
Authors: Moss E L , Hollingworth J , Reynolds T M 
Published: February 2005

Background:CA125 is a high molecular weight glycoprotein, which is expressed by a large proportion of epithelial ovarian cancers. The sensitivity and specificity of CA125 are poor and there are no guidelines produced by the Royal College of Pathologists or the Association of Clinical Biochemists to aid clinicians and laboratories in its most appropriate use.Aim:To identify the patient population having a CA125 measurement and to determine its contribution to individual patient management.Methods:A retrospective case note audit looking at patients who had a CA125 measurement performed between April 2000 and April 2002.Results:The study comprised 799 patients; 751 (94%) were female and 48 (6%) male; 221 (29%) females and 22 (46%) males had an abnormal result. CA125 was mainly used to investigate a wide range of signs and symptoms, and few tests were for follow up or screening of ovarian cancer. In female patients having a CA125 for suspicion of malignancy/ovarian cancer, only 39 (20%) of the abnormal results were caused by ovarian cancer. False positive results were largely caused by another malignancy (48 cases; 26%), benign ovarian disease (26 cases; 14%), and benign gynaecological conditions, particularly leiomyomas (18 cases; 9%). The specificity of CA125 for ovarian cancer increased with concentrations >1000 kU/litre.Conclusions:These results confirm the high false positive rate and poor sensitivity and specificity associated with CA125. The substantial inappropriate usage of CA125 has led to results that are useless to the clinician, have cost implications, and add to patient anxiety and clinical uncertainty.
Ultrarapid Ki-67 immunostaining in frozen section interpretation of gliomas
Authors: Haapasalo J , Mennander A , Helen P , Haapasalo H , Isola J 
Published: February 2005

Background:Astrocytic tumours, the most common gliomas, are often classified intraoperatively using standard morphological staining. The final diagnosis and grading of gliomas on paraffin wax sections is often assisted by Ki-67 immunohistochemistry, but standard immunostaining protocols take too long to be used intraoperatively.Aims:To investigate a new rapid Ki-67 immunohistochemical test for its use in an intraoperative setting.Methods:The new Ki-67 immunostaining (Ultrarapid-Ki67®) method on frozen sections can be carried out in 10 minutes. Thirty four pilocytic and diffuse astrocytomas were immunostained by rapid Ki-67 and results were compared with corresponding MIB-1 staining, histological grading, and prognosis.Results:The staining protocol was practical to perform and the results were morphologically and quantitatively indistinguishable from those after immunostaining with MIB-1, an antibody recognising Ki-67 in paraffin wax embedded tissue. A comparison of Ultrarapid-Ki67 and MIB-1 immunostaining of paraffin wax sections showed almost identical quantitative correlation in astrocytic gliomas (r = 0.916; p<0.001). The Ultrarapid-Ki67 indices (percentage of positive cells) of low grade (I/II) astrocytomas ranged from 0% to 6.1%, whereas those of representative high grade (III/IV) tumours were significantly higher (range, 5.6–45%; p<0.001). The best prognostic cutoff point for Ultrarapid-Ki67 was 7.5%, which divided diffuse grade II–IV astrocytomas into significantly differing subsets (p = 0.0008).Conclusion:Ultrarapid-Ki67 immunostaining is a useful adjunct to morphological diagnosis and grading of astrocytic tumours, and as a fast test (∼10 minutes for staining plus three to four minutes for scoring), it could be used in routine intraoperative diagnosis of gliomas and other neoplastic diseases.
The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey
Authors: Dennis T , Start R D , Cross S S 
Published: February 2005

Aims:To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology.Methods:A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK.Results:There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings.Conclusions:There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.
CagA in Barrett’s oesophagus in Colombia, a country with a high prevalence of gastric cancer
Authors: Kudo M , Gutierrez O , El-Zimaity H M T , Cardona H , Nurgalieva Z Z , Wu J , Graham D Y 
Published: February 2005

Background:In the USA, atrophic gastritis and gastric cancer are rare, whereas gastro-oesophageal reflux disease (GERD) is common. Infection withHelicobacter pylori, especially a CagA positive strain, is unusual in patients with GERD/Barrett’s oesophagus in the USA.Aim:To examine the relation between Barrett’s oesophagus and CagA positiveH pyloriin Colombia, a country with a high prevalence of CagA positiveH pyloriassociated atrophic gastritis and gastric cancer.Methods:Helicobacter pyloriand CagA status was determined among Colombian patients with long segment Barrett’s oesophagus and a control group with simpleH pylorigastritis.Helicobacter pyloristatus was determined using a triple stain and CagA status was determined by immunohistochemistry using a specific rabbit anti-CagA serum.Results:Gastric and oesophageal mucosal biopsies were obtained from 51 patients—39 men (mean age, 57.8 years; SD, 13.1) and 12 women (mean age, 51.8 years; SD, 14.4)—with documented long segment Barrett’s oesophagus. The results were compared with 24 Colombian patients withH pylorigastritis without oesophageal disease. Thirty two patients with Barrett’s oesophagus had activeH pyloriinfection. CagA status was evaluated in a subset of 23H pyloriinfected patients with Barrett’s oesophagus, and was positive in eight of these patients compared with 19 of 24 controls (p  =  0.01).Conclusions:Although most Colombian patients with Barrett’s oesophagus hadH pyloriinfection, CagA positive infections were unusual. These data illustrate how consistent corpus inflammation reduces acid secretion, which prevents Barrett’s oesophagus among those with abnormal gastro-oesophageal reflux barriers.
Clostridium bacteraemia characterised by 16S ribosomal RNA gene sequencing
Authors: Woo P C Y , Lau S K P , Chan K-m , Fung A M Y , Tang B S F , Yuen K-y 
Published: February 2005

Background:Owing to problems in accurate species identification of the diverse genus clostridium, the epidemiology and pathogenicity of many species are not fully understood. Moreover, previous studies on clostridium bacteraemia have been limited and relied only on phenotypic species identification.Aims:To characterise the epidemiology, disease spectrum, and outcome of clostridium bacteraemia using 16S ribosomal RNA (rRNA) gene sequencing.Method:During a four year period (1998–2001), all cases of clostridium bacteraemia were prospectively studied and all “non-perfringens” clostridium isolates identified to the species level by 16S rRNA gene sequencing.Results:Fifty one blood culture isolates were identified asClostridium perfringensand 17 belonged to 11 other clostridium species. The first case ofC disporicuminfection and two cases of clostridium bacteraemia in children with intussusception were also described. Of the 68 clostridium isolates from 68 different patients, 38 were associated with clinically relevant bacteraemia. The gastrointestinal and hepatobiliary tracts were common sites of both underlying disease and portal of entry in these patients.Clostridium perfringensaccounted for 79% of all clinically relevant bacteraemia, with the remainder caused by a diversity of species. The attributable mortality rate of clinically relevant clostridium bacteraemia was 29%. Younger age and underlying gastrointestinal/hepatobiliary tract disease were associated with mortality (p < 0.05).Conclusions:Patients with clinically relevant clostridium bacteraemia should be investigated for the presence of underlying disease processes in the gastrointestinal or hepatobiliary tracts. 16S rRNA gene analysis will continue to be useful in further understanding the pathogenicity of various clostridium species.
VIRTUAL BLACK HOLES AND THE S-MATRIX
Authors: GRUMILLER D. 
Published: February 2005

A brief review on virtual black holes is presented, with special emphasis on phenomenologically relevant issues like their influence on scattering or on the specific heat of (real) black holes. Regarding theoretical topics, the results important for (the avoidance of) information loss are summarized.After recalling Hawking's Euclidean notion of virtual black holes and a Minkowskian notion which emerged in studies of 2D models, the importance of virtual black holes for scattering experiments is addressed. Among the key features is that virtual black holes tend to regularize divergences of quantum field theory and that a unitary S-matrix may be constructed. Also, the thermodynamical behavior of real evaporating black holes may be ameliorated by interactions with virtual black holes. Open experimental and theoretical challenges are mentioned briefly.
Screening and treatment for prostate cancer: The evidence and implications for practice
Authors: Steggall Martin J. , Lee Angela 
Published: February 2005

Prostate cancer is the second most diagnosed cancer in men, but there is considerable debate over whether or not to screen for the condition. The issues in the debate surrounding screening are clarified in this paper. One of the recommendations of the guidelines for urology from the National Institute for Clinical Excellence (NICE, 2002) is that patients receive balanced information about management options for their condition. The NICE guidelines also suggest that ‘major improvements' are required in information and support services for patients and carers, and that nurse specialists in the urology cancer team will play a key role in these services. The options for management and treatment are discussed in the light of these recommendations and the relative merits of each are considered.