title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Role of DNA double-strand break repair genes in cell proliferation under low dose-rate irradiation conditions. | Radiation-induced DNA double-stand breaks (DSBs) lead to numerous biological effects. To elucidate the molecular mechanisms involved in cellular responses to low dose and low dose-rate radiation, it is informative to clarify the roles of DSB repair related genes. In higher vertebrate cells, there are at least two major DSB repair pathways, namely non-homologous end-joining (NHEJ) and homologous recombination (HR). Here, it is shown that in chicken DT40 cells irradiated with gamma-rays at a low dose-rate (2.4 cGy/day), the growth delay in NHEJ-related KU70- and PRKDC (encoding DNA-PKcs)-defective cells were remarkably higher than in cells defective for the HR-related RAD51B and RAD54 genes. DNA-PKcs- defective human M059J cells also showed an obvious growth delay when compared to control M059K cells. RAD54(-/-)KU70(-/-) cells demonstrated their highest degree of growth delay after an X-irradiation with a high dose-rate of 0.9 Gy/min. However they showed a lower degree of growth delay than that seen in KU70(-/-) and PRKDC(-/-/-) cells exposed to low dose-rate irradiation. These findings indicate that cellular responses to low dose-rate radiation are remarkably different from those to high dose-rate radiation. The fact that both DT40 and mammalian NHEJ-defective cells were highly sensitive to low dose-rate radiation, provide a foundation for the concept that NHEJ-related factors may be useful as molecular markers to predict the sensitivity of humans to low dose-rate radiation. | 18,797,158 |
Cows milk-dependent exercise-induced anaphylaxis under the condition of a premenstrual or ovulatory phase following skin sensitization. | A 24 year-old woman with atopic dermatitis occasionally developed symptoms, including dyspnea and generalized urticaria, following ingestion of food containing cows milk. Similar episodes had continued, and had been treated empirically since the age of 16 years. Although a skin test and IgE RAST showed positive reactions to cows milk, a provocation test with cows milk alone did not induce any symptoms. Therefore, food-dependent exercise-induced anaphylaxis (FDEIA) was suspected, but examination using various combinations of cows milk, aspirin and exercise failed to elicit any symptoms. Finally, a provocation test during the ovulatory phase with cows milk followed by aspirin and exercise evoked systemic urticaria, dyspnea and hypotension. The symptoms against cows milk began when she took baths with bath salts containing cows milk as its main ingredient for one year at the age 15 years. Sensitization to cows milk through eczematous skin is indicated from this history. Hormonal change during a premenstrual or ovulatory phase is also an important factor for the development of FDEIA in this case. | 18,797,181 |
Correlation between the prostaglandin D(2)/E(2) ratio in nasal polyps and the recalcitrant pathophysiology of chronic rhinosinusitis associated with bronchial asthma. | The prevalence of patients with chronic rhinosinusitis (CRS) refractory to traditional therapy appears to be on the increase. In these cases, CRS tends to be associated with bronchial asthma (BA), especially, aspirin-intolerant asthma (AIA). On the other hand, arachidonic acid metabolites have been extensively investigated in the pathogenesis of BA. We sought to assess the role of prostaglandin D(2) (PGD(2)) and prostaglandin E(2) (PGE(2)) in the recalcitrant pathophysiology of CRS. Samples were prepared from the nasal polyps and mucosa of 40 patients undergoing endoscopic sinus surgery (ESS) at our hospital. The nasal polyp specimens obtained from the patients with CRS were divided into three groups, as follows: the CRS-AIA group, consisting of specimens obtained from patients with CRS complicated by AIA, the CRS-ATA group, consisting of specimens obtained from patients with CRS associated with aspirin-tolerant asthma (ATA), and the CRS-NA group, consisting of specimens obtained from CRS patients without BA. PGD(2) and PGE(2) were extracted from the specimens and quantified. The concentrations of PGD(2) were significantly higher in the nasal polyps of the CRS-ATA group. The concentrations of PGE(2) were lowest in the nasal polyps of the CRS-AIA group. The PGD(2)/PGE(2) ratio was highest in the CRS-AIA group. It has previously been reported that CRS complicated by AIA is most likely to be characterized by repeated remissions and relapses, and is thus the most intractable. We may therefore say that the PGD(2)/PGE(2) ratio reflects the intractable nature of CRS. | 18,797,183 |
Risk factors for death in children and adolescents with cancer and sepsis/septic shock. | To assess risk factors for mortality in children and adolescents with cancer and sepsis/septic shock, admitted to intensive care unit. Retrospective study of a cohort of cancer and sepsis/septic shock patients (n=155) admitted to Oncological Pediatric Intensive Care Unit, between October 1998 and October 2001, with assessment of 12 potential risk factors for mortality by univariate analysis, followed by multivariable analysis. Forty-seven out of 155 patients died (30.3%). In the present sample, after multivariable analysis, 3/12 variables proved to be statistically significant: respiratory infection [hazard ratio (HR)=2.3 and 95% confidence interval (CI)=1.3-4.2], duration of granulocytopenia (HR=2.4 and 95% CI=1.2-4.9), and number of organ dysfunction (HR=7.4 and 95% CI=2.6-21.3). Our data suggest that mortality in Oncological Pediatric Intensive Care Unit is high and the main factors involved in prognosis are number of dysfunctional organs, respiratory infections, and duration of granulocytopenia; the mortality rises 7.4 times for each dysfunctional organ. We believe that prospective and multicenter studies are necessary to better characterize risk factors that are specific for cancer patients to produce a particular score to predict severity of complications and mortality of children with cancer. | 18,797,197 |
Metastatic hepatic epithelioid hemangioendothelioma in a teenage girl. | Hepatic epithelioid hemangioendothelioma (HEHE) is a rare malignant tumor characterized by its epithelioid structure and vascular endothelium origin. The clinical course of HEHE is variable, ranging from long-term survival without treatment to a rapidly progressive course with a fatal outcome. As a consequence, no standard treatment has been determined. We present a case of HEHE occurring in a 13-year-old girl, in which a novel treatment approach using antiangiogenic therapy was tried and was successful in slowing the progression of the disease. | 18,797,205 |
Asymmetrical visual-spatial attention in college students diagnosed with ADD/ADHD. | Research indicates that individuals with attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) may exhibit left-right asymmetric spatial attention, with deficient processing of stimuli in the left visual hemispace. However, there is controversy as to when this phenomenon can be observed. People with ADD/ADHD do not have obvious spatial bias when performing everyday tasks. Visual cancellation tasks have demonstrated behavioral asymmetry in ADD/ADHD, but results have not been consistent across studies. Children and older adults with ADD or ADHD have been assessed, but previous studies of college students with ADD/ADHD are not available. We tested 24 students with ADD or ADHD and 24 control students on a verbal and nonverbal cancellation task. The ADD/ADHD group made significantly more left-sided omission errors than controls on a letter cancellation task. This group difference was not observed for a shape cancellation task, however. These results support possible left visual inattention in college students with ADD/ADHD. Studies of functional correlates of these attentional phenomena are needed. | 18,797,260 |
Human papillomavirus vaccine and adolescents. | The present review describes recent advances in our understanding about the epidemiology of human papillomavirus infection among female adolescents and describes several adolescent-specific issues related to administering human papillomavirus vaccines. National estimates demonstrate that human papillomavirus infection is most prevalent among adolescents and young adults. Parents, patients, and providers have a high interest in vaccination against this virus, but current patterns of adolescent healthcare utilization suggest that changes in adolescent preventive care delivery may be needed to provide these vaccines in a timely manner. Debate over whether adolescents should be legally allowed to self-consent to vaccination is another issue that remains unresolved and could have a substantial impact on vaccination rates. Legislation on school entry requirements related to human papillomavirus vaccination has been introduced in many states as a mechanism to circumvent some of these concerns, but the details of this legislation and its effect on adolescent vaccine utilization remain to be determined. Female adolescents are at a high risk for human papillomavirus infection and are likely to derive significant benefits from vaccination against this virus. However, administering human papillomavirus vaccines to this age group will require providers to be familiar with several issues unique to the adolescent population. | 18,797,267 |
Intrauterine devices and adolescents. | The purpose of this review is to inform the reader of new information published on intrauterine devices (IUDs) and adolescents. There are few studies on the use of IUDs in adolescents. The article reviews topics related to IUD use such as adolescents' knowledge of and attitudes toward IUDs, mechanism of action of copper-releasing and levonorgestrel-releasing IUDs, benefits of using IUDs with adolescents, safety, side effects, as well as noncontraceptive benefits such as management of menstrual disorders and endometriosis using IUDs. IUDs are a safe and effective long-term contraceptive method with no increase in risk of pelvic inflammatory disease, tubal infertility or ectopic pregnancies. IUDs are underutilized in the United States, especially by adolescents. Because adolescents contribute disproportionately to the epidemic of unintended pregnancy, IUDs should be considered as a first-line contraceptive choice regardless of parity. The levonorgestrel-releasing intrauterine system (LNG IUS) is a particularly good choice for adolescents because of associated noncontraceptive benefits such as decreased menstrual bleeding, dysmenorrhea and pain associated with endometriosis. There is a clear need for further studies in the use of the IUD among adolescents. | 18,797,269 |
The use of grafts for anterior vaginal prolapse repair: pros and cons. | To review the advantages and disadvantages of ungrafted and grafted methods of anterior vaginal prolapse repair. Successful correction of anterior vaginal prolapse remains one of the most challenging aspects of pelvic reconstructive surgery. Anterior colporrhaphy is associated with an unacceptably high recurrence rate. Paravaginal repairs are technically more difficult to perform and may be associated with more complications. The low success rate has consequently led to more frequent use of grafts in anterior vaginal prolapse repair. Although retrospective case series of graft-reinforced anterior vaginal prolapse repair shows promising short-term success rates, mesh-related complications are of concern. The goal of pelvic surgery should be restoration of anatomic support without deleterious effects on visceral and sexual function. Limited data are available on quality of life and sexual function following both traditional and graft-reinforced anterior vaginal prolapse surgery. Although mesh-reinforced repair is associated with lower short-term anatomic recurrence, the long-term durability and safety of mesh-reinforced repair is unknown. Further research is required to determine whether surgical technique and type of graft used impact surgical outcome and complications. | 18,797,276 |
Migraine-associated vestibulopathy. | In the past few years, otologists have been seeing an increasing number of patients with vestibular disorders due to migraine-associated vestibulopathy. This article reviews some of the latest developments in the understanding of this disease process, specifically its incidence, symptoms, diagnosis, and treatment. Migraine-associated vestibular symptoms may include episodic true vertigo, movement-provoked dysequilibrium, imbalance/unsteadiness, and complaints of lightheadedness. The pathophysiology of migraine-associated vestibulopathy is not completely understood; however, both peripheral and central deficits have been observed. Although the International Headache Society classification does not include migraine-associated vestibulopathy as a subclassification of migraine, there is emerging evidence to support this development, which should then lead toward improved diagnosis and treatment. Currently, migraine-associated vestibulopathy is still considered a diagnosis of exclusion. Treatment of migraine-associated vestibulopathy is effective and includes lifestyle changes, such as reducing triggers that increase susceptibility to migraines (e.g. stress, poor diet, nicotine, or irregular sleep patterns), prophylactic and abortive medications, vestibular therapy, or a combination of these. Further research is needed to better understand migraine-associated vestibulopathy and improve treatment. | 18,797,281 |
Gap junctions and connexins in the inner ear: their roles in homeostasis and deafness. | Mutations in GJB2 and GJB6, the genes encoding the gap-junction proteins connexin 26 and connexin 30, are the most common cause of autosomal recessive nonsyndromic deafness in many populations across the world. In this review, we discuss current ideas about the roles of gap junctions in the inner ear and the implications of connexin mutations on auditory function. In recent years, a complex picture of the roles of gap junctions in cochlear physiology emerged. Rather than being mere conduits for the circulation of potassium ions in the inner ear, gap junctions have been implicated in intercellular signaling among nonsensory cells and may be involved in the maintenance of the endothelial barrier in the stria vascularis. Studies of mutant channels and mouse models for connexin-related deafness have provided valuable insights into some of the mechanisms by which connexin dysfunction causes cochlear degeneration. They have also identified potential therapeutic interventions for specific connexin mutations, such as the restoration of normal connexin 26 protein levels in GJB6-associated deafness. Despite recent advances, a better understanding of the complexity of gap-junctional communication in the inner ear and the structure-function relationships of connexin proteins is required for the development of mechanism-based treatments of connexin-associated hearing loss. | 18,797,288 |
Neuroanatomy of verbal working memory as a diagnostic biomarker for depression. | The functional neuroanatomy of verbal working memory is a potential diagnostic biomarker for depression. Twenty patients with unipolar depression and 20 healthy controls performed a variable load version (n-back) of the task. Functional MRI data were analysed with support vector machine methods. Diagnostic classification was highest at the mid-level of task difficulty (2-back) (sensitivity 65%, specificity 70%, P<0.009). Significant classification of clinical response (>or=50% reduction in clinical symptom ratings) was found at the most difficult level (3-back) (sensitivity 85%, specificity 52%, P<0.003). The functional neuroanatomy of verbal working memory provides a statistically significant but clinically moderate contribution as a diagnostic biomarker for depression, whereas its potential as a neural predictor of clinical response requires further investigation. | 18,797,307 |
Cerebellar deficits in schizophrenia are associated with executive dysfunction. | Cerebellar abnormalities have been documented in schizophrenia in postmortem, functional and volumetric neuroimaging studies. This study aims to establish the relationship between structural changes in the cerebellum and executive dysfunction in patients with schizophrenia using voxel-based morphometry. We compared 28 outpatients with 28 healthy controls. A widely used executive battery and the voxel-based morphometry approach were used to investigate possible structural cerebellum changes on magnetic resonance imaging. Working memory dysfunctions in schizophrenia correlated with grey matter in both cerebellar hemispheres and vermis. Mental flexibility dysfunctions also correlated with reductions in white matter volume in bilateral cerebellum. This evidence supports the contribution of cerebellar grey and white matter deficits to executive dysfunctions observed in schizophrenia. | 18,797,308 |
Projections of olfactory bulbs to the olfactory and vomeronasal cortices. | Projections from the olfactory bulbs have been traditionally described as 'nontopographically organized'. Olfactory and vomeronasal projections have been reported to reach nonoverlapping cortical areas. Four receptor expression zones have been described in the olfactory epithelium, maintained in the main olfactory bulb, but none in the olfactory cortex. Recent data have demonstrated convergence in the basal telencephalon of olfactory and vomeronasal projections. Injections of methanesulfonate hydroxystilbamidine (FluoroGold) in the chemosensory cortex were done to map retrograde labeling in the bulbs. Topography was not observed in the four zones of the main olfactory bulb. Areas of the rostral telencephalon were shown to receive simultaneous inputs from the main and accessory olfactory bulbs. | 18,797,313 |
Morphology parameters for intracranial aneurysm rupture risk assessment. | The aim of this study is to identify image-based morphological parameters that correlate with human intracranial aneurysm (IA) rupture. For 45 patients with terminal or sidewall saccular IAs (25 unruptured, 20 ruptured), three-dimensional geometries were evaluated for a range of morphological parameters. In addition to five previously studied parameters (aspect ratio, aneurysm size, ellipticity index, nonsphericity index, and undulation index), we defined three novel parameters incorporating the parent vessel geometry (vessel angle, aneurysm [inclination] angle, and [aneurysm-to-vessel] size ratio) and explored their correlation with aneurysm rupture. Parameters were analyzed with a two-tailed independent Student's t test for significance; significant parameters (P < 0.05) were further examined by multivariate logistic regression analysis. Additionally, receiver operating characteristic analyses were performed on each parameter. Statistically significant differences were found between mean values in ruptured and unruptured groups for size ratio, undulation index, nonsphericity index, ellipticity index, aneurysm angle, and aspect ratio. Logistic regression analysis further revealed that size ratio (odds ratio, 1.41; 95% confidence interval, 1.03-1.92) and undulation index (odds ratio, 1.51; 95% confidence interval, 1.08-2.11) had the strongest independent correlation with ruptured IA. From the receiver operating characteristic analysis, size ratio and aneurysm angle had the highest area under the curve values of 0.83 and 0.85, respectively. Size ratio and aneurysm angle are promising new morphological metrics for IA rupture risk assessment. Because these parameters account for vessel geometry, they may bridge the gap between morphological studies and more qualitative location-based studies. | 18,797,347 |
Outcomes after repeat transsphenoidal surgery for recurrent Cushing's disease. | To systematically analyze patient outcomes after repeat transsphenoidal (TS) surgery for recurrent Cushing's disease. We retrospectively reviewed records of all patients with recurrent Cushing's disease who underwent repeat TS surgery for resection of a pituitary corticotroph adenoma at the University of Virginia Medical Center from 1992 to 2006. Remission at follow-up was defined as a normal postoperative 24-hour urine free cortisol, or continued need for glucocorticoid replacement after repeat TS surgery. Recurrence of the disease was defined as an elevated 24-hour urine free cortisol with clinical symptoms consistent with Cushing's disease while not receiving glucocorticoid replacement. Multivariate logistic regression was performed to evaluate the effect of potential predictors on remission. Recurrence rates, subsequent treatments, and the final endocrine status of the patients are presented. We identified 36 patients who underwent repeat TS surgery for recurrent Cushing's disease. The mean age of the patients was 40.3 years (range, 17.1-63.0 yr), and 26 were women. The median time to recurrence after initial successful TS surgery was 36 months (range, 4 mo-16 yr). Remission after repeat TS surgery was observed in 22 (61%) of the 36 patients. During the same time period, of the 338 patients who underwent first-time TS surgery for Cushing's disease, remission was achieved in 289 (85.5%). The odds of failure (to achieve remission) for patients with repeat TS surgery for recurrent Cushing's disease were 3.7 times that of patients undergoing first-time TS surgery (odds ratio, 3.7; 95% confidence interval, 1.8-7.8). Two of the 22 patients with successful repeat TS surgery had a second recurrence at 6 and 11 months, respectively. Complete biochemical and clinical remission after stereotactic radiosurgery, adrenalectomy, and ongoing ketoconazole therapy was achieved in 30 (83.3%) of the 36 patients, and active disease continued in 6 patients (16.7%). Although the success of repeat TS surgery for recurrence of Cushing's disease is less than that of initial surgery, a second procedure offers a reasonable possibility of immediate remission. If the operation is not successful, other treatments, including pituitary radiation, medical therapy, and even bilateral adrenalectomy, are required. | 18,797,356 |
Ecstasy (3,4-methylenedioxymethamphetamine)-induced inappropriate antidiuretic hormone secretion. | 3,4-Methylenedioxymethamphetamine (MDMA), popularly known as the illicit drug "Ecstasy," is an amphetamine derivative that has become widely abused throughout the United States and other industrialized nations. 3,4-Methylenedioxymethamphetamine has an undeserved reputation as a "safe" drug among its users, but MDMA shares the toxicity profile of other amphetamines. Its use may result in lethal cardiovascular, hepatic, metabolic, or neurological toxicity. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a unique toxicity that may occur after isolated MDMA use. Although the phenomenon is well described in adults, reports of MDMA-induced SIADH and symptomatic hyponatremia in children are rare. We describe a 13-year-old girl who experienced MDMA-induced SIADH with symptomatic hyponatremia. Toxicity of MDMA, in particular, the pathophysiology and treatment of MDMA-induced hyponatremia, is discussed. | 18,797,371 |
Faster than a speeding bullet: changes in medicare rules for the hospital case manager. | Compliance with the various Centers for Medicare & Medicaid Services rules and regulations is rapidly becoming a challenge in hospitals as the frequency and complexity of the new mandates have increased. Although compliance officers may oversee major elements emanating from the regulatory agencies, practical application during routine work activities requires current information and peer-to-peer reinforcement. This article addresses some of the more recent changes-or proposed changes-that may impact hospital case management practice and the case managers' role as patient advocate. The settings include acute care hospitals, short-stay hospitals, long-term acute care hospitals, and critical access hospitals. The more information hospital case managers have about the regulatory changes that affect the hospital, its patients, physicians, and associates, the better they can serve as sources of information, resources, and advocates. Direct interactions between the case manager and the physician are the best opportunities to share information. Influencing medical documentation at the point of service will be dependent upon the case managers' ability to link documentation improvements with benefits for the physician. Hospital-Issued Notice of Noncoverage letters are tools that warrant the case managers' attention to protect the patient and the hospital against financial risk. | 18,797,384 |
Fibrogenic polymorphisms (TGF-beta, PAI-1, AT) in Mexican patients with established liver fibrosis. Potential correlation with pirfenidone treatment. | The aim of this work was to establish a potential correlation between specific polymorphisms and presence of hepatic fibrosis in Mexican patients with established liver fibrosis (ELF). Second, necroinflammatory index improvement was correlated with Pirfenidone (PFD) treatment response and the same polymorphisms. We analyzed TGF-beta polymorphisms in codon 25, a single basepair guanine insertion-deletion polymorphism (4G/5G) for PAI-1 and angiotensin AT-6 single nucleotide polymorphism located in -6 promoter region. Twenty patients infected with either hepatitis C virus (HCV) (n = 13) or affected by alcohol consumption (n= 7) were included. Thirty subjects with no hepatic damage were included in control group. Blood samples for genomic DNA were obtained and plasminogen activator inhibitor-1 polymorphisms were done by polymerase chain reaction-artificial introduction of a restriction site, TGF-beta by polymerase chain reaction-amplification refractory mutation system and AT by polymerase chain reaction-restriction fragment length polymorphisms. Liver biopsies were obtained at baseline and after 12 months of PFD treatment. Established liver fibrosis patients had the homozygote G/G TGF-beta genotype, which has been associated with increased development of fibrosis. None of our patients had the G/C genotype. All pure HCV and pure alcohol abuse subjects carried G/G TGF-beta genotype (100% vs 37% control) (P = 0.0006). The odds of having TGF-beta G/G genotype was 19.5 for HCV patients and 10.83 for alcohol consumption patients as compared with healthy subjects (P < 0.001). Established liver fibrosis patients had an improvement in necroinflammatory index after PFD treatment when correlated with plasminogen activator inhibitor-1 and angiotensinogen-6 genotypes. Our data suggested that a combination of inherited polymorphisms increased the risk of advanced fibrosis in ELF patients. Pure HCV and pure alcohol consumption patients which were homozygous G/G carriers had 19.5- and 10.8-fold higher risk to develop advanced fibrosis respectively. | 18,797,412 |
Longitudinal study of self-reported sexually transmitted infection incidence by gender and age up to age thirty-two years. | To examine how incidence of self-reported sexually transmitted infections (STIs) varies by gender and age, and the factors that influence this. A longitudinal study of a cohort born in Dunedin, New Zealand in 1972/1973. They were questioned about STIs and sexual behavior at age 21, 26, and 32 years (1993-2005). Incidence rates were calculated over 3 age periods and compared using Poisson regression. Of the 1037 members of the original cohort, 92% or more of survivors completed the computer questionnaire at each age. Incidence rates of STIs from first coitus to age 21, age 21 to 26, and age 26 to 32, were 2.0, 3.2, and 2.0 per 100 person-years, respectively for men and 4.4, 3.0, and 1.4 per 100 person-years, respectively for women. After adjustment for sexual behavior, rates for men were elevated from age 21 to 26 compared with first coitus to 21 years of age [incidence rate ratio (IRR) = 1.9, 95% confidence interval (CI) 1.3 to 2.8), but not from age 26 to 32 (IRR = 1.1, 95% CI 0.70-1.9). For women, adjusted rates decreased with age; from 21 to 26 compared with first coitus to 21 (IRR = 0.79, 95% CI 0.56-1.1) and further from 26 to 32 (IRR = 0.39, 95% CI 0.27-0.57). These unique data, comprising repeated assessment of reported behaviors and STIs in the same population, show that the period before age 21 is a time of special risk for STIs for women and of lower risk for men. The low risk among women aged 26 to 32 years after adjustment for sexual behavior warrants further investigation. | 18,797,425 |
Ethnic differences in cardiovascular disease risk factors and diabetes status for Pacific ethnic groups and Europeans in the Diabetes Heart and Health Survey (DHAH) 2002-2003, Auckland New Zealand. | The aim of this paper is to provide levels of cardiovascular disease (CVD) risk factors and diabetes status for Pacific ethnic groups and make comparisons amongst these groups (Samoan, Tongan, Niuean, Cook Islanders) with European New Zealanders by gender from the 2002-03 DHAH Survey. The DHAH was a cross-sectional population-based survey and was carried out in Auckland between 2002-03. A total of 1011 Pacific comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders, and 47 Other Pacific (mainly Fijian) and 1745 European participants took part in the survey. Participants answered a self-administered questionnaire to assess whether they had previously diagnosed CVD risk factors (blood pressure, cholesterol, diabetes) and lifestyle risk factors (smoking, physical inactivity). All participants provided an early morning mid-stream urine sample, an initial blood test and full glucose tolerance test (GTT) for those not previously diagnosed with diabetes. In both men and women, CVD risk among the Pacific groups were all significantly higher than Europeans. Niueans had the lowest Pacific CVD risk and Samoans had the highest estimated risk. Individual risk factors differed between the groups, however; the most observable differences were the more adverse lipid profile in Tongan men and the lower total cholesterol and micro-albumin in Niuean women when compared to their Samoan counterparts. Diabetes prevalence was highest in Samoan men (26.2%) and Tongan women (35.8%). Tongan women had a diabetes prevalence over double that of their men (17.8%), whereas in the other Pacific groups, male and female prevalence was very similar. Niueans had the lowest diabetes prevalence of both sexes (men 14.9%, women 10.8%). Undiagnosed diabetes as a proportion of total diabetes was similar in Samoan, Niuean and Cook Islands groups (1/4-5) suggesting efficient screening. Cook Islanders had a ratio of one undetected diabetes case for every two known cases. CVD risk factors, diabetes prevalence, and levels of undetected diabetes differed between the Pacific ethnic groups with Niueans having the healthiest profile. More rigorous screening of diabetes in Cook Islanders is needed if they are to experience similar detection rates as other Pacific Island communities in New Zealand. Greater attention is required to identify and manage CVD risk among all Pacific peoples to reduce the gap in CVD risk factors, morbidity and mortality when compared to European New Zealanders. | 18,797,481 |
Ethnic counts on mortality and census data (mostly) agree for 2001-2004: New Zealand Census-Mortality Study update. | The New Zealand Census-Mortality Study (NZCMS) previously demonstrated substantial undercounting of Maori and Pacific deaths on mortality data relative to census data for the 1980s and 1990s. The recent linkage of 2001-04 mortality data to 2001 census data allows us to determine whether any such 'numerator-denominator' bias persists. 2001 census anonymously and probabilistically linked to 3 years of subsequent mortality data (82,404 eligible mortality records), allowing a comparison of ethnicity recording. Using a 'total' definition of ethnicity, there was a close agreement of census and mortality counts: 7419 Maori on the 2001 census compared to 7536 Maori according to mortality data--a census to mortality ratio of 0.98; Pacific--2451 and 2493, ratio 0.98; Asian--1236 and 1215, ratio 1.02; non-Maori non-Pacific non-Asian--73,089 and 72,051, ratio 1.01. Using a 'sole' definition of Maori ethnicity, census counts were only 86% of mortality counts, indicating that mortality data is not recording as many people with two or more ethnic groups as would be expected based on census data. This 'sole' bias was more pronounced in the South Island. There is now little bias in ethnic group counts between census and mortality data for a 'total' definition of ethnic group. Calculations of mortality rates by ethnicity using unlinked census and mortality data and a total definition of ethnicity should be unbiased. These results strongly support using the census definition of ethnicity on all health datasets. | 18,797,482 |
Neural correlates of perceiving emotional faces and bodies in developmental prosopagnosia: an event-related fMRI-study. | Many people experience transient difficulties in recognizing faces but only a small number of them cannot recognize their family members when meeting them unexpectedly. Such face blindness is associated with serious problems in everyday life. A better understanding of the neuro-functional basis of impaired face recognition may be achieved by a careful comparison with an equally unique object category and by a adding a more realistic setting involving neutral faces as well facial expressions. We used event-related functional magnetic resonance imaging (fMRI) to investigate the neuro-functional basis of perceiving faces and bodies in three developmental prosopagnosics (DP) and matched healthy controls. Our approach involved materials consisting of neutral faces and bodies as well as faces and bodies expressing fear or happiness. The first main result is that the presence of emotional information has a different effect in the patient vs. the control group in the fusiform face area (FFA). Neutral faces trigger lower activation in the DP group, compared to the control group, while activation for facial expressions is the same in both groups. The second main result is that compared to controls, DPs have increased activation for bodies in the inferior occipital gyrus (IOG) and for neutral faces in the extrastriate body area (EBA), indicating that body and face sensitive processes are less categorically segregated in DP. Taken together our study shows the importance of using naturalistic emotional stimuli for a better understanding of developmental face deficits. | 18,797,499 |
Unveiling the bmp13 enigma: redundant morphogen or crucial regulator? | Bone morphogenetic proteins are a diverse group of morphogens with influences not only on bone tissue, as the nomenclature suggests, but on multiple tissues in the body and often at crucial and influential periods in development. The purpose of this review is to identify and discuss current knowledge of one vertebrate BMP, Bone Morphogenetic Protein 13 (BMP13), from a variety of research fields, in order to clarify BMP13's functional contribution to developing and maintaining healthy tissues, and to identify potential future research directions for this intriguing morphogen. BMP13 is highly evolutionarily conserved (active domain >95%) across diverse species from Zebrafish to humans, suggesting a crucial function. In addition, mutations in BMP13 have recently been associated with Klippel-Feil Syndrome, causative of numerous skeletal and developmental defects including spinal disc fusion. The specific nature of BMP13's crucial function is, however, not yet known.The literature for BMP13 is focused largely on its activity in the healing of tendon-like tissues, or in comparisons with other BMP family molecules for whom a clear function in embryo development or osteogenic differentiation has been identified. There is a paucity of detailed information regarding BMP13 protein activity, structure or protein processing. Whilst some activity in the stimulation of osteogenic or cartilaginous gene expression has been reported, and BMP13 expression is found in post natal cartilage and tendon tissues, there appears to be a redundancy of function in the BMP family, with several members capable of stimulating similar tissue responses. This review aims to summarise the known or potential role(s) for BMP13 in a variety of biological systems. | 18,797,508 |
The role of general practice in cancer care. | The incidence of cancer is rising, so the workload of managing cancer is increasing rapidly. Among the advances in cancer care are advances in coordination of care, with team care being a preferred method. This article examines the role of the general practitioner, by looking at each step in the patient's cancer journey. The current role of the GP and practice staff is examined, as well as potential roles that can be undertaken to maximise the role of general practice in an integrated cancer service. A complete rethink of how cancer is managed, in particular defining the roles that must be performed by specialists and those that can be performed in primary care, needs to take place in order to deal with the rising cancer incidence in Australia. General practice must prepare to modify how it works to meet this challenge, in a similar way to confronting the rising tide of other chronic illnesses. | 18,797,526 |
[Prevalence and co-occurrence of five types of ill-treatment in relation with depression and conduct disorder in adolescent mothers]. | In this article, the authors reflect on co-occurrence of different types of maltreatment that adolescent mothers have suffered during their childhood in order to better understand intergenerational transmission of maltreatment. They underline that studies on maltreatment that adults or adolescents have been subjected to during their childhood generally do not take into account co-occurrence of different types of maltreatment. The authors first attempt to verify if adolescent mothers are different from women of the general population in regards to prevalence and co-occurrence of various types of maltreatment suffered during their own development. They then try to establish prevalence and co-occurrence of types of maltreatment in relation to diagnoses of major depression or conduct disorder in adolescent mothers. | 18,797,540 |
[The influence of estrogen and progestogen replacement on growth hormone activity in women with hypopituitarism]. | Treatment of hypogonadotropic hypogonadism in adult women with hypopituitarism can include a wide range of estrogen and progestogen treatment alternatives and oral administration is the route of least cost and greatest patient comfort. The oral estrogen route has a major impact on the growth hormone-insulin-like growth factor I (GH/IGF-1) axis. Oral estrogen therapy, when given concurrently with GH to patients with hypopituitarism, antagonizes the biological effects of GH treatment and aggravates the abnormalities of body composition and the metabolism in general. It is presumed that oral estrogen suppresses the secretion/production of IGF-1 by a hepatic first-pass mechanism, resulting in increased GH secretion by means of suppressing the IGF-1 negative feedback that is present in healthy women. This is clinically manifested in reduced lean body mass, increased fat mass, an atherogenic lipid profile and damage to psychological well-being. Some studies have indicated that progestogens with androgenic actions reverse the effect of reduced serum IGF-1 levels that is induced by the oral estrogens. Neutral progestogens do not exert this effect, however the stronger the androgenic potentialis, the more the effect of reduced IGF-1 will be reversed. This bibliographical review will deal with the clinical aspects of estrogen and progestogen replacement in women with hypopituitarism, their interactions with other hormone deficiencies and the impact of estrogen treatment on the metabolic actions of GH. | 18,797,598 |
Ethical analysis to improve decision-making on health technologies. | Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology that is easy and flexible to use in different organizational settings and cultures. The model is part of the EUnetHTA project, which focuses on the transferability of HTAs between countries. The EUnetHTA ethics model is based on the insight that the whole HTA process is value laden. It is not sufficient to only analyse the ethical consequences of a technology, but also the ethical issues of the whole HTA process must be considered. Selection of assessment topics, methods and outcomes is essentially a value-laden decision. Health technologies may challenge moral or cultural values and beliefs, and their implementation may also have significant impact on people other than the patient. These are essential considerations for health policy. The ethics model is structured around key ethical questions rather than philosophical theories, to be applicable to different cultures and usable by non-philosophers. Integrating ethical considerations into HTA can improve the relevance of technology assessments for health care and health policy in both developed and developing countries. | 18,797,620 |
Methods of suicide: international suicide patterns derived from the WHO mortality database. | Accurate information about preferred suicide methods is important for devising strategies and programmes for suicide prevention. Our knowledge of the methods used and their variation across countries and world regions is still limited. The aim of this study was to provide the first comprehensive overview of international patterns of suicide methods. Data encoded according to the International Classification of Diseases (10th revision) were derived from the WHO mortality database. The classification was used to differentiate suicide methods. Correspondence analysis was used to identify typical patterns of suicide methods in different countries by providing a summary of cross-tabulated data. Poisoning by pesticide was common in many Asian countries and in Latin America; poisoning by drugs was common in both Nordic countries and the United Kingdom. Hanging was the preferred method of suicide in eastern Europe, as was firearm suicide in the United States and jumping from a high place in cities and urban societies such as Hong Kong Special Administrative Region, China. Correspondence analysis demonstrated a polarization between pesticide suicide and firearm suicide at the expense of traditional methods, such as hanging and jumping from a high place, which lay in between. This analysis showed that pesticide suicide and firearm suicide replaced traditional methods in many countries. The observed suicide pattern depended upon the availability of the methods used, in particular the availability of technical means. The present evidence indicates that restricting access to the means of suicide is more urgent and more technically feasible than ever. | 18,797,649 |
Age norms for monocular grating acuity measured by sweep-VEP in the first three years of age. | To determine age norms for grating visual acuity and interocular acuity differences measured by the sweep-visually evoked potentials (VEP) technique in the first three years of life. Monocular grating visual acuity was measured using the sweep-VEP in 67 healthy normal infants and children in the first 36 months of life. Sweep-VEP grating acuity ranged from 0.80 logMAR (20/125 Snellen equivalent) in the first month of life to 0.06 logMAR (20/20 Snellen equivalent) at 36 months of age. Lower normal limits (95th percentile limit) ranged from 0.95 logMAR (20/180) to 0.12 logMAR (20/25) with a progression of approximately 3 octaves in the first 36 months of age. The largest acceptable interocular acuity difference for clinical purposes was 0.10 logMAR. Age norms for grating acuity along with interocular acuity differences were determined using the sweep-VEP technique. These norms should be incorporated in clinical practice for precise diagnosis of visual status in infants and preverbal children. | 18,797,653 |
[Results and complications of bicanalicular intubation in external dacryocystorhinostomy]. | To analyze the success rate and complications in patients with lacrimal obstruction submitted to surgeries. The data of patients operated in the "Hospital do Servidor Público Estadual of São Paulo" were analyzed. The lacrimal intubation was performed with a silicone tube, removed after 8 weeks. Surgeries were considered successful in those cases where patients had no postoperative epiphora or ocular secretion, and with a good passage of fluid to the nose or oropharynx. The complications related to the silicone tube were grouped in a table. The patients were operated from April 2002 to July 2006 with an average follow-up period of three months. In a total of 65 eyes, success was obtained in 89.2% of the cases. Seven patients presented postoperative epiphora, and 5 of them were reoperated. In 7 eyes there was an extrusion of the silicone in less than 15 days from surgery, and in this group one patient needed a reoperation. Six eyes presented complications with the silicone: tube prolapse (4 cases), granuloma formation in the nasal cavity (1 case) and lacrimal puncta adhesion (1 case). This group of patients presented a high success rate with Ex-DCR surgery associated with lacrimal intubation. The intraoperative intubation with silicone tube is not free of complications. | 18,797,663 |
[Association between optic disc hemorrhages and the position of central retinal vessels]. | To investigate the correlation between optic disc hemorrhages (ODHs) and the position of the central retinal vessel trunk (RVT) in patients with glaucoma. Fundus photographs of 1,830 participants were reviewed. The exit position of the central retinal vessel trunk was classified as being in the superior or inferior hemisphere of the optic disc and the relative vertical position was expressed as a fraction of the disc diameter (ratio between the position of the trunk and the diameter of the disk). A group of patients from the same population, but without ODHs, was randomly selected and compared with the patients with ODHs. Among the 1,830 patients, 53 hemorrhages were detected in 41 patients with glaucoma or suspected glaucoma. We found an inverse relationship between the inferior/superior position of the central RVT and the inferior/superior position of the hemorrhages (Kappa=-0.34). Using the trunk/disc ratio, we found that superior ODHs correlated with inferior RVTs (trunk/disc ratio, 0.450; SD=0.070) and inferior ODHs correlated with superior RVTs (trunk/disc ratio, 0.510; SD=0.054) (p=0.027). The number of patients with normal tension glaucoma was significantly higher among patients with ODHs than among those without ODHs (p=0.009). Our patients had a negative correlation between the position of central RVT and the location of the ODHs. Normal tension glaucoma was more prevalent among patients with ODHs than among those without it. | 18,797,668 |
Perineural arachnoidal gliomatosis: case report. | Gliomas are the most common infiltrative neoplasms of the optic nerve and can present as two distinct growth patterns: intraneural glial proliferation and perineural arachnoidal gliomatosis (PAG). It has been suggested that perineural arachnoidal gliomatosis is seen almost exclusively in the setting of neurofibromatosis type 1 (NF1). We describe a child with perineural arachnoidal gliomatosis occurring without neurofibromatosis type 1, supported by both radiographic and histological findings. A 4-year-old female without neurofibromatosis type 1 presented with rapidly progressive right-sided proptosis. Magnetic resonance imaging (MRI) revealed an enhancing fusiform intraconal lesion, which was hypointense on T1 and hyperintense on T2-weighted images: characteristic of perineural arachnoidal gliomatosis, the optic nerve was visualized coursing the tumor. Histopathologic study was consistent with perineural arachnoidal gliomatosis. Perineural arachnoidal gliomatosis can develop independent of neurofibromatosis type 1, as demonstrated by this case. | 18,797,677 |
The effect of gastric dilatation in rats submitted to gasified water ingestion under the hepatic metabolic function. | The amounts of people that are overweight have been increasing within the population in significant ways during the last decades. In this view, gasified beverages have become an important environmental concern in relation to the eating habits of people, especially who lives in the USA, Mexico, and Brazil. In this order, these three countries constitute the major beverages producers and consumers of the whole world. To investigate the effects of gastric dilatation in rats submitted to gasified water ingestion, uniform vehicle for all soft drinks, under metabolic patterns of the hepatic function. Two groups of 15 rats were formed and observed during two weeks. The rats of the group I, were fed with 200g/day of rat food ad libitum and 100ml of non-gasified water during three daily periods. The rats composing the group II, were fed with 200g/day of rat food ad libitum and 100ml of gasified water within 3 daily periods. The media (x) and standard deviation (s) were calculated through the paired t-test for each group in order to compare the effects of the different types of water and its effect in each one of them. The results indicated that the animals which were submitted to the treatment with gasified water (G-II), presented an increase of glutamic-pyruvic transaminase (GPT) and alkaline phosphatase (ALP) (p<0,01), tendency to increase the glutamic-oxaloacetic transaminase (GOT) (0,10>p>0,05) and increase of the gastric area with macroscopic morphologic alterations, such as the loss of the characteristic linear depressions on the surface of the mucous membrane. The gasified water favored the expansion of the gastric area and contributed to the extinction of the linear depressions of the mucous organ, which caused metabolic alterations of the hepatic function. | 18,797,684 |
Rosuvastatin and vascular dysfunction markers in pulmonary arterial hypertension: a placebo-controlled study. | We investigated whether chronic rosuvastatin administration could improve the abnormalities of the circulating levels of vascular dysfunction markers in pulmonary arterial hypertension (PAH). Sixty patients, aged 13 to 60 years, with idiopathic (N = 14) or congenital heart disease-associated PAH (N = 46) were equally but randomly assigned to rosuvastatin treatment (10 mg a day, orally) or placebo for 6 months in a blind fashion. Plasma levels of P-selectin, tissue-plasminogen activator and its inhibitor as well as von Willebrand factor antigen were measured by enzyme-linked immunoassay before and after 1, 3, and 6 months of treatment. Baseline levels of biomarkers were elevated (68, 16, 45 and 46% increase relative to controls, for P-selectin, von Willebrand factor antigen, tissue-plasminogen activator and its inhibitor, respectively; P < 0.001). P-selectin values at baseline, 1, 3, and 6 months were 39.9 +/- 18.5, 37.6 +/- 14.6, 34.8 +/- 14.6, and 35.4 +/- 13.9 ng/mL, respectively, for the rosuvastatin group and 45.7 +/- 26.8, 48.0 +/- 26.9, 48.1 +/- 25.7, and 45.7 +/- 25.6 ng/mL for the placebo group. The P-selectin level was lower in the rosuvastatin group compared with placebo throughout treatment (P = 0.037, general linear model). A trend was observed towards a decrease in tissue-plasminogen activator in the statin group (16% reduction, P = 0.094), with no significant changes in the other markers. Since P-selectin is crucial in inflammation and thrombosis, its reduction by rosuvastatin is potentially relevant in the pathophysiological scenario of PAH. | 18,797,697 |
N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a noninvasive marker for restrictive syndromes. | Constrictive pericarditis (CP) and restrictive cardiomyopathy share many similarities in both their clinical and hemodynamic characteristics and N-terminal prohormone brain natriuretic peptide (NT-proBNP) is a sensitive marker of cardiac diastolic dysfunction. The objectives of the present study were to determine whether serum NT-proBNP was high in patients with endomyocardial fibrosis (EMF) and CP, and to investigate how this relates to diastolic dysfunction. Thirty-three patients were divided into two groups: CP (16 patients) and EMF (17 patients). The control group consisted of 30 healthy individuals. Patients were evaluated by bidimensional echocardiography, with restriction syndrome evaluated by pulsed Doppler of the mitral flow and serum NT-proBNP measured by immunoassay and detected by electrochemiluminescence. Spearman correlation coefficient was used to analyze the association between log NT-proBNP and echocardiographic parameters. Log NT-proBNP was significantly higher (P < 0.05) in CP patients (log mean: 2.67 pg/mL; 95%CI: 2.43-2.92 log pg/mL) and in EMF patients (log mean: 2.91 pg/mL; 95%CI: 2.70-3.12 log pg/mL) compared with the control group (log mean: 1.45; 95%CI: 1.32-1.60 log pg/mL). There were no statistical differences between EMF and CP patients (P = 0.689) in terms of NT-proBNP. The NT-proBNP log tended to correlate with peak velocity of the E wave (r = 0.439; P = 0.060, but not with A wave (r = -0.399; P = 0.112). Serum NT-proBNP concentration can be used as a marker to detect the presence of diastolic dysfunction in patients with restrictive syndrome; however, serum NT-proBNP levels cannot be used to differentiate restrictive cardiomyopathy from CP. | 18,797,698 |
Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil. | Ethnicity has been shown to be associated with micro- and macrovascular complications of diabetes in European and North American populations. We analyzed the contribution of ethnicity to the prevalence of micro- and macrovascular complications in Brazilian subjects with type 2 diabetes attending the national public health system. Data from 1810 subjects with type 2 diabetes (1512 whites and 298 blacks) were analyzed cross-sectionally. The rates of ischemic heart disease, peripheral vascular disease, stroke, distal sensory neuropathy, and diabetic retinopathy were assessed according to self-reported ethnicity using multiple logistic regression models. Compared to whites, black subjects [odds ratio = 1.72 (95%CI = 1.14-2.6)] were more likely to have ischemic heart disease when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, smoking habit, and serum creatinine. Blacks were also more likely to have end-stage renal disease [3.2 (1.7-6.0)] and proliferative diabetic retinopathy [1.9 (1.1-3.2)] compared to whites when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, and smoking habit. The rates of peripheral vascular disease, stroke and distal sensory neuropathy did not differ between groups. The higher rates of ischemic heart disease, end-stage renal disease and proliferative diabetic retinopathy in black rather than in white Brazilians were not explained by differences in conventional risk factors. Identifying which aspects of ethnicity confer a higher risk for these complications in black patients is crucial in order to understand why such differences exist and to develop more effective strategies to reduce the onset and progression of these complications. | 18,797,699 |
Breastfeeding and feeding patterns in three birth cohorts in Southern Brazil: trends and differentials. | Breastfeeding is fundamental for child health. Changes in the duration of breastfeeding are compared for three population-based cohorts of children born in 1982, 1993 and 2004 in the city of Pelotas, Southern Brazil. Samples of the 1982 and 1993 children and all of the children from the 2004 cohort study were sought at home when they were aged around 12 months. Both the duration of breastfeeding and the stage at which different kind of foods were regularly introduced were investigated. The median duration of breastfeeding increased from 3.1 to 6.8 months in this period. Exclusive breastfeeding at three months was practically non-existent in 1982 and had reached one third of infants by 2004. The increase was faster after 1993, suggesting an important impact made by promotion activities. Up to about 6-9 months, breastfeeding was more prevalent in high-income families, but after this age it became more common among the poor. Low birth weight babies were breastfeed for shorter durations. The duration of breastfeeding is still far short of international recommendations, justifying further campaigns. Special attention should be given to low birth weight babies and those from low-income families. | 18,797,716 |
Infant mortality in three population-based cohorts in Southern Brazil: trends and differentials. | We studied time trends in infant mortality and associated factors between three cohort studies carried out in Pelotas, Rio Grande do Sul State, Brazil, in 1982, 1993, and 2004. All hospital births and deaths were determined by means of regular visits to hospitals, registrar's offices, and cemeteries. This data was used to calculate neonatal, post-neonatal, and infant mortality rates per thousand live births. Rates were also calculated according to cause of death, sex, birth weight, gestational age, and family income. The infant mortality rate fell from 36.4 per 1,000 live births in 1982 to 21.1 in 1993 and 19.4 in 2004. Major causes of infant mortality in 2004 were perinatal causes and respiratory infections. Mortality among low birth weight children from poor families fell 16% between 1993 and 2004; however, this rate increased by more than 100% among high-income families due to the increase in the number of preterm deliveries in this group. The stabilization of infant mortality in the last decade is likely to be due to excess medical interventions relating to pregnancies and delivery care. | 18,797,721 |
PAH biomarkers for human health risk assessment: a review of the state-of-the-art. | Polycyclic aromatic hydrocarbons (PAH) are widely distributed in the environment, and some are carcinogenic to human beings. The study of biomarkers has helped clarify the nature and magnitude of the human health risks posed by such substances. This article provides a review of the state-of-the-art on PAH biomarkers for human health risk assessment and also discusses their applicability within the context of environmental management in Brazil. The article discusses the methodologies for determination of some biomarkers such as 1-hydroxypyrene and PAH-DNA adducts. Cytogenetic markers, frequency of chromosomal aberrations, and micronucleus induction were considered for the evaluation of cancer risk. The current stage of studies on validation of such biomarkers was also approached. | 18,797,723 |
A salutogenic approach to oral health promotion. | Theoretical frameworks on health promotion focusing on social determinants of oral health have highlighted promising approaches for improving the oral health of populations and reducing inequities in oral health. In the last two decades the salutogenic theory has gained ground in the field of health promotion, but not in oral health promotion. Instead of focusing on risk factors and behavior change, the theory highlights the importance of resources and the ability to use them. The model's central construct, sense of coherence (SOC), suggests explanations of the relationship between life stressors and health status. The stronger the SOC, the more successfully people will cope with stressors and thus maintain their health. This paper discusses the potential of the salutogenic theory to guide the development of actions in the five fields of oral health promotion: creating supportive environments; promoting health through public policy; strengthening community action; developing personal skills; and reorienting health services. The theory can serve as a framework for oral health promotion measures that strengthen the available resources, create better ones, and enable people to identify and benefit from them. | 18,797,728 |
Physical activity during pregnancy and maternal-child health outcomes: a systematic literature review. | A systematic literature review was conducted to investigate the effects of physical activity during pregnancy on selected maternal-child health outcomes. The search included articles published from 1980 to 2005 in the MEDLINE and LILACS databases using key words such as physical activity, physical exercise, pregnancy, and gestation. The methodological quality of 37 selected articles was evaluated. It appears to be a consensus that some light-to-moderate physical activity is not a risk factor and may even be considered a protective factor for some outcomes. However, some studies found an association between specific activities (e.g., climbing stairs or standing for long periods) and inadequate birth weight, prematurity, and miscarriage. Few studies found an association between physical activity and maternal weight gain, mode of delivery, or fetal development. Further research is needed to fill these gaps and provide guidelines on the intensity, duration, and frequency of physical activity during pregnancy. | 18,797,729 |
Antimicrobial resistance among Brazilian Corynebacterium diphtheriae strains. | The increasing problems with multidrug resistance in relation to Corynebacterium, including C. diphtheriae, are examples of challenges confronting many countries. For this reason, Brazilian C. diphtheriae strains were evaluated by the E-Test for their susceptibility to nine antibacterial drugs used in therapy. Resistance (MIC < 0.002; 0.38 microg/ml) to penicillin G was found in 14.8% of the strains tested. Although erythromycin (MIC90 0.75 microg/ml) and azithromycin (MIC90 0.064 microg/ml) were active against C. diphtheriae in this study, 4.2% of the strains showed decreased susceptibility (MIC 1.0 microg/ml) to erythromycin. Multiple resistance profiles were determined by the disk diffusion method using 31 antibiotics. Most C. diphtheriae strains (95.74%) showed resistance to mupirocin, aztreonam, ceftazidime, and/or oxacillin, ampicillin, penicillin, tetracycline, clindamycin, lincomycin, and erythromycin. This study presents the antimicrobial susceptibility profiles of Brazilian C. diphtheriae isolates. The data are of value to practitioners, and suggest that some concern exists regarding the use of penicillin. | 18,797,769 |
[Educational obstacles in the everyday living of the nurse teacher's pedagogical practice]. | University teaching emerges as a theme frequently discussed in the educational scene. This article aims to investigate the educational obstacles emerging in the everyday living of the pedagogical practice of the nurse teacher from the Nursing Graduation Course at UEPSI, wishing to subsidize the elaboration of proposals for overcoming of these obstacles. It is a study of qualitative approach with data collection, questionnaire and semi-structured interview and data analysis through content analysis. According to the analysis, it is clear that the educational obstacles relate to the teacher person, to the students and to the institution. Thus, an establishment of a continuing education program in the action-reflection-action perspective is proposed as a way of overcoming the obstacles. | 18,797,777 |
[Sexual violence against children in a family environment attended by SAMVVIS, Teresina, PI]. | This study deals with the characterization of sexual violence in children seen at the Services for the Assistance of Women Victims of Sexual Violence (SAMVVIS) from 2004 to 2007 in Teresina, PI. Data collected from 229 charts indicate that the age of the children varies from less than one year up to 12 years of age. The identification of the aggressor was the neighbor (29.7%), stepfather (11.4%), father (9.4%) and uncle with 8.4%. In regards to the occupation of the aggressor, 20.35% are students, unemployed (26.85%) and retired (3.89%). It follows that there is the need for more efficiency in the policy of child protection and a need for campaigns to alert the mothers when choosing the caretakers of their daughters. | 18,797,781 |
[Nature, classification and nursing interventions for patients with mediastinitis]. | This is a descriptive and retrospective study that aimed at analyzing the nature and classification of nursing interventions for patients with mediastinitis following cardiac surgery. The results obtained from the surgical wards show an incidence of mediastinitis of 3%. The subjects studies were primarily male, all of whom suffer from diabetes. The nursing problems were categorized according to Horta and the interventions according to the NIC. Among the problems found, 76.5% were of psychobiological needs and 23.5% were psychosocial. Fifty-three (53) nursing interventions were implemented: 84.9% were physiological in nature, 11.3% behavioral and 3.8% family related. The relationship between the problems identified and the interventions developed were adjusted principally to address the psychobiological needs. Educational interventions were used frequently to attend to the psychosocial needs of the patients. | 18,797,783 |
Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium. | Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasia or adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS). An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications. | 18,797,802 |
Secular trends in hip fracture incidence and recurrence. | The decline in hip fracture incidence is now accompanied by a further reduction in the likelihood of a recurrent hip fracture among survivors of the first fracture. Hip fracture incidence is declining in North America, but trends in hip fracture recurrence have not been described. All hip fracture events among Olmsted County, Minnesota residents in 1980-2006 were identified. Secular trends were assessed using Poisson regression, and predictors of recurrence were evaluated with Andersen-Gill time-to-fracture regression models. Altogether, 2,752 hip fractures (median age, 83 years; 76% female) were observed, including 311 recurrences. Between 1980 and 2006, the incidence of a first-ever hip fracture declined by 1.37%/year for women (p < 0.001) and 0.06%/year for men (p = 0.917). Among 2,434 residents with a first-ever hip fracture, the cumulative incidence of a second hip fracture after 10 years was 11% in women and 6% in men with death treated as a competing risk. Age and calendar year of fracture were independently associated with hip fracture recurrence. Accounting for the reduction in first-ever hip fracture rates over time, hip fracture recurrence appeared to decline after 1997. A recent reduction in hip fracture recurrence is somewhat greater than expected from the declining incidence of hip fractures generally. Additional research is needed to determine the extent to which this can be attributed to improved patient management. | 18,797,813 |
Effects of exhaustion and calcium supplementation on adrenocorticotropic hormone and cortisol levels in athletes. | The present study was performed to investigate the effects of strenuous exercise and calcium supplementation on cortisol and adrenocorticotropic hormone levels in athletes at rest and exhaustion. Thirty male athletes, ages 17-21 years, were enrolled in the 4-week study. They were divided into three groups as follows: group 1 (n = 10): training without supplementation; group 2 (n = 10): training and calcium supplemented, and group 3 (n = 10): calcium supplemented without training. Venous blood samples were obtained for determination of the hormones. One-month supplementation with calcium does not influence the cortisol and adrenocorticotropic hormone in athletes, but strenuous exercise results in a significant increase in their levels with or without supplementation (p < 0.05). | 18,797,825 |
Analysis of condylar differences in functional unilateral posterior crossbite during early treatment--a randomized clinical study. | The analysis of potential discrepancies in condyle position among different occlusal relations (centric relation and maximum intercuspidation) is a key diagnostic component when treating children with unilateral posterior crossbite. Due to strict requirements imposed by ethics committees, and new regulations regarding the use of X-rays, radiological examinations (axial cephalometric radiographs or postero-anterior cephalometric radiographs) are not feasible. Thus the aim of this study was to apply an alternative procedure for the assessment of condylar deviations. : We employed ARCUS digma, a measuring system based on ultrasound technology, to record condylar differences occurring in 65 children (6.9+/-2.0 years of age) with functional unilateral posterior crossbite in late deciduous and early mixed dentition. After randomization, 31 patients underwent early orthodontic treatment (bonded palatal expansion appliance and U-bow activator), whereas 34 patients remained untreated. Examinations were carried out at the beginning (T1) and after 12 months of treatment (T2). A three-dimensional (3D) assessment of deviations between maximum intercuspidation and centric position was carried out. Statistical analysis was performed using the SPSS 12.0 software program. Initially, the electronic position analysis revealed no significant differences between the control and therapy groups. A mean condylar deviation of > 2 mm was noted at T1 in the sagittal, frontal and transversal planes for crossbite and the noncrossbite sides. This difference was reduced in the therapy group, a finding that proved statistically highly significant (p<0.001). We also observed a highly significant (p<0.001) difference between the control and therapy groups at T2. The Münster concept for early treatment of functional unilateral posterior crossbites in late deciduous and early mixed dentition significantly improved the treated patients' occlusion in comparison to a randomized control group, which exhibited no spontaneous self-healing tendencies. | 18,797,832 |
A 57-year follow-up study of occlusion. Part 2: oral health and attitudes to teeth among individuals with deep overbite at the age of 8 years. | To analyze changes in occlusion between the ages of 8 and 65 years in persons with a deep overbite at the age of 8 who did not receive orthodontic treatment. To describe their experiences regarding their own dentition as well as their opinions on dental esthetics and oral health. To compare these findings with those of the Normal Occlusion (N-Group) described in Part 1. With one exception, the 20 persons in our cohort had not undergone orthodontic therapy. Our documentation was based on intraoral photographs taken at the two time points in addition to an interview and facial photos at the age of 65. The overbite could be evaluated in 16 persons. In four persons various degrees of mucosal indentations in connection with the overbite had been registered. The average number of missing teeth was 3.4, compared to 1.6 in the N-group. All participants reported their oral health to be good or excellent and, similar to the N-group, nearly all considered dental esthetics to be important. The overbite had decreased during the observation period in nine, increased in five, and remained stable in two persons. | 18,797,834 |
Phenotypic and genetic characterization of the pistillate mutation in tomato. | Many floral phenotypes have been described in decades of tomato genetics, but for very few of them the underlying genes have been identified so far. Because the increasing availability of genome sequence data will facilitate forward genetics in tomato, novel descriptive and map information will help the attribution of genes to phenotypes. In this contribution, we present our work on pistillate (pi), a genotype that directly recalls mutations affecting class B MADS-box genes, but that has not been further characterized after the first description. Plants homozygous for the pi allele appear with Mendelian proportions and, compared to wild-type, show delayed flowering, a frequently modified sympodial segment, higher occurrence of compound inflorescences, and reversion of the floral meristem to vegetative identity. In pi mutant flowers, the most striking aberration is the homeotic transformation of stamens into carpels. Ultrastructural analysis also reveals more or less subtle sepaloid features in the three inner floral whorls, mainly based on the presence, distribution and amount of glandular and non glandular trichomes. In the ovary, a 'flower within flower' phenotype was seldom observed; in one instance such phenotype was coupled with the setting of a parthenocarpic fruit, that reiterated the differentiation of a new flower. Mapping experiments positioned PI on the distal end of the long arm of chromosome 3. This position was not compatible with any class B or E MADS box gene; differently, the PI genetic window contained the FALSIFLORA (FA) gene, the tomato orthologue of LEAFY (LFY). The pi defects in flowering time and inflorescence development are in agreement with a direct involvement of the floral meristem identity gene. The class B- and E-like phenotypes shown by pi mutant plants are likely an indirect consequence because FA, as LFY, is reported as a positive regulator of homeotic MADS-box genes. Because fa mutant plants do not form complete flowers, the pi mutation deserves a particular interest, producing four-whorled, although modified, flowers useful to study the functional linkage between flower induction and flower organ identity specification. | 18,797,840 |
Evaluation of a pharmacokinetic hypothesis for reduced locomotor stimulation from methamphetamine and cocaine in adolescent versus adult male C57BL/6J mice. | Adolescent mice display reduced locomotor stimulation to cocaine and amphetamine compared to adults, but the mechanisms are not known. The primary aim of the current study is to test a possible pharmacokinetic explanation for the attenuated locomotor stimulation seen in adolescents. A secondary aim is to extend the current literature for acute methamphetamine in adolescents. Male, adolescent (PN 30-35) and adult (PN 69-74) C57BL/6J mice were administered an intraperitoneal injection of cocaine (5, 15, 30 mg/kg) or methamphetamine (1, 2, 4 mg/kg) and euthanized 5, 10, 15, 30, 60, 120, or 240 min later. Home cage locomotor activity was recorded by video tracking, and drug concentration levels in brain and blood from the infraorbital sinus were measured using liquid chromatography combined with mass spectroscopy. Both methamphetamine and cocaine increased locomotor activity in a dose-response fashion, but the magnitude of the increase was less in adolescents than adults. Concentration of methamphetamine in the brain was similar between ages across time points. Concentration of cocaine in the brain was significantly higher in adolescents than adults at 5 min, but similar at all other time points. Results suggest pharmacokinetics may make a small contribution to differential stimulation between adolescents and adult mice, but are unlikely the only factor. Developmental differences within the brain that effect pharmacodynamic properties of psychostimulants (e.g., number of receptor or transporters) represent alternatives. | 18,797,848 |
Static-dynamic sequential superheated liquid extraction of phenols and fatty acids from alperujo. | Superheated liquids of different polarity have been used for sequential extraction of fatty acids and phenols from alperujo. Multivariate methodology has been used to optimise the static-dynamic extraction. Forty-two minutes are required to complete extraction (20 mg/kg of fatty acids and up to 2,200 mg/kg of hydroxytyrosol in the raw material used). The efficacy of the extraction has been demonstrated and compared with that of conventional methods (Folch and stirring-based methods for fatty acids and phenols, respectively), which needed 4.5 and 24 h for the extraction of fatty acids and phenols, respectively. The non-polar and polar extracts were injected into GC-MS and HPLC-MS-MS equipment, respectively, for individual separation-quantification of the target compounds. The simplicity of the experimental setup and the low costs of the raw material make the proposed method advisable when extraction of both fractions is required. | 18,797,851 |
Cortical and cerebellar activation induced by reflexive and voluntary saccades. | Reflexive saccades are driven by visual stimulation whereas voluntary saccades require volitional control. Behavioral and lesional studies suggest that there are two separate mechanisms involved in the generation of these two types of saccades. This study investigated differences in cerebral and cerebellar activation between reflexive and self-paced voluntary saccadic eye movements using functional magnetic resonance imaging. In two experiments (whole brain and cerebellum) using the same paradigm, differences in brain activations induced by reflexive and self-paced voluntary saccades were assessed. Direct comparison of the activation patterns showed that the frontal eye fields, parietal eye field, the motion-sensitive area (MT/V5), the precuneus (V6), and the angular and the cingulate gyri were more activated in reflexive saccades than in voluntary saccades. No significant difference in activation was found in the cerebellum. Our results suggest that the alleged separate mechanisms for saccadic control of reflexive and self-paced voluntary are mainly observed in cerebral rather than cerebellar areas. | 18,797,855 |
Ethnic differences in immunogenetic features and photosensitivity of cutaneous lupus erythematosus. | Genetic differences are involved in the development of lupus erythematosus (LE). Skin lesions are influenced by environmental triggers such as ultraviolet light, temperature, and chemical stresses, and the patterns of skin lesion are variable in cutaneous LE such as systemic LE (SLE), chronic discoid LE (CDLE), subacute cutaneous LE (SCLE), and LE tumidus (LET). Although there are a few conflicting reports, many Japanese dermatologists feel there are photosensitivity differences in lupus erythematosus between Asian and Caucasian subjects with SCLE and LET. HLA studies in Japanese subjects revealed that HLA-DRB1*1501 association was with both CDLE and SLE. The association between HLA-Cw6 and CDLE was first reported in Japanese population, and a HLA-A33-B44-DRB1*1302 haplotype showed a positive association in CDLE. However, these results are not compatible with those from Caucasian subjects. There are no significant associations among HLA studies, photosensitivity, and anti-Ro/SS-A antibodies in Japanese CLE patients. Photosensitivity will be a key factor to dissolve multi-factorial complexes of LE etiopathogenesis. Our present understanding is that an axis of photosensitivity, anti-Ro/SS-A antibodies and apoptosis via TNF are the best (markers) to verify the contribution of genetics in SCLE, LET, and other CLEs. The incidence and photosensitivity of SCLE and LET are much lower in Japanese than in Caucasian subjects. However, this discrepancy may open the window for investigating CLE pathogenesis through global collaborations. For this purpose and goal, a new and more conventional method should be developed for the examination of so-called photosensitivity. | 18,797,890 |
Two methods for determining plasma IL-6 in humans at rest and following exercise. | We compared two methods to determine IL-6 at rest and following exercise. On two occasions, plasma IL-6 was determined in 10 men and 13 women before and immediately following 90 min of cycling at 65% V(O)(2max) using a cytometric bead array (CBA) and an ELISA. The CBA detected IL-6 in 63% of pre-exercise samples and 84% of post-exercise samples; the ELISA detected IL-6 in all samples. In samples with detectable IL-6, resting values were comparable between the CBA and ELISA (2.3 +/- 1.0 and 2.4 +/- 1.2 pg/mL, respectively; p = 0.99); the IL-6 response to exercise was underestimated (p = 0.0003) by the CBA by ~45%, compared with the ELISA. CBA- and ELISA-determined IL-6 values were moderately correlated (r = 0.66, p < 0.0001), but exhibited poor agreement (mean bias +/- 1SD = -1.4 +/- 2.1 pg/mL). The CBA provided concordant IL-6 concentrations at rest, when detected, but underestimated exercise-induced increases in IL-6 versus the ELISA method. | 18,797,920 |
Sponge OAS has a distinct genomic structure within the 2-5A synthetase family. | 2',5'-Oligoadenylate synthetases (2-5A synthetases, OAS) are enzymes that play an important role in the interferon-induced antiviral defense mechanisms in mammals. Sponges, the evolutionarily lowest multicellular animals, also possess OAS; however, their function is presently unclear. Low homology between primary structures of 2-5A synthetases from vertebrates and sponges renders their evolutionary relationship obscure. The genomic structure of vertebrate OASs has been thoroughly examined, making it possible to elucidate molecular evolution and expansion of this gene family. Until now, no OAS gene structure was available from sponges to compare it with the corresponding genes from higher organisms. In the present work, we determined the exon/intron structure of the OAS gene from the marine sponge Geodia cydonium and found it to be completely different from the strictly conserved exon/intron pattern of the OAS genes from vertebrates. This finding was corroborated by the analysis of OAS genes from another sponge, Amphimedon queenslandica, whose genome was recently sequenced. Our data suggest that vertebrate and sponge OAS genes have no direct common intron-containing ancestor and two (sub)types of OAS may be discriminated. This study opens new perspectives for understanding the phylogenesis and evolution of 2-5A synthetases as well as functional aspects of this multigene family. | 18,797,928 |
Course of distress in breast cancer patients, their partners, and matched control couples. | Previous studies offer a limited perspective on the dynamic course of distress in cancer patients and their partners, owing to a restricted number of assessment points and the absence of comparison controls drawn from the general population. This study investigated the course of distress among breast cancer patients and their partners (N = 92 couples) in comparison to matched control couples (N = 64). Furthermore, the influence of neuroticism on distress was investigated. The Hospital Anxiety and Depression Scale was administered nine times over a 12-month period, and neuroticism was assessed at the beginning of the study using the Eysenck Personality Questionnaire. Multilevel analyses revealed that patients were more distressed during the first 15 months after diagnosis than nonpatients. A significant portion of the distress that could not be explained by the cancer experience was explained by neuroticism. Differences in distress between patients and comparison-control women are relatively small and decreased over time, while distress in male partners was not elevated in comparison to their controls. | 18,797,979 |
Gallstone ileus: a difficult emergency diagnosis! | Gallstone ileus (GSI) is a rare cause of mechanical small bowel obstruction. It occurs when a fistula between the gallbladder and the small bowel facilitates the migration of gallstone(s) into the small bowel. The commonest site of impaction is in the terminal ileum. We report the case of a 71-year-old female presenting with GSI diagnosed on CT scan. She was surgically explored and gallstones extracted by a simple enterotomy leading to full recovery of the patient. | 18,797,981 |
Protective potential of SCF for mice preimplantation embryos cultured in vitro in suboptimal conditions. | To examine the effect of stem cell factor (SCF) to embryos exposed to detrimental factors. Mice embryos cultured in control medium or Exp.1. with FasL or FasL+SCF Exp.2. with hydrogen peroxide (HP) or HP+SCF; Exp.3. frozen-thawed and cultured with or without SCF. Immunohistochemistry for Fas and c-kit receptors was performed in blastocysts. Blastocyst rates, total numbers of blastocyst cells (TB) and inner cell mass cell counts (ICM) were determined. Immunohistochemical studies revealed expression of both Fas and c-kit in blastocyst cells. Exp.1. Significantly more blastocysts were found in control when compared to FasL group and to FasL+SCF group. TB and ICM counts in control and FasL+SCF group were significantly higher comparing to FasL group. Exp.2. We found significant differences between three groups in all three evaluated parameters. The highest blastocyst rates, TB and ICM counts were found in control, lower in HP+SCF group and the worst in HP group. Exp.3. No significant differences in TB and ICM counts were found. More embryos formed blastocyst in control than in two cryopreserved groups. Blastocyst rates did not differ between two cryopreserved groups. SCF may improve culture of embryos exposed to unfavorable milieu. | 18,797,989 |
Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature. | Inguinal hernia and colonic carcinoma are common surgical conditions, yet carcinoma of the colon occurring within an inguinal hernia sac is rare. Of 25 reported cases, only one was a perforated sigmoid colon carcinoma in an inguinal hernia. We report two cases of sigmoid colon carcinoma, one of which had locally perforated. Each presented within a strangulated inguinal hernia. Oncologically correct surgery in these patients presents a technical challenge. | 18,798,013 |
Modelling Aspergillus fumigatus infections in racing pigeons (Columba livia domestica). | In vivo modelling of aspergillosis in birds allows the evaluation of control measures and the study of host-pathogen interactions. In this study the impact of the use of different inoculation routes and immunosuppression on the course of an infection with Aspergillus fumigatus in racing pigeons (Columba livia domestica) was examined. A. fumigatus conidia were inoculated in the thoracic air sac, lung or trachea in immunocompetent or immunosuppressed pigeon squabs. Immunosuppression was induced by three dexamethasone injections before inoculation. Mortality in the A. fumigatus-inoculated groups varied between 1/4 and 4/4. The highest and more acute mortality was seen in immunocompetent pigeons inoculated in the thoracic air sac and in pigeons inoculated in the thoracic air sac or lung after immunosuppression. Pigeons inoculated in the lung or inoculated intratracheally after immunosuppression developed an aspergillosis infection with a slower course of disease and more prominent clinical symptoms. Using microsatellite length polymorphism, it was confirmed that all mycoses were caused by the inoculated strain except for one isolate in a dexamethasone-treated pigeon. In conclusion, inoculation in the lung is selected as the preferred model for chronic aspergillosis in pigeons, and inoculation in the thoracic air sac as the preferred model for acute aspergillosis. The use of immunosuppressed birds seems to be contra-indicated due to the risk of opportunistic infections. | 18,798,031 |
Use of computerized models to reduce the consequences of major outbreaks of food-borne illness. | Food-borne outbreak modelling is a technique by which statistical methodologies and data are used to model various aspects of food contamination outbreaks, with the primary goal of helping to reduce the threat of food-borne illness. There are two primary approaches to such modelling: risk ranking and pathway analysis. These two approaches fulfil different needs and are used side by side to help mitigate the risks of food-borne outbreaks. The increasing severity and impact of food poisoning outbreaks are increasing the need for new techniques to enable rapid detection and response to outbreaks whilst they are still in process. One such novel technique is implemented in the 'Consequence Management System', a computerized model that uses a structured, phased form of pathway analysis to model the entire evolution of food-borne illnesses involving scenarios of contamination of specific food products with various agents. The results of these models help in the evaluation of the probable consequences of the scenarios, the optimal ways to intervene in their evolution to reduce these consequences, and the overall risk associated with different products and agents. | 18,798,035 |
Measurement of nitric oxide in the vagina. | Local measurement of nitric oxide (NO) gas has been used to detect and monitor inflammatory processes in the airways, the colon and in the urinary bladder, but so far NO has not been studied in the lower female genital tract. The objective of this study is to measure NO gas directly in the vaginal lumen of healthy women and in patients with vaginitis. The outpatient clinic of a university hospital. Eighteen non-pregnant women from 19 to 65 years of age with symptoms of vaginitis, eight healthy women in reproductive age with regular menstrual cycles and nine healthy postmenopausal women were enrolled in the study. NO levels were measured in air incubated for five minutes in a catheter balloon in the vagina. In patients with symptoms of vaginitis, NO concentration was almost 100-fold increased compared to healthy controls (p<0.001) with no individual overlap. Vaginal NO levels were uniformly low among healthy women, both in reproductive age and in menopause. NO gas can be measured directly in the vagina with a fast, simple and safe method. The levels of NO are increased in patients with vaginitis. | 18,798,053 |
Over-expression of COX-2 induces human ovarian cancer cells (CAOV-3) viability, migration and proliferation in association with PI3-k/Akt activation. | COX-2 is involved in several pathological processes. The action of COX-2 on human ovarian cancer cell line (CAOV-3) and relative signal pathway has not been demonstrated. We explored the effects of COX-2 on the CAOV-3 viability and migration, moreover the proliferation of CAOV-3, and then ascertained the roles of PI3-k/Akt in these processes. The results showed that COX-2 increased the cells viability, migration and augment the number of CAOV-3. LY294002 could reduce COX-2 induce cells viability, migration and proliferation. These data indicate that COX-2 induce cells viability and migration, moreover promote the proliferation of CAOV-3 via PI3-k/Akt signal pathway. | 18,798,061 |
Overexpression of high mobility group (HMG) B1 and B2 proteins directly correlates with the progression of squamous cell carcinoma in skin. | High mobility group B (HMGB) chromosomal proteins, which plays important role in cancer and inflammation, were followed at various stages of the squamous cell carcinoma of skin. Present results were analyzed by histopathology, BrdU assay, immunohistochemistry, western blot and RT-PCR, which indicate that at early stages of tumorigenesis, expression of HMGB (B1, B2), raised only by about 20%. However, the advanced (> or =12 weeks) tumors showed significant (> or =80%) increase in HMG levels. Using skin cancer model, we demonstrated that high levels of HMGB directly correlate with the extent of neoplastic changes, and it appears that HMGB is an effective stimulus for cell differentiation, tumor progression, and metastatic invasion. | 18,798,064 |
Retinal function in X-linked ocular albinism (OA1). | To characterize retinal function in human recessive X-linked ocular albinism (OA1) across the normal lifespan. Retinal function was evaluated in 14 OA1 patients (ages 11 to 71 years) and five obligate carriers (ages 41 to 50 years) and compared to normal controls using full-field and multi-focal electroretinograms (ERG and mERG, respectively) and electro-oculography (EOG). No consistent differences in ERG response parameters were observed when OA1 patients were compared as a group to normal controls. A trend in the direction of better correlations of response parameters with age was, however, observed in OA1. EOG Arden ratios were normal or hypernormal for all patients, but were uncorrelated with age. Central retinal function measured with the mERG suggested a flat response topography with depressed macular function compared to normal controls. Panretinal function in OA1 is within normal limits at all ages, consistent with previous reports in generalized albinism. The stronger correlations with age in OA1 may suggest a different rate of age-related change in OA1 compared to normal populations, but the precise nature of this change must await an appropriate prospective study. The topography of mERG amplitudes in OA1 is relatively flat across the central retina with a reduction in amplitude in the macular region consistent with anatomical studies demonstrating an underdeveloped macular region in albinism. | 18,798,082 |
Multiparticulate drug delivery system of aceclofenac: development and in vitro studies. | The aim of this study was to develop an enteric-coated multiunit dosage form containing aceclofenac, a nonsteroidal anti-inflammatory drug. The pellets were prepared by using extrusion/spheronization method, and the core pellets were coated with a pH-sensitive poly(meth) acrylate copolymer (Eudragit L100-55) to achieve site-specific drug release. The formulated pellets were characterized for percentage yield, size distribution, surface morphology studies, drug content, and flow properties. In vitro dissolution test was used for comparison of drug release profiles of various coated pellets. The practical yield was found to be 90-95%. The particle size of enteric-coated pellets was found to be in the range of 0.59-0.71 mm. The pellets were spherical in shape and surfaces of pellets were found to be rough and showing micropores. Enteric-coated pellets showed good flow properties and in vitro dissolution profile. Dissolution tests were carried out in a USP type II dissolution apparatus in media-simulating pH conditions of the gastrointestinal tract. The release of the aceclofenac from formulated pellets was established to be minimum in the pH 1.2 (<5%) for a period of 2 h, and at pH 6.8, it shows the maximum release (85 +/- 5% release within 1 h) which indicates gastric resistance of the formulated pellets. The 20% wt/wt enteric-coated pellets were compared to that of marketed product (tablets), it was observed that pellets showed better release profile. The study concluded that the formulated multiparticulate dosage forms can be used as an ideal drug delivery system for the aceclofenac. | 18,798,090 |
Biologic features of Hodgkin lymphoma and the development of biologic prognostic factors in Hodgkin lymphoma: tumor and microenvironment. | Classical Hodgkin lymphoma is now recognised as a B-cell lymphoma. Improved therapy has increased cure rates dramatically; however, relapse and death still occurs in a minority of patients. Much has been learned about the biology of Hodgkin and Reed Sternberg cells and their interactions with the microenvironment, which has informed studies exploring biologic markers that may improve upon clinical prognostic models. This manuscript reviews recent advances in our understanding of the pathobiology of cHL with an emphasis on biologic prognostic markers. | 18,798,102 |
Positron emission tomography in mantle cell lymphoma. | Mantle cell lymphoma (MCL) is a rare but aggressive non-Hodgkin lymphoma subtype with a poor prognosis; most patients relapse despite initial response to therapy. Response was traditionally evaluated by computed tomography (CT), but the introduction of [(18)F]Fluorine-Deoxyglucose Positron Emission Tomography (PET) changed response assessment in aggressive lymphoma. However, the value of PET-evaluation in MCL has not been studied yet. Therefore, PET- and CT-findings were investigated in 37 patients with MCL (239 scans) and categorised following standardised response criteria for CT-evaluation (IWC-criteria), PET-evaluation (EORTC-criteria) and combined PET/CT-evaluation (IWC + PET-criteria). FDG-PET showed a high sensitivity for the detection of deposits of MCL and a higher FDG-uptake was shown in patients with the more aggressive blastoid-variant of MCL versus common MCL. However, routine use of PET for end-of-treatment response assessment in MCL cannot be recommended because CT- and PET-based designation systems had equivalent prognostic value. PET-based end-of-treatment response assessment only provided additional information over CT-based response assessment in a subpopulation of patients with highly FDG-avid MCL. PET allowed early detection of preclinical relapse during post-therapy surveillance, but the therapeutic consequences of such information are currently unclear. | 18,798,104 |
Long-term outcome of allogeneic stem cell transplantation in chronic lymphocytic leukemia: analysis after a minimum follow-up of 5 years. | In order to evaluate the long-term results of allogeneic stem cell transplantation (ASCT) in B-cell chronic lymphocytic leukemia (CLL), we reviewed the outcome of 12 consecutive CLL patients, who underwent ASCT at the Mayo Clinic prior to July, 2004. Median age was 44 years (range 18-55) and median time from diagnosis to transplant 58.5 months. All patients had failed prior fludarabine-based chemotherapy and all but two patients had chemo-resistant refractory disease at time of transplant. A 'myeloablative' conditioning regimen was used in 11 patients and 'reduced intensity' in one. Bone marrow was the source of hematopoietic stem cells in 10 patients and peripheral blood in two. Donors were matched sibling in nine patients, unrelated in two and partial phenotypic match father in one. Grade II-IV acute and chronic graft versus host disease was documented in five and four patients, respectively. To date, six patients (50%) have died including four early deaths from infection. Complete remission (CR) was documented in eight patients (66.7%) post-transplant; six are currently alive whereas one died at 7 months from infection while still in CR and one relapsed 7 months post-transplant and died later. One CR patient relapsed after 4.5 years but was successfully re-transplanted and remains in second CR for 6.5+ years. Another patient recently relapsed after 10.5 years of CR. Duration of ASCT-induced CR in the remaining four patients was 6.5+, 8.5+, 9+ and 10+ years. All surviving patients displayed excellent performance status without ongoing chronic graft versus host disease. We conclude that ASCT is an effective salvage therapy for fludarabine-refractory CLL but late relapses can occur. | 18,798,106 |
Hepatobiliary disposition of rhodamine 123 in isolated perfused rat livers. | The disposition of rhodamine 123 (RH-123), a known marker of P-glycoprotein, and its liver-generated glucuronide metabolite (RH-Glu), a marker of Mrp2, was studied in an isolated perfused rat liver model. Livers were perfused with a buffer containing 0.1 microg ml(-1) RH-123 for 30 or 60 min or for 30 min followed by 90 min of drug-free perfusion, and the concentrations of the drug and its metabolites were determined in the perfusate, bile, and the liver tissue. The outlet perfusate concentrations of RH-123 and RH-Glu reached an apparent plateau during the continuous infusion of the drug, with a very extensive extraction ratio of approximately 96% for the parent drug. However, the biliary excretion rates of both RH-123 and generated RH-Glu continued to rise almost linearly during the entire 60 min of drug infusion. This was associated with a linear increase in the amount of RH-123 recovered in the liver between 30 and 60 min of drug infusion, resulting in a significant (>50% of the administered dose) recovery of the marker in the liver both after 30 and 60 min of perfusion. Additionally, the washout experiments showed that the declines in the biliary excretion rates of RH-123 and RH-Glu were parallel to that of RH-123 concentration in the liver in the absence of drug input. The hepatobiliary disposition of RH-123 in rats is unique because of its substantial and time-dependent accumulation in the liver, resulting in a lack of steady-state in its biliary excretion despite apparent steady-state in the perfusate. | 18,798,123 |
Increased transendothelial permeability of anti-cancer agent carboplatin with the aid of hyperbaric oxygenation. | 1. The objective was to investigate the transport of an anticancer agent carboplatin across the blood-brain barrier in combination with hyperbaric oxygenation treatment. An in vitro well-validated model of bovine brain capillary endothelial cells was used. 2. A transendothelial transport of doxorubicin, a known P-glycoprotein substrate, was enhanced 1.5-fold by verapamil for 2-h incubation at 37 degrees C. A transendothelial permeability coefficient of carboplatin (1.29 x 10(-3)cm min-1) was also increased 1.8-fold by verapamil. 3. Under the hyperbaric oxygenation conditions (at 0.2 MPa for the first 10 min), the transendothelial transport for 2 h of doxorubicin and carboplatin were increased 1.3- to 1.8-fold by hyperbaric oxygenation, like the suppressive effects of verapamil on P-gp function, without increase of the transport of lucifer yellow, a non P-glycoprotein substrate. 4. Combination of hyperbaric oxygenation treatment and verapamil could not further increase the permeability coefficients of these drugs that were already enhanced by either treatment, implying the P-glycoprotein-mediated carboplatin efflux transport similarly as doxorubicin. 5. Together with our reported high efficacy of carboplatin combined with hyperbaric oxygenation therapy on brain tumours, the present results suggest that carboplatin could be transported by P-glycoprotein, but that this efflux mechanism would be reduced by the hyperbaric oxygenation with the consequences of clinical efficacy. | 18,798,124 |
Use of partially porous column as second dimension in comprehensive two-dimensional system for analysis of polyphenolic antioxidants. | In the present work, a comprehensive LC system using a microbore HPLC column in the first dimension and a partially porous column in the second dimension was developed and applied to the separation of polyphenolic components in a red wine sample. The performance of the partially porous short column (3.0 cm) was compared to that of a monolithic column, of comparable dimensions. The results obtained demonstrated the possibility to use partially porous columns to obtain fast analyses, using high flow rates, under repetitive gradient conditions and with very brief reconditioning times. A conventional HPLC system was used since the backpressure generated by the shell-packed column, even at very high flow rates, was well within the operational limits. The use of an increased column temperature (60 degrees C) allowed a further pressure-drop decrease, with no stationary phase degradation, or loss in column performance. | 18,798,217 |
Breast cancer special types: why bother? | Breast cancer is a heterogeneous disease, encompassing multiple entities associated with distinct biological features and clinical behaviours. Microarray-based expression profiling analysis has been used to unravel the molecular underpinning of several characteristics of breast cancer, including its proclivity to disseminate to distant sites and the molecular basis of histological grade. Furthermore, a breast cancer molecular classification based on transcriptional analysis has been proposed. However, microarray studies have primarily analysed invasive ductal carcinomas of no special type. Histological special types of breast cancer, which account for up to 25% of all invasive breast cancers, have not been systematically studied. Despite the limited interest, in recent years it has become apparent that the histopathological characteristics of these cancers may be underpinned by distinct arrays of genetic changes, providing direct evidence for genotypic-phenotypic correlations between morphological patterns and molecular changes in breast cancer (eg t(12;15) in secretory carcinoma of the breast). Here we review the molecular characteristics of special types of breast cancer, with special emphasis on their microarray-based expression profiles and their impact on our understanding of breast cancer. | 18,798,222 |
Low gradient aortic stenosis: assessment, treatment, and outcome. | Aortic stenosis is a commonly encountered valvular disorder in the treatment of cardiovascular disease. Generally, symptomatic patients who undergo valve replacement experience a vast reduction in symptoms and a great improvement in survival. A subset of symptomatic patients in whom management is less clear are those with a small transvalvular gradient and low cardiac output, or low gradient aortic stenosis. The assessment, treatment, and outcome of this unique group of patients will be reviewed. | 18,798,234 |
Transcatheter closure of patent ductus arteriosus and aorto-pulmonary vessels using non-ferromagnetic Inconel MReye embolization coils. | We report the use of non-ferromagnetic embolization coils for transcatheter PDA closure. Transcatheter patent ductus arteriosus (PDA) closure has been performed for 40 years. A number of devices have been used with varying degrees of success. Gianturco embolization coils have been used frequently since 1992 with excellent results. These coils are a stainless steel alloy, and create an artifact when subsequent MRI imaging is performed. Eight patients underwent right and left heart catheterization and transcatheter PDA closure. Angiography displayed a PDA with left to right shunting. The minimum PDA diameter was measured. An Inconel MReye coil was implanted using standard retrograde technique. A postimplant angiogram was performed. Evaluations were performed the following morning and after 2 months. The median age was 5.5 years, median weight was 24 kg. The PDA minimum diameter was 1.7 mm (range 1.4-2.4 mm), with a median Qp:Qs=1.33:1. In all patients, the PDA was completely immediately closed using one Inconel coil. Two patients also had a small aorto-pulmonary collateral vessel that was occluded using a separate Inconel coil. All patients had follow-up evaluation the following day; the PDA remained completely occluded and there was no obstruction of the pulmonary artery branches or descending aorta. Seven patients had subsequent follow-up and echocardiograms; the PDA remained completely occluded. There were no complications. The Inconel MReye coil is safe and effective for coil occlusion of small PDA and aorto-pulmonary vessels. Additional studies are needed to define the maximum vessel diameter for Inconel coil occlusion. | 18,798,238 |
Biophysical and biochemical characterization of a liposarcoma-derived recombinant MnSOD protein acting as an anticancer agent. | A recombinant MnSOD (rMnSOD) synthesized by specific cDNA clones derived from a liposarcoma cell line was shown to have the same sequence as the wild-type MnSOD expressed in the human myeloid leukaemia cell line U937, except for the presence of the leader peptide at the N-terminus. These results were fully confirmed by the molecular mass of rMnSOD as evaluated by ES/MS analysis (26662.7 Da) and the nucleotide sequence of the MnSOD cDNA. The role of the leader peptide in rMnSOD was investigated using a fluorescent and/or (68)Gallium-labelled synthetic peptide. The labelled peptide permeated MCF-7 cells and uptake could be inhibited in the presence of an excess of oestrogen. In vivo it was taken up by the tumour, suggesting that the molecule can be used for both therapy and diagnosis. The in vitro and in vivo pharmacology tests confirmed that rMnSOD is only oncotoxic for tumour cells expressing oestrogen receptors. Pharmacokinetic studies in animals performed with (125)I- and (131)I-labelled proteins confirmed that, when administered systemically, rMnSOD selectively reached the tumour, where its presence was unambiguously demonstrated by scintigraphic and PET scans. PCR analysis revealed that Bax gene expression was increased and the Bcl2 gene was down regulated in MCF7 cells treated with rMnSOD, which suggests that the protein induces a pro-apoptotic mechanism. | 18,798,256 |
Probability of parenthood after early onset cancer: a population-based study. | We evaluated in a population-based setting the postdiagnosis parenthood among survivors compared with the fertility patterns of siblings. Cancer patients aged 0-34 years at diagnosis were identified from the Finnish Cancer Registry (N = 25,784), and their siblings (N = 44,611) by registry linkage. Further linkage identified the offspring of the patient and sibling cohorts. The relative probabilities of parenthood for first and second births separately were estimated for male and female survivors in different diagnostic age-groups and subsites using a Cox proportional hazards model, with age as the time variable and adjusting for the birth cohort of parents. In addition, estimates were calculated for 5 diagnostic eras in all subsites combined. Compared to siblings, both female and male cancer survivors were less likely to parent at least 1 child (RR 0.46, 95% CI 0.44-0.48 and RR 0.57, 95% CI 0.54-0.60, respectively). The relative probability of parenthood was especially low in male childhood cancer survivors and female young adult cancer survivors. However, cancer patients were only slightly less likely than siblings to parent a second child, with RR 0.91, 95% CI 0.86-0.97 and RR 0.95, 95% CI 0.89-1.01 for females and males, respectively. The relative probability of parenthood increased over calendar time among young adult cancer patients. The relative probability of parenthood following early onset cancer was overall significantly reduced by approximately 50%. Parenting a second child, however, was not reduced among pediatric and adolescent survivors, and only slightly reduced among early adulthood cancer survivors compared to siblings. | 18,798,259 |
Anti-adult T-cell leukemia effects of brown algae fucoxanthin and its deacetylated product, fucoxanthinol. | Adult T-cell leukemia (ATL) is a fatal malignancy of T lymphocytes caused by human T-cell leukemia virus type 1 (HTLV-1) infection and remains incurable. Carotenoids are a family of natural pigments and have several biological functions. Among carotenoids, fucoxanthin is known to have antitumorigenic activity, but the precise mechanism of action is not elucidated. We evaluated the anti-ATL effects of fucoxanthin and its metabolite, fucoxanthinol. Both carotenoids inhibited cell viability of HTLV-1-infected T-cell lines and ATL cells, and fucoxanthinol was approximately twice more potent than fucoxanthin. In contrast, other carotenoids, beta-carotene and astaxanthin, had mild inhibitory effects on HTLV-1-infected T-cell lines. Importantly, uninfected cell lines and normal peripheral blood mononuclear cells were resistant to fucoxanthin and fucoxanthinol. Both carotenoids induced cell cycle arrest during G(1) phase by reducing the expression of cyclin D1, cyclin D2, CDK4 and CDK6, and inducing the expression of GADD45alpha, and induced apoptosis by reducing the expression of Bcl-2, XIAP, cIAP2 and survivin. The induced apoptosis was associated with activation of caspase-3, -8 and -9. Fucoxanthin and fucoxanthinol also suppressed IkappaBalpha phosphorylation and JunD expression, resulting in inactivation of nuclear factor-kappaB and activator protein-1. Mice with severe combined immunodeficiency harboring tumors induced by inoculation of HTLV-1-infected T cells responded to treatment with fucoxanthinol with suppression of tumor growth, showed extensive tissue distribution of fucoxanthinol, and the presence of therapeutically effective serum concentrations of fucoxanthinol. Our preclinical data suggest that fucoxanthin and fucoxanthinol could be potentially useful therapeutic agents for patients with ATL. | 18,798,263 |
Tumor microenvironment: Modulation by decorin and related molecules harboring leucine-rich tandem motifs. | Decorin, the prototype member of the small leucine-rich proteoglycans, resides in the tumor microenvironment and affects the biology of various types of cancer by downregulating the activity of several receptors involved in cell growth and survival. Decorin binds to and modulates the signaling of the epidermal growth factor receptor and other members of the ErbB family of receptor tyrosine kinases. It exerts its antitumor activity by a dual mechanism: via inhibition of these key receptors through their physical downregulation coupled with attenuation of their signaling, and by binding to and sequestering TGFbeta. Decorin also modulates the insulin-like growth factor receptor and the low-density lipoprotein receptor-related protein 1, which indirectly affects the TGFbeta receptor pathway. When expressed in tumor xenograft-bearing mice or injected systemically, decorin inhibits both primary tumor growth and metastatic spreading. In this review, we summarize the latest reports on decorin and related molecules that are relevant to cancer and bring forward the idea of decorin as an anticancer therapeutic and possible prognostic marker for patients affected by various types of tumors. We also discuss the role of lumican and LRIG1, a novel cell growth inhibitor homologous to decorin. | 18,798,267 |
Disruption of the blood-brain barrier following ALA-mediated photodynamic therapy. | Photodynamic therapy (PDT) is a local antineoplastic treatment with the potential for tumor cell specificity. PDT using either hematoporphyrin derivatives or 5-aminolevulinic acid (ALA) has been reported to induce brain edema indicating disruption of the blood-brain barrier (BBB). We have evaluated the ability of ALA-mediated PDT to open the BBB in rats. This will permit access of chemotherapeutic agents to brain tumor cells remaining in the resection cavity wall, but limit their penetration into normal brain remote from the site of illumination. ALA-PDT was performed on non-tumor bearing inbred Fischer rats at increasing fluence levels. Contrast T(1)-weighted high field (3 T) magnetic resonance imaging (MRI) scans were used to monitor the degree of BBB disruption which could be inferred from the intensity and volume of the contrast agent visualized. PDT at increasing fluence levels between 9 and 26 J demonstrated an increasing contrast flow rate. A similar increased contrast volume was observed with increasing fluence rates. The BBB was found to be disrupted 2 hours following PDT and 80-100% restored 72 hours later at the lowest fluence level. No effect on the BBB was observed if 26 J of light was given in the absence of ALA. ALA-PDT was highly effective in opening the BBB in a localized region of the brain. The degradation of the BBB was temporary in nature at fluence levels of 9 J, opening rapidly following treatment and significantly restored during the next 72 hours. No signs of tissue damage were seen on histological sections at this fluence level. However, higher fluences did demonstrate permanent tissue changes localized in the immediate vicinity of the light source. | 18,798,293 |
Comparison of ultrasound-guided core-needle biopsy and fine-needle aspiration in the assessment of head and neck lesions. | Core-needle biopsy (CNB) has been successfully applied in other medical specialties, but its value is undetermined in otolaryngology. This prospective study includes 75 patients, who were seen at our institution with a cervical mass. The results of CNB were compared with those of fine-needle aspiration (FNA) in the 68 histologically verified cases. CNB was superior to FNA providing a specific diagnosis (90% vs 66%) and achieved a higher accuracy in identifying true neoplasms (100% vs 93%) and detecting malignancy (99% vs 90%). However, the sensitivity and specificity did not differ significantly between both methods. Sonography and if necessary FNA should continue to be the investigation method of first choice for head and neck lesions. The main indication for CNB is after repeated failures of FNA to provide a diagnosis. It can also be performed in patients who are not surgical candidates or in those who refuse surgery. | 18,798,314 |
Validation and assessment of voice-related quality of life in Indian patients undergoing total laryngectomy and primary tracheoesophageal puncture. | Voice-related quality of life (V-RQOL) has never been studied in Indian patients. This study was planned to validate and assess V-RQOL in patients using tracheoesophageal puncture (TEP). A cross-sectional study was undertaken to validate V-RQOL questionnaire by testing reliability, validity, and responsiveness. V-RQOL was assessed in patients undergoing total laryngectomy with primary TEP. One hundred thirty-two patients filled 188 questionnaires. Analysis was carried out on 122 patients. Reliability and validity of questionnaire were tested by Cronbach's alpha (.84-.91) and item-scale correlation (.67-.86). Median V-RQOL-Total score was 76.2 indicating excellent V-RQOL. Higher scores were observed in patients less than 50 years (82.5 vs 72.5, p = .08). There was no effect of time interval between laryngectomy and assessment of questionnaire on the V-RQOL scores. V-RQOL questionnaire can be used reliably to assess V-RQOL, which is found to be excellent in Indian patients undergoing TEP. | 18,798,315 |
Mutation analysis of B3GALTL in Peters Plus syndrome. | Peters Plus syndrome comprises ocular anterior segment dysgenesis (most commonly Peters anomaly), short stature, hand anomalies, distinctive facial features, and often other additional defects and is inherited in an autosomal-recessive pattern. Mutations in the beta1,3-glucosyltransferase gene (B3GALTL) were recently reported in 20 out of 20 patients with Peters Plus syndrome. In our study, B3GALTL was examined in four patients with typical Peters Plus syndrome and four patients that demonstrated a phenotypic overlap with this condition. Mutations in B3GALTL were identified in all four patients with typical Peters Plus syndrome, while no mutations were found in the remaining four patients that demonstrated some but not all characteristic features of the syndrome. The previously reported common mutation, c.660 + 1G > A, accounted for 75% of the mutant alleles in our Peters Plus syndrome population. In addition, two new mutant alleles, c.459 + 1G > A and c.230insT, were identified and predicted to result in truncated protein products. These data confirm an important role for B3GALTL in causing typical Peters Plus syndrome, and suggest that this gene may not be implicated in syndromic cases that involve Peters anomaly but lack other classic features of this complex condition. | 18,798,333 |
[Monitoring of patients with breast cancer after multimodal treatment]. | Breast cancer is a frequent neoplasm in Latin America. Its control implies surveillance for about 10 years after diagnosis. The possibilities of metastatic disease depend on stage at diagnosis and the treatment administered to the patient. It is important that all medical centers implement their own follow-up that fits its needs. Surveillance must include physical therapy, attention to psychosocial aspects as well as treatment for toxicity, secondary effects, recurrence and second primaries. The American Society of Clinical Oncology (ASCO) includes monthly self-examination, annual mammography, office visits every three months for the first three years, and then biannual visits for the next two years and then annually. Randomized studies and the Cochrane database have proved that intensive follow-up is of no value compared with periodic appointments and annual mammography. Existing evidence suggests that postoperative surveillance of breast cancer patients is extremely expensive, time consuming and of no benefit in terms of survival. Most of recurrences present out of context from follow up visits. Thus, efficacy of routine doctor visits is questionable and a prospective study is needed to outline the adequate strategy. | 18,798,403 |
[Evidence-based medicine: benefits, inconveniences and risks of a new dogma]. | Progress in biostatistics and epidemiology during twentieth century contributed to clinical research development. Controversy about the real role of these disciplines in validating clinical activity isn't new: in history of medicine there are evidence since nineteenth century. Evidence-based medicine is a recent methodology to evaluate clinical investigation that begins to be considered gold standard in knowledge and medical practice evaluation. Its method is based mainly in systematized meta-analyses or revisions through which tries to offer answers to concrete clinical questions. These answers are, however, clearly of statistical nature. It is not useful in clinical practice but rather should be focused to teaching-learning process, as well as on the creation of work regulations. Its application implies certain benefits, but also several practical difficulties in cultural, academic and socio-economic fields, due to its use without discriminating. Thus, its correct use is a challenge to contemporary medicine. | 18,798,412 |
[Anemic syndrome frequency in complicated obstetrical patients]. | The prevalence of anemia varies from country to country and there is not a trustworthy record. To determine the frequency of anemia in obstetric patients and the association among healthy pregnancy and aggregate complications. Was carried out as transversal, observational and comparative study. Obstetrical patients entered and responded in the period of a year, were formed a group with normal pregnancy and another with complicated pregnancy, with a total sample of 194 patients. In the statistical analysis was employed Student t test for independent groups, with value if p < 0.05. When was included all patients from both groups of study a general frequency of anemia was found in 22.4%. Hematological stage from group with normal pregnancy was mild anemia in 16.9% and anemia moderated in 4.1% of the cases. The anemia degrees in the group with associated illness and pregnancy were mild anemia in 19.2% and moderated anemia in 4.2%. Not any case was found with severe anemia. The statistical analysis showed difference significant among both groups p < 0.05. The most frequently causes of the obstetrical morbidity were preeclampsia severe (22.6%), type 2 diabetes (13.9%), gestational diabetes (12.2%) and the remainder with other complications that include to the hypertiroidism, rheumatoid arthritis, lupus, asthma and vein deep thrombosis. Frequency of anemia in this study was greater upon informing in the international literature. The obstetrical complication more frequently relates to diverse anemia degrees were the hypertensive stage during pregnancy. The anemia is presented with greater frequency in pregnancy patients with others associated illness. | 18,798,460 |
[Surgical treatment of temporal lobe epilepsy]. | The surgical treatment of epilepsy is a therapeutic procedure aimed at removal of the brain tissue responsible for seizures. Neurological examinations are performed to delineate the epileptic zone, which is then removed, without causing a functional deficit. In order to fulfill these goals, it is essential to localize accurately and lateralize the epileptogenic zone and the surrounding eloquent cortex. Ninety-four adult patients were included in the study of the Epilepsy Center, National Institute of Psychiatry and Neurology, Budapest. All patients underwent a standard anterior temporal lobectomy between 1989 and 2001, whereas their preoperative evaluation consisted of detailed history of epilepsy, interictal EEG (awake and asleep), video EEG monitoring of seizures, magnetic resonance imaging, all according to the epilepsy protocol and neuropsychological investigations. The mean follow up was 6.1 years (range: 2-17 years). Seizure outcome was assessed annually, using Engel's classification. Seventy-two percents of patients were seizure-free 1 year after surgery. The percentage of seizure-free patients two, five and ten years after the surgery was 67%, 59%, and 61%, respectively. According to cost analysis, epilepsy surgery is considered to be cost effective. However, in the long run, indirect cost benefits (employment, independent living) add even more to the cost effectiveness of this method. Although the economic aspect is of great importance, especially in countries with limited financial resources, it is often neglected both by neurologists and health authorities. | 18,798,470 |
[Construction and expression of replication-deficient recombinant adenovirus vector with hNET gene by adeasy-1 system]. | To construct and identify the recombinant replication deficient adenovirus vector which codes for human Norepinephrine Transporter (hNET) gene by using the method of homogenous recombination in bacteria. hNET gene was obtained from the recombinant plasmid pCMV5 via Kpn I + Xba I digestion, and subcloned into E1 deleted expression plasmid pAdtrack-CMV shuttle vector, forming transfer vector pAdtrack-CMV-hNET. Then it was linearized with Pme I followed by homologous recombination with bone plasmid pAdEasy-1 in BJ5183 cells to generate recombinant plasmid Ad-hNET. The DNA of identified Ad-hNET was digested with Pac I and transfected to HEK293 cells by liposome-mediated method to package recombinant adenovirus. The PCR technique was applied to detect the target gene and Western Blotting to verify the expression of hNET. The titre of the Ad-hNET was measured with the aid of green fluorescence protein (GFP) expression after multiplication and purification. By sequencing, it was confirmed that the product was the gene of hNET. PCR test, restriction endonuclease digestion and Western Blotting confirmed the successful construction of the recombinants Ad-hNET. The titre of purified recombinant adenovirus Ad-hNET was 1.2 X 10(10) pfu/mL. The recombinant adenovirus with the hNET gene was constructed successfully. It will be helpful for the further investigation of its potentiality to be applied in the tumors targeted therapeutic strategy. | 18,798,484 |
[Research on construction and expression of recombinant eukaryotic expression plasmid for mouse adiponectin]. | To construct the recombinant eukaryotic expression plasmid for mouse adiponectin so as to supply experimental basis for research further on the function of adiponectin. Extracting the total RNA from mouse adipose tissue, applying RT-PCR to amplify the complete coding region of mouse adiponectin cDNA and connecting the amplified product with pCDNA3.1(+) vector; then verifying the recombinant plasmid by sequencing and detecting in vitro recombinant expression and cellular proliferation depression to mouse breast cancer cell 4T1. A 744 bp fragment was got after PCR amplification with the recombinant plasmid, which was confirmed by sequence and expression detected by Western-blot. Besides, compared with the control in vitro test, visible morphological changes of 4T1 cell could be observed after recombinant plasmid cell transfection for 48 h, with cells collapsed or shrunk and cellular proliferation inhibited. During the flow cytometry analysis, the transfected 4T1 cells could also be observed obviously to have a greater proportion of cell apoptosis than the control could be detected. The recombinant eukaryotic expression plasmid for mouse adiponectin is successfully constructed, which has an obvious inhibition effect on the proliferation of mouse breast cancer cell 4T1. | 18,798,486 |
[Protective effect of capsaicin on against myocardial ischemia-reperfusion injury of rat in vivo]. | To explore whether the capsaicin offers protective effect and possible mechanism on against myocardial ischemia-reperfusion injury of rat in vivo. Ligating the left anterior descending coronary artery for 45 min and loosing it for 120 min were performed to establish the rat model of local myocardial ischemia-reperfusion injury in vivo. Forty healthy male rats were randomly divided into control group, capsaicin group, capsazepine group, and S-3144 group. In 10 min and 5 min before ischemia, all drugs for this study were delivered into rat left ventricle (LV) via right carotid artery. Variations of left ventricular function were successively monitored with ECG (electrocardiogram). Levels of creatine kinase MB (CKMB) in serum were determined. Evans-blue and TTC were utilized to identify the area at risk and the infarct size of LV. In all groups, the variables of left ventricular developed pressure (LVDP) significantly decreased after ischemia and reperfusion (P < 0.05). Except capsaicin group, heart rates (HR) of three other groups markedly reduced with reperfusion for 120 min as compared to pre-reperfusion (P < 0.05). In capsaicin group, there were significant increases in HR and LVDP with reperfusion for 120 min when compared with the other three groups (P < 0.05). At the end of experiment, the levels of CKMB and infract size were lower in capsaicin group than in the other three groups (P < 0.05), and there was no statistical significance among the other three groups (P > 0.05). Pretreatment with capsaicin can attenuate myocardial ischemia-reperfusion injury, of which the likely mechanism is by stimulating capsaicin receptor or TRPV1 and further activating substance P receptor in the rat in vivo. | 18,798,491 |
[The research of animal model setting-up in human intra-utero fetal cardiac intervention]. | To research the techniques and correlated issues during analogous procedure of human intro-utero fetal cardiac intervention in animal model, so as to impulse the clinical utilizing of cardiac intervention in human fetus with severe cardiovascular malformations. Eight bigeminal pregnant ewes in latter 2nd-trimester and 3rd- trimester were taken into the research of fetal cardiac intervention. Under continuous ultrasound guidance, advanced an cannula and stylet needle through the maternal abdomen, uterine wall, and fetal lamb chest wall and into the fetal LV, then imitate human balloon aortic valvuloplasty at valve ring level. Probed into aspects of animal preparation, position of fetal lambs, paracentesis point selecting, main points of intervention, ultrasound utilizing, fetal lambs incubation and protection to placenta as well as umbilical cord. Eight pregnant ewes were all survival after procedure, 2 was executed after fetus' death, the other 6 continued gestation until spontaneous vaginal delivery after an uneventful pregnancy. After parturition the 6 ewes were in good condition. There were no nick infection, chorioamnionitis and other complications. Eight/sixteen fetal lambs were undergone intro-utero cardiac intervention. The values of body weight and Hct of lambs which were executed, pre-term and full-term delived were (1.77 +/- 0.14) kg vs. (2.15 +/- 0.23) kg vs. (2.41 +/- 0.19) kg and 29%o-33% vs. 27%-35% vs. 37%-41%. In autopsy, hydropericardium was found in 4/8 with 1-2.5 mL and 1/8 with 5 mL. Besides 1/8 with interventricular septum centesis injury, there was no centesis damage to endocardium, valve, chordae tendineae, papillary muscles and sortic tunics intima. Whereas there was no centesis injury to lung, liver and chylostomach, no trace of ericardium and thoracic infection. Animal model of intra-utero fetal cardiac intervention was setted up successfully, the experiences in this study was worth to be payed attention to in human fetal cardiac intervention. | 18,798,514 |
[Determination of trace ammonia in indoor air by ninhydrin spectrophotometry]. | To develop a new spectrophotometric method to detect trace ammonia in indoor air. Ammonia in the air was absorbed by 0.01 mol/L sulfuric acid in a bubbling absorption tube. With 95 degrees C of water bath and pH 5.5-6.0 of buffer solution of acetic acid-sodium acetate, the ammonium in the solution reacted with ninhydrin at the presence of ascorbic acid to form a royal purple product which has a maximum absorbance at 568 nm. This method produced a linear range of 0-8 microg/10 mL. The detection limit was 0.06 mg/m3. The recoveries of the method ranged from 96.2% to 102.3%, with 2.8%-6.8% of relative standard deviations. The method is simple, rapid and safe. The common coexisting substances in the air do not interfere with the determination. The precision and accuracy can satisfy the requirements of the determination of trace ammonia in indoor air. | 18,798,521 |
The seminal role of Cancer in our understanding of sarcoma. | The journal Cancer has played a critical role in advancing our understanding of sarcoma, a remarkable cluster of malignancies that arise from tissues of mesenchymal origin throughout the human body and indeed across the entire vertebrate animal spectrum. Approximately equally divided between soft tissue and bone origin, there are greater than 100 recognized histologic subtypes that collectively account for approximately 2% of adult solid tumors. | 18,798,535 |
Prenatal and perinatal risk factors for neuroblastoma. | Neuroblastoma is a rare embryonal tumor of childhood for which risk factors are not well known. Using a nested case-control design, we investigated prenatal, perinatal and neonatal risk factors in detail by linking 245 pediatric neuroblastoma cases identified in the Swedish Cancer Register diagnosed in the year 1973-1995 with the Swedish Medical Birth Register. Five living controls per case were randomly selected from the birth registry, matched by gender and age. Increased risks were associated with maternal anemia during pregnancy (odds ratio (OR) = 2.95, 95% confidence interval (CI): 1.53, 5.69), neonatal respiratory distress (OR = 3.61, 95% CI: 1.41, 9.24) and low (below or equal to 7) 1-min Apgar score (OR = 2.23, 95% CI: 1.41, 3.52). Increased risks were limited to cases diagnosed before 1 year of age. Markers of prenatal, perinatal and neonatal distress may be associated with neuroblastoma in infancy, but not with diagnoses at 1 year or above. | 18,798,548 |
Conservation of notochord gene expression across chordates: insights from the Leprecan gene family. | The notochord is a defining character of the chordates, and the T-box transcription factor Brachyury has been shown to be required for notochord development in all chordates examined. In the ascidian Ciona intestinalis, at least 44 notochord genes have been identified as bona fide transcriptional targets of Brachyury. We examined the embryonic expression of a subset of murine orthologs of Ciona Brachyury target genes in the notochord to assess its conservation throughout chordate evolution. We focused on analyzing the Leprecan gene family, which in mouse is composed of three genes, as opposed to the single-copy Ciona gene. We found that all three mouse Leprecan genes are expressed in the notochord. Additionally, while Leprecan expression in C. intestinalis is confined to the notochord, expression of its mouse orthologs includes dorsal root ganglia, limb buds, branchial arches, and developing kidneys. These results have interesting implications for the evolution and development of chordates. | 18,798,549 |
Accelerated embryonic development associated with increased risk of neural tube defects induced by maternal diet in offspring of SELH/Bc mice. | The SELH/Bc mouse strain has a high risk of the NTD, exencephaly, caused by multifactorial genetics. All SELH/Bc embryos have delayed elevation of neural folds; some never elevate (future exencephalics). Maternal diets affect SELH/Bc exencephaly rates: 25-35% on Purina Diet 5015 versus 5-10% on Purina Diet 5001. We hypothesized that in SELH/Bc, the diets affect maternal blood glucose and embryonic developmental rate. We compared mice fed the two diets. On GD 9.4 we tested maternal blood glucose and examined embryos for developmental age (somite count) and cranial neural fold morphology. We observed GD 14 exencephaly rates. Diet 5015 caused fivefold more exencephaly (40 vs. 7% on GD 14), significantly higher mean maternal blood glucose in replicate experiments (6.3 vs. 5.5, p < .05; 6.3 vs. 5.3 mmol/L, p < .05), and significantly higher mean litter somite count on GD 9.4 (18.4 vs. 15.0, p < .05; 16.7 vs. 14.4 somites, p < .05). Among midrange embryos (15-16 somites), embryos from Diet 5015 were significantly shifted to earlier stages of midbrain fold morphology and had significantly more distance between the tips of the folds (p < .05). In SELH/Bc mice, the 5015 diet causes higher maternal blood glucose, a faster overall embryonic developmental rate during neural tube closure, and delayed midbrain fold elevation relative to overall development. This pattern suggests that maternal dietary effects that modestly increase embryonic growth rate may exacerbate a lack of coordination between genetically delayed neural folds and normally developing underlying tissues, increasing risk of NTD. | 18,798,560 |
Serum antithyroid antibodies in female patients with chronic urticaria. | To determine the frequencies of serum antithyroglobulin and antimicrosomal autoantibodies in female patients with chronic urticaria, and the association between thyroid autoantibodies and chronic urticaria, if any. Non-interventional, case-control analytic study. This study was carried out by the Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006 on patients selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre and The Aga Khan University Hospital, Karachi and from the Community Clinics in Karachi. A total number of 90 subjects were enrolled and divided in three groups consisting of 30 patients each. Group 1 comprised of patients with diagnosis of chronic urticaria, Group 2 of diagnosed cases of hypothyroidism with/without urticaria, and Group 3 of normal age and gender-matched healthy volunteers. In all patients, serum antithyroid autoantibodies (antithyroglobulin and antimicrosomal) and thyroid profile (serum T3, T4 and TSH levels) was carried out. Chi-square test was used to determine significance of proportion of variables at p < 0.05. Elevated titres of antithyroglobulin antibodies were found to be present in 9 (30%) patients in Group 1 (chronic urticaria), 24 (80%) patients in Group 2 (known cases of hypothyroidism) compared to control. Elevated titres of antimicrosomal antibodies were found to be present in 13 (43.3%) patients in Group 1, 27 (90%) patients in Group 2 (known cases of hypothyroidism) compared to control. The association between hypothyroidism and chronic urticaria with regard to autoantibodies titres was highly significance (p <0.001). A highly statistically significant association was found between chronic urticaria and hypothyroidism with special regard to antithyroglobulin and antimicrosomal autoantibodies. Therefore, assays of these two autoantibodies are justified for the early diagnosis of autoimmune thyroiditis in combination with chronic urticaria for better treatment options. | 18,798,586 |
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