title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Magnetic resonance imaging techniques: fMRI, DWI, and PWI. | Magnetic resonance imaging (MRI) is a noninvasive technique which can acquire important quantitative and anatomical information from an individual in any plane or volume at comparatively high resolution. Over the past several years, developments in scanner hardware and software have enabled the acquisition of fast MRI imaging, proving extremely useful in various clinical and research applications such as in brain mapping or functional MRI (fMRI), perfusion-weighted imaging (PWI), and diffusion-weighted imaging (DWI). These techniques have revolutionized the use of MRI in the clinics, providing great insight into physiologic mechanisms and pathologic conditions. Since these relatively new areas of MRI have relied on fast scanning techniques, they have only recently been widely introduced to clinical sites. As such, this review article is devoted to the technological aspects of these techniques, as well as their roles and limitations in neuroimaging applications. | 18,843,569 |
Neuroimaging in ischemia and infarction. | The authors provide an overview of current clinical neuroimaging techniques for acute ischemic stroke. The pathophysiology of ischemic stroke is briefly reviewed, especially as it pertains to cerebral blood flow. There are three important goals that must be met in the imaging of an acute ischemic stroke: (1) to quantitate the extent of infarction already present; (2) to quantitate the amount of salvageable brain remaining; and (3) to identify the presence of arterial stenosis or occlusion that is both responsible for the stroke and potentially amenable to treatment. Methods of quantifying the degree of infarction, by magnetic resonance imaging or computed tomography, are compared. Techniques for measuring cerebral blood flow, to quantify tissue at risk, are detailed and compared. The quantification of cerebral blood flow is discussed in detail. Methods of visualizing the cerebral circulation are illustrated. | 18,843,573 |
Neuroimaging of toxic and metabolic disorders. | Imaging of the brain, magnetic resonance imaging (MRI) in particular, is a key adjunctive tool in the diagnosis and management of toxic-metabolic disorders such as alcoholism, mitochondrial encephalopathies, disorders of iron or copper metabolism, exposure to carbon monoxide, radiotherapy, immunosuppressive agents, toluene, and recreational drugs. In this article, we review the neuroimaging findings of common toxic and metabolic disorders focusing on the role of conventional MRI. We also consider advanced imaging methods, such as magnetic resonance spectroscopy, diffusion MRI, and positron emission tomography. We hope this article will prove useful to trainees and practitioners in the clinical and imaging fields of the neurosciences. | 18,843,577 |
Periventricular leukomalacia in premature infants in mainland China. | Periventricular leukomalacia (PVL) in premature infants is a major cause of mortality and disability. However, while China is the largest developing country, there is an absence of data concerning PVL. This study was carried out in order to explore the incidence rate and analyze the high-risk factors of PVL in premature infants, and to suggest a working protocol for the prevention of PVL in newborns at risk. The cohort prospective study included 921 premature infants < 37 weeks' gestation from January 2004 to July 2007. The study group was comprised of 271 premature infants with an ultrasound diagnosis of PVL and the control group was comprised of 650 premature infants who were submitted to the same evaluation protocol but did not show any echographic signs of PVL. The results showed that the incidence rate of PVL was 29.4% in China. High-degree PVL accounted for < 12% and > 88% of PVL was low-degree. The incidence rate was much higher when premature infants were accompanied by the following complications: low gestational age, low birth weight, prolonged rupture of membranes, chorionitis, mechanical ventilation, periventricular-ventricular hemorrhage, hypocapnia, and hyperlactacidemia. Severe complications that occur in premature infants also significantly increase the incidence of PVL. Antenatal corticosteroids can significantly decrease the incidence rate of PVL. This investigation provided a theoretical reference for the prevention of premature PVL. | 18,843,588 |
Antiplatelet agents for preventing thrombosis after peripheral arterial bypass surgery. | Peripheral arterial disease (PAD) may cause occlusions (blockages) in the main arteries of lower limbs. One treatment option is bypass surgery using autologous (the patient's own tissue) vein graft or artificial graft. A number of factors influence occlusion rates, including the material used. To prevent graft occlusion patients are usually treated with antiplatelet, antithrombotic drugs, or a combination of both. To evaluate whether antiplatelet treatment in patients with symptomatic PAD undergoing infrainguinal bypass surgery improves graft patency, limb salvage and survival. The authors searched the Cochrane Peripheral Vascular Diseases Group Specialised Register (January 2008) and the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4). Additional trials were sought through reference lists of papers and proceedings from the vascular surgical society meetings. For this update the methodological quality of each original trial was assessed independently by review authors (JB, HM, AW) with emphasis on concealment of allocation. Details of the selected studies were extracted independently by JB and HM for the update. The treatment and control groups were compared for important prognostic factors and differences described. If any data were unavailable, further information was sought from authors. Data were synthesised by comparing group results. Unit of analysis issues were addressed by subgroup analysis. The administration of a variety of platelet inhibitors resulted in improved venous and artificial graft patency when compared to no treatment. However, analysing patients for graft-type indicated that those patients receiving a prosthetic graft were more likely to benefit from administration of platelet inhibitors than patients treated with venous grafts. Antiplatelet therapy with aspirin had a slight beneficial effect on the patency of peripheral bypass grafts but seemed to have an inferior effect on venous graft patency compared with artificial grafts. The effect of aspirin on cardiovascular outcomes and survival was small and not statistically significant. This might be due to the fact that the majority of patients receiving a peripheral graft have an advanced stage of PAD with critical ischaemia. They are usually seriously ill as a result of cardiovascular disease and have high mortality rates, of 20% per year. Additionally, the number of patients included in this analysis might be too small to reach a statistically significant effect for mortality and cardiovascular morbidity. | 18,843,613 |
Oestrogens and progestins for preventing and treating postpartum depression. | Postpartum depression is a common complication of childbirth, affecting approximately 13% of women. A hormonal aetiology has long been hypothesised due to the sudden and substantial fluctuations in concentrations of steroid hormones associated with pregnancy and the immediate postpartum period. There is also convincing evidence that oestrogens, progestins, and related compounds have important central nervous system activity at physiological concentrations. The primary objective of this review was to assess the effects of oestrogens and progestins, including natural progesterone and synthetic progestogens, compared with placebo or usual antepartum, intrapartum, or postpartum care in the prevention and treatment of postpartum depression. We searched The Cochrane Pregnancy and Childbirth Group trials register (June 2004), the Cochrane Depression Anxiety and Neurosis Group trials register (July 2004), the Cochrane Central Register of Controlled Trials (July 2004), MEDLINE (1966 to 2004), EMBASE (1980 to 2004), and CINAHL (1982 to 2004). We scanned secondary references and contacted experts in the field. All published and unpublished randomised controlled trials comparing an oestrogen and progestin intervention with a placebo or usual antepartum, intrapartum, or postpartum care among pregnant women or new mothers recruited within the first year postpartum. Two review authors participated in the evaluation of methodological quality, data extraction, and data analysis. Results are presented using relative risk for categorical data and weighted mean difference for continuous data. Two trials, involving 229 women, met the selection criteria. Norethisterone enanthate, a synthetic progestogen, administered within 48 hours of delivery was associated with a significantly higher risk of developing postpartum depression. Oestrogen therapy was associated with a greater improvement in depression scores than placebo among women with severe depression. Synthetic progestogens should be used with significant caution in the postpartum period. The role of natural progesterone in the prevention and treatment of postpartum depression has yet to be evaluated in a randomised, placebo-controlled trial. Oestrogen therapy may be of modest value for the treatment of severe postpartum depression. Its role in the prevention of recurrent postpartum depression has not been rigorously evaluated. Further research is warranted. | 18,843,619 |
Massage for low-back pain. | Low-back pain is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. To assess the effects of massage therapy for non-specific low-back pain. We searched MEDLINE, EMBASE, CINAHL from their beginning to May 2008. We also searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, issue 3), HealthSTAR and Dissertation abstracts up to 2006. There were no language restrictions. References in the included studies and in reviews of the literature were screened. The studies had to be randomized or quasi-randomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for non-specific low-back pain. Two review authors selected the studies, assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group, and extracted the data using standardized forms. Both qualitative and meta-analyses were performed. Thirteen randomized trials were included. Eight had a high risk and five had a low risk of bias. One study was published in German and the rest in English. Massage was compared to an inert therapy (sham treatment) in two studies that showed that massage was superior for pain and function on both short and long-term follow-ups. In eight studies, massage was compared to other active treatments. They showed that massage was similar to exercises, and massage was superior to joint mobilization, relaxation therapy, physical therapy, acupuncture and self-care education. One study showed that reflexology on the feet had no effect on pain and functioning. The beneficial effects of massage in patients with chronic low-back pain lasted at least one year after the end of the treatment. Two studies compared two different techniques of massage. One concluded that acupuncture massage produces better results than classic (Swedish) massage and another concluded that Thai massage produces similar results to classic (Swedish) massage. Massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low-back pain. | 18,843,627 |
Nutrition support for bone marrow transplant patients. | This is an update of the original Cochrane review published in Issue 2, 2002. Bone marrow transplantation involves administration of toxic chemotherapy and infusion of marrow cells. After treatment, patients can develop poor appetite, mucositis and gastrointestinal failure, leading to malnutrition. To prevent this, parenteral nutrition (PN) support is often first choice but is associated with increased risk of infection. Enteral nutrition (EN) is an alternative, as is addition of substrates. To determine efficacy of EN or PN support for patients receiving bone marrow transplant. Search of The Cochrane Library, MEDLINE, EMBASE and CINAHL in November 2000 and subsequently June 2006. RCTs that compared one form of nutrition support with another, or control, for bone marrow transplant patients. Twenty nine studies were identified. Data were collected on participants' characteristics; adverse effects; neutropaenia; % change in body weight; graft versus host disease; and survival. In two studies (82 participants) glutamine mouthwash reduced number of days patients were neutropenic (6.82 days, 95%CI (1.67 to 11.98) P = 0.009) compared with placebo. Three studies reported (103 participants) that patients receiving PN with glutamine had reduced hospital stay, 6.62 d (95%CI 3.47 to 9.77, P = 0.00004) compared with patients receiving standard PN. However, in the update a further study was added (147 participants) which altered the pooled results: duration in hospital may be increased for those who receive PN with additional glutamine - 0.22 days (95%CI (1.29 to 1.72). Two other studies reported that (73 participants) patients receiving PN plus glutamine had reduced incidence of positive blood cultures (OR 0.23, 95%CI 0.08 to 0.65, P = 0.006) compared to those receiving standard PN. However, a study from the update (113 participants in total) showed the odds of having a positive blood culture have increased but are still less likely if the patient receives PN with glutamine compared to standard PN (OR 0.46, 95%CI 0.20 to 1.04). When patients were given PN versus IV hydration, (25 participants) patients receiving PN had a higher incidence of line infections (OR 21.23, 95%CI 4.15 to 108.73, P = 0.0002) compared to those receiving standard IV fluids. The update identified one study which recognised that (55 participants) those who received IV were likely to spend less time in hospital, 3.30 days (95%CI -0.38 to 6.98, P = 0.08), although this result was not significant. As reported in the original review there remains no evaluable data to properly compare PN with EN. In this update an additional study that compared PN and Glutamine versus standard PN showed that the certain benefits of parenteral nutrition with added glutamine compared to standard PN for reducing hospital stay are no longer definite. When PN with glutamine is compared with standard PN, patients may not leave hospital earlier, but do have reduced incidence of positive blood cultures, than those receiving standard PN. Where possible use of intravenous fluids and oral diet should be considered as a preference to parenteral nutrition, however, in the event of a patient suffering severe gastrointestinal failure even with a trial of enteral feeding, PN with the addition of glutamine could be considered. | 18,843,634 |
Fluticasone versus placebo for chronic asthma in adults and children. | Inhaled fluticasone propionate (FP) is a relatively new inhaled corticosteroid for the treatment of asthma. To assess efficacy and safety outcomes in studies that compared FP to placebo for treatment of chronic asthma. We searched the Cochrane Airways Group Specialised Register (January 2008), reference lists of articles, contacted trialists and searched abstracts of major respiratory society meetings (1997-2006). Randomised trials in children and adults comparing FP to placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and risk of bias. Two review authors extracted data. Quantitative analyses were undertaken using Review Manager software. Eighty-six studies met the inclusion criteria, recruiting 16,160 participants. In non-oral steroid treated asthmatics with mild and moderate disease FP resulted in improvements from baseline compared with placebo across all dose ranges (100 to 1000 mcg/d) in FEV1 (between 0.1 to 0.43 litres); morning PEF (between 23 and 46 L/min); symptom scores (based on a standardised scale, between 0.44 and 0.7); reduction in rescue beta-2 agonist use (between 1 and 1.4 puffs/day). High dose FP increased the number of patients who could withdraw from prednisolone: FP 1000-1500 mcg/day Peto Odds Ratio 14.07 (95% CI 7.17 to 27.57). FP at all doses led to a greater likelihood of sore throat, hoarseness and oral Candidiasis. Doses of FP in the range 100-1000 mcg/day are effective. In most patients with mild-moderate asthma improvements with low dose FP are only a little less than those associated with high doses when compared with placebo. High dose FP appears to have worthwhile oral-corticosteroid reducing properties. FP use is accompanied by an increased likelihood of oropharyngeal side effects. | 18,843,640 |
Antibiotics for the prophylaxis of bacterial endocarditis in dentistry. | Infective endocarditis is a severe infection arising in the lining of the heart with a high mortality rate.Many dental procedures cause bacteraemia and it was believed that this may lead to bacterial endocarditis (BE) in a few people. Guidelines in many countries have recommended that prior to invasive dental procedures antibiotics are administered to people at high risk of endocarditis. However, recent guidance by the National Institute for Health and Clinical Excellence (NICE) in England and Wales has recommended that antibiotics are not required. To determine whether prophylactic antibiotic administration compared to no such administration or placebo before invasive dental procedures in people at increased risk of BE influences mortality, serious illness or endocarditis incidence. The search strategy from the previous review was expanded and run on MEDLINE (1950 to June 2008) and adapted for use on the Cochrane Oral Health, Heart and Infectious Diseases Groups' Trials Registers, as well as the following databases: CENTRAL (The Cochrane Library 2008, Issue 2); EMBASE (1980 to June 2008); and the metaRegister of Controlled Trials (to June 2008). Due to the low incidence of BE it was anticipated that few if any trials would be located. For this reason, cohort and case-control studies were included where suitably matched control or comparison groups had been studied. The intervention was the administration of antibiotic compared to no such administration before a dental procedure in people with an increased risk of BE. Cohort studies would need to follow those at increased risk and assess outcomes following any invasive dental procedures, grouping by whether prophylaxis was received. Included case-control studies would need to match people who had developed endocarditis (and who were known to be at increased risk before undergoing an invasive dental procedure preceding the onset of endocarditis) with those at similar risk but who had not developed endocarditis. Outcomes of interest were: mortality or serious adverse event requiring hospital admission; development of endocarditis following any dental procedure in a defined time period; development of endocarditis due to other non-dental causes; any recorded adverse events to the antibiotics; and cost implications of the antibiotic provision for the care of those patients who develop endocarditis. Two review authors independently selected studies for inclusion, then assessed quality and extracted data from the included study. No randomised controlled trials (RCTs), controlled clinical trials (CCTs) or cohort studies were included. One case-control study met the inclusion criteria. It collected all the cases of endocarditis in The Netherlands over 2 years, finding a total of 24 people who developed endocarditis within 180 days of an invasive dental procedure, definitely requiring prophylaxis according to current guidelines and who were at increased risk of endocarditis due to a pre-existing cardiac problem. This study included participants who died because of the endocarditis (using proxys). Controls attended local cardiology outpatient clinics for similar cardiac problems, had undergone an invasive dental procedure within the past 180 days and were matched by age with the cases. No significant effect of penicillin prophylaxis on the incidence of endocarditis could be seen. No data were found on other outcomes. There remains no evidence about whether penicillin prophylaxis is effective or ineffective against bacterial endocarditis in people at risk who are about to undergo an invasive dental procedure. There is a lack of evidence to support previously published guidelines in this area. It is not clear whether the potential harms and costs of antibiotic administration outweigh any beneficial effect. Ethically practitioners need to discuss the potential benefits and harms of antibiotic prophylaxis with their patients before a decision is made about administration. | 18,843,649 |
Combination contraceptives: effects on weight. | Weight gain is often considered a side effect of combination hormonal contraceptives, and many women and clinicians believe that an association exists. Concern about weight gain can limit the use of this highly effective method of contraception by deterring the initiation of its use and causing early discontinuation among users. However, a causal relationship between combination contraceptives and weight gain has not been established. The aim of the review was to evaluate the potential association between combination contraceptive use and changes in weight. We searched the computerized databases MEDLINE, POPLINE, CENTRAL, EMBASE, and LILACS for studies of combination contraceptives, as well as clinical trials databases. We also wrote to known investigators and manufacturers to request information about other published or unpublished trials not discovered in our search. All English-language, randomized controlled trials were eligible if they had at least three treatment cycles and compared a combination contraceptive to a placebo or to a combination contraceptive that differed in drug, dosage, regimen, or study length. All titles and abstracts located in the literature searches were assessed. Data were entered and analyzed with RevMan, and a second author verified the data entered. Depending on the data available, the mean difference using a fixed effects model with 95% confidence interval (CI) was calculated for the mean change in weight between baseline and post-treatment measurements or the Peto odds ratio with 95% confidence interval was calculated using the proportion of women who gained or lost more than a specified amount of weight. The three placebo-controlled, randomized trials did not find evidence supporting a causal association between combination oral contraceptives or a combination skin patch and weight gain. Most comparisons of different combination contraceptives showed no substantial difference in weight. In addition, discontinuation of combination contraceptives because of weight gain did not differ between groups where this was studied. Available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident. | 18,843,652 |
Surgical versus conservative management for odontoid fractures. | Fractures of the odontoid process of the second cervical vertebra can result in instability, neurological damage and death. Treatment includes conservative management (external immobilisation devices) or surgical treatment (internal fixation by posterior fusion or anterior screw fixation). To compare surgical with conservative treatment for fractures of the odontoid process. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE (1966 to February 2008), EMBASE (1988 to February 2008), LILACS (accessed February 2008), reference lists of articles and registries of ongoing trials. Randomised and quasi-randomised controlled trials comparing surgical versus conservative management of odontoid fractures. Two review authors independently examined the search results to identify trials for inclusion. We did not identify any studies that met our inclusion criteria. We excluded one ongoing and registered study that is comparing surgery versus conservative treatment because it does not involve randomisation of treatment allocation. There is no evidence available from adequately controlled trials to inform the decision on whether the surgical treatment of odontoid fractures gives a better outcome. A sufficiently powered good quality multicentre randomised controlled trial comparing surgery versus conservative treatment is warranted. | 18,843,678 |
Interventions to improve outpatient referrals from primary care to secondary care. | The primary care specialist interface is a key organisational feature of many health care systems. Patients are referred to specialist care when investigation or therapeutic options are exhausted in primary care and more specialised care is needed. Referral has considerable implications for patients, the health care system and health care costs. There is considerable evidence that the referral processes can be improved. To estimate the effectiveness and efficiency of interventions to change outpatient referral rates or improve outpatient referral appropriateness. We conducted electronic searches of the Cochrane Effective Practice and Organisation of Care (EPOC) group specialised register (developed through extensive searches of MEDLINE, EMBASE, Healthstar and the Cochrane Library) (February 2002) and the National Research Register. Updated searches were conducted in MEDLINE and the EPOC specialised register up to October 2007. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time series of interventions to change or improve outpatient referrals. Participants were primary care physicians. The outcomes were objectively measured provider performance or health outcomes. A minimum of two reviewers independently extracted data and assessed study quality. Seventeen studies involving 23 separate comparisons were included. Nine studies (14 comparisons) evaluated professional educational interventions. Ineffective strategies included: passive dissemination of local referral guidelines (two studies), feedback of referral rates (one study) and discussion with an independent medical adviser (one study). Generally effective strategies included dissemination of guidelines with structured referral sheets (four out of five studies) and involvement of consultants in educational activities (two out of three studies). Four studies evaluated organisational interventions (patient management by family physicians compared to general internists, attachment of a physiotherapist to general practices, a new slot system for referrals and requiring a second 'in-house' opinion prior to referral), all of which were effective. Four studies (five comparisons) evaluated financial interventions. One study evaluating change from a capitation based to mixed capitation and fee-for-service system and from a fee-for-service to a capitation based system (with an element of risk sharing for secondary care services) observed a reduction in referral rates. Modest reductions in referral rates of uncertain significance were observed following the introduction of the general practice fundholding scheme in the United Kingdom (UK). One study evaluating the effect of providing access to private specialists demonstrated an increase in the proportion of patients referred to specialist services but no overall effect on referral rates. There are a limited number of rigorous evaluations to base policy on. Active local educational interventions involving secondary care specialists and structured referral sheets are the only interventions shown to impact on referral rates based on current evidence. The effects of 'in-house' second opinion and other intermediate primary care based alternatives to outpatient referral appear promising. | 18,843,691 |
Dengzhanhua preparations for acute cerebral infarction. | Dengzhanhua preparations are widely used in China. Many controlled trials have been undertaken to investigate the efficacy of dengzhanhua preparations in the treatment of acute cerebral infarction. To assess whether dengzhanhua preparations are effective and safe at improving outcomes in patients with acute cerebral infarction. We searched the Cochrane Stroke Group Trials Register (last searched October 2007), the Chinese Stroke Trials Register (last searched June 2006), the trials register of the Cochrane Complementary Medicine Field (last searched June 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2 2006), MEDLINE (1966 to June 2006), EMBASE (1980 to June 2006), AMED (the Allied and Complementary Medicine Database, 1985 to June 2006), the China Biological Medicine Database (CBM-disc, 1979 to June 2006), and Chinese Knowledge Infrastructure (CNKI,1994 to October 2007). We also searched the reference lists of relevant articles. Randomised and quasi-randomised controlled clinical trials of dengzhanhua preparations regardless of duration, dosage and route of administration in patients with confirmed acute cerebral infarction. Two review authors independently applied the inclusion criteria, assessed trial quality, and extracted the data. We included nine trials, all conducted in China, involving 723 participants. The method of randomisation and concealment was poorly described. The included trials compared dengzhanhua injection plus routine therapy with routine therapy alone. Patients were enrolled up to one week after the onset of stroke. No trials reported data on the pre-specified primary or secondary outcomes. In a post-hoc comparison of dengzhanhua injection plus routine therapy versus routine therapy alone, dengzhanhua injection showed a statistically significant benefit on the outcome 'marked neurologic improvement' (relative risk 1.53; 95% confidence interval 1.36 to 1.72). No serious adverse effects were reported. Due to the generally low methodological quality and small sample size of the included trials in this systematic review, we could not draw a firm conclusion. | 18,843,694 |
Antimotility agents for chronic diarrhoea in people with HIV/AIDS. | AIDS-related diarrhoea is a common cause of morbidity and mortality in HIV positive individuals, especially in the sub-Saharan Africa where 70% of deaths from HIV occur. It often compromises quality of life both in those receiving antiretroviral therapy (ART) and the ART naive. Empirical antidiarrhoeal treatment may be required in about 50% of cases which are non-pathogenic or idiopathic and in cases resulting from antiretroviral therapy. Antimotility agents (Loperamide, Diphenoxylate, Codeine) and adsorbents (Bismuth Subsalicylate, Kaolin/Pectin, Attapulgite) are readily available, and have been found to be useful in this condition and so, are often used. Antimotilitics are opioids, decreasing stool output by reducing bowel activity thereby increasing fecal transit time in the gut, promoting fluid and electrolyte retention while adsorbents act by binding to fluids, toxins and other substances to improve stool consistency and eliminate the toxins. Due to its potential impact on the management of chronic diarrhoea in persons with HIV/AIDS, we reviewed the effectiveness of antimotility agents in controlling chronic diarrhoea in immunocompromised states caused by HIV/AIDS. To assess the effectiveness of antimotility agents in controlling chronic diarrhoea in people with HIV/AIDS. We searched Medline, EMBASE, the Cochrane Controlled Trials Register, the Cochrane HIV/AIDS Register and AIDSearch databases in November 2006. We also contacted WHO, CDC, pharmaceutical companies and experts in the field for information on previous or on-going trials and checked reference list from retrieved studies, irrespective of language and publication status. Randomised controlled trials comparing an antimotility agent or an adsorbent with another antimotility agent, placebo, an adsorbent or no treatment in children and adults diagnosed with HIV and presenting with diarrhoea of three or more weeks duration. Two authors independently undertook study selection and examined full articles of potentially eligible studies. One trial was found assessing the use of an adsorbent (attapulgite) compared to a placebo for chronic diarrhoea in people with HIV/AIDS. It included 91 adults (Aged 18 to 60), diagnosed with AIDS and experiencing diarrhoea for at least 7 days. There was no evidence that attapulgite is superior to placebo in controlling diarrhoea by reducing stool frequency and normalising stool consistency on days 1 (0.34 (95% CI 0.01 - 8.15)), 3 (1.35 (95% CI 0.51 - 3.62)) and 5 (1.74 (95% CI 0.89 - 3.38)). This was a small trial and may not have had enough power to show evidence of effects. Five deaths were reported which was not classified according to the arms of the study.Studies assessing the use of antimotility agents were not found. This review highlights the absence of evidence for the use of antimotility agents and adsorbents in controlling diarrhoea in people with HIV/AIDS. While no trials assessing the use of Antimotilitics were found, the retrieved study showed that attapulgite was not better than placebo in controlling diarrhoea in HIV/AIDS patients . For optimum patient care, these agents can still be used, with greater emphasis placed on adjunct therapies like massive fluid replacement while evidence for practice is awaited from further studies and reviews. | 18,843,696 |
Nutritional supplements for people being treated for active tuberculosis. | Tuberculosis is a serious infection affecting mainly the lungs. It may contribute to nutritional deficiencies which in turn may delay recovery by depressing immune functions. Nutritional supplements might therefore promote recovery in people being treated for tuberculosis. To assess the provision of oral nutritional supplements to promote the recovery of people being treated with antituberculous drug therapy for active tuberculosis. We searched the Cochrane Infectious Disease Group Specialized Register (June 2008), CENTRAL (The Cochrane Library 2008, Issue 2), MEDLINE (June 2008), EMBASE (June 2008), LILACS (June 2008), mRCT (June 2008), the Indian Journal of Tuberculosis (1983 to June 2008), and checked the reference lists of all included studies. Randomized controlled trials comparing any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. Two authors independently selected trials, extracted data, and assessed risk of bias. We calculated risk ratios (RR) for dichotomous variables and mean differences (MD) for continuous variables, with 95% confidence intervals (CI). We pooled data from trials with similar interventions and outcomes. Twelve trials (3393 participants) were included. Five trials had adequate allocation concealment. Interventions included a high energy supplement, high cholesterol diet, vitamin D, vitamin A, zinc, arginine, multiple micronutrient supplements, combined multiple micronutrient supplements and zinc, combined vitamin A and zinc, and combined vitamin A and selenium. The following supplements were associated with increased body weight at follow up: high energy supplements (MD 1.73 kg, 95% CI 0.81 to 2.65; 34 participants, 1 trial); multiple micronutrients plus additional zinc (MD 2.37 kg, 95% CI 2.21 to 2.53; 192 participants, 1 trial); and vitamin A plus zinc (MD 3.10 kg, 95% CI 0.74 to 5.46; 80 participants, 1 trial). There was no evidence that any supplement affected the number of deaths or number of participants with sputum test positive results at the end of treatment. There is limited evidence that high energy supplements and some combinations of zinc with other micronutrients may help people with tuberculosis to gain weight. There is not enough evidence to assess the effect of other combinations of nutrients. A number of relevant trials are in progress, and, where appropriate, the results will be incorporated into future updates of this review. | 18,843,702 |
Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. | Staphylococcus aureus (S. aureus) is the leading nosocomial (hospital acquired) pathogen in hospitals throughout the world. Traditionally, control of S. aureus has been focused on preventing cross-infection between patients, however, it has been shown repeatedly that a large proportion of nosocomial S. aureus infections originate from the patient's own flora. Nasal carriage of S. aureus is now considered a well defined risk factor for subsequent infection in various groups of patients. Local antibiotic treatment with mupirocin ointment is often used to eradicate nasal S. aureus. To determine whether the use of mupirocin nasal ointment in patients with identified S. aureus nasal carriage reduced S. aureus infection rates. We searched the Cochrane Wounds Group Specialised Register (May 2008), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 2 2008), MEDLINE (1950 to May 2008), EMBASE (1980 to May 2008) and CINAHL (1982 to May 2008). To identify unpublished trials, abstract books from major scientific meetings (ICAAC, ESCMID and SHEA) were handsearched, researchers and manufacturers of mupirocin were contacted and other electronic databases were searched (SIGLE, ASLIB Index, mRCT, USA Clinical Trials). Randomised controlled trials (RCTs) comparing nasal mupirocin with no treatment or placebo or alternative nasal treatment in the prevention of S. aureus infections in nasal S. aureus carriers were included. Titles, abstracts and full-text articles of studies retrieved from the search process were independently assessed by two authors for inclusion. From included studies a data extraction form was made and the quality of the trial was assessed. The primary outcome was the S. aureus infection rate (any site). Secondary outcomes were time to infection, mortality, adverse events and infection rate caused by micro-organisms other than S. aureus. Nine RCTs involving 3396 participants met the inclusion criteria. Patient populations varied and several types of nosocomial S. aureus infection were described including bacteraemia, exit-site infections, peritonitis, respiratory tract infections, skin infections, surgical site infections (SSI) and urinary tract infections. After pooling the eight studies that compared mupirocin with placebo or with no treatment, there was a statistically significant reduction in the rate of S. aureus infection associated with intranasal mupirocin (RR 0.55, 95% CI 0.43 to 0.70).A planned subgroup analysis of surgical trials demonstrated a significant reduction in the rate of nosocomial S. aureus infection rate associated with mupirocin use (RR 0.55, 95% CI 0.34 to 0.89) however this effect disappeared if the analysis only included surgical site infections caused by S. aureus (RR 0.63, 95% CI 0.38 to 1.04), possibly due to a lack of power. The infection rate caused by micro-organisms other than S. aureus was significantly higher in patients treated with mupirocin compared with control patients (RR 1.38 95% CI 1.118 to 1.72). In people who are nasal carriers of S. aureus, the use of mupirocin ointment results in a statistically significant reduction in S. aureus infections. | 18,843,708 |
Touch therapies for pain relief in adults. | Pain is a global public health problem affecting the lives of large numbers of patients and their families. Touch therapies (Healing Touch (HT), Therapeutic Touch (TT) and Reiki) have been found to relieve pain, but some reviews have suggested there is insufficient evidence to support their use. To evaluate the effectiveness of touch therapies (including HT, TT, and Reiki) on relieving both acute and chronic pain; to determine any adverse effect of touch therapies. Various electronic databases, including The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED and others from their inception to June 2008 were searched. Reference lists and bibliographies of relevant articles and organizations were checked. Experts in touch therapies were contacted. Randomized Controlled Trials (RCTs) or Controlled Clinical Trials (CCTs) evaluating the effect of touch on any type of pain were included. Similarly, only studies using a sham placebo or a 'no treatment' control was included. Data was extracted and quality assessment was conducted by two independent review authors. The mean pain intensity for completing all treatment sessions was extracted. Pain intensity from different pain measurement scales were standardized into a single scale. Comparisons between the effects of treatment groups and that of control groups were made. Twenty four studies involving 1153 participants met the inclusion criteria. There were five, sixteen and three studies on HT, TT and Reiki respectively. Participants exposed to touch had on average of 0.83 units (on a 0 to ten scale) lower pain intensity than unexposed participants (95% Confidence Interval: -1.16 to -0.50). Results of trials conducted by more experienced practitioners appeared to yield greater effects in pain reduction. It is also apparent that these trials yielding greater effects were from the Reiki studies. Whether more experienced practitioners or certain types of touch therapy brought better pain reduction should be further investigated. Two of the five studies evaluating analgesic usage supported the claim that touch therapies minimized analgesic usage. The placebo effect was also explored. No statistically significant (P = 0.29) placebo effect was identified. Touch therapies may have a modest effect in pain relief. More studies on HT and Reiki in relieving pain are needed. More studies including children are also required to evaluate the effect of touch on children. | 18,843,720 |
Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression. | Although pregnancy was once thought of as a time of emotional well-being for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. To assess the effects, on mothers and their families, of non-pharmacological/psychosocial/psychological interventions compared with usual antepartum care in the treatment of antenatal depression. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2007), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (January 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to January 2007), EMBASE (1980 to January 2007) and CINAHL (1982 to January 2007). We scanned secondary references and contacted experts in the field to identify other published or unpublished trials. All published, unpublished and ongoing randomised controlled trials of non-pharmacological/psychosocial/psychological interventions to treat antenatal depression. All review authors independently participated in the evaluation of methodological quality and data extraction. . We included one US three-armed randomised controlled trial in this review, incorporating 61 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Maternal massage, compared to non-specific acupuncture (control group), did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 38; risk ratio (RR) 0.80, 95% confidence interval (CI) 0.25 to 2.53) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 1.93, 95% CI 0.37 to 10.01). Acupuncture specifically treating symptoms of depression, compared to non-specific acupuncture, did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 35; RR 0.48, 95% CI 0.11 to 2.13) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 0.64, 95% CI 0.06 to 6.39). The evidence is inconclusive to allow us to make any recommendations for massage therapy or depression-specific acupuncture for the treatment of antenatal depression. The included trial was too small with a non-generalisable sample, to make any recommendations. | 18,843,730 |
Early versus delayed laparoscopic cholecystectomy for biliary colic. | Biliary colic is one of the commonest indications for laparoscopic cholecystectomy. Laparoscopic cholecystectomy involves several months of waiting if performed electively. However, patients can develop life-threatening complications during this waiting period. To assess the benefits and harms of early versus delayed laparoscopic cholecystectomy for patients with biliary colic due to gallstones. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until March 2008. We included only randomised clinical trials irrespective of language and publication status. Two authors independently extracted the data. We intended to calculate the risk ratio, risk difference with 95% confidence intervals (CI) for dichotomous outcomes, and weighted mean difference (WMD) with 95% CI for continuous outcomes using RevMan 4.2 based on intention-to-treat analysis. Only one trial including 75 patients, randomised to early laparoscopic cholecystectomy (less than 24 hours of diagnosis) (n = 35) and delayed laparoscopic cholecystectomy (mean waiting period of 4.2 months) (n = 40), qualified for this review. This trial was of high risk of bias. During the waiting period in the delayed group (mean 4.2 months), the complications that the patients suffered included severe acute pancreatitis resulting in mortality (1), empyema of gallbladder (1), gallbladder perforation (1), acute cholecystitis (2), cholangitis (2), obstructive jaundice (2), and recurrent biliary colic requiring hospital visits (5). The rate of conversion to open cholecystectomy was lower in the early group (0%) than the delayed group (8/40 or 20%) (p = 0.0172). There was a statistically significant shorter operating time and hospital stay in the early group than the delayed group (WMD -14.80 minutes, 95% CI -18.02 to -11.58 and -1.25 days, 95% CI -2.05 to -0.45 respectively). Fourteen patients (35%) required 18 hospital admissions for symptoms related to gallstones during the mean waiting period of 4.2 months in the delayed group. This is equivalent to 11 admissions per 100 persons per month. Based on evidence from only one high-bias risk trial, it appears that early laparoscopic cholecystectomy (< 24 hours of diagnosis of biliary colic) decreases the morbidity during the waiting period for elective laparoscopic cholecystectomy, decreases the rate of conversion to open cholecystectomy, decreases operating time, and decreases hospital stay. Further randomised clinical trials are necessary to confirm or refute this finding. | 18,843,746 |
Organising health care services for persons with an intellectual disability. | When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, higher rates of unmet health needs, and more difficulty finding and getting health care. Organisational interventions are used to reconfigure the structure or delivery of health care services and may prove useful to decrease the noted disparities. To assess the effects of organisational interventions for the mental and physical health problems of persons with an intellectual disability. We searched the Cochrane Effective Practice and Organisation of Care Group specialised register (no year restriction), MEDLINE, EMBASE, CINAHL, other databases from January 1990 to April 2006 reference lists of included studies, and we consulted experts in the field. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time series of organisational interventions aimed at improving care of mental and physical health problems of adult persons with an intellectual disability. Two review authors independently extracted data and assessed study quality. Missing data were requested from authors of included studies. Eight studies met the selection criteria: six were randomised controlled trials, one was a controlled before and after study, and one was an interrupted time series. In general the studies were of acceptable methodological quality. The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability, none focused on physical health problems. Three of the studies identified effective organisational interventions and five showed no evidence of effect. Only two studies were similar enough to analyse using a meta-analysis. In the pooled analyses 25 participants received assertive community treatment and 25 received standard community treatment. Results from measures of function, caregiver burden and quality of life were non-significant. There are currently no well designed studies focusing on organising the health services of persons with an intellectual disability and concurrent physical problems. There are very few studies of organisational interventions targeting mental health needs and the results of those that were found need corroboration. There is an urgent need for high quality health services research to identify optimal health services for persons with an intellectual disability and concurrent physical problem. | 18,843,752 |
Electrocardiographic findings in psoriatic arthritis: a case-controlled study. | We assessed cardiac conduction properties in patients with psoriatic arthritis (PsA). Electrocardiogram (ECG) scans of 92 patients with PsA were compared to 92 age and sex matched nonpsoriatic, nonarthritic patients from general practice serving as controls. PR interval was found to be significantly longer in the PsA group compared to controls, 159.6 +/- 21 ms versus 151.3 +/- 26 ms, respectively (p = 0.021). No statistical difference was found with respect to the QRS interval or other atrial or ventricular conduction disturbances studied. No correlation was found between the PR interval and disease duration or PsA subtype. The use of nonsteroidal antiinflammatory drugs did not affect the PR interval. Methotrexate was not found to influence the PR interval, compared to other disease modifying antirheumatic drugs. Two PsA patients (2.1%) had a PR interval > 0.2 ms. Their prolonged PR interval could not be explained by medication use. The abnormal prolongation of the PR interval was asymptomatic, requiring no additional intervention. No patient had complete heart block. Our study may suggest subtle involvement of the atrioventricular node in patients with PsA. | 18,843,776 |
Associations between FCGR3A polymorphisms and susceptibility to rheumatoid arthritis: a metaanalysis. | .To investigate whether the Fcgamma receptor (FCGR) polymorphism confers susceptibility to rheumatoid arthritis (RA). We conducted metaanalyses on the associations between FCGR polymorphisms and RA susceptibility as determined using (1) allele contrast, (2) recessive models, (3) dominant models, and (4) contrast of homozygotes, using fixed or random effects models. A total of 10 separate comparisons were considered, which comprised 6 European and 4 Asian population samples. Metaanalysis of FCGR3A polymorphism revealed a significant association between the VV genotype and the risk of developing RA relative to the VF+FF genotype (OR 1.256, 95% CI 1.045-1.510, p = 0.015), with no evidence of between-study heterogeneity (p = 0.167). In subjects of European descent, a stronger association was observed between the VV genotype and RA than for the FF genotype (OR 1.374, 95% CI 1.101-1.714, p = 0.005). In Asians, no such association was found. Metaanalysis of the VV vs FF genotype revealed a significantly increased OR in Europeans (OR 1.399, 95% CI 1.107-1.769, p = 0.005), but not in Asians. No association was found between RA and the FCGR2A and FCGR3B polymorphisms in all subjects and in European and Asian populations, except for the NA22 vs NA11 of FCGR3B in Europeans. No relation was found between the FCGR2A polymorphism and susceptibility to RA in Europeans or Asians. The FCGR3A polymorphism was found to be associated with RA in Europeans but not in Asians. The FCGR3B polymorphism was associated with RA susceptibility in Europeans. | 18,843,786 |
Sleep-waking cycle in the cerveau isolé cat. | The experiments were performed on ten chronic low cerveau isolé cats: in eight cats the brain stem transection was prepontine and in two cats, intercollicular. The preparations survived from 24 to 3 days. During 24-36 hr sessions the ECoG activity was continuously recorded, and the ocular and ECoG components of the orienting reflexes to visual and olfactory stimuli were studied. 2. Three periods can be recognized in the recovery process of the low cerveau isolé cat. They are called acute, early chronic and late chronic stages. The acute stage lasts 1 day and the early chronic stage seems to last 3 weeks at least. During the acute stage the ability to desynchronize the EEG, either spontaneously or in response to sensory stimulations, is dramatically impaired and the pupils are fissurated. Thus the cat is comatous. 4. During the early chronic stage, although the ECoG synchronization-desynchronization cycle and the associated fissurated myosis-myosis cycle already exist, the episodes of ECoG desynchronization occupy only a small percentage of time and usually develop slowly. Visual and olfactory stimuli are often ineffective. Thus the cat is semicomatous. In the late chronic stage the sleep-waking cycle is present. The animal can be easily awakened by visual and olfactory stimuli. The intensity of the ECoG arousal to visual stimuli and the distribution of time between alert wakefulness, drowsiness, light synchronized sleep and deep synchronized sleep are similar to those in the chronic pretrigeminal cat. The recovery of the cerveau isolé seems to reach a steady level when the sleep-waking cycle becomes similar to that present in the chronic pretrigeminal cat. During the whole survival period the vertical following reflex is abortive. | 18,843,820 |
Device diagnostics for heart failure: identifying eligible patients. | The prevalence of heart failure has increased by 500% over the past 30 years, creating a significant burden on the health care system. Traditional means of detecting worsening heart failure, such as subjective assessment, symptoms, and physical examination, lack sensitivity and specificity. Many nurses who manage heart failure patients have become interested in the role implantable cardiac devices play in monitoring patients' clinical status. In addition to providing therapies, some devices track and report diagnostic information that allows clinicians to more closely and effectively monitor patients, with the possibility of helping to prevent hospitalizations and improve patient outcomes. Optimal use of device diagnostics requires clinics to establish systems for recognizing patients who are eligible for device monitoring. This paper highlights various methods clinics have used to identify patients with implantable cardiac devices so that their device data can be used in conjunction with clinical evaluations to help guide patient care. | 18,843,830 |
Disability associated with comorbid anxiety disorders in women with chronic physical illness in Ontario, Canada. | Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness, and about twice as prevalent in women as in men. This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these disorders on short-term disability and suicidal ideation. Comorbid anxiety disorders were more prevalent among women who were young, single, poor, and Canadian-born, and among women with chronic fatigue syndrome; fibromyalgia, bowel disorder or stomach or intestinal ulcers, or bronchitis had the highest rates of anxiety disorders. The presence of comorbid anxiety disorders was significantly associated with short-term disability, requiring help with instrumental daily activities, and suicidal ideation. Our findings underscore the importance of early detection and treatment of anxiety disorders in the physically ill, especially those who also suffer from mood disorders. | 18,843,837 |
Women's health policies associated with obesity, diabetes, high blood pressure, and smoking: a follow-up on the women's health report card. | This study sought to elucidate associations between state-level policies related to women's health and state prevalence of obesity, smoking, high blood pressure, and diabetes among women. Using data from national sources compiled for Making the Grade on Women's Health: A National and State-by-State Report Card, state policies on key women's health issues were evaluated on the degree to which policies adequately protected women's health. Blocked regressions assessed the policies associated with state outcomes. Antidiscrimination policies were prominent for high blood pressure, smoking, and obesity; models accounted for significant variance for all outcomes. State policies that support women may improve women's health. | 18,843,842 |
[Causes of climatic changes and their consequences on human health]. | Environmental disasters are common phenomena caused by human factors. Disaster episodes may be the result of climatic changes such as global warming, which can lead to floods or drought. Greenhouse gases, and especially the ozone, represent a special problem. Atmospheric pollutions are the result of fire, storm dusts, winds, acid rain, etc. Underwater earthquakes very often end in tsunami with waves of up to 30 meters. Disasters described in the territory of Croatia include atmospheric pollutions, fires, floods, and droughts. All disasters affect the health of the population, particularly of the elderly. This most often includes the cardiovascular and respiratory systems, allergic reactions, and carcinogenic effects, resulting in increased mortality. | 18,843,850 |
Evaluation of direct immunofluorescence test for diagnosis of upper respiratory tract infection by Chlamydia pneumoniae. | Chlamydia pneumoniae causes a variety of respiratory infections and is involved in cardiovascular diseases. Diagnosis of C. pneumoniae infection currently relies on antibody detection by microimmunofluorescence (MIF), which has limited use, and is the retrospective diagnosis for acute infection. Find an effective early diagnosis of acute upper respiratory infection, or use in combination with MIF to accurately diagnose the infection by C. pneumoniae. Direct immunofluorescence (DIF) was developed to detect C. pneumoniae in nasopharyngeal specimens obtained from patients with upper respiratory tract infection, and normal individuals. IgM and IgG antibodies against C. pneumoniae by MIF were determined for evaluation of the detected C. pneumoniae and seroconversion. DIF gave positive results in 29 of 37 (78.4%) samples from 31 patients. Fifteen samples positive by DIF illustrated antibody titers interpreted as acute C. pneumoniae infection, and eight DIF positive samples showed antibody titers of chronic infection. Negative results by both DIF and MIF were found in two patients and 23 of 25 by DIF but 20 of 25 by MIF in normal subjects. Five paired sera subsequently collected from three of the 31 patients illustrated seroconversion 2-4 months after the primary specimen collection, which gave positive results by DIF but negative for antibodies. Significant association was found between C. pneumoniae detection by DIF and antibodies by MIF when analysis was done in the group of patients and normal subjects (p < 0.001; Pearson chi-square test). DIF could be an alternative assay for early diagnosis of C. pneumoniae infection, and may be used in combination with MIF for accurate diagnosis of acute C. pneumoniae infection. | 18,843,873 |
Geographical variation of mortality in Thailand. | To examine geographical variation of mortality in Thailand. Descriptive ecological study using the national vital registration data in 2000, age-specific mortality rate and cause-specific standardized mortality ratio (SMR) were presented at district geographic level. Overall mortality was highly concentrated in the middle part of the upper north, as well as mortality of the working age. Clustering of cause-specific SMR in a single region was found for liver cancer (in the upper northeast region) and chronic obstructive pulmonary disease (in the upper north region). Clustering in multiple regions was found for renal failure (in the upper north and the upper northeast regions). Dispersed pattern of mortality with no regional clustering was found for leukemia. The geographical pattern of cause-specific mortality might be explained by distribution of incidence and related risk factors. Geographical variation of mortality exists and should be used as a target for reducing mortality gap across geographical areas. | 18,843,878 |
Biotypes, genotypes and ketoconazole susceptibility of Candida albicans isolates from a group of Thai AIDS patients. | A total of eighty-seven Candida albicans isolates from a group of Thai AIDS patients were characterized for phenotypic and genotypic profiles and antifungal susceptibility to ketoconazole. Phenotyping of the isolates was carried out by a biotyping method based on the enzyme profiles, carbohydrate assimilation patterns and boric acid resistance of the yeasts. Genotyping was performed through randomly amplified polymorphic DNA (RAPD) analysis. Antifungal susceptibility of ketoconazole was performed using the NCCLS broth microdilution method. Combination of the biotypic tests revealed a total of 49 different biotypes. The most predominant was A1S (31%), the remaining biotypes represented only few isolates in each. RAPD profiles identified 14 clusters of genotype among the 87 isolates. Almost every individual harboured his/her own specific isolate and in 25 of 26 (96.2%) harboured more than one clonal type. The heterogeneity of both phenotypic and genotypic profiles of C. albicans isolates in this study was similar to previous reports from other oral sources in different geographic areas. All isolates were susceptible to ketoconazole. The findings may be useful as baseline information of oral C. albicans colonization in Thai population living in the south of Thailand. | 18,843,897 |
[Surgical aspects of primary tuberculosis in children: clinical presentation and indications for surgical treatment]. | During the last years a trend of increasing the cases with primary pulmonary tuberculosis (PPT) in our country is observed. The aim of this study is to analyze retrospectively the pediatric cases with PPT and to determinate the specific clinical features as well the indications for surgery. For a period of six years (2000-2005) thirteen children with PPT were treated at the Department of pediatric surgery. The patients underwent different type surgical procedures. Lobectomy was the most frequent operation. The initial diagnosis at admission was: chronic pneumonia, mediastinal tumor, complicated hydatid cyst, congenital lung cyst and pleural complication of PPT. The radiological features were typical for PPT in only two cases. The remaining showed atypical presentation and the diagnosis were confirmed by histopathological study of the surgery specimens. There were no postoperative complications and no late morbidity. We classify the clinical course of children with PPT into three groups: 1) Identified PPT - two children, 2) Suspected PPT according the criteria of Migliori - six children and 3) Non identified PPT - five children. The diagnosis of the childhood pulmonary tuberculosis presents a major challenge. The most common radiological features are similar to those of other pulmonary affections and a thorough examination of symptoms of disease is necessary. Surgery has a complementary role in the complex treatment in children with PPT. | 18,843,903 |
Disparities in preventive care by body mass index categories among women. | The present analyses examined the relationship of body mass index (BMI) categories to receiving age-appropriate preventive services among women. Data from the Medical Expenditure Panel Survey (2003, N = 10,954) were analyzed using multiple logistic regressions. Outcomes were: age-appropriate Pap-test, mammography, colorectal, cholesterol and blood pressure screening, and influenza immunization. Overall, 3% of participants were underweight, and 26.3% were obese. Obese women were less likely to receive Pap-tests (p < .01), and underweight women less likely to receive mammography (p < .001). Dental care was less likely across all BMI groups outside the normal weight range. The association between BMI categories and preventive services use varied by type of preventive care. | 18,843,937 |
Frequent search for sense by long-term breast cancer survivors associated with reduced HRQOL. | This study examined breast cancer survivors' reports of continuing efforts to make sense of their breast cancer experience and associations of such efforts with post-traumatic stress symptomology (PTSS) and long-term health related quality of life (HRQOL). A cross-sectional survey was conducted with 636 women in 2002-2003 two, five and ten years after their diagnosis of breast cancer. Only a minority of women with breast cancer reported frequently searching for sense in their cancer experience, or wondering "why did this happen to me?" two or more years after diagnosis. Controlling for key demographic and disease variables, greater involvement in search two, five and ten years post-diagnosis was associated with higher levels of PTSS (R2 = 0.26; p < 0.001) and with reduced HRQOL as measured using the SF-36 scale (p < 0.01 for all scales). It appears that continued efforts to search for sense in the cancer experience two or more years after cancer diagnosis are associated with PTSS and lower levels of HRQOL in long-term survivors of breast cancer. | 18,843,938 |
[An experiment of 125I radioactive pancreatic duct stents implanted in the pancreatic ducts of pigs]. | To evaluate the feasibility and safety of radioactive pancreatic duct stents implanted in the pancreatic ducts of pigs by endoscopy. Different doses of 125I radioactive pancreatic duct stents were implanted in the pancreatic ducts of pigs by endoscopy. Blood tests were conducted before and after implantation. 14, 30 and 60 days after implantation of the radioactive stents, the pigs were euthanized in batch. All animals underwent post mortem examination to exclude intra-abdominal hemorrhage, pancreatic fistula or peritonitis. During autopsy, the liver, bile ducts, head of the pancreas, stomach and duodenum were examined for perforation, stricture or dilation and damage of the surrounding structures. Fourteen pigs were implanted with pancreatic duct stents by endoscopic procedures. There was no effusion, hemorrhage or necrosis in the adjacent duodenum, stomach, liver or right kidney. The normal morphological structures of the duct of Wirsung disappeared in all the treated pigs. Histopathological examination revealed that the stents were surrounded by necrotic tissue and outside fibrous tissue. During the follow-up period, the width of outside fibrous tissue gradually increased. There were no serious abnormalities noted in the blood tests after implantation. It is indicated that the radioactive stents are safe in all the different dose groups. For future clinical application, it is feasible to design a special radioactive stent for each patient according to the size, shape and position of the pancreatic tumor. | 18,843,954 |
[Expression of relaxin receptor in placental tissues of normal pregnancy and pre-eclampsia]. | To study the location and level of relaxin receptor in placenta tissues of pre-eclampsia and normal pregnancy, and the relationship of relaxin receptor with pre-eclampsia. Twenty-six placenta tissue samples from pregnant women with severe preeclampsia (study group), and 20 samples from normal pregnancies (control group) were obtained. We detected the expression of relaxin receptor by immunohistochemistry and the expression of relaxin receptor mRNA by RT-PCR. In the placenta of control and preeclampsia groups, the leucine-rich repeat-containing G protein-coupled receptor (LGR7) was positively expressed. Relaxin receptor was located in the membrane of trophoblast cells. There were both strong signals on cytotrophoblastic cells and syncytiotrophoblast. The level of relaxin receptor in the control group was 0.912 +/- 0.003, and 0.625 +/- 0.037 in the preeclampsia group. The difference between the two groups was obvious (P < 0.01). In the control group, the level of relaxin receptor mRNA was 0.776 +/- 0.021; in the preeclampsia group, it was 0.393 +/- 0.075. The difference was obvious (P < 0.01). Decrease in the expression of relaxin receptor at placenta is related with the occurrence and development of preeclampsia. | 18,843,967 |
[Intermediate and long term clinical effects of uterine arterial embolization with sodium alginate microspheres in treatment of diffuse adenomyosis]. | To study intermediate and long term efficacy of uterine arterial embolization (UAE) with sodium alginate microspheres (KMG) at diameters 500-00 microm in treatment of diffuse adenomyosis. Totally 40 patients with standard diffuse adenomyosis were enrolled and treated with UAE. KMG at diameters 500-700 microm for vascular embolization were used to embolize the arteries. The degree of dysmenorrhea, amount of menorrhea and uterine volume, as well as the level of serum CA125, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) were investigated before and after UAE. The follow up rates were 100% (40/40), 100% (40/40), 80% (32/40), 68% (27/40), 58% (23/40) after uterine arterial UAE 12, 24, 36, 48 and 60 months respectively. The early, intermediate and long-term effective rates were 90% (36/40), 88% (28/32), 83% (19/23). The degree of dysmenorrhea, the amount of menorrhea and the uterine volume, as well as serum CA125 all decreased significantly 3 months after UAE at varying degrees (P < 0.05). Compared with other follow-up time, the degree of dysmenorrhea and the amount of menorrhea declined to their lowest point at 6 month after UAE (P < 0.01). Paralleled with the decrease of volume of uterine, serum CA125 also decreased significantly and reached the lowest level 12 months later compared with other follow-up times (P < 0.01). Even at the 12th month after UAE serum CA125 was not normal and FSH, LH and E2 did not change all the times after UAE, (P > 0.05). No recurrence was found during the 60 months after UAE. KMG used in UAE at diameters 500-700 microm has good intermediate and long term effectiveness in treatment of diffuse adenomyosis with no side effects. | 18,843,968 |
[Study of brain-derived neurotrophic factor activating TrkB signaling cascades in the pathogenesis of multiple myeloma]. | To explore the significance of abnormal expression of brain-derived neurotrophic factor (BDNF)/TrkB in the development and evolution of multiple myeloma (MM) and the involved signaling pathways. The effect of BDNF on the cell viability of human myeloma cell line (HMCL) (RPMI8226, U266, KM3) was determined by trypan blue dye-exclusion. MTT assay was used to evaluate the cytotoxicity of tested chemotherapeutic agents. The effect of BDNF on the phosphorylation of TrkB was determined by Western blot. A human myeloma xenograft animal model was used to evaluate the effects of BDNF on tumor growth and survival time. BDNF at 50 microg/L triggered significant increase in cell viability of HMCL. BDNF protected KM3 cells from melphalan and vincristine. The viability of KM3 cells exposed to varying concentrations of melphalan with and without 50 microg/L BDNF showed that BDNF induced almost a 2-fold and a 3-fold increase in melphalan and vincristine toxicity respectively. BDNF treatment increased MM cell growth in xenografted MM model (3240.9 mm3 vs 1032.7 mm3 ) (P <0.05). Intratumoral injection of BDNF also significantly reduced survival time (13 d vs 21 d) (P <0.05). The phosphorylated TrkB level was increased significantly after treated by exogenous BDNF. BDNF-triggered migration in RPMI8226 cells was completely abrogated by a Trk tyrosine kinase inhibitor K252a. BDNF can activate TrkB signaling cascades resulting in MM cells growth, migration, and chemoprotection and appears to have a major contribution to the pathogenesis of MM. | 18,843,977 |
[Study on glutamate substrate-induced regulation on expression of glutamate transporter GLAST of mouse retinal Müller cells]. | To study glutamate substrate-induced regulation on the expression of glutamate transporter L-glutamate/L-aspartate transporter (GLAST) of retinal Müller cells (RMCs) in mice. Activity of GLAST was measured through L-3 H-glutamate uptake detection. The expression of GLAST protein in lysates cells was studied using Western blot. Glutamate was applied to cultured RMCs at various concentrations for 30 min. L-3 H-glutamate accumulation in RMCs increased as the increase of concentration of substrate glutamate and reached the maximum at 100 micromol/L glutamate. Glutamate treatment of RMCs increased GLAST transporter expression as compared with untreated cultures. Glutamate at 100 micromol/L caused a maximal increase of GLAST protein expression. Glutamate substrate increases GLAST activity and up-regulate the expression of GLAST protein. | 18,844,020 |
[Non-thoracoscopic Nuss procedure for correction operation of pectus excavatum ]. | To review the experience in correction operation of pectus excavatum with non-thoracoscopic Nuss procedure. From September 2005 to August 2007, 108 patients with pectus excavatum were surgically corrected by non-thoracoscopic Nuss procedure. There were 91 male patients and 17 female patients. The age was from 2 years and 10 months old to 25 years old with an average of 7 years and 9 months old. The Haller indexes were from 3.6 to 10.1 before the operation. The operation in all patients had been performed successfully without any severe complications. The average time of operation was 40 minutes. The average bleeding volume during procedure was 10 ml. Uneventful recovery was achieved in all the cases. Excellent outcome was obtained in the follow-up of 2 months to 21 months in 92 patients. Non-thoracoscopic Nuss procedure for correction of pectus excavatum is safe and effective. It is unnecessary to perform the procedure into thoracic cavity so that there is less trauma and shorter time for the operation. | 18,844,047 |
[Outcome of malignant melanoma in gastrointestinal tract: clinical analysis of 70 cases]. | To investigate the diagnosis and treatments of malignant melanoma in gastrointestinal tract. The clinical data of 70 cases of malignant melanoma in gastrointestinal tract treated between July 1965 and June 2007 were collected and analyzed. There were 27 male and 43 female patients in this group with a median age of 53 years. The melanoma arose from rectum in 50 cases, from anus in 10 cases and from esophagus in 10 cases. The overall 1, 3, 5 years survival rate were 48.3%, 14.6% and 6.5%, respectively, the median survival time was 379 days. Sixty-three cases received operations with or without adjuvant therapy after the operation. There was no significant differences in overall survival rate between the 25 cases received operation only (Group 1) and 38 cases supplemented by adjuvant therapy after operation (Group 2); whereas, the cases with clinical stage III tumor in Group 2 had significantly better survival than their counterparts in Group 1. It was found that the depth of tumor invasion was the risk factor of patient's prognosis on multivariate Cox regression analysis. Operation combined with adjuvant therapy can improve the survival of the patient with stage III melanoma in gastrointestinal tract. The depth of tumor invasion is a risk factor of survival in these patients. | 18,844,049 |
[The effect of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion in a rabbit model]. | To investigate the effect and mechanism of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion. A rabbit hepatic ischemia reperfusion injury model was established by hepatic portal occlusion and in situ hypothermic irrigation for 30 min. Twenty-four New Zealand white rabbits were employed and randomly divided into 3 groups equally by different dosage of portal blood stasis removal: group A5 (5 ml blood removal), group A10 (10 ml blood removal),and group B (no blood removal). Eight rabbits were served as controls with no hepatic portal occlusion and hypothermic irrigation. After reperfusion 4 h serum endotoxin content, tumor necrosis factor-alpha (TNF-alpha), urea nitrogen (BUN), and creatinine (Cr) were examined respectively, meantime lung and kidney tissues were sampled to determine the content of malondialdehyde (MDA), superoxide dismutase (SOD), the pathology, and wet to dry weight ratio, broncho-alveolar lavage fluid protein content in lung tissues. Removing portal blood stasis ameliorated lung and renal injury as shown by decreasing the level of serum endotoxin, TNF-alpha, BUN, Cr, wet to dry weight ratio, broncho-alveolar lavage fluid protein content, MDA, SOD. TNF-alpha, Cr, broncho-alveolar lavage fluid protein content in lung tissues and MDA in kidney tissue in group A5 were significantly reduced compared with those in group B (P < 0.05), while in lung tissue in group A10 were also markedly reduced (P < 0.05). The activation of SOD in group A5 were significantly increased (P < 0.05). Removal of portal blood stasis before the resume of splanchnic circulation may ameliorate the lung and renal injury induced by hepatic ischemia reperfusion. The possible mechanism may be that portal blood stasis removal reduces endotoxin absorption, and further decreases production of serum TNF-alpha. | 18,844,057 |
[Promoter methylation status of PTEN gene and the effect of induced demethylation in leukemia cell lines]. | To explore the mechanism of PTEN gene expression silence in leukemia cells, and the effect of induced PTEN gene expression in leukemia cells. Methylation status of PTEN in leukemic cell lines, including HL-60, Nalm-6, NB4, U937, Raji, K562 and KG-1a was assessed by methylation specific PCR (MSP). The cell lines were then treated with different concentrations of methyltransferase inhibitor 5-Aza-2'-deoxycytidine (5-Aza-CdR). After that the changes in PTEN methylation status were detected by MSP, and PTEN mRNA expression level by reverse transcription PCR (RT-PCR). Growth inhibition and apoptosis of HL-60 and Nalm-6 cells induced by 5-Aza-CdR were observed by MTT assay, and Wright and Annexin V staining, respectively. Hypermethylation of PTEN promoter was detected in HL-60, U937, Nalm-6, Raji and KG-1a, while hypomethylation was found in NB4 and K562 by MSP. After 5-Aza-CdR treatment, the hypermethylation status of PTEN promoter in HL-60 and Nalm-6 cells was reversed and their PTEN mRNA expression levels were up regulated in dose dependent manner with the 5-Aza-CdR concentrations, and the cell apoptosis was induced. Hypermethylation in the promoter region is one of major mechanisms responsible for transcriptional suppression of PTEN. Methyltransferase inhibitor could induce the expression of PTEN gene and lead to the leukemia cells apoptosis. | 18,844,062 |
[The clinical and laboratory features of 263 cases of chronic lymphocytic leukemia]. | To analyze the clinical and laboratory features of chronic lymphocytic leukemia (CLL). Retrospective investigation of 263 patients with CLL in our hospital between Feb. 2000 and Jan. 2007. The median age was 60 years with male/female ratio of 2.17 : 1. Patients who were asymptomatic at diagnosis (35.4%) had low Rai grades. Fatigue and lymphadenopathy (54.8%) were the most common features at presentation. Infections, connective tissue diseases and secondary tumors frequently occurred in CLL. WBC counts were between (10 - 100) x 10(9)/L, with lymphocytes percentages more than 0.50 in 97.1% patients. Bone marrow was normal- to hyper-cellularity with lymphocytes percentages more than 0.300 in 99.4% patients. Diffuse infiltrations in bone marrow section were found in 72.2% patients. There were lower CD5 (85.1%) and higher CD25 (78.9%) positivities in the present series as compared with that in other reports. Hypogammaglobulinemia, especially hypo-IgM, usually occurred. Chromosome abnormality were rarely found by routine chromosome examination. There were some clinical and laboratory characteristics different from that of abroad data. Further exploration of new markers is required for prognosis prediction and treatment choice. | 18,844,065 |
[Identification of interaction partners and function analysis of new splicing product of human LMO2 gene]. | To identify the interaction partners of a new splicing product of LMO2 gene (LMO2-C), and study its function in K562 cells. Maltose binding protein (MBP) pull down and mammalian two-hybrid assay (MTHA) were used to identify the interaction partners of LMO2-C in K562 cells. Semiquantitative RT-PCR was used to detect the expression of hematopoietic specific gene glycoprotein (GPA) in K562 cells. MBP-LMO2-C fusion protein was expressed and purified in soluble form successfully. Endogenous GATA1 and LDB1 proteins were confirmed to bind to LMO2-C by MBP pull down analysis. The MTHA also showed that LMO2-C had comparable binding affinities to LDB1 with LMO2-L, and over expression of LMO2-C prevented LMO2-L from binding to LDB1, the inhibition rate being (81.13 +/- 0.68)%. RT-PCR results showed that the expression level of GPA was reduced [(51.00 +/- 1.58)%] in K562 cells while LMO2-C overexpressed. LMO2-C can bind endogenous GATA1 and LDB1 protein in K562 cells and down regulates the expression of GPA. | 18,844,071 |
Health information outreach: experiences from the University of Zambia Medical Library. | Access to health information for health workers in Zambia is limited and inadequate, especially to those health workers that are not affiliated with institutions such as the University of Zambia. In order to meet their information needs, it is important to devise and implement appropriate health information access methods. One such method is an Outreach Program. This article is an audit and a review of the health information outreach programs that the University of Zambia Medical Library has implemented over many years. | 18,844,090 |
[Association of stroke and different combinations of metabolic syndrome components in Chinese adults]. | To analyze the association of stroke and metabolic syndrome as well as its component combinations in Chinese adults. Logistic regression was used to analyze the data, including anthropometric measurement, fasting plasma glucose (FPG), blood lipids, and histories of smoking, drinking, and anamnesis, of 47,414 subjects, 22,305 males and 25,105 females, aged 20-75, obtained from Chinese National Health and Nutrition Survey in 2002. (1) Blood pressure and waist circumference were the most important factors associated with stroke. Along with the clustering of the risk factors, the subjects became more liable to suffer from stroke. Logistic regression showed that after adjustment for age, sex, smoking status, and LDL-C level, the odd ratio (OR) values of the individuals with one, two, three, and four or more factors were 3.01 (1.89-4.81) ,4.37 (2.72-7.01), 9.20 (5.75-14.73), and 13.09 (7.98-21.49) respectively. (2) The combinations of raised hypertension plus hyperglycemia and low LDL-C and central obesity were the most hazard groups, with the OR values of 16.58 (95% CI 8.78-31.32) for stroke. The OR value for the full metabolic syndrome was 10.79 (95% CI 6.81-17.10). Hypertriglyceridemia was not an independent risk factor of stroke. (3) The relationships of metabolic risk factors and stroke were various among different age groups. Stroke was not related with blood glucose, blood pressure, serum lipids, and obesity in the subjects under 35; in those aged 35-55, diastolic Bp and low HDL-C were most significantly related to stroke; as for those above 55, systolic Bp and waist circumference were most significantly related to stroke. Central obesity cored metabolic syndrome is an important risk factor of stroke. Different combinations of the components attribute variously to stroke. In people above middle age, stroke is related to metabolic risk factors. | 18,844,096 |
[Influence of recombinant transforming growth factor-beta3 on collagen synthesis and deposition: experiment with rat cell model of liver fibrosis]. | To investigate the influence of recombinant transforming growth factor-beta3 (TGF-beta3) on collagen synthesis and deposition. Plasmids pcDNA3.1 (+)-TGF-beta3 and pcDNA3.1 (+)-TGF-beta1 were constructed. Rat hepatic stellate cells (HSCs) of the strain HSC-T6 were cultured as cell model of fibrosis and divided into 4 groups: blank control group, pcDNA3.1-enhanced green fluorescent protein (EGFP)-transfected group (negative control group), pcDNA3.1 (+)-TGF-beta1 transfected group, and pcDNA3.1 (+)-TGF-beta3 transfected group. A positive cell clone stably and highly expressing TGF-beta1 was established after being screened by G418 medium. pcDNA3.1 (+)-TGF-beta3 was transfected into the positive clone. Real-time PCR was used to detect the mRNA expression of TGF-beta3. Western blotting was used to detect the protein expression of TGF-beta1, collagen I, matrix metalloproteinase (MMP)-2, MMP-9, and tissue inhibitor of metallo-proteinase (TIMP)-1. There was no significant difference in the TGF-beta1 mRNA expression between the TGF-beta1 positive clone group and the TGF-beta3 transfected group. The mRNA and protein expression levels of TGF-beta1, collagen I, MMP-2, and TIMP-1 of the TGF-beta1 positive clone group were all significantly higher than those of the blank control, negative control groups (all P < 0.05), and the MMP-9 mRNA expression of the TGF-beta1 positive clone group was significantly lower than those of the blank control and negative control groups (all P < 0.05); and the mRNA and protein expression levels of MMP-9 of the TGF-beta1 positive clone group were significantly lower than those of the blank control and negative control groups (all P < 0.05). The TGF-beta1 and MMP-2 mRNA expression levels of the TGF-beta3 transfected group were not significantly different from those of the positive clone group (all P > 0.05), the mRNA expression levels of collagen I and TIMP-1 of the TGF-beta3 transfected group were significantly lower than those of the positive clone group (both P < 0.05), and the mRNA expression level of MMP-9 of the TGF-beta3 transfected group was significantly higher than that of the positive clone group (P < 0.05). The protein expression levels of TGF-beta1, collagen I, and TIMP-1 of the TGF-beta3 transfected group were all significantly lower than those of the positive clone group (P < 0.05), the protein expression level of MMP-9 of the TGF-beta3 transfected group was significantly higher than that of the positive clone group (P < 0.05), and the protein expression level of MMP-2 of the TGF-beta3 transfected group was not significantly different from that of the positive clone group. Recombinant TGF-beta3 eukaryotic expression vector reduces the synthesis of collagen and inhibits the collagen deposition by adjusting the expression of matrix metalloproteinases and their inhibitors. | 18,844,103 |
[Effects of sulfur dioxide, on the proliferation and apoptosis of aorta smooth muscle cells in hypertension: experiments with rats]. | To explore the effects of sulfur dioxide (SO2) on the proliferation and apoptosis of aorta smooth muscle cells in hypertension rats and possible mechanism thereof. Sixteen 4-week-old male spontaneously hypertensive rats (SHRs) were randomly divided into 2 equal groups: control and Na2SO3/NaHSO3 (a SO2 donor)-treated group. Eight 4-week-old male WKY (Wistar Kyoto) rats were assigned for normal control group. Five weeks later, the pressure was measured. The rat aortas were dyed with Hart's method. The morphometric parameters were calculated by Leica workstation. The plasma level of SO2 was determined by HPLC method. VSMC apoptosis was measured by TUNEL technique. The expression levels of proliferating cell nuclear antigen (PCNA), Bcl-2, Fas and caspase-3 were detected by immunohistochemical assay. (1) Compared with those of the WKY rats, the blood pressure, ratio of media to lumen radius, and proliferation index (PI) of the SHRs were increased [(172 +/- 10) mm Hg vs (112 +/- 9) mm Hg, 0.073 +/- 0.004 vs 0.057 +/- 0.004, 0.32 +/- 0.06 vs 0.05 +/- 0.03, respectively], but the plasma level of SO2 and the apoptosis index (AI) were decreased in the SHRs [(6.4 +/- 1.5) micromol/L vs (11.3 +/- 1.0) micromol/L, 0.16 +/- 0.07 vs 0.30 +/- 0.19, respectively]. The expression of Bcl-2 was increased (0.209 +/- 0.007 vs 0.202 +/- 0.006), and the expression levels of Fas and caspase-3 of SHRs were both lower than those of the WKY rats (0.205 +/- 0.006 vs 0.211 +/- 0.005, 0.229 +/- 0.005 vs 0.244 +/- 0.010, respectively). (2) Compared with the SHR control group, the systolic blood and the ratio of media to lumen radius were decreased [(128 +/- 7) mm Hg, 0.066 +/- 0.002, respectively], but the plasma level of SO2 was increased [(8.3 +/- 1) micromol/L] for the SHR + Na2SO3/NaHSO3 group. PI was lower (0.14 +/- 0.03) and AI was higher (0.40 +/- 0.11) in SHR + Na2SO3/NaHSO3 group than those in SHR control group. The expression of Bcl-2 of VSMCs was down-regulated (0.199 +/- 0.006), but the levels of Fas and caspase-3 were up-regulated (0.218 +/- 0.003 and 0.251 +/- 0.011 respectively) in the SHR + Na2SO3/NaHSO3 group. SO2 may attenuate the structural remodeling through reducing the proliferation and enhancing the apoptosis of smooth muscle cells in SHRs. SO2 may modulate the process of apoptosis possibly through the downward regulation of the level of Bcl-2 and enhance the expression of Fas and caspase-3. | 18,844,104 |
[Hydrological and edaphic structure of an oyster-farming site: Duna Blanca (Bay of Dakhla, south Morocco)]. | Morocco shelters lagoons, estuaries and bays along its paralic coasts which are among the most productive in the world. The Bay of Dakhla is the longest and the most important site in Morocco due to its halieutic richness. In fact, this bay is an ecosystem with great potential in terms of aquaculture, mainly shellfish farming, and shelters favorable zones for tapiculture, mytiliculture and ostreiculture, in accordance with ecological planning. A hydrological study (temperature, salinity, chlorophyll "a", suspended matter and organic matter) was conducted on a breeding project of the cupped oyster (Crassostrea gigas) installed on the Duna Blanca site since April 2003. A seasonal follow-up of sediment structure was carried out involving granulometric and metallic studies. The hydrological sampling was performed monthly on the surface and at the bottom, during spring tides, low tide and high tide. The results confirmed that the site encompasses a wealth of nutritive elements and a significant chlorophyll-rich biomass. A gradient of hypersalinity is well correlated with seasonal variation of the temperature. The sedimentary structure ranges from muddy-sandy to sandy type. The metal concentrations in the sediments never exceeded the toxicity thresholds. However, the site's production potential cannot be limitless and could be affected by the extension and installation of new conchylaceous farms. | 18,844,130 |
[Frequency up-conversion properties of Er3+ /Yb3+ co-doped zinc oxide powders]. | Er3+ /Yb3+ co-doped ZnO powders were prepared by the high temperature sintering method with starting composition of (mol%) 95ZnF2-4. 8Yb2 O3-0. 2Er2 O3. Microstructure analysis by X-ray diffraction (XRD) showed that the sample consists of two phases, i. e. ZnO and YbF3, which verified that the ZnF2 was oxidized during the high temperatue sintering Composition analysis by scanning electron microscope (SEM) and spectroscopic measurements showed that the Er3+ and Yb3+ ons were successfully used in doping the lattice of ZnO, but most of Yb3+ ions were in the YbF3 phase. These results indicated that the up-conversion luminescence was emitted from ZnO, not from YbF3. Under the excitation of 980 nm diodelaser, four strong up-conversion emissions peaks centered at 658, 538, 522 and 409 nm, corresponding to the transitions 4F9/2 --> 4I15/2, 4S3/2 --> 4I15/2, 2 H11/2 --> 4I15/2 and 2 H9/2 --> I15/2, respectively, were observed. Especially, a strong red up-conversion emission was observed, which is different from that the green up-converted luminescence is dominated in glass and ceramics. Three important cross energy transfer (CRET) processes between Er3+ ions played an important role for this. Under 488 nm Ar+ laser excitation, intense violet (409 nm), weak blue (466, 450 nm) and ultraviolet (379 nm) up-conversion luminescence originating from the transitions 2 H9/2 --> 4I15/2, 2P3/2 --> 4I11/2, 4 F3/2 /4 F5/2 --> 4I15/ 2 and 4G11/2 --> 4 I15/2, respectively, were obtained. The dependence of up-conversion intensities on excitation power indicated that two-photon absorption processes were responsible for the violet luminescence under 488 nm excitation, and the violet up-converted luminescence was achieved through the forward and back energy transfer between Er3+ and Yb3+ ions. Our results show that ZnO as a host material has the potential applications in the up-conversion red phosphors and ultraviolet laser materials. | 18,844,142 |
[Application of near-infrared spectroscopy in golf turfgrass management]. | The management of golf course is different from other turfs. Its particularity lies in its higher and more precise requirement during maintenance compare with other turfs. In case something happened to turf of golf course, more effective and higher speed detecting and resolution are required. Only the data about turf growth and environment were mastered precisely in time, the friendly environmental and scientific management goal could be completed effectively and economically. The near infrared spectroscopy is a new kind of effective, convenient and non-destructive analytical method in the turfgrass management of golf course in recent years. Many factors of turf-soil system in golf course could be determined by near infrared spectroscopy at the same time. In this paper, the existing literature that use of near infrared spectroscopy to study turfgrass and soil nutrient content, soil hygroscopic moisture, feasible fertilizer application time and rate, to fix the time and volume of irrigation, turfgrass visual quality evaluation, turfgrass disease prediction and prevention were reviewed. Most researchers considered the nutrition condition of turf impacted the visual and playing quality of golf course directly and then indirectly influenced most of assistant cultivation such as fertilization, mowing and irrigation and so on. The using of NIRS can detect the nutrient content of turfgrass effectively and estimate the nutrient is excessive or deficient quickly. And then the feasible time and rate of fertilizers can be decided. Comparing with the common judgment ways based on the season fertilization and visual estimation, the using of NIRS can reduce the application of fertilizers on the base of keeping the same turf quality simultaneously. NIRS can analysis many items of soil such as moisture, elements concentration, textures on the spot by the thousands. This method can get lots of cover-all data non-destructively. What's more, NIRS can analysis soil betimes quickly. NIRS is cheap and simply to operate. Many spectral data of many chemical constituents can be determined only through scanning once. Except for detecting the nutrient concentration of turf or soil, NIRS can analysis the textures and pH of soil and so on. NIRS can analysis the moisture content of soil on the spot quickly and be helpful to decide the right time and mass of irrigation. NIRS can also be used of appraising visual quality of turf including turf color, density, uniformity and cover and so on. And then the quantitative indexes of visual quality of turf can be drawn. NIRS can help analysis the condition of the plant diseases and insect pests and adopt some prevention and cure measure effectively. As a consequence, the negative reaction on environment is avoided because of spraying bactericide and pesticide blindly. The using of near infrared spectroscopy could be helpful of obtaining the data about the turgrass and environment in golf course and contributed to improve turfgrass management and decision-making effectively. Nowadays some problems baffled the far and wide use of near infrared spectroscopy in golf course. Its widely use needs to accumulate the basic chemical analytical data about the golf course. In addition, another problem need to solve is how to ascertain the ground biomass of turfgrass. It is required for NIRS use widely to invent more portable and 'on-the-go' golf course using near infrared spectroscopy apparatus. Together with the more and deeper research on NIRS, new NIRS apparatuses will come up and the application software of NIRS will be upgraded. NIRS will play a more important role in turf management of golf course. | 18,844,156 |
[Applications of near-infrared spectroscopy to analysis of traditional Chinese herbal medicine]. | Analysis of traditional Chinese herbal medicine is of great importance to its quality control Conventional analysis methods can not meet the requirement of rapid and on-line analysis because of complex process more experiences or needed. In recent years, near-infrared spectroscopy technique has been used for rapid determination of active components, on-line quality control, identification of counterfeit and discrimination of geographical origins of herbal medicines and so on, due to its advantages of simple pretreatment, high efficiency, convenience to use solid diffuse reflection spectroscopy and fiber. In the present paper, the principles and methods of near-infrared spectroscopy technique are introduced concisely. Especially, the applications of this technique in quantitative analysis and qualitative analysis of traditional Chinese herbal medicine are reviewed. | 18,844,158 |
[Study of applying fluorescence spectrum imaging to quantitative assay of proteins in bio-chip]. | In the present work, the amount and the activity of the goat anti-human IgG, to bind the human IgG labelled with fluorescein isothiocyanate (FITC), immobilized on silicon surfaces modified with APTES and APTES-Glu, respectively, were studied using the fluorescence spectrum imaging (FSI), the results of which were compared with that of ellipsometry. It is shown that the amount of the human IgG labeled with FITC on APTES-Glu measured using FSI is 2.8 times higher than that on APTES, which is nearly coincident with the 2.2 times obtained using ellipsometry, showing that the activity of the goat anti-human IgG on APTES-Glu is higher than that on APTES. It is reasoned that the FSI is used in the fluorescence immunoassay the for measurement of quasi-quantification or quantification. | 18,844,170 |
[Mineralogical effect correction for pressed iron ore samples in wavelength dispersive X-ray fluorescence analysis]. | The possibility of correcting mineralogical effect for pressed powder pellets of iron ore samples was studied in wavelength dispersive X-ray fluorescence analysis of major and minor elements with 10 Chinese iron ore CRMs. Two methods were applied to reduce the influence of mineralogical effect. The first one is to check 20 angles for every sample before measurement to correct peak shift; another method is replacing peak intensity with peak area of the analytical line to correct the shape distortion of the spectrum. The K factors of the two methods for each element were compared to those from regular measurements. The results show that the calibration for most of the elements was improved, although to different degrees. The improvement in the calibration for sulfur is evident. The calibration for other elements can meet the general requirements except for total iron. | 18,844,184 |
Exploring the reactivity of C(sp3)-cyclometalated Ir(III) compounds in hydrogen transfer reactions. | The manuscript describes the synthesis and full characterization of a new PC(sp(3))P-based cyclometalated Ir(III) complex that manifests an exceptional thermal stability, as well as outstanding reactivity in hydrogen transfer reactions. The described compound represents the first example of a new family of stable C(sp(3))-metalated compounds. | 18,844,205 |
TCEB1 promotes invasion of prostate cancer cells. | Amplification of the long arm of chromosome 8 is one of the most recurrent findings in prostate cancer and it is associated with poor prognosis. Several minimal regions of amplification suggest multiple target genes which are yet to be identified. We have previously shown that TCEB1, EIF3S3, KIAA0196 and RAD21 are amplified and overexpressed in prostate cancer and they are located in the 8q area. In this study, we examined the functional effects of these genes to prostate cancer cell phenotype. We overexpressed and inhibited the genes by lentivirus mediated overexpression and RNA interference, respectively. shRNA mediated TCEB1 silencing decreased significantly cellular invasion of PC-3 and DU145 cells through Matrigel. TCEB1 silencing reduced the anchorage-independent growth of PC-3 cells. Similar effects were not seen with any other genes. When overexpressed in NIH 3T3 cells, TCEB1 and EIF3S3 increased the growth rate of the cells. Transcriptional profiling of TCEB1 silenced PC-3 cells revealed decrease of genes involved in invasion and metastasis. Finally, we also confirmed here the overexpression of TCEB1 in hormone-refractory prostate tumors. This study indicates that TCEB1 promotes invasion of prostate cancer cells, is involved in development of hormone-refractory prostate cancer and is thereby a strong candidate to be one of the target genes for the 8q gain. | 18,844,214 |
Index finger salvage with replantation and revascularization: revisiting conventional wisdom. | Replantation/revascularization of severely injured single digits is controversial, especially at the index position. Conventional wisdom is that these digits if salvaged will ultimately worsen residual hand function and they should be amputated. Twenty-eight cases of such index salvages were reviewed to test this hypothesis. Five cases involved children and were excluded. Twenty-three replants/revascularizations survived (100%). Total active motion was 170 degrees in zone 1, and 133 degrees for zone 2 injuries. Patient satisfaction was high in all cases. In selected cases, salvage of severely injured and amputated index fingers has the potential for satisfying survival and functional results and dogmatic treatment with completion amputation should be avoided. | 18,844,227 |
Use of circular external fixation to maintain foot position during free tissue transfer to the foot and ankle. | Limb salvage techniques of traumatized extremities using free-tissue transfer and microsurgical techniques have become standard reconstructive methods. To our knowledge there is no published data on the incidence or likelihood of equinus following free tissue transfer about the ankle, although in our experience we have perceived an unacceptable incidence of equinus following free tissue transfers about the ankle and therefore initiated prophylactic ring fixation across the ankle. Fourteen patients were placed in circular external fixation spanning the ankle at the time of free tissue transfer for a mean of 12 weeks (Median 7 weeks, Range 6-28 weeks). The results were evaluated using the degree of active ankle dorsiflexion and return to independent ambulation. Six patients had excellent results with active ankle dorsiflexion beyond neutral, and four patients had good results with neutral ankle alignment that did not require further intervention. All patients saved their limb and returned to independent ambulation. When performing free tissue transfer about the ankle, temporary spanning with a circular fixator is effective in preventing equinus deformity and provides a stable mechanical construct protecting the flap. | 18,844,229 |
Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. | The aim was to assess the feasibility of performing stapled haemorrhoidopexy under local anaesthesia. Fifty-eight patients with haemorrhoid prolapse were randomized to receive local or general anaesthesia. The perianal block was applied immediately peripheral to the external sphincter. Submucosal block was added after applying the purse-string suture. Patients reported average and peak pain daily for 14 days using a visual analogue scale (VAS). They also completed anal symptom questionnaires before the operation and at follow-up. The surgeon assessed the restoration of the anal anatomy 3-6 months after surgery. The anal block was sufficient in all patients. The mean accumulated VAS score for average pain was 23.1 in the general anaesthesia group and 29.4 in the local anaesthesia group (P = 0.376); mean peak pain scores were 42.1 and 47.9 respectively (P = 0.537). Mean change in symptom load was also similar between the groups, with score differences of 7.0 in the general anaesthesia group and 6.1 in the local anaesthesia group. No patient had a recurrence of prolapse. Perianal local block is easy to apply with a high degree of acceptability among patients. Postoperative pain, restoration of anatomy and symptom resolution were similar to that of stapled haemorrhoidopexy performed under general anaesthesia. ISRCTN19930199 (http://www.controlled-trials.com). | 18,844,245 |
Evaluation of critical incidents in general surgery. | The analysis of adverse events is a central step in critical incident reporting, but has not been described in a surgical setting. The aim of this study was to develop an evaluation protocol and assess its feasibility. All incidents were analysed by a multidisciplinary team. A coding system based on three published theories was used to assess all incidents and their underlying causes. A risk analysis was also conducted. Between July 2004 and December 2005, 9785 inpatients were treated and 139 critical incidents reported. Classification of active errors revealed 47.7 per cent to be execution failures and 45.9 per cent knowledge-based errors. The distribution of medical errors was 12.9 per cent diagnostic, 46.0 per cent treatment, 17.3 per cent preventive and 23.7 per cent other. Some 282 latent failures were identified among the 139 incidents. Risk analysis revealed a severe incident rate of 21.6 per cent. This study has shown the feasibility of an evaluation protocol based on a combination of three classification systems and a risk analysis. It allows a thorough assessment of critical incidents, identification of priorities and tailored countermeasures. | 18,844,272 |
Long-term follow-up of proximal versus distal laparoscopic gastric bypass for morbid obesity. | Laparoscopic gastric bypass is the 'gold standard' for treatment of morbidly obese patients in many centres. There is debate regarding the optimal length for small bowel limbs. This study aimed to determine whether the proximal or distal approach is better. Twenty-five patients undergoing primary distal gastric bypass in 2000-2002 were randomly matched for age, sex and preoperative body mass index (BMI) with 25 patients having a primary proximal bypass. All distal operations were performed laparoscopically; one proximal procedure was converted to open surgery. Mean operating time was 170 min for proximal and 242 min for distal bypasses (P = 0.004); median hospital stay was similar in the two groups. There were no deaths and the overall complication rate was similar, as was weight loss at 4 years: BMI decreased from 45.9 to 31.7 kg/m2 for the proximal and from 45.8 to 33.1 kg/m2 for the distal approach. Co-morbidities decreased after surgery in both groups; the prevalence of diabetes, arterial hypertension and dyslipidaemia at all time points was similar in the two groups. Proximal and distal laparoscopic gastric bypass operations are feasible and safe, with no differences in weight loss or reduction of co-morbidity in unselected morbidly obese patients. | 18,844,274 |
Antioxidant metabolism induced by quinic acid. Increased urinary excretion of tryptophan and nicotinamide. | For over 50 years, hippuric/quinic acids were believed to have no biological efficacy. Here data are presented to support the hypothesis that quinic acid is not responsible for any efficacy, but rather that quinic acid nutritionally supports the synthesis of tryptophan and nicotinamide in the gastrointestinal (GI) tract, and that this in turn leads to DNA repair enhancement and NF-kB inhibition via increased nicotinamide and tryptophan production.Moreover, it is shown that quinic acid is a normal constituent of our diet, capable of conversion to tryptophan and nicotinamide via the GI tract microflora, thus providing an in situ physiological source of these essential metabolic ingredients to humans. The concentrations of quinic and hippuric acids in the diet were dependent on each other when analysed in urine, as was evidenced by a significant linear regression analysis that included unsupplemented control subjects (n = 45, p < 0.001). Thus, these ingredients were identified as major dietary components, and not simply originating from environmental pollution as previously had been thought. | 18,844,285 |
Antinociceptive peripheral effect of Achillea millefolium L. and Artemisia vulgaris L.: both plants known popularly by brand names of analgesic drugs. | The hydroalcohol extracts of Achillea millefolium L. (AM) and Artemisia vulgaris L. (AV), both belonging to the Asteraceae family, were evaluated by the hot plate, writhing, formalin and intestinal transit tests in an attempt to confirm their folk use as analgesic, antiinflammatory and antispasmodic agents. AM 500 and 1000 mg/kg significantly inhibited abdominal contortions by 65% and 23%, respectively, whereas AV 500 and 1000 mg/kg inhibited them by 48% and 59%, respectively. None of the extracts produced differences in the intestinal transit in mice, nor in the response time in the hot plate or in the immediate or late responses in the formalin test. In HPLC/DAD analyses 'fingerprint', monitored at 360 and 270 nm, both hydroalcohol extracts showed the same flavonoid glycoside as a principal constituent, which was identified as rutin. A high content of caffeic acid derivatives were also found in both extracts. The main differences were observed at 240 nm: AM had a higher content of rutin, while in AV the hydroxybenzoic acid derivative was the major component. | 18,844,327 |
Premalbrancheamide: synthesis, isotopic labeling, biosynthetic incorporation, and detection in cultures of Malbranchea aurantiaca. | An advanced metabolite, named premalbrancheamide, involved in the biosynthesis of malbrancheamide (1) and malbrancheamide B (2) has been synthesized in double (13)C-labeled form and was incorporated into the indole alkaloid 2 by Malbranchea aurantiaca. In addition, premalbrancheamide has been detected as a natural metabolite in cultures of M. aurantiaca. The biosynthetic implications of these experiments are discussed. | 18,844,365 |
Imines that react with phenols in water over a wide pH range. | Cyclic imine derivatives that react with phenols, including tyrosine residues of peptides, have been developed. Reactions of the imines with phenols proceeded in water over a wide pH range (pH 2-10) at room temperature to 37 degrees C and afforded Mannich products without the need of additional catalysts. | 18,844,415 |
Role of tissue kallikrein-related peptidases in cervical mucus remodeling and host defense. | Human tissue kallikrein-related peptidases (KLKs) are 15 hormonally regulated genes on chromosome 19q13.4 encoding secreted serine proteases. Many KLKs are expressed throughout the female reproductive system and found in cervico-vaginal fluid (CVF). Immunohistochemistry was performed to determine KLK localization in the female reproductive system (fallopian tube, endometrium, cervix and vagina tissues). KLK levels were measured in CVF and saliva over the menstrual cycle to study whether KLKs are regulated by hormonal changes during the cycle. In vitro cleavage analysis was performed to establish whether KLKs may play a role in vaginal epithelial desquamation, mucus remodeling or processing of antimicrobial proteins. KLKs were localized in the glandular epithelium of the fallopian tubes and endometrium, the cervical mucus-secreting epithelium and vaginal stratified squamous epithelium. KLK levels peaked in CVF and saliva after ovulation. In vitro cleavage analysis confirmed KLKs 5 and 12 as capable of digesting desmoglein and desmocollin adhesion proteins and cervical mucin proteins 4 and 5B. KLK5 can digest defensin-1alpha, suggesting it may aid in cervico-vaginal host defense. We provide evidence of potential physiological roles for KLKs in cervico-vaginal physiology: in desquamation of vaginal epithelial cells, remodeling of cervical mucus and processing of antimicrobial proteins. | 18,844,451 |
Extensions, validation, and clinical applications of a feedback control system simulator of the hypothalamo-pituitary-thyroid axis. | We upgraded our recent feedback control system (FBCS) simulation model of human thyroid hormone (TH) regulation to include explicit representation of hypothalamic and pituitary dynamics, and updated TH distribution and elimination (D&E) parameters. This new model greatly expands the range of clinical and basic science scenarios explorable by computer simulation. We quantified the model from pharmacokinetic (PK) and physiological human data and validated it comparatively against several independent clinical data sets. We then explored three contemporary clinical issues with the new model: combined triiodothyronine (T(3))/thyroxine (T(4)) versus T(4)-only treatment, parenteral levothyroxine (L-T(4)) administration, and central hypothyroidism. Combined T(3)/T(4) therapy--In thyroidectomized patients, the L-T(4)-only replacement doses needed to normalize plasma T(3) or average tissue T(3) were 145 microg L-T(4)/day or 165 microg L-T(4)/day, respectively. The combined T(4) + T(3) dosing needed to normalize both plasma and tissue T(3) levels was 105 microg L-T(4) + 9 microg T(3) per day. For all three regimens, simulated mean steady-state plasma thyroid-stimulating hormone (TSH), T(3), and T(4) was within normal ranges (TSH: 0.5-5 mU/L; T(4): 5-12 microg/dL; T(3): 0.8-1.9 ng/mL). Parenteral T(4) administration--800 microg weekly or 400 microg twice weekly normalized average tissue T(3) levels both for subcutaneous (SC) and intramuscular (IM) routes of administration. TSH, T(3), and T(4) levels were maintained within normal ranges for all four of these dosing schemes (1x vs. 2x weekly, SC vs. IM). Central hypothyroidism--We simulated steady-state plasma T(3), T(4), and TSH concentrations in response to varying degrees of central hypothyroidism, reducing TSH secretion from 50% down to 0.1% of normal. Surprisingly, TSH, T(3), and T(4) plasma concentrations remained within normal ranges for TSH secretion as low as 25% of normal. Combined T(3)/T(4) treatment--Simulated standard L-T(4)-only therapy was sufficient to renormalize average tissue T(3) levels and maintain normal TSH, T(3), and T(4) plasma levels, supporting adequacy of standard L-T(4)-only treatment. Parenteral T(4) administration-TSH, T(3), and T(4) levels were maintained within normal ranges for all four of these dosing schemes (1x vs. 2x weekly, SC vs. IM), supporting these therapeutic alternatives for patients with compromised L-T(4) gut absorption. Central hypothyroidism--These results highlight how highly nonlinear feedback in the hypothalamic-pituitary-thyroid axis acts to maintain normal hormone levels, even with severely reduced TSH secretion. | 18,844,475 |
Serum interleukin 6 (IL-6) and C-reactive protein (CRP) levels in colorectal adenoma and cancer patients. | Colorectal cancer is one of the most common cancers of the gastrointestinal tract and the fourth cause of cancer death in the world. It has been shown that local chronic inflammation may lead to colorectal carcinogenesis via adenomatous polyps. Interleukin-6 and C-reactive protein are biomarkers of inflammation and indicators of the immune response to tumors. Serum levels of interleukin-6, carcinoembryonic antigen and carbohydrate antigen 19-9 were determined using immunoenzymatic assays, and C-reactive protein concentrations by immunoturbidimetric kits in 76 colorectal cancer patients before surgery, in 38 colorectal adenoma patients and in 35 healthy controls. Serum levels of interleukin-6, C-reactive protein and carcinoembryonic antigen were significantly higher in cancer patients when compared to adenoma patients and healthy subjects, and increased in more advanced stages of disease and in patients with non-resectable tumors. Based on Cox's analysis, the elevated preoperative serum level of C-reactive protein was an independent significant prognostic factor for patients' survival. Our findings suggest the usefulness of interleukin-6 in the diagnosis of colorectal cancer patients and C-reactive protein in the survival prognosis. | 18,844,497 |
Preanalytical effects of pneumatic tube transport on routine haematology, coagulation parameters, platelet function and global coagulation. | Pneumatic tube transport of blood samples reduces turnaround times and labour. However, the preanalytical effects on new clinical chemistry parameters and instruments are not fully known. The aim of this study was to evaluate the effect of pneumatic tube transport on haematology and coagulation parameters, including platelet function with PFA-100, and global coagulation with a thromboelastograph. Paired venous blood samples from healthy volunteers were obtained before and after 1 week of treatment with acetylsalicylic acid. One sample was transported by pneumatic tube transport, while the other remained in the laboratory. No preanalytical effect of pneumatic tube transport could be seen for most haematology and coagulation parameters, as well as analysis with PFA-100. For the thromboelastographic analysis, time to clot formation was shorter (-16%, p=0.037) in the transported samples. Treatment with acetylsalicylic acid had no effect on the majority of the test results. Pneumatic tube transport does not introduce preanalytical errors when transporting samples for analysis of routine haematology, coagulation parameters and platelet function with the PFA-100. We recommend manual transport of samples for analysis with thromboelastographic techniques. | 18,844,500 |
Effect of ampicillin-sulbactam on clinical capillary zone electrophoresis of serum proteins. | Capillary zone electrophoresis (CZE) is a well-accepted automated method used to separate serum proteins and detect monoclonal components. CZE uses ultraviolet detection at 214 nm to directly quantify proteins via peptide bonds. Any substance that absorbs at 214 nm and is present in serum can potentially interfere with CZE analysis. This has been reported for radio-contrast media and antibiotics. Here we describe a peak on the anode side of the alpha(2)-globulin fraction caused by the antibiotic ampicillin-sulbactam (Unacid). Extra peaks that can be misinterpreted as monoclonal components can be present in almost all electrophoretic fractions of CZE. Immunosubtraction or immunofixation is always required to rule out these conditions. | 18,844,504 |
Factors associated with smoking cessation among Chinese adults in rural China. | To examine the factors associated with smoking cessation among adult Chinese males in rural China. The data were collected by face-to-face interviews at the respondents' household using interviewer-administered questionnaires. The factors associated with quitting were being residents of Guiyang, having received junior or high school education, being unmarried, being a farmer or other job holder, smoking fewer than 20 cigarettes per day, starting smoking late, smoking for shorter duration, and having a high mean score on hedonism seeking. Several predictors of successful quitting were identified that could help improve smoking cessation programs in China. The findings also have implications for the need for future surveys on the quitting process among rural Chinese. | 18,844,507 |
Development of a drug use resistance self-efficacy (DURSE) scale. | To develop and evaluate psychometric properties of a new instrument, the drug use resistance self-efficacy (DURSE) scale, designed for young adolescents. Scale construction occurred in 3 phases: (1) initial development, (2) pilot testing of preliminary items, and (3) final scale administration among a sample of seventh graders (n=223) to examine psychometric properties. DURSE items appeared to tap a unique dimension of resistance self-efficacy. Initial psychometric properties of the scale were satisfactory. The DURSE scale may offer an opportunity to measure important, as yet untapped, constructs related to adolescents' abilities to refuse substance use in social contexts. | 18,844,509 |
Finding the right direction: the importance of open communication in a governance model of nurse management. | Change and its management is a widely researched and documented activity. Yet amidst this plethora of literature there is little that looks at the central tenets of the change process: exemplar setting; communication and executive guidance. The nursing management system at King Faisal Specialist Hospital and Research Centre agreed to change direction and embrace the concept of shared governance to bring about equality and parity in decision making. This process demanded that the nursing executive gave direction by providing an example of how shared governance could be actuated. This paper argues how shared governance is a viable alternative management structure for nursing practice and details how the organisation implemented it through open and honest communication. | 18,844,543 |
Acute (adult clinical inpatient) care nurses' attitudes towards and knowledge of nationally endorsed 5As smoking cessation guidelines. | Nurses are expected to be involved in health promotion, including smoking cessation. This study aimed to assess nurses' knowledge, sense of responsibility and willingness to provide smoking cessation interventions as described in the national 5As guideline. Data were collected by a survey distributed to a convenience sample of nursing staff (n=162) from thirteen different adult acute care wards at a major metropolitan Melbourne hospital. Nearly all respondents (87%) agreed that they had a responsibility to counsel patients, and 22% were already doing so, but only 22% (n=36) of respondents demonstrated an adequate level of knowledge of smoking cessation. Nurses were more likely to counsel patients on health conditions related to their area of practice than those that were not. The findings indicate that greater emphasis is needed in undergraduate courses and in-service programs to increase nurses' awareness, and implementation of the 5As guideline for smoking cessation. | 18,844,545 |
Nurses on the move: diversity and the work environment. | Over 191 million people make up the international migrant population of today. Their numbers have doubled since 1970, with women now accounting for almost half. The migrant population has been transformed and is changing the very nature of society in both source and destination countries. Greater differences in culture, language, work relationships, and coping mechanisms - in short, greater diversity in society and the workplace - offer many opportunities for excellence in transcultural nursing but also provides fertile ground for discrimination, victimisation, harassment and isolation. This article explores and describes current nurse migration flows, the impact migration has on nurses and the value of positive practice environment for the full integration of international nurses. | 18,844,573 |
PCR-based simultaneous analysis of the interferon-alpha family reveals distinct kinetics for early interferons. | Here we describe a PCR-based analysis system that allows the simple simultaneous assessment of murine interferons (IFN)-alpha and IFN-beta induction in a single reaction. In this analysis, the so-called early IFN-alpha4 can be distinguished from the so-called late IFN-nonalpha4 by employing a primer mixture that amplifies a part of the IFN-alpha genes in which IFN-alpha4 exhibits a deletion of 15 nucleotides compared to IFN-nonalpha4. By including a final denaturation and a slow cooling step at the end of the PCR procedure, hybrid formation was avoided that regularly occurred when standard protocols were used. Separation of the amplification products on 4.5% agarose gels allowed the comparative assessment of the classical type I IFNs. Using this analysis system, we could show that in immortalized adult fibroblasts, IFN-beta is induced first and the two types of IFN-alpha are induced later and simultaneously. When similar fibroblasts derived from mice that lack IFN-beta were tested, the IFN response was delayed. However, now IFN-alpha4 appeared first and apparently induced the cascade of IFN-nonalpha4. This confirms the role of IFN-beta as master regulator of the normal IFN response. | 18,844,580 |
Intradermal, epidermal and transcutaneous vaccination: from immunology to clinical practice. | The dermis and epidermis are alternative sites for prophylactic vaccination that have received renewed interest in recent years, not only because of the ease of access to the skin, but also its unique immunological properties. This review discusses the characteristics of the skin, current knowledge on skin immunity and clinical experience with cutaneous immunization against infectious diseases, with a special focus on intradermal immunization. The most widely accepted paradigm explaining the efficacy of cutaneous immunization is reviewed and recent research suggesting where this paradigm may need some refinement is highlighted. Clinical investigations that have concentrated on the intradermal route to vaccinate against influenza, rabies or hepatitis B support the current knowledge on skin immunity and, when combined with recent progress made in the development of user-friendly injection systems, have stimulated the ongoing clinical development of novel vaccines. | 18,844,594 |
Crohn's disease but not chronic ulcerative colitis induces the expression of PAI-1 in enteric neurons. | Chronic inflammation of the intestinal wall is the common characteristic of Crohn's disease and ulcerative colitis; disorders, which in some cases can be difficult to distinguish. The inflammation also affects the local neuronal plexuses of the enteric nervous system. It is known that plasminogen activator inhibitor-1 (PAI-1) and urokinase receptor (uPAR) are upregulated in neurons after experimental peripheral nerve injury and have been linked to nerve regeneration. The expression of PAI-1 and uPAR in neuronal cells in lesions of the gastrointestinal tract was analyzed by immunohistochemical techniques. PAI-1 was found in a subset of neurons primarily located in the submucosal plexus of the small and large intestine in 24 of 28 cases (86%) with Crohn's disease, but in none of 17 cases with chronic ulcerative colitis and other severe inflammatory conditions in the intestinal wall. The PAI-1 was seen in the perikarya of the neurons and a few proximal axons, whereas nerves were negative. uPAR was seen in nerves in all types of lesion varying from 21% to 88% of the cases, most frequent in colon adenocarcinomas. No uPAR-positive nerves were detected in normal colon. PAI-1-positive neurons in inflammatory bowel disease are linked to chronic inflammation in Crohn's disease, implying PAI-1 as a potential parameter for the differential diagnosis between Crohn's disease and ulcerative colitis. The findings also suggest that PAI-1 in neurons is related to pain and that both PAI-1 and uPAR are involved in neuronal repair in the inflamed tissue. | 18,844,621 |
Recommendations for routine reporting on indications for cesarean delivery in developing countries. | Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Data are presented from selected countries, categorizing cesareans by three classification systems. A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery. | 18,844,646 |
Quality of life of caregivers of very low-birthweight infants. | The health and developmental outcomes of very low-birthweight infants are unpredictable over the first year of life. This uncertainty may have meaningful consequences for parents' quality of life. The objective of this study was to explore the quality of life of caregivers of these infants. Primary caregivers of very low-birthweight infants, 12 to 18 months old, who had been cared for in an inner-city hospital were enrolled in the study. Primary caregivers of full-term infants of the same age served as a comparison group. During a telephone survey, participants answered questions about their quality of life, mental and physical health, living arrangements, and child's health. Eighty-three caregivers of very low-birthweight infants and 84 caregivers of full-term infants were enrolled in the study. Demographic characteristics of the caregivers were similar between the groups. Forty-five percent of caregivers of very low-birthweight infants reported that their child had an ongoing medical problem compared with 23 percent of caregivers of full-term infants. Both groups of caregivers reported significant physical and mental health problems. Caregivers of very low-birthweight infants reported higher quality of life than did caregivers of full-term infants, but the difference did not reach statistical significance. Although very low-birthweight infants had poorer health and required significantly more health care resources than full-term infants, caregivers' quality of life did not differ between the two groups. Caregivers of both groups of infants reported substantial mental and physical health problems but perceived good quality of life. These data will aid parents, physicians, and policy makers as they struggle to make decisions concerning care of high-risk, costly, very low-birthweight infants. | 18,844,647 |
Quantitative correlation between theoretical molecular descriptors and drug-HSA binding affinities for various cox-2 inhibitors. | In this study, quantitative structure-protein binding relationships have been derived to predict the binding affinities of cox-2 inhibitor drugs to HSA from the structure of drug molecules. Drug-HSA binding affinities were determined using fluorescence spectroscopic technique. For the calculation of theoretical molecular descriptors and statistical treatment of data dragon, codessa and spss software were used. In the quantitative structure-protein binding model, one-parameter correlations were statistically not very sound. Quadratic equations gave better fit of the data in some cases. Two-parameter correlations could explain 94-98% of the variance in the data. Steric, geometric and topological descriptors outweighed all other parameters in the developed quantitative structure-protein binding relationships. There was some contribution from electrostatic descriptors as well, but the role of hydrophobic binding was completely ruled out in the protein binding of coxibs. The quantitative correlations derived in this paper are useful in predicting the protein binding of coxibs and may help in the design of cox-2 inhibitors with appropriate HSA binding properties. | 18,844,676 |
Experimental and QSAR of acetophenones as antibacterial agents. | Antibacterial activity of 20 acetophenone derivatives was evaluated against two Gram-positive and three Gram-negative organisms, namely, Bacillus subtilis NCIM 2718, Staphylococcus aureus NCIM5021, Salmonella typhi NCIM2501, Enterobacter aerogenes NCIM5139, and Proteus vulgaris NCIM2813 by two-fold dilution method. The most active amongst this group of compounds were 4-methyl, 2-hydroxy, 3-bromo, 4-ethoxy, 3-nitro and 4-nitro acetophenones. Quantitative structure-activity relationships were developed by dividing the data into training and validation sets, the former was used to develop and the latter was used to test the models. Spatial, electronic and topological descriptors were predominantly found to influence the activity. The statistical measures such as r( 2) (0.76-0.91), cross-validated r( 2) (0.56-0.85), F-ratio and predicted residual sum of square values were found to be in the acceptable range. The developed models were able to predict the activity of the validation data set within the 99% confidence limit (except for two data points). 4-Nitroacetophenone was found to be the most slimicidal in nature. Bacterial Adhesion to Hydrocarbons (BATH) assay indicated that Staphylococcus aureus NCIM5021 had the most hydrophobic cell surface of these five organisms. Cell surface hydrophobicity of organisms also had an impact on the antibacterial activity of the acetophenones. | 18,844,677 |
Evaluation of the effect of the specific CCR1 antagonist CP-481715 on the clinical and cellular responses observed following epicutaneous nickel challenge in human subjects. | The CC-chemokine receptor-1 (CCR1) is thought to be involved in recruitment of inflammatory cells in allergic contact dermatitis (ACD). CP-481715 is a specific antagonist of CCR1. To determine the inhibitory effects of CP-418 715 in ACD by evaluating the clinical signs and cellular infiltration in skin biopsies following epicutaneous nickel challenge in allergic subjects. In this phase 1/2 study, 40 subjects were randomized to 5 days of treatment in four parallel groups (placebo three times daily (TID), placebo once daily (QD), 1000 mg CP-418 715 TID, and 3000 mg CP-418 715 QD). Twenty-four hours after the first drug administration, nickel sulfate patches were applied on subjects' backs and removed 48 hours later. Pretreatment with 1000 mg CP-481715 TID resulted in significant reductions in visual scores of the nickel reactions (P = 0.01). Instrumentally measured erythema tended to decrease in the CP-481715 mg TID group (P = 0.06). No differences were noted between the 3000 mg CP-481715 mg QD group and pooled placebo. No significant differences were found for immunohistological cell counts. CP-418 715 was generally safe and well tolerated. Blocking of CCR1 only partly inhibited clinical manifestations of ACD. Several chemokine receptors are likely relevant for the cellular influx observed in ACD lesions. | 18,844,696 |
Anogenital allergic contact dermatitis, the role of spices and flavour allergy. | In patients with vulval or anogenital dermatitis, irritant contact dermatitis is more common than allergic contact dermatitis. The reported frequency and relevance of contact sensitivity in anogenital dermatitis varies greatly. To determine the frequency and relevance of contact sensitization in a Dutch group of female patients with chronic anogenital complaints. We reviewed patch test results of 53 women with chronic anogenital complaints, with sole vulval symptoms in 29 women and sole perianal in 5, in whom inflammatory skin diseases like lichen sclerosus, lichen planus, psoriasis, as well as infectious diseases were unlikely or excluded as a cause of their symptoms. All women were tested with the European baseline series plus additional test series according to their personal history. Thirty-five patients (66%) showed one or more positive test reactions. Seven of these patients (20%) had one or more clinically relevant positive reactions, most often to flavours and spices. A considerable number of patients with anogenital dermatitis have a contact sensitization. Clinically relevant reactions were mainly found to spices and flavours. This is in contrast to the data reported in the literature that shows most contact allergies in vulval patients to ingredients of topical medication. | 18,844,699 |
Trends of contact allergy to fragrance mix I and Myroxylon pereirae among Danish eczema patients tested between 1985 and 2007. | Fragrance contact allergy has for long been recognized as an important health issue. In Denmark, the frequency of fragrance mix (FM) I contact allergy increased between 1985-1986 and 1997-1998 among male and female dermatitis patients. To investigate the development of FM I and Myroxylon pereirae (MP) contact allergy between 1985 and 2007 with an emphasis on recent years. A retrospective analysis of all patch test data from our database was performed. Comparison of sensitivity rates was made using a chi-squared test for trend. Logistic regression analyses were used to test for associations. Of 16,173 patients, 7.2% were sensitized to FM I and 4% to MP. FM I contact allergy was associated with female sex [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 1.33-1.74] and age between 41 and 60 years (OR = 3.20; 95% CI = 1.98-5.21). Significant declines of FM I and MP reactions among women but not men were observed between 1999 and 2007. Although the frequency of FM I contact allergy has decreased in Denmark in recent years, it is still high. Furthermore, fragrance contact allergy is caused by other important allergens not included in this analysis. Allergic contact reactions to the ingredients of FM I remain a problem in European consumers. | 18,844,700 |
Resistant arterial hypertension is associated with higher blood levels of complement C3 and C-reactive protein. | Arterial hypertension is associated with increased plasma levels of complement C3, C4, and C-reactive protein (CRP). The aim of the study was to compare these laboratory markers in patients with resistant arterial hypertension (RAH) and controlled arterial hypertension (CAH). Patients with RAH (n = 34), those with CAH (n = 34), and 26 normotensive controls were included. White blood cell count, erythrocyte sedimentation rates, and blood levels of complement components C3, C4, and high-sensitivity C-reactive protein (hs-CRP) were compared among the study groups. In the RAH group, serum C3 (183.9+/-47.5 mg/dL) and hs-CRP (6.9+/-5.8 mg/L) were higher than in the CAH group (C3, 123.1+/-42.3 mg/dL; P < .001, hs-CRP, 4.2+/-4.8; P = .021, respectively). Significant positive correlations between systolic blood pressure and C3 (r = 0.6481; P < .001) and hs-CRP (r = 0.3968; P = .02) were observed in the RAH group. RAH is associated with higher blood levels of C3 and CRP. | 18,844,762 |
Is patients' insurance coverage associated with prescribing after hospitalization for severe, poorly controlled hypertension? | High medication costs may be a significant cause of nonadherence and threaten recent gains in hypertension treatment. It is unclear whether prescribing patterns differ with patients' insurance coverage. The objective of this study was to determine whether insurance coverage, reported difficulty affording medications, or nonadherence were associated with antihypertensive prescribing in a high-risk population. The authors conducted a cross-sectional survey of 189 patients admitted to an inner-city academic hospital with severe, poorly controlled hypertension. Patients' poor medication access (one-third lacked insurance and half reported difficulty affording medications) was not associated with admission or discharge regimen costs. Substituting the least expensive drug within each class would have reduced costs by 42%, and reducing calcium channel blocker use would have significantly reduced costs. In conclusion, markers of poor medication access were not associated with prescribing patterns. Further research is needed to explore these patterns and their impact on vulnerable populations' financial burden and adherence. | 18,844,763 |
Anger types: heritability and relation to blood pressure, body mass index, and left ventricular mass. | The relationship between anger and cardiovascular morbidity has not been investigated among Mexican Americans. This exploratory study examined the heritability of anger types and their relationship to cardiovascular variables in samples of unrelated and related Mexican Americans residing near Chicago, Illinois. All of the anger variables of the Spielberger Anger Expression Scale (in, out, control, total expression) had significant heritabilities. Using the total sample of related individuals, higher female anger-out scores were associated with greater left ventricular mass after correction for height to the 2.7 power (LVM/HT2.7), systolic blood pressure, and diastolic blood pressure. Females had positive, significant associations for body mass index with LVM/HT2.7, systolic blood pressure, and diastolic blood pressure; among males, these variables were similarly but less strongly related. Anger (coraje in Spanish) is discussed in the context of folk medicine as a risk factor for cardiovascular morbidity. | 18,844,765 |
Effect of salicylic acid on salinity-induced changes in Brassica juncea. | Seeds of Indian mustard (Brassica juncea (L.) Czern. et Coss.) were exposed to 0, 50, 100 and 150 mmol/L NaCl for 8 h and seeds were sown in an earthen pot. These stressed seedlings were subsequently sprayed with 10 micromol/L salicylic acid (SA) at 30 d and were sampled at 60 d to assess the changes in growth, photosynthesis and antioxidant enzymes. The seedlings raised from the seeds treated with NaCl had significantly reduced growth and the activities of carbonic anhydrase, nitrate reductase and photosynthesis, and the decrease was proportional to the increase in NaCl concentration. However, the antioxidant enzymes (catalase, peroxidase and superoxide dismutase) and proline content was enhanced in response to NaCl and/or SA treatment, where their interaction had an additive effect. Moreover, the toxic effects generated by the lower concentration of NaCl (50 mmol/L) were completely overcome by the application of SA. It was, therefore, concluded that SA ameliorated the stress generated by NaCl through the alleviated antioxidant system. | 18,844,778 |
C5 inhibitor rEV576 protects against neural injury in an in vitro mouse model of Miller Fisher syndrome. | Guillain-Barré syndrome and its clinical variants, including the anti-GQ1b ganglioside-mediated Miller Fisher syndrome (MFS), comprise the world's leading cause of acute neuromuscular paralysis. Presently, no specific drug therapies exist. The complement cascade, which is activated in these patients, forms an attractive drug target. In this study, we tested whether the complement C5-inhibiting recombinant protein, rEV576, was able to prevent neural injury in a previously developed in vitro mouse model for MFS. Mouse hemidiaphragm preparations were treated with anti-GQ1b antibody and normal human serum as a source of complement with added rEV576 or control protein. Immunohistology in control tissue showed deposition of C3c and membrane attack complex at neuromuscular junctions (NMJs), along with terminal motor axonal neurofilament degradation as well as ethidium homodimer-2 staining showing perisynaptic Schwann cell (pSC) injury. Electrophysiological and functional analyses showed block of synaptic transmission at the NMJ after an initial period of a dramatically high level of asynchronous acetylcholine release. In tissue treated with rEV576, all these indicators of motor neuronal damage were absent, except for the presence of C3c, indicating effective inhibition of C5. These results demonstrate that rEV576 effectively prevents development of neuronal and pSC damage in experimental murine neuropathy. | 18,844,789 |
Perceived barriers and benefits to research participation among school administrators. | Gaining access to conduct research in schools can be challenging, but little has been done to directly assess school administrators' perceptions of research. The purpose of this qualitative study was to increase understanding of barriers and benefits of research participation as perceived by superintendents and principals in elementary, middle, and high school settings. Administrators (14 elementary, 14 middle, and 15 high school principals and 14 superintendents; total n = 57) were randomly selected from across a Midwestern state and were interviewed by phone following a semistructured guide of questions. Six major themes were consistent across principals and superintendents and reached saturation. Themes indicated that administrators were interested in research projects that (1) provide tangible benefits to their school, (2) are consistent with their academic mission, (3) are not burdensome, (4) do not take place during state assessment time or other busy times, and (5) are credible and noncontroversial. Previous research experiences leave a lasting impression on administrators and influenced their future decisions. Findings indicate that researchers should carefully frame their research in terms of how it will directly benefit the school, keeping in mind that academic performance is the top priority for school administrators. Researchers should be very clear and realistic about the time commitments, how the research results will be provided, and how the study may be used to improve the school's academic mission. | 18,844,810 |
Self-reported substance use and sexual behaviors among adolescents in a rural state. | Research finds a strong association between substance use and risky sexual behavior but more needs to be known about this relationship. Few studies have examined this relationship among rural sixth- to eighth-grade students. As such, the purposes of this study were to provide a descriptive profile of rural sixth- to eighth-grade students' substance use behavior and sexual activity and to examine the relationship between substance use behaviors and sexual activity. Participants consisted of a convenience sample of 10,273 middle school students (sixth to eighth grade) attending 10 public schools in rural Tennessee. The middle school Youth Risk Behavior Survey was administered to these students during April and May 2004. Analysis found that a large percentage of students had tried cigarettes, alcohol, and inhalants. Additionally, it was found that sexual intercourse had been initiated by 18.8% of females and 25.4% of males. Of those students who reported ever having had sexual intercourse, 75% had reported the use of cigarettes and alcohol. In addition, approximately 50% of those students reported marijuana and inhalant use. The results suggest that substance use behavior has a relationship with the likelihood of initiating sexual activity. Additional longitudinal research with this population will be needed for explaining whether these select substance use behaviors are probable risk factors predisposing young rural adolescents to report engaging in sexual behaviors or a result of other factors. | 18,844,811 |
Regulation of vitamin D homeostasis: implications for the immune system. | Vitamin D homeostasis in the immune system is the focus of this review. The production of both the activating (25- and 1alpha-hydroxylase) and the metabolizing (24-hydroxylase) enzymes by cells of the immune system itself, indicates that 1,25(OH)(2)D(3) can be produced locally in immune reaction sites. Moreover, the strict regulation of these enzymes by immune signals is highly suggestive for an autocrine/paracrine role in the immune system, and opens new treatment possibilities. | 18,844,839 |
Vitamin D: a D-Lightful health perspective. | Sunlight provides most humans with their vitamin D requirement. Adequate vitamin D(3) by synthesis in the skin or from dietary and supplemental sources is essential for bone health throughout life. Vitamin D deficiency is defined as a 25(OH)D concentration <20 ng/mL (50 nmol/L); vitamin D sufficiency as a 25(OH)D >30 ng/mL (75 nmol/L), and insufficiency as 21-29 ng/mL. Vitamin D deficiency and insufficiency has been linked to a wide variety of chronic diseases including common cancers, autoimmune, cardiovascular, and infectious diseases. Healthcare professionals need to be aware of the vitamin D deficiency pandemic. Guidelines for sensible sun exposure and supplemental vitamin D of 800-1000 IU/day are needed. | 18,844,847 |
Towards establishing a national colorectal cancer database: lessons learnt from Bio21 molecular medicine informatics model. | Collecting data regarding treatment and outcomes of patients with cancer, for both audit and research purposes, is a common but challenging goal. Modern technology promises greater ease and sophistication for data collection, linkage and analysis, but many traditional challenges remain. Here we relate our experience of an initiative aimed at multicentre colorectal cancer data collection, that is, in collaboration with the Colorectal Surgical Society Australia and New Zealand, moving towards a national initiative. Initiated from a single site in Melbourne, using a range of data collection and linkage processes, and optimizing the use of modern technology, we have now implemented and sustained comprehensive and multidisciplinary data collection across multiple Victorian and interstate institutions. Specific challenges related to ethics and privacy, data accuracy and completeness and data ownership have been addressed and many lessons have been learnt. Multicentre audit and research queries can now be conducted with confidence that privacy, security and intellectual property issues are addressed. Research output, including many studies that were not previously possible, has informed a broad range of topics relevant to colorectal cancer. Multicentre and comprehensive data collection for colorectal cancer is achievable and sustainable and promises great benefit as an audit and research tool. Similar initiatives could be established for other tumour types. | 18,844,914 |
Immunohistochemical detection of carcinoma in radical prostatectomy specimens following hormone therapy. | Following hormone therapy, residual carcinoma is frequently difficult to identify on HE-stained prostatectomy specimens. The aim of the present study was therefore to investigate whole-mounted specimens obtained by radical prostatectomy from patients who had undergone hormone therapy. Formalin-fixed and paraffin-embedded specimens were immunostained with prostate secretory cell markers including prostate-specific antigen (PSA), P504S (alpha-methylacyl-coenzyme A racemase, AMACR), P501S (prostein), and prostate-specific membrane antigen (PSMA). Residual carcinoma was detected in 250 histological slides of 42 patients in a total of 497 slides from 45 patients. In five of 250 slides (2%), carcinoma was not able to be recognized on HE-stained slides, but was found on the immunohistochemistry slides. PSMA had reacted positively beyond a moderate degree in carcinoma from all patients. PSA was positive for carcinoma in most of the patients, while negative or minimal staining was observed in a small number of patients. Carcinoma was positively reactive with P504S and P501S in most of the patients, but was negatively reactive in a few. The Gleason score for a pretreatment needle biopsy correlated with P504S staining of the prostatectomy specimens. P504S and P501S had limited ability to identify degenerated carcinoma. PSMA was the most useful marker to identify carcinoma after hormone therapy. | 18,844,933 |
Histological characteristics of 21 Papua New Guinean children with high-grade B-cell lymphoma, which is frequently associated with EBV infection. | The aim of the present study was to confirm the histopathological features of aggressive B-cell lymphoma in Papua New Guinea (PNG)-an EBV endemic region. The immunophenotypic features and expression of EBV-encoded proteins and RNA in B-cell lymphomas were analyzed in 21 PNG children, and compared to the corresponding features of 17 Japanese children with Burkitt lymphoma (BL). Histological diagnosis of the lymphomas from the PNG children was BL in nine patients; atypical Burkitt/Burkitt-like variant of BL (BLL) in three; diffuse large B-cell lymphoma (DLBCL) in four; and B-lymphoblastic lymphoma (B-LBL) in five. The lymphomas from the PNG children had a high positive rate on EBV-RNA in situ hybridization (EBV-ISH; 66.7%). With regard to the histological typing, 10 of 12 patients (83%) with BL/BLL, one of four (25%) with DLBCL, and three of five (60%) with B-LBL were positive for EBV-ISH. The findings of EBV-positive B-LBL were surprising because it is commonly considered that lymphoblastic lymphoma is not associated with EBV. EBV positivity was not detected in the 12 Japanese patients who were available for the EBV-ISH evaluation. It is concluded that it is possible that a proportion of DLBCL and B-LBL besides BL/BLL are associated with EBV in endemic region. | 18,844,934 |
Follicular lymphoma with marked infiltration of eosinophils. | Eosinophilia and tissue infiltration by eosinophils are frequent findings in Hodgkin lymphoma, but they are extremely rare in B-cell lymphoma. Reported herein is a case of follicular lymphoma with extensive lymph node infiltration by eosinophils. The patient was a 71-year-old woman who had a mass in the vicinity of the pancreas found on routine ultrasonography. Subsequent CT indicated several enlarged abdominal lymph nodes, although superficial lymph nodes were not palpable. Two swollen mesenteric lymph nodes were excised to determine the cause of the lymphadenopathy. Histology indicated extensive infiltration of numerous eosinophils to the interfollicular area, especially in the dilated sinuses. The lymphoid follicles were relatively small, had inconspicuous germinal centers, and were scattered between dilated sinuses. Based on the histology, immunohistochemistry, and chromosomal abnormality, a diagnosis of follicular lymphoma was made. Expression of interleukin-3 (IL-3), IL-5, eotaxin, eotaxin-2, and eotaxin-3 was investigated on reverse transcription-polymerase chain reaction of the lymph node tissue, but none of the mRNA expression levels were elevated. This was a unique case of follicular lymphoma with extensive eosinophil infiltration, and to the best of the authors' knowledge this is the first such case ever reported. | 18,844,935 |
Mucoepidermoid carcinoma of the thyroid gland showing marked ciliation suggestive of its pathogenesis. | Mucoepidermoid carcinoma of the thyroid gland is a rare tumor first described by Rhatigan et al. in 1977. Its pathogenesis is still controversial. With regard to its most likely origin, some authors have suggested that it arises directly from follicular epithelium whereas others have proposed that it arises from ultimobranchial body (diverticulum from the fourth pharyngeal pouch) remnants, also known as solid cell nests (SCN). Herein is reported a unique case of thyroid mucoepidermoid carcinoma. The patient, a 67-year-old man, presented with a non-tender thyroid mass and vocal cord fixation. The tumor was poorly defined, necessitating subtotal thyroidectomy with composite resection of the adjacent structures. Pathologically, the tumor cells had characteristics of mucoepidermoid carcinoma, along with layers of columnar cells showing marked ciliation resembling respiratory-type epithelium, suggesting that this rare tumor had originated from SCN. p63 immunopositivity in the tumor provided additional evidence for the pathogenesis. | 18,844,942 |
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