ADDICTION, Issue 5 2010
Reka Toth
ABSTRACT Background Standardized death rates from chronic liver diseases (CLDs) in Hungary are much higher than the European Union average. Carrying the alcohol dehydrogenase 1B 48His allele (rs1229984 or ADH1B*2) could decrease the risk of alcoholism, but with persistent drinking may confer a greater risk of CLDs. The aim of this study was to assess the prevalence of this polymorphism in the Hungarian population and its association with alcohol consumption and with CLDs. Methods and results A total of 278 cases with diagnosed CLDs and 752 controls without any alterations in liver function, all males aged 45,64, were screened for ADH1B Arg48His polymorphism. ADH1B*2 allele frequencies in controls and cases were 8.31% and 4.50%, respectively (,2 = 9.2; P = 0.01). Carrying the ADH1B*2 allele was associated with significantly lower odds ratio (OR) for drinking frequency (OR = 0.63; P = 0.003), the number of positive answers on CAGE (Cut-down, Annoyed, Guilt, Eye-opener) assessment (OR = 0.58; P = 0.005) and a positive CAGE status (OR = 0.55; P = 0.007). There was a significant association between ADH1B*2 and CLDs (OR = 0.50; P = 0.003), but it disappeared after adjusting for CAGE status and scores (OR = 0.67 P = 0.134; OR = 0.67 P = 0.148, respectively) and weakened after adjusting for drinking frequency (OR = 0.61; P = 0.045). Among heavy drinkers the presence of ADH1B*2 did not increase the risk of cirrhosis but there was a significant interaction between genotype and CAGE status (P = 0.003, P = 0.042), with ADH1B*2 conferring reduced risk of CLDs in CAGE negatives. Conclusion In Hungarians, the ADH1B 48His allele reduces the risk of alcoholism, but not the risk of chronic liver disease among heavy drinkers. [source]

Brief screening questionnaires to identify problem drinking during pregnancy: a systematic review

ADDICTION, Issue 4 2010
Ethel Burns
ABSTRACT Aims Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect ,at-risk' drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71,91%) and AUDIT-C (95%), with high specificity (71,89%, 73,83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score ,3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score ,8 performed poorly. Conclusion T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. [source]

Paradoxical increase of positive answers to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of decreasing alcohol consumption: results from two population-based surveys in Île-de-France, 1991 and 2005

ADDICTION, Issue 4 2008
Antoine Messiah
ABSTRACT Aims To describe trends of responses to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of declining alcohol consumption, in a country with no temperance history. Design Two random-sample surveys, conducted in 1991 and 2005, respectively. Setting The adult population of Ile-de-France. Participants A total of 1183 subjects in 1991 and 5382 subjects in 2005. Measurements Responses to CAGE questions, obtained by face-to-face interviews in 1991 and by telephone in 2005. Results were standardized on the 2005 population structure. Findings The proportion of subjects giving at least two positive answers has increased by 4.2 times; the biggest increase was observed for the Guilt question (4.8 times) and the smallest for the Eye-opener question (2.6 times). Several increases were higher for women than for men: 12.9 times versus 3.3 times for two or more positive answers, 9.8 times versus 3.8 times for the Guilt question. Increases did not vary consistently by age. Conclusion These paradoxical trends do not support the use of CAGE in general population surveys. They confirm previous reports suggesting that CAGE was sensitive to community temperance level. They might reflect the emergence of a temperance movement in France, with stronger impact among women. This movement might be responsible for the fall in alcohol consumption. [source]

Is the Full Version of the AUDIT Really Necessary?

ALCOHOLISM, Issue 8 2010
Internal Construct of Its Abbreviated Versions, Study of the Validity
Background:, This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults. Methods:, The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearson's correlation coefficient. Results:, The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbach's alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments. Conclusions:, The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE. [source]

Prevalence of Alcohol-Related Problems in an Elderly Population and Their Association With Cognitive Impairment and Dementia

ALCOHOLISM, Issue 4 2010
Marcos A. Lopes
Background:, Studies investigating the association between alcohol use and cognitive disorders in the elderly population have produced divergent results. Moreover, the role of alcohol in cognitive dysfunction is not clear. The aims of this study were to estimate the prevalence of alcohol-related problems in an elderly population from Brazil and to investigate their association with cognitive and functional impairment (CFI) and dementia. Methods:, A community-based cross-sectional study was performed. A sample of 1,145 elderly people was examined in 2 phases. Several instruments were utilized in the first phase: the CAGE questionnaire was used to identify potential cases of alcohol-related problems, and a screening test for dementia was used to estimate CFI. The CAMDEX interview (Cambridge Examination) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) criteria were used for the clinical diagnosis of dementia in the second phase. Results:, "Heavy alcohol use" (CAGE , 2) was found in 92 subjects (prevalence: 8.2%). It was associated with gender (males, p < 0.001), low education (only in females, p = 0.002), and low socioeconomic level (p = 0.001, in females; p = 0.002, in males). The Mini Mental State Examination exhibited a nonlinear relationship with alcohol-related problems in females; "mild,moderate alcohol use" (CAGE < 2) presented the highest score. A significant association between alcohol-related problems and cognitive dysfunction was found only in females. "Heavy alcohol use" was associated with higher CFI and dementia rates compared to "mild,moderate alcohol use" (p = 0.003 and p < 0.001, respectively). "Mild,moderate alcohol use" had a tendency of association with lower CFI and dementia rates when compared to "no alcohol use" (p = 0.063 and 0.050, respectively). Conclusion:, Our findings suggest that alcohol use does not have a linear relationship with cognitive decline. [source]

A Metric of Maternal Prenatal Risk Drinking Predicts Neurobehavioral Outcomes in Preschool Children

ALCOHOLISM, Issue 4 2009
Lisa M. Chiodo
Background:, Fetal Alcohol Spectrum Disorders (FASDs), including Fetal Alcohol Syndrome, continue to be high-incidence developmental disorders. Detection of patterns of maternal drinking that place fetuses at risk for these disorders is critical to diagnosis, treatment, and prevention, but is challenging and often insufficient during pregnancy. Various screens and measures have been used to identify maternal risk drinking but their ability to predict child outcome has been inconsistent. This study hypothesized that a metric of fetal "at-risk" alcohol exposure (ARAE) derived from several indicators of maternal self-reported drinking would predict alcohol-related neurobehavioral dysfunctions in children better than individual measures of maternal alcohol consumption alone. Methods:, Self-reported peri-conceptional and repeated maternal drinking during pregnancy were assessed with semi-structured interviews and standard screens, i.e., the CAGE, T-ACE, and MAST, in a prospective sample of 75 African-American mothers. Drinking volumes per beverage type were converted to standard quantity and frequency measures. From these individual measures and screening instruments, a simple dichotomous index of prenatal ARAE was defined and used to predict neurobehavioral outcomes in the 4- to 5-year-old offspring of these women. Study outcomes included IQ, attention, memory, visual-motor integration, fine motor skill, and behavior. Statistical analyses controlled for demographic and other potential confounders. Results:, The current "at-risk" drinking metric identified over 62% of the mothers as drinking at risk levels,23% more than the selection criterion identified,and outperformed all individual quantity and frequency consumption measures, including averages of weekly alcohol use and "binge" alcohol exposures (assessed as intake per drinking occasion), as well as an estimate of the Maternal Substance Abuse Checklist (Coles et al., 2000), in predicting prenatal alcohol-related cognitive and behavioral dysfunction in 4- to 5-year-old children. Conclusions:, A metric reflecting multiple indices of "at-risk" maternal alcohol drinking in pregnancy had greater utility in predicting various prenatal alcohol-related neurobehavioral dysfunction and deficits in children compared to individual measures of maternal self-reported alcohol consumption or a previous maternal substance abuse index. Assessing fetal risk drinking in pregnant women was improved by including multiple indicators of both alcohol consumption and alcohol-related consequences and, if appropriate practical applications are devised, may facilitate intervention by health care workers during pregnancy and potentially reduce the incidence or severity of FASDs. [source]

Effectiveness of Structured Questionnaires for Screening Heavy Drinking in Middle-Aged Women

ALCOHOLISM, Issue 11 2006
Mauri Aalto
Background: There is a need for an effective and feasible alcohol screening instrument. The aim of the study was to evaluate how the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire perform in comparison with the original AUDIT and what the optimal cutoffs are when screening for heavy drinking among women. Methods: All the 40-year-old women in the city of Tampere, Finland, are invited yearly for a health screening. From 1 year, data from 894 women (response rate 68.2%) invited for a health screening were utilized in the study. The original 10-item AUDIT, AUDIT-C, Five Shot, AUDIT-PC, AUDIT-3, AUDIT-QF, and CAGE were evaluated against the Timeline Followback. Consumption of at least 140 g of absolute ethanol per week on average during the past month was considered heavy drinking. Results: In the Timeline Followback, the mean±SD weekly reported alcohol consumption was 45±67 g (range 0,936 g) of absolute ethanol. Of the women, 6.2% (55/894) were heavy drinkers. The optimal combination of sensitivity and specificity was reached for the AUDIT with cutoff ,6, for the AUDIT-C with cutoff ,5, for the Five Shot with cutoff ,2.0, for the AUDIT-PC with cutoff ,4, and for the AUDIT-QF with cutoff ,4. When choosing the optimal cutoffs, the AUDIT-C, the Five Shot, the AUDIT-PC, and the AUDIT-QF performed as well as the 10-item AUDIT. With these cutoffs, sensitivities were 0.84 to 0.93 and specificities were 0.83 to 0.90. The AUDIT-3 and the CAGE did not perform as well as the other questionnaires. Conclusions: The 10-item AUDIT, AUDIT-C, Five Shot, AUDIT-PC, and AUDIT-QF seem to be equally effective tools in screening for heavy drinking among middle-aged women. However, their applicability is achieved only if the cutoffs are tailored according to gender. [source]

Spouse Abuse and Alcohol Problems Among White, African American, and Hispanic U.S. Army Soldiers

ALCOHOLISM, Issue 10 2006
Nicole S. Bell
Background: Prior studies suggest racial/ethnic differences in the associations between alcohol misuse and spouse abuse. Some studies indicate that drinking patterns are a stronger predictor of spouse abuse for African Americans but not whites or Hispanics, while others report that drinking patterns are a stronger predictor for whites than African Americans or Hispanics. This study extends prior work by exploring associations between heavy drinking, alcohol-related problems, and risk for spouse abuse within racial/ethnic groups as well as variations associated with whether the perpetrator is drinking during the spouse abuse incident. Methods: Cases (N=7,996) were all active-duty male, enlisted Army spouse abusers identified in the Army's Central Registry (ACR) who had also completed an Army Health Risk Appraisal (HRA) Survey between 1991 and 1998. Controls (N=17,821) were matched on gender, rank, and marital and HRA status. Results: We found 3 different patterns of association between alcohol use and domestic violence depending upon both the race/ethnicity of the perpetrator and whether or not alcohol was involved in the spouse abuse event. First, after adjusting for demographic and psychosocial factors, weekly heavy drinking (>14 drinks per week) and alcohol-related problems (yes to 2 or more of 6 alcohol-related problem questions, including the CAGE) were significant predictors of domestic violence among whites and Hispanics only. Also for the white soldiers, the presence of family problems mediated the effect of alcohol-related problems on spouse abuse. Second, alcohol-related problems predicted drinking during a spouse abuse incident for all 3 race groups, but this relation was moderated by typical alcohol consumption patterns in Hispanics and whites only. Finally, alcohol-related problems predicted drinking during a spouse abuse incident, but this was a complex association moderated by different psychosocial or behavioral variables within each race/ethnic group. Conclusion: These findings suggest important cultural/social influences that interact with drinking patterns. [source]

Alcohol Use Disorders Among Emergency Department,Treated Older Adolescents: A New Brief Screen (RUFT-Cut) Using the AUDIT, CAGE, CRAFFT, and RAPS-QF

ALCOHOLISM, Issue 5 2004
Thomas M. Kelly
Abstract: Background: Early identification of alcohol use disorders (AUD) among emergency department (ED)-treated patients is important for facilitating intervention and further evaluation outside EDs. A number of brief screening instruments have been developed for identifying patients with AUD, but it is not clear whether they are practical and perform well with older adolescents in an ED setting. This study contrasted four brief screening instruments for detecting DSM-IV,defined AUD and tested a newly developed brief screen for use among ED-treated older adolescents. Methods: The Alcohol Use Disorders Identification Test (AUDIT), the CAGE, the CRAFFT, and a modified RAPS-QF were given to 93 alcohol-using older adolescents (55% men; aged 18,20 years) in an ED. Receiver operator characteristic analyses were used to evaluate the performance of brief screens against the criterion of a lifetime DSM-IV alcohol abuse or dependence diagnosis. Results: Of existing instruments, the AUDIT had the best overall performance in identifying AUD (sensitivity, 82%; specificity, 78%). A new, shorter screening instrument composed of two AUDIT items, two CRAFFT items, and one CAGE item (RUFT-Cut) performed as well as the AUDIT (sensitivity, 82%; specificity, 78%). Conclusions: Among existing alcohol screening instruments, the AUDIT performed best for identifying ED-treated older adolescents with alcohol use disorders. The RUFT-Cut is a brief screening instrument for AUD that shows promise for identifying ED-treated older adolescents who are in need of intervention or further evaluation. Future research should focus on use of the RUFT-Cut in other settings with larger, more diverse samples of adolescents. [source]

Screening for Alcohol Problems in the U.S.

ALCOHOLISM, Issue 11 2002
Ethnicity, General Population: Comparison of the CAGE, RAPS, RAPS4-QF by Gender, Service Utilization
Background The purpose of this study was to compare the performance (sensitivity and specificity) of two brief screening instruments, CAGE and the Rapid Alcohol Problems Screen 4 (RAPS4), against ICD-10 and DSM-IV criteria for alcohol dependence and abuse in a representative sample of the U.S. adult household population by gender, ethnicity, and service utilization (emergency room and primary care) in the last year. Methods Data are from the Alcohol Research Group's 2000 National Alcohol Survey (n= 7612), which is a computer-assisted telephone interview survey of the U.S. general population 18 and over in all 50 U.S. states and the District of Columbia. Results Sensitivity of the RAPS4 (0.86) was better than the CAGE (0.67) given similar specificity (0.95 vs. 0.98) and outperformed the CAGE for alcohol dependence across all gender, ethnic, and service utilization groups, except among blacks and Hispanics. The RAPS4 also performed equally well for females and males (0.88 vs. 0.85), whereas sensitivity of the CAGE was lower for females. Although sensitivity of the RAPS4 was better than the CAGE for alcohol abuse, sensitivity was low for both (0.56 and 0.36, respectively). When quantity-frequency (QF) questions (drinking five or more drinks on at least one occasion during the last year and drinking as often as once a month during the last year) were added to the RAPS4, the RAPS4-QF performed significantly better for alcohol abuse and outperformed the CAGE at a cut point of one across all gender, ethnic, and service utilization groups. The RAPS4-QF appeared to be most sensitive for alcohol abuse among both males and females reporting emergency room use (0.90). Conclusions The data suggest that the RAPS4 outperforms the CAGE in this general population sample. The addition of a QF question to the RAPS4 improves performance in relation to sensitivity for alcohol abuse, and the RAPS4 and RAPS4-QF may be the instruments of choice in brief screening for alcohol use disorders. Additional research is needed to further explore these issues. [source]

Variations on the CAGE Alcohol Screening Questionnaire: Strengths and Limitations in VA General Medical Patients

ALCOHOLISM, Issue 10 2001
Katharine A. Bradley
Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n= 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (,14 drinks/week or ,5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking ,6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking ,6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. [source]

Phylogeography of the common goby, Pomatoschistus microps, with particular emphasis on the colonization of the Mediterranean and the North Sea

MOLECULAR ECOLOGY, Issue 2 2004
E. S. Gysels
Abstract The phylogeographical patterns of a small marine fish, the common goby, Pomatoschistus microps, were assessed at 12 sites along the northeastern Atlantic coasts and the western Mediterranean Sea. A combination of two genetic markers was employed: cellulose acetate allozyme electrophoresis (CAGE) and sequence analysis of a 289 bp fragment of the mitochondrial locus cytochrome b. Both markers were congruent in revealing significant differences between samples (global FST = 0.247 for the allozymes and ,ST = 0.437 for the mitochondrial DNA data) and a pattern of isolation-by-distance. Phylogeographical analyses yielded a shallow branching structure with four groups. Three of those were confined to the Atlantic basin and showed a star-like pattern. The fourth group contained a central haplotype occurring at the edges of the species' distribution, accompanied by a few more rare variants, which were restricted to the Mediterranean Sea. A genetic break was observed around the British Isles, with distinct haplotypes dominating at either side of the English Channel. A significantly negative correlation between the degree of genetic diversity and latitude was recorded both for mitochondrial DNA (mtDNA) and allozymes in the Atlantic basin. Gene flow analysis suggested that recolonization of the North Sea and the coasts of western Scotland and Ireland may have taken place from a glacial refugium in the Southern Bight of the North Sea. These results are discussed in the perspective of possible postglacial migration routes of marine fish along the northeastern Atlantic coasts. [source]

CT31 HYPERBARIC OXYGEN IN POST-CARDIAC SURGERY STROKE PATIENTS , THE CHRISTCHURCH EXPERIENCE

ANZ JOURNAL OF SURGERY, Issue 2007
A. J. Gibson
Introduction Post-operative strokes occur in a small percentage of adult cardiac surgical patients and have devastating consequences for these patients. There is evidence to suggest that Cerebral Arterial Gas Embolism (CAGE) is an important aetiological factor in most of these cases. Hyperbaric Oxygen therapy (HBOT) is the administration of 100% oxygen at greater than atmospheric pressure. It is accepted as the definitive treatment for CAGE related to SCUBA diving accidents. The similarities between this and the pathophysiology of post cardiac-surgical strokes due to iatrogenic CAGE suggest that beneficial effects from HBOT may accrue to these patients. Purpose The purpose of this study is to review the experience of treating post cardiac-surgical stroke patients in our local hyperbaric oxygen facility, including their presentation, delay before treatment and outcomes. The current evidence base is reviewed. Method A retrospective case series analysis was conducted. Results Over a 10 year period, patients with post cardiac-surgical strokes and who presented within the first 48 hours were referred for HBOT, of whom 12 were treated. The neurological outcomes were excellent in all but one case who died. A review of the literature provides a rational basis for the potential benefits of HBOT in this scenario, but at present there is only limited clinical data to support its use. Conclusion The postulated mechanisms for the development of post cardiac-surgical strokes provide a sound theoretical basis for the suggestion that the use of HBOT is associated with improved outcomes. However there is no prospective data to support such a claim. Such a trial would be problematic and until more evidence is available, HBOT should be considered on a case by case basis. [source]

NS13P A PROSPECTIVE COMPARISON OF TWO CERVICAL INTERBODY FUSION CAGES

ANZ JOURNAL OF SURGERY, Issue 2007
M. A. Hansen
Purpose For some time the surgical management of chronic back pain has utilised interbody lumbar cages. Recently interbody cages for use in the cervical spine have been produced. Cervical cages provide initial stability during the fusion process. There is little literature comparing the performance of interbody cage systems due to their relative recent introduction. Methodology Patients with symptomatic cervical degeneration or traumatic lesions were treated with the dynamic ABC 2 Aesculap anterior cervical plating system and either the B-Braun Samarys or Zimmer cage systems. A single surgeon conducted all surgery. Pre- and post-operative radiological examinations were compared. Changes in disc height at affected and adjacent levels, lordosis and evidence of fusion were recorded. Patient outcome was measured with questionnaires. The modified Oswestry neck pain disability and Copenhagen neck disability scale scores were utilised to allow comparison between patients. Results A total of 43 patients were involved in the study (30 with the Zimmer cage system and 13 with the Samarys cage). Patient follow-up has been up to 12 months. Improvement in disability scores was shown in 90% of patients. Follow up imaging did not demonstrate subsidence of the cage or adjacent instability in either group. There was no statistical difference in complication rate between the two groups. Discussion Initial stability was provided by both interbody cervical spine cage system. Rates of fusion and symptomatic relief compared favourably to fusion involving autogenous bone graft without associated morbidity. Longer follow up is necessary to determine whether there is evidence of adjacent level instability or vertebral end-plate subsidence. [source]

Heart in a Hard Cage: Startling Calcific Constrictive Pericarditis

CONGESTIVE HEART FAILURE, Issue 3 2008
Nandakumar Srinivasan MD
"My heart is turned to stone; I strike it and it hurts my hand.",Shakespeare, from Othello. [source]

Structural Characterization of a Microperoxidase Inside a Metal-Directed Protein Cage,

ANGEWANDTE CHEMIE, Issue 39 2010
Thomas W. Ni
Beugehaft: Die Zinkionen-gelenkte Aggregation von tetraedrischen Proteinkäfigen (Zn30:CFMC-112) in einem rhomboedrischen Kristallgitter wird beschrieben. Die Histidin-Seitenketten und exponierten hydrophoben Gruppen, die entlang der Käfighöhlung aufgereiht sind, ermöglichten es, ein flexibles Hämpeptidfragment vom c -Typ (eine Mikroperoxidase) im Käfig zu immobilisieren und seine Kristallstruktur mit 1.9,Å Auflösung zu bestimmen. [source]

A Shape-Persistent Organic Molecular Cage with High Selectivity for the Adsorption of CO2 over N2,

ANGEWANDTE CHEMIE, Issue 36 2010
Yinghua Jin Dr.
Ein organischer Käfig für Kohlenstoff: Ein formpersistenter, organischer prismatischer molekularer Käfig (siehe Struktur) wurde in einem Schritt und in hoher Ausbeute aus einfach zugänglichen Ausgangsmaterialien mithilfe dynamischer kovalenter Verknüpfungsreaktionen hergestellt. Dieses Käfigmolekül adsorbiert hoch selektiv CO2 gegenüber N2 und könnte deshalb für den Kohlenstoffeinfang geeignet sein. [source]

Chlorination of C86 to C84Cl32 with Nonclassical Heptagon-Containing Fullerene Cage Formed by Cage Shrinkage,

ANGEWANDTE CHEMIE, Issue 28 2010

Geschrumpftes Fulleren: Ein ungewöhnlicher C84 -Fullerenkäfig mit siebengliedrigem Ring liegt in C84Cl32 vor, das (neben C86(16)Cl28) bei der Chlorierung von C86(16) mit VCl4 gebildet wird. Ein Vergleich der Strukturen von C84Cl32 (siehe Bild; C grau, Cl grün; rote Bindungen markieren das Heptagon) und C86(16)Cl28 sowie theoretische Studien zeigen, dass der C86(16)-Käfig schrumpft, wenn eine C2 -Einheit aus dem Corranulen-Fragment entfernt wird. [source]

A Giant Silver Alkynyl Cage with Sixty Silver(I) Ions Clustered around Polyoxometalate Templates,

ANGEWANDTE CHEMIE, Issue 10 2010
Juan Qiao
Nano-Nuss: AgCCtBu reagiert mit AgOTf in Gegenwart eines Polyoxometallats (POM) als Templat unter Solvothermalbedingungen zu einem Kern-Schale-Nanocluster, dessen erdnussartige Struktur (siehe Bild) aus zwei Mo6O228, -,Nüssen" (grün) und einer Ag60 -Schale (lila) besteht. Nach elektrochemischen Untersuchungen wirkt die Silberschale als elektronisches Relais, und die POM-Kerne stabilisieren als Redoxpuffer den Cluster. [source]

Inclusion of Anionic Guests inside a Molecular Cage with Palladium(II) Centers as Electrostatic Anchors,

ANGEWANDTE CHEMIE, Issue 38 2009
Guido
Vier bananenförmige Liganden und zwei PdII -Ionen bauen quantitativ eine ballförmige Struktur mit vier großen Öffnungen auf (siehe Bild). Die beiden PdII -Ionen bilden mit Pyridindonoren der Liganden stabile quadratisch-planare Komplexe, sie können aber zusätzlich mit Anionen wechselwirken. Weil sie in einem bestimmten Abstand positioniert sind, der durch die starren Liganden vorgegeben ist, wirken die PdII -Ionen als elektrostatische Anker für dianionische Gäste entsprechender Größe. [source]

Fusing Pentagons in a Fullerene Cage by Chlorination: IPR D2 -C76 Rearranges into non-IPR C76Cl24,

ANGEWANDTE CHEMIE, Issue 32 2009

Eine spektakuläre Gerüstumlagerung des C76 -Fullerenkäfigs resultiert aus der Chlorierung von D2 -C76 zu C76Cl24 (siehe Struktur: C,grau, Cl,grün; orangefarbene Bindungen zeigen Fünfringe an), dessen Kohlenstoffgerüst merklich abgeflacht ist und gegen die Regel der isolierten Fünfringe verstößt. Der Übergang umfasst vermutlich sieben Stone-Wales-Umlagerungen, die durch die Chlorierung deutlich erleichtert werden. [source]

Design of a Protective Cage for an Intravascular Axial Flow Blood Pump to Mechanically Assist the Failing Fontan

ARTIFICIAL ORGANS, Issue 8 2009
Amy L. Throckmorton
Abstract Currently, no long-term mechanical bridge-to-transplant or bridge-to-recovery therapeutic alternative exists for failing single ventricles. A blood pump that would augment pressure in the cavopulmonary circulation is needed, and would lead to a reduction in elevated systemic venous pressure, and improve cardiac output. Thus, we are developing a collapsible, percutaneously inserted, axial flow blood pump to support the cavopulmonary circulation in adult patients with a failing single ventricle physiology. This collapsible axial flow pump is designed for percutaneous positioning. The outer protective cage will be designed with radially arranged filaments as touchdown surfaces to protect the vessel wall from the rotating components. This study examined the geometric characteristics of the protective cage of filaments and the impeller through the development and numerical analysis of 13 models. A blood damage analysis was also performed on selected geometric models to assess the probability of blood trauma. All models demonstrated an acceptable hydraulic performance by delivering 2,6 L/min at a rotational speed of 6000,10 000 rpm and generating pressure rise of 5,20 mm Hg. Expected trends in the hydraulic performance of the pump models were found. This study represents the initial first design phase of the impeller and protective cage of filaments. Validation of these flow and performance predictions will be completed in the next round of experimental testing with blood bag evaluation. [source]

ChemInform Abstract: Encapsulation of a Radiolabeled Cluster Inside a Fullerene Cage, 177LuxLu(3-x)N@C80: An Interleukin-13-Conjugated Radiolabeled Metallofullerene Platform.

CHEMINFORM, Issue 23 2010
Harry C. Dorn
Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source]

ChemInform Abstract: Competition Among fcc-Like, Double-Layered Flat, Tubular Cage, and Close-Packed Structural Motifs for Medium-Sized Aun (n = 21,28) Clusters

CHEMINFORM, Issue 26 2008
Dongxu Tian
Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source]

A Hollow Tetrahedral Cage of Hexadecagold Dianion Provides a Robust Backbone for a Tuneable Sub-Nanometer Oxidation and Reduction Agent via Endohedral Doping.

CHEMINFORM, Issue 8 2007
Michael Walter
Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF. [source]

Expanding the Number of Stable Isomeric Structures of the C80 Cage: A New Fullerene Dy3N@C80.

CHEMINFORM, Issue 16 2006
Shangfeng Yang
Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF. [source]

Au42: An Alternative Icosahedral Golden Fullerene Cage

CHEMINFORM, Issue 22 2005
Yi Gao
Abstract For Abstract see ChemInform Abstract in Full Text. [source]

Spherical Double Electric Layer Structure and Unprecedented High Stability of the P20O20 Cage and Its Anionic Endohedral Complex Na - @P20O20

CHEMINFORM, Issue 26 2004
Yanjin Wang
Abstract For Abstract see ChemInform Abstract in Full Text. [source]

Synthesis and Characterization of the D5h Isomer of the Endohedral Dimetallofullerene Ce2@C80: Two-Dimensional Circulation of Encapsulated Metal Atoms Inside a Fullerene Cage

CHEMISTRY - A EUROPEAN JOURNAL, Issue 37 2009
Michio Yamada Dr.
Abstract Herein we show the synthesis and characterization of the second known Ce2@C80 isomer. A 13C,NMR spectroscopic study revealed that the structure of the second isomer has D5h symmetry. Paramagnetic NMR spectral analysis and theoretical calculation display that the encapsulated Ce atoms circulate two-dimensionally along a band of ten contiguous hexagons inside a D5h -C80 cage, which is in sharp contrast to the three-dimensional circulation of two Ce atoms in an Ih -C80 cage. The electronic properties were revealed by means of electrochemical measurements. The D5h isomer of Ce2@C80 has a much smaller HOMO,LUMO gap than cluster fullerenes (M3N@C80, M=Sc, Tm, and Lu) with the same D5h -C80 cages. The chemical reactivity was investigated by using disilirane as a chemical probe. The high thermal reactivity toward 1,1,2,2-tetramesityl-1,2-disilirane is consistent with the trends of the redox potentials and the lower LUMO level of the D5h isomer of Ce2@C80 compared with that of C60. [source]

Proton Transfer in the Complex H3N,,,HCl Catalyzed by Encapsulation into a C60 Cage

CHEMPHYSCHEM, Issue 7 2009
Fang Ma Dr.
Abstract Caged up: In contrast to acid,base behavior in solution, single molecules of NH3 and HCl do not react to form the ion pair NH4+Cl, in isolation. Proton transfer occurs in the complex H3N,,,HCl inside the C60 cage, to form the ion pair NH4+Cl, under the catalytic action of C60 (see picture). We report proton transfer in the complex H3N,,,HCl to form the ion pair NH4+Cl,, which is favored inside the C60 cage according to quantum chemical calculations. The results show that the NH4+Cl,@C60 is stable with an interaction energy of ,2.78 kcal,mol,1. Compared with the complex H3N,,,HCl without proton transfer, it is found that the C60 cage plays the role of a catalyst for proton transfer. In NH4+Cl,@C60 a negative charge area in the C60 cage is near the cation NH4+ whereas a positive charge area is near the anion Cl,. Also, a confinement effect of the C60 cage is noticed, as the endohedral structure of NH4+Cl, is more compact than the structure of NH4+Cl, in the gas-phase complex. These findings indicate that the catalysis by the C60 cage comes from two effects: 1) electrostatic inducement between the C60 cage and endohedral molecules and 2) the confinement effect that compresses endohedral molecular structures inside the C60 cage. In the infrared spectrum, it is found that the confinement effect of the cage can cause large blue shifts of the N,H stretching vibrations in NH4+Cl,@C60 compared with those in the NH4+Cl,,,,H2O complex. [source]