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ORs
Kinds of ORs Selected AbstractsHuman melanocytes can be isolated, propagated and expanded from plucked anagen hair folliclesEXPERIMENTAL DERMATOLOGY, Issue 6 2010Christina Dieckmann Please cite this paper as: Human melanocytes can be isolated, propagated and expanded from plucked anagen hair follicles. Experimental Dermatology 2010; 19: 543,545. Abstract:, Herein, we report a technically simple method for isolation and culture of human follicular melanocytes based on explant cultures of epilated hair follicles. This technique does not require any surgical intervention and allows the isolation and cultivation of follicular melanocytes from a comparatively small amount of raw material. Generally, 30,60 human anagen hair follicles have been plucked from the scalp of healthy donors and cultivated under low oxygen pressure (5%). After a short period of time cells of various types were growing out from the outer root sheath (ORS) of the hair follicles. Under the selected culture conditions, most of the cells other than melanocytes have been eliminated and a nearly 100% pure population of melanocytes has been achieved, as confirmed by immunohistochemical analyses for melanocyte-specific markers, for example, Tyrosinase-1, S-100 and premelanosomal antigens. These melanocytes derived from the ORS were proliferating for up to 2 months. [source] Reorganization of hair follicles in human skin organ culture induced by cultured human follicle-derived cellsEXPERIMENTAL DERMATOLOGY, Issue 8 2005Walter Krugluger Abstract:, Studies of human hair follicle (HF) induction by follicle-derived cells have been limited due to a lack of suitable test systems. In this study, we established a skin organ culture system which supports HF formation by follicle-derived cells. Long-term skin organ cultures were set up from human retroauricular skin specimens and maintained in culture for up to 8 weeks. In vitro expanded human HF-derived cells from the dermal papilla (DP) and the outer root sheath (ORS) were injected together into the skin specimens and evaluated for their ability to induce reorganization of HFs. Macroscopic analysis of the cultured skin specimens demonstrated the growth of velus-like hair after 4 weeks in culture. Histologic evaluation of the cultured skin specimens after 8 weeks of culture revealed multiple miniaturized HFs with sebaceous glands. In addition, cell clusters of various differentiation stages could be demonstrated in serial sections of the cultured skin specimens. Labeling of HF-derived cells with the fluorescence dye CFDA-1 prior to injection suggested a de novo reorganization of HFs out of the injected cells. In conclusion, the study demonstrated HF formation by HF-derived cells in an in vitro skin organ culture model. [source] Sedimentation and tectonics: the marine Silurian,basal Lower Old Red Sandstone transition in southwest WalesGEOLOGICAL JOURNAL, Issue 3-4 2004Robert D. Hillier Abstract Both regional and localized tectonic events controlled deposition within the Wenlock and early Ludlow of SW Wales. Estuarine deposits within north,south-tending incised valleys dominate the youngest (Homerian) Gray Sandstone Group, valley incision being probably related to changing base-levels associated with Avalonia/Laurentian collision. Available accommodation space was outpaced by sediment supply, with the Red Cliff Formation (Late Ludfordian) defining a conformable transition from marine to Old Red Sandstone (ORS) deposition within the Marloes Peninsula. Sedimentation was dominated by fine-grained pedified siliciclastics, with subordinate fine-grained ephemeral sheet-flood sandstones. Local palaeocurrents indicate sediment transport from the south and west, though long-distance transport from a distant Laurentian provenance is assumed. A probable tectonically generated sequence boundary marks the base of petrographically distinctive, multi-storey pebbly sandstones of the Albion Sands Formation, deposited within the hangingwall valley of the active east,west-trending Wenall Fault. Sediment accommodation space was controlled by proximity to the tip-point of this important growth fault within the Lower ORS. Debris-flow-dominated fans, shed from both the hangingwall and footwall of the Wenall Fault, deposited the Lindsway Bay Formation, an exotic-clast conglomerate unit sourced predominantly from the south and west. It is uncertain as to whether movement along the Wenall Fault was caused by collision-related transtension, or rifting associated with the southern margin of Avalonia. Copyright © 2004 John Wiley & Sons, Ltd. [source] Variable alluvial sandstone architecture within the Lower Old Red Sandstone, southwest WalesGEOLOGICAL JOURNAL, Issue 3-4 2004Brian P. J. Williams Abstract Sandstone bodies within the Lower Old Red Sandstone (ORS) in southern Pembrokeshire exhibit variability in architecture, sediment grade and composition both spatially and temporally. Four architectural styles are observed, namely decimetre- to metre-thick sheets, metre-thick multi-storey amalgamations, inclined-heterolithic units and ribbon geometries. Sandstone bodies in the Freshwater East Formation are sheet-like, heterolithic units several metres thick. An association with lingulids and wave ripples alludes to a marine influence, possibly estuarine tidal flats or storm washovers. Within the Moor Cliffs Formation, the most common sandstone bodies are centimetre- to metre-thick sheets with high width-to-depth ratios. Fine-grained sandstones represent sheet-flood deposition on unconfined, planar surfaces, whereas coarser-grained sandstones constitute distinctive amalgamations of discrete flood events, reflecting either a change in provenance or tectonic influence. Clear incision of coarse-grained, multi-storey units within the Inter-Tuff Moor Cliffs Formation reflects a change in relative sea-level, possibly tectonically induced. The base of the Conigar Pit Sandstone Member (CPSM) is marked by a distinctive, exotic-clast conglomerate defining the base to heterolithic, lateral-accretion bedsets and sandstone sheets. This association defines a significant influx of coarse-grained sediment post-Chapel Point Calcrete formation, an interval of presumed topographic stability across the Anglo-Welsh Basin. This influx must reflect rejuvenation of source regions, with changes in base-level reflecting either eustatic or tectonic influences. Commonly observed in the CPSM are fine-grained, inclined-heterolithic bedsets recording deposition by highly sinuous rivers with flashy discharge. Up-sequence within the CPSM are metre-thick, multi-storey amalgamations of predominatly trough cross-stratified medium- to coarse-grained sandstone. It is likely that these units are genetically related to contemporaneous decimetre-thick sandstone sheets, the latter being ,splay' events marginal to the main channel axis. The interbedding of multi-storey sandstones and fine-grained laterally accreted units reflects changes in provenance, slope and/or climate. Thickness variations within the Lower ORS detail significant thickening of all units northward into the Benton Fault. It seems likely that this thickening reflects variable accommodation space development associated with active growth along this and other WNW,ESE-trending faults, and migration of channel belts toward the footwall. Copyright © 2004 John Wiley & Sons, Ltd. [source] Prescription practices of public and private health care providers in Attock District of PakistanINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2002S. Siddiqi Abstract The irrational use of drugs is a major problem of present day medical practice and its consequences include the development of resistance to antibiotics, ineffective treatment, adverse effects and an economic burden on the patient and society. A study from Attock District of Pakistan assessed this problem in the formal allopathic health sector and compared prescribing practices of health care providers in the public and private sector. WHO recommended drug use indicators were used to study prescription practices. Prescriptions were collected from 60 public and 48 private health facilities. The mean (±,SE) number of drugs per prescription was 4.1,±,0.06 for private and 2.7,±,0.04 for public providers (,p,<,0.0001). General practitioners (GPs) who represent the private sector prescribed at least one antibiotic in 62% of prescriptions compared with 54% for public sector providers. Over 48% of GP prescriptions had at least one injectable drug compared with 22.0% by public providers (,p,<,0.0001). Thirteen percent of GP prescriptions had two or more injections. More than 11% of GP prescriptions had an intravenous infusion compared with 1% for public providers (,p,<,0.001). GPs prescribed three or more oral drugs in 70% of prescriptions compared with 44% for public providers (,p,<,0.0001). Prescription practices were analysed for four health problems, acute respiratory infection (ARI), childhood diarrhoea (CD), fever in children and fever in adults. For these disorders, both groups prescribed antibiotics generously, however, GPs prescribed them more frequently in ARI, CD and fever in children (,p,<,0.01). GPs prescribed steroids more frequently, however, it was significantly higher in ARI cases (,p,<,0.001). For all the four health problems studied, GPs prescribed injections more frequently than public providers (,p,<,0.001). In CD cases GPs prescribed oral rehydration salt (ORS) less frequently (33.3%) than public providers (57.7%). GPs prescribed intravenous infusion in 12.3% cases of fever in adults compared with none by public providers (,p,<,0.001). A combination of non-regulatory and regulatory interventions, directed at providers as well as consumers, would need to be implemented to improve prescription practices of health care providers. Regulation alone would be ineffective unless it is supported by a well-established institutional mechanism which ensures effective implementation. The Federal Ministry of Health and the Provincial Departments of Health have to play a critical role in this respect, while the role of the Pakistan Medical Association in self-regulation of prescription practices can not be overemphasized. Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use. Copyright © 2002 John Wiley & Sons, Ltd. [source] Fibre retention osseous resective surgery: a novel conservative approach for pocket eliminationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2007Gianfranco Carnevale Abstract Aim and Background: The position of the most apical inter-dental portion of the alveolar crest is classically used in osseous resective surgery (ORS) to establish the amount of the inter-proximal and buccal/lingual bone resection. Supracrestal fibres connected to the root cementum are always present coronal to the alveolar crest both in healthy and diseased sites. The aim of this paper is to report a novel surgical approach that combines the classical method of osseous resection with the gingival fibre retention technique. Material and Methods: A description of the surgical procedure in four steps is provided (flap design, marginal soft tissue removal and fibre retention, ORS, suture of the flap). Results and Conclusion: The proposed technique shifts the bottom of the defect in a more coronal position at the level of the connective tissue fibre attachment, establishing a more conservative supporting bone resection. [source] A study on plucked hair as a substrate for direct immunofluorescence in pemphigus vulgarisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2009M Daneshpazhooh Abstract Background, It has recently been demonstrated in a study on 15 patients that plucked hair can be used as a substrate for direct immunofluorescence (DIF) in pemphigus. Objective, Our aim was to assess the sensitivity of DIF on plucked hairs in pemphigus vulgaris (PV) patients with positive DIF of oral mucosa. Methods, One hundred and ten new PV patients were enrolled in the study. They all showed the typical clinical and histological findings as well as positive DIF of the oral mucosa, diagnostic for PV. Approximately 30 hairs were obtained in the same way as for the trichogram. The hairs with their outer root sheaths (ORS) were processed for DIF in order to detect immunoglobulin G and C3. Results, Immunodeposits favouring PV were demonstrated in the ORS of 100 cases showing a sensitivity of 91%. Conclusion, Regarding the relatively high sensitivity of DIF on plucked hair in PV patients with positive oral mucosal DIF in our study, it seems that hair plucking is a suitable alternative to the more invasive techniques of skin or mucosal biopsy for obtaining specimens for DIF in PV. Conflicts of interest None declared [source] A trace fossil assemblage from fluvial Old Red deposits (Wood Bay Formation; Lower to Middle Devonian) of NW-Spitsbergen, SvalbardLETHAIA, Issue 2 2004MAX WISSHAK From the fluvial Old Red Sandstone (ORS) of the Lower to Middle Devonian Wood Bay Formation (NW-Spitsbergen), a diverse trace fossil assemblage, including two new ichnotaxa, is described: Svalbardichnus trilobus igen. n., isp. n. is interpreted as the three-lobed resting trace of an early phyllocarid crustacean (Rhinocarididae). Cruziana polaris isp. n. yields morphological details that point towards a trilobite origin. This occurence of presumably marine trace makers in a fluvial red bed sequence raises the question of whether we are dealing with marine ingressions that are not sedimentologically expressed, with homeomorphy, or with an adaptation of marine groups to non-marine environments. [source] Enhancement in the absorption of water and electrolytes from rat intestine by Hemidesmus indicus R. Br. root (water extract)PHYTOTHERAPY RESEARCH, Issue 7 2004D. A. Evans Abstract Hemidesmus indicus root in the form of suspension in water (10 mg/ml) containing 15.5 mM NaCl, 3 mM KCl and 12 mM glucose, when injected into the ligated jejunal sac (1 ml/sac) of rat, increased the absorption of water, Na+ and K+ (but not glucose) from the sac. This bioactivity was present in the water extract (5 or 10 mg/sac) of the root and not in the hexane extract. In contrast, the ethanol extract decreased the absorption of water and electrolytes from the jejunal sac. The effect of water extract was not affected by heat at 100 °C for 30 min. Intraperitoneal administration of the water extract (50 to 200 mg/kg) was devoid of any signi,cant effect on the jejunal absorption. Neither the root suspension nor the water extract (125,500 mg/kg) showed any signi,cant anti-ulcer and diuretic activities in rats. The intestinal motility was also not in,uenced by the root (water extract) when tested in mice. The present study indicates that H. indicus root powder or its water extract can be incorporated in oral rehydrating salt solution (ORS) for increasing its anti-diarrhoeal ef,cacy. Copyright © 2004 John Wiley & Sons, Ltd. [source] Thyrotropin-releasing hormone and oestrogen differentially regulate prolactin and prolactin receptor expression in female human skin and hair follicles in vitroBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2010E.A. Langan Summary Background, Human skin and scalp hair follicles are both a nonclassical target and an extrapituitary source of prolactin (PRL), which is a potent hair growth modulator. However, how the expression of PRL and PRL receptor (PRLR) is regulated in human skin is unknown. Objectives, To investigate whether two key stimulators of pituitary PRL secretion, thyrotropin-releasing hormone (TRH) and oestrogen, also regulate cutaneous PRL and PRLR expression. Methods, Female scalp skin and/or microdissected hair follicles were treated for 6 days in serum-free organ culture with oestrogen (100 nmol L,1), TRH (1,10 ng mL,1, 3,30 nm) or vehicle control. Quantitative immunohistomorphometry of skin and hair follicle sections was complemented with quantitative polymerase chain reaction for PRL and PRLR in cultured hair follicles and/or female human outer root sheath (ORS) keratinocytes. Results, Oestrogen treatment significantly upregulated PRL and PRLR immunoreactivity in selected skin and hair follicle compartments, at the gene and protein level (P < 0·05). TRH significantly increased PRL immunoreactivity and transcription in hair follicles (P < 0·05); however, while it also increased PRLR transcription in hair follicles, it downregulated PRLR immunoreactivity in the hair follicle ORS (P < 0·05). Conclusions, Our pilot study shows that two key endocrine controls of pituitary PRL secretion, oestrogen and TRH, also regulate PRL and PRLR expression in human skin. This provides novel insights into the regulation of extrapituitary PRL and PRLR expression, and invites exploration of oestrogen and TRH as novel therapeutic agents in the management of skin and hair diseases characterized by aberrant PRLR-mediated signalling. [source] The neuroepithelial stem cell protein nestin is a marker of the companion cell layer of the adult and developing human hair follicleBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2009D. Krahl Summary Background, The interface between the inner root sheath (IRS) and the outer root sheath (ORS) represents a slippage plane for the hair shaft to evolve from the pilar canal to the skin surface. Interposed between the IRS and ORS is a single cell layer which is believed to represent the angle point of that slippage plane, termed the companion cell layer (CCL). The CCL is cited in most of the literature as part of the ORS. Objectives, To describe the expression pattern of nestin, a neuroepithelial stem cell protein, in the adult and developing human hair follicle. Methods, Immunohistochemical evaluation with a monoclonal antibody against nestin was performed using standard techniques. Results Nestin is selectively expressed in the CCL of the adult anagen and late stage fetal hair follicles. Early stages of hair follicle development are negative for nestin expression. Conclusions, The selective demarcation of the CCL by nestin highlights the unique feature of this follicular cell layer and raises the question of whether the CCL should not be better conceptualized as a part of the IRS rather than the ORS. The results of the present study, together with published ultrastructural data, also suggest that the slippage plane for the evolving hair shaft may be located at the interface between the CCL and the ORS. [source] Stem cell markers (cytokeratin 15, CD34 and nestin) in primary scarring and nonscarring alopeciaBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2009M.P. Hoang Summary Background, Although the pathogenesis of most primary scarring alopecias is poorly understood, recent studies implicate the bulge region as a possible target. Objectives, To corroborate these results, we ascertained involvement of follicular bulge stem cells using a panel of antibodies that putatively targeted the same. Methods, Antibodies used included anticytokeratin (CK) 15, CD34 and nestin on vertical and horizontal tissue sections of 50 cases of scarring and 34 cases of nonscarring alopecia. Results, Comparing expression of these markers in scarring vs. nonscarring alopecia, CK15 was noted in the follicular bulge region in 23 of 43 (53%) vs. 27 of 27 (100%) cases and in the peripheral layer of the outer root sheath (ORS) (upper two-thirds of the follicle) in 50 of 50 (100%) vs. 34 of 34 (100%) cases; CD34 was noted in the peripheral layer of the ORS (below pilar muscle attachment) in 24 of 35 (69%) vs. 18 of 18 (100%) cases; and nestin was noted in the infundibular region in 18 of 46 (39%) vs. seven of 32 (22%) cases and in the inner aspect of the ORS (below pilar muscle attachment) in eight of 31 (26%) vs. 23 of 23 (100%) cases. Conclusions, Our findings of differential follicular localization of stem cells underscore follicular progenitor cell heterogeneity and suggest the target in scarring alopecia is not merely follicular bulge stem cells but involves stem cells in the inner and outer aspect of the ORS. Enhanced expression of nestin in the infundibular region in scarring alopecia indicates availability of an accessible, in vivo niche of potential utility as an autologous source of stem cells for therapeutic application. [source] Publication rates of scientific papers presented at the Otorhinolarygological Research Society meetingsCLINICAL OTOLARYNGOLOGY, Issue 3 2001D. Roy The aim of this study was to determine the publication rate of scientific papers in peer review journals presented at the Otorhinolarygological Research Society (ORS) meetings from 1978 to 1995 inclusive. The abstracts of the presentations at ORS meetings are published in Clinical Otolaryngology. A MEDLINE search was performed on abstracts presented at ORS meetings from 1978 to 1995 using both authors and key words within the text of the abstract. The publication rate, journal of publication, time to publication, change in contents, change in authors and change in conclusions of abstracts were tabulated. The publication rate for papers presented at ORS meetings from 1978 to 1995 was 69.09%. The average time to publication was 22.5 months. Papers derived from the ORS abstracts were most commonly published in Clinical Otolaryngology (34%) and Journal of Laryngology and Otology (18.64%). The results indicate that nearly 69% of presented material at the biannual ORS meetings eventually get published in peer reviewed journals. This compares favourably with publication rate of other specialities. [source] Effect of Point-of-care Influenza Testing on Management of Febrile ChildrenACADEMIC EMERGENCY MEDICINE, Issue 12 2006Srikant B. Iyer MD Abstract Objectives To determine the effect of point-of-care testing (POCT) for influenza on the physician management of febrile children who are at risk for serious bacterial illness (SBI) on the basis of age and temperature and who are presenting to a pediatric emergency department (ED) during an influenza outbreak. Methods Patients 2,3 months of age with temperature of ,38°C and patients 3,24 months of age with temperature of ,39°C who were presenting to a pediatric ED during an influenza outbreak were enrolled into a prospective, quasi-randomized, controlled trial. Influenza testing was performed on enrolled patients by either the POCT or the standard-testing (ST) methods. The two groups were compared in terms of laboratory testing, chest radiography, antibiotic use, visit-associated costs, pediatric ED lengths of stay, inpatient admission, and return visits to the pediatric ED. Similar analyses also were performed on the resulting subgroups of patients on the basis of method of testing (POCT or ST) and test result (positive or negative). Results Of 767 eligible patients, 700 (91%) completed the study. No significant differences were demonstrated between the POCT and ST groups with respect to laboratory tests ordered, chest radiographs obtained, antibiotic administration, inpatient admission, return visits to the pediatric ED, lengths of stay, or visit-associated costs. In the subgroup analysis, the adjusted odds ratios (ORs) for blood culture in influenza test,positive to ,negative patients were 0.59 and 0.71 in the POCT and ST groups, respectively (p = 0.088). The adjusted ORs for urine culture in influenza test,positive to ,negative patients were 0.46 and 0.67 in the POCT and ST groups, respectively (p = 0.005). Conclusions When using a strategy of performing influenza testing on all patients at risk for SBI who presented to a pediatric ED during an influenza outbreak, the method of testing (POCT or ST) did not appear to significantly alter physician management, cost, or length of stay in the pediatric ED. However, if the interaction of the method of testing and the test result (positive or negative) were considered, a positive POCT for influenza was associated with a significant reduction in orders for urinalyses and urine cultures. [source] The molecular receptive range of an olfactory receptor in vivo (Drosophila melanogaster Or22a)DEVELOPMENTAL NEUROBIOLOGY, Issue 14 2006Daniela Pelz Abstract Understanding how odors are coded within an olfactory system requires knowledge about its input. This is constituted by the molecular receptive ranges (MRR) of olfactory sensory neurons that converge in the glomeruli of the olfactory bulb (vertebrates) or the antennal lobe (AL, insects). Aiming at a comprehensive characterization of MRRs in Drosophila melanogaster we measured odor-evoked calcium responses in olfactory sensory neurons that express the olfactory receptor Or22a. We used an automated stimulus application system to screen [Ca2+] responses to 104 odors both in the antenna (sensory transduction) and in the AL (neuronal transmission). At 10,2 (vol/vol) dilution, 39 odors elicited at least a half-maximal response. For these odorants we established dose-response relationships over their entire dynamic range. We tested 15 additional chemicals that are structurally related to the most efficient odors. Ethyl hexanoate and methyl hexanoate were the best stimuli, eliciting consistent responses at dilutions as low as 10,9. Two substances led to calcium decrease, suggesting that Or22a might be constitutively active, and that these substances might act as inverse agonists, reminiscent of G-protein coupled receptors. There was no difference between the antennal and the AL MRR. Furthermore we show that Or22a has a broad yet selective MRR, and must be functionally described both as a specialist and a generalist. Both these descriptions are ecologically relevant. Given that adult Drosophila use approximately 43 ORs, a complete description of all MRRs appears now in reach. © 2006 Wiley Periodicals, Inc. J Neurobiol, 2006 [source] Alveolar bone loss associated with glucose tolerance in Japanese menDIABETIC MEDICINE, Issue 9 2003T. Marugame Abstract Aims Type 2 diabetes is known to affect alveolar bone loss (ABL). The purpose of this study was to examine whether impaired glucose tolerance (IGT) is associated with ABL, as is diabetes. Methods A case,control study was performed with 664 Japanese men aged 46,57 years. Panoramic radiographs revealed 513 severe ABL cases, 22 moderate ABL cases, and 129 controls with good alveolar bone. Diabetes status was classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), IGT, and newly diagnosed diabetes according to the fasting plasma glucose and 75-g oral glucose tolerance test (OGTT). Diabetes under treatment was excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from ordinal logistic regression analysis. Statistical adjustment was made for total cholesterol, HDL-cholesterol, triglyceride, rank in the Self Defence Forces (SDF), cigarette-years, alcohol use, body mass index, previous 10 years' brushing habits and instrument use other than toothbrush, and history of periodontal treatment. Results A significant, approximately three-fold increase in the crude OR (crude OR = 3.28; 95% CI = 1.16,9.27) and non-significant 2.6-fold increase in the adjusted OR (adjusted OR = 2.55; 95% CI = 0.86, 7.54) of ABL was observed among men with newly diagnosed Type 2 diabetes compared with the reference group (NGT combined with IFG). However, there was no association between IGT and ABL (adjusted OR = 0.99; 95% CI = 0.59,1.64). Conclusions Type 2 diabetes, but not IGT, was positively associated with ABL. Preventive maintenance against periodontitis is important in middle-aged men with diabetes. [source] How confident should we be that smoking cessation treatments work?ADDICTION, Issue 10 2009John R. Hughes ABSTRACT Aim To determine (i) the concordance among recent meta-analyses about which treatments for smoking cessation are efficacious; (ii) the similarity of odds ratios (ORs) across meta-analyses; and (iii) among the validated treatments, the proportion of studies that found higher quit rates. Methods Computerized literature search for meta-analyses during the last 5 years in PubMed and PsychInfo. Data were extracted from summary tables of overall effect of validated treatments. Results Fourteen meta-analyses agreed 100% on the presence/absence of efficacy of 17 proven treatments. The ORs differed by <0.5 in 72/76 of the comparisons of meta-analyses. Among 37 comparisons in 33 comparisons, >85% of the studies reported numerical superiority for the active treatment. Conclusions The efficacy of treatments for smoking cessation are extremely reliable. This argues for inclusion of treatment as an essential feature of tobacco control and clinical practice and argues for reimbursement of smoking cessation treatments on a par with other medical and behavioral disorders. [source] A Comparison of Trauma Intubations Managed by Anesthesiologists and Emergency PhysiciansACADEMIC EMERGENCY MEDICINE, Issue 1 2004Joseph S. Bushra MD Although airway management by emergency physicians has become standard for general emergency department (ED) patients, many believe that anesthesiologists should manage the airways of trauma victims. Objectives: To compare the success and failure rates of trauma intubations performed under the supervision of anesthesiologists and emergency physicians. Methods: This was a prospective, observational study of consecutive endotracheal intubations (ETIs) of adult trauma patients in a single ED over a 46-month period. All ETIs before November 26, 2000, were supervised by anesthesiologists (34 months), and all ETIs from November 26, 2000, onward were supervised by emergency physicians (12 months). Data regarding clinical presentation, personnel involved, medications used, number of attempts required, and need for cricothyrotomy were collected. Study outcomes were: 1) successful intubation within two attempts, and 2) failure of intubation. Failure was defined as inability to intubate, resulting in successful intubation by another specialist, or cricothyrotomy. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were used to compare results between groups. Results: There were 673 intubations during the study period. Intubation within two attempts was accomplished in 442 of 467 patients (94.6%) managed by anesthesiologists, and in 196 of 206 of patients (95.2%) managed by emergency physicians (OR = 1.109, 95% CI = 0.498 to 2.522). Failure of intubation occurred in 16 of 467 (3.4%) patients managed by anesthesiologists, and in four of 206 (1.9%) patients managed by emergency physicians (OR = 0.558, 95% CI = 0.156 to 1.806). Conclusions: Emergency physicians can safely manage the airways of trauma patients. Success and failure rates are similar to those of anesthesiologists. [source] The Impact of Race on the Acute Management of Chest PainACADEMIC EMERGENCY MEDICINE, Issue 11 2003Arvind Venkat MD Abstract Objectives: African Americans with acute coronary syndromes receive cardiac catheterization less frequently than whites. The objective was to determine if such disparities extend to acute evaluation and noninterventional treatment. Methods: Data on adults with chest pain (N= 7,935) presenting to eight emergency departments (EDs) were evaluated from the Internet Tracking Registry of Acute Coronary Syndromes. Groups were selected from final ED diagnosis: 1) acute myocardial infarction (AMI), n= 400; 2) unstable angina/non,ST-elevation myocardial infarction (UA/NSTEMI), n= 1,153; and 3) nonacute coronary syndrome chest pain (non-ACS CP), n= 6,382. American College of Cardiology/American Heart Association guidelines for AMI and UA/NSTEMI were used to evaluate racial disparities with logistic regression models. Odds ratios (ORs) were adjusted for age, gender, guideline publication, and insurance status. Non-ACS CP patients were assessed by comparing electrocardiographic (ECG)/laboratory evaluation, medical treatment, admission rates, and invasive and noninvasive testing for coronary artery disease (CAD). Results: African Americans with UA/NSTEMI received glycoprotein IIb/IIIa receptor inhibitors less often than whites (OR, 0.41; 95% CI = 0.19 to 0.91). African Americans with non-ACS CP underwent ECG/laboratory evaluation, medical treatment, and invasive and noninvasive testing for CAD less often than whites (p < 0.05). Other nonwhites with non-ACS CP were admitted and received invasive testing for CAD less often than whites (p < 0.01). African Americans and other nonwhites with AMI underwent catheterization less frequently than whites (OR, 0.45; 95% CI = 0.29 to 0.71 and OR, 0.40; 95% CI = 0.17 to 0.92, respectively). A similar disparity in catheterization was noted in UA/NSTEMI therapy (OR, 0.53; 95% CI = 0.40 to 0.68 and OR, 0.68; 95% CI = 0.47 to 0.99). Conclusions: Racial disparities in acute chest pain management extend beyond cardiac catheterization. Poor compliance with recommended treatments for ACS may be an explanation. [source] Association between Insurance Status and Admission Rate for Patients Evaluated in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2003Jennifer Prah Ruger PhD Abstract Objectives: To determine if differences exist in hospital and intensive care unit (ICU)/operating room admission rates based on health insurance status. Methods: This was a retrospective, cross-sectional study of data from hospital clinical and financial records for all 2001 emergency department (ED) visits (80,209) to an academic urban hospital. Hospital admission and intensive care unit (ICU)/operating room admissions were analyzed, controlling for triage acuity, primary complaint, diagnosis, diagnosis-related group (DRG) severity, and demographics. Multivariate logistic regression models identified factors associated with hospital admission for underinsured (self-pay and Medicaid) compared with other insured (private health maintenance organization, preferred provider organization, worker's compensation, and Medicare) patients. Results: Compared with the other insured group, underinsured patients were less likely, overall, to be admitted to the hospital (odds ratio [OR], 0.82; 95% CI = 0.76 to 0.90), controlling for all other factors studied. Subgroup analysis of common complaints showed underinsured patients with a chief complaint of abdominal pain (OR, 0.67; 95% CI = 0.55 to 0.80) or headache (OR, 0.61; 95% CI = 0.39 to 0.95) had the lowest adjusted ORs for admission to the hospital, compared with other insured patients. Underinsured patients with DRG of "menstrual and other female reproductive system disorders" (OR, 0.17; 95% CI = 0.06 to 0.51) or "esophagitis, gastroenteritis, and miscellaneous digestive disorders" (OR, 0.55; 95% CI = 0.28 to 0.96) also were less likely to be admitted compared with the other insured group. No significant differences in ICU/operating room admission rates were found between insurance groups. Conclusions: Whereas there was no difference in admission rates to the ICU/operating room by insurance status, this single-center study does suggest an association between insurance status and admission to a general hospital service, which may or may not be causally related. Factors other than provider bias may be responsible for this observed difference. [source] Drinking pattern and risk of non-fatal myocardial infarction: a population-based case,control studyADDICTION, Issue 3 2004Maurizio Trevisan ABSTRACT Aims Alcohol consumption has been associated with a reduced risk of heart disease incidence and mortality. However, most studies have focused on an average volume per specific time period and have paid little attention to the pattern of drinking. The aim of this study was to examine the association between various drinking patterns and myocardial infarction (MI). Design A population-based case,control study. Methods Participants were 427 white males with incident MI and 905 healthy white male controls (age 35,69 years) selected randomly from two Western New York counties. During computer-assisted interviews detailed information was collected regarding patterns of alcohol consumption during the 12,24 months prior to interview (controls) or MI (cases). Findings Compared to life-time abstainers, adjusted odds ratios (ORs) and 95% confidence interval (CI) for non-current and current drinkers were 0.66 (0.31,1.39) and 0.50 (0.24,1.02), respectively. Daily drinkers exhibited a significantly lower OR (0.41) compared to life-time abstainers. Participants who drank mainly without food had an OR of 1.49 (0.96,2.31) compared to those who drank mainly with food and 0.62 (0.28,1.37) compared to life-time abstainers. Men who reported drinking only at weekends had a significantly greater MI risk [1.91; (1.21,3.01)] compared to men who drank less than once/week, but not compared to life-time abstainers [0.91 (0.40,2.07)]. Conclusions Our results indicate that patterns of alcohol use have important cardiovascular health implications. [source] Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern BrazilADDICTION, Issue 6 2003Raúl A. Mendoza-Sassi ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61,13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91,5.58) and ex-smokers (OR 1.30; CI 0.56,2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35,4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [source] Headache prevalence related to smoking and alcohol use.EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2006The Head-HUNT Study The aim of this study was to examine a possible association between smoking, alcohol and headache in a large population-based cross-sectional study. A total of 51 383 subjects completed a headache questionnaire and constituted the ,Head-HUNT' Study. Questionnaire-based information on smoking was available in 95% and on alcohol in 89% of the individuals. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). Prevalence rates for headache were higher amongst smokers compared with never smokers, most evident for those under 40 years smoking more than 10 cigarettes per day (OR 1.5, 95% CI 1.3,1.6). Passive smoking was also associated with higher headache prevalence. For alcohol use, there was a tendency of decreasing prevalence of migraine with increasing amounts of alcohol consumption compared with alcohol abstinence. Only with regard to symptoms indicating alcohol overuse, a positive association with frequent headache was found. The association between headache and smoking found in the present study raises questions about a causal relationship, e.g. that smoking causes headache or that it allays stress induced by headache. The observed negative association between migraine and alcohol consumption is probably explained by the headache precipitating properties of alcohol. [source] Characterization of novel GPCR gene coding locus in amphioxus genome: Gene structure, expression, and phylogenetic analysis with implications for its involvement in chemoreceptionGENESIS: THE JOURNAL OF GENETICS AND DEVELOPMENT, Issue 2 2005Gouki Satoh Abstract Chemosensation is the primary sensory modality in almost all metazoans. The vertebrate olfactory receptor genes exist as tandem clusters in the genome, so that identifying their evolutionary origin would be useful for understanding the expansion of the sensory world in relation to a large-scale genomic duplication event in a lineage leading to the vertebrates. In this study, I characterized a novel GPCR (G-protein-coupled receptor) gene-coding locus from the amphioxus genome. The genomic DNA contains an intronless ORF whose deduced amino acid sequence encodes a seven-transmembrane protein with some amino acid residues characteristic of vertebrate olfactory receptors (ORs). Surveying counterparts in the Ciona intestinalis (Asidiacea, Urochordata) genome by querying BLAST programs against the Ciona genomic DNA sequence database resulted in the identification of a remotely related gene. In situ hybridization analysis labeled primary sensory neurons in the rostral epithelium of amphioxus adults. Based on these findings, together with comparison of the developmental gene expression between amphioxus and vertebrates, I postulate that chemoreceptive primary sensory neurons in the rostrum are an ancient cell population traceable at least as far back in phylogeny as the common ancestor of amphioxus and vertebrates. genesis 41:47,57, 2005. © 2005 Wiley-Liss, Inc. [source] MTHFR 677C>T and ACE D/I Polymorphisms in Migraine: A Systematic Review and Meta-AnalysisHEADACHE, Issue 4 2010Markus Schürks MD (Headache 2010;50:588-599) Background., Data on the association between the MTHFR 677C>T and ACE D/I polymorphisms and migraine including aura status are conflicting. Objective., The objective of this study is to perform a systematic review and meta-analysis on this topic. Methods., We searched for studies published until March 2009 using electronic databases (MEDLINE, EMBASE, Science Citation Index) and reference lists of studies and reviews on the topic. Assessment for eligibility of studies and extraction of data was performed by 2 independent investigators. For each study we calculated the odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models. We then calculated pooled ORs and 95% CIs. Results., Thirteen studies investigated the association between the MTHFR 677C>T polymorphism and migraine. The TT genotype was associated with an increased risk for any migraine, which only appeared for migraine with aura (pooled OR = 1.48, 95% CI 1.02-2.13), but not for migraine without aura. Nine studies investigated the association of the ACE D/I polymorphism with migraine. The II genotype was associated with a reduced risk for migraine with aura (pooled OR = 0.71, 95% CI 0.55-0.93) and migraine without aura (pooled OR = 0.84, 95% CI 0.70-0.99). Results for both variants were driven by studies in non-Caucasian populations. Results among Caucasians did not suggest an association. Extractable data did not allow investigation of gene,gene interactions. Conslusions., The MTHFR 677TT genotype is associated with an increased risk for migraine with aura, while the ACE II genotype is protective against both migraine with and without aura. Results for both variants appeared only among non-Caucasian populations. There was no association among Caucasians. [source] Is Headache Related to Asthma, Hay Fever, and Chronic Bronchitis?HEADACHE, Issue 2 2007The Head-HUNT Study Objectives.,To examine the relationship between migraine and nonmigrainous headache and asthma, hay fever, and chronic bronchitis in a large cross-sectional population-based study. Background.,Associations between prevalence of migraine and asthma or allergy have been demonstrated in clinic-based and epidemiologic studies whereas studies on chronic bronchitis are scarce. Methods.,A total of 51,383 subjects completed a headache questionnaire and constituted the "Head-HUNT" Study. Of these 50,401 (98.1%) answered the questions about asthma and chronic bronchitis, and 47,029 (91.5%) answered the question about hay fever. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). Results.,Both migraine and nonmigrainous headache were approximately 1.5 times more likely among those with current asthma, asthma related symptoms, hay fever, and chronic bronchitis than those without. The association increased with increasing headache frequency. Conclusions.,This large questionnaire-based study confirms that migraine and other headaches are associated with respiratory and allergic disorders. The magnitude of the association between headache and asthma, hay fever, and chronic bronchitis tended to be in the same order. Headache frequency seems to have a greater impact on the association with respiratory or allergic conditions than headache diagnoses. Whether it is a causal relationship is uncertain, but the results underline the importance of considering comorbid disorders among patients with frequent headache. [source] Interleukin-2 Gene Polymorphisms Associated with Increased Risk of Gastric Atrophy from Helicobacter pylori InfectionHELICOBACTER, Issue 3 2005Shozo Togawa ABSTRACT Background., Gastric atrophy induced by Helicobacter pylori is thought to predispose patients to noncardiac gastric cancer development. However, the host genetic factors that influence the progression of gastric atrophy have not been elucidated. In this study, we examined the effects of cytokine polymorphisms on H. pylori -induced gastric atrophy. Methods., Blood samples were taken from 454 Japanese subjects. The interleukin-2 (IL-2; T-330G), IL-4 (C-33T), and IL-13 (C-1111T) polymorphisms were genotyped by polymerase chain reaction with confronting two-pair primers (PCR-CTPP). Anti- H. pylori IgG antibody and pepsinogen I and II were measured to diagnose H. pylori infection and atrophic gastritis. Results., The odds ratios (ORs) for the association between IL-2 polymorphism [OR = 2.78, 95% CI (confidence interval) = 1.26,6.17 (T/T to G/G)] or IL-4 polymorphism [OR = 2.22, 95% CI = 1.01,4.89 (T/C to C/C)] were increased significantly with gastric atrophy, whereas the corresponding OR of IL-13 polymorphism was decreased with gastric atrophy [OR = 0.61, 95% CI = 0.39,0.96 (C/T and T/T to C/C)]. There were no significant H. pylori seropositivity-related differences between these polymorphisms. We examined the relationship between these polymorphisms and gastric atrophy separately in H. pylori -seropositive and -seronegative groups. In the H. pylori -seropositive group, the IL-2 T/T (OR = 2.78, 95% CI = 1.12,6.93) had a significant association with gastric atrophy. Conclusions., These results reveal that the IL-2 gene polymorphism is associated with an increased risk of gastric atrophy induced by H. pylori infection and might predispose to gastric cancer. [source] Is the Association Between Helicobacter pylori and Gastric Cancer Confined to CagA-Positive Strains?HELICOBACTER, Issue 3 2004Maria Held ABSTRACT Background., Infection with Helicobacter pylori is associated with an increased risk of gastric cancer. Several studies have indicated that the association differs with strain type. We aimed to find out if infection with strains lacking the virulence factor CagA is linked to gastric cancer risk. Materials and methods., In a hospital-based case,control study, we collected sera from 100 case patients with a newly diagnosed gastric adenocarcinoma and 96 control patients with diseases unrelated to H. pylori status. Antibodies to H. pylori were analyzed by enzyme-linked immunosorbent assay (ELISA), and antibodies to CagA were detected by immunoblot. Logistic regression was used to obtain odds ratios (ORs) as estimates of relative risk, adjusted for potential confounding. Results., Among the case patients, 81% were ELISA positive and 86% had antibodies to CagA. The corresponding numbers among the controls were 58% and 55%, respectively. ELISA positivity was associated with an increased risk of gastric adenocarcinoma compared to ELISA negativity (OR for gastric cancer regardless of site 3.9, 95% CI 1.9,8.2). The OR was 7.4 (95% CI 3.3,16.6) for CagA-positive relative to CagA-negative subjects. Among ELISA-positive subjects the presence of CagA antibodies increased the risk 3.6 times (95% CI 1.2,11.1). ELISA-positive CagA-negative infections were associated with a fourfold increased risk (OR = 4.2, 95% CI 1.0,17.0) compared to no infection (ELISA-negative and CagA-negative). Conclusions., Although patients with antibodies to CagA have the greatest risk of developing gastric cancer, those with CagA-negative infections run a significantly greater risk than uninfected persons. [source] Techniques for liver parenchymal transection: a meta-analysis of randomized controlled trialsHPB, Issue 4 2009Viniyendra Pamecha Abstract Background:, Different techniques of liver parenchymal transection have been described, including the finger fracture, sharp dissection, clamp,crush methods and, more recently, the Cavitron ultrasonic surgical aspirator (CUSA), the hydrojet and the radiofrequency dissection sealer (RFDS). This review assesses the benefits and risks associated with the various techniques. Methods:, Randomized clinical trials were identified from the Cochrane Library Trials Register, MEDLINE, EMBASE, Science Citation Index Expanded and reference lists. Odds ratio (ORs), mean difference (MDs) and standardized mean differences (SMDs) were calculated with 95% confidence intervals based on intention-to-treat analysis or available-case analysis. Results:, We identified seven trials including a total of 556 patients. Blood transfusion requirements were lower with the clamp,crush technique than with the CUSA or hydrojet. The clamp,crush technique was quicker than the CUSA, hydrojet or RFDS. Infective complications and transection blood loss were greater with the RFDS than with the clamp,crush method. There was no significant difference between techniques in mortality, morbidity, liver dysfunction or intensive therapy unit and hospital stay. Conclusions:, The clamp,crush technique is more rapid and is associated with lower rates of blood loss and otherwise similar outcomes when compared with other methods of parenchymal transection. It represents the reference standard against which new methods may be compared. [source] Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001-2002INFLAMMATORY BOWEL DISEASES, Issue 6 2008Russell Cohen MD Abstract Background: Recent studies suggest that inflammatory bowel disease (IBD) may share an underlying pathogenesis with other autoimmune diseases. Methods: Two United States data sets with patient-level medical and drug claims were used to explore the occurrence of autoimmune diseases in patients with IBD, particularly Crohn's disease (CD) and ulcerative colitis (UC), with that in controls. From 2001 to 2002 IBD patients were identified using International Classification of Diseases, 9th revision, diagnosis codes in the IMS Health Integrated Administration Claims Database and the Market Scan Commercial Claims and Encounters Database. Controls were selected by matching on sex, age, Census Bureau region, and length of previous medical insurance coverage. Odds ratios (ORs) evaluated the risk relationship between IBD patients and controls within an estimated Mantel-Haenszel 95% confidence interval. Sensitivity analysis tested the case identification method used to select IBD patients. Results: The risk for ankylosing spondylitis (AS) was substantially increased across both data sets: OR (95% confidence interval [CI]) of 7.8 (5.6,10.8) in IMS Health and 5.8 (3.9,8.6) in MarketScan. The risk for rheumatoid arthritis (RA) was 2.7 (2.4,3.0) and 2.1 (1.8,2.3), respectively; for multiple sclerosis (MS); the ORs were 1.5 (1.2,1.9) and 1.6 (1.2,2.1), respectively. There was no increased risk for type 1 diabetes mellitus, and the results for psoriatic arthritis (PsA) were inconsistent. The sensitivity analysis supported these findings. Conclusions: A much higher risk for RA, AS, PsA, and MS was observed in IBD patients compared with controls. Prospective epidemiologic studies are needed to confirm these findings and explore the pathogenic mechanism of this relationship. (Inflamm Bowel Dis 2008) [source] | |||||||||||||||||||||||||||||||||||||