Impairment of spermatogenesis and enhancement of testicular germ cell apoptosis induced by exogenous all-trans-retinoic acid in adult lizard Podarcis sicula.

In mammals, retinoic acid is involved in the regulation of testicular function by interaction with two families of nuclear receptors, retinoic acid receptor (RAR) and retinoid X receptor (RXR). Among RAR isoforms, the testicular cells of the lizard were found to express only RARalpha (3.7 kb) and RARbeta (3.

Reasons to omit digital rectal exam in trauma patients: no fingers, no rectum, no useful additional information.

Background: Performance of digital rectal examination (DRE) on all trauma patients during the secondary survey has been advocated by the Advanced Trauma Life Support course. However, there is no clear evidence of its efficacy as a diagnostic test for traumatic injury. The purpose of this study is to analyze the value of a policy mandating DRE on all trauma patients as part of the initial evaluation process and to discern whether it can routinely be omitted.

Old fashion clinical judgment in the era of protocols: is mandatory chest X-ray necessary in injured patients?

Background: The ATLS Course advocates that injured patients have a chest x-ray (CXR) to identify potential injuries. The purpose of this study was to correlate clinical indications and clinician judgment with CXR results to ascertain if a selective policy would be beneficial.

Methods: Patients treated at a Level I trauma center over 12 months were prospectively evaluated.

Half-a-dozen ribs: the breakpoint for mortality.

Background: We hypothesized that the number of rib fractures independently impacted patient pulmonary morbidity and mortality.

Methods: The National Trauma Data Bank (NTDB, v. 3.

Neurosurgical coverage: essential, desired, or irrelevant for good patient care and trauma center status.

Summary And Background Data: As a result of many factors, the availability of neurosurgeons (NS) to care for trauma patients (TP) is increasingly sparse. This has precipitated a crisis in access to neurosurgical support in many trauma systems, often placing undue burden on level I centers. This study examines the profile of head-injured (HI) trauma patients and their actual need for the specific expertise of a neurosurgeon.

Familial recurrence of congenital heart disease in patients with ostium secundum atrial septal defect.

Aims: Ostium secundum atrial septal defect (osASD) is one of the most common cardiac malformations. Few data are available on the familial recurrence of congenital heart disease (CHD), in particular, in a large group of patients with isolated osASD. The aim is to investigate the familial recurrence of CHD in up to third-degree relatives from a large sample of consecutively enrolled patients with osASD, taking into account the influence of degree of relatedness (as number of relatives).

Factors affecting emergency department assessment and management of pain in children.

Objective: To evaluate statewide emergency department assessment and management of pain in pediatric patients as a quality improvement initiative.

Methods: 2002 Survey of Illinois Hospital emergency department's pediatric pain assessment and management strategies, in conjunction with a retrospective chart review of children, ages 0 to 15 years, treated for an extremity fracture. Survey results were available for 123 (59.

The hamster androgen receptor promoter: a molecular analysis.

The steroid/thyroid hormone receptors are members of a very large family of nuclear-activated transcription factors. These receptors play a crucial role in most biological function, including regulation of development, metabolism, behaviour and reproduction. Among androgen receptor (AR), we have recently demonstrated that its expression in the Harderian gland (HG) of the male hamster is under a well-co-ordinated cross-talk between various steroid hormone receptors.

Ventilator-associated pneumonia in injured patients: do you trust your Gram's stain?

Background: The results of sputum or bronchoalveolar lavage (BAL) fluid Gram's stain have been used to guide presumptive antibiotic therapy for ventilator-associated pneumonia (VAP) in injured patients, despite reported variability in sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Our aim was to evaluate the utility of Gram's stain of BAL fluid in the diagnosis of VAP.

Methods: We conducted a retrospective chart review of all mechanically ventilated trauma patients who developed pneumonia over a 5-year period in whom Gram's stain and final culture data were available.

Analysis of prior health system contacts as a harbinger of subsequent fatal injury in American Indians.

Context: Many American Indian nations, tribes, and bands are at an elevated risk for premature death from unintentional injury. Previous research has documented a relationship between alcohol-related injury and subsequent injury death among predominately urban samples. The presence or nature of such a relationship has not been documented among American Indians living in the northern plains.

Medicare's bundling of trauma care codes violates relative value principles.

Background: Physician payment by Medicare is based on a Resource-Based Relative Value Scale (RBRVS). The Correct Coding Initiative (CCI) was introduced to counter unbundling by pairing component procedures with more comprehensive procedures. We hypothesized that Medicare's rebundling process ignored relative value concepts.

Urgent airways after trauma: who gets pneumonia?

Background: Several risk factors, including emergent intubation, severe head injury, shock, blunt trauma, and high severity of injury, have been identified as risk factors for the development of pneumonia after trauma. This study assesses the contribution of emergent intubation to the development of pneumonia after injury.

Methods: A retrospective review of all trauma patients requiring intubation or cricothyroidotomy in the Emergency Department (ED) or in the pre-hospital area (field) over a 41/2 year period.

Ten year experience of burn, trauma, and combined burn/trauma injuries comparing outcomes.

Background: Percent total body surface area (TBSA) burn, inhalation injury (INH), and age all have been shown to be independent predictors of mortality in burn victims. Little is known regarding patients sustaining combined thermal and mechanical injuries in relation to either injury sustained in isolation or with regard to these variables. This descriptive study profiles the 10-year experience of a single American Burn Association/American College of Surgeons verified Level I trauma and burn center and the treatment of this patient population.

Emergence of Talanin protein associated with human uric acid nephrolithiasis in the Hominidae lineage.

Recently, we identified a susceptibility locus for human uric acid nephrolithiasis (UAN) on 10q21-q22 and demonstrated that a novel gene (ZNF365) included in this region produces through alternative splicing several transcripts coding for four protein isoforms. Mutation analysis showed that one of them (Talanin) is associated with UAN. We examined the evolutionary conservation of ZNF365 gene through a comparative genomic approach.

Mechanism of injury does not predict acuity or level of service need: field triage criteria revisited.

Background: Trauma systems use specific criteria based on physiologic, anatomic, and mechanistic factors for field triage. The purpose of this study was to evaluate the emergency department disposition of patients not meeting mandatory criteria (ie, physiologic or anatomic factors) for triage to a trauma center and the potential for over- or undertriage.

Methods: This was a retrospective review of trauma admissions from July 1999 to June 2001, to a level I trauma center.

Reducing trauma payment denials with computerized collaborative billing.

Background: Trauma care demands constant physician availability, resulting in rotational coverage systems. Third-party payors consider separate trauma surgeon bills as originating from the same individual. Trauma surgeons may be unaware of their colleagues' billing history on jointly managed patients.

Identification of a novel gene and a common variant associated with uric acid nephrolithiasis in a Sardinian genetic isolate.

Uric acid nephrolithiasis (UAN) is a common disease with an established genetic component that presents a complex mode of inheritance. While studying an ancient founder population in Talana, a village in Sardinia, we recently identified a susceptibility locus of approximately 2.5 cM for UAN on 10q21-q22 in a relatively small sample that was carefully selected through genealogical information.

Effect of a voluntary trauma system on preventable death and inappropriate care in a rural state.

Background: This study compares the preventable death rate and the nature and degree of inappropriate care in a rural state before and after implementation of a voluntary trauma system.

Methods: Deaths attributed to mechanical trauma occurring in the state of Montana between January 1, 1998, and December 31, 1998, were retrospectively reviewed by a multidisciplinary panel of physicians and nonphysicians representing the hospital and prehospital phases of care. Deaths were judged frankly preventable, possibly preventable, and nonpreventable.

A comparison of the abilities of nine scoring algorithms in predicting mortality.

Objective: The purpose of this study was to compare the abilities of nine Abbreviated Injury Scale (AIS)- and (ICD-9)-based scoring algorithms in predicting mortality.

Methods: The scores collected on 76,871 incidents consist of four AIS-based algorithms (Injury Severity Score [ISS], New Injury Severity Score, Anatomic Profile Score [APS], and maximum AIS [maxAIS]), their four ICD to AIS mapped counterparts, and the ICD-9-based ISS (ICISS). A 10-fold cross-validation was performed and area under the receiver operating characteristic curve was used to determine algorithm discrimination.

Regulation of androgen receptor mRNA expression in primary culture of Harderian gland cells: cross-talk between steroid hormones.

The androgen receptor (AR) must be considered a transcription factor belonging to the steroid-thyroid hormones receptor superfamily. Previous results gained from the Harderian gland, a tubulo-alveolar gland located in the orbital cavity of the golden hamster, indicate that Harderian gland cells express mRNAs encoding for androgen, glucocorticoid, thyroid hormone (T(3)), and estrogen receptors, respectively. Since in other systems, these receptors have been related to the expression of the androgen receptor, we have studied the regulation of AR expression in primary cultures of the male hamster Harderian gland.

Physical and genetic characterization reveals a pseudogene, an evolutionary junction, and unstable loci in distal Xq28.

A large portion of human Xq28 has been completely characterized but the interval between G6PD and Xqter has remained poorly understood. Because of a lack of stable, high-density clone coverage in this region, we constructed a 1.6-Mb bacterial and P1 artificial chromosome (BAC and PAC, respectively) contig to expedite mapping, structural and evolutionary analysis, and sequencing.

Differential divergence of three human pseudoautosomal genes and their mouse homologs: implications for sex chromosome evolution.

The human pseudoautosomal region 1 (PAR1) is essential for meiotic pairing and recombination, and its deletion causes male sterility. Comparative studies of human and mouse pseudoautosomal genes are valuable in charting the evolution of this interesting region, but have been limited by the paucity of genes conserved between the two species. We have cloned a novel human PAR1 gene, DHRSXY, encoding an oxidoreductase of the short-chain dehydrogenase/reductase family, and isolated a mouse ortholog Dhrsxy.