bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitude and practice towards SARS
Authors: Bener Abdulbari , Al-Khal Abdullatif
Published: November 2005

The objective of the study was to explore the knowledge, attitude and practice of the population of Qatar towards severe acute respiratory syndrome (SARS). The study took the form of a cross-sectional community-based survey in Doha International Airport and primary health care centres situated in urban and semi-urban areas of Qatar. The survey was conducted among travellers arriving at Doha International Airport and community residents visiting health centres from April to September 2003. A total of 1,800 subjects were approached for the study of which 1,386 (77.0%) responded to the questionnaire.

The study showed that although 79.4% of the total subjects claimed to know about SARS, only 8.0% had accurate knowledge about all of the symptoms of SARS. The respondents’ satisfaction with the preventive measures taken by the health authorities was only 66.6%. Overall, 73.0% of the total subjects knew that SARS was highly infectious; 69.9% knew that it could spread through close contact;67.4% were aware that high fever was the early symptom; and 60.8% thought SARS could be cured. Half of the subjects said they had gained most of their knowledge on SARS through television and radio programmes (52.2%). Three-fifths (60.1%) were afraid to travel for fear of being affected by SARS. The level of awareness of SARS among Qataris was poor (31.7%) compared to that among non-Qataris(68.3%). The level of knowledge about SARS was better among educated subjects. The survey found a high level of stress and fear among the respondents.

Health authorities should be on the alert and re-examine their capacity to manage an outbreak like SARS in the event that such a mishap should recur in the future.
Building for health? The construction managers of tomorrow
Authors: Pritchard Catherine
Published: November 2005

Attitudes to health and health promotion have an impact on health-related behaviour. This is important when considering the different settings where health promotion can take place. The workplace is increasingly becoming recognised as an important setting for health promotion. Research has formerly concentrated on workplaces that are static, i.e. on one site; however, the greater challenge lies in the industries that have transient populations, such as the construction industry.

High levels of accidents and ill health have long been synonymous with the construction industry and yet there has been limited research carried out into attitudes to health and the extent of health promotion activities within the industry. The aim of this research was to investigate the attitudes, beliefs and knowledge to health and health promotion of final year students who will graduate to work as construction managers. The students that participated in the study had had the experience of both university and a year-long placement within the industry.

The method used for data collection was semi-structured, face-to-face interviews. Students from the BSc (Hons) Building and Construction Management courses were invited for interviews and a response rate of 85% was achieved. Results revealed that the students were aware of factors that influenced health, but tended to focus on health-related behaviours. This attitude influenced the measures they suggested to promote health in the workplace. The students’ knowledge of health within the construction industry was disappointing. Work experience in the industry had exposed them to various sources of health information, but little action was taken to involve employees and structural issues limited the effectiveness of this information. Policy development in the construction industry appeared to rely on disciplinary procedures with an emphasis being placed on employees signing declarations after receiving the information.

The conclusion of this research was that attitudes to health are dominated by the structures within the organisation, with those paid on an hourly basis being less likely to participate in workplace health promotion. The information provided to site workers is limited in its approach and application. The impact of employment structure and the work environment presents a challenge to promoting health in this environment.
The dental caries experience of five-year-old children in St Helena
Authors: Entwistle Nigel B A
Published: November 2005

This paper reports the results of a clinical dental caries survey of five-year-old children on the South Atlantic island of St Helena. The paper compares their caries prevalence in 2003 with that of contemporary five-year-old children in the United Kingdom, and those in St Helena in 1989, to assess the dental health of children and monitor the delivery of dental services on the island in the past 14 years.
Awareness of atherosclerosis risk factors in Nigeria
Authors: Oghagbon E K , Okesina A B , Adebisi S A
Published: November 2005

Non-communicable diseases, which include hypertension and diabetes mellitus, have become an important cause of morbidity and mortality in Nigeria. The determination of serum lipid levels is used routinely to assess the risk of atherosclerosis. This study was performed in order to determine the frequency of serum lipid requests in the community. Information on both lipid and total chemical pathology requests for the study period (May 1998 to April 2000) was obtained from the Department of Chemical Pathology, University of Ilorin Teaching Hospital, whilst data on the total hospital attendance was obtained from the hospital’s Record Department.

The number of serum lipid requests increased from year to year (May 1998 to April 1999 = 780; May 1999 to April 2000 = 1,357; May 2000 to April 2001 = 1,382). The percentages of total requests for serum lipids when compared with the total laboratory requests for the period of study were 12.0%, 13.3% and 14.0% for the first, second and third year respectively. More men than women had their serum lipid levels determined; 31.3% of the patients had hyper-cholesterolaemia (>5.2 mmol/L), while 9.9% had values >6.2 mmol/L. Industrial disputes (strikes) affected our results. For the three-year period there was no remarkable increase in the use of the lipid profile facilities available in the centre. This reflects the inadequate awareness of lipid disorders as a risk factor for atherosclerosis.
Historical perspectives on health
Authors: Brewer Harry
Published: November 2005

The Arabian conquests during and after the 7th century led to a spread of Islam as well as the consequential influence of theology on health through the teachings of the Qur’an (Koran). Although traditional medicine was widely accepted and used, the character of early aggrandisement of Arabic medicine involved a facility for adapting and absorbing Graeco-Roman knowledge. The translation schools and libraries, famous in both the East and West, preserved and expanded the knowledge acquired. European academic learning owed much to the Arabs. Information came through Spain to Italy, France and, later on, England. The founding of hospitals, whilst not an Arab initiative, received a fillip from the religious prescriptions for care of the sick. The Military Orders developed specialist institutions for the sick, probably as a result of what they saw during their sojourn in the Middle East. The legacy of Arabic medical care is still with us today and deserves understanding and greater appreciation.
Lessons to be learned: a case study approach
Authors: Mohan Kamlesh , Sayer Richard , Acharya Devikumar
Published: November 2005

A 70-year-old lady was admitted to hospital through the casualty department with suspected bilateral community acquired pneumonia. Although she received intravenous antibiotics, high concentrations of supplemental inhaled oxygen and continuous positive airway pressure therapy there was failure to respond. Abnormal levels of peripheral blood neutrophil and eosinophil counts as well as computerised tomography chest scan appearances suggested bronchiolitis obliterans organising pneumonia. The diagnosis was confirmed by a lung biopsy obtained by video-assisted thoracoscopy under general anaesthesia. She made a prompt and complete recovery with oral steroid treatment.
Testicular cancer
Authors: Shabbir Majid , Morgan Robert J
Published: November 2005

Testicular cancer is a rare condition, accounting for approximately 1-1.5% of all cancers in men. It is the most common cancer affecting men in their 20s and 30s. Little is known about the exact cause of this disease, although numerous risk factors have been recognised.

Treatment of testicular cancer has been extremely successful, with impressive cure rates reported. This is due to the excellent tumour response to chemotherapy and radiotherapy, and also to the diagnosis and follow-up regimes.
Understanding prostate cancer
Authors: Siddiqui Emad , Mumtaz Faiz H , Gelister James
Published: November 2005

Prostate cancer is the second most common cancer affecting men in Europe and the USA. The incidence of prostate cancer has risen by 60-75% in the Western world in the last 15 years. One in twelve men over the age of 60 develop prostate cancer and this figure is expected to rise to three in twelve in the next 20 years. Early prostate cancer often does not cause symptoms. However, patients may present with lower urinary tract symptoms (LUTS) and therefore, such patients should be investigated. Effective treatment in the form of surgery and radiotherapy is available for individuals with localised disease, and the effectiveness of different combination therapy is being assessed to improve the outcome further.

Approximately 20% of the patients have metastatic disease on presentation. The mainstay of treatment for these patients is androgen ablation therapy; however patients on this regime eventually relapse and develop an androgen independent tumour. This aggressive stage of the disease carries a high morbidity and mortality. At present the treatment for such hormone refractory prostate cancer is inadequate and the desperate search for alternative forms of therapy continues.
Cancers of the bladder
Authors: Sengupta N , Siddiqui Emad , Mumtaz Faiz H
Published: November 2005

Bladder cancer is the fifth most common malignancy in Europe and the fourth most common malignancy in the United States.1 It affects one in 4000 people and accounts for 5% of all diagnosed cancers. The peak incidence is in the fifth and seventh decade.

There is a strong association between smoking and bladder cancer. Smokers have a fourfold higher incidence of developing bladder cancer than the general population.2

The disease has a spectrum of clinical severity varying from superficial bladder cancer to muscle invasive or metastatic disease which carries a poor prognosis. Currently the superficial form of the disease is managed by endoscopic resection of the tumour, often followed by the instillation into the bladder of cytotoxic agents. Due to the tendency of bladder cancer to recur repeated cystoscopies and resections are often required. Because of this, one of the main thrusts of research is to find a way of preventing the progression from superficial disease to muscle invasive and metastatic bladder cancer.
Condom use with sex workers and abstinence behaviour among men in Nigeria
Authors: Lawoyin Taiwo O
Published: November 2005

Non-regular, non-cohabiting relationships and condom neglect are known to fuel the HIV/AIDS epidemic in Africa. Reproductive health needs of the men, the major decision-makers in this community, have been grossly neglected in this regard. This exploratory, community-based study assessed condom use among married men when with commercial sex workers (CSWs) and abstinent behaviour when their wives were unavailable for sex. (A CSW is one known to receive payment for sex.)

Out of the 3,178 married respondents, 1,755 (55.2%) had ever used condoms. Of this number, 1,296 (73.8%) resided in urban locations while 459 (26.2%) resided in rural areas. Of these men, 137 had used CSWs in the six months prior to the study. Only 63 (46%) of these had used a condom at the last visit. Young age (<30 years) was the only predictor of condom use when with CSWs (p=0.03). Predictors of abstinence behaviour when the wife was unavailable for sex included: primary and secondary education, young age of the wife, low occupational status and monogamy.

National HIV/AIDS control programmes should address men’s risk-taking behaviour, empowering women to negotiate condom use and reduce long abstinence periods.

Continued efforts should be made to reach sex workers and to make condoms much more widely available, acceptable and affordable, especially in rural areas.
Managing the health effects of the explosive remnants of war
Authors: Kett Maria E , Mannion Steve J
Published: November 2005

Many civilian deaths and injuries across the globe are a consequence of `explosive remnants of war' (ERW). These ERW include mines, unexploded ordnance (UXO) and cluster bombs. The numbers of deaths, injuries and resulting disabilities from ERW are expected to increase as armed conflicts proliferate. This will have a substantial effect on all aspects of health. This article first describes the mechanisms of these ERW and the nature of the injuries they can cause. It then briefly outlines the immediate medical management such injuries require; the long-term outcomes and sequelae, and what can be done to manage them. It highlights how research and medical interventions must take into account cultural, social and economic factors in addition to utilising safe and appropriate techniques and practices. The article concludes by noting that medical personnel are well placed not only to intervene and manage the direct health effects of ERW, but also indirectly by advocating on behalf of those affected by adding their voices to campaigns against their proliferation.
Mental health promotion in post-conflict countries
Authors: Ghosh Neill , Mohit Ahmad , Murthy R Srinivasa
Published: November 2005

Meeting the mental health needs of those persons in conflict and post-conflict situations in the eastern Mediterranean region (EMR) is an important goal of the World Health Organization. Of the 22 countries in the EMR, 85% of the population has been affected by conflict in the past two decades. This has resulted in a high prevalence of mental disorder, most commonly depression, post-traumatic stress disorder and anxiety. A number of innovative, culturally sensitive interventions have been developed to meet the mental health needs of the populations. These include the use of `focusing' in Afghanistan, the Education for Peace Programme in Lebanon, the United Nations Relief and Works Agency's work with refugees in Gaza, life skills education in Iran and the training of professionals in Afghanistan.

In post-conflict situations there are six levels of interventions needed: first, increasing resilience; second, making the family the focus for effective support; third, encouraging community solidarity and traditional methods of support; fourth, using the media in mental health promotion; fifth, the integration of mental health skills of caring for the population with general services; and sixth, focusing on long-rather than short-term measures.
Rear seat belt use as an indicator of safe road behaviour in a rapidly developing country
Authors: McIlvenny Shirley , Al Mahrouqi Fatma , Al Busaidi Thuraiya , Al Nabhani Ahmed , Al Hikmani Fatma , Al Kharousi Zaher , Al Mammari Salima , Al Hoti Anwar , Al Shihi Aysha , Al Lawati Anwar , Al Kharousi Ibtisam
Published: November 2005

Injuries from road traffic accidents are set to become the second highest cause of disability-adjusted life years lost in developing countries by 2020. The number of injuries and deaths are disproportionately high in low income countries, which account for only 40% of all motor vehicles. Human behaviour is thought to be a major factor in most accidents. In Oman wearing a seat belt is compulsory in the front seats but not in the rear. Wearing a seat belt can reduce the severity of injuries when sitting in rear seats. This study examines the use of seat belts in cars entering a university and hospital campus in Oman to determine the degree of seat belt wearing in the rear.

At peak times on a selected day, cars were stopped at the university's entrance barrier. The type of driver was identified - student, employee, hospital patient or visitor - and the degree of seat belt wearing among driver and passengers was noted.

A total of 1,066 cars were stopped. Of this total, 90.1% of drivers and 80.9% of front seat passengers were wearing a restraint complying with local traffic regulations. However, only 1.4% of back seat passengers wore a seat belt. Only 3.7% of children under the age of five were restrained in a child seat and only 16.7% of five- to 12-year-olds were strapped in. A third (34.6%) of under-fives were sitting in the front seat. In cars with child occupants, 40% of the time parents wore seat belts but the children did not.

Occupants conformed to the law but behaviour indicated a lack of awareness of the dangers of not wearing seat belts, especially towards children. Traffic regulations need to be updated and the public educated about the need to wear seat belts. Health agencies could be more active in educating the public about road safety behaviour and should also be involved in the overall strategy to reduce injuries and deaths.
Historical perspectives on health
Authors: Chamberlain Geoffrey
Published: November 2005

Medicine in ancient Egypt was much more advanced than the rest of the Biblical world, especially in trauma surgery. Care at the time of childbirth was however virtually non-existent. There were no trained obstetricians or midwives but a galaxy of gods were at hand.

This article traces what we can piece together about pregnancy of childbirth from the evidence we have in tombs and papyri of Egypt.
Multiple deprivation and excess winter deaths in Scotland
Authors: Howieson Stirling G , Hogan M
Published: November 2005

The recent publication of the Scottish Index of Multiple Deprivation (SIMD) has allowed some tentative statistical correlations to be undertaken to assess the impact poverty may have on mortality and morbidity. During the period 1989 to 2001, Scotland registered around 51,600 excess winter deaths (EWDs). An EWD is taken as the additional deaths during December to March than occurred in the preceding and subsequent four-month periods. Almost all of these EWDs were in the population aged over 65. This represents 50 more deaths per day in January than in July. The SIMD measured five criteria by region: income; employment; health and disability; education, skills and training; and geographical access to services. Glasgow was the most deprived region with an SIMD score of 46.88 and East Dunbartonshire, the least deprived region, with a score of 9.07. For the over 65s, the chance of becoming an EWD in Glasgow is one in 36, rising to one in 68 for North Ayrshire. The SIMD is positively correlated with EWD by region (0.35 at the 5% confidence level).

This correlation appears to go against the influence of climatic variations, house type, energy efficiency and access to the gas network which favours urban areas. Although some of the additional winter deaths have been ascribed to outdoor cold exposure - exacerbated by inappropriate clothing or culturally determined behaviour - the majority of EWDs are premature and essentially preventable if the elderly can be kept warm in their homes during the winter months.
Whistleblowing on health, welfare and safety: the UK experience
Authors: Vinten Gerald , Gavin Thomas A
Published: November 2005

This article takes a look at how whistleblowing has changed over the last 25 years highlighting some well-known cases and focusing on the areas of health and safety, health services and social services. The article also covers government legislation and the lead taken by professional bodies to encourage and support whistleblowers.
Lessons to be learned: a case study approach
Authors: Dewan Madhu , Malatani Tarek Saed , Ansari Mohammad Amin
Published: November 2005

Malignant melanoma of soft tissue, also called clear cell sarcoma (CCS) of tendons and aponeuroses, presents as a soft tissue mass, usually in the lower extremity of young females. We report two cases of CCS of the upper extremity - in a Korean and a Saudi Arabian girl. Because of the presence of melanin, melanosomes, S-100 protein and the tendency for regional nodal metastases, it has been suggested that this entity be considered a melanoma rather than a soft tissue sarcoma. The evidence for a neuroectodermal origin of these neoplasms is compelling. Despite these features, CCS has been reported as showing a distinct chromosomal translocation pattern t(12;22)(q13;q12) in certain isolated cytogenetic or molecular diagnostic case reports; however, there is no information about the breakpoints at genomic level. Such genetic studies need to be performed on primary and metastatic cutaneous, mucosal or ocular melanomas prior to considering them specific for malignant melanoma of soft tissue/CCS.

Microscopically, solid nests and fascicles of pale fusiform or cuboidal cells are divided by fine fibrous tissue septa. Characteristically, the cells possess a round to oval nucleus with a central prominent nucleolus. Pleomorphism may or may not be present; the cytoplasm is clear due to the presence of glycogen but, occasionally, the cytoplasm is more eosinophilic, resembling a melanoma. A tumour size (>5 cm) and the presence of necrosis are statistically significant predictors of poor prognosis. A lesion on the proximal part of an extremity progresses slower than one that is more distal (i.e. acral). An early diagnosis and initial radical surgery are essential for a favourable clinical outcome. Once regional lymph node metastases or haematogenous dissemination has occurred, the prognosis becomes dismal.
Promoting the social and emotional health of children: where to now?
Authors: Barlow Jane , Underdown Angela
Published: November 2005

In advanced industrial societies such as the UK, the burden of disease is shifting from physical to mental health problems - emotional and behavioural problems currently being the major cause of disability in children. Evidence concerning the role of parents in promoting children’s social and emotional health, in conjunction with the benefits of supporting parents in this role, has focused attention on the need for greater clarity concerning the role of both parents and governments in supporting and protecting children’s social and emotional health.

This paper examines the evidence base concerning children’s social and emotional development and suggests some steps that may be necessary to ensure the future promotion of children’s social and emotional health.
Supporting young people who repeatedly self-harm
Authors: Storey Pamela , Hurry Jane , Jowitt Sharon , Owens David , House Allan
Published: November 2005

This paper explores the views and experiences of a group of 74 young people aged 16-22 who were interviewed following presentation in accident and emergency (A&E) departments after intentionally harming themselves. It focuses on a sub-group of 38 young people with a history of self-harm behaviour that extended from when they were under the age of 16, one-third of whom had been or were currently in care. Whilst some had kept their self-harming hidden and had not received any professional intervention until they reached adulthood, others had been in touch with services, although their treatment had not prevented them from continuing to self-harm. Medication was perceived as ‘fobbing off’, particularly when unaccompanied by other treatments. The young people described their encounters with counsellors and clinicians, some of whom they perceived not to understand or to listen to their perspective. Whilst not representative of all young people who self-harm, these views are important and deserve attention if interventions for children and adolescents are to prevent repetition of self-harm.
A review of low birth weight: predictors, precursors and morbidity outcomes
Authors: Ashdown-Lambert Joan R
Published: November 2005

This paper reviews the global evidence concerning infant low birth weight (LBW) (2.500kg and below) in relation to suggested causative factors, such as undernutrition, stress, smoking, drug abuse and deprived living environments. In addition, health promotion strategies in place to reduce LBW incidence in both developed and underdeveloped countries are reviewed.The paper also focuses on the high incidence of LBW in the UK in comparison to other European and developed countries. Predictors of LBW are then considered comparing findings of a study conducted in the UK with findings in underdeveloped countries. In addition, LBW risk is discussed in the context of vulnerability factors, such as teen pregnancy, child abuse and domestic violence.In conclusion, the author argues for a health promotion policy in the UK to reduce incidence of LBW in areas of deprivation and suggests that the improvement of maternal health is key in improving the health of todays infants and children who will one day become the adults of tomorrow.
Fetal gender determination and the male: female population ratio in Bangladesh
Authors: Quddus Sabrin
Published: November 2005

Gender determination of the fetus can be an important issue to parents, especially in Bangladesh and other South Asian countries. This study was conducted to determine how often we can detect the gender of the fetus and whether the gender ratio of the fetus correlated with the gender ratio of the population as determined by the census.

Fetal gender ratio of male and female was found to be 1.04:1; the population gender ratio of the same period was 1.038:1. This study was conducted from March 1999 to December 2001.
Use of Complementary Therapies Among Breast and Prostate Cancer Patients During Treatment: A Multisite Study
Authors: Hann D. M. , Baker F. , Roberts C. S. , Witt C. , McDonald J. , Livingston M. , Ruiterman J. , Ampela R. , Crammer C. , Kaw O.
Published: November 2005

Purpose:The purpose of this study was to compare the use of complementary therapies (CT) among breast and prostate cancer patients during active cancer treatment. The authors compared use and beliefs about the role of CT in cancer recovery. Methods:A self-report survey was completed by 126 breast cancer patients and 82 prostate cancer patients as part of a multisite research project. The self-report questionnaire inquired about the use of various CTs, sources of information about CT, reasons for using CT, beliefs about the benefits and risks of CT, demographic characteristics, and cancer treatment history. Results:Most of the respondents were older than 50 years, Caucasian, married, had attended or completed college, and were less than 1 year postdiagnosis. Prostate cancer patients were significantly older than the breast cancer patients ( P< .001). Several differences emerged between the groups. Compared to the prostate cancer patients, significantly more of the breast cancer patients reported using CT because they wanted to reduce the risk of recurrence ( P< .01), play a more active role in recovery ( P< .01), help manage stress ( P< .01), take a more holistic approach ( P< .01), or boost the immune system ( P< .01). More of the prostate cancer patients reported using CT to have more control of their recovery ( P< .05). The 2 groups also differed significantly ( P< .01) on several beliefs about the potential benefits and risks of using CT. Conclusions:Most of the patients in this study had used some form of CT since the time of their diagnosis. Differences among breast and prostate cancer patients with regard to their use of CT during cancer treatment should be considered by oncology professionals who are discussing this topic with their patients.
Expression of Vascular Endothelial Growth Factor (VEGF) and VEGF Receptors in Tumor Angiogenesis and Malignancies
Authors: Pradeep C. R. , Sunila E. S. , Kuttan G.
Published: November 2005

Angiogenesis is a process by which new blood vessels are formed from preexisting vessels. New blood vessel formation by angiogenesis involves the degradation of extra-cellular matrix combined with sprouting and migration of endothelial cells from preexisting capillaries. Solid tumors consist of several components, including normal and stromal cells, extracellular matrix, and vasculature. To grow and metastasize, tumors must stimulate the development of new vasculature through angiogenesis. Vascular endothelial growth factor (VEGF) is a potent angiogenic peptide with biologic effects that include regulation of hematopoietic stem cell development, extracellular matrix remodeling, and inflammatory cytokine regeneration. VEGF is both a vascular growth factor and a vascular permeability factor. Its expression can upregulate several proangiogenic and prometa-static molecules. As a central mediator of angiogenesis, VEGF has emerged as an important target for antiangiogenic therapy. In this review, the authors describe the essential characteristics of VEGF and the VEGF family of ligands and their receptors. They also provide an overview of the central role of VEGF in physiologic and pathologic angiogenesis, directly or indirectly. This review sheds light on the importance of VEGF-targeted antiangiogenic therapy based on the monoclonal antibodies against VEGF, small interfering RNA, and therapy directed against VEGF-VEGFR kinase. It also gives a brief overview of the natural products or dietary compounds that could be used as antiangiogenic agents. Therapeutic inhibition of vessel formation could be best suited to preventive strategies aimed at the suppression of angiogenesis in primary tumors in subjects at risk or of micrometastases after surgical removal of primary tumor.
Commentary: The Pharmacological Antioxidant Amifostine—Implications of Recent Research for Integrative Cancer Care
Authors: Block Keith I. , Gyllenhaal Charlotte
Published: November 2005

Amifostine is a pharmacological antioxidant used as a cytoprotectant in cancer chemotherapy and radiotherapy. It is thought to protect normal tissues relative to tumor tissue against oxidative damage inflicted by cancer therapies by becoming concentrated at higher levels in normal tissues. The degree to which amifostine nevertheless accumulates in tumors and protects them against cancer therapies has been debated. Guidelines have been published that direct its use in chemotherapy and radiation, taking into consideration the concerns of tumor protection. In this article, clinical studies of amifostine appearing since the publication of the most recent set of guidelines are reviewed. Randomized and nonrandomized trials of regimens involving chemo-therapeutic agents (chemotherapy, chemoradiation, conditioning regimens for bone marrow transplant) are discussed. Nineteen studies showed positive effects for amifostine reducing the level of side effects of these regimens, while 9 showed no effect and 1 had a questionable result. Clinically relevant levels of amifostine toxicity were observed in several studies, but subcutaneous administration may reduce such toxicity. Amifostine showed protection against mucositis, esophagitis, neuropathy, and other side effects, although protection against cisplatin-induced ototoxicity was not observed. No evidence of tumor protection was observed. Amifostine may enable populations unable to tolerate conventional cancer therapy to receive treatment of their cancers, even if some degree of tumor protection is eventually discovered. The authors discuss the implications of this research for patient populations seen in integrative cancer care centers and for research on phytochemical antioxidants such as vitamins and carotenoids.
The Beijing genotype and drug resistant tuberculosis in the Aral Sea region of Central Asia
Authors: Cox Helen Suzanne , Kubica Tanja , Doshetov Daribay , Kebede Yared , Rüsch-Gerdess Sabine , Niemann Stefan
Published: November 2005

Background

After the collapse of the Soviet Union, dramatically increasing rates of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) have been reported from several countries. This development has been mainly attributed to the widespread breakdown of TB control systems and declining socio-economic status. However, recent studies have raised concern that the Beijing genotype of Mycobacterium tuberculosis might be contributing to the epidemic through its widespread presence and potentially enhanced ability to acquire resistance.

Methods

A total of 397 M. tuberculosis strains from a cross sectional survey performed in the Aral Sea region in Uzbekistan and Turkmenistan have been analysed by drug susceptibility testing, IS6110 fingerprinting, and spoligotyping.

Results

Fifteen isolates showed mixed banding patterns indicating simultaneous infection with 2 strains. Among the remaining 382 strains, 152 (40%) were grouped in 42 clusters with identical fingerprint and spoligotype patterns. Overall, 50% of all isolates were Beijing genotype, with 55% of these strains appearing in clusters compared to 25% of non-Beijing strains. The percentage of Beijing strains increased with increasing drug resistance among both new and previously treated patients; 38% of fully-susceptible isolates were Beijing genotype, while 75% of MDR-TB strains were of the Beijing type.

Conclusion

The Beijing genotype is a major cause of tuberculosis in this region, it is strongly associated with drug resistance, independent of previous tuberculosis treatment and may be strongly contributing to the transmission of MDR-TB. Further investigation around the consequences of Beijing genotype infection for both tuberculosis transmission and outcomes of standard short course chemotherapy are urgently needed.
SSH adequacy to preimplantation mammalian development: Scarce specific transcripts cloning despite irregular normalisation
Authors: Bui LC , Léandri RD , Renard JP , Duranthon V
Published: November 2005

Background

SSH has emerged as a widely used technology to identify genes that are differentially regulated between two biological situations. Because it includes a normalisation step, it is used for preference to clone low abundance differentially expressed transcripts. It does not require previous sequence knowledge and may start from PCR amplified cDNAs. It is thus particularly well suited to biological situations where specific genes are expressed and tiny amounts of RNA are available. This is the case during early mammalian embryo development. In this field, few differentially expressed genes have been characterized from SSH libraries, but an overall assessment of the quality of SSH libraries is still required. Because we are interested in the more systematic establishment of SSH libraries from early embryos, we have developed a simple and reliable strategy based on reporter transcript follow-up to check SSH library quality and repeatability when starting with small amounts of RNA.

Results

Four independent subtracted libraries were constructed. They aimed to analyze key events in the preimplantation development of rabbit and bovine embryos. The performance of the SSH procedure was assessed through the large-scale screening of thousands of clones from each library for exogenous reporter transcripts mimicking either tester specific or tester/driver common transcripts. Our results show that abundant transcripts escape normalisation which is only efficient for rare and moderately abundant transcripts. Sequencing 1600 clones from one of the libraries confirmed and extended our results to endogenous transcripts and demonstrated that some very abundant transcripts common to tester and driver escaped subtraction. Nonetheless, the four libraries were greatly enriched in clones encoding for very rare (0.0005% of mRNAs) tester-specific transcripts.

Conclusion

The close agreement between our hybridization and sequencing results shows that the addition and follow-up of exogenous reporter transcripts provides an easy and reliable means to check SSH performance. Despite some cases of irregular normalisation and subtraction failure, we have shown that SSH repeatedly enriches the libraries in very rare, tester-specific transcripts, and can thus be considered as a powerful tool to investigate situations where small amounts of biological material are available, such as during early mammalian development.
A descriptive study of older adults with persistent pain: Use and perceived effectiveness of pain management strategies [ISRCTN11899548]
Authors: Kemp Carol A , Ersek Mary , Turner Judith A
Published: November 2005

Background

Persistent pain is a common, often debilitating, problem in older adults; however, few studies have focused on the experiences of older adults in managing their pain. The objective of this study was to describe the use and perceived effectiveness of pain management strategies in a sample of older adults and to explore the associations of these variables with demographic and psychosocial characteristics.

Methods

Adults ≥ 65 years old and living in retirement facilities who reported persistent pain (N = 235, mean age = 82 years, 84% female, 94% white) completed measures of demographics, pain, depression, self-efficacy for managing pain, and a Pain Management Strategies Survey. Participants identified current and previous-year use of 42 pain management strategies and rated helpfulness of each on a 5-point scale.

Results

Acetaminophen, regular exercise, prayer, and heat and cold were the most frequently used pain management strategies (61%, 58%, 53%, and 48%, respectively). Strategies used by >25% of the sample that were rated moderately or more helpful (i.e., >2 on a 0 to 4 scale) were prayer [mean (SD) = 2.9 (0.9)], opioids [2.6 (0.8)], regular exercise [2.5 (1.0)], heat/cold [2.5 (1.0)], nonsteroidal anti-inflammatory drugs [2.4 (1.0)], and acetaminophen [2.3 (1.0)]. Young-old (65–74 years) study participants reported use of more strategies than did old-old (85+ years) participants (p = .03). Perceived helpfulness of strategy use was significantly associated with pain intensity (r = -.14, p < .0001), self-efficacy (r = .28, p < .0001), and depression (r = -.20, p = .003).

Conclusion

On average, older adults view the strategies they use for persistent pain as only moderately helpful. The associations between perceived helpfulness and self-efficacy and depression suggest avenues of pain management that are focused less on specific treatments and more on how persons with persistent pain think about their pain.
Prevalence of pre- and postpartum depression in Jamaican women
Authors: Wissart Janice , Parshad Omkar , Kulkarni Santosh
Published: November 2005

Background

Maternal depression during pregnancy has been studied less than depression in postpartum period. The aims of this study were to find out the prevalence of prepartum and postpartum depression and the risk factors associated in a cohort of Afro-Jamaican pregnant women in Jamaica.

Methods

The Zung self-rating depression scale instrument was administered to 73 healthy pregnant women at 28 weeks gestation and at 6 weeks postpartum for quantitative measurement of depression. Blood samples were collected at 8, 28, 35 weeks gestation and at day 1 and 6 weeks postpartum to study the thyroid status.

Results

Study demonstrated depression prevalence rates of 56% and 34% during prepartum and postpartum period, respectively. 94% women suffering depression in both periods were single. There were significant variations in both FT3 and TT4 concentrations which increased from week 8 to week 28 prepartum (p < 0.05) and then declined at the 35th week (p < 0.05 compared with week 28) and 1 day post delivery study (p < 0.05 compared with week 35). The mean values for TSH increased significantly from week 8 through week 35. The mean values at 1 day postpartum and 6 week postpartum were not significantly different from the 35 week values. For FT3, TT4 and TSH there were no significant between group differences in concentrations. The major determinants of postpartum depression were moderate and severe prepartum depression and change in TT4 hormone concentrations.

Conclusion

High prevalence of depression was found during pre- and postpartum periods. Single mothers, prepartum depression and changes in TT4 were factors found to be significantly associated with postpartum depression.
Immediate endoscopic management of complete iatrogenic anterior urethral injuries: A case series with long-term results
Authors: Maheshwari Pankaj N , Shah Hemendra N
Published: November 2005

Background

Urethral injury produces partial or complete disruption of the urethral integrity. Advances in endourology have made endoscopic management of most of these injuries feasible without greatly compromising the final result. We report our institutional experience of immediate endoscopic realignment of complete iatrogenic anterior urethral injury.

Methods

From May 1997 to May 2003, seven patients with complete anterior urethral disruption were managed by immediate endoscopy guided splinting of urethra. Retrograde urethroscopy, combined with fluoroscopic guidance and in some cases antegrade cystoscopy through a suprapubic stab cystostomy was performed. A guide wire was negotiated across the disruption. Later, a 16 F Foley catheter was placed for 1–3 weeks. Patients were followed up at 1, 3, 6 and 12 months and then yearly to assess the long-term outcome of endoscopic management.

Results

Immediate endoscopic realignment was achieved in all patients. Three patients developed recurrence at six months; that was treated by optical urethrotomy. Only one patient developed multiple recurrences over an average follow-up of 49.2 months (range 7 to 74 months). He was offered open end-to-end urethroplasty at twenty months after third recurrence. Thus immediate endoscopic realignment avoided any further intervention in four patients (57.14%); while after an additional optical urethrotomy, urethroplasty could be avoided in six patients (87.2%).

Conclusion

Immediate endoscopic realignment of traumatic urethral disruption is a feasible, safe and effective treatment modality for management of patients with iatrogenic complete anterior urethral injuries.
Specific distribution of overexpressed aurora B kinase in interphase normal epithelial cells
Authors: Abdullah Ash-shafie , Foong Charlene , Murata-Hori Maki
Published: November 2005

Background

It is known that aurora B, a chromosomal passenger protein responsible for the proper progression of mitosis and cytokinesis, is overexpressed throughout the cell cycle in cancer cells. Overexpression of aurora B produced multinuclearity and induced aggressive metastasis, suggesting that overexpressed aurora B has multiple functions in cancer development. However, the detailed dynamics and functions of overexpressed aurora B are poorly understood.

Results

We overexpressed GFP fused aurora B kinase in normal rat kidney epithelial cells. Using spinning disk confocal microscopy, we found that overexpressed aurora B-GFP was predominantly localized in the nucleus and along the cortex as a dot-like or short filamentous structure during interphase. Time-lapse imaging revealed that a cytoplasmic fraction of overexpressed aurora B-GFP was incorporated into the nucleus after cell division. Immunofluorescence studies showed that the nuclear fraction of overexpressed aurora B did not induce ectopic phosphorylation of histone H3 after cell division. The cytoplasmic fraction of overexpressed aurora B-GFP was mainly associated with cortical actin filaments but not stress fibers. Myosin II regulatory light chain, one of the possible targets for aurora B, did not colocalize with cortical aurora B-GFP, suggesting that overexpressed aurora B did not promote phosphorylation of myosin II regulatory light chain in interphase cells.

Conclusion

We conclude that overexpressed aurora B has a specific localization pattern in interphase cells. Based on our findings, we propose that overexpressed aurora B targets the nuclear and cortical proteins during interphase, which may contribute to cancer development and tumor metastasis.
Complement receptor 1 polymorphisms associated with resistance to severe malaria in Kenya
Authors: Thathy Vandana , Moulds JoAnn M , Guyah Bernard , Otieno Walter , Stoute José A
Published: November 2005

Background

It has been hypothesized that the African allelesSl2andMcCbof the Swain-Langley (Sl) and McCoy (McC) blood group antigens of the complement receptor 1 (CR1) may confer a survival advantage in the setting ofPlasmodium falciparummalaria, but this has not been demonstrated.

Methods

To test this hypothesis, children in western Kenya with severe malaria-associated anaemia or cerebral malaria were matched to symptomatic uncomplicated malaria controls by age and gender. Swain-Langley and McCoy blood group alleles were determined by restriction fragment length polymorphism and conditional logistic regression was carried out.

Results

No significant association was found between the African alleles and severe malaria-associated anaemia. However, children withSl2/2genotype were less likely to have cerebral malaria (OR = 0.17, 95% CI 0.04 to 0.72, P = 0.02) than children withSl1/1. In particular, individuals withSl2/2 McCa/bgenotype were less likely to have cerebral malaria (OR = 0.18, 95% CI 0.04 to 0.77, P = 0.02) than individuals withSl1/1 McCa/a.

Conclusion

These results support the hypothesis that theSl2allele and, possibly, theMcCballele evolved in the context of malaria transmission and that in certain combinations probably confer a survival advantage on these populations.
Evaluating change in health-related quality of life in adult rhinitis: Responsiveness of the Rhinosinusitis Disability Index
Authors: Chen Hubert , Katz Patricia P , Shiboski Stephen , Blanc Paul D
Published: November 2005

Background

The Rhinosinusitis Disability Index (RSDI) is a validated measure of health-related quality of life (HRQL) in rhinitis. Responsiveness of the RSDI to changes in health status over time has not been described.

Methods

We studied adults with a self-reported physician diagnosis of rhinitis identified through a national telephone survey. HRQL was assessed at baseline and at 24 months using the RSDI. Symptom severity, physical health status (SF-12 PCS), psychological mood (CES-D), and perceived control of symptoms were also assessed at the time of each interview. In addition, we ascertained specific health outcomes attributed to rhinitis, including days of restricted activity, job effectiveness, number of physician visits, and medication costs.

Results

Of 109 subjects interviewed at baseline, 69 (63%) were re-interviewed 24 months later. RSDI scores improved by = 0.5 standardized response mean in 13 (19%) subjects and worsened in 17 (25%). Change in the RSDI over time correlated with changes in symptom severity (r = 0.38, p = 0.001), physical health (r = -0.39, p = 0.001), mood (r = 0.37, p = 0.002) and perceived control of symptoms (r = -0.37, p = 0.01). In multivariate analyses adjusted for baseline health status, improvement in RSDI was associated with less restricted activity (p = 0.01), increased job effectiveness (p = 0.03), and decreased medication costs (p = 0.05), but was not associated with change in the number of physician visits from baseline (p = 0.45).

Conclusion

The RSDI is responsive to changes in health status and predicts rhinitis-specific health outcomes.