bluuebunny/crossref_metadata_2025 huggingface dataset:
Time for a change to assess and evaluate body temperature in clinical practice
Authors: Sund‐Levander Märtha , Grodzinsky Ewa
Published: August 2009

The definition of normal body temperature as 37°C still is considered the norm worldwide, but in practice there is a widespread confusion of the evaluation of body temperature, especially in elderly individuals. In this paper, we discuss the relevance of normal body temperature as 37°C and consequences in clinical practice. Our conclusion is that body temperature should be evaluated in relation to the individual variability and that the best approach is to use the same site, and an unadjusted mode without adjustments to other sites. If the baseline value is not known, it is important to notice that frail elderly individuals are at risk of a low body temperature. In addition, what should be regarded as fever is closely related to what is considered as normal body temperature. That is, as normal body temperature shows individual variations, it is reasonable that the same should hold true for the febrile range.
Overseas trained nurses' perception of UK nurses' caring attitudes: A qualitative study
Authors: Alexis Obrey
Published: August 2009

The aim of this study was to explore overseas nurses' perception of their nursing colleagues' caring attitudes in the National Health Service (NHS) in the UK. A qualitative phenomenological approach using semi‐structured interviews was used to obtain data from 12 overseas nurses. The interview transcripts were transcribed verbatim and analysed using van Manen thematic approach. Although many themes emerged following thematic analysis, this study will report the findings of three themes such as empathy, understanding and caring perspectives, emotional impact and lack of teamwork. In conclusion, this study provides an insight and it increases our understanding of overseas nurses' perceptions of their nursing colleagues' caring attitudes in the NHS in the UK. This paper concludes by indicating that teamwork, being empathetic, understanding and reducing emotional labour for overseas nurses could lead to a more satisfied working environment for overseas nurses in the NHS in the UK.
Implementing interdisciplinary practice change in an international health‐care organization
Authors: Reinhardt Anita C , Keller Teresa
Published: August 2009

The current emphasis on adopting evidence‐based practice often results in the need to change interdisciplinary practice. This article describes the successful system‐wide change to evidence‐based wound care practices in a large, Middle‐Eastern health services organization using a multinational workforce. Elements within this change initiative are identified that stimulated experimentation and collaboration among members of this organization's workforce while also preserving culturally determined expectations for authority and decision‐making. The result was a system‐wide practice change accomplished through consensus‐building and interdisciplinary learning while also utilizing the strengths to be found in an established organizational hierarchy. This description of practice change among the members of a multicultural, multinational workforce provides lessons for managing a diversity of perspectives, creating consensus and accomplishing change in an environment where multiple cultural values intersect.
The easy option? Australian findings on mothers' perception of elective Caesarean as a birth choice after a prior Caesarean section
Authors: McGrath Pam , Ray‐Barruel Gillian
Published: August 2009

As the rate of primary and repeat Caesareans around the world increases, obstetricians, midwives and primary care providers are being expected to provide counsel to women seeking information regarding birth choices for delivery after a prior emergency Caesarean. This article seeks to contribute to the knowledge on this topic by presenting research findings from a qualitative study designed to explore, from the mothers' perspective, the decision‐making experience with regards to subsequent birth choice for women who have previously delivered by Caesarean section. Specifically, the findings in this article present the perspective of the mothers who opted for elective Caesarean. Eighty per cent of mothers in this study chose elective Caesarean for reasons of fear and the desire to retain some control over the birthing process. For many, this decision is made prior to or early in pregnancy without any openness to consider other possibilities. Thus, the findings strongly emphasize the importance of understanding and taking into consideration the mothers' psychosocial perspective on birth choices as a key to providing counsel and support.
An evaluation of lecturer practitioners in Ireland
Authors: Hartigan Irene , Cummins Ann , O'Connell Elizabeth , Hughes Mary , Hayes Claire C , Noonan Brendan , Fehin Patricia
Published: August 2009

Nursing continues to struggle to integrate the theoretical and clinical aspects of nurse education for the development of competent practitioners. Collaborative approaches to nurse education as well as the development of joint clinical‐academic roles have had questionable success to date on merging the theoretical and clinical components of nursing. Lecturer practitioners' posts are new in Ireland. These posts were created as nurse educators were cognizant of the need for students to integrate theory to practice. The aim of the lecturer practitioner role was to increase the support forstudent nurses in both academia and practice. An evaluation of the impact of the lecturer practitioner role from three key perspectives was conducted in three Irish teaching hospitals in 2007. The results of this study suggest that as lecturer practitioners have both a clinical and academic remit they can integrate theory to practice through collaborative practice.
Maintainance of patients' dignity during hospitalization: Comparison of staff–patient observations and patient feedback through interviews
Authors: Henderson Amanda , Van Eps Mary Ann , Pearson Kate , James Catherine , Henderson Peter , Osborne Yvonne
Published: August 2009

Patients' rights such as the need for dignity and respect are essential in the provision of quality care. This exploratory clinical study explored patient dignity within the acute hospital environment through observation of staff–patient interactions and interviews with patients. Dignity can be influenced through two major mediums—maintenance of the physical environment and the communication style of the nurse. The findings identified deviations to ideal practice in the maintenance of the physical environment and communication styles of the nursing staff. Maintenance of dignity and privacy were not identified by patients during the interviews as being under threat despite deviations to ideal practice being observed. Patients possibly accept that ‘ideal practice’ is not always provided to them because nurses are ‘busy’, or other factors take precedence in this environment. It is possible that a prevailing culture influences patients' perceptions of whether dignity is maintained.
Parents' perceptions and needs of children's hospital discharge information
Authors: Keatinge Diana , Stevenson Karen , Fitzgerald Mary
Published: August 2009

Two linked descriptive qualitative studies, conducted 12 months apart aimed to identify parents' perceptions of discharge information relating to a recent admission of their child to hospital. Study one participants included parents (n = 7) who telephoned a paediatric telephone triage service seeking information about their child's postdischarge care. Study 2 included parents (n = 12) of children admitted to a regional hospital's general paediatric ward. Data were collected via semi‐structured interviews conducted with parents following their child's discharge from hospital. These data were analysed using qualitative content analysis separately. The studies were linked in so far as the results from study one informed the modification of the design of study two and its interview protocol. Both studies revealed verbal as well as written information is helpful to parents, plain language usage is important, messages from the health‐care team are sometimes inconsistent, and parents need information specific to their particular circumstances.
Elevation of serum aminotransferase activity increases risk of carotid atherosclerosis in patients with non‐alcoholic fatty liver disease
Authors: Wang Chia‐Chi , Lin Shinn‐Kuang , Tseng Yuan‐Fu , Hsu Ching‐Sheng , Tseng Tai‐Chung , Lin Hans Hsienhong , Wang Li‐Yu , Kao Jia‐Horng
Published: August 2009

Background and Aim:  Patients with non‐alcoholic fatty liver disease (NAFLD) have an increased risk of atherosclerosis and alanine aminotransferase (ALT) is associated with insulin resistance independently of metabolic factors. The aim of the present study was to investigate whether NAFLD patients with ALT elevation had a higher risk of carotid atherosclerosis.

Methods:  A total of 190 individuals were enrolled from the health management center. Among them, 20 subjects were excluded due to the presence of hepatitis B surface antigen (HbsAg), anti‐hepatitis C virus (HCV) and cardiovascular disease. NAFLD was diagnosed by ultrasound examination. Carotid ultrasonography was used to measure maximal intima‐media thickness (IMT) of the common carotid artery (CCA) and IMT (mean) > 1.0 mm was defined as the presence of carotid atherosclerosis.

Results:  NAFLD patients with ALT elevation had increased risk of carotid atherosclerosis than those with normal ALT by Fisher's exact test (P < 0.05). Multivariate analyses showed that serum ALT levels were positively associated with carotid atherosclerosis after adjustment for age, sex, number of metabolic syndrome components or status of metabolic syndrome (OR, 1.44; 95% CI 1.09–1.89; OR, 1.45; 95% CI 1.11–1.91). In addition, the higher the serum ALT levels with every 10 IU/L increment, the greater the risk of carotid atherosclerosis.

Conclusions:  Serum ALT levels are positively associated with the risk of carotid atherosclerosis in patients with NAFLD, suggesting that serum ALT levels could serve as a surrogate marker of cardiovascular risk in this special clinical setting.
Distribution of Helicobacter pylori cagA, cagE, oipA and vacA in different major ethnic groups in Tehran, Iran
Authors: Dabiri Hossein , Maleknejad Parviz , Yamaoka Yoshio , Feizabadi Mohammad M , Jafari Fereshteh , Rezadehbashi Maryam , Nakhjavani Farrokh A , Mirsalehian Akbar , Zali Mohammad R
Published: August 2009

Background and Aim:  There are geographical variations in Helicobacter pylori virulence genes; cagA, cagE, vacA and oipA. The present study compared the distribution of these genotypes in major ethnic groups residing in Tehran, Iran and their association with clinical outcomes.

Methods:  A total of 124 H. pylori‐positive patients living in Tehran were enrolled in this study. The ethnic distribution was 74 Persians, 33 Turks and 17 other ethnics including Kurds, Lurs, Afghanis and Arabs. The presence of the cagA, cagE and oipA genes and vacA alleles (signal [s] and middle [m] region) were determined by polymerase chain reaction (PCR) from H. pylori DNA.

Results:  The cagA‐positive status was predominant in all three ethnic groups (e.g. 65% in Persians and 73% in Turks). In contrast, the cagE‐positive status was less than half in Persians (47%) and Turks (30%), whereas it was 77% in other ethnicities (P = 0.008). The predominant vacA genotypes were s1 and m1 in all three ethnic groups (e.g. 68% in Persians and 70% in Turks were s1). There was no significant association between cagA and cagE status or vacA genotypes and clinical outcomes. The oipA‐positive strains were more common in non‐ulcer dyspepsia (NUD) (63%) than in peptic ulcer patients (15%) (P = 0.001) in Persians, but the association was not observed in other ethnic groups.

Conclusion:  There are some differences in the H. pylori genotypes among the ethnic groups in Iran. However, none of these markers seemed to be clinically helpful in predicting the clinical presentation of a H. pylori infection in Iran.
Endoscopic retrograde cholangiopancreatography in hepatic alveolar echinococcosis
Authors: Ozturk Gurkan , Polat Kamil Yalcin , Yildirgan Mehmet Ilhan , Aydinli Bulent , Atamanalp Sabri Selcuk , Aydin Unal
Published: August 2009

Background and Aim:  Hepatic alveolar echinococcosis (HAE) involves both the vascular and biliary structures of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) is said to be an alternative for the diagnosis and treatment of biliary complications of HAE. We present here our experience with ERCP in HAE.

Methods:  We followed 13 patients who underwent ERCP for the treatment of biliary complications of HAE in the endoscopy unit of our clinic at Ataturk University School of Medicine, Erzurum between January 2002 and June 2008.

Results:  Eight men and five women were followed up. Mean age was 43.2 (24–64 years). All patients had non‐resectable HAE. Indications for ERCP were biliary fistula in seven patients, obstructive jaundice in five patients and cholangitis in one patient. Endoscopic sphincterotomy (ES) was carried out in 12 patients, and in one patient with biliary leakage, a stent was inserted into the right hepatic branch. ERCP findings were dilated common bile duct, irregular narrowing and distortion of the common bile duct and common hepatic duct, communication with the cystic cavity or biliocutaneous fistula and complete disappearance of the biliary tree above the level of the common hepatic duct or hepatic bifurcation. In patients with biliary leakage, biliary drainage decreased only in two patients after ERCP and in patients with obstructive jaundice, the high bilirubin levels decreased in only one patient.

Conclusion:  ERCP showed structural changes of the external biliary tract and ES has a limited effect on these changes and stents can be used in selected cases.
Assessment of gastric motor function by cine magnetic resonance imaging
Authors: Baba Shigeaki , Sasaki Akira , Nakajima Jun , Obuchi Toru , Koeda Keisuke , Wakabayashi Go
Published: August 2009

Background and Aim:  The aim of the present study was to evaluate gastric motor function by magnetic resonance imaging (MRI) and investigate whether this examination is a useful tool for therapeutic efficacy or postoperative gastric motor function.

Methods:  Twenty‐five healthy volunteers and 10 gastric cancer patients with pylorus‐preserving gastrectomy (PPG) underwent cine‐MRI. Gastric volume was determined by 3D‐volumetry. Gastric motility was quantified by calculating the gastric motility index (GMI).

Results:  The image acquisition and analysis were successfully carried out for all subjects. In healthy volunteers, mean frequency, amplitude, velocity of gastric peristaltic waves and GMI 30 min after the intake of jelly were 3/min, 8.8 mm, 2.2 mm/s and 19.6 mm2/s, respectively. Mean amplitude (8.8 vs 10.4 mm, P = 0.027), velocity (2.2 vs 2.6 mm/s, P < 0.001) of peristaltic waves, and GMI (19.6 vs 26.7 mm2/s, P < 0.001) significantly increased at 30 min after giving mosapride citrate (MS). Mean gastric volume after MS administration was significantly decreased; 0 min (317.3 vs 272.9 mL, P = 0.021), 45 min (263.4 vs 206.4 mL, P = 0.004) and 60 min (228.7 vs 165 mL, P = 0.001). PPG patients with postprandial symptoms were observed having antiperistalsis‐like contraction waves and reflux of gastric contents from the pyloric region into the upper part of the stomach. Mean gastric volume in PPG patients with postprandial symptoms at 30 min after intake of jelly tended to be greater than in those without such symptoms.

Conclusions:  The present study demonstrates that cine‐MRI is a sensitive and non‐invasive imaging technique for simultaneously measuring gastric motility and emptying.
Treatment strategy for laterally spreading tumors in Japan: Before and after the introduction of endoscopic submucosal dissection
Authors: Kobayashi Nozomu , Saito Yutaka , Uraoka Toshio , Matsuda Takahisa , Suzuki Haruhisa , Fujii Takahiro
Published: August 2009

Background and Aims:  Laterally spreading tumors (LST) in the colorectum are considered good candidates for endoscopic resection (ER). Because LST‐non‐granular (NG) tumors show multifocal invasion into the submucosal layer, en bloc resection is necessary for adequate histopathological evaluation. Therefore, surgical resection has been recommended when a lesion is suspected to be an invasive cancer and too large to resect en bloc. The aim of the present study was to evaluate whether the introduction of colorectal ESD, which was developed for en bloc resection of early gastric cancers, could improve the en bloc resection rate of large LST‐NG‐type tumors and reduce the surgical resection rate.

Methods:  Between January 1999 and December 2005, a total of 166 LST‐NG‐type tumors measuring ≥ 20 mm in 161 patients were included in this study. The en bloc resection rate and the surgical resection rate were historically compared between two periods, before and after the introduction of ESD.

Results:  The en bloc resection rate for ER lesions was significantly higher in the latter period (35.0% [14/40]vs 76.5% [75/98]; P < 0.001), and the rate of surgery for adenomas and intramucosal or sm minute cancers was significantly lower in the latter period (20.0% [10/50]vs 1.1% [1/89]; P < 0.001).

Conclusions:  The introduction of colonic ESD was able to change our treatment strategy for LST, improving the en bloc resection rate and reducing the surgical resection rate.
Extracorporeal shock wave lithotripsy of large difficult common bile duct stones: Efficacy and analysis of factors that favor stone fragmentation
Authors: Tandan Manu , Reddy D Nageshwar , Santosh Darisetty , Reddy Venkat , Koppuju Vinod , Lakhtakia Sandeep , Gupta Rajesh , Ramchandani Mohan , Rao Guduru Venkat
Published: August 2009

Background and Aim:  Difficult common bile duct stones (CBD) are those not amenable to extraction by the standard technique of sphincterotomy followed by use of a Dormia basket or balloon. The role of extracorporeal shock wave lithotripsy (ESWL) in stone fragmentation and clearance of difficult CBD stones and the factors which favor fragmentation were prospectively evaluated in the present study.

Methods:  A total of 283 patients with large CBD stones were subjected to ESWL. A maximum of 5000 shocks was delivered per session until CBD stones were fragmented to less than 5 mm diameter. CBD was cleared by biliary endotherapy using a basket or balloon. Outcome was assessed by CBD clearance.

Results:  Total CBD clearance was achieved in 239 patients (84.4%) and partial CBD clearance in 35 patients (12.3%). Three or fewer sessions of ESWL were required in 74.6% of patients. Minor complications were seen in 45 patients (15.9%). There was no procedure‐related mortality. Epidural anesthesia, shock frequency of 90/min, radiolucent calculi and presence of fluid around the calculus helped in better fragmentation.

Conclusion:  A high success rate, negligible complications and non‐invasive nature of the procedure make ESWL a useful tool for removing large CBD stones.
Improving visualization techniques by narrow band imaging and magnification endoscopy
Authors: Muto Manabu , Horimatsu Takahiro , Ezoe Yasumasa , Morita Shuko , Miyamoto Shinichi
Published: August 2009

Endoscopy plays an important role in the early detection of gastrointestinal tract neoplasms. Using conventional white light or dye‐based image enhanced endoscopy, it has been difficult to assess pre‐malignant and early neoplastic lesions precisely. However, narrow band imaging (NBI) dramatically improves the detection of these lesions, particularly in combination with magnifying endoscopy. This allows the endoscopist to accomplish accurate diagnosis. Such enhanced detection of pre‐malignant and early neoplastic lesions in the gastrointestinal tract should allow better targeting of biopsy, improved and more appropriate treatment, and thereby contribute to optimal quality of life and patient survival.
Chinese herbal medicine modified xiaoyao san for functional dyspepsia: Meta‐analysis of randomized controlled trials
Authors: Qin Feng , Huang Xi , Ren Ping
Published: August 2009

Background:  To critically assess the evidence of modified xiaoyao san (MXS) for treating functional dyspepsia (FD).

Methods:  Systematic literature searches were carried out on the Medline database, CNKI database, Wanfang Data, VIP Information and the Cochrane Library. Reference lists located were checked for further relevant publications. Experts in the field and manufacturers of identified products were contacted for unpublished material. Studies were selected according to predefined inclusion and exclusion criteria. All randomized clinical trials of MXS for treating FD were included. Study selection, data extraction and validation were carried out by at least two reviewers with disagreements being settled by discussion. Weighted means and 95% confidence intervals were calculated and sensitivity analyses were carried out.

Results:  Thirty‐three potentially relevant articles were retrieved for further evaluation. Fourteen were suitable for inclusion in the meta‐analysis. There was evidence that MXS compared with prokinetic drugs reduced symptoms (odds ratio 3.26, 95% CI 2.24 to 4. 47). There was evidence that MXS + prokinetic drugs compared with prokinetic drugs reduced symptoms (odds ratio 4.32, 95% CI 2.64 to 7.08).

Conclusion:  MXS appears to be more effective compared to prokinetic drugs in the treatment of FD and no serious side‐effects were identified. However, the evidence remains weak due to publication bias and methodological flaws, which may amplify the therapeutic benefit of MXS.
Overexpression of metastasis‐associated protein 2 is associated with hepatocellular carcinoma size and differentiation
Authors: Lee Hyunseung , Ryu Soo Hyung , Hong Soon Sun , Seo Dong Dae , Min Hyun Joo , Jang Myoung Kuk , Kwon Ho Jeong , Yu Ensil , Chung Young‐Hwa , Kim Kyu‐Won
Published: August 2009

Background and Aim:  Metastasis is a multistep event in which neoplastic cells detach from the tumor, migrate, disseminate, extravasate, and eventually proliferate at the secondary distant sites. Hepatocellular carcinoma (HCC) is characterized by hypervascularity and frequent metastasis. Recently, metastasis‐associated proteins were identified and named metastatic tumor antigens (MTA) 1, 2, and 3. They have been found to be contained in the nucleosome remodeling and histone deacetylase complex. MTA2 has been reported to interact with p53 and inhibit p53‐mediated cell growth arrest and apoptosis by deacetylation. Although it has been reported that the expression of MTA1 is related to tumor progression and metastasis, it is still unclear how MTA2 is involved in HCC. In this study, we found that the overexpression of MTA2 is associated with HCC size and differentiation after hepatectomy.

Methods:  The expression of MTA2 was examined in 506 human HCC samples that underwent hepatic resection using tissue microarray. The expression of MTA2 was classified into 0, 1, 2, and 3, based on immunoreactivity.

Results:  The expression of MTA2 was predominantly localized to the nucleus. MTA2 was detected in 487 (96.2%) of the 506 human HCC samples. Notably, the MTA2 expression level strongly increased depending on the size and differentiation of HCC.

Conclusions:  These findings indicate a tight correlation between the MTA2 expression level and HCC size and differentiation. Therefore, MTA2 might be a predictor of aggressive phenotypes and a possible target molecule for anticancer drug design in human HCC.
Prevention of hepatocellular carcinoma in hepatitis B virus infection
Authors: Lim Seng Gee , Mohammed Rosmawati , Yuen Man‐Fung , Kao Jia‐Horng
Published: August 2009

Chronic hepatitis B is the main risk factor for hepatocellular carcinoma (HCC) in Asia. The most important preventive strategy's adoption of the universal hepatitis B vaccination program is now in its third decade. There is a clear reduction in both chronic hepatitis B virus (HBV) infection (hepatitis B surface antigen “carriage”) but also in childhood HCC in Taiwan. An outstanding concern is variability in vaccine coverage between countries. For patients with chronic hepatitis B, serum HBV DNA levels have emerged as the key risk factor for development of HCC. The initial treatment for chronic hepatitis B was interferon. One randomized control trial, and several case–control or cohort studies have shown benefits for preventing HCC, particularly in cirrhotic patients who responded to therapy. With nucleos(t)ide analogs, the most important study has been the Asian Cirrhosis Lamivudine multicenter randomized controlled trial. This showed that lamivudine can reduce disease progression in HBV‐related cirrhosis, including an approximately 50% decrease in HCC incidence. Such efficacy was achieved despite emergence of drug resistance in approximately 50% of cases. Case–control studies have suggested that hepatitis B cases without cirrhosis may also benefit. In conclusion, it is now possible to prevent HBV‐related HCC. The most effective method is hepatitis B vaccination, which prevents chronic HBV infection and chronic liver disease resulting therefrom. Interferon therapy appears to confer benefit but the evidence is weaker. First‐generation oral antiviral (lamivudine) reduces HCC risk, particularly in cirrhotics. Long‐term outcome data with newer, more potent HBV antivirals that have a higher genetic barrier to drug resistance are eagerly awaited.
Risk factors for adult‐onset asthma: A 14‐year longitudinal study
Authors: JAMROZIK Euzebiusz , KNUIMAN Matthew W. , JAMES Alan , DIVITINI Mark , MUSK AW (Bill)
Published: August 2009

Background and objectives:  Few longitudinal studies have examined the risk factors and natural history of adult‐onset asthma. This study assessed the subject characteristics and lifestyle factors that predicted the new diagnosis of asthma in adulthood and how these factors changed over time in those who developed asthma compared with those who do not.

Methods:  The study enrolled 1554 adults from the Busselton Health Study seen in 1981 and again in 1994–1995 who initially reported never having had doctor‐diagnosed asthma. Questionnaire measures were used to assess doctor‐diagnosed asthma, respiratory history and tobacco smoking. Height, weight and spirometric measures of lung function were measured. Atopy was assessed by skin prick tests. Logistic regression analysis was used to identify risk factors for adult‐onset asthma and changes over time.

Results:  Reported wheeze, rhinitis, chronic cough, smoking and lower levels of lung function in 1981 each predicted asthma diagnosis by 1994–1995. Neither initial skin‐prick reactivity nor newly positive skin‐prick tests at follow up were associated with adult‐onset asthma. Those diagnosed with asthma were more likely to have new wheeze, new rhinitis, new habitual snoring, weight gain and excess decline in lung function.

Conclusions:  Adult‐onset asthma has risk factors that are distinct from those observed in childhood asthma. The presence of upper airway symptoms including rhinitis, as well as lifestyle factors, such as smoking, predicts those at greatest risk. However, neither pre‐existing atopy nor new atopy as measured by skin prick tests was associated with adult‐onset asthma.
The effect of natural adjuvants on tracheal responsiveness and cell count in lung lavage of sensitized guinea pigs
Authors: NEAMATI Ali , BOSKABADY Mohammad H. , AFSHARI Jalil T. , HAZRATI Saleh M. , ROHANI Ali H.
Published: August 2009

Background and objective:  Airway inflammation is a well‐characterized pathological feature of asthma. The effects of two natural adjuvants on lungs of sensitized guinea pigs were examined.

Methods:  The responses of guinea pig tracheal chains, WBC, differential WBC in lung lavage and IL‐4 and interferon (IFN)‐γ levels in serum were examined in control guinea pigs and four treatment groups, including sensitized animals (S) and sensitized animals treated with the adjuvants PC (S + PC), G2 (S + G2) or both adjuvants (S + PCG2) (n = 6). Animals were sensitized by injection and inhalation of ovalbumin.

Results:  Tracheal responsiveness to methacholine (concentration of methacholine causing 50% of maximum contraction), WBC, eosinophil, neutrophil and basophil numbers were increased and lymphocyte numbers were decreased in lung lavage of sensitized animals compared with the control group (P < 0.01 to P < 0.001). However, G2 adjuvant and the combination of G2 and PC adjuvants caused a significant reduction in tracheal responsiveness (P < 0.01 and P < 0.001, respectively). In addition both adjuvants prevented changes in WBC (P < 0.001 for both). Both adjuvants and the combination prevented changes in eosinophil, neutrophil and basophil numbers in lung lavage of sensitized animals (P < 0.05 to P < 0.001). The adjuvants also prevented changes in IL‐4 but increased IFN‐γ levels in all treatment groups compared with group S (P < 0.001 for all cases).

Conclusions:  These results indicate that the two natural adjuvants (especially G2 adjuvant) and their combination have therapeutic effects, with reduction in tracheal responsiveness and WBC in lung lavage of sensitized guinea pigs.
The effects of a swimming intervention for children with asthma
Authors: WANG Jeng‐Shing , HUNG Wen‐Ping
Published: August 2009

Background and objective:  Asthma is a common paediatric airway disease with increasing prevalence. Studies comparing swimming with other sports have found that swimming is unlikely to provoke unstable asthma but possible benefits are not defined. This study investigated the benefits of a 6 week swimming intervention on pulmonary function tests (PFT), PEF and severity of asthma in children.

Methods:  Young asthmatics were randomly assigned to the experimental or the control group, with 15 subjects in each group. In addition to regular treatment for asthma, the experimental group received swimming training for 6 weeks. PFT, PEF and severity of asthma were measured.

Results:  There was a significant improvement (P < 0.01) in PEF in the experimental group compared with the control group (330 L/min, 95% CI: 309–351 vs. 252 L/min, 95% CI: 235–269) after the swimming intervention. There was also a significant improvement (P < 0.05) in the severity of asthma in the experimental group compared with the control group.

Conclusions:  These data suggest that a swimming programme for asthmatic children can improve some disease parameters (PEF and the severity of asthma). Swimming may be an effective non‐pharmacological intervention for the child or adolescent with asthma.
Factors influencing visibility and diagnostic yield of transbronchial biopsy using endobronchial ultrasound in peripheral pulmonary lesions
Authors: HUANG Chun‐Ta , HO Chao‐Chi , TSAI Yi‐Ju , YU Chong‐Jen , YANG Pan‐Chyr
Published: August 2009

Background and objective:  Endobronchial ultrasound (EBUS) has increased the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPL). However, certain lesions cannot be localized by EBUS, and the factors associated with the visibility of PPL by EBUS have not been investigated. This study evaluated the factors predicting the visualization of EBUS in PPL and the diagnostic yield of EBUS‐guided transbronchial biopsy (TBB).

Methods:  n 2007, 83 patients with PPL underwent EBUS‐guided TBB, and their medical records were reviewed and analysed retrospectively.

Results:  Of the 83 patients examined, EBUS images could not be obtained in 23 patients (28%). Lesion size was a determining factor for the visibility of PPL, with the visualization yield of EBUS in lesions <20 mm being significantly lower than that in lesions ≥20 mm (P < 0.001). A definitive diagnosis of PPL localized by EBUS was established using EBUS‐guided TBB in 73% of patients. There were no significant differences in diagnostic yield related to underlying disease, lobar distribution, CT scan appearance or presence of complications. Multivariate analysis revealed that the location of PPL on CT scans and position of the probe were independent predictors of the diagnostic yield by EBUS‐guided TBB (P < 0.001 and P = 0.001, respectively).

Conclusions:  Lesion size is a significant factor predicting visualization of EBUS for PPL. The location of PPL on CT scans and position of the probe are significantly related to a higher diagnostic yield with EBUS‐guided TBB.
Low doses of silver nitrate induce pleurodesis with a limited systemic response
Authors: MARCHI Evaldo , VARGAS Francisco S. , ACENCIO Milena M.P. , ANTONANGELO Leila , TEIXEIRA Lisete R. , LIGHT Richard W.
Published: August 2009

Background and objective:  Both talc and 0.5% silver nitrate have been shown to induce effective pleurodesis. However, acute adverse systemic inflammatory effects have been described with both agents. The aim of this study was to assess in rabbits the systemic effects associated with a new technique of pleurodesis using repeated low doses of 0.1% silver nitrate.

Methods:  Rabbits were injected intrapleurally through a chest tube with 0.1% silver nitrate at 0, 24 and 48 h. Other groups received a single injection of 0.5% silver nitrate or 400 mg/kg of talc. Blood samples were collected at 24, 48 and 72 h, and at 7 days, and cytological and biochemical measurements were performed. After 28 days, the presence of macroscopic pleural adhesions and microscopic pleural fibrosis in the pleural cavity were evaluated.

Results:  Both talc and 0.5% silver nitrate caused significant increases in blood neutrophils, serum LDH, IL‐8, transforming growth factor‐β and CRP in comparison with control at almost all time points, whereas sequential doses of 0.1% silver nitrate only increased LDH and CRP in the first 24 h and transforming growth factor‐β at all time points. All groups showed efficient pleurodesis, with no differences in pleural adhesions or fibrosis.

Conclusions:  Sequential doses of 0.1% silver nitrate produced efficient pleurodesis in rabbits, with a low systemic inflammatory response in comparison with 400 mg/kg of talc or 0.5% silver nitrate.
Rehabilitation and palliative care in lung fibrosis
Authors: SPRUIT Martijn A. , JANSSEN Daisy J.A. , FRANSSEN Frits M.E. , WOUTERS Emiel F.M.
Published: August 2009

The idiopathic interstitial pneumonias are a heterogeneous group of diffuse parenchymal lung diseases with varying degrees of inflammation and fibrosis, like interstitial pulmonary fibrosis. Functional exercise tolerance and quality of life have been shown to be significantly affected in patients with lung fibrosis. Moreover, interstitial pulmonary fibrosis is a progressive disease with poor prognosis and limited response to conventional pharmacological treatment like immunosuppressive agents. So, in patients with lung fibrosis there seems a clear indication to refer them for comprehensive pulmonary rehabilitation programmes and to initiate palliative care in an early phase of the disease. In the current review we will present a rationale for pulmonary rehabilitation in patients with lung fibrosis and the effects of this type of non‐pharmacological intervention on exercise capacity and quality of life. In addition, we will discuss possibilities for palliative care in these patients.
Non‐invasive biomarkers in pulmonary fibrosis
Authors: PRASSE Antje , MÜLLER‐QUERNHEIM Joachim
Published: August 2009

The practise of modern medicine is unthinkable without biological markers, and their adoption is now established in various clinical settings. Pulmonary fibrosis occurs in a heterogeneous group of diseases. IPF is the most frequent fibrotic lung disease and has a poor prognosis. Despite the heterogeneity in underlying diseases multiple common mechanism resulting in pulmonary fibrosis are documented. In this context, several biomarkers for pulmonary fibrosis have been described. Some substances are produced by alveolar epithelial cells such as surfactant proteins A and D, the glycoprotein Krebs von den Lungen 6 Antigen, while others are derived from macrophages such as CCL18. Most recently, increased fibrocyte counts were proposed as a marker of acute exacerbation in IPF. None of these markers is established in clinical practise so far. Studies regarding the clinical value of biomarkers in pulmonary fibrosis are hampered by the fact that fibrotic lung diseases are uncommon and variable in course. However, some markers are clearly promising, and as a spin‐off the analysis of some of these in samples from recently finished pharmacological multicentric studies might give urgently needed information regarding their clinical value.
Host species and plant part specificity of the polyphagous onion thrips, Thrips tabaci Lindeman (Thysanoptera: Thripidae), in an Australian cotton‐growing area
Authors: Milne M , Walter GH
Published: August 2009

We determined the pattern of host plant use of Thrips tabaci by surveying wheat and five weed species growing near cotton crops in the area centred on the Namoi Valley, northern New South Wales. Highest densities of T. tabaci females and larvae were found on inflorescences and vegetative parts of turnip weed, Rapistrum rugosum, and lowest on wheat, Triticum aestivum. The other plant species (Paterson’s curse, Echium plantagineum, curled dock, Rumex crispus, Mayne’s pest, Verbena tenuisecta and sowthistle, Sonchus oleraceus) hosted intermediate densities of T. tabaci. The presence of high densities of reproductive T. tabaci on flowering and vegetative parts of turnip weed suggests that this species is a primary host of T. tabaci in the study area.
Seasonal fluctuations in bodyweight, lipid content and the starvation‐longevity ofAmorbus obscuricornis(Westwood) andGelonus tasmanicus(Le Guillou) (Hemiptera: Coreidae)
Authors: Steinbauer MJ
Published: August 2009

The live weight (LW) and dry weight (DW), lipid and water content and starvation‐longevity of adultAmorbusobscuricornisand adultGelonustasmanicuswere examined in successive seasons.Amorbusobscuricorniswas consistently heavier thanG.tasmanicus. In both species, water content was inversely related to lipid content. The LW, DW and lipid contents ofA.obscuricorniswere lowest in spring. In contrast, LW and DW ofG.tasmanicuswere highest in spring, whereas lipid content was highest in autumn. These differences appear to be related to the reproductive cycles of these species. Starvation‐longevity of both species was affected by relative humidity, being greatest at 99% and declining rapidly below 80%, and by temperature, being greatest forA.obscuricornisat 10.6°C and increasing forG.tasmanicuswith decreasing temperature to 4.5°C. These differences may be related to differences in the habitat preferences of the two species, withG.tasmanicusapparently preferring cooler habitats thanA.obscuricornis. It was considered that the conditions that pre‐wintering adults of either species could withstand would facilitate their hibernation.
Seasonal phenology and distribution in soil in sugarcane fields of the pink ground pearl, Eumargarodes laingi Jakubski, with notes on Promargarodes spp. (Hemiptera: Margarodidae)
Authors: Samson PR , Harris WJ
Published: August 2009

The distribution of cysts of Eumargarodes laingi in soil and the seasonal phenology of the different life stages were examined in sugarcane fields near Bundaberg. Cysts were widely distributed in soil, occurring in equal numbers in both the planting rows of sugarcane and most or all of the inter‐row space. Cysts were smaller at increasing distance from the sugarcane plants. Most cysts were found in the top 20 cm of soil but some occurred to a depth of at least 50 cm. Cysts of Promargarodes spp. were also found in one field. These had a similar lateral distribution to E. laingi but a greater proportion occurred more than 20 cm deep. Adults of E. laingi were found from October to February in the four fields examined in 1993 and 1994. Adults were found in the greatest numbers in November, but they comprised less than 10% of the total E. laingi population at any time. A large number of cysts of all sizes was present throughout the year, and the results indicate that most individuals had a life cycle of at least 2 years. The large reservoir of cysts during the adult emergence period explains why E. laingi has proved difficult to control with insecticides and with cultural methods during this supposedly vulnerable time.
Thermophilia in a tropical Australian ant of the Melophorus aeneovirens (Lowne) species‐group (Hymenoptera: Formicidae)
Authors: Hoffmann Benjamin D
Published: August 2009

Observations were made on the activity of three colonies of a Melophorus species of the aeneovirens species‐group in woodland at Black Jungle, near Darwin in the monsoonal tropics of the Northern Territory. Melophorusaeneovirens displays thermophilic behaviour typical of the genus. Colony activity rates and duration varied between colonies in relation to the microclimatic conditions of the nests. The lowest nest mound temperature at which activity was initiated was 35.2°C; the highest was 45.3°C. Foraging (leaving the nest) did not occur below a threshold of 38°C. Activity levels peaked at around midday. Cessation of activity in the afternoon corresponded with temperatures between 38.3°C and 42.8°C. Activity levels differed between minor and major workers, with the latter most active prior to 10.00 h and the minors most active during the remaining hours of the day. The activity of a single colony of M. aeneovirens was strongly negatively correlated to the activity of the behaviourally dominant ant Iridomyrmex sanguineus. The average foraging time of M. aeneovirens workers was 11 min, the mean furthest displacement from the colony was 9 m and the furthest, 25 m. Melophorus aeneovirens differed from arid and semi‐arid congeners in having year‐round activity, lower initial activity levels, less random and slower foraging, and in not exploiting thermal refugia.
Expatriate Japanese women's growth and transformation through childbirth in Hawaii, USA
Authors: Taniguchi Hatsumi , Magnussen Lois
Published: August 2009

The purpose of this study was to describe the meaning of the childbirth experience for Japanese mothers who gave birth soon after they moved to Hawaii, USA. The research design was descriptive, using Colaizzi's phenomenological approach. The sample consisted of 10 Japanese expatriate women. The major findings of this study consisted of four theme categories: the challenges of living overseas, the challenges of motherhood, reaching the goal of motherhood, and relationships with others. In describing the meaning of their childbirth experience, the new mothers recognized their own parents' efforts in raising them and their love. The new mothers also identified themselves as “irreplaceable” mothers for their new family. They believed that their childbirth experience in Hawaii helped them to become more mature as individuals. The implication arising from this study for caregivers is that it is necessary to understand culturally sensitive care that meets the individual needs of women in each transition.
Gender and culture differences in the quality of life among Americans and Koreans with atrial fibrillation
Authors: Kang Younhee
Published: August 2009

This study examined the gender and culture differences in relation to the quality of life among Americans and Koreans with atrial fibrillation. It employed secondary data analysis and a descriptive comparative design. The settings were the cardiology outpatient clinics and the outpatient clinic in two urban hospitals in the USA and one university hospital in Korea. The quality of life was measured by the Short‐Form Health Survey. The data from 129 subjects were analyzed by two‐way ANCOVA and a post‐hoc test. In relation to physical function, there was a statistically significant effect shown by gender, but no significant differences were found by the main effect of culture and the interaction effect of gender and culture. The significant interaction effect of gender and culture on mental health was shown. In conclusion, gender differences in the quality of life perceived by patients with atrial fibrillation varied with their cultural background. Thus, patients' cultural background should be considered in nursing practice.
Evaluation of the pathogenicity of microorganisms isolated from Egyptian broomrape (Orobanche aegyptiaca) in Israel
Authors: DOR EVGENIA , HERSHENHORN JOSEPH
Published: August 2009

Diseased Egyptian broomrape (Orobanche aegyptiaca) inflorescences were collected from a heavily broomrape‐infested tomato (Lycopersicon esculentum) field in Israel. The microorganisms that were isolated from the diseased inflorescences were passed through Koch's postulates on Egyptian broomrape‐parasitizing tomato roots in a polyethylene bag system and pots under greenhouse conditions. The fungi, Alternaria alternata, Macrophomina phaseolina, Rhizoctonia solani, and Fusarium solani, and the bacterium, Bacillus sp., were newly isolated from the diseased inflorescences of Egyptian broomrape and were found to be pathogenic to the parasite. Fusarium solani damaged all of the developmental stages of broomrape and prevented the damage that Egyptian broomrape causes to tomato plants. The level of pathogenicity and the damage of M. phaseolina, A. alternata, and Bacillus sp. to Egyptian broomrape in greenhouse experiments were relatively low. All the tested microorganisms are known as pathogens of tomato, yet none caused disease symptoms on the tomato plants grown in the inoculated polyethylene bags or in the pots. Fusarium solani demonstrated the highest potential for further development as a mycoherbicide for Egyptian broomrape control in tomato.
Influence of after‐ripening environments on the germination characteristics and seed fate of Italian ryegrass (Lolium multiflorum)
Authors: ICHIHARA MINORU , YAMASHITA MASAYUKI , SAWADA HITOSHI , KIDA YOICHI , ASAI MOTOAKI
Published: August 2009

Italian ryegrass (Lolium multiflorumLam.) is an exotic winter annual weed that recently has seriously infested wheat fields in central Japan. To understand the influence of tillage systems on the germination ecology and seedbank dynamics of naturalized Italian ryegrass, we compared the fate of the seeds that were after‐ripened in the soil with that of the seeds on the soil surface, and then examined the germination characteristics of the seeds retrieved from both treatments by germination tests in both a light/dark (12 h photoperiod) condition and in constant darkness. The seedling emergence was greater initially for the seeds after‐ripened on the soil surface than for the seeds in the soil. The component of emergent seeds after‐ripened on the soil surface increased as time passed during the summer, whereas that of emergent seeds in the soil scarcely increased. This contrasting emergence was, in part, attributable to the ability of the seeds to germinate at higher temperatures in the light/dark condition than in constant darkness. These results suggest that untilled systems, which leave many seeds on the soil surface, might promote the rapid depletion of Italian ryegrass seeds through germination before wheat sowing in early winter. In contrast, seed burial by tillage might inhibit the germination of the seeds and form a large transient seed bank available to germinate during the wheat‐growing season.