bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidermal growth factor induces acute matrix contraction and subsequent calpain‐modulated relaxation
Authors: ALLEN FRED D. , ASNES CLARA F. , CHANG PHILIP , ELSON ELLIOT L. , LAUFFENBURGER DOUGLAS A. , WELLS ALAN
Published: March 2003

During wound healing, dermal fibroblasts switch from a migratory, repopulating phenotype to a contractile, matrix‐reassembling phenotype. The mechanisms controlling this switch are unknown. A possible explanation is suggested by the finding that chemokines that appear late in wound repair prevent growth factor‐induced cell‐substratum de‐adhesion by blocking calpain activation. In this study, we tested the specific hypothesis that fibroblast contraction of the matrix is promoted by a pro‐repair growth factor, epidermal growth factor, and is modulated by calpain‐mediated release of adhesions. We employed an isometric force transduction system designed to measure the contraction of a collagen matrix under tension by a population of NR6 fibroblasts transfected with the human epidermal growth factor receptor. By maintaining a fixed level of strain, we could monitor both the initial contraction and subsequent relaxation of the matrix. Epidermal growth factor stimulated a transient, dose‐dependent increase in matrix contraction that peaked within 60 minutes and then decayed over the ensuing 3 to 6 hours. Calpain inhibitor I (ALLN) prevented epidermal growth factor‐stimulated cell de‐adhesion and resulted in a significantly slower decay of matrix contraction, with only a slight decrease of the peak magnitude of contraction. The mitogen‐activated protein kinase kinase‐1‐selective inhibitor PD 98059 that blocks signaling through the extracellular signal‐regulated kinase/mitogen‐activated protein kinase pathway, required for epidermal growth factor receptor‐mediated activation of calpain and de‐adhesion, does not significantly affect the magnitude of matrix contraction within minutes of epidermal growth factor addition, but slows the decay similarly to calpain inhibition. Epidermal growth factor receptor signaling thus stimulates the complementary mechanisms of intracellular contractile force generation and calpain‐mediated de‐adhesion, which are known to coordinately facilitate cell migration. These findings suggest that calpain can act as a functional switch for transmission of intracellular contractile force to the surrounding matrix, with calpain‐mediated de‐adhesion reducing this transmission and corresponding matrix contraction. Countervailing processes that down‐regulate calpain activation can, accordingly, direct the transition of cell function from locomotion to matrix contraction.
Ratios of activated matrix metalloproteinase‐9 to tissue inhibitor of matrix metalloproteinase‐1 in wound fluids are inversely correlated with healing of pressure ulcers
Authors: LADWIG GLENN P. , ROBSON MARTIN C. , LIU RAN , KUHN M. ANN , MUIR DAVID F. , SCHULTZ GREGORY S.
Published: March 2003

Previous analyses of fluids collected from chronic, nonhealing wounds found elevated levels of inflammatory cytokines, elevated levels of proteinases, and low levels of growth factor activity compared with fluids collected from acute, healing wounds. This led to the general hypothesis that chronic inflammation in acute wounds produces elevated levels of proteinases that destroy essential growth factors, receptors, and extracellular matrix proteins, which ultimately prevent wounds from healing. To test this hypothesis further, pro‐ and activated matrix metalloproteinases (MMP‐2 and MMP‐9), tissue inhibitors of metalloproteinases (TIMP‐1 and TIMP‐2), and the ratios of MMPs/TIMPs were assayed in fluids and biopsies collected from 56 patients with chronic pressure ulcers. Specimens included ulcers treated for 0, 10, and 36 days with conventional therapy or with exogenous cytokine therapies. Quantitative assay data were correlated with the amount of healing. The average MMP‐9/TIMP‐1 ratio in fluids from 56 ulcers decreased significantly as the chronic pressure ulcers healed. Furthermore, the average MMP‐9/TIMP‐1 ratio was significantly lower for fluids collected on day 0 from wounds that ultimately healed well (≥85% reduction in initial wound volume) compared with wounds that healed poorly (<50% wound volume reduction). These data show that the ratio of MMP‐9/TIMP‐1 levels is a predictor of healing in pressure ulcers and they provide additional support for the hypothesis that high levels of MMP activity and low levels of MMP inhibitor impair wound healing in chronic pressure ulcers.
The flow of surface‐derived fluids through Alice Springs age middle‐crustal ductile shear zones, Reynolds Range, central Australia
Authors: Cartwright  , Buick
Published: March 2003

The south‐east Reynolds Range, central Australia, is cut by steep north‐west‐trending Alice Springs age (c. 334 Ma) shear zones that are up to hundreds of metres wide and several kilometres long with reverse senses of movement. Amphibolite facies (550–600 °C, 500–600 MPa) shear zones cut metapelites, while greenschist facies shear zones (420–535 °C, 400–650 MPa) cut metagranites. The sheared rocks commonly underwent metasomatism implying that the shear zones were the pathways of significant fluid flow. Altered granites within greenschist facies shear zones have gained Si and K but lost Ca and Na relative to their unsheared counterparts, suggesting that the fluid flowed down‐temperature (and hence probably upward) through the shear zones. Time‐integrated fluid fluxes calculated from silica addition are up to 2.1×1010 mol m−2 (c. 4.2×105 m3 m−2). Similar time‐integrated fluid fluxes are also estimated from changes in K and Na. The sheared granitic rocks locally have δ18O values as low as 0 which is much lower than the δ18O values of the adjacent unsheared granites (7 to 9), implying that the fluid which flowed through these shear zones was derived from the surface. For the estimated time‐integrated fluid fluxes, the fluids would be able to retain their isotopic signature for many tens to hundreds of kilometres. The flow of surface‐derived fluids into the ductile middle crust, with subsequent expulsion upwards through the shear zones, may have been driven by seismic activity accompanying the Alice Springs deformation.
Causes of the uniformly high crystallinity of graphite in large epigenetic deposits
Authors: Pasteris
Published: March 2003

In low‐pressure environments, precipitation of graphite is hindered at low to moderate temperatures by the high solubility of carbon in C‐O‐H fluids and by kinetic barriers to nucleation. Those low‐temperature fluids that do attain saturation tend to precipitate graphite continuously during flow and cooling, thereby producing widely dispersed films of low‐crystallinity graphite. In contrast, at high temperatures, particularly when combined with high pressures, the precipitation of graphite is enhanced by decreased solubility of carbon in C‐O‐H fluids and by improved nucleation under those conditions. The longevity of fluid systems in high‐temperature, high‐pressure terranes permits efficient, long‐term scavenging of dispersed carbon from the crust. The latter may be redistributed in a much more concentrated form as fluids rise, cool and decompress, and as the carbon is finally precipitated as highly crystalline graphite in fracture systems. The combined effects of the thermochemical controls on carbon solubility and the geological controls on fluid generation, movement and P–T  pathways are the reason that large, epigenetic graphite deposits form dominantly at high temperatures and pressures. Those high‐temperature, high‐pressure conditions, in turn, account for the uniformly high crystallinity of the fluid‐deposited graphite.
Evolution of the Pan‐African Wadi Haimur metamorphic sole, Eastern Desert, Egypt
Authors: Abd El‐Naby H. , Frisch W. , Hegner E.
Published: March 2003

By comparison with the general features of metamorphic soles (e.g. vertical and lateral extension, metamorphic grade and diagnostic mineral parageneses, deformation and dominant rock types), it is inferred that the amphibolites, metagabbros and hornblendites of the Wadi Um Ghalaga–Wadi Haimur area in the southern part of the Eastern Desert of Egypt represent the metamorphic sole of the Wadi Haimur ophiolite belt. The overlying ultramafic rocks represent overthrusted mantle peridotite. Mineral compositions and thermobarometric studies indicate that the rocks of the metamorphic sole record metamorphic conditions typical of such an environment. The highest P–T conditions (c. 700 °C and 6.5–8.5 kbar) are preserved in clinopyroxene amphibolites and garnet amphibolites from the top of the metamorphic sole, which is exposed in the southern part of the study area. The massive amphibolites and metagabbros further north (Wadi Haimur) represent the basal parts of the sole and show the lowest P–T  conditions (450–620 °C and 4.7–7.8 kbar). The sole is the product of dynamothermal metamorphism associated with the tectonic displacement of ultramafic rocks. Heat was derived mainly from the hot overlying mantle peridotites, and an inverted P–T  gradient was caused by dynamic shearing during ophiolite emplacement. Sm/Nd dating of whole‐rock–metamorphic mineral pairs yields similar ages of c. 630 Ma for clinopyroxene and hornblende, which is interpreted as a lower age limit for ophiolite formation and an upper age limit for metamorphism. A younger Sm/Nd age for a garnet‐bearing rock (c. 590 Ma) is interpreted as reflecting a meaningful cooling age close to the metamorphic peak. Hornblende K/Ar ages in the range 570–550 Ma may reflect thermal events during late orogenic granite magmatism.
Kinetics of decompressional reactions in eclogitic rocks – formation of plagioclase coronas around kyanite
Authors: Nakamura D.
Published: March 2003

This paper describes a kinetic study on reaction textures in eclogitic rocks from the Sulu region, eastern China. Some of the eclogitic rocks display a decompressional reaction texture, whereby kyanite grains are surrounded by plagioclase coronas and are never in contact with quartz. The change in mineral parageneses with progress of the reaction was predicted by constructing chemical potential diagrams in a model system. The chemical potential diagrams indicated that the chemical potential of 2Na2O + CaO (2µNa2O + µCaO) in intergranular regions between kyanite and quartz should decrease with decreasing pressure, whereas 2µNa2O + µCaOin intergranular regions between garnet and omphacite should increase with decreasing pressure. Thus, upon decompression, an inequality in chemical potential arises in the rock. To reduce this inequality, garnet and omphacite react to produce amphibole and plagioclase and release Na2O and CaO. Then, the released Na2O and CaO components diffuse into the regions between kyanite and quartz grains and react to produce plagioclase between them. This model also indicates that the chemical potential of SiO2should decrease around kyanite grains during the progress of the decompressional reaction, and Si‐undersaturated conditions should have formed around kyanite grains in spite of the presence of quartz in these eclogitic rocks. Thus, spinel or corundum that are not stable in the system with excess quartz can form as a metastable phase, as observed in eclogitic rocks from the study areas. Phase diagrams in the system with excess quartz should be carefully applied for analysis of such reaction textures.
Exhumation of the Schistes Lustrés complex: in situ laser probe 40Ar/39Ar constraints and implications for the Western Alps
Authors: Agard P. , Monié P. , Jolivet L. , Goffé B.
Published: March 2003

The Schistes Lustrés (SL) suture zone occupies a key position in the Alpine chain between the high‐pressure (HP) Brianconnais domain and the ultrahigh‐pressure (UHP) Dora Maira massif, and reached subduction depths ranging from c. 40–65 km (Cottian Alps). In order to constrain the timing of HP metamorphism and subsequent exhumation, several phengite generations were differentiated, on the basis of habit, texture, paragenesis and chemistry, as belonging to the first or second exhumation episode, respectively, D2 or D3, or to earlier stages of the tectono‐metamorphic evolution.

 Ten carefully selected samples showing D2, D3 (D2 + D3), or earlier (mostly peak temperature) phengite population(s) were subjected to laser probe 40Ar/39Ar analysis. The data support the results of the petrostructural study with two distinct age groups (crystallization ages) for D2 and D3 phengite, at 51–45 and 38–35 Ma, respectively. The data also reveal a coherent age cluster, at 62–55 Ma, for peak temperature phengite associated with chloritoid which were preserved in low strain domains.

 The age of the D3 event in the SL complex appears very similar to ages recently obtained for greenschist facies deformation on the border of most internal crystalline massifs. Exhumation rates of the order of 1–2 mm yr−1 are obtained for the SL complex, which are compatible with velocities documented for accretionary wedge settings. Similarly, cooling velocities are only moderate (c.5 °C Myr−1), which is at variance with recent estimates in the nearby UHP massifs.
Large‐scale melt‐depletion in granulite terranes: an example from the Archean Ashuanipi Subprovince of Quebec
Authors: Guernina S. , Sawyer E. W.
Published: March 2003

This study uses field, petrographic and geochemical methods to estimate how much granitic melt was formed and extracted from a granulite facies terrane, and to determine what the grain‐ and outcrop‐scale melt‐flow paths were during the melt segregation process. The Ashuanipi subprovince, located in the north‐eastern Superior Province of Quebec, is a large (90 000 km2) metasedimentary terrane, in which > 85% of the metasediments are of metagreywacke composition, that was metamorphosed at mid‐crustal conditions (820–900 °C and 6–7 kbar) in a late Archean dextral, transpressive orogen. Decrease in modal biotite and quartz as orthopyroxene and plagioclase contents increase, together with preserved former melt textures indicate that anatexis was by the biotite dehydration reaction: biotite + quartz + plagioclase = melt + orthopyroxene + oxides. Using melt/orthopyroxene ratios for this reaction derived from experimental studies, the modal orthopyroxene contents indicate that the metagreywacke rocks underwent an average of 31 vol% partial melting.

The metagreywackes are enriched in MgO, CaO and FeOt and depleted in SiO2, K2O, Rb, Cs, and U, have lower Rb/Sr, higher Rb/Cs and Th/U ratios and positive Eu anomalies compared to their likely protolith. These compositions are modelled by the extraction of between 20 and 40 wt %, granitic melt from typical Archean low‐grade metagreywackes. A simple mass balance indicates that about 640 000 km3 of granitic melt was extracted from the depleted granulites.

The distribution of relict melt at thin section‐ and outcrop‐scales indicates that in layers without leucosomes melt extraction occurred by a pervasive grain boundary (porous) flow from the site of melting, across the layers and into bedding planes between adjacent layers. In other rocks pervasive grain boundary flow of melt occurred along the layers for a few, to tens of centimetres followed by channelled flow of melt in a network of short interconnected and structurally controlled conduits, visible as the net‐like array of leucosomes in some outcrops. The leucosomes contain very little residual material (< 5% biotite + orthopyroxene) indicating that the melt fraction was well separated from the residuum left in situ as melt‐depleted granulite. Only 1–3 vol percentage melt remained in the melt‐depleted granulites, hence, the extraction of melt generated by biotite dehydration melting in these granulites, was virtually complete under conditions of natural melting and strain rates in a contractional orogen.
ACID‐BASE IN RENAL FAILURE: A Review of the Effects of Correction of Acidosis on Nutrition in Dialysis Patients
Authors: Brady John P. , Hasbargen James A.
Published: March 2003

Metabolic acidosis is a condition that is commonly encountered in both chronic renal failure (CRF) and in end‐stage renal disease (ESRD). Known complications and surmised consequences associated with the acidosis of renal disease include bone lesions, depression of myocardial contractility, and growth retardation. Conversely the correction of acidosis in children with renal tubular acidosis improves growth velocity. This is also the case in children with CRF. The conclusion drawn from this study was that the correction of metabolic acidosis improved serum albumin concentrations in patients on hemodialysis and that this correction also induced a decrease in the nPCR.
Effect of Hemodialysis Membranes on β2‐Microglobulin Amyloidosis
Authors: Jaradat Majd I. , Moe Sharon M.
Published: March 2003

Early after the identification of β2‐microglobulin amyloidosis (Aβ2M) as the cause of carpal tunnel syndrome, it was thought that hemodialysis was a major cause in the development of the disease. It was subsequently shown that hemodialysis was not necessary for the development of dialysis‐related amyloidosis; however, it was believed that the different dialysis membranes did modulate the progression of the disease. Current data demonstrate that hemodialysis fails to prevent or reverse the disease, but there is substantial evidence that high‐flux, high‐efficiency dialyzers slow its progression. Many factors related to hemodialysis have been evaluated in relation to Aβ2M, including the effect of the bioincompatibility of the membrane, the capacity of the different membranes to remove β2M, and the effect of reuse on β2M levels. Moreover, there have been intensive efforts to evaluate, explore, and improve the different mechanisms in β2M removal, with adsorption as a promising prospect. With the available evidence, it seems that the removal of β2M by the membrane plays the most important role in modulating the disease outcome and rate of progression, although a large, long‐term, multicentered and randomized study is still lacking to prove this relationship. However, it is possible that with the continuing advances in optimizing the β2M removal efficiency of the different membranes, the frequency and severity of the disease can be substantially decreased.
Screening for Subclinical Nephropathy in Relatives of Dialysis Patients
Authors: Satko Scott G. , Freedman Barry I.
Published: March 2003

Despite the availability of improved medical therapy to slow the progression of nephropathy, a worldwide epidemic of end‐stage renal disease (ESRD) exists. Many patients are not diagnosed until the late stages of disease, as early kidney disease may be asymptomatic. Ideally all adults would be routinely screened for evidence of early kidney disease and associated risk factors such as hypertension and diabetes mellitus. Unfortunately this would be a massive and expensive undertaking. A more practical, cost‐effective solution might be to direct screening at those individuals who are known to be at high risk for the development of nephropathy. The familial clustering of ESRD has been reported for many types of renal disease. We propose that the routine screening of first‐ and second‐degree relatives of ESRD patients for nephropathy might be an efficient way to detect subclinical renal disease. Early detection and intensive treatment of renal disease may help to curb the current epidemic of ESRD.
Concepts in the Interpretation of Dialysis Literature Series Editor: Lynda Anne Szczech: An Introduction to Epidemiology and Biostatistics and Issues in Interpretation of Studies
Authors: Szczech Lynda Anne , Coladonato Joseph A. , Owen Jr William F.
Published: March 2003

Epidemiology is the basic medical science that focuses on the distribution and determinants of disease frequency in human populations. An understanding of the tools of epidemiology is helpful in defining the limitations of medical research and evaluating the conclusions of studies. This is the first in a series of three articles whose objective will be to present the basic concepts of epidemiology and biostatistics. Examples of each of the tools and limitations discussed from studies of patients with end‐stage renal disease (ESRD) will be presented to provide the reader with a practical application of the concepts. This series of articles will help the reader to weigh methods and study designs to understand the appropriate conclusions that may be drawn from any data.
Automated Peritoneal Dialysis Symposium: Role of APD in Compliance with Therapy
Authors: Raj Dominic S. C.
Published: March 2003

Lack of compliance with prescribed treatment is an important cause of inadequate dialysis in patients on peritoneal dialysis (PD). The reported prevalence of noncompliance with treatment in PD varies from 5 to 38%. The predictors of noncompliance, its consequences, methods to identify and monitor compliance, differences in frequency between continuous ambulatory PD (CAPD) and automated PD (APD), and management are reviewed. The risk of noncompliance is greater in CAPD than in APD. Noncompliance should be managed by patient education and appropriate modification of therapy, including consideration of APD.
Comparative Analysis of the Role of Prostate Specific Antigen Parameters in Clinical Practice
Authors: Lynn Naing N. K. , Collins Gerald N. , Alexandrou Kyriakos , Brown Stephen C. W. , Brooman Peter J. C. , O'reilly Patrick H
Published: March 2003

Introduction: Serum prostate specific antigen at the cutoff levels of 4 ng/ml has low specificity for prostate cancer. We evaluated various PSA parameters (i.e., total PSA density [tPSAD], free PSA density [fPSAD], the ratio of free to total PSA [f/t ratio], and age‐specific PSA) in terms of cancer diagnosis and reducing the number of negative results for prostatic biopsies.

Materials and Methods: A series of 305 patients was studied. Serum tPSA and fPSA levels were measured. Prostate volume was measured with transrectal ultrasound, and sextant biopsies were performed. The f/t ratio, tPSAD, and fPSAD were calculated. Sensitivity and specificity were calculated for age‐specific PSA. Receiver operating characteristic curve analysis was used to analyze the diagnostic performance of these PSA parameters. A subpopulation of patients with serum PSA levels between 4 and 10 ng/ml also was analyzed with a specific view to reducing negative results of biopsies. The Mann‐Whitney U test was used to analyze the difference in these parameters between patients with benign and malignant histologies.

Results: There was significant difference in these PSA parameters between patients with benign and malignant histologies (p < 0.05). tPSAD had the largest area under the curve for total population as well as for patients with tPSA levels between 4 and 10 ng/ml. Although the f/t ratio had a larger area under the curve than did tPSA assay in patients with PSA levels between 4 and 10 ng/ml, the difference was not statistically significant. Using a tPSAD of 0.12 ng/ml/ml as the cutoff level of negative results of prostate biopsies could be reduced by 37% in patients with PSA levels between 4 and 10 ng/ml. Although the f/t ratio could reduce negative results of biopsies by 33.8% at the cutoff value of 0.26, 15.6% of cancers would be missed. Age‐specific PSA could reduce 31% of negative prostatic biopsies, but 28% of cancers would be missed. Using combined tPSAD and the f/t ratio did not improve reductions of negative biopsy results.

Conclusion: tPSA density has the highest sensitivity and specificity in differentiating benign from malignant prostates. By using tPSA density, negative results of prostate biopsies can be reduced by 37%, while missing only a small number of cancers.
Cost Analyses of Home Care and Nursing Home Services in the Southern Taiwan Area
Authors: Chiu Lian , Tang Kwong‐Yui , Shyu Woei‐Cherng , Huang Chan‐Ling , Wang Shiou‐Ping
Published: March 2003

This study compares the cost of long‐term care provided at patient homes with that of long‐term care provided in nursing homes in southern Taiwan. Caring for a patient with a high degree of dependence at home is more expensive than caring for a patient in a nursing home facility when family costs and provider costs are considered together. This phenomenon is not demonstrated for patients with medium degrees of dependence. To be cost‐effective, home care services should target patients with medium physical disability, and nursing home care should focus on patients with high levels of dependence.
Prenatal Risk Factors Among Foreign‐Born Central American Women: A Comparative Study
Authors: Gaffney Kathleen F
Published: March 2003

The purpose of this study was to compare the incidence of empirically established prenatal risk factors for low birthweight (LBW) outcomes among two groups of low‐income mothers: foreign‐born Central American women and nonimmigrant, non‐Hispanic women. Two hundred ninety‐six women who were part of a larger study of maternal role sufficiency were included in the present study: 127 Central American women and 169 nonimmigrant, non‐Hispanic women who identified themselves as Black (n= 59) or White (n= 110). Data were collected by public health nurses (PHNs) during home visits and by research nurses in prenatal health department clinics. Comparisons were made between the two groups in areas of demographic characteristics, prenatal health behaviors, and prenatal stressful life‐events. Foreign‐born Central American mothers were found to be less educated, more likely to be living with their partners, less likely to engage in prenatal health risk behaviors, and less likely to identify stressors in their lives. The initiation of prenatal PHN services by the target group was similar to the comparison group. Their rate of LBW deliveries did not reflect the protective effect often attributed to foreign‐born Hispanic mothers. Findings are discussed in light of the paradox of LBW and Hispanic heritage. Recommendations for practice, clinical research, and public policy are also addressed.
Home Hygiene Practices and Infectious Disease Symptoms Among Household Members
Authors: Larson Elaine , Duarte Cabilia Gomez
Published: March 2003

Public health programs are generally targeted to communitywide, population‐based prevention strategies, with little attention focused on the home environment as one potential source of transmission of infectious diseases. The purpose of this correlational prevalence survey was to describe the relationship between home hygiene practices and prevalence of infectious disease symptoms among household members. Three hundred and ninety‐eight households with 1,662 members in an inner‐city population (96.4% Hispanic) were surveyed to examine hygiene practices and determine the presence of transmission of infection, defined as the presence of the same symptom(s) in two or more household members for which at least one individual sought medical attention and received treatment. At least one individual in 78.6% of households reported symptoms of infection in the previous 30 days, and 37.9% of households met the definition of disease transmission. In univariate analyses, five factors were significantly associated with risk of household transmission, but in the logistic regression model, only use of communal laundry (p= 0.009) and lack of bleach use (p= 0.04) were significantly predictive of increased risk of transmission. This is the first comprehensive survey of home hygiene practices and the first study to identify a potential link between laundry and risk of disease transmission in homes. This potential link warrants further study in clinical trials.
Building Academic and Practical Knowledge in Nursing Through TB Skin Testing Certification in a BSN Curriculum
Authors: Stone Cynthia L
Published: March 2003

Tuberculosis (TB) is a communicable disease with worldwide health care consequences. After decades of declining incidence there was a 14% increase in the United States from 1985 to 1992, although rates are now declining due to focused programs. The State of Indiana mandates continuous TB monitoring by health care workers who have completed an educational course. The Indiana State Department of Health (ISDH) and the American Lung Association designed an educational program called a Basic TB Skin Test Course, which is used by the Community Health Nursing faculty at Indiana University School of Nursing (IUSON) in the baccalaureate curriculum to assist students in meeting state requirements. All students receive the didactic TB content of the course in the epidemiological concepts unit. Students can elect to receive certification by attending an additional 2‐hour clinical session. Over 500 community health nursing students have completed the Basic TB Skin Test course in the past 5 years. The outcomes are positive for students, community, and public health.
Perceived Health Needs of Urban African American Church Congregants
Authors: Baldwin Kathleen A. , Humbles Patricia L. , Armmer Francesca A. , Cramer Marilee
Published: March 2003

Theory‐based assessment of congregant expectations and needs should be conducted prior to beginning a parish nurse program. However, no such assessments are found in the literature. Using Andersen's Health Access Model as a framework, investigators conducted interviews with 117 randomly selected congregants in five urban African American churches to describe their perceived needs and expectations. Causing most concern were the following: (a) symptoms of illness—high blood pressure (50.4%), dental problems (43.6%), and back pain (41%); and (b) health habits/risks—weight (75%), exercise (63%), and diet (63%). Younger adults were significantly more concerned about all aspects of their health than their older counterparts. Women were significantly more likely to express concern about health habits and health risks than males. No significant relationship was found between perceived need and access to care. Although terming health care services “adequate”, congregants expressed many unmet health needs. This seemingly contradictory finding may illuminate a concrete role for the parish nurse, i.e., addressing personal health care concerns not alleviated by the current “adequate” health care delivery system. This study's significance lies not only in providing programming guidance, but also in theoretical insights into the role of the parish nurse.
Incontinence in a Manufacturing Setting: Women's Perceptions and Responses
Authors: Kirkland Victoria L. , Palmer Mary H. , Fitzgerald Sheila T.
Published: March 2003

The true prevalence of urinary incontinence (UI) and its impact on the quality of life in working women are not well established. Many women do not report UI to a health care provider because they mistakenly believe UI is a natural part of aging. This situation exists despite the dissemination of a national guideline for UI in adults. The aims of this study were to (1) explore what incontinent women in a manufacturing setting name or identify as the proposed cause of urinary leakage (2) analyze an association between identifying a UI cause and reporting it to a health care provider and (3) determine how many women were aware of the AHCPR Guideline. The results indicate that the majority of incontinent women (62%) have not reported this to a health care provider. Most women attributed urinary leakage to parity and waiting too long to empty the bladder. There was no relationship between identifying a UI cause and reporting it to a health care provider. Only 2 of the women out of 78 had heard of the AHCPR Guideline but the majority of women wanted more information about UI (85%). Mechanisms are suggested for querying women with UI and disseminating the AHCPR Guideline.
Interagency Relationships Among Rural Early Intervention Collaboratives
Authors: Polivka Barbara J. , Dresbach Sereana Howard , Heimlich Joe E. , Elliott Michael
Published: March 2003

Interagency collaboration is used to coordinate services and programs, pool resources, or achieve goals. This study utilizes the Interagency Collaboration Model to assess interagency relationships of Early Intervention (EI) collaboratives in three rural Ohio counties. The model includes five constructs: environmental factors (broader community environment), situational factors (organizational factors), task characteristics (project's scope and complexity), interagency processes (between agency processes), and outcomes (end products). Respondents from 42 agencies completed the 18‐item Interagency Collaboration Assessment Tool (ICAT) and demographic questions. The ICAT uses a 5‐point Likert‐type scale to assess the five domains of the model. Respondents included public health nurses, representatives from schools, social service agencies, and hospitals. State policies were perceived as encouraging local interagency collaboration; respondents knew staff and goals of other agencies, but agencies did not share funding sources or provide similar services. Diverse specialists were needed to accomplish goals. Some information was exchanged between agencies. Interagency activities were not perceived to be well coordinated and outcomes were only moderately positive. Path analysis revealed that interagency processes were directly affected by environmental and situational factors, but not task characteristics (R2= 0.42). Situational factors, and interagency processes predicted outcomes (R2= 0.60). Awareness of personnel, goals and services of other agencies were key to positive interagency process and perceived outcomes.
The Influence of the Hypertensive Patient's Education in Compliance with Their Medication
Authors: Saounatsou Maria , Patsi Ourania , Fasoi Georgia , Stylianou Maria , Kavga Anna , Economou Ourania , Mandi Panagiota , Nicolaou Maria
Published: March 2003

The purpose of this study was to examine the relationships between patient's education in compliance with their medical regimen and the external variables: (1) “years of schooling,” (2) duration of treatment, and (3) compliance with the medical regimen. The hypothesis tested in this study was as follows: “Hypertensive individuals who are educated about the importance of their medication and about the consequences of not taking the prescribed dosage will show better compliance with their prescribed drug regimen than those who are not thus educated.” The sample of the study consisted of 40 hypertensive patients. A “posttest‐only” control group design was used in this study. The hypothesis of the study was tested by using the Mann‐Whitney U test. For the relationship between the external variables (years of schooling, duration of treatment, and compliance with the medical regimen), the Spearman test was used. The findings of the study revealed a statistically significant difference between compliance levels in the experimental group and in the control group (U= 130, p < 0.05), a positive correlation between “years of schooling” and compliance (rs= 0.33, p= 0.04), and a negative correlation between duration of treatment and compliance (rs=–0.45, p= 0.005). The findings support the hypothesis of the study.
Effectiveness of a Mobile Medical Van in Providing Screening Services for STDs and HIV
Authors: Liebman Jon , Pat Lamberti Mary , Altice Frederick
Published: March 2003

This retrospective study assesses the efficacy of a mobile medical van in screening high risk individuals and identifying new cases of HIV and other sexually transmitted diseases (STDs) in an urban setting from July 1996 through March 1997. High risk sex and drug use were common, while consistent condom use was rare. Relatively few patients were screened for STDs; positive cases represented only a small proportion of the STD cases identified in the study community. The mobile program, however, accounted for 11.5% of all HIV tests conducted at public test sites in the city. Mobile medical programs have the potential to improve STD and HIV control efforts by providing services to high risk individuals who may lack access to care elsewhere. Doing so, however, will require more active case finding techniques, including new, less invasive techniques to test asymptomatic individuals.
Mexican American Elders' Use of Skilled Home Care Nursing Services
Authors: Crist Janice D.
Published: March 2003

Hispanic elders use skilled home care nursing (SHCN) services less often than Anglo elders. The purpose of this study was to identify factors that influence whether disabled Mexican American elders decide to use SHCN services. The research process included reviewing the historical context in one Mexican American community, interviewing key and primary informants, presenting a report to the community and getting feedback, and assessing whether the community perceived a need for increased use of SHCN services by their disabled elders. Seven barriers to the use of SHCN services were identified: expectations of discrimination, lack of knowledge about services, expectations embedded in familism, lack of sense of prevention, lack of health insurance, preference for traditional remedies, and neglect/abuse. A community advisory committee validated the barriers identified during interviews and the need for increased use of SHCN services. Results provide new insight into the sociopolitical and cultural complexities that influence health care utilization decisions by Mexican American elders and their families and uncover traditional, oversimplified beliefs and practices by mainstream professionals and policymakers. Interventions that decrease inequities in a southern Arizona community may be transferable to other vulnerable populations in the United States and globally.
Population‐Based Osteoporosis Education for Older Women
Authors: Curry Linda C. , Hogstel Mildred O. , Davis Gail C. , Frable Pamela J.
Published: March 2003

Abstract With an increased focus on wellness and health promotion, there is a need for community‐based strategies to complement traditional strategies aimed at improving individual and aggregate health. An educational program on the prevention, diagnosis, and treatment of osteoporosis was provided for 188 women age 60 and older in three different community settings: churches, retirement homes, and senior citizen centers. The major purposes of the study were to determine whether a community‐based program might (a) contribute to older women's knowledge about osteoporosis and (b) promote their intent to use this knowledge. Each participant completed a demographic profile, the Osteoporosis Risk Checklist, and the Osteoporosis Knowledge Questionnaire (OKQ), with the OKQ serving as a pre‐ and post‐test. Before post‐testing, a 30‐min educational program was provided. Differences among the three groups were risk factors, prior knowledge about osteoporosis, and knowledge at the completion of the program. A majority of the clients indicated an intent to increase calcium in their diet, discuss osteoporosis with their health care provider, check their home environment for safety/falls, and discuss what they had learned with others. Nurses need to plan educational programs in all settings to teach older clients about the risk factors, prevention, diagnosis, and treatment of osteoporosis.
Factors Associated with Adolescent Pregnancy— A Sample of Taiwanese Female Adolescents
Authors: Wang Ruey‐Hsia , Wang Hsiu‐Hung , Hsu Min‐Tao
Published: March 2003

Abstract This study was designed to explore the factors that differentiate sexually experienced teenagers who become pregnant from those who do not. The study examined the differences between pregnant and never‐pregnant female adolescents in personal background characteristics, family characteristics, substance use, contraceptive attitude, contraceptive knowledge, contraceptive self‐efficacy, sexual history, and effective contraceptive use. Sexually experienced but never‐pregnant female adolescents were selected from two vocational high schools. Pregnant adolescents were recruited by convenience sampling from obstetric clinics and health stations in Tainan City, Taiwan. Multiple logistic regression analysis identified six factors associated with pregnancy: poor contraceptive knowledge, poor contraceptive self‐efficacy, low socioeconomic status, low effective contraceptive use scores, more frequent sexual intercourse, and older age. The results of this study provide health professionals with information to develop more‐effective prevention and intervention programs to reduce adolescent pregnancy. The results also could be used as a reference for related research and policy development in other countries.
Rubinstein–Taybi Syndrome and Ulerythema Ophryogenes in a 9‐Year‐Old Boy
Authors: Centeno Pilar Gómez , Rosón Elena , Peteiro Carmen , Pereiro Ma. Mercedes , Toribio Jaime
Published: March 2003

Rubinstein–Taybi syndrome is characterized by the presence of a peculiar facies, mental retardation, and broad thumbs and great toes. Several associated cutaneous abnormalities have been reported with this syndrome. Ulerythema ophryogenes is a form of follicular keratosis associated occasionally with other ectodermal defects and congenital anomalies. We describe a 9‐year‐old child with Rubinstein–Taybi syndrome and ulerythema ophryogenes. This association has not been described previously to our knowledge.
The Natural History of Primary Herpes Simplex Type 1 Gingivostomatitis in Children
Authors: Amir J. , Harel L. , Smetana Z. , Varsano I.
Published: March 2003

Abstract: Herpetic gingivostomatitis is the most common specific clinical manifestation of primary herpes simplex infection in childhood. The aim of the present study was to describe the clinical signs, symptoms, viral shedding, serologic findings, and complications in communityacquired gingivostomatitis. We prospectively followed children with herpes simplex type 1 gingivostomatitis lasting less than 72 hours. Clinical examination and viral culture were repeated every 2 to 3 days as long as symptoms or signs persisted. Thirty‐six children (ages 12–77 months) were included in the study. Mean duration of oral lesions was 12.0 ± 3.4 days; extraoral lesions (in 26 children), 12.0 ± 3.9 days; fever, 4.4 ± 2.4 days; and eating/drinking difficulties, 9.1 ± 3.0 and 7.1 ± 3.1 days, respectively. In all children, viral cultures of the oral lesions were positive for herpes simplex virus (HSV) type 1; viral shedding persisted for a mean of 7.1 ± 2.5 days (range 2–12 days). The main complications were dehydration, with three children hospitalized for intravenous rehydration, and one case of secondary bacteremia. Herpetic gingivostomatitis is a relatively severe manifestation of primary HSV type 1 infection in young children.
Childhood Lichen Planus: A Report of Fifty Cases
Authors: Sharma Rajeev , Maheshwari Veena
Published: March 2003

Abstract: Lichen planus is an uncommonly encountered dermatosis in children. In the present study of 50 children the limbs were the most common site of involvement (70.0%). A majority of the children (60.0%) presented with the classic form of the disease. Hypertrophic lesions were present in 26.0% of children while linear lesions were seen in 8.0%. There was no scalp, nail, or hair involvement in any child. The Koebner phenomenon was observed in 28.0%, and mucosal involvement, which is very uncommon in children affected by lichen planus, was seen in 30.0%. In this subset of children, hypertrophic lesions were seen in 53.4% while widespread disease was present in only 6.7%. The response to treatment and the course of the disease were similar to that seen in adults.
Proceedings of the 1998 Meeting of the Society for Pediatric Dermatology
Authors: Duarte Ana M. , BOLOGNIA JEAN L.
Published: March 2003

The Society for Pediatric Dermatology held its annual meeting in Cambridge, Massachusetts, on July 23–26, 1998. Selected summaries of presentations at the meeting follow.
Selective Antibody Deficiency to Bacterial Polysaccharide Antigens in Patients with Netherton Syndrome
Authors: Stryk Steve , Siegfried Elaine C. , Knutsen Alan P.
Published: March 2003

Three patients with Netherton syndrome, recurrent sinopulmonary infections, and humoral immune deficiency are described. Although quantitative serum immunoglobulin levels were generally normal, two patients had selective antibody deficiency to bacterial polysaccharide antigens, one associated with IgA–IgG‐2 deficiency. A third patient had an antibody deficiency to protein antigens. This is the first report, to our knowledge, that describes antibody deficiency in patients with Netherton syndrome. This finding demonstrates the importance of evaluating functional antibody responses to both protein and bacterial polysaccharide antigens and not relying on IgG subclass determination.
Lymphomatoid Granulomatosis in a 4‐Year‐Old Boy
Authors: LeSueur Benjamin W. , Ellsworth Lansing , Bangert Jerry L. , Hansen Ronald C.
Published: March 2003

Abstract: Lymphomatoid granulomatosis is a necrotizing angiocentric and angiodestructive infiltrative process involving primarily the lung, skin, central nervous system, and kidney. The incidence is highest in middle‐aged men and is rare in children. We report a case of lymphomatoid granulomatosis involving both skin and lung in a 4‐year‐old boy. The disease progressed to peripheral T‐cell lymphoma, which was unusual in light of recent evidence suggesting a B‐cell origin in the majority of cases.
Congenital Midline Cervical Cleft: Case Report and Review of the English Language Literature
Authors: Eastlack Jennifer P. , Howard Renee M. , Frieden Ilona J.
Published: March 2003

Abstract: Congenital midline cervical cleft is a rare anomaly of the ventral neck that heretofore has not been reported in the dermatology literature. We present a case of a midline cervical cleft that was diagnosed and managed at an early age. We also review the literature and discuss its clinical and histologic features, treatment, and possible embryology.
Gianotti–Crosti Syndrome in an Infant Following Immunization
Authors: Murphy Lesley‐Ann , Buckley Colin
Published: March 2003

Abstract: Gianotti–Crosti syndrome (GCS) is a distinctive, self‐limiting acropapular or papulovesicular eruption. Typical clinical presentation is that of a monomorphic, nonpruritic eruption most commonly involving the face, neck, buttocks, and extremities. It tends to occur in childhood, though infrequently it has been reported in adults. We report GCS occurring in an infant following immunization.
Verrucous Hemangioma: Report of Two Cases and Review of the Literature
Authors: Calduch Luis , Ortega Carmen , Navarro Virgilio , Martínez Esperanza , Molina Inmaculada , Jordá Esperanza
Published: March 2003

Abstract: Verrucous hemangiomas are usually congenital lesions which typically present as warty, bluish, vascular papules, plaques, or nodules, mainly on the lower limbs of children. They show no tendency to spontaneous resolution, and tend to spread and recur after inadequate treatments. We report two instances of verrucous hemangioma, one in an adult and one in a child, discuss the clinical, histopathologic, and therapeutic aspects of this entity, and review the literature.
Virginal Breast Hypertrophy
Authors: O'hare Patricia M. , Frieden Ilona J.
Published: March 2003

Abstract: Macromastia is the massive enlargement of the breast, unilateral or bilateral, disproportional to growth in the remainder of the body. Most patients seen with macromastia have breasts that develop normally at puberty but simply reach excessive size. Virginal breast hypertrophy is a rare and distinct disorder with the rapid onset of macromastia at the onset of puberty. Although the disorder has been reported in the surgical, pediatric, and gynecologic literature, virginal breast hypertrophy has not been reported in dermatologic journals. We report two cases of virginal breast hypertrophy. Patient 1 is a 14‐year‐old girl who developed macromastia 6 months after a liver transplant for α 1‐antitrypsin deficiency. She had intense erythema as well as verrucous hyperplasia overlying the breasts. Patient 2 was a 12‐year‐old girl who experienced severe bilateral breast enlargement 4 months after beginning treatment for thyrotoxicosis. She had extreme tenderness, erythema, and edema of the breasts and was treated with tamoxifen citrate, with improvement of her symptoms. Although virginal breast hypertrophy is a rare disorder, the dermatologist may be asked to consult on the associated skin changes in these cases and should be aware of its existence. The definitive therapy is surgical, but until breast growth is stabilized, cutaneous manifestations need to be managed.