bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences Between Exclusive Breastfeeders, Formula-Feeders, and Controls: A Study of Stress, Mood, and Endocrine Variables
Authors: Groër Maureen W.
Published: November 2005

The purpose of this study was to examine relationships among lactational status, naturalistic stress, mood, and levels of serum cortisol and prolactin and plasma adrenocorticotropic hormone (ACTH). Eighty-four exclusively breastfeeding, 99 exclusively formula-feeding, and 33 nonpostpartum healthy control women were studied. The postpartum mothers were studied cross-sectionally once between 4 and 6 weeks after the birth. Stress was measured using the Perceived Stress Scale, the Tennessee Postpartum Stress Scale, and the Inventory of Small Life Events. Mood was measured using the Profile of Mood States. Serum prolactin, plasma ACTH, and serum cortisol levels were measured by commercial ELISA (enzyme-linked immunosorbent assay) kits. Results indicate that breastfeeding mothers had more positive moods, reported more positive events, and perceived less stress than formula-feeders. Reports of stressful life events were generally equivalent in the two groups. Serum prolactin was inversely related to stress and mood in formula-feeders. When breast and formula-feeders were compared to controls, they had higher serum cortisol, lower stress, and lower anxiety. Breastfeeders had lower perceived stress than controls. Breastfeeders had lower depression and anger and more positive life events reported than formula-feeders. However, there were few correlations among stress, mood, and the hormones in postpartum mothers, and those only in formula-feeders, whereas strong relationships were found between serum ACTH and a number of stress and mood variables in controls. Postpartum mothers reported a range of stress and negative moods at 4 to 6 weeks, and in formula-feeders, serum prolactin was related to some of the stress and mood variables. Breastfeeding appears to be somewhat protective of negative moods and stress.
Physiological Wet Laboratory Facilities in Colleges of Nursing
Authors: Schaffer Susan , Yucha Carolyn B.
Published: November 2005

The purpose of this study was to describe physiological wet laboratories as they exist within colleges of nursing with doctoral programs. Surveys were sent to the current deans and directors of all 96 nursing colleges/schools with doctoral programs as of January 2004, obtained from the American Association of Colleges of Nursing Web site. Only 26 (37%) of 71 responding schools operate their own wet laboratory, either singly or with another college. The most common analyses done are hormone levels, immune proteins, and cell counts, followed by catecholamines, chemistries, and bacterial cultures. Approximate annual costs of running wet laboratories range from $1,500 to $320,000 per school. Schools based in an academic health center were more likely to operate a wet laboratory ( 2 = .003). There were no differences based on source of university funding (public vs. private) or Carnegie classification.
Strategic Practice, 'Discourse' and the Everyday Interactional Constitution of 'Power Effects'
Authors: Samra-Fredericks Dalvir
Published: November 2005

This paper responds to the empirical and analytical challenge that surrounds tracing the constitution of 'power effects of corporate strategy discourse' notably documented in Knights and Morgan's seminal contribution. To meet the empirical challenge,interaction is centralized and ethnographies of strategists at-work are extended to include audiorecording their naturally occurring talk-based interactive routines over time/space. To meet the analytical challenge, the paper turns to two distinct social science traditions—Habermas' critical social theory and ethnostudies set against the stance of 'supplementation'. Habermas' schema suggests a re-conceptualization of strategic practice as a process where strategists routinely draw upon four forms of knowledge, which arguably 'makes-up' any 'Discourse'. These knowledges concern the external, social and subjective domain with the overarching knowledge being language use. Each also raises associated validity claims. While brief, the ethnomethodological perspective provides the fundamental methodology and indicates the ways further analytical texture is yielded to strategizing processes. Taken together, the paper paves the way for fine-grained studies of the everyday interactional constitution of power effects yielding that 'capillary image' of power relations. Two brief transcribed strips of interaction are reproduced from an earlier ethnography to illustrate theoretical, conceptual and analytical possibilities for critical analyses. A complexified notion of 'competence' constituting practice is maintained with the conclusion touching upon how this approach also potentially contributes to critical management education.
Shielding Idiosyncrasy from Isomorphic Pressures: Towards Optimal Distinctiveness in European Filmmaking
Authors: Alvarez José Luis , Mazza Carmelo , Pedersen Jesper Strandgaard , Svejenova Silviya
Published: November 2005

This paper advances a micro theory of creative action by examining how distinctive artists shield their idiosyncratic styles from the isomorphic pressures of a field. It draws on the cases of three internationally recognized, distinctive European film directors—Pedro Almodóvar (Spain), Nanni Moretti (Italy) and Lars von Trier (Denmark). We argue that, in a cinema field, managing artistic pressures for distinctiveness versus business pressures for profits drives filmmakers' quest for optimal distinctiveness. This quest seeks both exclusive (unique style) and inclusive (audience-appealing) artwork with legitimacy in the field. Our theory of creative action for optimal distinctiveness suggests that film directors increase their control by personally consolidating artistic and production roles, by forming close partnerships with committed producers, and by establishing their own production companies. Ironically, to escape the iron cage of local cinema fields, film directors increasingly control the coupling of art and business.
Organizational Citizenship Behavior: What's Gender Got To Do With It?
Authors: Kark Ronit , Waismel-Manor Ronit
Published: November 2005

In this paper we present a feminist reading of the concept of Organizational Citizenship Behavior (OCB) and its components. We propose that although the OCB discourse in the literature is presented as gender-neutral, gender is deeply embedded within the concept. We reveal the gendered nature of the concept in two ways. First, drawing on a poststructural feminist perspective, the analysis examines the rhetorical nature of the text, the language and metaphors used in the definition of the concept of OCB and its different dimensions. Second, using a critical post liberal perspective, which considers gender as socially constructed and focuses on gender/power relations, the analysis explores how the constructs of the OCB concept are defined and enacted in ways which culturally differentiate men and women, and reveals the dynamics through which the use of this concept reproduces the gendered division of labor and inequality between women and men in organizations. The importance of this critique is that it highlights the theoretical concepts themselves, and shows that they not only reflect existing organizational work structures, but also contribute to the nature of these structures and help stabilize and reproduce the existing order. Finally, we conclude with a discussion of the possible negative aspects of OCB for both men and women, consider the implications of our analysis and point to future directions.
Development of ACROSSnet: an online support system for rural and remote community suicide prevention workers in Queensland, Australia
Authors: Penn Danielle L. , Simpson Lyn , Edie Gavin , Leggett Susan , Wood Leanne , Hawgood Jacinta , Krysinska Karolina , Yellowlees Peter , De Leo Diego
Published: November 2005

Communication and information technologies can reduce the barriers of distance and space that disadvantage communities in Australia's underserved rural areas, where the health status of residents is often worse than that of their urban counterparts. ACROSSnet (Australians Creating Rural Online Support Systems) is a 3 year collaborative action research project that aims to design and develop an online support system that will assist rural communities in accessing information, education and support regarding suicide and its prevention, whilst considering the challenges of Internet speed, cost and availability that can impede the delivery of online services. The site provides three distinct levels of access: one level for community members, and two further levels for appropriately credentialled mental health workers. In creating this environment, the ACROSSnet team hopes that online communities of practice will develop, engaging participants of different ages, income and education levels, location, and socioeconomic backgrounds.
Perceptions of change over time in early-stage Alzheimer's disease
Authors: Clare Linda , Roth Ilona , Pratt Rebekah
Published: November 2005

Emerging models of subjective experience, awareness and coping in early-stage dementia may usefully be enhanced by incorporating a temporal perspective. As an initial step in this direction, we undertook a prospective one-year follow-up of participants with a diagnosis of early-stage Alzheimer's disease whose accounts had contributed to the development of Clare's phenomenological model of awareness incorporating the continuum model of coping in early-stage dementia. All 12 participants from the original study completed a follow-up interview one year later. Interpretative phenomenological analysis was used to identify emergent themes. All participants continued to demonstrate some awareness of difficulties with memory, but individuals varied in their evaluations of the extent and implications of these changes, with the majority tending towards more normalizing explanations. Many were nevertheless making practical adjustments to their activities, and the need to renegotiate relationships was a prominent issue. Subsequently, the data were examined for evidence of the themes identified in the original study, the initial model was reapplied, and changes in individual coping style over time were explored through case study analysis. The range of processes and coping styles observed across participants 12 months earlier was still apparent, with some indication of increased polarization between self-maintaining and self-adjusting styles of coping. A small number of participants showed significant changes in coping style, with changes occurring in both directions. The findings suggest that expression of awareness interacts with coping style, illustrating the need to consider both factors in combination in order to better understand individual expressions of awareness of change.
Self-reported severe memory problems as a screen for cognitive impairment and dementia
Authors: Crooks Valerie C. , Buckwalter J. Galen , Petitti Diana B. , Brody Kathleen K. , Yep Ralph L.
Published: November 2005

Undetected cognitive impairment (CI) and dementia are important clinical and epidemiological problems. This study addresses the effectiveness of using a single self-reported measure of severe memory problems (SMP) as a screen for CI and dementia. For the purposes of the study, 3220 elderly women participated in a mailed Health Survey Questionnaire and telephone interviews. Cognitive scores derived from the Telephone Interview for Cognitive Status–modified (TICSm) were calculated. Based on a multi-stage assessment strategy, all subjects were classified in one of three status categories: dementia, CI, or unimpaired. The SMP question was suggestive of cognitive problems in the majority of responders. t-tests found affirmative responders scored much lower on the cognitive test than negative responders. The SMP question had a sensitivity of .24 and a specificity of .99 for screening CI and dementia. While other assessment measures are needed, the SMP question is highly suggestive of CI and may serve as a first-stage screen in clinical and research settings.
Dementia care in England and the social model of disability
Authors: Gilliard Jane , Means Robin , Beattie Angela , Daker-White Gavin
Published: November 2005

This article reviews the development of a social model of disability and considers whether or not it provides a helpful framework for dementia care. The social model has not yet fully included cognitive impairment, although considerable work has been carried out with regard to learning disability. By applying this model to dementia care, those who surround people with dementia can review the impact that they as 'non-demented' people have on others; can reconsider the value of hearing and responding to personal experiences; can reframe the focus to consider abilities instead of losses; and can better understand the impact of public policy. The article also considers the present shortcomings of a disability model in terms of how it relates to dementia care and concludes with some thoughts for future consideration. The article draws heavily on the findings of a research project conducted by Dementia Voice and the University of the West of England, Bristol, UK to consider the needs of two sub-groups of people with dementia – younger people (i.e. those under the age of 65) and those from minority ethnic groups.
Institutional Transformation and Planning: From Institutionalization Theory to Institutional Design
Authors: Alexander E. R.
Published: November 2005

For planners, institutional transformation is important in two ways. From the positive aspect they need to know their institutional environment: institutionalization theory can help. Three 'schools' of institutionalization theory are presented: 'Historical', 'Rational Choice' and 'Sociological Institutionalism'. The normative aspect of institutional transformation is institutional design: planning often demands this. Institutional design is defined and described: what is it, where is it done, and who does it. The article identifies the institutional-agent interactions that are the media and tools of institutional design, and reviews some of the knowledge base for institutional design practice under the headings of governance, coordination, and agency.
Planning as Anticipation of Resistance
Authors: Sanyal Bishwapriya
Published: November 2005

This article argues that an inadvertent side effect of the current preoccupation with planning from below has been a lack of attention to public sector planning at the top, which remains a critical institutional mechanism for development. To be effective, however, public sector planners must anticipate institutional resistance to their efforts, particularly from within the state structure, and incorporate this understanding into the formulation and sequencing of planning tasks in unorthodox and counterintuitive ways. Drawing on examples of planning for the provision of housing and employment for the urban poor in newly industrializing nations, the article demonstrates that in effective practice, substantive and procedural theories of planning are not separated, because planning procedures are largely influenced by the particular substantive nature of problems to be addressed. Hence, planning theorists need to better understand the substantive nature of problems in order to provide practicing planners with institutional insights about the type of resistance they are likely to encounter when a problem is formulated in a particular way. This awareness of resistance to planning was absent in development planning's formative years; but the last 50 years of planning experience have generated rich tacit knowledge which, if formalized, can contribute to more effective public sector planning.
The Jewish Background to The Resurrection of the Son of God by N.T.Wright
Authors: Bryan David
Published: November 2005

This response to N.T. Wright's recent magnum opus on the resurrection of Jesus concentrates on his handling of the Jewish background to the beliefs about what had happened to Jesus. It was made in dialogue with the author at the British New Testament Conference in Edinburgh (Sept. 2004). In his study Wright vigorously argues that Christian beliefs stand out as both continuous with the mainstream of Jewish thought on the subject, but also introducing a new and unexpected element, namely that no one expected an individual to rise ahead of the rest of humankind. This conclusion forms the bedrock for Wright's investigation of the New Testament traditions about Jesus and his robust defence of the traditional belief in the bodily resurrection of Jesus as an historical event. The pivotal nature of his conclusion about the background beliefs therefore called for a thorough analysis of his handling of this material. This article goes some way to offering that kind of critique.
Against the Historical Plausibility of the Empty Tomb Story and the Bodily Resurrection of Jesus: A Response to N.T. Wright
Authors: Crossley James
Published: November 2005

Wright's recent book on the resurrection is the most important defence of the historical accuracy of the empty tomb and the bodily resurrection. However, his arguments do not stand up to close scrutiny. Sufficient attention is not paid to the importance of Jewish and pagan legendary traditions concerning great figures of the past. Unlike non-Christian traditions, the Gospel narratives are never treated with any decree of scepticism (not even Mt. 27.52-53) which is a dubious practice for a historian. The earliest evidence for the empty tomb has no genuine eyewitness support (in contrast to the resurrection appearances) and Mk 16.8 suggests that the story was not well known. The first resurrection appearances are more likely to be visionary experiences interpreted as a bodily raised figure, which meant that the early accounts of Paul and Mark could assume an empty tomb even if historically this was not the case.
Jesus' Resurrection in the Early Christian Texts: An Engagement with N.T. Wright
Authors: Hurtado Larry
Published: November 2005

Wright's latest book in his multi-volume treatment of 'the New Testament and God' reveals an impressive amount of research and reflection on practically every topic. The size and detail of Wright's book make it difficult to do justice to it, and it requires anyone who engages it in such a limited presentation to select matters for particular attention. This is an attempt to contribute productively by offering critique of certain matters, particularly those of apologetics, Wright's portrayal of Jesus' resurrection in the New Testament, 'metaphorical' use of resurrection language, religious experience and devotion to Jesus, and variety in early Christian resurrection-beliefs. But the critical focus should not be misconstrued and the overall reaction is one of appreciation and gratitude.
Jewish Burial Traditions and the Resurrection of Jesus
Authors: Evans Craig
Published: November 2005

The burial of Jesus, in light of Jewish tradition, is almost certain for at least two reasons: (1) strong Jewish concerns that the dead—righteous or unrighteous—be properly buried; and (2) desire to avoid defilement of the land. Jewish writers from late antiquity, such as Philo and Josephus, indicate that Roman officials permitted executed Jews to be buried before nightfall. Only in times of rebellion—when Roman authorities did not honour Jewish sensitivities—were bodies not taken down from crosses or gibbets and given proper burial. It is highly improbable, therefore, that the bodies of Jesus and the other two men crucified with him would have been left unburied overnight, on the eve of a major Jewish holiday, just outside the walls of Jerusalem. Scholarly discussion of the resurrection of Jesus should reckon with the likelihood that Jesus was buried in an identifiable tomb, a tomb that may well have been known to have been found empty.
Resurrecting Old Arguments: Responding to Four Essays
Authors: Wright N.
Published: November 2005

The author is grateful for the attention given to his book The Resurrection of the Son of God by the four reviewers. David Bryan is right to highlight the Enoch literature as a more fertile source of resurrection ideas than the book allowed for; but he has overstated his objection. Granted that the stream of thought represented by resurrection is more diverse even than RSG allowed, the book's argument did not hinge on the wide spread of resurrection belief at the time but on the meaning of 'resurrection', i.e. a two-stage post-mortem existence, the second stage being a new embodiment. Bryan's suggested elevation of Enoch, Elijah and others as precursors of the exaltation of Jesus fails in that these figures neither die nor are resurrected. James Crossley's counter-proposal—resurrection stories grew from 'visions' which gave rise to the idea of an empty tomb as an attempt to 'vindicate' the 'ideas and beliefs of Jesus'—fails on several counts, not least because it ignores Jesus' kingdom-proclamation which was not the promulgation of ideas and beliefs but the announcement that Israel's God was going to do something that would claim his sovereignty over the world. Michael Goulder revives the highly contentious hypothesis that the early Church was polarized between the Jerusalem apostles, who believed in a non-bodily resurrection, and Pauline Christians for whom the resurrection was bodily. The claim that Mark 16.1-8 is full of contradictions and impossibilities is rejected. Larry Hurtado warns against downplaying the role of experience both in the Christian life and in describing the devotion and liturgy of the early Church. While cautioning against the use of the word 'metaphor' to mean 'less than fully real', I acknowledge the force of the argument, and suggest the cognitive processes I propose and the devotional life sketched by Hurtado are complementary.
Proposed methods for testing and selecting the ERCC external RNA controls
Authors:   External RNA Controls Consortium
Published: November 2005

The External RNA Control Consortium (ERCC) is an ad-hoc group with approximately 70 members from private, public, and academic organizations. The group is developing a set of external RNA control transcripts that can be used to assess technical performance in gene expression assays. The ERCC is now initiating the Testing Phase of the project, during which candidate external RNA controls will be evaluated in both microarray and QRT-PCR gene expression platforms. This document describes the proposed experiments and informatics process that will be followed to test and qualify individual controls. The ERCC is distributing this description of the proposed testing process in an effort to gain consensus and to encourage feedback from the scientific community. On October 4–5, 2005, the ERCC met to further review the document, clarify ambiguities, and plan next steps. A summary of this meeting and changes to the test plan are provided as an appendix to this manuscript.
cGMP-independent nitric oxide signaling and regulation of the cell cycle
Authors: Cui Xiaolin , Zhang Jianhua , Ma Penglin , Myers Daniela E , Goldberg Ilana G , Sittler Kelly J , Barb Jennifer J , Munson Peter J , del Pilar Cintron Ana , McCoy J Philip , Wang Shuibang , Danner Robert L
Published: November 2005

Background

Regulatory functions of nitric oxide (NO•) that bypass the second messenger cGMP are incompletely understood. Here, cGMP-independent effects of NO•on gene expression were globally examined in U937 cells, a human monoblastoid line that constitutively lacks soluble guanylate cyclase. Differentiated U937 cells (>80% in G0/G1) were exposed to S-nitrosoglutathione, a NO•donor, or glutathione alone (control) for 6 h without or with dibutyryl-cAMP (Bt2cAMP), and then harvested to extract total RNA for microarray analysis. Bt2cAMP was used to block signaling attributable to NO•-induced decreases in cAMP.

Results

NO•regulated 110 transcripts that annotated disproportionately to the cell cycle and cell proliferation (47/110, 43%) and more frequently than expected contained AU-rich, post-transcriptional regulatory elements (ARE). Bt2cAMP regulated 106 genes; cell cycle gene enrichment did not reach significance. Like NO•, Bt2cAMP was associated with ARE-containing transcripts. A comparison of NO•and Bt2cAMP effects showed that NO•regulation of cell cycle genes was independent of its ability to interfere with cAMP signaling. Cell cycle genes induced by NO•annotated to G1/S (7/8) and included E2F1 and p21/Waf1/Cip1; 6 of these 7 were E2F target genes involved in G1/S transition. Repressed genes were G2/M associated (24/27); 8 of 27 were known targets of p21. E2F1 mRNA and protein were increased by NO•, as was E2F1 binding to E2F promoter elements. NO•activated p38 MAPK, stabilizing p21 mRNA (an ARE-containing transcript) and increasing p21 protein; this increased protein binding to CDE/CHR promoter sites of p21 target genes, repressing key G2/M phase genes, and increasing the proportion of cells in G2/M.

Conclusion

NO•coordinates a highly integrated program of cell cycle arrest that regulates a large number of genes, but does not require signaling through cGMP. In humans, antiproliferative effects of NO•may rely substantially on cGMP-independent mechanisms. Stress kinase signaling and alterations in mRNA stability appear to be major pathways by which NO•regulates the transcriptome.
The gene for a lectin-like protein is transcriptionally activated during sexual development, but is not essential for fruiting body formation in the filamentous fungus Sordaria macrospora
Authors: Nowrousian Minou , Cebula Patricia
Published: November 2005

Background

The filamentous fungus Sordaria macrospora forms complex three-dimensional fruiting bodies called perithecia that protect the developing ascospores and ensure their proper discharge. In previous microarray analyses, several genes have been identified that are downregulated in sterile mutants compared to the wild type. Among these genes was tap1 (t ranscript a ssociated with p erithecial development), a gene encoding a putative lectin homolog.

Results

Analysis of tap1 transcript levels in the wild type under conditions allowing only vegetative growth compared to conditions that lead to fruiting body development showed that tap1 is not only downregulated in developmental mutants but is also upregulated in the wild type during fruiting body development. We have cloned and sequenced a 3.2 kb fragment of genomic DNA containing the tap1 open reading frame and adjoining sequences. The genomic region comprising tap1 is syntenic to its homologous region in the closely related filamentous fungus Neurospora crassa. To determine whether tap1 is involved in fruiting body development in S. macrospora, a knockout construct was generated in which the tap1 open reading frame was replaced by the hygromycin B resistance gene hph under the control of fungal regulatory regions. Transformation of the S. macrospora wild type with this construct resulted in a tap1 deletion strain where tap1 had been replaced by the hph cassette. The knockout strain displayed no phenotypic differences under conditions of vegetative growth and sexual development when compared to the wild type. Double mutants carrying the Δtap1 allele in several developmental mutant backgrounds were phenotypically similar to the corresponding developmental mutant strains.

Conclusion

The tap1 transcript is strongly upregulated during sexual development in S. macrospora; however, analysis of a tap1 knockout strain shows that tap1 is not essential for fruiting body formation in S. macrospora.
A fully automatable enzymatic method for DNA extraction from plant tissues
Authors: Manen Jean-François , Sinitsyna Olga , Aeschbach Lorène , Markov Alexander V , Sinitsyn Arkady
Published: November 2005

Background

DNA extraction from plant tissues, unlike DNA isolation from mammalian tissues, remains difficult due to the presence of a rigid cell wall around the plant cells. Currently used methods inevitably require a laborious mechanical grinding step, necessary to disrupt the cell wall for the release of DNA.

Results

Using a cocktail of different carbohydrases, a method was developed that enables a complete digestion of the plant cell walls and subsequent DNA release. Optimized conditions for the digestion reaction minimize DNA shearing and digestion, and maximize DNA release from the plant cell. The method gave good results in 125 of the 156 tested species.

Conclusion

In combination with conventional DNA isolation techniques, the new enzymatic method allows to obtain high-yield, high-molecular weight DNA, which can be used for many applications, including genome characterization by AFLP, RAPD and SSR. Automation of the protocol (from leaf disks to DNA) is possible with existing workstations.
EDTA chelation therapy for cardiovascular disease: a systematic review
Authors: Seely Dugald MR , Wu Ping , Mills Edward J
Published: November 2005

Background

Numerous practitioners of both conventional and complementary and alternative medicine throughout North America and Europe claim that chelation therapy with EDTA is an effective means to both control and treat cardiovascular disease. These claims are controversial, and several randomized controlled trials have been completed dealing with this topic. To address this issue we conducted a systematic review to evaluate the best available evidence for the use of EDTA chelation therapy in the treatment of cardiovascular disease.

Methods

We conducted a systematic review of 7 databases from inception to May 2005. Hand searches were conducted in review articles and in any of the trials found. Experts in the field were contacted and registries of clinical trials were searched for unpublished data. To be included in the final systematic review, the studies had to be randomized controlled clinical trials.

Results

A total of seven articles were found assessing EDTA chelation for the treatment of cardiovascular disease. Two of these articles were subgroup analyses of one RCT that looked at different clinical outcomes. Of the remaining five studies, two smaller studies found a beneficial effect whereas the other three exhibited no benefit for cardiovascular disease from the use of EDTA chelation therapy. Adverse effects were rare but those of note included a few cases of hypocalcemia and a single case of increased creatinine in a patient on the EDTA intervention.

Conclusion

The best available evidence does not support the therapeutic use of EDTA chelation therapy in the treatment of cardiovascular disease. Although not considered to be a highly invasive or harmful therapy, it is possible that the use of EDTA chelation therapy in lieu of proven therapy may result in causing indirect harm to the patient.
Increased oxidative stress associated with the severity of the liver disease in various forms of hepatitis B virus infection
Authors: Bolukbas Cengiz , Bolukbas Fusun Filiz , Horoz Mehmet , Aslan Mehmet , Celik Hakim , Erel Ozcan
Published: November 2005

Background

Oxidative stress can be defined as an increase in oxidants and/or a decrease in antioxidant capacity. There is limited information about the oxidative status in subjects with hepatitis B virus infection. We aimed to evaluate the oxidative status in patients with various clinical forms of chronic hepatitis B infection.

Methods

Seventy-six patients with hepatitis B virus infection, in whom 33 with chronic hepatitis, 31 inactive carriers and 12 with cirrhosis, and 16 healthy subjects were enrolled. Total antioxidant response and total peroxide level measurement, and calculation of oxidative stress index were performed in all participants.

Results

Total antioxidant response was significantly lower in cirrhotics than inactive HbsAg carriers and controls (p = 0.008 and p = 0.008, respectively). Total peroxide level and oxidative stress index was significantly higher in cirrhotic (p < 0.001, both) and chronic hepatitis B subjects (p < 0.001, both) than inactive HbsAg carriers and controls. Total antioxidant response was comparable in chronic hepatitis B subjects, inactive HbsAg carriers and controls (both, p > 0.05/6). Total peroxide level and oxidative stress index were also comparable in inactive HBsAg carriers and controls (both, p > 0.05/6). Serum alanine amino transferase level was positively correlated with total peroxide level and oxidative stress index only in chronic hepatitis B subjects (p = 0.002, r = 0.519 and p = 0.008, r = 0.453, respectively).

Conclusion

Oxidative stress occurs secondarily to increased total lipid peroxidation and inadequate total antioxidant response and is related to severity of the disease and replication status of virus in hepatitis B infection.
The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003
Authors: Lee Kyung-Yil , Burgner David , Lee Hyung-Shin , Hong Ja-Hyun , Lee Mi-Hee , Kang Jin-Han , Lee Byung-Churl
Published: November 2005

Background

Aseptic meningitis is a relatively frequent childhood disease and virologic data suggest that enteroviruses are the commonest etiologic agents. We evaluated the epidemiologic characteristics of aseptic meningitis in Daejeon, South Korea from 1987 to 2003.

Methods

2201 medical records of children with aseptic meningitis admitted to The Catholic University of Korea, Daejeon St Mary's Hospital were retrospectively analyzed.

Results

Outbreaks of aseptic meningitis were observed in 1990, 1993, 1996, 1997, 2001 and 2002. The age distribution of cases was relatively uniform, with a higher incidence in those aged < 1 year and 4–7 years. The male-to-female ratio was 2:1. There was a higher incidence of disease in the summer (May to August, 74.1% of total). Comparison of the largest epidemics in 1997 and 2002 showed significant differences in the incidence in those < 1 year (11.8% vs. 4.4%, respectively; P = 0.001). Neurologic sequelae were observed in 0.7% of the patients.

Conclusion

Aseptic meningitis, rare before the 1980s in Korea, has since become a common clinical entity. Since 1990, outbreaks of aseptic meningitis have occurred every 1 to 3 years in Daejeon in keeping with Korea-wide epidemics. The frequency of disease affecting children less than one year of age may reflect herd immunity to the epidemic strain.
Determination of Interleukin-6 and Tumor Necrosis Factor-alpha concentrations in Iranian-Khorasanian patients with preeclampsia
Authors: Afshari J Tavakkol , Ghomian N , Shameli A , Shakeri MT , Fahmidehkar MA , Mahajer E , Khoshnavaz R , Emadzadeh M
Published: November 2005

Background

Our objective was to determine the role of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), markers of immune activation and endothelial dysfunction, in patients with preeclampsia.

Methods

Twenty four women with preeclampsia and eighteen antepartum normotensive pregnant women were recruited as controls. Serum levels of IL-6 and TNF-alpha were measured by enzyme-linked immunosorbent assay. We used independent-samples t test to assess the differences in the concentration of cytokines in preeclamptic patients and control subjects.

Results

IL-6 levels [mean (S.D.)] were significantly higher in preeclamptic women [5.8 (4.85) pg/ml] compared to normal pregnant women [3.01 (2.45) pg/ml] (p = 0.02). There was no significant change in concentration of TNF-alpha in preeclamptic women [53.8 (30.0) pg/ml] compared to normal pregnant women [51.9 (33.8) pg/ml] (p > 0.1).

Conclusion

The results of this study show that IL-6 as a pro-inflammatory cytokine is present in higher concentration in women with preeclampsia. The study was undertaken in women with established preeclampsia and it is not possible to determine whether the increased concentration of IL-6 is a cause or consequence of the disease. Furthermore, these findings suggest that serum TNF-alpha level is not associated with preeclampsia.
Clinical and pathologic factors associated with survival in young adult patients with fibrolamellar hepatocarcinoma
Authors: Moreno-Luna Laura E , Arrieta Oscar , García-Leiva Jorge , Martínez Braulio , Torre Aldo , Uribe Misael , León-Rodríguez Eucario
Published: November 2005

Background

Fibrolamellar Carcinoma (FLC), a subtype of hepatocellular carcinoma (HCC), is a rare primary hepatic malignancy. Several aspects of the clinic features and epidemiology of FLC remain unclear because most of the literature on FLC consists of case reports and small cases series with limited information on factors that affect survival.

Methods

We did a retrospective analysis of the clinical and histological characteristics of FLC. We also determined the rate of cellular proliferation in biopsies of these tumors. We assessed whether these variables were associated with survival.

Results

We found 15 patients with FLC out of 174 patients with HCC (8.6%). Between patients with these neoplasms, we found statistically significant survival, age at onset, level of alpha fetoprotein, and an earlier stage of the disease. The 1, 3 and 5 year survival in patients with FLC was of 66, 40 and 26% respectively. The factors associated with a higher survival in patients with FLC were age more than 23 years, feasibility of surgical resection, free surgical borders, absence of thrombosis or invasion to hepatic vessels and the absence of alterations in liver enzymes. The size of the tumor, gender, cellular proliferation and atypia did not affect the prognosis.

Conclusion

We concluded that FLC patients diagnosed before 23 years of age have worse prognosis than those diagnosed after age 23. Other factors associated with worse prognosis in this study are: lack of surgical treatment, presence of positive surgical margins, vascular invasion, and altered hepatic enzymes.
The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases
Authors: Ozkalemkas Fahir , Ali Rıdvan , Ozkocaman Vildan , Ozcelik Tulay , Ozan Ulku , Ozturk Hulya , Kurt Ender , Evrensel Turkkan , Yerci Omer , Tunali Ahmet
Published: November 2005

Background

Although bone marrow metastases can be found commonly in some malignant tumors, diagnosing a nonhematologic malignancy from marrow is not a usual event.

Methods

To underscore the value of bone marrow aspiration and biopsy as a short cut in establishing a diagnosis for disseminated tumors, we reviewed 19 patients with nonhematologic malignancies who initially had diagnosis from bone marrow.

Results

The main indications for bone marrow examination were microangiopathic hemolytic anemia (MAHA), leukoerythroblastosis (LEB) and unexplained cytopenias. Bone marrow aspiration was not diagnostic due to dry tap or inadequate material in 6 cases. Biopsy results were parallel to the cytological ones in all cases except one; however a meticulous second examination of the biopsy confirmed the cytologic diagnosis in this patient too. The most common histologic subtype was adenocarcinoma, and after all the clinical and laboratory evaluations, the primary focus was disclosed definitively in ten patients (5 stomach, 3 prostate, 1 lung, 1 muscle) and probably in four patients (3 gastrointestinal tract, 1 lung). All work up failed in five patients and these cases were classified as tumor of unknown origin (TUO).

Conclusion

Our series showed that anemia, thrombocytopenia, elevated red cell distribution width (RDW) and hypoproteinemia formed a uniform tetrad in patients with disseminated tumors that were diagnosed via bone marrow examination. The prognosis of patients was very poor and survivals were only a few days or weeks (except for 4 patients whose survivals were longer). We concluded that MAHA, LEB and unexplained cytopenias are strong indicators of the necessity of bone marrow examination. Because of the very short survival of many patients, all investigational procedures should be judged in view of their rationality, and should be focused on treatable primary tumors.
Homeopathic medical practice: Long-term results of a cohort study with 3981 patients
Authors: Witt Claudia M , Lüdtke Rainer , Baur Roland , Willich Stefan N
Published: November 2005

Background

On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions.

Methods

In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year) consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10) and quality of life at baseline, and after 3, 12, and 24 months.

Results

A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years) and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years). Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p < 0.001) between baseline and 24 months (adults from 6.2 ± 1.7 to 3.0 ± 2.2; children from 6.1 ± 1.8 to 2.2 ± 1.9). Physicians' assessments yielded similar results. For adults and young children, major improvements were observed for quality of life, whereas no changes were seen in adolescents. Younger age and more severe disease at baseline were factors predictive of better therapeutic success.

Conclusion

Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.
Pharmacovigilance program to monitor adverse reactions of recombinant streptokinase in acute myocardial infarction
Authors: Betancourt Blas Y , Marrero-Miragaya María A , Jiménez-López Giset , Valenzuela-Silva Carmen , García-Iglesias Elizeth , Hernández-Bernal Francisco , Debesa-García Francisco , González-López Tania , Alvarez-Falcón Leovaldo , López-Saura Pedro A ,   the Cuban National Network of Pharmacoepidemiology
Published: November 2005

Background

Streptokinase (SK) is an effective fibrinolytic agent for the treatment of acute myocardial infarction (AMI). The objective of the present study was to assess the adverse drug reactions (ADRs) associated with intravenous recombinant SK in patients with AMI in routine clinical practice.

Methods

A national, prospective and spontaneous reporting-based pharmacovigilance program was conducted in Cuba. Patient demographics, suspected ADR description, elements to define causality, and outcomes were documented and analyzed.

Results

A total of 1496 suspected ADRs identified in 792 patients out of the 1660 (47.7 %) prescriptions reported in the program, were received from July 1995 to July 2002. Most of the patients (71.3%) were male, 67.2% were white and mean age was 61.6 ± 13.0 years. The mean time interval between the onset of symptoms and the start of the SK infusion was 4.9 ± 3.7 h. The most frequently reported ADRs were hypotension, arrhythmias, chills, tremors, vomiting, nauseas, allergy, bleeding and fever. ADR severity was 38% mild, 38% moderate, 10% severe, and 4% very severe. Only 3 patients with hemorrhagic stroke were reported. Seventy-two patients died in-hospital mainly because of cardiac causes associated with the patient's underlying clinical condition. Mortality was 3 times more likely in patients suffering arrhythmias than in those without this event (odds ratio 3.1, 95% CI: 1.8 to 5.1). Most of the reported ADRs were classified as possibly or probably associated with the study medication.

Conclusion

Recombinant SK was associated with a similar post-marketing safety profile to those suggested in previous clinical trials.
Translating research into policy and practice in developing countries: a case study of magnesium sulphate for pre-eclampsia
Authors: Aaserud Morten , Lewin Simon , Innvaer Simon , Paulsen Elizabeth J , Dahlgren Astrid T , Trommald Mari , Duley Lelia , Zwarenstein Merrick , Oxman Andrew D
Published: November 2005

Background

The evidence base for improving reproductive health continues to grow. However, concerns remain that the translation of this evidence into appropriate policies is partial and slow. Little is known about the factors affecting the use of evidence by policy makers and clinicians, particularly in developing countries. The objective of this study was to examine the factors that might affect the translation of randomised controlled trial (RCT) findings into policies and practice in developing countries.

Methods

The recent publication of an important RCT on the use of magnesium sulphate to treat pre-eclampsia provided an opportunity to explore how research findings might be translated into policy. A range of research methods, including a survey, group interview and observations with RCT collaborators and a survey of WHO drug information officers, regulatory officials and obstetricians in 12 countries, were undertaken to identify barriers and facilitators to knowledge translation.

Results

It proved difficult to obtain reliable data regarding the availability and use of commonly used drugs in many countries. The perceived barriers to implementing RCT findings regarding the use of magnesium sulphate for pre-eclampsia include drug licensing and availability; inadequate and poorly implemented clinical guidelines; and lack of political support for policy change. However, there were significant regional and national differences in the importance of specific barriers.

Conclusion

The policy changes needed to ensure widespread availability and use of magnesium sulphate are variable and complex. Difficulties in obtaining information on availability and use are combined with the wide range of barriers across settings, including a lack of support from policy makers. This makes it difficult to envisage any single intervention strategy that might be used to promote the uptake of research findings on magnesium sulphate into policy across the study settings. The publication of important trials may therefore not have the impacts on health care that researchers hope for.
Assessment of pulse rate variability by the method of pulse frequency demodulation
Authors: Hayano Junichiro , Barros Allan Kardec , Kamiya Atsunori , Ohte Nobuyuki , Yasuma Fumihiko
Published: November 2005

Background

Due to its easy applicability, pulse wave has been proposed as a surrogate of electrocardiogram (ECG) for the analysis of heart rate variability (HRV). However, its smoother waveform precludes accurate measurement of pulse-to-pulse interval by fiducial-point algorithms. Here we report a pulse frequency demodulation (PFDM) technique as a method for extracting instantaneous pulse rate function directly from pulse wave signal and its usefulness for assessing pulse rate variability (PRV).

Methods

Simulated pulse wave signals with known pulse interval functions and actual pulse wave signals obtained from 30 subjects with a trans-dermal pulse wave device were analyzed by PFDM. The results were compared with heart rate and HRV assessed from simultaneously recorded ECG.

Results

Analysis of simulated data revealed that the PFDM faithfully demodulates source interval function with preserving the frequency characteristics of the function, even when the intervals fluctuate rapidly over a wide range and when the signals include fluctuations in pulse height and baseline. Analysis of actual data revealed that individual means of low and high frequency components of PRV showed good agreement with those of HRV (intraclass correlation coefficient, 0.997 and 0.981, respectively).

Conclusion

The PFDM of pulse wave signal provides a reliable assessment of PRV. Given the popularity of pulse wave equipments, PFDM may open new ways to the studies of long-term assessment of cardiovascular variability and dynamics.