bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to use virological tools for the optimal management of chronic hepatitis C
Authors: de Leuw Philipp , Sarrazin Christoph , Zeuzem Stefan 
Published: January 2011

AbstractApproximately 180 million individuals are chronically infected with hepatitis C, which is strongly associated with the development of cirrhosis, end‐stage liver disease and hepatocellular carcinoma. Several virological tools (anti‐HCV antibody assays, measurement of HCV‐RNA, HCV‐genotyping) are useful in management of hepatitis C infected patients. The primary goal of antiviral therapy in chronic hepatitis C is a sustained virological response (SVR). The HCV genotype should be determined in every patient considered for antiviral therapy because the currently recommended treatment duration and ribavirin doses differ among HCV genotypes. Exact subtyping might gain increased importance for future therapies with direct‐acting antiviral agents (DAA) because of differences of antiviral activities and barriers to resistance among HCV subtypes. Monitoring HCV RNA by a highly sensitive assay (LOD≤15 IU/ml) is the basis for management of response guided therapy of chronic hepatitis C with pegylated IFN plus ribavirin. Rules for early discontinuation of antiviral therapy in non‐responders and determination of optimal treatment durations in virologic responders have been developed for application of individualized treatment strategies.
Hepatitis B virus resistance to antiviral drugs: where are we going?
Authors: Zoulim Fabien 
Published: January 2011

AbstractChronic hepatitis B virus (HBV) infections remain a major public health problem worldwide. According to World Health Organization estimates, more than 300 million people are chronically infected and exposed to the risk of developing severe complications including cirrhosis and hepatocellular carcinoma (HCC). Major progress in the treatment of chronic hepatitis B (CHB) has been made during the last decade with the development of antivirals that inhibit viral polymerase activity. Antiviral drug resistance is an important factor in determining the success of long‐term therapy for CHB. The development of resistance to nucleoside analogues (NUCs) has been associated with exacerbations of liver disease. Sequential therapy increases the risk of the emergence of multidrug resistance. The selection of a potent antiviral with a high barrier to resistance as a first‐line therapy provides the best chance of achieving long‐term treatment goals and should be used whenever possible. This has led to a significant decrease in drug resistance in countries where this strategy is affordable. However, the barrier to resistance of a given antiviral agent is influenced by the genetic barrier, drug potency, patient adherence, pharmacological barrier, viral fitness, the drug mechanisms of action and cross resistance. Furthermore, because of specific viral kinetics, prolonged treatment with NUCs does not result in the clearance of the viral genome from the infected liver. It is therefore important to continue research to identify new viral and immune targets and develop novel antiviral strategies for controlling viral replication as well as preventing drug resistance and its complications in the long term.
Milestones and perspectives in viral hepatitis B
Authors: Hadziyannis Stephanos J. 
Published: January 2011

AbstractThere have been numerous research milestones since the discovery of the hepatitis B virus (HBV) in the 1960s. These mark major advances in the serology and epidemiology of HBV infection, in indentifying the wide clinical spectrum of acute and chronic hepatic diseases as well as the extrahepatic conditions induced by this virus, the molecular biology of the virus including its variants and mutants, its molecular diagnosis and monitoring, the host immune responses to the infecting virus, the pathogenesis and immunopathogenesis of liver disease as well as its natural course and outcome. These landmark discoveries are the firm background for current and future developments in treatment. There are three consecutive and partly overlapping chronological periods to treatment milestones beginning with recombinant standard interferon‐alpha (IFN‐α) in the 1980s, then oral antivirals from 1998 to the present and in 2005 pegylated IFN‐α (PEG‐IFN). The renewed interest in PEG‐IFN‐α treatment is now focused on both HBeAg‐positive and HBeAg‐negative chronic hepatitis B and it now also aims at HBsAg loss when associated with on‐treatment monitoring of serum HBV DNA and HBsAg levels, resulting in the closest thing to a cure of hepatitis B. The impressive progress made in all aspects of hepatitis B research suggests that curative therapy may be developed for all patients and for all phases of HBV infection in the foreseeable future. However for the moment, realistic efforts should be made to make treatment as widely available and affordable as possible and to apply current therapies to significantly reduce HBV morbidity and mortality.
Hepatitis D revival
Authors: Wedemeyer Heiner 
Published: January 2011

AbstractMore than 30 years after Mario Rizzetto and colleagues described a new antigen in livers of HBsAg‐positive patients called the “delta antigen”, a re‐emerging interest in hepatitis delta is currently observed. The state‐of‐the art on basic and clinical research on hepatitis delta was presented during a monothematic conference organized by the European Association for the Study of the Liver (EASL) in September 2010. Hepatitis delta is caused by infection with the hepatitis D virus (HDV) which requires presence of HBsAg for complete replication and transmission. Recent data confirmed the severe long‐term course of HDV infection with high rates of hepatic decompensation while controversial data on the risk for the development of hepatocellular carcinoma were reported. Pegylated interferon alpha can lead to sustained HDV RNA elimination in about one quarter of patients while HBV polymerase inhibitors are ineffective against HDV. Novel treatment options include prenylation inhibitors and HBV entry inhibitors which are currently in early clinical development.
New direct‐acting antivirals' combination for the treatment of chronic hepatitis C
Authors: Asselah Tarik , Marcellin Patrick 
Published: January 2011

AbstractChronic hepatitis C is one of the leading causes of chronic liver disease, with approximately 170 million people infected worldwide. The severity of disease varies from asymptomatic chronic infection to cirrhosis and hepatocellular carcinoma (HCC). Sustained virological response (SVR) is long lasting, associated with a reduced risk of cirrhosis and HCC. In the near future, standard of care (SOC) treatment of hepatitis C virus (HCV) will include the addition of direct‐acting antivirals (DAAs) with a protease inhibitor to the pegylated interferon (PEG‐IFN) plus ribavirin (RBV). In HCV genotype 1 patients, promising results have been reported when the protease inhibitor telaprevir or boceprevir is added to the SOC, increasing SVR rates from less than 50% (PEG‐IFN plus RBV) to 70% (in patients treated with a triple combination of PEG‐IFN, RBV plus a protease inhibitor). The future management of patients with these new molecules will require good clinical practice, knowledge of indications, prediction of side effects and monitoring for antiviral resistance. Certain major medical needs are still unmet, requiring studies in special populations (human immunodeficiency virus–HCV‐coinfected patients, transplanted patients, etc.) in genotype non‐1 patients and in absolute non‐responders. Combinations of antivirals with additive potency that lack cross resistance and with a good safety profile may provide new regimens in the future to make HCV the first chronic viral infection eradicated worldwide with a finite duration of combination DAA therapy without IFN. There is ongoing development of new molecules such as HCV enzyme inhibitors. The aim of this review is to summarize the results obtained with DAAs: protease and polymerase inhibitors.
Nursing leadership at the crossroads: evidence‐based practice ‘Matching Michigan‐minimizing catheter related blood stream infections’*
Authors: Goeschel Christine A 
Published: January 2011

Aims and objectives: A highly successful intervention to reduce infections in intensive care units (ICUs) is now being widely replicated and involved significant nursing leadership. The objective of this manuscript is to describe briefly the intervention, and more explicitly the implications for nursing leadership as quality improvement and patient safety become global healthcare priorities. Design: Collaborative cohort study in over 100 ICUs in the United States to implement and evaluate interventions to improve patients' safety. Methods: Conceptual model aimed at improving clinicians' use of five evidence‐based recommendations to reduce rates of catheter‐related bloodstream infections rates, with measurement and feedback of infection rates. Results: One hundred and three ICUs contributed 1981 ICU‐months of data representing 375,757 catheter‐days. The median rate of catheter‐related bloodstream infection per 1000 catheter‐days decreased from 2.7 infections at baseline to 0 at 3 months after implementation of the study intervention (P ≤ 0·002), and the mean rate per 1000 catheter‐days decreased from 7.7 at baseline to 1.4 at 16–18 months of follow‐up (P < 0·002). During the sustainability period, the mean bloodstream infection rate did not significantly change from the initial 18 month postimplementation period (−1%, 95% confidence interval −9% to 7%). Eighty seven percent of the original study participants had data available for the sustainability study. Conclusions: Broad use of this intervention with achievement of similar results could substantially reduce the morbidity and costs associated with catheter‐related bloodstream infections. Relevance to clinical practice: The initial Michigan study and the follow‐up analysis, that demonstrated sustained improvements, are leading to similar projects in other countries, include the Matching Michigan project in England. Discussing not only the technical components of the program, but also the nursing leadership aspects may assist nurses just embarking on this work.
Understanding the effects of oxygen administration in haemorrhagic shock
Authors: Knight Amanda R , Fry Lauren E , Clancy Richard L , Pierce Janet D 
Published: January 2011

Aims and objectives: The aim of this article is to provide a review of the literature regarding oxygen administration and the use of oxygen in patients experiencing haemorrhagic shock (HS). Results: Oxygen is administered to patients to assist them in maintaining oxygenation. The administration of oxygen is complex and varies significantly among patients. In order to optimize patient care, clinicians need to be aware of the potential effects, both beneficial and harmful, that oxygen can have on the body. Inclusion and exclusion criteria: Literature inclusion criteria for this article was any article (1995 to present) pertaining to oxygen administration and HS. Also included were articles related to tissue injury caused by an overabundance of free radicals with the administration of oxygen. Articles related to oxygen and wound healing, pollution, aerospace, food and industrial uses were excluded. Conclusions: This review of the literature provides an overview of the use of oxygen in clinical practice and HS. The harmful effects of oxygen are highlighted to alert the clinician to this potential when there is an overabundance of oxygen. Relevance to clinical practice: Oxygen is one of the most common drugs used in the medical community; however, the effects of oxygen on the body are not well understood. The use of oxygen if not prescribed correctly can cause cellular damage and death. Clinicians need to be more aware of the effects of oxygen and the damage it may cause if not administered properly.
Carbamazepine coadministration with an oral contraceptive: Effects on steroid pharmacokinetics, ovulation, and bleeding
Authors: Davis Anne R. , Westhoff Carolyn L. , Stanczyk Frank Z. 
Published: January 2011

SummaryPurpose:  Antiepileptic drugs (AEDs) are widely used in reproductive‐age women. The AED carbamazepine (CBZ) induces the hepatic cytochrome P450 system, thereby accelerating hormone metabolism. We sought to assess the pharmacodynamic effects of CBZ on breakthrough bleeding and ovulation during oral contraceptive (OC) use.Methods:  A double‐blind, randomized, crossover study of healthy women ages 18–35 years. Participants took an OC containing 20 μg ethinyl estradiol (EE) and 100 μg levonorgestrel (LNG) for 4 months. Concurrently, participants took 600 mg CBZ or a matching placebo for 2 months each, administered in random order. During the second month of CBZ or placebo, we measured EE and LNG levels 12 times over 24 h, ovarian follicular diameters with eight biweekly vaginal ultrasounds, weekly progesterone levels, and bleeding (using a diary).Key Findings:  We enrolled 25 women; 10 completed the study. Five women discontinued because of reversible CBZ side effects. Mean area under the curve (AUC) measurements were lower during CBZ use compared to placebo for EE (1,778 vs. 986 pg*h/ml, p < 0.001) and LNG (24.8 vs. 13.8 pg*h/ml, p = 0.04). Ovulation occurred in 5 of 10 CBZ cycles compared to 1 of 10 placebo cycles (p = 0.06). Three or more days of breakthrough bleeding occurred during 8 of the 10 CBZ cycles compared to 2 of the 10 placebo cycles (p = 0.07).Significance:  A commonly used dose of CBZ decreased levels of contraceptive steroids, increased breakthrough bleeding, and permitted ovulation during use of a low‐dose OC. Women treated with CBZ are not adequately protected from pregnancy by low‐dose OCs.
Core Decompression of the Equine Navicular Bone: An In Vitro Biomechanical Study
Authors: Jenner Florien , Kirker‐Head Carl 
Published: January 2011

Objective:To determine the effect of core decompression surgery and bone mineral density (BMD) on the mechanical properties of equine navicular bones.Study Design:Experimental, in vitro study.Sample Population:Fore limb navicular bones (n=36 pairs) from sound 2–5‐year‐old horses with no radiographic abnormalities of the distal aspect of the forelimbs.Methods:Navicular BMD was measured using dual energy X‐ray absorptiometry. One randomly assigned navicular bone from each pair served as control. The contralateral test specimen was allocated to 1 of 6 treatment groups defined by drill bit size (3.2 versus 2.5 mm diameter) and by the number of drill channels (1, 2, or 3) created in the proximal border of the bone. Bones were then tested until failure in 3‐point bending. Data were statistically analyzed using ANOVA and regression analysis.Results:There were significant (P<.001) positive correlations between BMD and biomechanical data. A significant (P<.001) reduction in breaking strength was noted between intact and drilled bone pairs; however, the diameter and number of decompression channels did not significantly (P>.05) influence the extent of the reduction in mechanical strength.Conclusion:In vitro core decompression significantly decreases the breaking strength of the equine navicular bone.
Treatment of Epiglottic Entrapment by Transnasal Axial Division in Standing Sedated Horses Using a Shielded Hook Bistoury
Authors: Lacourt Mathieu , Marcoux Marcel 
Published: January 2011

Objectives:To report use of a shielded hook bistoury developed for correction of epiglottic fold entrapment in standing sedated horses.Study Design:Prospective clinical study.Animals:Standardbreds (n=8), 3–19 years of age.Methods:Epiglottic fold entrapment was corrected during standing sedation using a shielded hook bistoury passed nasally into the pharynx. Owners, trainers, and referring veterinarians were contacted by telephone to establish outcome.Results:Axial division of the entrapping epiglottic fold was successful in all horses. No short‐ or long‐term complications occurred. Axial transection of the entrapping fold was performed rapidly (mean, 83 seconds between advancing the bistoury into the pharynx and transection of the entrapping fold).Conclusion:Transnasal axial division of the aryepiglottic fold can be accomplished safely using the shielded hook bistoury. The shield mechanism minimizes the risk of injury from the cutting blade to adjacent structures.
Translating the Insomnia Severity Index Into Arabic
Authors: Suleiman Khaled H. , Yates Bernice C. 
Published: January 2011

Abstract Purpose: The purpose of this study was to translate the Insomnia Severity Index (ISI) into Arabic (Fusha dialect), and obtain preliminary reliability and validity estimates for the translated version. Background: Arabic populations experience sleep problems that interfere with their vitality and quality of life. The ISI was established to screen for insomnia in both clinical and research situations. Design: This study used a descriptive correlational design. The ISI was translated into Arabic using the back‐translation method and compared with three other sleep measures: the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Vitality Subscale from the Medical Outcomes Study Short Form‐36. These measures were administered to 35 healthy Arabic bilingual participants from three community locations. Findings: The mean ISI score was 9.2 (SD= 5.8; range 0–20). Internal consistency reliability was 0.84. The correlations between the total ISI score and the single items ranged from 0.49 to 0.92 (p < .01). In terms of convergent validity, the total ISI score showed a strong positive correlation with the Pittsburgh Sleep Quality Index global score (r= 0.76, p < .001) and a moderate, negative correlation with vitality (r= ‐0.38, p=.026). Conclusions: The translated ISI demonstrated adequate reliability and validity. The translated ISI needs further testing in a larger sample of both clinical and healthy Arabic populations in their own countries. Clinical Relevance: Preliminary psychometric estimates show that the translated ISI is reliable and valid in this community‐dwelling Arabic sample. The translated ISI allows for Arabic researchers to screen for insomnia and plan for future intervention studies.
Emerging Biobehavioral Factors of Fatigue in Sickle Cell Disease
Authors: Ameringer Suzanne , Smith Wally R. 
Published: January 2011

Abstract Purpose: The symptom most frequently associated with sickle cell disease (SCD) is pain, but recent research is beginning to indicate that fatigue as an increasingly important symptom of this disease upon which to focus research efforts. This article explores biological and behavioral factors that can potentially contribute to fatigue in SCD. Organizing Framework: A biobehavioral framework guides this discussion of factors that may contribute to SCD fatigue. Findings: The pathophysiology of the disease process, such as the profound hemolytic anemia and unpredictable vasoocclusive crises, suggests that individuals with SCD are at risk for both acute and chronic fatigue. For example, hypoxemia can cause muscle weakness and produce oxidative stress, which, in turn, increases fatigue. Sickled erythrocytes disrupt the vascular endothelium and stimulate proinflammatory cytokines, which are linked to sleep disruptions. Pain, the most notorious symptom of SCD, has a complex and mechanistically poorly understood relationship with fatigue. Conclusions: Little is known about the symptom of fatigue in SCD. Considering the biological and behavioral factors of SCD that could potentially contribute to fatigue, there is a great need for research on the nature and potential mechanisms of fatigue in SCD. Clinical Relevance: Fatigue in SCD may negatively affect quality of life. Understanding factors that may contribute to fatigue aids the clinician in identifying causes and determining treatment.
Nurse Leader Mentor as a Mode of Being: Findings From an Australian Hermeneutic Phenomenological Study
Authors: McCloughen Andrea , O’ Brien Louise , Jackson Debra 
Published: January 2011

Abstract Purpose: To develop an interpretation of Australian nurse leaders’ understandings and experiences of mentorship for nurse leadership. The study aimed to explore experiential meanings and understandings that Australian nurse leaders apply to their mentoring relationships; determine whether mentoring relationships contribute to nurse leader development in Australia; and identify how Australian nurse leaders conceptualize mentorship. Design: Hermeneutic phenomenology provided the methodological framework for the study. A purposive sample of 13 Australian nurse leaders was interviewed so they could share subjective experiences of mentorship through conversational narrative. Interview transcripts were analyzed to uncover and isolate key aspects of the phenomenon in text. An adaptation of Radnitzky's hermeneutic circle was used to develop a hermeneutic meaning interpretation of the text. Findings: The lived experience of mentorship for nurse leadership was understood and described through three existential motifs: imagination, journey, and mode of being. This article specifically addresses the finding that mentorship for leadership was sustained by the mentor's mode of being. These nurse leaders were not formally prepared to be mentors; rather, they grew into being mentors as a result of their life journeys. Conclusions: The nurse leaders possessed a life attitude of mentorship that impacted how they perceived and interacted with their world. Mentorship was not formally learned, nor was it enacted as an adjunct role. Being a mentor was a fully integrated aspect of their person. Clinical Relevance: Nurse‐leaders use mentorship to grow and develop leadership potential in other nurses. Formal preparation to be a mentor is not fundamental to all mentorship. Some nurse leaders who mentor others for leadership grow into being mentors as a result of lifelong subjective experiences.
PCOS – what matters in early pregnancy?– data from a cross‐sectional, multicenter study
Authors: VANKY ESZTER , STRIDSKLEV SOLHILD , SKOGØY KRISTIN , KLEGGETVEIT ODRUN , HJELLE SISSEL , BRANDIS PHILIP V. , EIKELAND TORUNN , FLO KARIN , BERG KRISTIN FLATEN , BUNFORD GABOR , LUND AGNETHE , BJERKE CECILIE , ALMÅS INGUNN , BERG ANN HILDE , DANIELSSON ANNA , LAHMAMI GULIM , CARLSEN SVEN M. 
Published: January 2011

Abstract Objective. To describe patient characteristics according to different diagnostic criteria in early pregnancy, in women with polycystic ovary syndrome (PCOS). Design. Descriptive, cross‐sectional study of 257 women with PCOS in the first trimester of pregnancy. Setting. Data from a multicenter trial at the time of inclusion. Population. 257 PCOS women with singleton pregnancies. Methods. Investigator‐administrated questionnaires were filled out. Clinical examination was performed by the investigators. Fasting blood samples were collected. Main outcome measures. Biometric data, androgens, glucose and insulin levels. Results. Women who met the National Institutes of Health (NIH) criteria for PCOS had higher body mass index (BMI), testosterone, dehydroepiandrostenedione, free testosterone index (FTI) and insulin levels compared with those who only met the Rotterdam consensus criteria. Adjusted for age and BMI, only testosterone and FTI were higher in those who met the NIH criteria. BMI was a strong, independent predictor of both systolic and diastolic blood pressure in early PCOS pregnancy, while both FTI and fasting insulin were independent predictors of systolic blood pressure. Twenty‐two (9%) of the participants had gestational diabetes mellitus in the first trimester of pregnancy. Conclusions. In the first trimester, PCOS women diagnosed according to NIH criteria were more metabolically and endocrinologically abnormal compared with those who only met the Rotterdam consensus criteria. BMI and FTI were independent predictive factors for blood pressure. There was a high prevalence of gestational diabetes mellitus in early PCOS pregnancies.