bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women's Experiences of Participating in the Magpie Trial: A Postal Survey in the United Kingdom
Authors: Smyth Rebecca M.D. , Duley Lelia , Jacoby Ann , Elbourne Diana 
Published: September 2009

ABSTRACT: Background:
The Magpie Trial compared magnesium sulfate with placebo for women with preeclampsia. The objective of this study was to explore women's views and experiences of participating in the Magpie Trial in the United Kingdom.
Methods:
Postal questionnaires were sent to 771 women participants in the Magpie Trial to assess long‐term health of UK women and children. The questionnaire included three questions exploring women's experience of participating in the trial: (a) If time suddenly went backward, and you had to do it all over again, would you agree to participate in the Magpie Trial? (b) Please tell us if there was anything about the Magpie Trial that you think could have been done better; and (c) Please tell us if there was anything about the Magpie Trial, or your experience of joining the trial, that you think was particularly good.
Results:
Overall, 619 of the 771 women who were sent questionnaires returned them. In response to the three questions: (a) 58 percent (356) of women responded “definitely yes,” 27 percent (169) “probably yes,” 4 percent (23) “probably no,” 5 percent (33) “definitely no,” and 5 percent (34) “not sure.” No clear evidence was shown of a relationship with allocated treatment, although women who responded “probably or definitely no” were more likely to have had side effects from trial treatment. (b) Although 44 percent of women stated that nothing could have been done better, free text suggestions related to content of recruitment information, and its timing, and wanting to know treatment allocation and trial results. c) Women were generally extremely positive about being followed up and receiving trial results.
Conclusions:
Women were largely positive about participation in the trial and its follow‐up, but still reported ways they believed the study could have been improved, such as more information, given earlier, which also has implications for clinical care.
Relationship Between Higher Estradiol Levels and 9‐Year Mortality in Older Women: The Invecchiare in Chianti Study
Authors: Maggio Marcello , Ceda Gian Paolo , Lauretani Fulvio , Bandinelli Stefania , Ruggiero Carmelinda , Guralnik Jack M. , Jeffrey Metter E. , Ling Shari M. , Paolisso Giuseppe , Valenti Giorgio , Cappola Anne R. , Ferrucci Luigi 
Published: September 2009

OBJECTIVES: To investigate the relationship between total estradiol (E2) levels and 9‐year mortality in older postmenopausal women not taking hormone replacement therapy (HRT).DESIGN: Population‐based study of persons living in the Chianti geographic area (Tuscany, Italy).SETTING: Community.PARTICIPANTS: A representative sample of 509 women aged 65 and older with measures of total E2.MEASUREMENTS: Serum total E2 was measured at the University of Parma using ultrasensitive radioimmunoassay (RIA).RESULTS: Women who died (n=135) during 9 years of follow up were older; had higher total E2 levels; and were more likely to have evidence of stroke, hypertension, diabetes mellitus, and congestive heart failure at baseline than survivors. Higher E2 levels were associated with a greater likelihood of death (hazard ratio (HR)=1.03, 95% confidence interval (CI)=1.01–1.06), and the relationship was independent of age, waist:hip ratio, C‐reactive protein, education, cognitive function, physical activity, caloric intake, smoking, and chronic disease (HR=1.08 pg/mL, 95% CI=1.03–1.13, P=.003). The excessive risk of death associated with higher total E2 was not attenuated after adjustment for total testosterone (HR=1.12, 95% CI=1.02–1.18, P<.001) and after further adjustment for insulin resistance evaluated using the homeostasis model assessment (HR=1.07, 95% CI=1.03–1.17, P<.001).Total E2 was highly predictive of death after more than 5 years (HR=1.42: CI 1.01–1.91, P=.04) and not predictive of death for less than 5 years (P=.78).CONCLUSION: Higher total E2 concentration predicts mortality in older women not taking HRT.
Factors Associated with Accurate Recall of Prior Disability in Older Persons
Authors: Gill Thomas M. , Ness Peter H. Van , Gahbauer Evelyne A. 
Published: September 2009

OBJECTIVES: To identify the factors associated with accurate recall of prior disability.DESIGN: Cohort study.SETTING: Greater New Haven, Connecticut.PARTICIPANTS: Ninety‐two participants, included in each of two analytical samples, who were nondisabled at the present time in four essential activities of daily living (ADLs; bathing, dressing, transferring, and walking) but who had had at least 1 month of disability during the prior year as determined from monthly telephone interviews.MEASUREMENTS: Participants who did not need help from another person at the present time were asked to recall whether they had needed help from another person to complete the relevant ADL at any time during the previous 12 months.RESULTS: Forty‐five (48.9%) and 46 (50.0%) of the 92 participants accurately recalled having had disability in the prior year in the first and second analytical samples, respectively. Having at least a high school education was the only factor independently associated with accurate recall in the first analytical sample, with an adjusted odds ratio (AOR) of 3.03 (95% confidence interval (CI)=1.11−8.31), whereas a composite disability scale that considered the timing and severity of prior disability was the only factor independently associated with accurate recall in the second analytic sample (AOR=5.38, 95% CI=1.81−16.1).CONCLUSION: The results of the current study, coupled with those of previous studies, suggest potential strategies that could be used to more completely and accurately ascertain the occurrence of disability in older persons.
Moderate Alcohol Intake and Risk of Functional Decline: The Health, Aging, and Body Composition Study
Authors: Maraldi Cinzia , Harris Tamara B. , Newman Anne B. , Kritchevsky Stephen B. , Pahor Marco , Koster Annemarie , Satterfield Suzanne , Ayonayon Hilsa N. , Fellin Renato , Volpato Stefano ,   for the Health ABC study
Published: September 2009

OBJECTIVES: To investigate the prospective relationship between alcohol consumption and incident mobility limitation.DESIGN: Cohort study.SETTING: The Health Aging and Body Composition study, conducted in Memphis, Tennessee, and Pittsburgh, Pennsylvania.PARTICIPANTS: Three thousand sixty‐one adults aged 70 to 79 without mobility disability at baseline.MEASUREMENTS: Incidence of mobility limitation, defined as self‐report at two consecutive semiannual interviews of any difficulty walking one‐quarter of a mile or climbing stairs, and incidence of mobility disability, defined as severe difficulty or inability to perform these tasks at two consecutive reports. Alcohol intake, lifestyle‐related variables, diseases, and health status indicators were assessed at baseline.RESULTS: During a follow‐up time of 6.5 years, participants consuming moderate levels of alcohol had the lowest incidence of mobility limitation (total: 6.4 per 100 person‐years (person‐years); men: 6.4 per 100 person‐years; women: 7.3 per 100 person‐years) and mobility disability (total: 2.7 per 100 person‐years; men: 2.5 per 100 person‐years; women: 2.9 per 100 person‐years). Adjusting for demographic characteristics, moderate alcohol intake was associated with lower risk of mobility limitation (hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.55–0.89) and mobility disability (HR=0.66, 95% CI=0.45–0.95) than never or occasional consumption. Additional adjustment for lifestyle‐related variables substantially reduced the strength of the associations (HR=0.85, 95% CI=0.66–1.08 and HR=0.81, 95% CI=0.56–1.18, respectively). Adjustment for diseases and health status indicators did not affect the strength of the associations, suggesting that lifestyle is most important in confounding this relationship.CONCLUSION: Lifestyle‐related characteristics mainly accounted for the association between moderate alcohol intake and lower risk of functional decline over time. These findings do not support a direct causal effect of alcohol intake on physical function.
Variability in calcium, phosphorus, and parathyroid hormone in patients on hemodialysis
Authors: LEVITT Helena , SMITH Kenneth G. , ROSNER Mitchell H. 
Published: September 2009

AbstractCalcium, phosphorus, and parathyroid hormone (PTH) levels are routinely measured in patients undergoing chronic hemodialysis. Medications, diet, and dialytic therapies are modified based upon these lab values to achieve specific goal values in the hope of improving outcomes. However, the variability of these values in patients undergoing chronic hemodialysis has only been rarely studied.We prospectively investigated the variability of these measures in 35 patients undergoing chronic hemodialysis as well as the impact of this variability on clinical decision‐making in a prospective manner over a month. There is significant session‐to‐session variability in phosphorus and PTH values (mean coefficient of variations [CV] of 0.19 and 0.31, respectively). Calcium variability is much lower (mean CV of 0.05). Not surprisingly, the CV for all values is increased during the long interdialytic interval. The impact of this variability on clinical decision‐making was analyzed. The variability in calcium, phosphorus, and PTH values would lead to a different clinical decision in 23.6%, 41.2%, and 39.7% of different session lab values. We also investigated the variability of these lab measures over a year in these patients and found that the session‐to‐session variability was very similar to the month‐to‐month variability.The high degree of variability of these parameters has important implications for clinical decision‐making and for implementation of pay‐for‐performance measures.
Bone marrow blasts level predicts prognosis in patients with refractory cytopenia with multilineage dysplasia
Authors: Wang Hong , Wang Xiao‐Qin , Xu Xiao‐Ping , Lin Guo‐Wei 
Published: September 2009

AbstractObjectives:  Current prognostic models for myelodysplastic syndrome (MDS) do not consider the prognostic value of a bone marrow blast level that is <5%. Exploring the prognostic value of the International Prognostic Scoring System (IPSS) and a marrow blast level that is <5% may lead to better risk‐adapted therapeutic strategies.Methods:  According to the World Health Organization classification, most of our patients (65.5%) fell into the new category ‘refractory cytopenia with multilineage dysplasia’ (RCMD). We evaluated the prognostic value of the IPSS in 435 adult patients with de novo MDS and in the 285 of them that had RCMD in a Chinese population. We also analyzed the prognostic value of bone marrow blast levels in patients with RCMD and in different IPSS risk groups.Results:  We found a significant difference in survival times between RCMD patients with a marrow blast level of 3.5% or higher vs. those with a blast level of <3.5%, with median survival times of 23.7 and 40.8 months, respectively. In addition, application of a marrow blast level cutoff of 3.5% in patients with RCMD could identify patients with a lower IPSS risk but with a potentially worse prognosis. Multivariate analysis showed marrow blast level (using 3.5% as the cutoff) to be an independent factor that impacted survival times of patients with RCMD. Furthermore, we also found that IPSS had strong prognostic value in Chinese RCMD population.Conclusion:  In patients with RCMD, a higher percentage of marrow blasts was associated with a worse prognosis.
Topical 8‐methoxypsoralen increases the efficacy of narrowband ultraviolet B in psoriasis
Authors: Seckin Dilek , Usta Inan , Yazici Zuleyha , Senol Asli 
Published: September 2009

Background: A combination of oral psoralen with narrowband ultraviolet B (UVB), defined as ‘psoralen‐narrowband UVB’, was shown to have a superior efficacy than UVB alone and even a comparable efficacy to psoralen and ultraviolet A in psoriasis.Objective: To find out whether topical psoralen‐narrowband UVB provides any additional benefit to narrowband UVB alone in psoriasis.Methods: Nineteen patients with plaque psoriasis were included. Phototherapy was given three times per week. Two symmetrical lesions were selected as target lesions. In the first 12 sessions of phototherapy, the target lesion on one side was treated with 1% 8‐methoxypsoralen (MOP) gel 30 min before UVB radiation whereas the target lesion on the other side served as a control. Target lesion scores were assessed at baseline, third, sixth, ninth and 12th sessions. Side effects were recorded.Results: Sixteen patients completed the study. Target lesion scores decreased significantly on both sides (P<0.0001). The mean percentage of decreases was greater on the 8‐MOP‐applied sides compared with the control sides for all assessments, but the difference was statistically significant only at the ninth session (37.7% vs. 58.6%, P=0.043). Pigmentation was frequently seen in 8‐MOP gel‐applied lesions.Conclusion: Topical 8‐MOP gel plus narrowband UVB has greater efficacy than narrowband UVB alone in psoriasis.
Application of sunscreen preparations: a need to change the regulations
Authors: Reich Adam , Harupa Magdalena , Bury Marta , Chrzaszcz Justyna , Starczewska Anna 
Published: September 2009

Background/purpose: To achieve photoprotection indicated on the package of sunscreen products they should be used appropriately. As previously published data documented that people usually applied much less than the recommended dose, the current study was undertaken to assess whether a detailed instruction can improve the use of sunscreens.Methods: A total of 105 volunteers were asked to apply sunscreen to the whole skin surface in the same way that they would do it before sun exposure. A subgroup of patients (n=53) were precisely instructed about the proper usage of sunscreens and compared with uninstructed subjects (n=52). Each tube containing the tested product was weighed before and after application to determine the quantity of the substance, that was used, and to compare it with the recommended dose.Results: Instructed subjects used significantly more sunscreens (mean 8.6 ± 4.1 g/m2) compared with uninstructed controls (mean 6.8 ± 3.9 g/m2, P=0.03). However, both groups used much less of sunscreens than was the recommended amount (i.e. 43.0% and 34.1% of the recommended dose, respectively).Conclusion: Current regulations about the sunscreen use are inadequate when compared with clinical practice and better standards of photoprotection should be elaborated in the future.
A study of the way in which dermatologists and photosensitive patients apply sunscreen in China
Authors: Yang Hei Ping , Chen Kun , Ju Mei , Chang Bao Zhu , Wang Li Yin , Gu Heng 
Published: September 2009

Objective: To study sunscreen product application by dermatologists and photosensitive patients in China for drawing up proper directions for most efficient use of sunscreen.Methods: Thirty‐nine dermatologists and 41 photosensitive patients were enrolled in this study. They were asked to apply the cream in the same way they apply sunscreen products. The mimicking cream contained dipyridamole, which is fluorescent under Wood's light (WL). Cream distribution on skin and applied amount were visually assessed under WL using a grading scale.Results: Based on results from mimicking cream use, sunscreen application by both dermatologists and photosensitive patients was shown to be inadequate, i.e. wrongly done with the palm of the hand, unevenly distributed, an insufficient amount applied, and/or sensitive areas left uncovered. The ears, neck, and dorsum of the hands were most often left unprotected.Conclusion: Inadequate sunscreen application was found to be a common failing in both dermatologists and photosensitive patients. Suitable application was only provided on central, prominent areas, with a sharply decreasing gradient of product and low application toward lateral regions of the body as a result. Continuous education and further training programs are urgently needed to ensure the correct application of sunscreen and to provide effective sun protection.
Mitigation of acute ultraviolet B radiation‐mediated damages by baicalin in mouse skin
Authors: Zhou Bing‐Rong , Lin Bing‐Jiang , Jin Song‐Liang , Luo Dan 
Published: September 2009

Background: Solar ultraviolet (UV) irradiation, in particular UVB with a wavelength range between 290 and 320 nm, induces different hazardous effects on the skin, including sunburn, photoaging and cancer. Protection against sun‐induced damage is therefore a highly desirable goal. Chemoprevention is being investigated as a potential approach for the management of UV damages including skin cancer.Aim: In this study, to determine the relevance of our in vitro findings to in vivo situations, we assessed the effects of baicalin on UVB‐mediated damages in mice skin.Methods: Balb/C hairless mice were topically pretreated (24 h before UVB) or post‐treated (5 min after UVB) with baicalin (1 mg/cm2 skin area/mouse/100 μl acetone) and were exposed to UVB 24 h later (180 mJ/cm2). The animals were sacrificed 1 and 24 h after the UVB exposure. Skin edema, histopathology changes, hydrogen peroxide (H2O2) and cyclobutane pyrimidine dimers (CPDs)‐positive cells were assessed to determine the UVB‐induced photodamage.Results: Our data demonstrated that a topical application of baicalin, either as a pretreatment or as a post‐treatment, resulted in a significant decrease in UVB mediated increases in skin edema, skin hyperplasia and infiltration of leukocytes. Further, baicalin treatments (pre and post) also resulted in a significant decrease in UVB mediated (1) generation of H2O2 and (2) formation of DNA photolesions: CPDs.Conclusion: Based on these data, we suggest that baicalin could be developed as an agent for the management of conditions elicited by UV exposure including skin cancer.
Phototoxic reactions in healthy volunteers following photodynamic therapy with methylaminolevulinate cream or with cream containing 5‐aminolevulinic acid: a phase II, randomized study
Authors: Steinbauer Julia , Schreml Stephan , Karrer Sigrid , Ackermann Günther , Babilas Philipp , Landthaler Michael , Szeimies Rolf‐Markus 
Published: September 2009

Background: Photodynamic therapy (PDT) is the selective destruction of abnormal cells through activation of a photosensitizer in the presence of oxygen. Local phototoxic reactions and pain are the most common limiting side effects.Purpose: The primary objective was to compare the local phototoxic response following PDT with methylaminolevulinate (MAL) and 5‐aminolevulinic acid (ALA). The secondary objectives were to compare the two treatments regarding pain, detection of substance P, change in fluorescence intensity from before to 5 h after cream application and adverse events not related to local phototoxicity.Methods: Thirty‐four healthy volunteers were treated by PDT using MAL 160 mg/g cream and ALA cream 20% randomly assigned to treatment areas on the inside of each upper arm. A composite score of local phototoxic events (erythema, edema, hyperpigmentation) was calculated.Results: The area under the curve (AUC) analysis of composite scores showed a significantly higher AUC for ALA‐PDT (P≤0.0001). ALA‐ and MAL‐PDT showed equivalent local side‐effect frequencies, except for a higher frequency of hyperpigmentation after 28 d using ALA‐PDT (P=0.006).Conclusion: MAL‐ and ALA‐PDT are nearly equivalent regarding individual side‐effect frequencies, but MAL‐PDT has a more favorable phototoxicity pattern as seen by AUC analysis and the lower frequency of long‐lasting hyperpigmentation.
Reversal of ultraviolet B‐induced immunosuppression by inhibition of the extracellular signal‐regulated mitogen‐activated protein kinase
Authors: Leng Hong , Luo Xiaoqun , Ma Li , Kang Kefei , Zheng Zhizhong 
Published: September 2009

Objective: Topical treatment of the specific inhibitor PD98059 (PD) for extracellular signal‐regulated kinase (ERK)1/2 combined with ultraviolet B (UVB) exposure in an in vivo study was proposed to confirm the effectiveness of ERK1/2 involved in UVB‐induced immunosuppression that was reversed by PD.Methods: Based on the mouse model of local UVB‐induced immunosuppression [UVB exposure, followed by sensitization with dinitrofluorobenzene (DNFB) on the abdomen skin before challenge on the ear site], the PD was applied on the abdomen‐irradiated area 1 h, immediately before and 6 h after UVB exposure, respectively. The baseline of ear thickness was measured and remeasured 24 h after the challenge of DNFB for evaluation of ear‐swelling response. Histopathologically, the ear biopsies were taken for hematoxylin and eosin staining.Results: Mice that received PD post‐irradiation treatment showed a statistically significant contact hypersensitivity compared with the UVB‐irradiated mice (P<0.05), and paralleled with the biopsy showing a thickened epidermis with lymphocyte infiltration. Thus, the PD had abrogated the UV‐induced local suppression of contact hypersensitivity.Conclusion: The ERK1/2 mitogen‐activated protein kinase (MAPK) pathway plays an important role in the local UVB‐induced immunosuppression, and its specific inhibitor PD can arrest its function, resulting in protection against UVB‐induced immunosuppression in the present in vivo study.
Sunscreens: expectation and realization
Authors: Diffey Brian 
Published: September 2009

Background: The technical performance of sunscreens has improved dramatically over the past 20 years, so have we now succeeded in delivering protection that meets consumers' expectations?Methods: From a public health perspective, the desire to prevent sunburn and protect against skin cancer are the two major drivers for using sunscreen. This review examines how well consumers can expect to realize these expectations.Results: Sunscreens are used regularly by a minority of people, even during recreational summer exposure. The failure of sunscreen to prevent sunburn is almost always due to the way that sunscreens are applied rather than technical failure of the product. The mismatch between the labelled protection (sun protection factor) and that delivered in practice is a contributory factor to this ‘failure’. Sunscreens have been shown to be effective in reducing the incidence of squamous cell cancer and with promising benefits for basal cell cancer. However, the evidence that they are effective in melanoma remains lacking.Conclusion: The formulation and extinction of sunscreens have undoubtedly improved over recent years. Yet the notion that sunscreens provide unequivocal protection against the deleterious effects of sun exposure by everyone who uses them remains elusive.