bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of parenteral medicines in clinical areas: how can the risks be managed – a UK perspective?
Authors: Beaney Alison M 
Published: May 2010

Aims and objectives.  This article provides an overview of preparation of parenteral medicines in clinical areas. It describes the development of a tool to allow preparation of these medicines to be scored for risk. The article shows how this work was adopted by the National Patient Safety Agency (NPSA) and was subsequently issued as Patient Safety Alert 20 (Injectable Medicines).Background.  Although there are well‐established standards for preparation of parenteral medicines in pharmacy, there were no equivalent standards for their preparation in clinical areas, where risks to patients from medication error and microbiological contamination are greater. Use of a risk assessment process allows highest risk items to be targeted for transfer to pharmacy preparation. Defined standards and competency‐based training should reduce risk for preparation of those items remaining in clinical areas.Method.  Discursive.Conclusions.  This article identifies the risks involved in the preparation of parenteral medicines in clinical areas and describes ways in which these risks can be minimised.Relevance to clinical practice.  Use of risk assessment allows targeted transfer of high‐risk parenteral medicines to pharmacy preparation, where risks of medication error and microbiological contamination are lower. This transfer liberates nursing time for patient benefit.
Predictors of fatigue in patients with heart failure
Authors: Chen Li‐Huan , Li Chung‐Yi , Shieh Shyh‐Ming , Yin Wei‐Hsian , Chiou Ai‐Fu 
Published: May 2010

Aims and objectives.  The purpose of this study was to examine the level of fatigue perceived by patients with heart failure and to explore the potential factors influencing fatigue.Design.  A cross‐sectional, correlational design was used.Methods.  A convenience sample of 105 patients was recruited between July and September 2003 in northern Taiwan. The patients were interviewed, and their perceived fatigue was assessed with the modified Piper Fatigue Scale. The factors influencing fatigue were determined using a stepwise linear regression model.Results.  The majority of patients with heart failure experienced mild‐to‐moderate fatigue. Patients with higher levels of fatigue had worse physical functioning and more severe symptomatic and psychological distress. Symptomatic distress, psychological distress (depression and anxiety), New York Heart Association class, activities of daily living (ADL) and appraisal support by health care providers could explain 57·4% of the total variance of fatigue. Symptomatic distress was the strongest predictor of fatigue.Conclusion.  Higher levels of fatigue were found in patients with heart failure who had symptomatic or psychological distress. Additional research focusing on developing effective methods to reduce fatigue in patients with heart failure is recommended.Relevance to clinical practice.  Nurses should help patients with heart failure to monitor their symptoms and report them to health care providers. Early management of symptoms and support by health care providers may reduce patients’ fatigue, help maintain their physical functioning and improve their quality of life.
Pressure ulcer guideline development and dissemination in Europe
Authors: Meesterberends Esther , Halfens Ruud , Lohrmann Christa , De Wit Rianne 
Published: May 2010

Aims and objectives.  To explore the current state of pressure ulcer guideline development and dissemination, from national to local level (i.e. nursing homes) in six European countries: England, Germany, Italy, the Netherlands, Portugal and Sweden.Background.  Pressure ulcers are a persistent problem in healthcare institutions. Their prevalence is influenced by many factors, one of them being the development and dissemination of pressure ulcer guidelines. These are difficult and complex processes and it is not clear whether they differ between European countries.Design.  Literature review and semi‐structured interviews.Method.  Interviews were conducted in six countries at national and nursing home level.Results.  Four countries had national pressure ulcer prevention and treatment guidelines. Portugal had no national guidelines and Sweden had shifted the responsibility to regional level. All participating nursing homes had pressure ulcer guidelines except those in Portugal. Control and monitoring of guideline dissemination was carried out only in Sweden and England.Conclusions.  All countries studied have national or regional pressure ulcer prevention and treatment guidelines, except Portugal. Portugal is also the only country where none of the nursing homes included had pressure ulcer guidelines. Because the dissemination of such guidelines does not imply actual implementation, further research should focus on the implementation process.Relevance to clinical practice.  Clinical guidelines, like pressure ulcer guidelines, are important tools in guiding the care processes in healthcare institutions. Successful dissemination of guidelines from national level to individual healthcare institutions is a first and necessary step in actually applying them. Monitoring of the guideline dissemination process is therefore essential.
Increasing pressure ulcer rates and changes in delivery of care: a retrospective analysis at a University Clinic
Authors: Stausberg Jürgen , Lehmann Nils , Kröger Knut , Maier Irene , Schneider Helmut , Niebel Wolfgang ,   for the interdisciplinary decubitus project
Published: May 2010

Aim.  To evaluate the relation between pressure ulcers and delivery of care.Background.  No decrease of pressure ulcer rates could be recognised in acute hospital care, despite intensive efforts in prevention. Furthermore, reports show increasing rates.Design.  Retrospective analysis of hospital data.Methods.  The study included all inpatients from year 1 (2003/2004) and 4 (2006/2007) of the interdisciplinary decubitus project. Information on ulcers was recorded at admission, discharge and in case of new events. We analysed the effect of age, length of stay, operation and intensive care episode. In logistic regression, we used the existence of ulcers and the appearance of new ulcers as dependent variables.Results.  Parallel to a decrease in the number of inpatients, age, length of stay and operation frequency rose between 2003 and 2007. Higher age, longer length of stay, operation, intensive care episode and year 4 raise the odds for ulcers in univariate and with exception of operation in multivariate analyses. With exception of operation and year 4, the same variables raise the odds for new ulcers, too.Conclusions.  The increase of pressure ulcer frequency could be related to changes in delivery of care. The adverse event pressure ulcer will become more important in hospital care.Relevance to clinical practice.  There is no decrease in pressure ulcer rates, albeit enormous efforts in prevention. Hospital care has been facing changes in case mix. Age, length of stay and intensive care episodes are related to increasing ulcer rates at a University Clinic. Nursing management has to be aware of additional workload for pressure ulcer management in the future.
Variation in the cellular localization of host‐protective oncospheral antigens inTaenia saginataandTaenia solium
Authors: JABBAR A. , VERÁSTEGUI M. , LACKENBY J. A. , WALDUCK A. K. , GAUCI C. G. , GILMAN R. H. , LIGHTOWLERS M. W. 
Published: May 2010

SummaryImmunohistochemistry and immunofluorescence with confocal microscopy were used to localize the host‐protective antigens of Taenia saginata (TSA9 and TSA18) and Taenia solium (TSOL16, TSOL18 and TSOL45). In nonactivated oncospheres, TSA9 and TSOL45 antigens were found primarily in the cytoplasm of the penetration gland type one (PG1) cell. A similar pattern of staining was seen for TSOL45 in oncospheres of T. solium that remained within the oncospheral membrane. In addition, there was less intense staining of TSA9 and TSOL45 in the quadri‐nucleate penetration gland type 2 (PG2) cell. TSA18, TSOL16 and TSOL18 were predominantly found in the PG2 cell. In activated oncospheres that had escaped the oncospheral membrane, the antigens (other than TSA9) were seen both in the penetration gland cell locations and throughout the oncospheral parenchyma. Co‐localization analyses revealed that only TSOL16 and TSOL18 antigens were co‐localized in the PG2 cell of oncospheres that had not escaped the oncospheral membrane. However, in activated oncospheres that escaped the oncospheral membrane, all three antigens of T. solium were co‐localized as they were present throughout the parenchyma. No positive staining was observed on the surface of nonactivated or recently activated oncospheres of T. saginata or T. solium.
Retention of HIV‐infected and HIV‐exposed children in a comprehensive HIV clinical care programme in Western Kenya
Authors: Braitstein Paula , Katshcke Adrian , Shen Changyu , Sang Edwin , Nyandiko Winstone , Ochieng Vincent Ooko , Vreeman Rachel , Yiannoutsos Constantin T. , Wools‐Kaloustian Kara , Ayaya Samwel 
Published: May 2010

SummaryBackground  To describe incidence rates (IR) and risk factors for loss‐to‐follow‐up (LTFU) among HIV‐infected and HIV‐exposed children in a large HIV treatment programme in Western Kenya.Methods  The USAID‐AMPATH Partnership has enrolled >100 000 patients (20% children) at 23 clinic sites throughout western Kenya. LTFU is defined as being absent from the clinic for >3 months if on combination antiretroviral treatment (cART) and >6 months if not. Included in this analysis were children aged <14 years, HIV exposed or infected at enrolment, and enrolled between April 2002 and March 2009. The IR for LTFU are presented per 100 child‐years (CY) of follow‐up. Proportional hazards models with time‐independent and time‐dependent covariates were used to model factors associated with LTFU. Weight for height Z‐scores were calculated using EpiInfo, with severe malnutrition being defined as a Z‐score ≤−3.0. Immune suppression was defined as per WHO age‐specific categories.Results  There were 13 510 children eligible for analysis, comprising 3106 children who at enrolment were HIV infected and 10 404 children who were HIV exposed. The overall IR of LTFU was 18.4 (17.8–18.9) per 100 CY. Among HIV‐infected children, 15.2 (13.8–16.7) and 14.1 (13.1–15.8) per 100 CY became LTFU, pre‐ and post‐cART initiation, respectively. The only independent risk factor for becoming LTFU among the HIV‐infected children was severe immune suppression (AHR: 2.17, 95% CI: 1.51–3.12). Among the HIV‐exposed children, 20.1 per 100 (19.4–20.7) became LTFU. Independent risk factors for LTFU among them were being severely low weight for height (AHR: 1.69, 95% CI: 1.25–2.28), being orphaned at enrolment (AHR: 1.57, 95% CI: 1.23–1.64), being CDC Class B or C (AHR: 1.41, 95% CI: 1.14–1.74), and having received cART (AHR: 1.56, 95% CI: 1.23–1.99). Protective against becoming LTFU among the HIV exposed were testing HIV positive (AHR: 0.26, 95% CI: 0.21–0.32), older age (AHR: 0.90, 95% CI: 0.85–0.96), enrolling in later time periods, and receiving food supplementation (AHR: 0.58, 95% CI: 0.32–1.04).Conclusions  There is a high rate of LTFU among these highly vulnerable children, particularly among the HIV exposed. These data suggest that HIV‐infected and HIV‐exposed children are at especially high risk for LTFU if they are sick or malnourished.
Accordance and concordance of PCR and NASBA followed by oligochromatography for the molecular diagnosis of Trypanosoma brucei and Leishmania
Authors: Mugasa Claire M. , Deborggraeve Stijn , Schoone Gerard J. , Laurent Thierry , Leeflang Mariska M. , Ekangu Rosine A. , El Safi Sayda , Saad Al‐farazdag A. , Basiye Frank L. , De Doncker Simone , Lubega George W. , Kager Piet A. , Büscher Philippe , Schallig Henk D. F. H. 
Published: May 2010

SummaryObjective  To evaluate the repeatability and reproducibility of four simplified molecular assays for the diagnosis of Trypanosoma brucei spp. or Leishmania ssp. in a multicentre ring trial with seven participating laboratories.Methods  The tests are based on PCR or NASBA amplification of the parasites nucleic acids followed by rapid read‐out by oligochromatographic dipstick (PCR‐OC and NASBA‐OC).Results  On purified nucleic acid specimens, the repeatability and reproducibility of the tests were Tryp‐PRC‐OC, 91.7% and 95.5%; Tryp‐NASBA‐OC, 95.8% and 100%; Leish‐PCR‐OC, 95.9% and 98.1%; Leish‐NASBA‐OC, 92.3% and 98.2%. On blood specimens spiked with parasites, the repeatability and reproducibility of the tests were Tryp‐PRC‐OC, 78.4% and 86.6%; Tryp‐NASBA‐OC, 81.5% and 89.0%; Leish‐PCR‐OC, 87.1% and 91.7%; Leish‐NASBA‐OC, 74.8% and 86.2%.Conclusion  As repeatability and reproducibility of the tests were satisfactory, further phase II and III evaluations in clinical and population specimens from disease endemic countries are justified.
High proportion of mixed‐species Plasmodium infections in India revealed by PCR diagnostic assay
Authors: Gupta Bhavna , Gupta Purva , Sharma Arun , Singh Vineeta , Dash Aditya P. , Das Aparup 
Published: May 2010

SummaryAccurate diagnosis is the key to effective treatment and control of malaria. We screened 180 microscopically diagnosed Indian malaria‐positive blood samples for pure and mixed infections by Plasmodium falciparum and Plasmodium vivax. An unusually high proportion of mixed infections was detected, signifying the sensitivity of PCR assay over traditional microscopic diagnosis.
Evaluation of milk yield and some related maternal traits in a crossbreeding project of Egyptian Gabali breed with Spanish V‐line in rabbits
Authors: Iraqi M.M. , García M.L. , Khalil M.H. , Baselga M. 
Published: May 2010

SummaryThis study was conducted in a four‐year rabbit project that aimed to develop a synthetic line named Moshtohor (M) by crossing Sinai Gabali breed (G) with the Spanish V‐line (V). The G, V, F1 (G × V), F2 (G × V)2 and M line were analysed. Traits of doe body weight at delivery (DBW), litter size at birth (LSB) and at weaning (LSW), milk production during the first, second, third and fourth week of lactation and total milk yield (TMY) were recorded. Data were analysed using a repeatability uni‐trait animal model to estimate the genetic parameters and estimable functions of genetic group effects. Based on them and the matrix of their variance–covariance, the crossbreeding parameters were also estimated. Estimates of heritabilities for all the studied traits were low ranging from 0.06 to 0.11 for DBW, LSB and LSW and from 0.0 to 0.06 for milk production traits. Permanent environmental effects were very low ranging from 0.0 to 0.10 for all the traits, except for DBW (0.41). Least square means of V line were superior (p < 0.05) in DBW (3253 versus 3037 g) and LSB (6.71 versus 6.28 young) relative to G breed. M line had superiority in LSB (6.94 young) compared with G breed. M line and G breed were better than V line for milk production traits (3415 and 3236 versus 2893 g for TMY). Significant effects of direct additive were observed for most traits studied (ranged from −6.8 to 20.7%). Effects of individual heterosis for most milk production traits were significant and ranged from 2.1 to 13.9%, but they were not significant for DBW, LSB and LSW. On the opposite side, effects of maternal heterosis for all the traits were not significant.
Salmonellen in Milch und Milchprodukten
Authors: Becker H. , Terplan G. 
Published: May 2010

SummarySalmonellae in Milk and Milk ProductsSalmonellae, particularly typhoid and paratyphoid fever pathogens found in milk, were considered until the mid‐fifties as one of the major problems of food hygiene. By pasteurizing the entire consumer milk combined with technological and hygienic improvements in winning and processing milk as well as uninterrupted refrigeration, it has happened that milk, even in regard to other pathogens, is considered now one of the safest foodstuffs. For some milk products, e. g. dried milk products, the technological processes do not afford the same safety so that even when treated according to regulations, contamination is possible. The making of these products requires special in‐plant precautions. Apart from this, milk products do not involve any great risks compared with any other foodstuff.ZusammenfassungSalmonellen, vor allem Typhus‐ und Paratyphuserreger, in Rohmilch galten bis zur Mitte der fünfziger Jahre als eines der Hauptprobleme der Lebensmittelhygiene. Durch die generelle Pasteurisierung nahezu der gesamten Konsummilch in Verbindung mit technologischen und hygienischen Verbesserungen bei ihrer Gewinnung und Bearbeitung sowie einer geschlossenen Kühlkette wurden Voraussetzungen geschaffen, bei deren Beachtung Milch, auch im Hinblick auf andere Erreger, als eines der sichersten Lebensmittel gelten kann. Bei einigen Milchprodukten, z. B. getrockneten Milcherzeugnissen, bieten die technologischen Verfahren nicht die gleiche Sicherheit, so daß auch bei ordnungsgemäßem Betriebsablauf Kontaminationen nicht ausgeschlossen werden können. Die Herstellung dieser Erzeugnisse bedarf daher besonderer innerbetrieblicher Maßnahmen. Im übrigen stellen Milchprodukte heute im Vergleich zu anderen Lebensmitteln kein wesentliches Risiko dar.
Electron Microscopical Diagnosis of Ecthyma contagiosum in Camels (Camelus dromedarius) First Report of the Disease in Kenya
Authors: Munz E. , Schillinger D. , Reimann M. , Mahnel H. 
Published: May 2010

SummaryAn outbreak of generalized Ecthyma contagiosum in camels (Camelus dromedarius) was diagnosed for the first time in Kenya using electron microscopy for the investigation.ZusammenfassungElektronenmikroskopischer Nachweis von Parapocken bei Dromedaren Erster Bericht über das Auftreten der Krankheit in KenyaEs wird erstmals über generalisierte Parapocken (Ecthyma contagiosum) bei Kamelen (Camelus dromedarius) in Kenya berichtet. Die klinische Verdachtsdiagnose konnte durch den elektronenmikroskopischen Nachweis von typischen Parapocken‐Virionen gesichert werden.
Bacterial Growth in mastitic Milk and Whey
Authors: Malkamäki M. , Mattila T. , Sandholm M. 
Published: May 2010

SummaryGrowth ofStr. agalactiae, S. aureusandE. coliwas analyzed in 20 milk and whey samples, half of which were from mastitic quarters and the other half from healthy quarters of the same cows. The increase in bacterial biomass in whole milk was followed by monitoring ATP by a luciferin‐luciferase luminometric procedure. Bacterial growth in whey cultures was monitored by a tubidometric microtechnique. Bacteria showed significantly enhanced replication rates in mastitic milk and whey samples as compared with samples from control quarters. This was true for all three strains of bacteria used as inoculums. The increase in bacterial ATP showed a good correlation with the inflammatory markers for mastitis: SCC, NAGase, antitrypsin, BSA and plasmin. Monitoring bacterial growth by ATP is suggested as a marker for mastitis, keeping in mind the pathogenetic aspect of mastitis where the inflammation induces a change in milk which stimulates bacterial growth.ZusammenfassungDas Wachstum von Bakterien in Milch‐ und Molkenproben aus an Mastitis erkrankten EuterviertelnDas Wachstum vonStr. agalactiae, S. aureusundE. coliwurde in 20 Milch‐ und Molkenproben untersucht. Die Hälfte der Proben stammte aus an Mastitis erkrankten Eutervierteln und die andere Hälfte von gesunden Vierteln derselben Kühe. Die Zunahme der bakteriellen Biomasse in der Vollmilch wurde mittels ATP‐Bestimmung durch eine Luciferin‐Luciferase‐Lumineszenzmethode untersucht. Das Bakterienwachstum in den Molkenkulturen wurde mit einer turbidimetrischen Mikrotechnik dargestellt. Im Vergleich zu den Proben aus den gesunden Eutervierteln ließ sich in den Milch‐ und Molkeproben aus den kranken Vierteln eine deutlich gesteigerte Vermehrungsrate der Bakterien nachweisen. Dies galt für alle drei Bakterienstämme, die als Impfmaterial benutzt wurden. Die ATP‐Zunahme der Bakterien zeigte eine gute Korrelation mit den Entzündungssymptomen der Mastitis: SCC, NAGase, Antitrypsin, BSA und Plasmin. Da durch eine Entzündung eine Veränderung in der Milch hervorgerufen wird, die das Bakterienwachstum anregt, wird zur Erkennung der Mastitis eine Überwachung des Bakterienwachstums durch den ATP‐Nachweis vorgeschlagen.
Humoral Immune Response Following Rinderpest Vaccination in Cattle and Sheep1
Authors: Srour E. , El‐Zein A. 
Published: May 2010

SummaryThe effects of maternal antibodies (Ab) and of persisting Ab from previous vaccination on the humoral immune response of cattle to rinderpest virus was investigated. High or low prevaccination virus‐neutralizing Ab titres from passive or active sources resulted in weak or strong immune responses to vaccination, respectively. Under optimal conditions of vaccination, titres of 100, and in a few cases of 200 and 400, were observed. The magnitude of the immune response following primary vaccination in sheep is also reported.ZusammenfassungHumorale Immunantwort nach der Rinderpestschutzimpfung bei Rindern und SchafenEs wurden Wirkungen von maternalen Antikörpern und von Antikörpern aus früheren Impfungen im Hinblick auf die humorale Immunantwort des Rindes auf Rinderpestvirus untersucht. Hohe bzw. niedere Titer virusneutralisierender Antikörper vor der Impfung — passiv oder aktiv erworben — bewirkten jeweils schwache bzw. starke Immunantwort auf die Impfung. Bei optimalen Impfbedingungen wurden Titer von 100, in einigen Fällen von 200 und 400 beobachtet. Über die Stärke der Immunantwort nach Erstimpfung beim Schaf wird ebenfalls berichtet.
Comparison of the Effect of Viral Paramunity Inducers PIND‐AVI and PIND‐ORF with that of BCG, Corynebacterium parvum and Levamisole on the Growth of Radiation‐Induced Murine Osteosarcoma
Authors: Müller‐Brunecker G. , Erfle V. , Mayr A. 
Published: May 2010

SummaryThe effect of viral paramunity inducers PIND‐AVI and PIND‐ORF on the growth of a radiation‐induced murine osteosarcoma (TV) was compared with that of levamisole, BCG, and Corynebacterium parvum. The TV osteosarcoma was not immunogenic. PIND‐AVI or PIND‐ORF pretreatment of the animals significantly reduced the tumor induction rate and prolonged the latency period. A significantly lower tumor induction rate was also achieved with Corynebacterium parvum. In contrast to the paramunity inducers, Corynebacterium parvum treatment affected the physical condition of the treated animals. BCG and levamisole had no effect on the growth of murine osteosarcomas.ZusammenfassungIn vergleichenden Untersuchungen wurde der Einfluß der viralen Paramunitätsinducer PIND‐AVI und PIND‐ORF auf das Wachstum eines strahleninduzierten Osteosarkoms der Maus (TV) mit dem von Levamisol, BCG und Corynebacterium parvum untersucht. Das TV‐Osteosarkom induzierte keine tumorspezifische Immunantwort. Die Behandlung mit PIND‐AVI und PIND‐ORF verringerte signifikant die Tumorinzidenz und verlängerte die Tumorlatenzzeit. Auch mit C. parvum konnte eine niedrigere Tumorinduktion erreicht werden. Im Gegensatz zu PIND‐AVI und PIND‐ORF war der Allgemeinzustand nach C. parvum‐Behandlung stark beeinträchtigt. BCG und Levamisol zeigten keinen Effekt auf das Wachstum des Osteosarkoms.