bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Coercive Physical Measures in a Psychiatric Ward of a General Hospital in Greece
Authors: Bilanakis Nikolaos , Kalampokis Georgios , Christou Konstantinos , Peritogiannis Vaios 
Published: July 2009

Background: Coercive physical measures are commonly used in psychiatric units throughout the world for the management of severe behaviourally disturbed patients. Aim: The aim of this study was to assess the rates of coercive physical measures (seclusion and restraint) used in psychiatric inpatients in the psychiatric unit of a general hospital in Greece. Methods: A retrospective chart review of all admissions to the psychiatric unit of the University General Hospital of loannina during a six-month period was conducted. Differences between patients who were subjected to coercion and patients who did not receive any coercive treatment were statistically analyzed and compared. Results: Of the total of 282 admissions during the study period, 31 (11.0%) cases had been subjected to some form of coercive physical measures: 9.55% and 1.76% were affected by seclusion and mechanical restraint, respectively (one patient had been subjected to both). The mean duration of any one seclusion and mechanical restraint was 64.9 hours and the mean number of seclusion and restraint per affected case was 3.58. Statistical analysis between the group subjected to coercive measures and the group who was not did not reveal any association with demographic data or diagnosis. Coercive measures were found to be associated only with the type of admission at intake. Conclusions: Involuntary admissions were associated with statistically significant higher levels of restraint and seclusion in this patient sample. Strategies that will enhance patients’ follow-up are expected to prevent involuntary admissions and reduce the use of coercive measures.
Distinct spatio-temporal Ca2+ signaling elicited by integrin α2β1 and glycoprotein VI under flow
Authors: Mazzucato Mario , Cozzi Maria Rita , Battiston Monica , Jandrot-Perrus Martine , Mongiat Maurizio , Marchese Patrizia , Kunicki Thomas J. , Ruggeri Zaverio M. , De Marco Luigi 
Published: July 2009

AbstractWe studied how integrin α2β1 and glycoprotein VI (GPVI) contribute to collagen-induced platelet activation under flow conditions by evaluating stable adhesion and intracellular Ca2+ concentration ([Ca2+]i) of FLUO 3-AM–labeled platelets perfused over acid-soluble type I or microfibrillar type VI collagen. Adhering platelets displayed 2 kinds of [Ca2+]i oscillations. Rapid α-like peaks were unaffected by the membrane-impermeable Ca2+ chelator ethyleneglycoltetraacetic acid but abolished by membrane-permeable BAPTA-AM. Longer-lasting γ-like peaks were always preceded by at least one α-like peak and abolished by intracellular or extracellular Ca2+ chelation. Inhibition of phosphatidylinositol 3-kinase or phospholipase C and modulation of cyclic nucleotides, but not blockage of adenosine diphosphate receptors, prevented both Ca2+ responses. Human or mouse platelets lacking GPVI function exhibited α-like but not γ-like Ca2+ peaks, whereas those lacking α2β1 showed markedly reduced to absent α-like and no γ-like Ca2+ peaks. Specific α2β1 ligation induced α-like but not γ-like peaks. Thus, α2β1 may generate Ca2+ signals that are reinforced by GPVI and required for subsequent longer-lasting Ca2+ oscillation mediated by GPVI through transmembrane ion flux. Our results delineate a GPVI-independent signaling role of α2β1 in response to collagen stimulation.
Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil
Authors: Ribeiro Eleonora RO , Guimarães Alzira Maria DN , Bettiol Heloísa , Lima Danilo DF , Almeida Maria Luiza D , de Souza Luiz , Silva Antônio Augusto M , Gurgel Ricardo Q 
Published: July 2009

Abstract

Background
The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil.

Methods
A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Results: Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age < 18 to 34 years at delivery, low maternal schooling, low family income, two or more previous deliveries, maternal smoking during pregnancy, having no partner and prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use.

Conclusion
Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.
"Good idea but not feasible" – the views of decision makers and stakeholders towards strategies for better palliative care in Germany: a representative survey
Authors: Lueckmann Sara Lena , Behmann Mareike , Bisson Susanne , Schneider Nils 
Published: July 2009

Abstract

Background
Statements on potential measures to improve palliative care in Germany predominantly reflect the points of view of experts from specialized palliative care organizations. By contrast, relatively little is known about the views of representatives of organizations and institutions that do not explicitly specialize in palliative care, but are involved to a relevant extent in the decision-making and policy-making processes. Therefore, for the first time in Germany, we carried out a representative study of the attitudes of a broad range of different stakeholders acting at the national or state level of the health care system.

Methods
442 organizations and institutions were included and grouped as follows: patient organizations, nursing organizations, medical associations, specialized palliative care organizations, political institutions, health insurance funds and others. Using a standardized questionnaire, the participants were asked to rate their agreement with the World Health Organization's definition of palliative care (five-point scale: 1 = completely agree, 5 = completely disagree) and to evaluate 18 pre-selected improvement measures with regard to their general meaningfulness and the feasibility of their introduction into the German health care system (two-point scale: 1 = good, 2 = poor).

Results
The response rate was 67%. Overall, the acceptance of the aims of palliative care in the WHO definition was strong. However, the level of agreement among health insurance funds' representatives was significantly less than that among representatives of the palliative care organizations. All the improvement measures selected for evaluation were rated significantly higher in respect of their meaningfulness than of their feasibility in Germany. In detail, the meaningfulness of 16 measures was evaluated positively (70–100% participants chose the answer "good"); for six of these measures feasibility was evaluated negatively (0–30% "good"), while for the remaining ten measures feasibility was evaluated inconsistently (31–69% "good").

Conclusion
The reason why potentially meaningful improvement measures are considered to be not very feasible in Germany may be the existence of barriers resulting from the high degree of fragmentation of health care provision and responsibilities. In overcoming these barriers and further improving palliative care it may be helpful that the basic understanding of the palliative care approach seems to be quite homogenous among the different groups.
Use of dried blood for measurement of trans fatty acids
Authors: Gupta Ruby , Abraham Ransi Ann , Dhatwalia Savita , Ramakrishnan Lakshmy , Prabhakaran Dorairaj , Reddy Kolli Srinath 
Published: July 2009

Abstract

Background
Fatty acid measurements especially trans fatty acid has gained interest in recent times. Among the various available biomarkers, adipose tissue is considered to be the best for the long term dietary intake but the invasive nature of tissue aspiration reduces its utility. Phlebotomy is a much less invasive method of sample collection when a large number of participants are involved in the study and therefore is an alternative, most suitable for large population based studies. In the present study fatty acid (with special emphasis on trans fatty acid) extraction from blood spotted and dried on filter paper was carried out to simplify the sample collection procedure and transportation.

Methods
Blood samples were collected from 19 healthy volunteers. The blood was spotted (30 spots of 10 μl each) on filter paper, dried at room temperature and stored at 4°C in zip-lock poly bags. For comparison whole blood stored at -70°C was simultaneously analyzed.

Results
A good agreement was seen between trans fatty acid values obtained in dried blood and whole blood as evident from the pearson correlation coefficients ('r' for monounsaturated (trans) 0.70 and for polyunsaturated (trans) 0.692 respectively). The intraclass correlation coefficient for monounsaturated trans was 0.805 and for polyunsarurated trans was 0.776.

Conclusion
Dried blood spots can be used for trans fatty acid analysis.
DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease – a multicentre RCT
Authors: Jones Rob , Sheehan Bart , Phillips Patrick , Juszczak Ed , Adams Jessica , Baldwin Ashley , Ballard Clive , Banerjee Sube , Barber Bob , Bentham Peter , Brown Richard , Burns Alistair , Dening Tom , Findlay David , Gray Richard , Griffin Mary , Holmes Clive , Hughes Alan , Jacoby Robin , Johnson Tony , Jones Roy , Knapp Martin , Lindesay James , McKeith Ian , McShane Rupert , Macharouthu Ajay , O'Brien John , Onions Caroline , Passmore Peter , Raftery James , Ritchie Craig , Howard Rob ,   the DOMINO-AD team
Published: July 2009

AbstractBackgroundAlzheimer's disease (AD) is the commonest cause of dementia. Cholinesterase inhibitors, such as donepezil, are the drug class with the best evidence of efficacy, licensed for mild to moderate AD, while the glutamate antagonist memantine has been widely prescribed, often in the later stages of AD. Memantine is licensed for moderate to severe dementia in AD but is not recommended by the England and Wales National Institute for Health and Clinical Excellence. However, there is little evidence to guide clinicians as to what to prescribe as AD advances; in particular, what to do as the condition progresses from moderate to severe. Options include continuing cholinesterase inhibitors irrespective of decline, adding memantine to cholinesterase inhibitors, or prescribing memantine instead of cholinesterase inhibitors. The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil.MethodDOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5 and 13 are being recruited. Each is randomized to one of four treatment options: continuation of donepezil with memantine placebo added; switch to memantine with donepezil placebo added; donepezil and memantine together; or donepezil placebo with memantine placebo. 800 participants are being recruited and treatment continues for one year. Primary outcome measures are cognition (SMMSE) and activities of daily living (Bristol Activities of Daily Living Scale). Secondary outcomes are non-cognitive dementia symptoms (Neuropsychiatric Inventory), health related quality of life (EQ-5D and DEMQOL-proxy), carer burden (General Health Questionnaire-12), cost effectiveness (using Client Service Receipt Inventory) and institutionalization. These outcomes are assessed at baseline, 6, 18, 30 and 52 weeks. All participants will be subsequently followed for 3 years by telephone interview to record institutionalization.DiscussionThere is considerable debate about the clinical and cost effectiveness of anti-dementia drugs. DOMINO-AD seeks to provide clear evidence on the best treatment strategies for those managing patients at a particularly important clinical transition point.Trial registrationCurrent controlled trials ISRCTN49545035
Quasi-MSn identification of flavanone 7-glycoside isomers in Da Chengqi Tang by high performance liquid chromatography-tandem mass spectrometry
Authors: Xu Fengguo , Liu Ying , Zhang Zunjian , Yang Cheng , Tian Yuan 
Published: July 2009

Abstract

Background

Da Chengqi Tang (DCT) is a common purgative formula in Chinese medicine. Flavanones are its major active compounds derived from Fructus Aurantii Immaturus. The present study developed an LC-MS/MS method to characterize two pairs of flavanone 7-glycoside isomers, i.e., hesperidin versus neohesperidin and naringin versus isonaringin.

Methods
After solid phase purification, components in sample were separated on a Agilent zorbax SB-C18 (5 μm, 250 mm × 4.6 mm) analytical column. ESI-MS and quasi-MSn were performed in negative ion mode to obtain structural data of these two pairs of flavanone 7-glycoside isomers. Moreover, UV absorption was measured.

Results
There was no intra-pairs difference in the UV-Vis and MS/MS spectra of the two pairs of 7-glycoside isomers, whereas the mass spectrometry fragmentation pathways between pairs were different.

Conclusion
The present study developed a LC-MS/MS method to explore the inter- and intra-pair difference of two pairs of flavanone 7-glycoside isomers.
Pulmonary nocardiosis in the acquired immunodeficiency syndrome, computed tomographic findings: a case report
Authors: Sarcinelli-Luz Branca , Marchiori Edson , Zanetti Gláucia , Mano Claudia Mauro , Abdalla Flávia , Carvalho Juliana França , Assed Carla , Santos Isabella Guedes 
Published: July 2009

Abstract
The authors describe a case of pulmonary nocardiosis in a 37-year-old man with acquired immunodeficiency syndrome in treatment with antiretroviral drugs. Clinical symptoms were productive cough, hemoptysis and progressive weight loss. A chest x-ray showed a right upper lobe consolidation while the computed tomography demonstrated consolidation with air bronchogram and airspace nodules. The radiologic findings were unspecific. Consequently, a bronchoscopy with bronchoalveolar lavage was performed, revealing filamentous Gram-positive bacteria (Nocardia species). Treatment with trimethoprim-sulfamethoxazole resulted in complete remission of the respiratory symptoms.
Hourglass urinary bladder in a spinal cord injury patient - unusual late complication of suprapubic cystostomy: a case report
Authors: Vaidyanathan Subramanian , Hughes Peter L , Soni Bakul M , Singh Gurpreet , Mansour Paul 
Published: July 2009

Abstract

Introduction
Suprapubic cystostomy is performed in spinal cord injury patients in order to prevent complications associated with long-term urethral catheter drainage. We report a patient in whom suprapubic catheter did not drain urine satisfactorily and imaging studies revealed hourglass bladder.

Case presentation
A female patient sustained paraplegia in a traffic accident in 1994 at the age of seventeen years. When she was discharged from spinal unit, she was performing self- catheterisations. In 1995, indwelling urethral catheter drainage was instituted, as she was not able to cope up with self-catheterisations. Intravenous urography, performed in 1994, 1997, 2000 and 2003 showed urinary bladder of normal shape. In 2004, this patient developed frequent blockages and bypassing of catheter; therefore, suprapubic cystostomy was performed. In 2005, she was leaking urine per urethra; therefore, an indwelling catheter was inserted; both suprapubic and urethral catheters drained urine. In 2008, suprapubic catheter failed to drain any urine. Cystogram revealed hourglass bladder. The balloon of suprapubic Foley catheter was located in the upper compartment of hourglass bladder whereas the urethral catheter was placed in the inferior compartment. Ultrasound examination of urinary bladder showed two compartments of hourglass bladder separated by a narrow waist. Computed tomography cystogram delineated smaller superior and larger inferior compartment of the hourglass bladder. At present this patient is happy to manage her bladder with suprapubic and urethral catheters.

Conclusion
When prompt replacement of a mal-functioning suprapubic catheter fails to rectify the problem, computer tomography cystography should be performed to check precise location of suprapubic catheter and structural abnormalities of urinary bladder. In this patient, cystogram revealed hourglass bladder. Possible reasons for development of hourglass bladder in spinal cord injury patients are: traction applied to dome of urinary bladder by Foley balloon when suprapubic catheter is taped tightly to anterior abdominal wall for several months; uncoordinated contractions of detrusor muscle; chronic cystitis leading to hypertrophy of bladder wall.
Isolated common femoral artery aneurysm: a case report
Authors: Sharma Saurabh , Nalachandran Sanjay 
Published: July 2009

Abstract

Introduction
Isolated aneurysm of common femoral artery is a rare occurrence. They may mimic other common conditions like groin lymph nodes or groin hernia.

Case presentation
Here we present a case of 61-years-old Chinese gentleman who presented with a right groin lump, which was suspected to be groin hernia but turned out common femoral artery aneurysm. The aneurysm was surgically excised and a prosthetic vascular repair was done.

Conclusion
Isolated common femoral artery aneurysms are rare and can mimic groin hernias, so one must be careful. Color Doppler is the investigation of choice. Best treatment modality is surgical excision with repair with or without graft for aneurysms > 2.5 cm.
Rigid fibrescope Bonfils: use in simulated difficult airway by novices
Authors: Piepho Tim , Noppens Rüdiger R , Heid Florian , Werner Christian , Thierbach Andreas R 
Published: July 2009

Abstract

Background
The Bonfils intubation fibrescope is a promising alternative device for securing the airway. We examined the success rate of intubation and the ease of use in standardized simulated difficult airway scenarios by physicians. We compared the Bonfils to a classical laryngoscope with Macintosh blade.

Methods
30 physicians untrained in the use of rigid fibrescopes but experienced in airway management performed endotracheal intubation in an airway manikin (SimMan, Laerdal, Kent, UK) with three different airway conditions. We evaluated the success rate using the Bonfils (Karl Storz, Tuttlingen, Germany) or the Macintosh laryngoscope, the time needed for securing the airway, and subjective rating of both techniques.

Results
In normal airway all intubations were successful using laryngoscope (100%) vs. 82% using the Bonfils (p < 0.05). In the scenario "tongue oedema" success rate using the Macintosh laryngoscope was 67% and 83% using the Bonfils. In the scenario "decreased cervical range of motion with jaw trismus", success rate using the Macintosh laryngoscope was 84% vs. 76%. In difficult airway scenarios time until airway was secured did not differ between the two devices. Use of Bonfils was rated "easier" in both difficult airway scenarios.

Conclusion
The Bonfils can be successfully used by physicians unfamiliar with this technique in an airway manikin. The airway could be secured with at least the same success rate as using a Macintosh laryngoscope in difficult airway scenarios. Use of the Bonfils did not delay intubation in the presence of a difficult airway. These results indicate that intensive special training is advised to use the Bonfils effectively in airway management.
Uric acid is a strong independent predictor of renal dysfunction in patients with rheumatoid arthritis
Authors: Daoussis Dimitrios , Panoulas Vasileios , Toms Tracey , John Holly , Antonopoulos Ioannis , Nightingale Peter , Douglas Karen MJ , Klocke Rainer , Kitas George D 
Published: July 2009

Abstract
Introduction
Recent evidence suggests that uric acid (UA), regardless of crystal deposition, may play a direct pathogenic role in renal disease. We have shown that UA is an independent predictor of hypertension and cardiovascular disease (CVD), and that CVD risk factors associate with renal dysfunction, in patients with rheumatoid arthritis (RA). In this study we investigated whether UA associates with renal dysfunction in patients with RA and whether such an association is independent or mediated through other comorbidities or risk factors for renal impairment.

Methods
Renal function was assessed in 350 consecutive RA patients by estimated glomerular filtration rate (GFR) using the six-variable Modification of Diet in Renal Disease equation. Risk factors for renal dysfunction were recorded or measured in all participants. Linear regression was used to test the independence of the association between GFR and UA.

Results
Univariable analysis revealed significant associations between GFR and age, systolic blood pressure, total cholesterol, triglycerides, RA duration and UA. UA had the most powerful association with renal dysfunction (r = -0.45, P < 0.001). A basic model was created, incorporating all of the above parameters along with body mass index and gender. UA ranked as the first correlate of GFR (P < 0.001) followed by age. Adjustments for the use of medications (diuretics, low-dose aspirin, cyclooxygenase II inhibitors and nonsteroidal anti-inflammatory drugs) and further adjustment for markers of inflammation and insulin resistance did not change the results.

Conclusions
UA is a strong correlate of renal dysfunction in RA patients. Further studies are needed to address the exact causes and clinical implications of this new finding. RA patients with elevated UA may require screening for renal dysfunction and appropriate management.