bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding nurses' psychosomatic complications that relate to the practice of nursing
Authors: Gouva Mary , Mantzoukas Stefanos , Mitona Eleni , Damigos Dimitrios 
Published: April 2009

AbstractThe literature acknowledges that nursing practice can create physical and emotional stresses for its practitioners. This study aimed to acquire an in‐depth understanding of being a nurse in the Greek National Health System. Interpretive phenomenology was used and Van Manen's method of analysis was implemented. Conversational interviews were conducted with a purposive sample of nine nurses employed at the University Hospital of Ioannina in Greece. The findings produced three essential themes: a dissonance between the images and reality of nursing, emotional burnout, and psychosomatic entanglement. The dissonance between the idealization of nursing and the reality of nursing, along with the emotional crisis created by daily practice, constituted the two fundamental factors for developing psychosomatic complications. These impacted negatively on the participants' personal and professional well‐being. Psychosomatic complications can be prevented by clearly delineating roles, enabling collaboration between education and practice, developing mentorship programs, and using reflection in practice.
Stage I seminoma: What should a practicing uro‐oncologist do in 2009?
Authors: Skliarenko Julia , Vesprini Danny , Warde Padraig 
Published: April 2009

AbstractTesticular tumors are uncommon, but they continue to represent an important group of malignancies in young men. It is the most common solid malignancy in males between the ages of 20 and 35, and primary germ cell tumors are the most common histological type. In the United States in 2008, approximately 4800 cases of seminoma, approximately 4100 of which were stage I disease were projected after the completion of staging investigations.Remarkable progress has been made in the treatment of testicular seminoma over the past 25 years. Management options of stage I seminoma include radiotherapy, surveillance, or adjuvant chemotherapy. Standard management until recent years has been adjuvant retroperitoneal radiotherapy. Although providing excellent long term results, this approach has been associated with increased risk of gonadal toxicity, development of secondary malignancies and an increased risk of cardiovascular disease. The use of surveillance in management of patients with stage I seminoma is therefore becoming more frequent as it minimizes the burden of treatment and maintains the cure rate at virtually 100%. Adjuvant chemotherapy using Carboplatin has been investigated as an alternative management approach. However, the long term outcomes of patients managed with Carboplatin are not yet clear and this strategy should only be used in a study setting. It has been suggested that more patients with stage I seminoma will die of their treatment than of their cancer; therefore, the thrust of modern management should be to maintain 100% cure while minimizing the burden of treatment.
2009 update on the classification of renal epithelial tumors in adults
Authors: Lopez‐Beltran Antonio , Carrasco Jose C , Cheng Liang , Scarpelli Marina , Kirkali Ziya , Montironi Rodolfo 
Published: April 2009

AbstractThe classification of kidney tumors in adults expands rapidly with new categories recently incorporated. This will result in the modification of the current 2004 World Health Organization (WHO) classification of the adult renal epithelial neoplasms. Emphasis should be placed in defining risk groups categorized as malignant or benign tumors, including a category of tumors with low malignant potential to accommodate recently recognized categories with extremely good prognosis after surgery. Unusual tumors such as familial renal cell carcinoma (RCC), translocation RCC, renal cell carcinoma after neuroblastoma, tubular mucinous and spindle cell carcinoma, and mixed epithelial and stromal tumors are also presented. A number of recently described entities and morphologic variants of classical categories deserve recognition since they can be important in differential diagnosis. This review emphasizes clinical, pathological and genetic features defining renal epithelial tumors in adults.
Restoring the banks of the Namoi on ‘Kilmarnock’: Success arising from persistence
Authors: Watson Robyn 
Published: April 2009

Summary  This is the story of one landholder's 20‐year effort to restore riparian vegetation to 35 km of the Namoi River in inland New South Wales, Australia. Decades of clearing, grazing and weed invasion had degraded the river to the extent that the banks were slumping during floods, with loss of old trees. Methods of willow control and revegetation are described to help guide landholders with similar problems and offer potential solutions. Most of the banks involved in the project are now stabilized by native trees, shrubs and grasses; wildlife is increasing; and water quality is improving. A small local Landcare group started in the early 1990s, and is now undertaking similar work on seven other properties. A state government initiative has also been developed in the area, and a 120‐km Demonstration Reach has now been established on the Namoi River between Narrabri and Boggabri.
Evaluation of potential visual acuity in eyes with macular oedema secondary to retinal vein occlusion
Authors: Sakamoto Atsushi , Tsujikawa Akitaka , Ota Masafumi , Yamaike Noritatsu , Kotera Yuriko , Miyamoto Kazuaki , Kita Mihori , Yoshimura Nagahisa 
Published: April 2009

AbstractPurpose:  To evaluate the potential visual acuity (VA) of eyes with macular oedema (MO) associated with retinal vein occlusion (RVO).Methods:  Thirty‐one eyes of 31 patients with MO associated with RVO were examined and then treated with an intravitreal injection of bevacizumab. Of these 31 eyes, 22 showed complete resolution of the MO at 1 month after treatment, at which time potential VA was determined; 12 eyes had good function and 10 had poor function at this time. Optical coherence tomography was used to detect the junctions between inner and outer segments of the photoreceptors (IS/OS) as a hallmark of integrity of the outer photoreceptor layer.Results:  In the poor function group, pretreatment VA was significantly worse (P = 0.0106) and pretreatment central macular thickness was significantly greater (P = 0.0121). Preservation of the foveal photoreceptor layer before treatment was associated closely with good visual function after resolution of MO, and IS/OS line beneath the fovea was detected more frequently before treatment in eyes with good function (P = 0.0053).Conclusions:  In eyes with MO associated with RVO, when the IS/OS line was detected beneath the fovea, they would be expected to have good vision after resolution of the MO.
2008 Sir Norman McAlister Gregg Lecture: 150 years of practical observations on the conical cornea – what have we learned?
Authors: McGhee Charles NJ 
Published: April 2009

AbstractThe first detailed descriptions of keratoconus were published exactly 150 years ago in the original work of Dr John Nottingham, bringing a degree of clarity to a previously confusing clinical phenomenon – further supported by observations of other contemporaries in the field such as Sir William Bowman. However, it would be another 100 years before knowledge of keratoconus would grow substantially; indeed, our current level of understanding is primarily a result of extensive clinical and laboratory research conducted over the last 50 years – particularly based upon the enormous technological advances of the last two decades. Large clinical studies have confirmed that keratoconus is a non‐inflammatory corneal disease with central or paracentral corneal thinning, which exhibits progressive corneal steepening and protrusion that typically results in increasing regular and thereafter irregular astigmatism. Ultimately, disease progression may lead to corneal scarring, corneal hydrops and loss of best spectacle‐corrected visual acuity. Although visual rehabilitation may be effected by expert contact lens fitting, 20% of subjects may require corneal transplantation. This Gregg lecture provides a highly referenced, wide‐ranging overview of both historical and contemporary aspects of keratoconus, including diagnostic, phenotypic and prognostic factors revealed by large clinical studies, critical diagnostic advances enabled by Placido and slit‐scanning computerized corneal topography, the emerging roles of higher order aberration wave‐front analysis and corneal hysteresis in delineating early and subclinical keratoconus, inheritance and genetic predisposition to keratoconus, corneal microstructural changes unveiled by in vivo confocal microscopy, unifying theories to explain associations between keratoconus, atopy, eye rubbing and keratocyte apoptosis, and surgical options for keratoconus, such as corneal transplantation, intrastromal ring segments, collagen cross‐linking and keratocyte transplantation. However, 150 years along the path our knowledge of keratoconus remains incomplete, but technological advances should enable us to put together the final pieces of the jigsaw in the foreseeable future.
Food allergy in adolescents and adults
Authors: Yun J. , Katelaris C. H. 
Published: April 2009

AbstractThere has been an increase in the prevalence of food allergy in the last few decades. Adult food allergy may represent persistence of reactions that commenced in infancy and early childhood or it may be initiated in adulthood through new sensitizations. Persistence of peanut allergy is an example of the former situation. Approximately 20% of children will develop tolerance to peanuts, so there will be an increasing number of individuals reaching adulthood where this problem will need ongoing management. In addition to peanut, tree nuts, fruits, vegetables and seafood are implicated as common causes of food allergy in adulthood. Sensitization may occur directly to a food allergen or indirectly through cross‐reactivity with an aeroallergen. Adults may present with a spectrum of clinical manifestations from oral allergy syndrome to fatal anaphylaxis. The management of food allergy consists of appropriate education regarding avoidance of implicated foods, modifying potential risk factors for anaphylaxis, such as asthma and prompt recognition and treatment of acute reactions.
Effects of norepinephrine on dynamic variables of fluid responsiveness during hemorrhage and after resuscitation in a pediatric porcine model
Authors: RENNER JOCHEN , MEYBOHM PATRICK , HANSS ROBERT , GRUENEWALD MATTHIAS , SCHOLZ JENS , BEIN BERTHOLD 
Published: April 2009

SummaryBackground:  The effect of vasopressors on pulse pressure variation (PPV), stroke volume variation (SVV) and on the volumetric variable global end‐diastolic volume (GEDV) during changing loading conditions is currently under debate. The aim of our study was to investigate the effect of norepinephrine (NE) on PPV, SVV and GEDV in a pediatric animal model of hemorrhage and resuscitation.Methods:  Eight anesthetized piglets were studied at normovolemia, after stepwise blood withdrawal (25 ml·kg−1), after infusion of NE to restore mean arterial pressure (MAP), after NE titration was stopped and shed blood was retransfused and finally again after NE titration. Stroke volume (SV) was measured using a thermodilution pulmonary artery catheter. GEDV was measured by transpulmonary thermodilution. PPV and SVV were monitored continuously by pulse contour analysis. In response to NE administration during hemorrhage, MAP significantly increased (P < 0.01), PPV significantly decreased (P = 0.02), whereas SVV, SV and GEDV remained unchanged. After retransfusion, SVV and GEDV significantly correlated with volume induced percentage change in SV. This significant correlation was reversed after NE administration for SVV and persisted for GEDV. In conclusion, NE administration significantly affected PPV and SVV, whereas the volumetric variable GEDV remained unchanged.
Changes in a tropical forest support metabolic zero‐sum dynamics
Authors: Ernest S. K. Morgan , White Ethan P. , Brown James H. 
Published: April 2009

AbstractMajor shifts in many ecosystem‐level properties of tropical forests have been observed, but the processes driving these changes are poorly understood. The forest on Barro Colorado Island (BCI) exhibited a 20% decrease in the number of trees and a 10% increase in average diameter. Using a metabolism‐based zero‐sum framework, we show that increases in per capita resource use at BCI, caused by increased tree size and increased temperature, compensated for the observed declines in abundance. This trade‐off between abundance and average resource use resulted in no net change in the rate resources are fluxed by the forest. Observed changes in the forest are not consistent with other hypotheses, including changes in overall resource availability and existing self‐thinning models. The framework successfully predicts interrelated changes in size, abundance and temperature, indicating its utility for understanding changes in the structure and dynamics of ecosystems.
The effect of endothelin‐1 on the production of interleukin‐6 in cultured human detrusor smooth muscle cells, and the effect of interleukin‐6 on the contractile response of bladder smooth muscle strips from rats
Authors: Han June Hyun , Lee Moo Yeol , Myung Soon Chul 
Published: April 2009

OBJECTIVETo determine the effect of endothelin‐1 (ET‐1) on the production of interleukin‐6 (IL‐6) in cultured human detrusor smooth muscle cells (HDSMCs) and the effect of IL‐6 on the contractile response of bladder smooth muscle strips from rats.MATERIALS AND METHODSThe expression of IL‐6 mRNA and production of IL‐6 protein in cultured HDSMCs treated with the different concentrations of ET‐1 were assayed by reverse transcriptase‐polymerase chain reaction and specific enzyme‐linked immunosorbent assay, respectively. The strips from Sprague‐Dawley rats were either untreated or treated with 1 ng/mL of IL‐6 for 60 min. Using increasing cumulative concentrations of acetylcholine (ACh), bethanechol (BCh), or sodium nitroprusside, we assessed the concentration‐contraction or the relaxation responses. In cystitis‐induced strips, change of contractions induced by noradrenaline (NA) with or without treatment of IL‐6 were assessed. The IL‐6‐treated strips were incubated for 30 min in the presence or absence indomethacin or SQ29548, and then the effects on ACh‐ or BCh‐induced contractions were measured.RESULTSThe expression of IL‐6 mRNA and the production of IL‐6 protein on the cultured HDSMCs pretreated by ET‐1 were significantly higher than in the control (P < 0.05). The ACh‐ and BCh‐induced contractions were increased in the IL‐6 pretreated strips from both dome and trigone, regardless of the presence of urothelium (P < 0.05). The presence of cystitis augmented the NA‐induced contractions (P < 0.05). The contractions induced by ACh and BCh were inhibited by indomethacin and SQ29548.CONCLUSIONSET‐1 induces expression of IL‐6 mRNA and production of IL‐6 protein on HDSMCs. IL‐6 enhances detrusor smooth muscle contractility via the muscarinic or adrenergic receptor pathway.
A contemporary standard for morbidity and outcome after radical cystectomy
Authors: Ramani Vijay A.C. , Bromage Stephen J. , Clarke Noel W. 
Published: April 2009

OBJECTIVETo report the temporal changes in peri‐operative outcome over an extended period in patients undergoing radical cystectomy (RC) for all causes, irrespective of the previous treatment or pathology; and to establish a current standard of peri‐operative outcome for RC by analysis of contemporary operative mortality rates (2000–5) factored for risk factors that might predict outcome.PATIENTS AND METHODSAll patients undergoing RC between 1970 and 2005 were analysed; this was an unselected single‐centre series and included patients previously treated by definitive radiotherapy, chemotherapy, and cases of RC where the primary tumour involved the bladder but was not of bladder origin.RESULTSIn all, 846 patients had a RC, of whom 647 had a bladder primary tumour and 199 a primary tumour elsewhere (gynaecological, colorectal and others). There was a progressive reduction in 30‐ and 60‐day mortality rates, such that the current peri‐operative mortality (1999–2005) was 0.4% and 2.6%, respectively. There was a significant reduction in the re‐operation rate over the decades (P = 0.01), which is currently 4.7%. Patient age was a significant factor in 30‐ and 60‐day mortality rates (P < 0.001 for both) but there was no significant association between either American Society of Anesthesiologists grade or T stage with complication rates (P = 0.61 and 0.12, respectively).CONCLUSIONThere has been a progressive reduction in mortality related to RC, associated with both cases of RC and pelvic exenteration. The contemporary standard for 30‐and 60‐day mortality rates for these operations is 0.4% and 2.6%, respectively.
Lower urinary tract symptoms: lack of change in prevalence and help‐seeking behaviour in two population‐based surveys of women in 1991 and 2007
Authors: Wennberg Anna‐Lena , Molander Ulla , Fall Magnus , Edlund Christer , Peeker Ralph , Milsom Ian 
Published: April 2009

OBJECTIVESTo test the hypothesis that the overt prevalence and help‐seeking pattern for lower urinary tract symptoms (LUTS) might have changed over time, by comparing the prevalence of urinary incontinence (UI), overactive bladder (OAB) and other LUTS (principally storage symptoms) and help‐seeking pattern in two equivalent groups of women 16 years apart.SUBJECTS AND METHODSWe compared two cross‐sectional studies; population‐based random samples of women aged ≥20 years in the central district of Gothenburg in 1991 (2911) and 2007 (3158) were asked to complete similar self‐administered postal questionnaires regarding UI and other LUTS.RESULTSThe mean (sd, range) age of the two groups was 48.1 (20.4, 20–98 ) years in 1991 and 46.2 (20.0, 20–101) years in 2007, respectively. When comparing the two study populations there were no significant differences in the reported prevalence of UI, OAB or nocturia (defined as two or more voids per night) over time. Nocturia according to the International Continence Society definition was significantly more prevalent in 2007 than 1991, as was daytime voiding frequency of eight or more times a day. OAB dry (i.e. with no incontinence) was more common in 1991, while OAB wet (i.e. with incontinence) was more prevalent in 2007. Of the women in 1991 and 2007, 6% and 7%, respectively, had sought help from the healthcare system due to UI. Significantly more women in 2007 than in 1991 stated that the presence of UI limited their social life (29% vs 13%, P < 0.001).CONCLUSIONLUTS are common in women and the prevalence rates of UI and OAB have not changed during the last 16 years. Many women still do not seek help from the healthcare system, and the help‐seeking pattern has remained unchanged, despite effective treatment currently being offered.
Comparison between a serous‐lined extramural tunnel and T‐limb ileal procedure as an antireflux technique in orthotopic ileal substitutes: a prospective randomized trial
Authors: Osman Yasser , Abol‐Enein Hassan , El‐Mekresh Mohsen , Gad Hosam , Elhefnawy Ahmed , Ghoneim Mohamed 
Published: April 2009

OBJECTIVETo compare the functional results from a prospective randomized trial of two different reflux‐prevention techniques for ileal bladder substitution.PATIENTS AND METHODSIn all, 60 patients with invasive bladder cancer were randomized to receive either a serous‐lined extramural tunnel (group 1) or T‐limb ileal procedure (group 2) as an antireflux technique for the ileal substitute. The preoperative evaluation included intravenous urography, radioisotope renography to evaluate glomerular filtration rates (GFRs) and renal cortical imaging with 99mTc‐ dimercaptosuccinic acid to assess parenchymal scarring. Evaluable patients were re‐assessed by the same imaging, and by ascending studies.RESULTSThe follow‐up included 27 patients (49 units) in group 1 and 23 (45 units) in group 2, with a mean (sd) follow‐up of 6.3 (0.5) and 7.4 (1.9), respectively. Uretero‐ileal strictures were diagnosed in one renal unit in each group (P = 0.5). Ascending studies showed no reflux in any patients in group 1, while 13 renal units (29%) in group 2 were refluxing (P < 0.01). There was progressive cortical scarring with or with no significant reduction in GFR (>25%) in three and four renal units in groups 1 and 2, respectively. Among the 13 refluxing units in group 2, three showed a significant deterioration in GFR and one renal unit was diagnosed with progressive cortical scarring.CONCLUSIONBoth procedures provided a low rate of anastomotic stricture, with acceptable preservation of renal function. The serous‐lined extramural tunnel provided a more effective antireflux mechanism.
Expression of potential molecular markers in renal cell carcinoma: impact on clinicopathological outcomes in patients undergoing radical nephrectomy
Authors: Sakai Iori , Miyake Hideaki , Takenaka Atsushi , Fujisawa Masato 
Published: April 2009

OBJECTIVESTo evaluate the expression levels of several potential molecular markers in renal cell carcinoma (RCC), to clarify the significance of these markers as prognostic predictors in patients undergoing radical nephrectomy (RN).PATIENTS AND METHODSThe study included 153 patients with clinically organ‐confined RCC undergoing RN. Expression levels of 12 proteins, including Aurora‐A, Bcl‐2, Bcl‐xL, clusterin, heat‐shock protein 27 (HSP27), HSP70, HSP90, Ki‐67, matrix metalloproteinase (MMP)‐2 and ‐9, p53 and vascular endothelial growth factor, in RN specimens obtained from these 153 patients were measured by immunohistochemical staining.RESULTSOf the 12 markers, clusterin, HSP27, Ki‐67, MMP‐2 and ‐9 expression were significantly associated with several conventional prognostic factors. Univariate analysis also identified these five markers as significant predictors of disease recurrence, while mode of presentation, pathological stage, grade and microvascular invasion were also significant. Of these significant factors, Ki‐67 expression, pathological stage and microvascular invasion appeared to be independently related to disease recurrence. Furthermore, there were significant differences in recurrence‐free survival according to positive numbers of these three independent factors, i.e. disease recurred in four of 56 patients who were negative for risk factors (7%), 17 of 71 positive for one risk factor (24%), and 20 of 26 positive for two or three risk factors (77%).CONCLUSIONSCombined evaluation of Ki‐67 expression, pathological stage and microvascular invasion would be particularly useful for further refinement of the system for predicting the outcome after RN for patients with RCC.