bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finding Dementia in Primary Care: The Results of a Clinical Demonstration Project
Authors: Riley McCarten John , Anderson Pauline , Kuskowski Michael A. , McPherson Susan E. , Borson Soo , Dysken Maurice W. 
Published: February 2012

ObjectivesTo assess the effect of screening on diagnosing cognitive impairment.DesignQuality improvement initiative.SettingSeven Veterans Affairs Medical Centers.ParticipantsVeterans aged 70 or older without a prior diagnosis of cognitive impairment.MeasurementsVeterans failing a brief cognitive screen (Mini‐Cog score <4/5) at a routine primary care visit were offered a further, comprehensive evaluation with an advance practice registered nurse trained in dementia care and integrated into the primary care clinic. Veterans completing the evaluation were reviewed in a consensus conference and assigned a diagnosis of dementia; cognitive impairment, no dementia; or no cognitive impairment. Total numbers of screens, associated scores (0–5), and the consensus diagnoses were tallied. New cognitive impairment diagnoses were also tracked for veterans who passed the screen but requested further evaluation, failed but declined further evaluation, or were not screened. Primary care provider satisfaction with the program also was assessed.ResultsOf 8,342 veterans offered screening, 8,063 (97%) accepted, 2,081 (26%) failed the screen, 580 (28%) agreed to further evaluation, and 540 (93%) were diagnosed with cognitive impairment, including 432 (75%) with dementia. For screen passes requesting further evaluation, 87% (103/118) had cognitive impairment, including 70% (82/118) with dementia. Screen failures declining further evaluation had 17% (259/1,501) incident cognitive impairment diagnosed through standard care, bringing the total newly documented cognitive impairment in all screens to 11% (902/8,063), versus 4% (1,242/28,349) in similar clinics without this program. Eighty‐two percent of primary care providers in clinics with this program agreed that it provided a useful service.ConclusionScreening combined with offering further evaluation increased new diagnoses of cognitive impairment in older veterans two to three times. Veterans accepted screening well, and providers found the program useful.
Reliability of the Scales in the NC1172 Complex Nature of Saving Data Set
Authors: Hayhoe Celia R. , Gutter Michael E. 
Published: February 2012

The purpose of this study was to test the reliability of scales measuring the psychological aspects of savings behavior. The data set titled The Complex Nature of Saving: Psychological and Economic Factors was collected under the sponsorship of the North Central (NC) 1172 multistate research program. Researchers from 12 universities developed the questionnaire for the study. The sample consisted of low‐to‐moderate‐income consumers with a respondent (or spouse or partner of the respondent) between the ages of 24 and 66. The scales included in this study consist of Rook & Fisher (1995) Impulsivity Scale and three sub‐scales (distrust, anxiety, and bargain‐conscious) from the revised Yamauchi & Templer (1982) money attitudes scale by Roberts & Sepulveda (1999). Other scales that were included are the Richins & Dawson (1992) materialism scale, Sherer et al. (1982) Self‐efficacy Scale, and Grable & Joo (2004) financial risk‐tolerance scale. Also, these data were used to develop a Financial Management Behavior Score. Based on data from this sample, the results show that the modified scales work as well as the original scales.
Transepidermal elimination in cutaneous leishmaniasis: a multiregional study
Authors: Karram Sarah , Loya Asif , Hamam Hadi , Habib Robert H. , Khalifeh Ibrahim 
Published: February 2012

Background: Transepidermal elimination has been documented in a myriad of infectious diseases; however, its occurrence in cutaneous leishmaniasis has not been evaluated.Methods: Skin biopsies (n = 212) with cutaneous leishmaniasis in Lebanon (n = 46), Syria (n = 53), Saudi Arabia (n = 45) and Pakistan (n = 68) were evaluated. Clinical data collected included age, gender, eruption type (papule, nodule, verrucous or scar), duration and anatomic location. Histopathologically, multiple parameters were recorded including Ridley's parasitic index and pattern, transepidermal elimination, interface changes, ulceration and necrosis. Transepidermal elimination was defined as the presence of amastigotes in the epidermis in all layers, limited to the basal layer or present in a perforating plug. All cases were confirmed by polymerase chain reaction (PCR) analysis followed by restriction fragment length polymorphism analysis for molecular subspeciation.Results:
Leishmania tropica was identified in 88.2% and Leishmania major in 11.8% of all cases. Transepidermal elimination was observed in 28.3% of cases (29 perforating plug, 19 all layers and 12 basal layer) with a significant prevalence of L. major in this group (35 vs. 2%, p < 0.001). Cases with transepidermal elimination were associated with interface changes and higher parasitic index (p < 0.001) but not with an increased ulceration rate (p > 0.05). Multivariate analysis showed that transepidermal elimination was independently predicted by L. major [OR (95% confidence interval) = 80 (9–712); p < 0.001], parasitic index [OR = 3.4 (2.1–5.3); p < 0.001], interface changes [OR = 6.24 (2.2–17.8); p < 0.001] and necrosis [OR = 0.2 (0.1–0.8);p = 0.026].Conclusions: We report the largest multiregional cutaneous leishmaniasis series with a 28.3% documented transepidermal elimination incidence of which 48% were perforating plug; a significant prevalence of L. major was also identified in the transepidermal elimination group. The association of transepidermal elimination with interface changes and a higher parasitic index, without an increased ulceration rate, may reflect a unique biologic alteration in the epidermis, serving to facilitate the extrusion of the parasites through the skin.Karram S, Loya A, Hamam H, Habib RH, Khalifeh I. Transepidermal elimination in cutaneous leishmaniasis: a multiregional study.
Broad range of adverse cutaneous eruptions in patients on TNF‐alpha antagonists
Authors: Hawryluk Elena B. , Linskey Katy R. , Duncan Lyn M. , Nazarian Rosalynn M. 
Published: February 2012

Biologic therapies targeting tumor necrosis factor (TNF)‐alpha have become a mainstay in the management of a number of autoimmune diseases. We report a series of adverse skin eruptions in six patients (four females, two males, age: 21–58 years, mean: 39) receiving 4 months to 10 years (mean 3.1 years) of anti‐TNF‐alpha therapies (infliximab, n = 4; adalimumab, n = 1 or etanercept, n = 1). The following drug‐associated diagnoses were made in eight skin biopsies performed at Massachusetts General Hospital between 3/2007 and 10/2010: pustular folliculitis, psoriasis, interface dermatitis, neutrophilic eccrine hidradenitis, Sweet's syndrome, lupus, vasculitis and palmoplantar pustulosis. The descriptions of neutrophilic eccrine hidradenitis‐like and Sweet's‐like hypersensitivity eruptions induced by anti‐TNF‐alpha therapies are the first such cases described in the literature. Each cutaneous eruption improved or resolved with switching to a different TNF‐alpha inhibitor, discontinuation of the anti‐TNF‐alpha agent, and/or topical or systemic steroids. There was a clear chronologic relationship with, and clinical remission upon withdrawal or steroid suppression of the anti‐TNF‐alpha agents. The mechanism for such diverse cutaneous eruptions among this class of medications remains poorly understood. The cutaneous adverse reaction profile of TNF‐alpha inhibitors is broad and should be considered in the histopathologic differential in this clinical setting.Hawryluk EB, Linskey KR, Duncan LM, Nazarian RM. Broad range of adverse cutaneous eruptions in patients on TNF‐alpha antagonists.
Endozoochory decreases environmental filtering imposed to seedlings
Authors: Cavallero Laura , Aizen Marcelo A. , Raffaele Estela 
Published: February 2012

AbstractQuestionsRecruitment microsites are imposed on plants, first by seed dispersal and then by the environment. Different seed dispersal vectors could decrease or increase the environmental filtering imposed on seedlings, depending on their specificity to deliver seeds to suitable microsites for germination and establishment. We addressed the hypothesis that endozoochory reduces the environmental filtering imposed to seedlings to a larger extent than does anemochory. We predicted that seedlings from animal‐dispersed species should show a higher degree of environmental coupling.LocationNorthern Patagonian Andean region of Argentina, 40–42° S.MethodsWe characterized the relationship of seedlings, saplings and reproductive individuals to total radiation, air temperature and relative humidity for 16 woody species growing in 25 plant communities of different post‐fire ages in temperate forests of southern South America.ResultsSeedlings and saplings of endozoochorous species occurred under more similar environmental conditions than seedlings and saplings of anemochorous species. Basically, the mean difference in plant–environment correlation coefficients between saplings and seedlings was <0.2 for all endozoochorous species and >0.2 for all anemochorous species for all environmental variables. Comparisons between dispersal modes were also statistically significant before and after controlling for phylogenetic relationships among species. Even though saplings and seedlings of endozochorous species tended to occur under similar environmental conditions, we did not find evidence that saplings and seedlings co‐occur in the same physical microsites. Finally, we did not find evidence either that seedlings of endozoochorous species tended to occur differentially underneath reproductive individuals of the same species (i.e. more seeds falling by gravity beneath maternal plants).ConclusionsThe tighter coupling between seedlings of endozoochorous species and environmental factors persisting to the sapling stage suggests that relying on animals for seed dispersal reduces mortality costs during the early stages of recruitment by reducing the environmental filtering imposed on seedlings.
Characterization of Ursodeoxycholic and Norursodeoxycholic Acid as Substrates of the Hepatic Uptake Transporters OATP1B1, OATP1B3, OATP2B1 and NTCP
Authors: König Jörg , Klatt Sabine , Dilger Karin , Fromm Martin F. 
Published: February 2012

AbstractUrsodeoxycholic acid (UDCA) is the only approved treatment for primary biliary cirrhosis, and norursodeoxycholic acid (norUDCA) is currently tested in clinical trials for future treatment of primary sclerosing cholangitis because of beneficial effects in cholestatic Mdr2 knock‐out mice. Uptake of UDCA and norUDCA into hepatocytes is believed to be a prerequisite for subsequent metabolism and therapeutic action. However, the molecular determinants of hepatocellular uptake of UDCA and norUDCA are poorly understood. We therefore investigated whether UDCA and norUDCA are substrates of the hepatic uptake transporters OATP1B1, OATP1B3, OATP2B1 and Na+‐taurocholate co‐transporting polypeptide (NTCP), which are localized in the basolateral membrane of hepatocytes. Uptake of [3H]UDCA and [14C]norUDCA into Human embryonic kidney (HEK) cells stably expressing OATP1B1, OATP1B3, OATP2B1 or NTCP was investigated and compared with uptake into vector control cells. Uptake ratios were calculated by dividing uptake into transporter‐transfected cells by uptake into respective control cells. Uptake ratios of OATP1B1‐, OATP1B3‐ and OATP2B1‐mediated UDCA and norUDCA uptake were at maximum 1.23 and 1.49, respectively. Uptake of UDCA was significantly higher into HEK‐NTCP cells only at the lowest tested concentration (1 μM, p < 0.001) compared with the control cells with an uptake ratio of 1.34‐fold. NorUDCA was not significantly transported by NTCP. The low uptake rates suggest that OATP1B1, OATP1B3, OATP2B1 and NTCP are not relevant for hepatocellular uptake and effects of UDCA and norUDCA in human beings.
Prevention of relapses of nasal polyposis with intranasal triamcinolone acetonide after polyp surgery: A prospective double‐blind, placebo‐controlled, randomised study with a 9‐month follow‐up
Authors: Vento SI. , Blomgren K. , Hytönen M. , Simola M. , Malmberg H. 
Published: February 2012

Clin. Otolaryngol. 2012, 37, 117–123Objective: To determine whether intranasal triamcinolone acetonide prevents the regrowth of nasal polyps after polyp surgery.Study design: Randomised, double‐blind, placebo‐controlled, prospective study.Setting: Helsinki University Central Hospital.Participants: Sixty patients with nasal polyps entered the study. Patients were included upon arrival for elective polyp operations determined according to our standard clinical criteria. The recurrence of nasal polyposis was followed up for 9 months after surgical treatment at 3‐month intervals.Main outcome measures: Anterior rhinoscopy, nasal endoscopy, olfactory threshold measurement, active anterior rhinomanometry and acoustic rhinometry were performed at every follow‐up visit.Results: On the whole, there was a significant inter‐group difference in the change in polyp size of acetylsalicylic acid (ASA)‐tolerant patients during the follow‐up. In patients with acetylsalicylic acid intolerance, there was no inter‐group difference (P = 0.28). No significant differences were noted for nasal resistance, nasal cavity volume, sense of smell and nasal symptoms.Conclusion: Triamcinolone acetonide prevents regrowth of nasal polyps after polyp surgery in acetylsalicylic acid‐tolerant patients, but not in acetylsalicylic acid‐intolerant patients.
Determination of the Usage of Shade Structures via a Dosimetry Technique
Authors: Parisi Alfio V. , Eley Robert , Downs Nathan 
Published: February 2012

AbstractA measurement system is described that allows an objective review and evaluation of the amount of use by different population groups of provided shade structures. It employs the comparison of the erythemal UV exposure measured with dosimeters to either the vertex or forehead to that in full sun. The technique has been developed using three shade structures and found to provide a linear relationship with an R2 of 0.99 between the exposure ratio and the time spent in the shade for the solar zenith angle range of 19–53o and for both low‐ and high‐cloud levels. It provides an objective determination of the amount of shade use by population groups that have set periods of time outdoors.
Photodynamic Therapy Can Improve Warts’ Discomfort in Renal Transplant Patients Prospective Multicenter Study
Authors: Sparsa Agnès , Blaise Sophie , Tack Brigitte , Dalmay François , Leroy Dominique , Bonnetblanc Jean‐Marie , Béani Jean‐Claude , Bédane Christophe 
Published: February 2012

AbstractMany studies have been conducted showing that aminolevulinic acid (ALA)‐photodynamic therapy (PDT) can be an alternative treatment for recalcitrant warts. Recently, we performed a study evaluating methyl‐aminolevulinic acid (MAL)‐PDT for the treatment of hand warts in a population of renal transplant patients. Two symmetrical targets were selected on each hand and randomly assigned to chemical keratolytic treatment followed by three cycles of ALA‐PDT (75 J cm−² red light). Patients were evaluated after 3 months and a second run of PDT was performed if the total area and number of warts decreased less than 50%, with evaluation every 3 months for 1 year. Twenty patients were included and 16 were evaluable (9 M, 7 F). After 6 months the reduction of warts’ area was 48.4% on the treated side versus 18.4% in the control area (P = 0.021). The decrease in the total number of warts was 41%versus 19.4% (P = NS). The global tolerance of the treatment was good with acceptable pain during irradiation. These results suggest that ALA‐PDT is a safe and efficient treatment for transplanted patient warts. The improvement between treated and control zone is 20% due to the decrease in untreated warts’ area and number.
Misdiagnosis of Aortic Dissection: Experience of 361 Patients
Authors: Zhan Sun , Hong Shen , Shan‐shan Li , Chen‐ling Yao , Lai Wei , Dong‐wei Shi , Chao‐yang Tong , Xian‐hong Shu , Chun‐Sheng Wang 
Published: February 2012

J Clin Hypertens (Greenwich). 2012;14:256–260. ©2012 Wiley Periodicals, Inc.Aortic dissection (AD) is a life‐threatening condition that requires immediate diagnosis and surgical correction. Patients with acute AD usually present clinically with an insignificant medical history, leading to a high probability of misdiagnosis. The aim of the present study was to investigate the number of misdiagnoses of patients with AD in order to understand this problem and to avoid future misdiagnosis in the emergency department. Clinical data from 361 patients with AD admitted between January 2003 and June 2008 were reviewed as part of a retrospective chart review. Diagnosis of AD was made using either chest x‐ray, computed tomography, magnetic resonance imaging, or angiography. Fifty‐one patients had an initial misdiagnosis (14.1%), later found to have experienced AD. The condition may clinically present in a varied number of manifestations, including syncope, chest pain, abdominal pain, back pain, acute congestive heart failure, or alternatively with minimal symptoms. Persons of any age can experience an AD, with key clinical manifestations of pain. Echocardiography can be used for primary examination of patients with suspected AD; however, a definite diagnosis is usually made using computed tomographic or magnetic resonance angiography. Care should be taken, particularly in the emergency department, to maintain a level of suspicion for AD diagnosis in order to avoid the potential for misdiagnosis.
Efficacy and safety of the long‐acting muscarinic antagonist GSK233705 delivered once daily in patients with COPD
Authors: Bateman Eric , Feldman Gregory , Kilbride Sally , Brooks Jean , Mehta Rashmi , Harris Stephanie , Maden Claire , Crater Glenn 
Published: February 2012

AbstractIntroduction:  GSK233705 is a recently developed inhaled anticholinergic being investigated for the potential treatment of chronic obstructive pulmonary disease (COPD).Objectives:  This dose‐ranging, parallel‐group, double‐blind study compared the bronchodilator efficacy, safety and pharmacokinetics of GSK233705 with placebo in patients with moderate‐to‐severe COPD.Methods:  Patients were randomised to receive 12.5 µg, 25 µg, 50 µg, 100 µg or 200 µg of GSK233705 or placebo once daily for 28 days. The primary endpoint was change from baseline in trough forced expiratory volume in 1 s (FEV1) on day 29.Results:  The intent‐to‐treat population consisted of 576 patients (mean predicted FEV1 51%; mean age 62 years). Treatment with GSK233705 produced statistically significant improvements in pulmonary function compared with placebo. Only the 200 µg dose exceeded the predefined target threshold of 130‐mL difference compared with placebo for the primary endpoint of change from baseline in trough FEV1 on day 29. No clear pattern of dose response was observed for the other doses. Serial FEV1 (0–24 h) showed a peak effect around 2 h postdose and tended to decline to clinically insignificant levels compared with placebo at 23 and 24 h.Each dose of GSK233705 was well tolerated. The incidence of adverse events was low and similar across all treatment groups. There were no clinically significant effects on laboratory parameters, vital signs or electrocardiograms.Conclusion:  All doses of GSK233705 demonstrated bronchodilatory activity and were well tolerated. Although the onset of bronchodilation was rapid, it was not sustained over 24 h making it unsuitable for once‐daily dosing.Please cite this paper as: Bateman E, Feldman G, Kilbride S, Brooks J, Mehta R, Harris S, Maden C and Crater G. Efficacy and safety of the long‐acting muscarinic antagonist GSK233705 delivered once daily in patients with COPD. Clin Respir J 2012; DOI:10.1111/j.1752‐699X.2011.00278.x.
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANTATION IN DIABETES WITH RENAL FAILURE: THE GOLD STANDARD?
Authors: Augustine Titus 
Published: February 2012

SUMMARYSimultaneous Pancreas and Kidney (SPK) transplantation in the 21st century is a proven therapeutic intervention for diabetes with renal failure. Although it is a major invasive procedure, successful transplantation leads to an overall improvement in the quality of life of the recipient, freedom from insulin and dialysis, along with stabilisation and improvement in several of the multi‐system complications associated with long‐term diabetes. It is also associated with improved longevity when compared to diabetics who have had a kidney transplant alone. The combined transplant could be considered a curative procedure albeit at the expense of long‐term immunosuppression. In essence, successful SPK transplantation may be considered the gold standard against which all other therapeutic interventions may be measured in diabetes with end‐stage renal failure.
EXPLORING THE PROCESS OF ADJUSTING TO DIABETIC KIDNEY DISEASE
Authors: Reid Katherine , Morris Marianne , Cormack Margaret , Marchant Karen 
Published: February 2012

SUMMARYThe psychological process of adjusting to diabetic kidney disease (DKD) has been afforded little attention within previous literature. This study aimed to explore the process of adjusting to DKD as a secondary condition to type 1 diabetes. A qualitative method was used in the study design. Eleven participants were interviewed using a semi‐structured and exploratory approach. Through inductive thematic analysis, three super‐ordinate themes were identified from the data: coming to an understanding over time, managing the impact of DKD and facing the future. The themes demonstrate that the DKD population has complex physical and psychological needs at all stages of their condition. Making sense of kidney disease as a secondary condition and integration of this information with existing beliefs was integral to the adjustment process. Attempts to manage uncertainty and change included asserting control of the situation and use of cognitive strategies. The results support the use of psychological models of adjustment in conceptualising the ‘process’ of adjustment and suggest the need for psychological interventions to support this population.
THE DIETARY MANAGEMENT OF PATIENTS WITH DIABETES AND RENAL DISEASE: CHALLENGES AND PRACTICALITIES
Authors: Willingham Fiona 
Published: February 2012

SUMMARYDiabetes Mellitus is one of the major causes of chronic kidney disease and end‐stage renal disease. Diet and lifestyle modification are vital components of optimal treatment for both conditions. This paper will address appropriate and often diverse treatment for each individual, understanding that advising changes which positively impact both conditions is a major challenge for health care professionals working within either speciality. It will also highlight where overlap can be contradictory rather than complementary, and offers practical guidance to support patients in making the necessary lifestyle changes to have maximal positive impact upon both conditions and their overall health.