bluuebunny/crossref_metadata_2025_split huggingface dataset:
Needle‐Free Subcutaneous Sumatriptan (Sumavel™ DosePro™): Bioequivalence and Ease of Use
Authors: Brandes Jan Lewis , Cady Roger K. , Freitag Fred G. , Smith Timothy R. , Chandler Patricia , Fox Anthony W. , Linn Lawrence , Farr Stephen J. 
Published: October 2009

Background.— Subcutaneous (s.c.) injection of sumatriptan is currently associated with needle aversion in some patients, and sharps disposal issues.Objectives.— To investigate whether a needle‐free system can deliver s.c. sumatriptan. If so, to examine whether needle‐free administration is bioequivalent to a 26‐gauge needle‐based auto‐injector. Lastly, to assess the needle‐free system for clinical acceptability and ease of use during migraine attacks.Methods.— Two clinical trials. Study A: Pharmacokinetics and bioequivalence was studied in normal adult volunteers (n = 57 total), directly comparing needle‐free (Sumavel™ DosePro™) with needle‐based (Imitrex STATdose System®) administration of 6 mg s.c. sumatriptan. An incomplete, randomized, partial factorial, crossover design was used. Each subject received 2 administrations of each product, at 2 of the 3 anatomical sites (abdomen, thigh or arm). There were appropriate “washout” periods between each. Pharmacokinetic sampling was at standard time points, and tests for bioequivalence then followed. Study B: The term “ease of use” was used for clinical acceptability and utility of the needle‐free system when it was assessed among 52 outpatients treating migraine attacks. Instructional materials were used as would be provided after ordinary prescription. The primary endpoint was successful use of the needle‐free system to administer sumatriptan at the first attempt, including appropriate injection site selection. Second and subsequent uses of the needle‐free system were also documented.Results.— For administration sites in the thigh and the abdomen, but not the arm, the needle‐free and needle‐based systems were bioequivalent (for all pharmacokinetic endpoints the mean ratios between the 2 devices were always between 90.1% and 115%). Among outpatients treating a migraine attack with the needle‐free system, 51 of 52 on first attempt used the needle‐free system successfully when treating a migraine attack.Conclusions.— Sumavel™ DosePro™ needle‐free delivery system is a new presentation of s.c. sumatriptan that delivers drug effectively, is bioequivalent to the existing needle auto‐injector when used at the thigh or abdomen, and is easy to use.
The Raw Material Equivalents of International Trade
Authors: Muñoz Pablo , Giljum Stefan , Roca Jordi 
Published: October 2009

SummaryThis article aims at estimating the raw material equivalents (RMEs)—the upstream used material flows required along the production chain—of imports and exports for some Latin American countries: Brazil, Chile, Colombia, Ecuador, and Mexico. Furthermore, the United States is included in the analysis as a reference for a high‐income economy. The RME concept and the empirical evidence are articulated by use of an input−output methodology. Results are set out for the year 2003 for each of the countries and in time series for the years 1977, 1986, 1996, and 2003 in the case of Chile. The findings show not only the physical dimensions behind direct material traded but also how the previous exporter (importer) position of a country (based on standard material flow analysis indicators) deteriorates, alleviates, or changes. Implications for material consumption indicators, such as direct material consumption (DMC) and raw material consumption (RMC), are also drawn. The results suggest basing the discussion of material flows on a broader set of indicators to obtain a more comprehensive picture of the implications of international trade and its impacts on the environment.
Using Material Flow Analysis to Illuminate Long‐Term Waste Management Solutions in Oahu, Hawaii
Authors: Eckelman Matthew J. , Chertow Marian R. 
Published: October 2009

SummaryHome to the capital city and nearly a million people, the island of Oahu in the state of Hawaii, USA, is highly dependent on external resources. Over the past decade, large‐scale agricultural production has diminished dramatically, leaving the island greatly reliant on imports for food and most other basic goods. A strong tourism sector and high levels of affluence contribute to per capita municipal waste generation rates exceeding all other U.S. states. The only municipal landfill requires immediate expansion if it is to remain in operation, and it has proven extremely difficult to find additional disposal sites. An island‐wide material flow analysis (MFA) was performed as an innovative means of considering issues of import, export, consumption, and substitution, resulting in long‐term strategies for diminishing the generation of waste that could complement current local conservation and recycling efforts. The findings indicate several opportunities for using domestic waste resources to substitute for imports and simultaneously reduce waste generation, particularly for construction materials. Legislative constraints and possible changes in this regard are also considered. Although past efforts by both the city and state governments to encourage on‐island recycling and reuse have not achieved set goals, the MFA results suggest numerous opportunities that could be pursued to increase material self‐sufficiency and/or reduce waste disposal by several hundred thousand short tons, enhancing the long‐term sustainability of the island.
Dysregulation of CD36 upon TLR‐2 stimulation in monocytes from patients with atopic dermatitis and the TLR2 R753Q polymorphism
Authors: Niebuhr Margarete , Langnickel Jens , Sigel Stefanie , Werfel Thomas 
Published: October 2009

Please cite this paper as: Dysregulation of CD36 upon TLR‐2 stimulation in monocytes from patients with atopic dermatitis and the TLR2 R753Q polymorphism. Experimental Dermatology 2010; 19: e296–e298.AbstractBackground:  The cutaneous colonization with Staphylococcus aureus represents a potent trigger factor of atopic dermatitis. Toll‐like receptor (TLR)‐2 and CD36 have been shown to play a pivotal role in the internalization of staphylococcal components.Aims:  To investigate the impact of TLR‐2 ligands on cell surface protein expression in monocytes from wild type (WT) AD patients and TLR‐2 R753Q polymorph AD patients.Results:  CD36 expression was significantly less downregulated in TLR‐2 polymorph AD patients compared to wild type AD patients upon stimulation with peptidoglycan (PGN) and lipoteichoic acid (LTA) and compared to healthy controls upon stimulation with PGN. Expression of CD86 was higher upon N‐palmitoyl‐S‐[2,3‐bis(palmitoyl)‐(2RS)‐propyl]‐(R)cysteinyl‐alanyl‐glycine (Pam3Cys) stimulation in TLR‐2 R753Q polymorph AD patients compared to wild type AD patients. Expression of CD80 and CD54 were unaffected.Conclusion:  The differences in CD36 expression in TLR‐2 polymorph AD patients compared to wild type AD patients and healthy controls may be associated with an enhanced susceptibility to skin infections with S. aureus.
Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children
Authors: Velló MA , Martínez‐Costa C , Catalá M , Fons J , Brines J , Guijarro‐Martínez R 
Published: October 2009

Oral Diseases (2010) 16, 257–262Objective:  To analyse the influence of several prenatal and neonatal risk factors in the development of enamel defects in low birth weight children.Subjects and methods:  Children between 4 and 5 years of age (n = 102) were classified into: Group 1) 52 low birth weight (<2500 g); Group 2) 50 normal birth weight (≥2500 g). Medical history, prenatal and neonatal variables were collected. Enamel defects were evaluated with the modified Developmental Defects of Enamel Index.Results:  The prevalence of hypoplasia and average number of affected teeth were significantly higher in group 1 than in group 2 (59.6%vs 16% and 1.6 vs 0.3 respectively). Low gestational age was linked to a higher prevalence of hypoplastic (P = 0.027) and combined defects (P = 0.001). Children with neonatal risk factors (low Apgar scores, parenteral nutrition, orotracheal intubation, mechanical ventilation and acidosis) developed defects more frequently (P < 0.05). Defects were symmetrically distributed in children who were not intubated; in those who required intubation they concentrated on the left maxillary teeth (P < 0.05). Smoking during pregnancy, young maternal age and multiple birth were significantly associated to developmental defects.Conclusions:  The prevalence of enamel defects in primary dentition is significantly influenced by birth weight, gestational age and several systemic factors. Orotracheal intubation probably plays an important role as a result of laryngoscope trauma on the maxilla.
Confounding and interaction effect of Treponema denticola salivary carriage in chronic periodontitis
Authors: Martínez‐Pabón MC , Martínez‐Gaviria A , Isaza‐Guzmán DM , Muskus‐López CE , Tobón‐Arroyave SI 
Published: October 2009

Oral Diseases (2010) 16, 278–285Aim:  To evaluate the salivary carriage of Treponema denticola and its association with demographic variables in the etiopathogenesis of chronic periodontitis.Subjects and methods:  Ninety‐seven chronic periodontitis (CP) patients and a control group of 51 healthy subjects (HC) were selected. Periodontal status was assessed by criteria based on probing depth, attachment loss, extent, and severity of periodontal breakdown. A polymerase chain reaction method was used to determine the occurrence of T. denticola in saliva samples. Risk indicators for CP were assessed individually and adjusted for confounding and/or interaction using a logistic regression model.Results:  Although univariate analysis revealed a positive association of age ≥30 years, smoking, and salivary carriage of T. denticola with CP, after logistic regression analysis, the association between age ≥30 years/smoking and CP persisted, whereas salivary carriage of T. denticola failed to achieve statistical significance. An interaction effect was significantly detected between these three variables.Conclusion:  Although salivary carriage of T. denticola may be a risk indicator for CP, its pathogenicity should not be exclusively endorsed to its detection in saliva, but it might be associated with the synergistic biological interaction of the bacterium with some demographic characteristics of the susceptible host.
Parapsoriasis lichenoides/Parapsoriasis variegata – a new concept
Authors: Wolf Ingrid H. , Kerl Katrin , Cerroni Lorenzo , Kerl Helmut 
Published: October 2009

SummaryWe present a new concept on the nosology of parapsoriasis lichenoides (= parakeratosis variegata) and show that this parapsoriasis type is not a separate entity. It represents different diseases: a large number of cases presenting as reticular parapsoriasis are mycosis fungoides, another group represents reticular variants of the parapsoriasis guttata group (pityriasis lichenoides acuta et chronica). Further, cases exist that can be classified as lichen planus reticularis or other diseases (e. g. keratosis lichenoides).
A case of near‐drowning: a case for routine cerebral monitoring
Authors: Ponnusamy V , Beach RC , Blake J , Clarke P 
Published: October 2009

AbstractA 6‐week‐old infant presenting with near‐drowning was medically paralysed and ventilated on admission. Status epilepticus was found on cerebral function monitoring, without which the diagnosis would have been missed or delayed for many hours. This case illustrates the value of cerebral function monitoring for patients in intensive care, where clinical signs of seizure activity are frequently masked by paralysis and sedation.Conclusion:  Limited availability of electroencephalogram (EEG) and cerebral function monitoring (CFM) in paediatric intensive care may inadvertently delay diagnosis and appropriate treatments and so adversely affect outcomes. We propose that round‐the‐clock cerebral function and/or EEG monitoring should be available in all centres that provide paediatric intensive care.
Stent salvage for parent vessel coil herniation during intracranial aneurysm embolization
Authors: Wong George K.C. , Yu Simon C.H. , Wong Ka‐Tak , Poon Wai‐Sang 
Published: October 2009

Background:  Despite accumulated experience and improved understanding of the tools, endovascular treatment of cerebral aneurysms still has risks associated with the technique itself and with the specificity of the pathology treated. An important risk is parent vessel Guglielmi detachable coil herniation. Here we review and illustrate our experiences in using a stent to manage this complication.Methods:  We reviewed our experiences in 142 intracranial aneurysm embolizations over a four and a half year period and identified 13 cases with intravascular stent deployment. Three cases were unique in using a stent for salvage of coil herniation into the parent vessel.Results:  We reported these cases and reviewed the literature for the management of parent vessel coil herniation.Conclusion:  Parent vessel coil herniation was an uncommon but important complication of endovascular coiling of intracranial aneurysm. Intravascular stent placement provided a tool to sequester herniated coils from the lumen of the parent artery to minimize thromboembolic complications and restore flow.
Surgical patient satisfaction in Hong Kong: Validation of a new instrument
Authors: Bower Wendy Fiona , Cheung Catherine S.K. , Wong Eric M.C. , Lee Ping‐Yin , Van Hasselt Charles Andrew 
Published: October 2009

Objective:  To validate the locally developed surgical inpatient satisfaction instrument (SIPS) across a diverse population of perioperative patients and to identify independent contributors to patient satisfaction.Methods:  Patients over 18 years of age who had undergone surgery either as a day or inpatient in three public hospitals within the eastern area of the New Territories in Hong Kong were recruited prior to discharge. Seven hundred and sixty‐five patients completed our 40‐item seven‐factor surgical patient satisfaction instrument along with an existing European measure of inpatient satisfaction in cancer patients (EORTC In‐Pats 32). Analysis included factorial validity by exploratory factor analyses, unidimensionality, item fit, differential item functioning and concurrent validity. Univariate and linear logistic regression analysis of overall satisfaction was carried out.Results:  Psychometric testing demonstrated the instrument to be robust and generalizable and did not support removal of any of the items. The independent predictor of overall surgical inpatient satisfaction was the quality of nursing care and age over 50 years. Satisfaction was not confounded by gender, length of hospital stay or educational level.Conclusions:  SIPS was shown to be valid across a range of surgical procedures.
Early experience on simultaneous mastectomy and video‐assisted thoracoscopic surgery lobectomy via mastectomy incision
Authors: Chong Charing Ching‐Ning , Wan Innes Yuk‐Pui , Ng Calvin Sze‐Hang , Hsin Michael Kuan‐Yew , Leung Siu‐Lan , Chan Wing‐Cheong 
Published: October 2009

Aim:  To assess the feasibility of simultaneous video‐assisted thoracoscopic surgery (VATS) lobectomy and mastectomy via the same incision in patients with synchronous primary carcinoma of the ipsilateral breast and lung.Methods:  The patient was first positioned supine and modified radical mastectomy for the breast carcinoma was carried out in the standard way. After that, the mastectomy wound was partially closed and the patient was then turned into a full right decubitus position. Camera and instrument ports were inserted and a utility thoracotomy was made through the mastectomy wound. VATS lobectomy was then carried out.Results:  From December 2007 to December 2008, three patients with synchronous primary breast and lung tumour received simultaneous mastectomy and VATS lobectomy through a single mastectomy incision in our institute. There was no operation‐related mortality. The median operation time was 253 min (range 246–345 min) and the median blood loss was 250 mL (range 110–300 mL). All except one patient had uneventful postoperative recovery and deep vein thrombosis was noted in one patient.Conclusion:  Simultaneous lobectomy through the mastectomy incision is a safe and feasible treatment option for ipsilateral pulmonary and breast lesion with encouraging outcome.
Value of monitoring postoperative intra‐abdominal drainage fluid for the diagnosis of postoperative pancreatic fistula: Results of a prospective study in 134 patients
Authors: Shi Chenye , Jin Dayong , Xu Bin , Lou Wenhui 
Published: October 2009

Objective:  To evaluate the value of monitoring postoperative intra‐abdominal drainage in the diagnosis and treatment of postoperative pancreatic fistula (POPF).Methods:  Intra‐abdominal drainage adjacent to the pacreaticoenteric anastomosis was prospectively collected from 134 patients accepted for pancreatic surgery in our department between November 2005 and August 2007 to determine the concentration of amylase and bacteriology. Also, the clinical outcome of each patient was recorded. The international study group definition was used to diagnose POPF.Results:  The overall incidence of POPF was 39.6% in 53 patients diagnosed as POPF, among which 50 patients (37.3%, 50/134) were graded as I/II of POPF. The rising trend of the amylase level in the drainage fluid (P = 0.001), the texture of the pancreatic remnant (P = 0.042), and the amylase level on the 3rd and 7th postoperative days demonstrated good diagnostic values in univariate analysis (P < 0.001). The amylase value in drains on the 3rd postoperative day (POD3) and the 7th postoperative day (POD7) were the predicting factors (P < 0.001) of POPF by multivariate analysis.Conclusions:  The amylase values in drains on the 3rd postoperative day and on the 7th postoperative day (POD7) were both valuable factors in the diagnoses of POPF. It is very important to monitor the dynamic change of amylase concentration in the drainage, not the result of a single test. These clinical factors could help us to detect the incidence of POPF earlier.
Are we doing too many surveillance colonoscopies on colonic adenoma? A 4‐year study on a major colorectal cancer screening hospital
Authors: Leung Edmund , Hughes Paul , McKay Stephen , Wong Ling 
Published: October 2009

Introduction:  The British Society of Gastroenterology (BSG) has set clear guidelines on post‐polypectomy surveillance colonoscopy for adenomatous polyps. The present study aims to determine whether these guidelines were adhered to in a screening unit, where colonoscopy is offered to anyone between 50 and 69 with positive faecal occult blood testing.Methods:  All patients (asymptomatic and symptomatic) who underwent surveillance colonoscopy were retrospectively included between 2003 and 2006. Surveillance colonoscopy was carried out as a follow‐up examination to a patient previously found to have adenoma(s), malignancy, strong family history or history of inflammatory bowel disease. Patients with no evidence of adenomas on their baseline or any repeat colonoscopy were excluded. Information relating polyp number, size and histology was collected, and their subsequent schedule colonoscopy was then compared with the BSG guidelines.Results:  Of the 1856 colonoscopies carried out, 779 cases of polyps were detected after exclusion criteria (478 symptomatic, 301 screened cases). In the symptomatic cohort, 344 cases (72%), whereas in the screened cohort, 242 cases (80%) were compliant with the BSG guidelines (P < 0.01). Reasons for non‐compliance were premature follow up, late follow up, follow up occurring when not indicated, follow up not occurring when indicated, and the use of flexible sigmoidoscopy for follow up.Conclusion:  Too many surveillance colonoscopies were performed in our unit. Targeting the reasons for non‐compliance could potentially reduce workload and improve efficiency in an over‐stretched colonoscopy unit.
Implementation of Standardized Nomenclature in the Electronic Medical Record
Authors: Klehr Joan , Hafner Jennifer , Spelz Leah Mylrea , Steen Sara , Weaver Kathy 
Published: October 2009

PURPOSE.  To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation.DATA SOURCES.  Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA‐I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user‐friendly format using the care plan activity.CONCLUSIONS AND IMPLICATIONS.  Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence‐based documentation enhanced institutional leadership in clinical documentation.
Problems Expressed by Caregivers of Children With Fetal Alcohol Spectrum Disorder
Authors: Caley Linda M. , Winkelman Theresa , Mariano Kathleen 
Published: October 2009

PURPOSE.  The purpose of this study was to determine if use of a standardized classification system could help identify potential nursing sensitive problems for caregivers of children with fetal alcohol spectrum disorder (FASD).METHOD.  This study is a secondary analysis of data obtained from transcripts of public testimonies. Content analysis was conducted using a standardized classification system. The sample consisted of 376 statements from electronic transcripts of first person testimonies given by 48 caregivers of children with FASD in four states.FINDINGS.  Forty‐eight caregivers expressed a total of 53 signs and symptoms. The majority was in the problem areas: communication with community resources, caretaking/parenting, mental health, and income.CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE.  Using a nursing classification system, investigators were able to identify nursing sensitive problems expressed by caregivers of children with FASD. The information from this study can be used in future studies to confirm or revise the signs/symptoms identified in this study.