bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhibition of tau fibrillization by oleocanthal via reaction with the amino groups of tau
Authors: Li Wenkai , Sperry Jeffrey B. , Crowe Alex , Trojanowski John Q. , Smith III Amos B , Lee Virginia M.‐Y. 
Published: June 2009

AbstractTau is a microtubule‐associated protein that promotes microtubule assembly and stability. In Alzheimer’s disease and related tauopathies, tau fibrillizes and aggregates into neurofibrillary tangles. Recently, oleocanthal isolated from extra virgin olive oil was found to display non‐steroidal anti‐inflammatory activity similar to ibuprofen. As our unpublished data indicates an inhibitory effect of oleocanthal on amyloid β peptide fibrillization, we reasoned that it might inhibit tau fibrillization as well. Herein, we demonstrate that oleocanthal abrogates fibrillization of tau by locking tau into the naturally unfolded state. Using PHF6 consisting of the amino acid residues VQIVYK, a hexapeptide within the third repeat of tau that is essential for fibrillization, we show that oleocanthal forms an adduct with the lysine via initial Schiff base formation. Structure and function studies demonstrate that the two aldehyde groups of oleocanthal are required for the inhibitory activity. These two aldehyde groups show certain specificity when titrated with free lysine and oleocanthal does not significantly affect the normal function of tau. These findings provide a potential scheme for the development of novel therapies for neurodegenerative tauopathies.
Immunotherapy for allergic rhinitis: clinical benefits and its working mechanisms
Authors: Nakai Y. , Ohashi Y. 
Published: June 2009

SummaryPollen immunotherapy exerts greater efficacy in the pollen season when the pollen count is not high than when it is high. Every pollen season, around half or more patients who have received pollen immunotherapy for >5 years are judged as good responders; those who have received immunotherapy for <5 years generally do less well. Therefore, the clinical response seems to depend on natural pollen counts and the duration of immunotherapy. In this study, peripheral blood mononuclear cells (PBMCs) were sampled before and during the pollen season to examine IL‐4, IL‐5, and IFN‐γ levels. It was revealed that pollen immunotherapy could decrease IL‐4 and ‐5 expression by pollen antigen‐stimulated PBMCs. When patients under immunotherapy were divided into good and poor response groups, clinical effectiveness was related to the depressed level of IL‐5 synthesis, but not to that of IL‐4 synthesis. Our study suggests that a decrease of IL‐5 expression during the pollen season is a key working mechanism of immunotherapy related to clinical effectiveness. In our patients, the incidence of systemic reactions was 5.8%/patient and <0.1%/injection. A higher incidence of systemic reactions was observed in patients with the presence or a past history of asthma, the presence but not a past history of atopic dermatitis, and higher levels of total IgE (>1000 U/mL). The incidence of systemic reactions in patients with 1 risk factor such as asthma, atopic dermatitis, and high IgE was 16.9%/patient and 0.1%/injection, whereas that in those without risk factors was 1.6%/patient and <0.1/injection.
Immunotherapy for cure and prophylaxis of allergic rhinitis
Authors: Ohashi Y. , Nakai Y. 
Published: June 2009

SummaryThe possible cure of Japanese cedar pollen‐induced allergic rhinitis (AR) by immunotherapy was investigated. The mechanism of cure was also studied from the viewpoint of the T cell response to allergen; it was documented that absence of IL‐5 production from allergen‐stimulated T cells was the major mechanism. The prophylactic aspect of immunotherapy was also investigated. Eighty‐eight asymptomatic subjects who were already sensitized to pollen were recruited. Of these subjects, 31 (prophylactic immunotherapy group) were treated with pollen immunotherapy for 3 years. The remaining 57 individuals (control group) were not treated with pollen immunotherapy. At the end of the 3‐year trial, only 28 of 57 individuals (49.1%) in the control group remained asymptomatic. On the other hand, 27 of 31 individuals (87.1%) in the prophylactic immunotherapy group remained asymptomatic. Prophylactic immunotherapy decreased IL‐4 synthesis from pollen allergen‐stimulated T cells, suggesting that this was the mechanism of prevention of symptoms' outbreak. We next examined whether mite immunotherapy for patients monosensitized to mite allergen could prevent new sensitization to pollens. A total of 132 patients monosensitized to house dust mites were included. Of these individuals, 52 (pharmacotherapy group) were treated with antihistamine tablets for 4 years, and the remaining 80 patients (mite immunotherapy group) were treated with mite immunotherapy for the same time period. Whereas 15 of 52 patients (28.8%) in the pharmacotherapy group attained new sensitization to some kinds of pollen allergens, only five of 80 patients (6.3%) in the mite immunotherapy group attained new sensitization. Our data suggest that mite immunotherapy can prevent new sensitization to pollen allergens. It is therefore concluded that pollen immunotherapy cannot only cure pollen‐induced AR but also prevent outbreaks of pollen‐induced AR, and that mite immunotherapy can prevent new sensitization to pollen allergens.
What has the relief of allergic conjunctivitis by intranasal steroids taught us about the pathophysiology of allergic rhinoconjunctivitis?
Authors: Naclerio R. , Baroody F. 
Published: June 2009

SummaryPatients with allergic rhinitis (AR) report ocular symptoms 40–70% of the time. These symptoms can be burdensome and have a major impact on patients' quality of life. Most clinicians believe that ocular symptoms result from direct contact of allergen with the conjunctiva, although other explanations such as a nasal‐ocular reflex, blockage of the nasal lacrimal duct, and systemic effects of cytokines released from the nasal mucosa can explain the association. However, if direct contact by an allergen is the sole explanation, how do we explain the efficacy of intranasal steroids on the eye symptoms of AR, especially because most intranasal steroids have <0.5% systemic bioavailability? This paper highlights a potential mechanism for the development of ocular symptoms after nasal exposure to antigen, the nasal‐ocular reflex, and speculates how intranasal steroids can affect this reflex and eye symptoms. Two nasal‐challenge studies assessing the nasal‐ocular reflex are presented. The first shows the presence of a nasal‐ocular reflex in response to localized nasal‐antigen challenge, which is initiated by the release of histamine and blocked by a topical, intranasal antihistamine. The second study shows that the nasal‐ocular reflex is augmented with repeated nasal antigen challenge, a response that is inhibited by pretreatment with an intranasal steroid. These studies provide an explanation for the way in which treatment with intranasal steroids can work locally in the nose to reduce ocular symptoms in patients with AR. This explanation, however, would only be valid if the majority of eye symptoms in patients with AR were caused by the nasal‐ocular reflex and not by direct contact of antigen with the conjunctiva – an assumption supported by clinical studies.
Surgical treatment of the inferior turbinate for allergic rhinitis: clinical evaluation and therapeutic mechanisms of the different techniques
Authors: Takeno S. , Hirakawa K. , Ishino T. , Goh K. 
Published: June 2009

SummaryMany different surgical procedures have been described to alleviate nasal obstruction due to turbinate hypertrophy in patients with allergic rhinitis (AR) who continuously have chronic nasal congestion. The goal of surgical procedures should be ‘optimal reduction of volume and secretion with preservation of function’. For a period of about 25 years, laser surgery of the inferior turbinate has been considered a simple and effective surgical treatment with a low complication rate that has been in widespread use by many ENT surgeons. Various trials have demonstrated the clinical effectiveness of a series of different laser systems including carbon dioxide, Nd:YAG, potassium‐titanyl‐phosphate, and diode laser. Laser surgery generally induces significant increases of the total volume of the nasal cavity. Several studies have provided evidence that the expression degree of local inflammatory cytokines and chemical mediators can be attenuated by the treatment. The mucociliary function of the inferior turbinate seems to be preserved after CO2 laser intervention. A breakthrough in the surgical procedures available for allergic patients who severely suffer from both intractable hypertrophic inferior turbinates and unregulated nasal secretion was introduced in Japan. Posterior nasal neurectomy is a novel alternative method in which neural bundles are selectively cut or cauterized from the sphenopalatine foramen. Resection of the posterior nasal nerve at this point enables surgeons to inhibit the parasympathetic nerve function of the nasal mucosa with no troublesome complications such as decrease of lacrimal secretion. The procedure simultaneously provides interruption of the somatic afferent innervation to the turbinate mucosa. Herein we assess the clinical effectiveness of this surgical procedure based on objective and measurable monitoring parameters and discuss the underlying therapeutic mechanisms.
Grasping the nutritional situation: a grounded theory study of patients’ experiences in intensive care
Authors: Persenius Mona W , Hall‐Lord Marie L , Wilde‐Larsson Bodil 
Published: June 2009

AbstractAim and objectives:  The aim of this study was to provide a theoretical understanding of nutritional experiences for patients with enteral nutrition (EN) during their stay in the intensive care unit (ICU).Background:  It is well known that EN can result in underfeeding for patients in ICUs. How the patients experience their nutritional care during their stay in the ICU remains somewhat unclear.Design and methods:  In this study, a grounded theory approach was chosen to conduct and analyse 14 interviews with patients and 21 observations of nutritional care during the patients’ stay in an ICU.Findings:  The core category ‘grasping nutrition during the recovery process’ was reflected in, and related to, the categories ‘facing nutritional changes’, ‘making sense of the nutritional situation’ and ‘being involved with nutritional care’. While grasping the nutrition, the patients were emotionally shifting between worry, fear and failure, and relief and hope. Turning points were having the appetite back, getting rid of the feeding tube and regaining a functioning gut.Conclusions:  The patients’ views of nutritional care during their stay in the ICU may contribute to understanding of how patients make sense of their nutritional changes and how they are involved in their nutritional care. This study shows that grasping the nutrition can be a way to regain some control in a situation where the patients are highly dependent on professional care. Further research is needed to develop this substantive theory in other intensive care settings to support patients’ nutritional journey in intensive care.Relevance to clinical practice:  Nurses can promote patients’ abilities to grasp their nutritional situation during their recovery process. There is a need to focus not only on the patients’ physical needs but also on their emotional and social needs.
Communication, swallowing and feeding in the intensive care unit patient
Authors: Batty Sally 
Published: June 2009

AbstractBackground:  It is not uncommon for patients requiring a period of time in the intensive care unit (ICU) to experience difficulties with communication and/or swallowing, either as a result of their illness or as a result of the treatments they receive. These difficulties can be both short term and long term and require timely and appropriate intervention in order to improve the patient’s experience and expedite recovery/rehabilitation.Aims:  The purpose of this article is to provide critical care nurses with an update on aspects of communication, swallowing and feeding in the ICU. The paper will focus on each area in relation to the current evidence base and factors of ‘best practice’ (as determined by expert opinion).Implications for critical care nursing practice:

Enabling communication can improve well‐being, increase compliance and reduce length of stay;
Simple modes of communication, e.g. writing/gesture/pictures can be very effective;
Coded eye blinking may be unreliable because of confusion with reflexive blinking;
Non‐oral nutrition will generally not meet the psychological and physical needs and benefits of oral intake;
Not all patients with a tracheostomy in situ will experience dysphagia; however, those considered ‘at risk’ should have their swallow assessed by an appropriately trained professional, e.g. speech and language therapist/dysphagia trained professional;
An inflated tracheostomy cuff will not prevent aspiration. The decision to commence oral intake in the presence of an inflated cuff should be made as a team and take into consideration the patient’s medical and psychological status;
The use of blue dye to assess the swallow carries a high false‐negative rate and cannot be relied on alone to predict either the presence or the absence of aspiration.

Conclusion:  There is still much more research to be performed and evidence to be gained regarding the input into communication, swallowing and feeding in the ICU; however, a full‐team approach to these areas can have very positive effects on the patient’s experience.
Quick change versus double pump while changing the infusion of inotropes: an experimental study
Authors: De Barbieri Ilaria , Frigo Anna C , Zampieron Alessandra 
Published: June 2009

AbstractBackground:  Quick change (QC) and double pumping (DP) are common methods of substituting the infusion of inotropes given through intravenous pump.Aims:  The aim of the study was to compare two methods in respect with the variation in mean arterial pressure (MAP). The hypothesis was that the DP method could be the most effective in achieving haemodynamic stability.Design:  The study is a randomized research in an open randomized clinical trial.Methods:  The study took place at the Paediatric Intensive Care Unit of Padua Hospital. It considered patients of 0–36 months, not premature, treated with inotropic infusion with monitoring of blood pressure. The research obtained the approval of the Hospital Research Ethics committee and parents signed informed consent. Comparison of the two groups made use of the Wilcoxon test for the continuous variables and the Fisher’s exact test for the comparison of frequencies, at significance value of 5%. The data were registered in an Excel spreadsheet and analysed with SAS.Results:  The sample comprised 30 patients of age between 1 and 27 months, of whom 13 (43%) were male. They were all affected by cardiac, respiratory or infective pathology, all of them intubated and on artificial respiratory support, sedated and infused with dopamine. The characteristics of the patients of the two groups did not differ significantly. The percentage variation of the baseline value of MAP after 30 min from starting the treatment between the two methods was not statistically significant (p = 0·85). The 95% confidence interval for the difference in the percentage variation of MAP between the two groups was (−3·1, +3·7). From a clinical perspective, the methods are to be considered equivalent.Conclusions:  The study was conducted on a limited sample; no statistically significant differences were detected; QC is the quickest and more cost‐effective method.
Acute kidney injury and renal replacement therapy in the intensive care unit
Authors: Faber Peter , Klein Andrew A 
Published: June 2009

AbstractBackground:  Renal replacement therapy (RRT) is now offered as a routine treatment in most intensive care units (ICU) in the UK for patients suffering from acute kidney injury (AKI). It is important for all ICU staff to understand the underlying principles of the available therapeutic options and the possible complications thereof.Aims and objectives:  The objective of this review was to provide an accessible theoretical and practical update on the management of RRT. In addition to a detailed discussion of the underlying principles and indications for the various modes of RRT, we will discuss the assessment of kidney function, possible complications and anticoagulation during RRT, following a review of the current literature.Search strategies:  Pubmed, Medline and the Cumulative Index to Nursing and Allied Health Literature were searched using the keywords renal function, RRT, dialysis, renal failure kidney injury, together with intensive care, intensive therapy and critical care. We included only studies published in English from 1998 to 2008 and from these identified and included additional publications. The 12 most relevant publications are referenced in this review.Conclusion:  AKI is associated with increased mortality in ICU, and RRT should be considered early in the disease process. Continuous haemofiltration is the most common modality of treatment in this group of patients, and a detailed knowledge of the management of such patients is required.
Earplugs improve patients’ subjective experience of sleep in critical care
Authors: Scotto Carrie J , McClusky Carol , Spillan Scott , Kimmel Justin 
Published: June 2009

AbstractAims:  This study aimed to determine the effects of earplug use on the subjective experience of sleep for patients in critical care.Background:  The negative effects of noise in critical care include sleep disturbances, increased stress response, and reduced patient satisfaction. The nature of critical care often precludes quiet time protocols. Previous studies indicated that earplugs can improve REM sleep and sleep efficiency. This study examined the effects of earplugs as a non‐invasive method for improving the subjective sleep experience and increasing patient satisfaction.Design:  Quasi‐experimental intervention study with random assignment of subjects.Method:  Subjects were non‐ventilated, non‐sedated adults admitted to critical care. The intervention group used earplugs during nighttime sleep hours allowing short term removal during patient care. Participants completed the Verran‐Snyder‐Halpern Sleep Scale, an 8‐question visual analogue scale, to describe their subjective response to sleep. Two sample T‐tests were used to detect differences between the group scores.Results:  88 participants (49 intervention/39 control) completed the study. Mean age 63, 56% males, 93% Caucasian. Total sleep satisfaction scores were significantly better for the intervention group (p = .002). Seven of the subjective categories were independently significant (p = .005‐.044). One category, satisfaction with the amount of time needed to fall asleep, was not significant (p = .111).Conclusions:  Earplug use improved the subjective experience of sleep for un‐medicated critical care patients without interfering with care delivery.Relevance to Practice:  The negligible cost and low level of invasiveness of earplugs makes this preferable as a primary intervention to promote sleep while avoiding unnecessary sedating medications.
Evaluation of chronic hypertension in pregnant young women
Authors: DE SOUSA Joana , EAGLETON Carl , LO Chern 
Published: June 2009

Women with chronic hypertension are at higher risk of adverse obstetric outcomes. It is essential that the condition is identified and evaluated appropriately in early pregnancy. Therefore, an audit has been carried out to assess how well young pregnant women with chronic hypertension were investigated for secondary cause in South Auckland, compared with the recommendations of the Australasian Society for the Study of Hypertension in Pregnancy.The evaluation of chronic hypertension by history taking, physical examination, laboratory assessment and radiology tests was highly variable. Only 76% of women had appropriate follow‐up for their hypertension. Screening for secondary causes was not consistent, and the majority had incomplete investigation.
The effect of the levonorgestrel releasing intrauterine system on endometrial hyperplasia: An Australian study and systematic review
Authors: BUTTINI Melissa J. , JORDAN Susan J. , WEBB Penelope M. 
Published: June 2009

Background: The levonorgestrel intrauterine system (LNG‐IUS) provides effective contraception and treatment for menorrhagia and is used to prevent endometrial hyperplasia (EH) in women taking unopposed oestrogens.Aims: The aim of this study was to assess whether the LNG‐IUS was also a safe and effective treatment for EH and to conduct a systematic review of the literature.Methods: A retrospective record review was undertaken in a private gynaecology practice in Brisbane, Australia, and included all women with EH treated with hysterectomy, oral progestins or LNG‐IUS between January 2004 and April 2007. Histopathological findings from hysterectomy specimens or endometrial biopsies were used to calculate rates of regression of the EH.Results: Twenty‐one women elected to have a hysterectomy and seven of those (33%) had no persisting hyperplasia at surgery. Twenty‐six women had a LNG‐IUS inserted at initial hysteroscopy dilatation and curettage or shortly afterwards; seven of those elected to proceed to hysterectomy when their diagnosis was known. Among ten women who used oral progestin treatment, 90% showed initial regression; two with recurrent EH were subsequently treated successfully with LNG‐IUS. All 21 women (100%), including one with atypia, treated with LNG‐IUS for more than seven weeks had normal endometrial histology on subsequent assessment. No women developed endometrial cancer. Pooled analysis of the published literature gave a 96% regression rate for non‐atypical EH treated with LNG‐IUS.Conclusions: These data contribute further evidence that LNG‐IUS is a safe and effective method for treating non‐atypical EH. Whether LNG‐IUS could provide a safe and cost‐effective alternative to hysterectomy for atypical EH warrants further examination.
Reclassification of unexplained stillbirths using clinical practice guidelines
Authors: HEADLEY Elizabeth , GORDON Adrienne , JEFFERY Heather 
Published: June 2009

Background: Twenty‐eight per cent of stillbirths in Australia remain unexplained. A clinical practice guideline (CPG) produced by the Perinatal Society of Australia and New Zealand (PSANZ) Perinatal Mortality Special Interest Group is in use to assist clinicians in the investigation and audit of perinatal deaths.Aims: To describe in a tertiary hospital using the PSANZ stillbirth investigation guidelines: (i) the distribution and classification of stillbirths, and (ii) the compliance with suggested stillbirth core investigations.Methods: Retrospective cohort of all stillbirths delivered between November 2005 and March 2008. Stillbirths were defined as no sign of life on delivery at ≥ 20 weeks gestation or 400 g birthweight if gestation is unknown. Data were collected via the hospital Perinatal Mortality Audit Committee (PMAC). Cause of death was classified by the PSANZ Perinatal Death Classification.Results: There were 86 stillbirths (rate 7.2 per 1000 births). The percentage of unexplained stillbirths was 34% and 13% before and after CPG investigations, respectively. Unexplained stillbirths had the highest compliance with the recommended investigations. The initial cause of death documented on the death certificate was changed by the PMAC in 19 cases. The investigations most likely to prompt a change in the cause of death classification were autopsy and placental pathology.Conclusions: The percentage of unexplained stillbirths is lower than the national average in a hospital using the Perinatal Mortality Audit Guidelines. However, overall compliance is low, suggesting a targeted approach to investigation is used by clinicians despite a policy that aims to be non‐selective. Autopsy and placental examination are the most useful investigations in assisting formal classification of cause of death.