bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-dose intramuscular octreotide in patients with acromegaly inadequately controlled on conventional somatostatin analogue therapy: a randomised controlled trial
Authors: Giustina Andrea , Bonadonna Stefania , Bugari Giovanna , Colao Annamaria , Cozzi Renato , Cannavo Salvatore , de Marinis Laura , degli Uberti Ettore , Bogazzi Fausto , Mazziotti Gherardo , Minuto Francesco , Montini Marcella , Ghigo Ezio 
Published: May 2009

ObjectiveIn acromegaly, 25–50% of patients respond inadequately to conventional long-acting somatostatin analogue (SSA) therapy. Response may be improved by increasing SSA frequency or dose. This study evaluated the biochemical efficacy and safety of high-dose octreotide in patients with acromegaly.DesignA 24-week prospective, multicentre, randomised, open-label trial conducted from 12 December 2005 to 23 October 2007 in patients with persistently uncontrolled acromegaly despite ≥6 month conventional SSA therapy.MethodsPatients with ≥50% reduction in GH levels during previous SSA treatment were randomised to high-dose (60 mg/28 days) or high-frequency (30 mg/21 days) octreotide i.m. injection. Primary end-points were week 12 and 24 reduction in serum IGF1 and GH from baseline. Secondary end points included IGF1 normalisation and tumour shrinkage rates, and safety/tolerability evaluations.ResultsSignificantly, more patients (10 out of 11) achieved week 24 IGF1 reduction in the high-dose than the high-frequency group (8 out of 15; P<0.05). In the high-dose group only, week-24 IGF1 values were significantly reduced (P=0.02) versus baseline. Normalisation of IGF1 occurred only with the high-dose regimen (4/11; P=0.02). Out of 14 patients experiencing adverse events, 5 reported drug-related gastrointestinal effects. No dose–response relationship was seen. Safety parameters were similar between treatment groups, apart from a slight decrease in HbA1c in the high-dose group only.ConclusionHigh-dose octreotide treatment is safe and effective (normalisation of IGF1 levels) in a subset of patients with active acromegaly inadequately controlled with long-term SSA. Individualised octreotide doses up to 60 mg/28 days may improve outcomes of SSA therapy.
Reconstructive surgery of penile deformities and tissue deficiencies
Authors: Kelemen Zsolt 
Published: May 2009

A hímvessző torzulatai és szövethiányos állapotai zavarják a közösülést vagy akár lehetetlenné tehetik. A dolgozat célja a különböző betegségek összefoglalása klinikai megjelenésük és kórfolyamataik alapján, a műtéti módszerek meghatározása és eredményességük bemutatása gyakorlatunkban. A hypo- és epispadiasis ellátása rendszerint gyermekkorban megtörténik, de a sikertelen műtétek utáni torzulatok a húgycső, a bőr és esetlegesen a barlangos testek helyreállítását is szükségessé tehetik. Az induratio penis plastica (Peyronie-kór) és a penis fractura utáni görbület a tunica albuginea műtétét igényli. A plakksebészet irha-, hereburok- vagy vénagraft felhasználását jelenti, a legjobb eredményeket azonban a Heinecke–Mikulitz-elv szerinti ellenoldali rövidítéssel érték el. Szövethiányos állapotokat és görbületeket észleltek olyan nekrotizáló, gyulladásos folyamatok után, mint a Fournier-gangraena vagy az idült bőrgyulladás. A bőrhiányokat lebenyekkel és graftokkal pótolták. Az erectilis diszfunkció kezelésében alkalmazott intracavernosus injekciók után a hímvessző súlyos tályogos szövetpusztulását vagy heges torzulatát észlelték. A helyreállító műtét lehetőségei ezen esetekben meglehetősen korlátozottak. Új feladatként jelentkezett a hímtag zsírgranulomájának eltávolítása. A bőrpótlás legjobb módszerének a hímvessző átmeneti herezacskóba bújtatása bizonyult.
Current status of treatment for early-stage invasive breast cancer
Authors: Kásler Miklós , Polgár Csaba , Fodor János 
Published: May 2009

Az emlőrák a nők leggyakoribb rákos megbetegedése. Évente több mint egymillió nő betegszik meg emlőrákban. Az emlőrákos morbiditás meredeken emelkedett a fejlett ipari országokban az utóbbi pár évtizedben, de a mortalitási ráta mostanában csökken. Az utóbbi a szervezett lakossági szűréseknek, a korszerű sebészi és sugárterápiás beavatkozásoknak és a hatékonyabb szisztémás kezeléseknek köszönhető. A fejlődés egyik legizgalmasabb területe az új terápiás szerek bevezetése a klinikai gyakorlatba. A célzott terápia (tirozinkinázok gátlása) rohamosan fejlődik. Korai (0./I./II. stádium) emlőrákban a daganatot műtéttel eltávolítják, és ezt követi az adjuváns kezelés. Az adjuváns kezelés célja a lokoregionális és távoli mikroszkopikus daganatdepozitok elpusztítása. A daganatos kiújulás kockázatának megbecsülésére prognosztikai faktorokat használunk. Az optimális individualizált kezelés meghatározását a prediktív faktorok segítik. A dolgozatban a korai emlőrák kezelésének jelenlegi helyzetét tárgyaljuk, beleértve az emlőmegtartó kezelést, a mastectomia utáni sugárkezelést, a hormon- és kemoterápiát, valamint a humán epidermális növekedési faktor receptor-2- (HER-2-) pozitív daganatok trastuzumabkezelését.
Immunohistochemical demonstration of NPMc+ acute myeloid leukemia: biological and clinical features related to cytoplasmic nucleophosmin expression
Authors: Bedekovics Judit , Rejtő László , Telek Béla , Udvardy Miklós , Újfalusi Anikó , Oláh Éva , Hevessy Zsuzsa , Kappelmayer János , Kajtár Béla , Méhes Gábor 
Published: May 2009

A nucleophosmin gén (NPM1) 12-es exonjának mutációja, jelenlegi ismereteink szerint, a leggyakoribb genetikai eltérés akut myeloid leukaemiában. Az eddigi beszámolók alapján kimutatásával a betegség sajátos biológiájú és kedvező lefolyású formája határozható meg, amely a leukaemiák WHO-osztályozásában 2008-tól külön csoportként kerül említésre. A mutáció hatására megváltozik a kódolt fehérje sejten belüli eloszlása, és az NPM fehérje a sejtmag helyett a citoplazmában halmozódik fel (NPMc+). Ez a jelenség, amely a kizárólag mutáns géntermék kapcsán figyelhető meg, szövettani vizsgálat keretében immunhisztokémiával is kimutatható. Jelen tanulmányunkban hazai körülmények között először vizsgáltuk az NPM-mutáció előfordulását felnőttkori AML-ben immunhisztokémia módszerével. A 2005 és 2008 között diagnosztizált összesen 41 eset részletes kiértékelése során 6 esetben (14,6%) észleltünk citoplazmikus reakciót, valamennyi
de novo
jelentkező és jellegzetes citogenetikai eltérést nem mutató AML-esetek közül került ki (6/23, 26,1%), egy kivételével nőbetegekben. A blasztsejtek alacsony CD34-, c-kit- és HLA-DR-expressziója alapján a NPMc+ AML a nem érintett esetektől jól elkülöníthetőnek bizonyult, ezek a markáns jellegzetességek az eddig közölt külföldi adatokkal teljes mértékben megegyeznek. Tapasztalataink alapján az NPM-mutáció immunhisztokémiai vizsgálata egyszerűen beépíthető a hétköznapi hematológiai diagnosztikai gyakorlatba.
Colonoscopic Findings and Tumor Site Do Not Predict Bowel Obstruction During Medical Treatment of Stage IV Colorectal Cancer
Authors: Ballian Nikiforos , Mahvi David M. , Kennedy Gregory D. 
Published: May 2009

Learning Objectives
Appraise the indications for and outcomes of primary tumor resection in stage IV colorectal cancer to avoid unnecessary resection. Evaluate the role of symptoms and colonoscopic findings in selecting stage IV colorectal cancer patients for primary tumor resection. Assess the effects of primary tumor-related complications on medical treatment in stage IV colorectal cancer.
This article is available for continuing medical education credit at CME.TheOncologist.com.
Genetic Aspects of Familial Thyroid Cancer
Authors: Morrison Patrick J. , Atkinson A. Brew 
Published: May 2009

Learning Objectives
Apply the principles of genetics to heritable aspects of thyroid cancer. Explain and discuss presymptomatic gene testing with family members of patients with familial thyroid cancer. Proactively manage patients presenting with a family history of thyroid cancer.
This article is available for continuing medical education credit at CME.TheOncologist.com.
Pandemic Influenza and Pregnancy: An Opportunity to Reassess Maternal Bioethics
Authors: Farrell Ruth M. , Beigi Richard H. 
Published: May 2009

Large-scale infectious epidemics present the medical community with numerous medical and ethical challenges. Recent attention has focused on the likelihood of an impending influenza pandemic caused by the H5N1 virus. Pregnant women in particular present policymakers with great challenges to planning for such a public health emergency. By recognizing the specific considerations needed for this population, we can preemptively address the issues presented by infectious disease outbreaks. We reviewed the important ethical challenges presented by pregnant women and highlighted the considerations for all vulnerable groups when planning for a pandemic at both the local and the national level.
Gel Pig Technology Applications in Pipeline Servicing
Authors: Uzu Obi , Napier Roy , Ngwuobia Kalu 
Published: May 2009

Abstract
Pigging is one of the basic techniques used by the pipeline engineers to maintain line efficiency and aid in the control of corrosion. A diverse range of pigs are available, they are metal-bodied, polyurethane, foam or inflatable. While most pigs are inert, some can ‘see’, some can ‘speak’, and others are ‘intelligent’. However, not one of them will do all these things: -
pass line restrictions, instrument probes perform effectively in extended lines of varying diameter maintain a good seal over very long distances generate data to support the degree of cleanliness, and move large amounts of solid debris without sticking or plugging.
Gel pigs can do all of these things. They will perform most of the functions of conventional pigs, have additional chemical capabilities, and can be injected into a pipeline through a 2-inch. valve. Most important, they do not fail in services, as do mechanical pigs. However, for gas displacement, a mechanical pig must be used to propel the gel pig. Gel pig technology has been used in the Nigeria, North Sea, Saudi Arabia, North and South America and other regions with excellent results. The case history presented in this paper describes the successful desanding/debris removal of a major SPDC export pipeline using gel pig technology.
Effectiveness of a Depression Disease Management Program in Improving Depression and Work Function—A Pilot Study
Authors: Zivin Kara , Kerber Kevin , Kuebler Julie , Jiang Qingmei , Walters Heather , Klinkman Michael , McInnis Melvin , Valenstein Marcia 
Published: May 2009

Objective: We examined whether there were differences in depression and work function outcomes among primary care and specialty mental health patients treated by the Michigan Depression Outreach and Collaborative Care (M-DOCC), a depression care management program, developed by the University of Michigan Depression Center. In addition, we examined the relationship between depressive symptoms and workplace functioning among M-DOCC enrollees over time. Method: We used mixed model and logistic regression analyses. Results: Despite baseline differences in patient characteristics between primary care and specialty care patients, the location of treatment setting was not a significant predictor of depression or work function outcomes over time among patients enrolled in a depression care management program. Patients in both treatment settings showed significant decreases in depressive and functional impairment over time, with improvements in these symptoms occurring concurrently. Patients with greater case severity were less likely to demonstrate depression and work function improvements over time, and more severe side effects were associated with fewer depression symptom improvements over time. Conclusions: Both depression and work function outcomes improved over time among patients enrolled in a depression care management program, and this improvement did not differ based on whether a patient was treated in a primary or specialty care setting.
Culture-Bound Syndromes in Hispanic Primary Care Patients
Authors: Bayles Bryan P. , Katerndahl David A. 
Published: May 2009

Introduction: We sought to document Hispanic primary care patients' knowledge and experience of five culture-bound syndromes (CBS), as well as the basic socio-cultural correlates of these disorders. Methods: A convenience sample of 100 adult Hispanic patients presenting in an urban South Texas primary care clinic was recruited to complete a brief cross-sectional survey, presented in an oral format. Interviews sought information concerning five culture-bound syndromes— susto, empacho, nervios, mal de ojo, and ataques de nervios. Additional demographic, socio-economic, and acculturation data was collected. Descriptive and bivariate statistics (chi square, Fisher's) were used to assess relationships among variables and experience with each CBS. A multivariate logistic analysis was conducted to determine the possible contributions of age, gender, acculturation, and education to the personal experience of a culture-bound syndrome. Results: Results indicate that 77% of respondents had knowledge of all five syndromes, with 42% reporting having personally experienced at least one CBS. Nervios was the most commonly suffered disorder, being reported by 30 respondents. This was followed, in declining order of prevalence, by susto, mal de ojo, empacho, and ataques de nervios. Multivariate logistic regression analysis found that higher education beyond high school was associated with a slightly decreased likelihood of reporting having suffered from any culture-bound syndrome. While co-occurrence among these disorders occurred, the patterns of predictors suggest that the co-occurrence is not a reflection of mislabeling of one common syndrome. Conclusion: Knowledge of and experience with culture-bound syndromes is common among Hispanic primary care patients in South Texas. Healthcare providers ought to consider discussing these illnesses in a non-judgmental manner with patients who present with symptoms that are consistent with these syndromes. Future studies, with larger sample sizes, are warranted to elucidate the nature of culture-bound disorders and their relationships with conventional diagnostic entities and treatment-seeking behaviors.
Medically Unexplained Symptoms Presenting at Secondary Care—A Comparison of White Europeans and People of South Asian Ethnicity
Authors: Mangwana Sonia , Burlinson Sarah , Creed Francis 
Published: May 2009

Objective: To assess whether, among new out-patients at secondary care medical clinics, people of South Asian origin have a higher proportion of medically unexplained symptoms, and receive different care compared to white Europeans. Method: A retrospective case note study was performed in a district general hospital with a high proportion of ethnic minorities in the local population. We examined the notes of 100 people each of South Asian and white European origin who were in the 20–39 years age range and attending as new medical out-patients. We recorded the presenting symptoms, investigation results, and management plan, and from this we classified them as either explained by recognized organic disease or medically unexplained. We also recorded the number of investigations and whether psychosocial factors were mentioned in the letter to the referring doctor. Results: Complete data were available for 93 people of South Asian origin and 98 white Europeans. The proportion of each who had medically unexplained symptoms was 52% and 49% respectively. The mean number ( SD) of investigations in each was 1.8 (1.5) and 1.7 (1.6). Psychosocial factors were mentioned in correspondence of 42% and 45% respectively. Conclusions: The prevalence of medically unexplained symptoms, in this UK clinic, is similar among younger adults of South Asian and white European origin. South Asians undergo similar investigation and psychosocial inquiry to their white counterparts, suggesting that younger South Asians are managed similarly to white Europeans with respect to this aspect of medical care.
Repetition of Suicide-Related Behavior: A Study of the Characteristics, Psychopathology, Suicidality and Negative Life Events in Iran
Authors: Sheikholeslami Homayoun , Kani Camellia , Kani Kayvan , Ghafelebashi Hossein 
Published: May 2009

Objective: Repetition of suicide-related behavior (SRB) is a risk factor for further suicidal behavior and death. The purpose of this study was to compare characteristics of patients with and without repeated episodes of SRB to determine whether characteristics of suicide attempt, psychopathology, and psychiatric comorbidity differ between groups, and if specific aspects of core suicidality may help guide screening of individuals at risk of further suicidal behaviors. Methods: Thirty-five patient with repeated episodes of SRB and 49 with a single episode who came to the emergency room of two Qazvin referral hospitals after an episode of SRB were compared on demographic and background characteristics, the circumstances of the suicide attempts, levels of suicidality (i.e., ideation), and psychological characteristics. Results: Patients with repeated episodes were more depressed, hopeless, and impulsive, had higher scores on factors associated with expected outcome and planning activities of the Suicide Intent Scale. They displayed greater suicidality, psychiatric comorbidity, and reported more negative life events, dissatisfaction with life, and poorer perceive social support. Conclusions: Some of the characteristics of patients with repeated suicide-related behavior propose major clinical challenges that should be addressed in an endeavor to reduce suicide risk.
Psychiatric Comorbidity and Quality of Life in Obese Patients. Results from a Case-Control Study
Authors: Carpiniello Bernardo , Pinna Federica , Pillai Gianluca , Nonnoi Valentina , Pisano Enrica , Corrias Silvia , Orrù Maria Germana , Orrù Walter , Velluzzi Fernanda , Loviselli Andrea 
Published: May 2009

Objective: The authors sought to evaluate psychiatric comorbidity, subjective quality of life, and impact of psychopathology on quality of life measures in a clinical sample of patients attending a center for the diagnosis and treatment of obesity compared to a matched sample of non-obese subjects. Methods: Two hundred ninety-three consecutive obese patients (48 males, 245 females, mean age 45.41 α 13.55 yrs; mean BMI 35.60 α 6.20) were compared with a control group made of 293 non obese subjects (48 males, 245 females, mean age 45.66 α 13.86 yrs; mean BMI 21.8 α 2.06); all subjects were interviewed by means of SCID I and SCID II and completed the WHO-QoL-Bref, a self-administered instrument for evaluation of subjective quality of life. Results: Obesity was associated with a significant lifetime major risk both for axis I (OR = 3.47, p = 0.000) and axis II disorders (OR = 2.27, p = 0.000); obesity was also associated with significantly lower measures of subjective quality of life on physical, social, and psychological domains; comorbidity with axis I/II disorders was associated with lower QoL measures on WHO-QoL-Bref, in particular among obese patients. Conclusions: Obesity is significantly associated with a significant major risk of psychiatric comorbidity and poor quality of life; comorbid mental disorders play a significant role in worsening quality of life of obese patients; a multimodal approach to the treatment of obesity, including psychiatric evaluation and intervention, is needed to improve quality of life of patients.
The 12-Month Prevalence of Patient-Initiated Aggression against Psychiatrists: A New Zealand National Survey
Authors: Gale Christopher , Arroll Bruce , Coverdale John 
Published: May 2009

Objectives: We surveyed the prevalence of various types of threats or assaults by patients against psychiatrists and determined the impact of the most distressing event. Method: An anonymous questionnaire was mailed to all 308 vocationally registered psychiatrists practicing in New Zealand. Results: A response rate of 63.9% ( n = 197) was obtained. In the preceding 12 months, as many as 46% ( n = 89) of respondents had been verbally threatened and 39% ( n = 76) had been physically intimidated by patients. In addition 16% ( n = 32) had been assaulted without requiring medical attention, 14% ( n = 27) had been harassed through formal complaint mechanisms, 10% ( n = 20) had been sexually harassed, and 5% ( n = 9) had been stalked. As indicated by responses on the Impact of Event Scale, only one-third of the psychiatrists had any symptoms related to the most distressing event and only two had symptoms that might be associated with clinically significant levels of distress. Conclusions: The prevalence of these events suggest a need for the development and evaluation of preventive interventions.
A Case Control Study of Psychiatric Morbidities among Subjects with Leprosy in Lagos, Nigeria
Authors: Erinfolami Adebayo R. , Adeyemi Joseph D. 
Published: May 2009

Objectives: To determine the pattern of psychiatric morbidity prevalent among leprosy patients and to compare it with two control groups; those suffering from Tinea vesicolor and Normal subjects. Design: Eighty-eight leprosy patients were matched for age and sex with those suffering from Tinea vesicolor as well as normal subjects. The subjects were assessed for psychiatric morbidity through a clinical interview with PSE-9. Results: The prevalence of psychiatric morbidity among leprosy patients (580/1000) was significantly more than those with tinea vesicolor patients (182/1000) and normal subjects (148/1000) ( p < 0.05). Depressive illness was the most common diagnosis in the three groups. Conclusions: Leprosy patients are more likely to manifest with psychiatric illness than those suffering from Tinea vesicolor and normal subjects.
Sense of Coherence in Patients Treated for Depression with ECT
Authors: Berg John E. , Kononova Natalia 
Published: May 2009

Objective: The purpose of the study was to investigate whether the Antonovsky Sense of Coherence test administered before and after electroconvulsive treatment (ECT) can contribute more information pertinent to outcome than a test of depression. Method: Twenty patients with a severe unipolar or bipolar depression underwent a series of unipolar ECT under standard conditions. As part of the routine of the department, the patients filled in, before and after ECT, the following questionnaires: Beck Depression Inventory (Beck), 20-item version and Antonovsky Sense of Coherence test (SOC), 13-item version. Mean age was 40.3, somewhat less for women. Results: A reduction was obtained from 35 to 17 in total score on Beck, i.e., to mild depression. The SOC value increased to the normal range from a mean of 2.5 to 3.2, indicating a better manageability, comprehensibility and meaningfulness in life. Four patients had an invalidity pension. Ten of the 16 remaining patients attained work after ECT, and scored better than those not starting to work on both tests, SOC >Beck. A low SOC value may indicate increased mortality risk. Conclusions: Patients who are favorably treated with ECT against any depression, but who do not show a considerable improvement in SOC, would need special follow-up on factors not directly related to mental illness to reduce relapse and mortality risk.
Topological representation for monadic implication algebras
Authors: Abad Manuel , Cimadamore Cecilia , Díaz Varela José 
Published: May 2009

Abstract
In this paper, every monadic implication algebra is represented as a union of a unique family of monadic filters of a suitable monadic Boolean algebra. Inspired by this representation, we introduce the notion of a monadic implication space, we give a topological representation for monadic implication algebras and we prove a dual equivalence between the category of monadic implication algebras and the category of monadic implication spaces.