bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ginsenoside Rg1 protects dopaminergic neurons in a rat model of Parkinson's disease through the IGF‐I receptor signalling pathway
Authors: Xu Li , Chen Wen‐Fang , Wong Man‐Sau 
Published: August 2009

Background and purpose:  We have shown that ginsenoside Rg1 is a novel class of potent phytoestrogen and activates insulin‐like growth factor‐I receptor (IGF‐IR) signalling pathway in human breast cancer MCF‐7 cells. The present study tested the hypothesis that the neuroprotective actions of Rg1 involved activation of the IGF‐IR signalling pathway in a rat model of Parkinson's disease, induced by 6‐hydroxydopamine (6‐OHDA).Experimental approach:  Ovariectomized rats were infused unilaterally with 6‐OHDA into the medial forebrain bundle to lesion the nigrostriatal dopamine pathway and treated with Rg1 (1.5 h after 6‐OHDA injections) in the absence or presence of the IGF‐IR antagonist JB‐1 (1 h before Rg1 injections). The rotational behaviour induced by apomorphine and the dopamine content in the striatum were studied. Protein and gene expression of tyrosine hydroxylase, dopamine transporter and Bcl‐2 in the substantia nigra were also determined.Key results:  Rg1 treatment ameliorated the rotational behaviour induced by apomorphine in our model of nigrostriatal injury. This effect was partly blocked by JB‐1. 6‐OHDA significantly decreased the dopamine content of the striatum and treatment with Rg1 reversed this decrease. Treatment with Rg1 of 6‐OHDA‐lesioned rats reduced neurotoxicity, as measured by tyrosine hydroxylase, dopamine transporter and Bcl‐2 protein and gene level in the substantia nigra. These effects were abolished by JB‐1.Conclusions and implications:  These data provide the first evidence that Rg1 has neuroprotective effects on dopaminergic neurons in the 6‐OHDA model of nigrostriatal injury and its actions might involve activation of the IGF‐IR signalling pathway.
British Association of Critical Care Nurses position statement on prescribing in critical care
Authors: Bray Kate , Dawson Deborah , Gibson Vanessa , Howells Heather , Cooper Heather , McCormick Joanna , Plowright Catherine 
Published: August 2009

ABSTRACTBackground: Nurses in the UK are now one group of non‐medical staff who can prescribe. This practice is evolving for critical care nursing staff who care for critically ill patients during their stay in hospital through ward and outpatient follow‐up after admission to critical care.Aim: The purposes of this paper were to present existing information regarding prescribing to support nurses in critical care currently prescribing and to inform those who are intending to prescribe.Methods: To develop the position statement, a search of the literature was conducted using key databases. To ascertain the current level and type of prescribing in critical care, a short questionnaire was sent by email to British Association of Critical Care Nursing members, and the results of this are presented in Appendix A.Outcomes/Results: Evidence was found in relation to the history, context in critical care, educational requirements and issues of consent related to non‐medical prescribing.Conclusions: The position statement is based upon evidence from the literature, National Health Service policy and the Nursing and Midwifery Council regulations. It takes account of the critical care patient pathway before, during and after an admission to critical care.
Interacting with relatives in intensive care unit. Nurses' perceptions of a challenging task
Authors: Ågård Anne Sophie , Maindal Helle Terkildsen 
Published: August 2009

ABSTRACTAims: To describe how Danish intensive care unit (ICU)‐nurses perceive personal knowledge and skills (self‐efficacy) and outcome expectations to interacting with relatives. Moreover, to explore relationships between self‐efficacy and outcome expectations and the nurses' attitude towards involving relatives in care‐related tasks and allowing relatives to be with the patient during critical situations.Background: Interacting with relatives can be a challenging task, and nurses play a leading role in integrating relatives in ICU. Little is known about how ICU‐nurses cope with this part of nursingDesign: Cross‐sectionalMethod: Sixty‐eight ICU‐nurses responded to a self‐administered questionnaire based on Bandura's self‐efficacy theory adjusted to critical care.Results: The nurses' perceptions of personal knowledge, skills and expectations to the outcome of interacting with relatives were positive. There were disparities in nurses' level of agreement on when to involve relatives in caring activities. Generally, the nurses did not support the presence of relatives in critical situations. Nurses' outcome expectations were correlated to their attitude towards involving relatives in caring activities. No other statistically significant correlations were found between general attitude, knowledge, skills, and attitude of nurses towards involving relatives in caring activities or allowing them to be with the patient at cardiac arrest or acute intubation.Conclusion: The nurses' outcome expectations and self‐efficacy in terms of knowledge and skills interacting with relatives were high. There was considerable variation in the nurses' agreement on when to involve relatives in caring activities or allowing them to be with the patient in critical situations. The self‐efficacy theory was not supported as a result of lack of correlation between nurses' self‐efficacy and outcome expectations and their attitude towards involving relatives in ICU.Relevance to clinical practice: The study provides important knowledge to clinicians, educators and managers on how to educate and supervise ICU‐nurses to support their efforts to interact proficiently with relatives.
PROGRESS IN UREMIC TOXIN RESEARCH: Guanidino Compounds as Uremic (Neuro)Toxins
Authors: De Deyn Peter Paul , Vanholder Raymond , Eloot Sunny , Glorieux Griet 
Published: August 2009

AbstractNeurological and vascular impairment are important sources of morbidity in patients with renal failure. A portion of patients still suffers from uremic encephalopathy or other signs of nervous system impairment. Several reports demonstrate increased incidence of cardiac infarction and cerebrovascular accidents in chronic renal failure patients, even in those otherwise adequately dialyzed. Epileptic and cognitive symptoms are among the most typical manifestations of uremic encephalopathy. Several guanidino compounds (GCs) may play an important role in the etiology of uremic encephalopathy. Four GCs appeared to be substantially increased as well in serum, cerebrospinal fluid, and brain of uremic patients. These compounds, “uremic” GCs, are creatinine, guanidine (G), guanidinosuccinic acid (GSA), and methylguanidine. All four compounds are experimental convulsants in concentrations similar to those found in uremic brain. We described a possible mechanism for the contribution of GCs to uremic hyperexcitability, referring to the in vitro effects of uremic GCs on inhibitory and excitatory amino acid receptors. It was demonstrated that the excitatory effects of uremic GCs on the central nervous system can be explained by the activation of N‐methyl‐d‐aspartate receptors by GSA, concomitant inhibition of γ‐aminobutyric acid type A receptors by uremic GCs, and other depolarizing effects. These effects might also indicate the putative contribution of uremic GCs to the etiology of uremic encephalopathy. In this article, we review the uremic GCs with particular attention to their neurotoxicity. We elaborate in detail on the mechanisms of action of the neurotoxic uremic GCs and summarize the kinetics of these toxins.
PROGRESS IN UREMIC TOXIN RESEARCH: Phosphate Metabolism in Chronic Kidney Disease: From Pathophysiology to Clinical Management
Authors: Spasovski Goce , Massy Ziad , Vanholder Raymond 
Published: August 2009

AbstractHyperphosphatemia is considered as an independent risk factor for surrogate clinical endpoints like vascular calcification (VC) and bone disease, or hard clinical outcomes like cardiovascular events. To date, various treatment options for phosphate removal or reduction are available. The great expectations put into calcium‐based phosphate binders were mitigated because of their possible contribution to progressive VC, particularly in patients treated simultaneously with active vitamin D derivatives. Thus, a paradigm change occurred whereby the main clinical concern shifted from the avoidance of hypocalcemia to that of the consequences of inducting a positive calcium balance. Sevelamer‐HCl treatment allowed a comparable control of hyperphosphatemia with a lower risk of hypercalcemia than calcium‐based phosphate binders, and a slower progression of VC; however, convincing evidence of improved clinical outcomes in dialysis patients is lacking. Although data on the safety and efficacy of lanthanum carbonate in the treatment of hyperphosphatemia have been provided in long‐term clinical studies, there is still an ongoing scientific debate about its possible long‐term toxicity. Moreover, there are no data from randomized clinical trials demonstrating beneficial effects of La carbonate treatment on VC or cardiovascular outcomes. In the absence of convincing clinical trials testing the effects of non‐metal‐based phosphate binders on cardiovascular and global outcomes it appears reasonable to maintain bone health and mineral homeostasis by mainly relying on adaptations of standard therapies. Noncalcium, non‐aluminum‐based binders might be reserved for patients with major mineral metabolism abnormalities and a high risk of VC.
PROGRESS IN UREMIC TOXIN RESEARCH: Parathyroid Hormone, A Uremic Toxin
Authors: Rodriguez Mariano , Lorenzo Victor 
Published: August 2009

AbstractDespite the innovations in the treatment of secondary hyperparathyroidism, there are uremic patients with marked elevation in PTH levels. Uremic toxicity is in part attributable to the excess of circulating PTH. It has been known for many years that PTH may induce changes in cell calcium, a key intracellular signal required for normal cell function. The effect of PTH in dialysis patients is not limited to bone; the diversity of biologic effects of PTH is summarized in this review. In addition, the present review addresses other issues: (i) the presence of different circulating PTH fragments in uremic patients, (ii) the PTH assays currently utilized to measure circulating PTH, and (iii) the fact that some of the PTH effects seen in uremic patients may be due to the interaction of C‐terminal PTH fragment with putative C‐terminal PTH receptors.
PROGRESS IN UREMIC TOXIN RESEARCH: Resistin as a Cardiovascular and Atherosclerotic Risk Factor and Uremic Toxin
Authors: Cohen Gerald , Hörl Walter H. 
Published: August 2009

AbstractResistin is a 12.5 kDa protein originally found to be secreted by mouse adipocytes. Whereas in rodents adipose tissue is the main source of resistin, in humans resistin is expressed primarily in macrophages. In a variety of pathophysiologic states, particularly in type 2 diabetes mellitus and in chronic kidney disease, the serum concentration of resistin is increased. Resistin reduces the glucose uptake in adipose tissue and skeletal muscle cells and may be involved in insulin resistance. A positive correlation between resistin levels and inflammatory markers has been described. Resistin has a potential role in cardiovascular disease and may contribute to an increased atherosclerotic risk by modulating the activity of endothelial cells. We recently found that resistin in concentrations measured in uremia is able to interfere with the chemotactic movement and the oxidative burst of neutrophils, cells of the first‐line nonspecific immune defense. Therefore, resistin may also contribute to the disturbed immune response and as a consequence to the increased risk of infections in uremic and diabetic subjects.
PROGRESS IN UREMIC TOXIN RESEARCH: Dinucleoside Polyphosphates and Uremia
Authors: Jankowski Vera , Günthner Thomas , Herget‐Rosenthal Stefan , Zidek Walter , Jankowski Joachim 
Published: August 2009

AbstractDinucleoside polyphosphates constitute a group of endogenous vasoregulatory purines and pyrimidines with a strong impact on physiologic and pathophysiologic processes of the cardiovascular system. Recently, the importance of dinucleoside polyphosphates in chronic kidney disease (CKD) and uremia gained increasing interest. Although our knowledge about the impact of dinucleoside polyphosphates in CKD and uremia is just at the beginning, this article reviews the current knowledge of the physiologic and pathophysiologic role of dinucleoside polyphosphates in CKD and uremia.
PROGRESS IN UREMIC TOXIN RESEARCH: The Role of Oxidative Stress in Chronic Kidney Disease
Authors: Massy Ziad A. , Stenvinkel Peter , Drueke Tilman B. 
Published: August 2009

AbstractNew, reliable circulating oxidative stress markers have become available in chronic kidney disease (CKD) patients and have confirmed the long held belief that CKD is a pro‐oxidant state. However, several questions related to this state of oxidative stress remain largely unresolved. First, the relative importance of each type of oxidant involved has been insufficiently evaluated. Only two recent studies have addressed this issue, and both suggested that chlorinated stress played a central role. Second, as only few population‐based studies are available, the prevalence of oxidative stress among CKD patients remains undetermined. Third, although the link between oxidative stress and inflammation in CKD is emerging as a key process contributing to the genesis of oxidative stress in these patients, its pathogenesis remains poorly defined. Fourth, data favoring the involvement of oxidative stress in uremic toxicity are still limited. Finally, while two recent pilot studies have demonstrated that treatment of CKD patients with antioxidants is able to reduce cardiovascular events, information related to the pharmacokinetic characteristics of antioxidants, as well as their efficacy to prevent oxidative stress, is still limited in this patient group. Thus, although existing data suggest a prominent role of CKD‐associated oxidative stress in uremic toxicity, further studies are required to definitively prove this concept.
PROGRESS IN UREMIC TOXIN RESEARCH: Proteomics in Uremia and Renal Disease
Authors: Mischak Harald , Massy Ziad A. , Jankowski Joachim 
Published: August 2009

AbstractProteomics has emerged as a powerful technology to decipher biological processes. One of the main goals of proteomics is the identification of biomarkers for diseases from tissues and body fluids. However, the complexity and wide dynamic range of protein expression presents an enormous challenge. This review gives an overview of the different technologies used, their potentials and limitations, focusing on capillary electrophoresis coupled to mass spectrometry (CE‐MS). CE‐MS is discussed from an application point of view, evaluating its merits and vices for biomarker discovery and clinical applications in chronic kidney disease. Finally, several examples on the application of CE‐MS to determine biomarkers for disease diagnosis, prognosis, and therapy evaluation are presented.
PROGRESS IN UREMIC TOXIN RESEARCH: Platelet/Leukocyte Activation, Inflammation, and Uremia
Authors: Glorieux Griet , Cohen Gerald , Jankowski Joachim , Vanholder Raymond 
Published: August 2009

AbstractChronic kidney disease (CKD) is a state of chronic, low‐grade inflammation which contributes to the accelerated progression of chronic inflammatory disturbances of which atherosclerosis is a major example. Platelet and leukocyte activation and interaction, evoked by the uremic condition, play an important role in this process. The effect of specific uremic retention solutes, progressively retained in uremia, on important platelet and leukocytes functions is discussed and summarized. The main uremic toxins involved are molecules with a molecular weight above 500 Da (the so‐called “middle molecules”) and/or protein‐bound molecules. Classification of the molecules and elucidation of the pathophysiological pathways involved will result in new therapeutic strategies pursuing specific removal or pharmacological neutralization of molecular impact.
PROGRESS IN UREMIC TOXIN RESEARCH: Lipoprotein Lipase Disturbances Induced by Uremia and Hemodialysis
Authors: Stegmayr Bernd , Olivecrona Thomas , Olivecrona Gunilla 
Published: August 2009

AbstractFactors such as malnutrition, physical inactivity, uremic toxins, and inflammation are known to influence the activity of lipoprotein lipase (LPL), an important enzyme in metabolism of blood lipids. In patients with chronic kidney disease these factors are common and may result in a decreased LPL activity. This is particularly so in patients on hemodialysis. Further, during each dialysis treatment, the use of heparin (or low molecular weight heparin) induces a release of LPL from its normal binding sites at the plasma membrane of endothelial cells. This results in an increased degradation of the enzyme and a relative lack of LPL activity for up to 10 hours from the start of the dialysis. Thus, the use of conventional anticoagulation for hemodialysis, in addition to the consequences of the uremic state, may cause a severe functional deficiency of LPL. This in turn may have deleterious effects on energy metabolism and may contribute to the increased risk for cardiovascular disease in this vulnerable group of patients.
PROGRESS IN UREMIC TOXIN RESEARCH: Should Dialysis Modalities be Designed to Remove Specific Uremic Toxins?
Authors: Baurmeister Ulrich , Vienken Joerg , Ward Richard A. 
Published: August 2009

AbstractThe definition of optimal dialysis therapy remains elusive. Randomized clinical trials have neither supported using urea as a surrogate marker for uremic toxicity nor provided clear cut evidence in favor of larger solutes. Thus, where to focus resources in the development of new membranes, and therapies remains unclear. Three basic questions remain unanswered: (i) what solute(s) should be used as a marker for optimal dialysis; (ii) should dialytic therapies be designed to remove a specific solute; and (iii) how can current therapies be modified to provide better control of uremic toxicity? Identification of a single, well‐defined uremic toxin appears to be unlikely as new analytical tools reveal an increasingly complex uremic milieu. As a result, it is probable that membranes and therapies should be designed for the nonspecific removal of a wide variety of solutes retained in uremia. Removal of the widest range of solutes can best be achieved using existing therapies that incorporate convection in conjunction with longer treatment times and more frequent treatments. Membranes capable of removing solutes over an expanded effective molecular size range can already be fabricated; however, their use will require novel approaches to conserve proteins, such as albumin.
Householder Status and Residence Type as Correlates of Radon Awareness and Testing Behaviors
Authors: Larsson Laura S. , Hill Wade G. , Odom‐Maryon Tamara , Yu Paul 
Published: August 2009

ABSTRACT
Objectives: The primary aim of this research was to assess radon awareness and testing across 2 housing types.Design and Sample: Cross‐sectional prevalence study with time trends. National, probabilistic sample of 18,138 and 29,632 respondents from the 1994 and 1998 National Health Interview Surveys, respectively.Results: Odds ratio (OR) estimates confirmed that occupants of single family homes/townhomes were twice as likely to have ever heard of radon (1994: OR=2.18; confidence intervals [CI]=2.01–2.36) (1998: OR=2.26; CI=2.09–2.44) and also more likely to know if their household air had been tested for radon (1994: OR=2.04; CI=1.57–2.65) (1998: OR=1.38; CI=1.19–1.59) as occupants of apartments/condominiums. Time trend analyses revealed that radon awareness improved from 69.4% to 70.7% and home testing among those with knowledge of radon increased from 9.7% to 15.5% over the 4‐year period.Conclusions: Housing type provided fairly stable estimates of radon awareness and testing. Findings demonstrate that housing status may be a useful variable to differentiate risk for radon awareness and testing. Public health nurses should consider their client's housing type when assessing families for environmental risks.
Work Setting, Community Attachment, and Satisfaction Among Rural and Remote Nurses
Authors: Kulig Judith C. , Stewart Norma , Penz Kelly , Forbes Dorothy , Morgan Debra , Emerson Paige 
Published: August 2009

ABSTRACT
Objectives: To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada.Design and Sample: Cross‐sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long‐term care, community health, home care, and primary care comprised the sample.Measures: The home community satisfaction scale measured community satisfaction, whereas single‐item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open‐ended questions.Results: Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open‐ended responses that describe community satisfaction and community attachment.Conclusions: Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.