bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telehomecare Communication and Self‐Care in Chronic Conditions: Moving Toward a Shared Understanding
Authors: Shea Kimberly , Chamoff Breanna 
Published: March 2012

ABSTRACTBackground: Remote telemonitoring of patients’ vital signs is a rapidly increasing practice. Although methods of communication in remote electronic monitoring differ from those in traditional home health care, the understanding shared by the nurse, patient, and family members remains the same: patients’ self‐care behaviors affect exacerbations of chronic health conditions. The purpose of this paper is to examine the relationship between communication and information integration into the daily lives of patients with chronic illnesses and offer best practice recommendations for telehomecare nurses (THN).Methods: The original study used the Social Relations Model to examine relationships within 43 triads composed of patients with chronic conditions, home helpers, and their nurse involved in telehomecare at three Veterans Health Administration sites. This secondary descriptive and correlational analysis compared 43 patients’ and nine THNs’ ratings of themselves and each other on communication (frequency, timeliness, and understanding) and the use of patients’ daily telemonitored information.Results: There was almost no correlation between patients’ perception of THNs’ communication (frequency [r= 0.05], timeliness [r= 0.09], and understandability [r= 0.03]) and patients’ integration of information into daily health practices. However, significant correlations were found between the THNs’ perception of patients’ communication frequency and timeliness, and integration, (p= 0.02; p < 0.001) respectively.Conclusions: This study suggests that frequent phone communication may lead the remote THN to believe patients are integrating blood pressure, weight, and other information into daily self‐care behaviors, when in fact the patient reports that they are not. The influence of a halo effect on the THN may cloud an accurate perception of what is actually occurring. Remote communication may require more attention to THNs educating patients about shared understandings when using telemonitoring. Best practices for THN should include explicit goals and intentions for telemonitored home care with individualized instructions about how to use the information for self‐care.
Is advanced age a barrier to effective cancer treatment? The experience of nonagenarians receiving radiation therapy
Authors: THOMPSON Aimee , CONE Rebecca , GAO Helen , HAMMOND Elizabeth , FRASER David , BACK Michael F 
Published: March 2012

AbstractAim:  Decision‐making about elderly patients is difficult due to the absence of clinical experience or evidence‐based results to develop optimal treatment plans. This study aims to determine the tolerability and impact of radiation therapy (RT) when delivered to patients aged >89 years.Methods:  A retrospective review was conducted on all nonagenarian patients (defined as aged 90 years or over) managed with RT between 2005 and 2007. Patients' records were reviewed in regard to their characteristics, the presence of significant medical comorbidities, performance status, management intent, cancer diagnosis and RT modality. Outcome end‐points were overall survival and the tolerability of RT (presence of grade 3 or 4 morbidity, hospital admission or treatment interruption).Results:  Between 2005 and 2007, 2762 new courses of RT were delivered to patients at the Northern Sydney Cancer Centre, of whom 55, or 2%, were nonagenarians. Median age at treatment was 92 years, with range 90–104 years. A total of 56% were managed with radical intent, 31% had significant comorbidities, 55% had non‐skin primary tumors and 78% received linac‐based treatment. The mean follow up for survivors was 19.8 months (10.2–41.8 months). RT was well tolerated, with 89% completing planned RT and only 18% requiring interruption. One patient was hospitalized due to RT toxicity. Median survival post‐RT was 13.0 months, with 56% of patients alive at 12 months. Survival duration was associated with radical management intent (P= 0.001), cutaneous primary site (P= 0.001) and female gender (P= 0.043).Conclusion:  Nonagenarian patients receiving treatment had satisfactory tolerability and achieved expected survival rates post‐RT.
Mortality within 30 days of receiving systemic anti‐cancer therapy at a regional oncology unit: What have we learned?
Authors: YOONG Jaclyn , SEAH Jo‐An , HAMILTON Katherine , TEO Lee Na , CHONG Geoffrey 
Published: March 2012

AbstractAims:  Benefits to patients from systemic anti‐cancer therapies (SACT) occur at a cost of significant toxicities that can be life threatening. Published data of SACT mortality outside clinical trials is limited with no published Australia data. We aim to establish local outcomes at a regional Victorian oncology center to allow comparison with limited international data.Methods:  An audit was undertaken at Ballarat Health Services to analyze all deaths occurring within 30 and 60 days of receiving SACT (cytotoxic chemotherapy and targeted therapy) for epithelial malignancies and hematological malignancies (excluding acute leukemia), over a 12‐month period. Hormonal therapy was excluded.Results:  Between 1 January and 31 December 2008, 378 patients received SACT. In total 13 deaths (3.4%) occurred within 30 days following SACT. Three deaths (23%) were definitely treatment‐related – neutropenic sepsis, pneumocystis pneumonia and bowel perforation, respectively. Eight deaths (62%) were definitely unrelated to treatment. Most deaths were due to disease progression (six patients) For two patients (15%), the cause of death was unknown. Most patients were treated with palliative intent. Most patients were receiving first‐line treatment (seven patients, 50%). A further five deaths (1.3%) occurred 31–60 days after SACT, four of which were due to disease progression.Conclusion:  Our local outcome data are comparable to limited current international data. This type of audit reviews local outcomes and identifies factors contributing to mortality in order to improve standards of care. We encourage similar audits to establish national benchmarks of 30‐day mortality rate.
Diagnosis prevention and treatment for PICC‐related upper extremity deep vein thrombosis in breast cancer patients
Authors: XING Lei , ADHIKARI Vishnu Prasad , LIU Hong , KONG Ling Quan , LIU Sheng Chun , LI Hong Yuan , REN Guo Sheng , LUO Feng , WU Kai Nan 
Published: March 2012

AbstractAim:  To study the incidence, diagnosis, prevention and treatment of peripherally inserted central catheter (PICC)‐related upper extremity deep vein thrombosis (DVT) in breast cancer patients using a PICC catheter for chemotherapy.Methods:  The data of the incidence, diagnosis and treatment of PICC‐related upper extremity DVT in 187 breast cancer patients using a PICC catheter for chemotherapy, from August 2009 to July 2011 were retrospectively analyzed.Results:  In total 188 PICC were inserted between August 2009 and July 2011 and followed up for a total of 14 399 catheter‐days (median placement, 76.6 days; range, 1 to 170 days). Four (2.1%) of 188 PICC were removed as a result of PICC‐related upper extremity DVT in 14 to 112 catheter‐days, at a rate of 0.28/1000 catheter‐days.Conclusion:  The use of PICCs in breast cancer patients for chemotherapy is safe and effective. However, some patients may develop catheter‐related upper extremity DVT. In order to minimize complications, we should pay attention to its early symptoms and signs, as well as the timely removal of the catheter and appropriate anti‐coagulant treatment.
A female‐produced short‐range sex pheromone in the egg parasitoid Trissolcus brochymenae
Authors: Salerno Gianandrea , Frati Francesca , Iacovone Alessia , Conti Eric , Peri Ezio , Colazza Stefano 
Published: March 2012

AbstractThe potential for short‐range sex pheromone communication by the egg parasitoid wasp Trissolcus brochymenae (Hymenoptera: Platygastridae) was investigated in closed arena bioassays. Males of this parasitoid showed more antennal drumming and more frequent mounting behaviour on 1‐ to 2‐d‐old virgin females compared with 8‐d‐old virgin females. Male copulation attempts were fewer with previously mated females than with virgin females. Males courted and made copulation attempts with 1‐ to 2‐d‐old female cadavers, but not with male cadavers or with female cadavers rinsed in organic solvents of different polarities. Male attraction to female cadavers was re‐established by treating cadavers with acetone extracts of females, but not with ether or hexane extracts. In experiments using female cadavers dissected into head, mesosoma, and gaster, and then reassembled using one unwashed body section and two body sections washed in acetone, males were attracted only to the reassembled cadavers with an unwashed mesosoma. These findings suggest that (1) courtship behaviour in males of T. brochymenae is triggered by a short‐range sex pheromone produced by females; (2) the age and the physiological condition of females (virgin/mated) influence pheromone release or production; (3) the female's mesosoma is the source of the sex pheromone; and (4) polar components of the sex pheromone play a major role in influencing male behaviour. Our results suggest that quasi‐gregarious egg parasitoids are selected for short‐range rather than long‐range sex pheromones.
Impact of geomorphology and fluoride genesis on groundwater quality along the Bay of Bengal of Srikakulam District, Andhra Pradesh, India
Authors: Kumar Kotra Krishna 
Published: March 2012

AbstractCoastal groundwaters are always a circumspect for qualitative fluctuations by the virtue of their complex segregation of the plain and uplands with sporadic intrusions of marine water. Moreover, the impact of geomorphology by virtue of natural and anthropogenic phenomenon plays a significant role in deciding their state. Added to these, the fluoride concentrations do share their part in finalizing their potable status. To evaluate the extent of these impacts on the quality of groundwater, 50 water samples of bore and open well were geochemically assessed along the coast of Bay of Bengal of Srikakulam district, Andhra Pradesh, India. The expansive correlative geochemical interpretation of the results revealed the groundwaters' status, mechanisms controlling the genesis of principal chemical species, reserves, type, drainage pattern and intrusion zones in the area. Mineral species and spatial distribution of fluoride were commutated. Based on the results, initiation of recommendations by the Groundwater Board, besides public awareness, helped the study in reaching its goal.
The larger exercise stroke volume in endurance‐trained men does not result from increased left ventricular early or late inflow or tissue velocities
Authors: Carrick‐Ranson G. , Doughty R. N. , Whalley G. A. , Walsh H. J. , Gamble G. D. , Baldi J. C. 
Published: March 2012

AbstractAimTo determine whether the larger exercise stroke volume in senior endurance‐trained athletes results from an attenuation of age‐related alterations in left ventricular (LV) early diastolic filling or a more vigorous late filling.MethodsBody composition (DEXA), VO2peak, stroke volume (CO2 rebreathing) and Doppler measures of early and late mitral inflow and mitral annular velocities were collected at seated upright rest and heart rate–matched exercise (100 and 120 bpm) in trained and untrained younger (18–30 years) men and trained and untrained older (60–80 years) healthy men.ResultsAgeing had a greater effect than training status on seated rest mitral inflow and tissue Doppler imaging parameters, as shown by a lower peak early‐to‐late mitral inflow velocity ratio (E/A ratio) and slower peak early mitral annular velocity (Em) in older compared with younger men. Exercise stroke volume was unaffected by healthy ageing; however, Em, an index of early LV lengthening rate and relaxation, was slower (P < 0.001), while measures of atrial systole were increased (P < 0.001) during exercise in older men. Stroke volume during exercise was larger in the trained men (P < 0.001); however, early and late mitral inflow and tissue velocities were not different between trained and untrained men.ConclusionThe larger exercise stroke volume in trained older male athletes does not seem to be related to faster filling or lengthening velocities during early or late filling. Thus, a larger, more compliant left ventricle in combination with an increased blood volume may explain the larger LV filling volumes in trained seniors.
Effect of α‐thalassaemia on exercise‐induced oxidative stress in sickle cell trait
Authors: Faёs C. , Martin C. , Chirico E. N. , Féasson L. , Oyonno‐Enguelle S. , Dubouchaud H. , Francina A. , Thiriet P. , Pialoux V. , Messonnier L. 
Published: March 2012

AbstractAimAlpha‐thalassaemia is known to reduce intra‐erythrocyte HbS (sickle haemoglobin) concentration in sickle cell trait (SCT) subjects. Because HbS was shown to increase oxidative stress, the purpose of this study was to assess the effects of the coexistence of α‐thalassaemia and SCT on oxidative stress markers and nitric oxide (NO) metabolism after an acute physical exercise.MethodsForty subjects (age: 23.5 ± 2.21 years), SCT carriers (HbAS) or healthy subjects (HbAA), with (‐αT) or without (‐NαT) an associated α‐thalassaemia took part in the study. Plasma markers of oxidative stress [advanced oxidation protein products (AOPP), protein carbonyl, malondialdehyde (MDA) and nitrotyrosine], anti‐oxidant defences and NO metabolism (NOx) were measured at rest (Trest), immediately following an incremental maximal exercise test (Tex) and during recovery (T1h, T2h and T24h).ResultsMalondialdehyde expressed as the percentage of changes from baseline was significantly higher in the HbAS‐NαT compared with HbAS‐αT during recovery (+36.3 ± 14.1% vs. −1.8 ± 13.2% at T1h, P = 0.02; +36.6 ± 13.4% vs. −11.4 ± 12.5% at T2h, P = 0.004 and +24.1 ± 12.3% vs. −14.4 ± 11.5% at T24h, P = 0.02 in HbAS‐NαT vs. HbAS‐αT). Compared with HbAS‐NαT, HbAS‐αT had a higher NOx change from baseline at Tex (−23.4 ± 20.6% vs. +57.7 ± 19.3%, respectively; P = 0.005) and lower nitrotyrosine change from baseline at T1h (+7.2 ± 22.2% vs. +93.5%±29.3%, respectively; P = 0.04).ConclusionAll these data suggest that the presence of α‐thalassaemia may blunt the higher level of oxidative stress and the impaired bioavailability of NO observed in the SCT carriers.
Shoulder Arthrodesis: Functional Outcome and Morbidity after Combined Plate/screw Fixation versus Screw Fixation Alone
Authors: Bosmans Bas , Van Der List Maarten , Gosens Taco , Verhaar Jan 
Published: March 2012

Background Shoulder arthrodesis is a unique procedure, which has shifted from a well-established procedure for osteoarthritis to a salvage procedure. In the present retrospective study, functional outcome and morbidity in shoulder arthrodesis using combined plate/screw fixation versus screw fixation alone were evaluated. Materials and Methods Shoulder arthrodesis was performed on 28 shoulders: 16 cases with only cancellous screws and 12 cases with combined plate/screw fixation. At a mean follow-up of 6.8 years (range 1 years to 20.4 years), patients were invited for clinical follow-up, with evaluations of visual analogue scale for pain, function and satisfaction, Constant–Murley scores, and recorded complications. Results All patients had severe limitations in the use of their shoulder, although they had little pain and were satisfied. The overall Constant–Murley score increased significantly from 33.4 to 52.2. In eight cases with combined plate/screw arthrodesis and nine with screw arthrodesis, there was persistent pain, which resolved after removal of osteosynthesis material. Non-union was only found in five patients with screw arthrodesis. Conclusions Although the risk of a second operation for removal of osteosynthesis material in combined plate/screw arthrodesis is equal to screw fixation alone, for complete glenohumeral fusion, a combined plate/screw fixation appears to be superior to screw fixation alone.
Characterization of Methicillin‐Resistant Staphylococcus aureus Isolates from Pig Carcasses in Hong Kong
Authors: Ho J. , O’Donoghue M. , Guardabassi L. , Moodley A. , Boost M. 
Published: March 2012

SummaryThis study describes the isolation and characterization of methicillin‐resistant Staphylococcus aureus (MRSA) from slaughtered pigs sampled from local markets in Hong Kong. The nares of 400 slaughtered pigs were cultured and MRSA isolates characterized for the presence of antibiotic‐resistance determinants, toxins and SCCmec and spa types using PCR. Clonality was investigated using PFGE and MLST. The prevalence of MRSA colonization of slaughter pigs was 39.3%, the majority (92%) harbouring SCCmec type IVb. Of the 157 samples yielding MRSA, 13 had two distinct MRSA strains present. Spa type t899 was predominant, with only 5/170 isolates displaying closely related types (t4474, t1939, t2922 and t5390). PFGE with sma1 and MLST confirmed the strains as ST9. Most isolates were multidrug resistant. Tetracycline resistance (97%) was mainly attributable to tet(K) with only 3% of isolates additionally harbouring tet(M). Resistance to erythromycin (89%) and chloramphenicol (71%) was associated with the presence of erm(C), and fex(A), respectively. No strains carried cfr and there was no resistance to linezolid, although minimum inhibitory concentration (MICs) were close to the resistance break point. Resistance to clindamycin (99%), ciprofloxacin(78%), quinopristin–dalfopristin (44%) and cotrimoxazole (32%) was common, but remained low for fusidic acid (4%) and rifampicin (2%). All strains were negative for PVL, exfoliative, and enterotoxins. This survey confirmed the uniformity of MRSA isolates in pigs from several regions of China, in contrast to more diversified characteristics reported in European studies. Colonization rates were higher than previously reported. Isolates were resistant to a wide range of antibiotics, but resistance was not detected to linezolid, nitrofurantoin, vancomycin or tigecycline. Although the clinical importance of ST9 in humans is uncertain, continued surveillance, in particular of those occupationally‐exposed, is recommended.
Inhibition of thrombin-induced Ca2+ influx in platelets by R59949, an inhibitor of diacylglycerol kinase
Authors: Marumo Mikio , Nakano Tomoyuki , Takeda Yuji , Goto Kaoru , Wakabayashi Ichiro 
Published: March 2012

Abstract

Objectives
The aim of this study was to determine whether diacylglycerol kinase (DGK) is involved in transplasmalemmal Ca2+ influx of platelets.

Methods
Effects of R59949, an inhibitor of diacylglycerol kinase, on intracellular Ca2+ concentration ([Ca2+]i) and mRNA expression of DGK isozymes were investigated using washed human platelet suspensions.

Key findings
Thrombin-induced increase in [Ca2+]i was significantly inhibited by pretreatment of platelets with R59949, while thapsigargin-induced increase in [Ca2+]i was comparable in platelets with and without R59949 pretreatment. Thapsigargin-induced increase in [Ca2+]i was markedly attenuated in the presence of SKF-96365. In the presence of SKF-96365, thrombin-induced increase in [Ca2+]i was significantly attenuated, and additional treatment with R59949 caused a further decrease in [Ca2+]i. Pretreatment of platelets with 1-butanol significantly attenuated thrombin-induced increase in [Ca2+]i, while thrombin-induced increase in [Ca2+]i was augmented in the presence of propranolol. mRNA expression of DGK-α and DGK-γ, which are known to be inhibited by R59949, in platelets was confirmed by RT-PCR analysis.

Conclusions
R59949 inhibited a store-depletion-insensitive component of transplasmalemmal Ca2+ entry induced by thrombin, while store-operated Ca2+ entry was not affected by R59949. The results of this study suggest that phosphatidic acid is involved in thrombin-induced Ca2+ influx of platelets.
Engineered PLGA nano- and micro-carriers for pulmonary delivery: challenges and promises
Authors: Ungaro Francesca , d' Angelo Ivana , Miro Agnese , La Rotonda Maria I , Quaglia Fabiana 
Published: March 2012

Abstract

Objectives
The aim of this review is to summarize the current state-of-the-art in poly(lactic-co-glycolic acid) (PLGA) carriers for inhalation. It presents the rational of use, the potential and the recent advances in developing PLGA microparticles and nanoparticles for pulmonary delivery. The most promising particle engineering strategies are discussed, highlighting the advantages along with the major challenges for researchers working in this field.

Key findings
Biodegradable polymer carriers, such as PLGA particles, may permit effective protection and long-term delivery of the inhaled drug and, when adequately engineered, its efficient transport to the target. The carrier can be designed for inhalation on the basis of several strategies through the adequate combination of available particle technologies and excipients. In so doing, the properties of PLGA particles can be finely tuned at micro-size and nano-size level to fulfill specific therapeutic needs. This means not only to realize optimal in vitro/in vivo lung deposition of the formulation, which is still crucial, but also to control the fate of the drug in the lung after particle landing.

Summary
Although many challenges still exist, PLGA carriers may be highly beneficial and present a new scenario for patients suffering from chronic lung diseases and for pharmaceutical companies working to develop novel inhaled products.