bluuebunny/crossref_metadata_2025_split huggingface dataset:
A homozygous inactivating calcium‐sensing receptor mutation, Pro339Thr, is associated with isolated primary hyperparathyroidism: correlation between location of mutations and severity of hypercalcaemia
Authors: Hannan Fadil M. , Nesbit M. A. , Christie Paul T. , Lissens Willy , Van der Schueren Bart , Bex Marie , Bouillon Roger , Thakker Rajesh V. 
Published: September 2010

SummaryBackground  Inactivating mutations of the calcium‐sensing receptor (CaSR), a G‐protein‐coupled receptor with extracellular (ECD), transmembrane (TMD) and intracellular (ICD) domains, cause familial hypocalciuric hypercalcaemia, neonatal severe primary hyperparathyroidism and occasionally primary hyperparathyroidism in adults.Objective  To investigate a patient with typical symptomatic primary hyperparathyroidism for CaSR abnormalities.Patient and design  A 51‐year‐old woman with primary hyperparathyroidism was investigated for CaSR abnormalities as her severe hypercalcaemia (3·75 mm) persisted after the removal of two large parathyroid adenomas and she was the daughter of normocalcaemic consanguineous parents. Following informed consent, CASR mutational analysis was undertaken using leucocyte DNA. Wild‐type and mutant CaSR constructs were expressed in human embryonic kidney (HEK) 293 cells and assessed by measuring their intracellular calcium responses to changes in extracellular calcium. Clinical data were pooled with previous studies to search for genotype–phenotype correlations.Results  The proband was homozygous for a Pro339Thr CaSR missense mutation, located in the ECD, and her normocalcaemic relatives were heterozygous. The mutant Thr339 CaSR had a rightward shift in its dose–response curve with a significantly higher EC50 = 3·18 mm ± 0·19 compared to the wild‐type EC50 =  2·16 mm ± 0·1 (P < 0·01), consistent with a loss‐of‐function mutation. An analysis of CaSR mutations in patients with primary hyperparathyroidism revealed that those of the ECD were associated with a significantly greater hypercalcaemia that was less likely to be corrected after removal of the parathyroid tumours.Conclusions  A CaSR missense mutation causing a loss‐of‐receptor‐function can cause symptomatic primary hyperparathyroidism in adulthood.
Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark
Authors: Glintborg Dorte , Mumm Hanne , Hougaard David , Ravn Pernille , Andersen Marianne 
Published: September 2010

SummaryObjective  Clinical manifestations and metabolic risk factors may differ in ethnic subgroups of patients with polycystic ovary syndrome (PCOS).Design  Retrospective trans‐sectional study.Patients  One thousand and two premenopausal women with the diagnoses hirsutism or PCOS were divided according to ethnicity: Caucasian (CA, n = 784), Middle East (ME, n = 190), Asian (n = 14) and others (n = 14).Measurements  Clinical evaluation (hirsutism, BMI, waist, blood pressure), hormone analyses (testosterone, sex hormone–binding globulin, prolactin, lipids, insulin, glucose) and transvaginal ultrasound were performed. Oral glucose tolerance tests (OGTT) (n = 499) and ACTH tests (n = 434) were performed in a subgroup of patients.Results (CA vs ME women)  CA women were older [32(25–37) vs 25(18–32) years, median (quartiles)] and had increased BMI compared to ME women. After correcting for age and BMI, CA women were less hirsute, but had increased testosterone levels compared to ME women. The Rotterdam criteria were fulfilled in 56% of both populations, but PCO was diagnosed in 47% CA vs 29% ME women, P < 0·01. CA women had increased blood pressure and smoked at a higher frequency (40 vs 23%), whereas area under the curve for insulin during OGTT was decreased, all P < 0·001. Prolactin levels were significantly lower in CA women compared to ME women [7(5–10) vs 9(6–12) μg/l] and were inversely associated with smoking status.Conclusion  CA women had a more adverse cardiovascular profile than ME women, whereas insulin sensitivity was higher. The prevalence of the individual Rotterdam criteria differed significantly in the two study populations.
Outcomes of surgical treatment for nonfunctioning pituitary adenomas: a systematic review and meta‐analysis
Authors: Murad Mohammad Hassan , Fernández‐Balsells M. M. , Barwise Amelia , Gallegos‐Orozco Juan F. , Paul Anu , Lane Melanie A. , Lampropulos Julianna F. , Natividad Inés , Perestelo‐Pérez Lilisbeth , Ponce de León‐Lovatón Paula G. , Albuquerque Felipe N. , Carey Jantey , Erwin Patricia J. , Montori Victor M. 
Published: September 2010

SummaryBackground  Surgery is commonly used in the management of pituitary nonfunctioning adenomas (NFPA). The goal of this systematic review and meta‐analysis is to evaluate the effect of surgery on mortality, surgical complications, pituitary function and vision.Methods  We searched MEDLINE, EMBASE and Cochrane CENTRAL, queried experts and reviewed the reference list of included publications. Eligible studies were comparative and noncomparative longitudinal studies that enroled patients with NFPA who underwent surgery (alone or in combination with other therapies). Reviewers, working independently and in duplicate, determined study eligibility with adequate reproducibility and extracted descriptive, quality and outcome data. Risks, relative risks (RR) and 95% confidence intervals (CIs) were estimated from each study and pooled using random‐effects meta‐analysis.Results  Most included studies were uncontrolled case series in which patients received a combination of surgery and radiotherapy. The overall quality of the evidence was very low. Median follow‐up was 4·29 years. When surgery was not combined with radiotherapy, there was an increased risk of tumour recurrence (RR 1·97; 95% CI, 1·15–3·35). Complications were more likely with the transcranial than with the transsphenoidal approach (mortality RR 4·89; 95% CI, 3·15–6·47; new anterior pituitary deficits RR 4·90; 95% CI, 2·94–7·82; and persistent diabetes insipidus RR 2·50; 95% CI, 1·05–5·35). Overall, transsphenoidal surgery had fairly low perioperative mortality (≤1%) and low complication rate (≤5% for all patient‐important outcomes), but only less than a third of the patients had improvement in pituitary function.Conclusions  Observational evidence supports the association between a combined approach of transsphenoidal surgery with radiotherapy and improvements in visual field defects and reduction in tumour recurrence.
From molecules to living systems: historical and contemporary issues in oxidative stress and antioxidant ecology
Authors: Costantini David , Rowe Melissah , Butler Michael W. , McGraw Kevin J. 
Published: September 2010

Summary1. Initial work on oxidative stress and antioxidant defences described basic chemical and biochemical properties and processes and applied this information to issues of animal health and husbandry. Seminal experimental investigations on the damaging effects of oxidative stress and the mitigating effects of antioxidant defences were conducted primarily in domesticated organisms.2. In recent years, ecologists have taken to studying antioxidants and oxidative stress in free‐ranging organisms and have integrated principles of oxidative stress into several core evolutionary concepts, such as life‐history trade‐offs (e.g. survival vs. reproduction), senescence and sexual selection. This initial flurry of studies has provided major advances in our understanding of how antioxidant defences evolve and function.3. In this overview, it is our goal to provide ecologists with an accessible summary of (i) the biochemical basis and conceptual frameworks behind oxidative stress and antioxidants, (ii) the research questions and hypotheses that are generated by incorporating antioxidants and oxidative stress into models of life‐history theory, ageing, mate selection, and honest signalling, and (iii) the trends in the evidence that have emerged from initial studies in these areas.4. Though much progress has been made on the ecological and evolutionary relevance of antioxidant and oxidative stress physiology, no consensus has emerged regarding the primacy of how oxidative stress challenges or antioxidant limits or values shape organismal life‐histories. However, there are many taxonomic biases in studies to date and several ideal environmental systems that are as‐of‐yet untapped.
How to measure oxidative stress in an ecological context: methodological and statistical issues
Authors: Hõrak Peeter , Cohen Alan 
Published: September 2010

Summary 1. Reactive oxygen and nitrogen species can damage biomolecules if these lack sufficient antioxidant protection. Maintaining and up‐regulating antioxidant defenses and repair of the damaged molecules require resources that could potentially be allocated to other functions, including life‐history and signal traits. 2. Identifying the physiological mechanisms causing and counteracting oxidative damage may help to understand evolution of oxidative balance systems from molecular to macroevolutionary levels. This review addresses methodological and statistical problems of measuring and interpreting biomarkers of oxidative stress or damage. 3. A major methodological problem is distinguishing between controlled and uncontrolled processes that can lead either to shifts in dynamic balance of redox potential or cause pathological damage. An ultimate solution to this problem requires establishing links between biomarkers of antioxidant defenses and oxidative damage and components of fitness. 4. Biomarkers of redox balance must correspond to strict technical criteria, most importantly to validated measurement technology. Validation criteria include intrinsic qualities such as specificity, sensitivity, assessment of measurement precision, and knowledge of confounding and modifying factors. 5. The complexity of oxidative balance systems requires that assay choice be informed by statistical analyses incorporating context at biochemical, ecological and evolutionary levels. We review proper application of statistical methods, such as principal components analysis and structural equation modelling, that should help to account for these contexts and isolate the variation of interest across multiple biomarkers simultaneously.
Estimating the adaptive potential of critical thermal limits: methodological problems and evolutionary implications
Authors: Rezende Enrico L. , Tejedo Miguel , Santos Mauro 
Published: September 2010

Summary 1. Current studies indicate that estimates of thermal tolerance limits in ectotherms depend on the experimental protocol used, with slower and presumably more ecologically relevant rates of warming negatively affecting the upper thermal limits (CTmax). Recent empirical evidence also gives credence to earlier speculations suggesting that estimates of heritability could drop with slower heating rates. 2. Using published data from the fruit fly Drosophila melanogaster, we show that empirical patterns can be explained if flies’ physical condition decreases with experimental time in thermal tolerance assays. This problem could even overshadow potential benefits of thermal acclimation, also suggesting that a drop in CTmax with slower heating rates does not necessarily rule out beneficial acclimatory responses. 3. Numerical results from a simple illustrative model show that no clear conclusions can be obtained on how the phenotypic variance in CTmax will be affected with different rates of thermal change. Conversely, the genetic variance and estimated heritabilities are expected to drop with slower heating rates, hence ramping rates in experiments aiming to study the evolutionary potential of thermal tolerance to respond to global warming should be as fast as possible (within the range in which measurement accuracy and physical condition are not affected). 4. Measurements under ecologically realistic warming rates should also consider the impact of other physiological and behavioural strategies that might partly compensate the negative effects of slow heating rates. However, there are situations in which slow heating rates closely mimic natural conditions, as those encountered by some aquatic ectotherms. These heating rates may be an issue of major concern in these species, given its negative impact on CTmax and its adaptive potential.
Haemorrhoidectomy: prevalence and risk factors of urine retention among post recipients
Authors: Lin Yu‐Hua , Liu Kuang‐Wen , Chen Hsin‐Pao 
Published: September 2010

Aims and objectives.  The purpose of this study was to explore the prevalence and risk factors of urine retention among posthaemorrhoidectomy recipients.Background.  Haemorrhoids are one of the most common functional disorders of the anus. The Haemorrhoidectomy surgical procedure is one of the primary treatments for more severe haemorrhoidal occurrences, such as for third‐ and/or fourth‐degree haemorrhoid conditions. Urine retention is a common acute complication after operation, but rare study conducted by nurses in Taiwan to explore the prevalence and risk factors.Design.  A retrospective chart review was conducted.Methods.  Data from a prospectively maintained database on patients who had undergone haemorrhoidectomy between April 2004 – August 2008 were retrospectively analysed. A total of 469 charts were used in this analysis. The following outcomes were studied: patient profiles, haemorrhoid type and severity, anaesthesia methods, length of operating room stay, urine retention and management, intravenous fluid given during operation and length of stay.Results.  The overall urinary retention rate was 32·8% (n = 153). Significant risk factors associated with postoperative urinary retention included severity of haemorrhoid and anaesthesia methods. Logistic regression analysis revealed that epidural anaesthesia (p = 0·008), spinal anaesthesia (p = 0·016) and haemorrhoids with a severity of three degrees or higher (p = 0·017) were predictors of urinary retention post haemorrhoidectomy.Conclusions.  Acute urinary retention can have an adverse effect on a patient’s quality of care. Careful follow‐up of patients with these risk factors can help nurses spot posthaemorrhoidectomy urinary retention early.Relevance to clinical practice.  The prevalence of acute urinary retention post haemorrhoidectomy is common. Surgical ward nurses should therefore take the responsibility regarding the impact of urinary retention and seeking appropriate nursing interventions of induced urination.
Patients’ perceptions of information and support received from the nurse specialist during HCV treatment
Authors: Grogan Anne , Timmins Fiona 
Published: September 2010

Aim. To identify patients’ perceptions of support received from the nurse specialist during Hepatitis C virus (HCV) treatment.Background. HCV is a worldwide health problem. However, it is a treatable disease and treatment success rates are high. Unfortunately, treatment comes with a multitude of adverse side effects and patients require informational and psychological support from specialist nurses while on treatment. To date, there is little nursing research on support received from this specialist nursing care.Design. This study used a quantitative descriptive design.Method. A 59‐item questionnaire collected data from 106 patients with a diagnosis of HCV attending a HCV outpatient clinic.Results. Overall, patients were very satisfied with support received. Advice on contraception was well received. However, many patients did not feel supported with regard to advice on sleep management. There were no statistically significant differences between overall satisfaction and gender, age, genotype and risk factor. However, there were significant correlations found between support received and reported genotype. Those patients presenting with genotype 1, who are mostly infected through blood or blood products, indicated that they require more support in relation to information on side effects of treatment, quality of life and support groups. Specific approaches to support and advice for this cohort may need to be incorporated into current services.Conclusion. Results of this study reinforce the need for the ongoing use of specialist nurse services and development of this service where no such facilities exist. In addition, the service may need to further recognise and support the information and psychological needs of patients with differing modes of HCV infection.Relevance to clinical practice. Findings provide information to practising nurse specialists about patient’s views of information and support received from nurse specialists in HCV treatment centres and identify where deficits exist.
Frequency and barriers of underreported needlestick injuries amongst Iranian nurses, a questionnaire survey
Authors: Azadi Arman , Anoosheh Monireh , Delpisheh Ali 
Published: September 2010

Aims and objectives.  To determine the frequency of needlestick injuries and barriers of reporting such injuries amongst Iranian nurses.Background.  Exposure to blood‐borne pathogens because of needlestick injuries in particular is a potential risk for healthcare workers, including clinical nurses. The burden of sharp injuries sustained by healthcare workers is still unclear, primarily because of underreporting.Design.  A cross‐sectional study was undertaken amongst 111 clinical nurses working in five major teaching hospitals in Tehran/Iran during 2007–2008 who were randomly selected.Methods.  A validated self‐reported questionnaire containing demographic characteristics and history of experiences with contaminated needlesticks as well as probably reason/s for underreporting such injuries was used.Results.  More than half of the enrolled nurses (54·1%, n = 60) had no experience of contaminated injuries, while the rest of 45·9% (n = 51) had experienced at least one contaminated needlestick injuries during their clinical performance. More than one‐third (34·0%, n = 38) had experienced a mean of 58 contaminated needlestick injuries during the past 12 months (crude incidence: 0·52 NSI/nurse/year). Only 14 nurses (36·8%) with needlestick injuries experiences had officially reported their experiences. The major reasons for not reporting needlestick injuries were dissatisfaction with follow‐up investigations by officials after reporting the events (33·3%) and safe/low risk considering of source patients (29·2%).Conclusions.  Increased frequency and underreporting of needlestick injuries amongst Iranian nurses is going to be a major concern. As a preventive strategy, further interventions such as constant staff training, life‐long learning and standardising postexposure procedures are recommended.Relevance to clinical practice.  Determining the prevalence, burden and reasons for underreporting needlestick injuries by clinical nurses are required for establishing a preventive strategy to decrease hospital infections.
Relatives’ information needs and the characteristics of their search for information – in the words of relatives of stroke survivors
Authors: Wallengren Catarina , Segesten Kerstin , Friberg Febe 
Published: September 2010

Aim and objectives.  To explore relatives’ information needs and the characteristics of their information‐seeking process shortly after the stroke event and six months later.Background.  Providing relatives of stroke survivors with information is important, as lack of information increases their uncertainty and risk becoming the ‘second patient in the family’ and early death. Therefore, it is essential to be aware of relatives’ information needs and information‐seeking process the first six months after stroke.Design.  This qualitative study has a descriptive design.Method.  Open‐ended interviews were conducted with sixteen relatives after stroke survivor’s admission to stroke unit and six months later with nine of these relatives. Data were analysed by means of content analysis.Results.  The identified information needs covered the spectrum from stroke survivor’s medical condition because nurses’ actions to relatives’ changed health and life situation. Furthermore, relatives’ information‐seeking process was found to be related to their level of personal involvement, situational circumstances, different forms of knowledge and sources of information.Conclusions.  Relatives’ search for information emerges when health and lifestyle changes occur in survivors or themselves. It is important that this information affect them personally. Also, they need to develop different forms of knowledge when they cannot trust their own competences. As a result, instead of following established curricula based on their beliefs of relatives’ information needs, nurses need to practice on identifying relatives’ information needs.Relevance to practice.  Different information needs and characteristics described in the study can serve as guidance in the development and implementation of pedagogical interventions to support relatives of stroke survivors. One pedagogical implication is to explore what a specific relative wants to know by how he/she talks or thinks about it. Thus, it must be taken into consideration that level of personal involvement, situational circumstances, sources of information and factual knowledge, understanding and skills are intertwined.
Preoperative information needs of children undergoing tonsillectomy
Authors: Buckley Aoife , Savage Eileen 
Published: September 2010

Aims and objectives.  To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision.Background.  Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision.Design.  A qualitative descriptive study.Method.  Data were collected from nine children (aged 6–9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information.Results.  Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing ‘soreness’ and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them.Conclusion.  Preoperative educational interventions need to take account of children’s information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area.Relevance to clinical practice.  Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child‐centred information leaflets using a question and answer format could also be helpful to children.