bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiphospholipid antibodies after renal transplantation and cardiovascular disease
Authors: Fernández‐Fresnedo Gema , López‐Hoyos Marcos , Segundo David San , Crespo Juan , Ruiz Juan Carlos , De Francisco Angel Luis M , Arias Manuel 
Published: August 2010

Abstract:  Background:  The aim was to assess the presence of pre‐ or post‐transplant serum antiphospholipid antibodies (APA) and its association with the development of cardiovascular disease (CVD) in renal transplantation.Methods:  We studied 138 patients transplanted with a cadaver kidney graft between 1990 and 1998 and with a graft functioning for longer than one yr. One pre‐transplant sample and another obtained after transplantation from our serum bank were analyzed. The ELISA used were set up in our laboratory, following established international guidelines, and results were confirmed in three different runs.Results:  23.9% and 31.2% of patients had pre‐ and post‐transplant positive titers of APA, respectively. 16% developed those antibodies de novo after transplantation. Post‐transplant CVD was observed in 20.3% of patients but they were not associated with the production of APA in the whole population studied. However, multivariate analysis demonstrated an increased risk (RR 2.27; p = 0.02) for CVD when APA were produced after acute rejection.Conclusions:  The presence of serum APA alone was not an independent risk factor for CVD after kidney transplantation. Nonetheless, in kidney recipients who produced APA de novo after acute rejection, the control of cardiovascular risk factors must be intensified.
The impact of induction on survival after lung transplantation: an analysis of the International Society for Heart and Lung Transplantation Registry
Authors: Hachem Ramsey R. , Edwards Leah B. , Yusen Roger D. , Chakinala Murali M , Alexander Patterson G. , Trulock Elbert P. 
Published: August 2010

Abstract:  Background:  The use of induction immunosuppression after lung transplantation remains controversial. In this study, we examined the impact of induction on survival after lung transplantation.Methods:  We performed a retrospective cohort study of 3970 adult lung transplant recipients reported to the ISHLT Registry. We divided the cohort into three groups based on the use of induction: none, interleukin‐2 receptor antagonists (IL‐2 RA), and polyclonal antithymocyte globulins (ATG). We estimated graft survival using the Kaplan‐Meier method and constructed a multivariable Cox proportional hazards model to examine the impact of induction on graft survival in the context of other variables.Results:  During the study period, 2249 patients received no induction, 1124 received IL‐2 RA, and 597 received ATG. Four years after transplantation, recipients treated with IL‐2 RA had better graft survival (64%) than those treated with ATG (60%) and those who did not receive induction (57%; log rank p = 0.0067). This survival advantage persisted in the multivariable model for single and bilateral recipients treated with IL‐2 RA compared to those who did not receive induction (RR = 0.82, p = 0.007). Similarly, bilateral recipients treated with ATG had a survival advantage over bilateral recipients who did not receive induction (RR = 0.78, p = 0.043), but single lung recipients treated with ATG did not have a survival advantage over single lung recipients who did not receive induction (RR = 1.06, p = 0.58).Conclusions:  Induction with lL‐2 RA for single and bilateral lung recipients and induction with ATG for bilateral recipients are associated with a survival benefit, independent of other variables that might impact survival.
Optimizing protein recovery for urinary proteomics, a tool to monitor renal transplantation
Authors: Sigdel Tara K. , Lau Ken , Schilling James , Sarwal Minnie 
Published: August 2010

Abstract:  Despite attractiveness of urine for biomarker discovery for systemic and renal diseases, the confounding effect of the high abundance plasma proteins in urine, and a lack of optimization of urine protein recovery methods are bottlenecks for urine proteomics.Three methods were performed and compared for percentage protein yield, yield consistency, ease and cost of analysis: (i) organic solvent precipitation, (ii) dialysis/lyophilization, and (iii) centrifugal filtration. Urine samples were subjected to an immunoaffinity column to deplete high abundance proteins. Difference gel electrophoresis was performed to assess use of depletion strategy for detection of low abundance proteins. Urine from healthy volunteers (n = 10) and kidney transplant recipients with proteinuria (n = 11) were used. Centrifugal filtration performed best for analysis ease and yield consistency. Highest percentage yield was obtained from dialysis/lyophilization but was laborious and residual salt interfered with subsequent gel electrophoresis. Organic solvent precipitation was inexpensive, but suffered from varying yield consistency. Increased spot intensity for some low abundance and previously undetected proteins were noted after depletion of high abundance proteins.In conclusion, we compare the pros and cons of different protein recovery methods and reveal an increase in the dynamic range of protein detection after depletional strategy that could be critical for biomarker discovery, particularly with reference to processing human study samples from clinical trials.
Primary health care personnel faced with cadaveric organ donation: a multicenter study in south‐eastern Spain
Authors: Ríos A. , Ramírez P. , Galindo P.J , Sánchez J , Sánchez E , Martínez‐Alarcón L. , Parrilla P 
Published: August 2010

Abstract:  Introduction:  Primary health care (PHC) is the first point of contact between the public and the health system and it is an important channel for the communication and promotion of organ donation and transplantation. The objective of this study was to analyze the attitude of PHC personnel toward donation and to determine the psychosocial variables affecting this attitude.Materials and methods:  A random sample was stratified by job category and geographical location among PHC personnel (n = 482) from 32 health centers. Attitude was evaluated using a questionnaire validated in our local area. (It was completed anonymously and was self‐administered.)Results:  The questionnaire completion rate was 86% (n = 414): 78% (n = 325) are in favor and the remaining 22% (n = 89) are either against or are not sure. The reason given for a negative attitude is fear of apparent death (16%; n = 14). There are many independent factors that affect attitude: (i) job category (OR = 2.4); (ii) knowledge of the concept of brain death (OR = 2.2); (iii) a preference for alternatives to burial (OR = 2.99); (iv) being in favor of cremation (OR = 01.87) and (v) knowledge of the attitude of one’s partner toward organ donation (OR = 0.312).Conclusion:  PHC personnel have a favorable attitude toward donation, especially physicians, although it would be useful to provide more information to PHC personnel. Physicians could be a key element in the direct and indirect promotion of donation and transplantation.
Aggressive steroid weaning after cardiac transplantation is possible without the additional risk of significant rejection
Authors: Teuteberg Jeffrey J. , Shullo Michael , Zomak Rachelle , McNamara Dennis , McCurry Kenneth , Kormos Robert L. 
Published: August 2010

Abstract: Background: Chronic steroid use after cardiac transplantation (CTX) is accompanied by co‐morbidities that are dependent on length of exposure.Methods: A retrospective review of all CTX without induction therapy from 1999–2004. After 2001, an aggressive strategy of steroid weaning was introduced.Results: A total of 165 patients underwent CTX, 82 from 1999–2001 (group 1) and 83 from 2002–2004 (group 2). There were no significant differences in recipient or donor characteristics between group 1 and group 2. The baseline calcineurin was cyclosporine in 41% and 5% (p < 0.0001) and tacrolimus in 59% and 95% (p < 0.0001), respectively. The mean duration of steroid use was 1023 d in group 1 and 383 d in group 2 (p < 0.0001). The overall incidence of any ≥ISHLT grade 3A rejection per year after CTX for group 1 vs. group 2 was as follows: year 1: 40% vs. 49% (p = NS) and year 2: 7.4% vs. 9.2% (p = NS).Conclusions: Steroid withdrawal by one yr after CTX using a contemporary immunosuppressive regimen is possible in most patients. In comparison with a slower steroid wean, a faster wean is not associated with an excess of significant rejection in the first two yr post CTX.
The financial impact of immunosuppressant expenses on new kidney transplant recipients*,†
Authors: Gordon Elisa J. , Prohaska Thomas R. , Sehgal Ashwini R. 
Published: August 2010

Abstract: Background: This study aimed to examine kidney transplant recipients’ ability to afford transplant‐related out‐of‐pocket expenses and the financial impact of these expenses on their lives.Patients and methods: This cross‐sectional study involved 77 kidney recipients. Variables analyzed were: ability to afford daily necessities; impact of immunosuppressant expenses on patients’ lives; awareness of Medicare support terminating three yr post‐transplant; and strategies used to pay for out‐of‐pocket transplant expenses. The Economic Strain Scale measured financial strain.Results: Twenty‐nine percent of kidney recipients experienced financial strain. Poor, less educated, and younger patients were more likely to report financial strain. Out‐of‐pocket expenses relating to kidney transplantation adversely affected patients’ ability to afford leisure activities (35%), a house (27%), and a car (26%). Thirty‐one percent reported that immunosuppressant expenses have had somewhat to great (adverse) impact on their lives. Of those on Medicare and not disabled (n = 41), 51% were unaware Medicare coverage will terminate and 71% did not know how long coverage lasts.Conclusions: Financial strain presents a considerable risk to kidney recipients’ ability to purchase immunosuppression. Socioeconomic disparities in recipients’ financial strain may be a source of disparities in graft survival. Transplant professionals should better inform transplant candidates about financial consequences of transplantation.
Predictor factors for the development of arterial hypertension following heart transplantation
Authors: Sánchez‐Lázaro Ignacio J. , Martínez‐Dolz Luis , Almenar‐Bonet Luis , Moro‐López José A. , Agüero Jaime , Ortiz‐Martínez Víctor , Izquierdo María Teresa , Salvador A. 
Published: August 2010

Abstract:  Introduction:  Up to 95% of the patients with heart transplantation (HT) suffer from arterial hypertension (AHT). The development of de novo AHT after HT has not been greatly studied.Aim:  To identify the predictor variables for the development of de novo AHT after HT.Materials and methods:  We retrospectively studied 253 patients with HT and who did not previously have AHT. We excluded cases of early mortality, re‐transplants and combined transplants. We considered AHT as the constant need to take anti‐hypertensive drugs to maintain blood pressure < 140/90 mmHg. We studied all the variables relating to recipient, donor, surgical procedure, immunosuppression and follow‐up. The statistics used were the Student's t‐test, chi‐square statistic and a logistic regression analysis.Results:  Of the 253 patients, 109 (43%) developed AHT. The variables associated with more prevalent AHT were male recipient/donor, idiopathic dilated cardiomyopathy (IDCM) as cause of HT, having been a smoker as well as renal deterioration (RD) and hypercholesterolemia after HT. The multivariate analysis found smoking prior to the HT and hypercholesterolemia during follow‐up as independent risk factors and urgent HT as a protective variable.Conclusions:  AHT after HT is frequent. The variables associated in our population were smoking before HT, male recipient/donor, IDCM prior to HT and hypercholesterolemia and RD after HT.
ESR MEASUREMENTS OF SHORT‐LIVED FREE RADICALS OBTAINED BY ADDITION OF OH TO DL‐METHIONINE
Authors: Bürk G. K. , Schoffa G. 
Published: August 2010

The ESR spectrum of DL‐methionine was investigated by the flow method first developed by Dixon & Norman (1962). By means of this spectrum four different types of radicals were detected and their coupling constants were determined.
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Further it could be pointed out that dimethyl sulfoxide (DMSO) treated in the same way showed a radical of the form O–S–CH3 in addition to (CH3 radical).
DEVELOPING STRATEGIES TO GATHER INFORMATION ABOUT THE MATERNITY EXPERIENCES OF INDIGENOUS WOMEN IN AN ACUTE CARE SETTING
Authors: Watson Jennifer , Hodson Katrina , Johnson Rhona 
Published: August 2010

ABSTRACT: This project emerged from the concerns of health care professionals at a large acute care hospital in the Northern Territory of Australia. The aim of the project was to develop educational resources through information and experiences provided by Aboriginal and Torres Strait Islander women and health care professionals. The objectives are to optimise collaboration and participation by Indigenous and Torres Strait Islander women in sharing their maternity experiences about the birthing of their baby either in hospital, or out of hospital before arrival. Stage one of a three stage project is reported here. In stage one a modified Delphi method was used to interview ten purposefully chosen professional Indigenous women with insight into the research process and changing social arrangements. Stage two involved the development of an interview schedule and face‐to‐face interviews. Stage three includes the development of a questionnaire to be answered by health care professionals.Discussion of the background to the study, reviewed literature and issues identified from interviews with the professional Indigenous women regarding best methods and appropriate data collection processes is presented. Research described here explores issues of concern for Indigenous women from the Northern Territory around their child birthing experiences in an acute care setting.
FARM‐RELATED FATAL INJURY OF YOUNG AND OLDER ADULTS IN AUSTRALIA, 1989–1992
Authors: Mitchell Rebecca J. , Franklin Richard C. , Driscoll Timothy R. , Fragar Lyn J. 
Published: August 2010

ABSTRACT: This paper describes the types of, and circumstances surrounding, unintentional farm‐related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989–1992.Around 14% of all farm‐related fatalities in Australia during 1989–1992 were of young adults aged 15–24 years and approximately one‐quarter were of older adults aged? 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults.Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored.
MANAGEMENT OF HIV/AIDS ON THE MID NORTH COAST: A COLLABORATIVE MODEL OF CARE INVOLVING GENERAL PRACTITIONERS AND THE PUBLIC HEALTH SYSTEM
Authors: Andrews Doug 
Published: August 2010

ABSTRACT: The Coffs Harbour AIDS Information Network was set up to co‐ordinate care planning and support service delivery for HIV/AIDS patients. This paper describes a collaborative model of care that brought together private general practitioners, a community nurse and a sexual health counsellor. Time involved in delivering services was monitored for each of the health professional groups during a 6 month period.Twenty‐three patients were involved in our study. Doctors averaged 23 min per consultation over 57 occasions of service. Travel or telephone contact took up 17% of the time spent on these patients. Corresponding figures for the nurse and counsellor were an average of 67 min over 144 services and 71 min over 16 services. They spent 16% and 27% of their time travelling or on the phone, respectively.HIV/AIDS care is time consuming for health professionals but comprehensive care can be given in rural areas with adequate support and integration.
RURAL DOCTORS‘ SATISFACTION IN JAPAN: A NATIONWIDE SURVEY
Authors: Matsumoto Masatoshi , Okayama Masanobu , Kajii Eiji 
Published: August 2010

Objectives: The purpose of this paper was to discover to what degree Japanese rural doctors are satisfied with various aspects of their jobs and lives, and to find out whether they intend to continue their rural careers. Design: Nationwide postal survey Setting: Public clinics or hospitals in municipalities that are authorised as ‘rural’ by the national government. Subjects: A total of 4896 doctors working for public clinics or hospitals. Interventions: Self‐evaluation questionnaires were mailed. The rural doctors were asked to evaluate their satisfaction with 19 items related to their job conditions and 10 items concerning life conditions, using a four‐point scale. They also were asked to evaluate their intent to stay in rural practice until retirement. Results: The response rate was 64%. Overall, rural doctors were satisfied with both their work and life conditions. However, only 27% of respondents hoped to continue rural practice beyond the usual age of retirement. Among job‐related items, continuing medical education and interactions with municipal governments were rated as least satisfactory. Among lifestyle‐related items, duration of holidays and workload were unsatisfactory. Subgroup analysis revealed male doctors showed greater intent to stay in rural practice. Doctors aged > 50 years were more satisfied with most aspects of their job and lifestyle than younger doctors. A strong correlation was found between the degree of intent to stay and several items such as interactions with municipal government, human interactions salary and job fulfilment. Conclusions: Strategies, based on the results of this survey, should be implemented. Particularly in Japan, positive interaction between doctors and municipal governments is crucial.
PSYCHOSOCIAL INVESTIGATION OF INDIVIDUAL AND COMMUNITY RESPONSES TO THE EXPERIENCE OF OVINE JOHNE'S DISEASE IN RURAL VICTORIA
Authors: Hood Bernadette , Seedsman Terence 
Published: August 2010

Objective: This paper explores the psychosocial outcomes for individuals and communities in rural Victoria who experienced the outbreak of Ovine Johne's Disease (OJD). Design: The study uses a qualitative methodology to analyse the minutes of evidence provided by the inquiry into the control of OJD to identify the psychosocial events, experiences and outcomes associated with the control of this outbreak. The inquiry was undertaken by the Environment and Natural Resources Committee of the Victorian State Government. Setting: Public hearings were undertaken by the committee across several rural Victorian communities and the state capital, Melbourne. Subjects: The transcripts detail 136 submissions from 98 individuals and 23 organisations.Outcome measures: The analysis aimed to provide insight into the impact of the disease on individuals and communities and also to explore the factors individuals perceived as associated with these outcomes. Results: While the paper identifies that aspects of stock loss associated with the outbreak caused substantial emotional and economic distress, for farmers the most significant finding was the impact of the government control program on individuals, families and rural communities. The control program was perceived as having very limited scientific credibility and its implementation was described as heartless, inflexible and authoritarian. Involvement with the program resulted in farmers reporting emotions, such as, trauma, shame, guilt and stigma. Families became discordant and the sense of community within rural townships fragmented. Psychological outcomes of grief, depression and anxiety emerged as prevalent themes within families and communities. Conclusions: These data highlight the need for significant attention to the management of rural disasters, such as, the OJD program.
CANCER AND CANCER RISK IN SOUTH AUSTRALIA: WHAT EVIDENCE FOR A RURAL–URBAN HEALTH DIFFERENTIAL?
Authors: Wilkinson David , Cameron Kate 
Published: August 2010

Objective: To determine the extent of evidence for a rural–urban health differential in cancer and cancer risk in South Australia Design: Secondary analysis and synthesis of data available between 1977 and 2000 from the publications of the South Australian Cancer Registry and reports of population health surveys carried out by the South Australian Department of Human Services. Results: The mean annual age‐standardised incidence of all forms of cancer combined was about 4% lower for rural residents (265.2 per 100 000 cf. 274.9 per 100 000). Of 31 types of cancer listed, the incidence of three was significantly higher among rural residents, the incidence of eight was significantly higher among urban residents and for 20 types there was no significant difference. Five year case survival for all cancers combined was 52% in both urban and rural residents. Significant survival differences were identified for only 10 cancers and survival for each was higher among urban residents. Melanomas were diagnosed in situ more often in the country, but invasive cases tended to be thicker. There was no rural– urban difference in early detection rates for breast cancer or bladder cancer. There were no substantial reported differences in major risk factors and early detection experiences apart from higher rates of smoking in the country. Conclusions: There is little evidence for substantial or systematic differences in risk factors for, and incidence and early detection of cancers between urban and rural South Australia. However, the apparent consistently poorer survival among rural residents warrants further study.
So far and yet so close: quality of management of diabetes in Australian and Canadian Indigenous communities
Authors: Mak Donna B. , Whitehead Sara , Plant Aileen J. 
Published: August 2010

Objectives: To compare quality of clinical management of Indigenous people with diabetes in remote areas of Australia and Canada. Design: Clinical audit of diabetes management. Setting: The Kimberley region of Western Australia and Northern Saskatchewan in Canada. Subjects: One hundred and two Saskatchewan and 142 Kimberley patients from seven and 11 primary health services, respectively. Main outcome measures: Indicators of quality of diabetes clinical management during the preceding two years. Results: Overall quality of management was poor. Retinopathy screening was better in the Kimberley than Saskatchewan (58% screened in the preceding two years cf 30%). Glycemic control of Saskatchewan patients was better than that of Kimberley patients (16% with optimal control vs. 9%). Conclusions: Continuing efforts at the level of health service organisation, patient and staff education, and creative ways to reduce barriers to access, as well as primary prevention initiatives, are required to counter the devastating effect of diabetes on Indigenous communities.