bluuebunny/crossref_metadata_2025_split huggingface dataset:
The 1999 Irish nurses’ strike: nursing versions of the strike and self‐identity in a general hospital
Authors: Brown Gary D. , Greaney Anna‐Marie , Kelly‐Fitzgibbon Mary E. , McCarthy Jane 
Published: October 2006

Aim.  The aim of this paper is to report findings from a study investigating nurses’ experiences of strike in one public general hospital in the Republic of Ireland.Background.  October 1999 heralded the first nationwide nurses strike in the Republic of Ireland. The strike reflected an international shift towards industrial action in a profession which had previously viewed such action as the antithesis of professional behaviour.Methods.  A focused ethnographic approach studied a group of striking Registered Nurses, not as a culture per se, but as a collection of individuals sharing a common human experience. A purposive sampling approach identified eight information‐rich cases from a modified quota structure. Semi‐structured interviews were carried out immediately prior to, during and at the end of the 1999 strike. The participants also maintained journals which were explored during the interviews. Data were analysed using a constant comparative approach, seeking to achieve category saturation.Findings.  Four strike versions were identified. The anticipatory version is constructed as an inevitable protest, the orientation version as history‐making solidarity and the performing version as a job of work. The withdrawal version is constructed as a conspiracy from which nurses are excluded. These versions portray ongoing tension that is experienced between conflicting self‐identities of Registered Nurses as nurses and as strikers. The analysis revealed strategies adopted to resolve tensions between these identities within the dimensions of carer, patient advocate, multidisciplinary team member and professional.Conclusions.  Debate on such potentially contentious issues by individual nurses, hospital managers and union leaders may facilitate awareness and preparation in advance of any future industrial action. Strategies that may be helpful in the event of a strike include a prestrike orientation programme for the entire organization, a support system for staff during the strike and informal de‐briefing among all staff in the context of a social gathering when the strike is over.
Oral nystatin prophylaxis to prevent invasive candidiasis in Neonatal Intensive Care Unit
Authors: Ozturk Mehmet Adnan , Gunes Tamer , Koklu Esad , Cetin Neside , Koc Nedret 
Published: October 2006

SummaryThe use of oral nystatin to prevent fungal colonisation and infection in neonates in the Neonatal Intensive Care Unit (NICU) is still an open question and not yet recommended as a standard of care. To determine whether prophylactic oral nystatin results in a decreased incidence of invasive candidiasis in the newborn infants, a total of 3991 infants were divided randomly into two groups. Group A infants (n = 1995), only those neonates who were identified as yeast carriers (oral moniliasis) were treated with oral nystatin. Group B infants, all neonates who were admitted to the unit received oral nystatin, was routinely administered three times a day. Group A was divided into groups A1 and A2 (who were treated only if identified as yeast carriers). Urine and rectal cultures were taken on admission and then weekly thereafter. There were 215 (14.2%), 27 (5.6%) and 36 (1.8%) patients positive for invasive candidiasis in groups A1, A2 and B respectively. Oral nystatin prophylaxis significantly reduced the invasive candidiasis (P = 0.004) in extremely low‐birth weight (ELBW) and very low‐birth weight (VLBW) infants. Prophylactic administration of oral nystatine to the ELBW and VLBW infants results in a decreased risk of invasive candidiasis.
Torsade de pointes induced by systemic antifungal agents: lessons from a retrospective analysis of published case reports
Authors: Justo Dan , Zeltser David 
Published: October 2006

SummaryTorsade de pointes (TdP) is a potentially fatal arrhythmia that might be associated with systemic antifungal agent (SAFAs) administration. The objective of this study was to investigate all published reports on TdP induced by SAFAs in order to characterise this association. Each original report was analysed for the presence of risk factors for TdP: female gender, structural heart disease, electrolyte imbalance, concomitant use of a QT interval prolonging agent which SAFA inhibits its liver metabolism, liver cirrhosis, renal failure and more. Naranjo probability scale for adverse drug reactions was applied for every full report. Twenty‐one reports on 28 patients were analysed. All patients survived. Most patients (25/28; 89.2%) used one or more agents that might have prolonged the QT interval and their liver metabolism might have been inhibited by SAFA. Female gender was the second most common risk factor for TdP (20/28; 71.4%). All patients, including female patients, had one or more risk factors for TdP prior to SAFA administration. According to Narajno probability scale, there was no definite association between TdP and SAFA in any report. SAFA alone might seldom trigger TdP. We wish to raise the level of awareness of risk factors for TdP prior to SAFA administration and for concomitant use of other dysrhythmogenic agents in particular.
The Na+/H+ exchanger is a major pH regulator in GABAergic presynaptic nerve terminals synapsing onto rat CA3 pyramidal neurons
Authors: Jang Il‐Sung , Brodwick Malcolm S. , Wang Zhi‐Ming , Jeong Hyo‐Jin , Choi Byung‐Ju , Akaike Norio 
Published: October 2006

AbstractThe effects of pHi on GABAergic miniature inhibitory postsynaptic currents (mIPSCs) were studied in mechanically dissociated CA3 pyramidal neurons, by use of ammonium prepulse and whole‐cell patch‐clamp techniques, under the voltage‐clamp condition. NH4Cl itself, which is expected to alkalinize pHi, increased GABAergic mIPSC frequency in a concentration‐dependent manner. In contrast, NH4Cl decreased mIPSC frequency, either in the presence of 200 µm Cd2+ or in Ca2+‐free external solution, suggesting that intraterminal alkalosis decreased GABAergic mIPSC frequency while [NH4+] itself may activate Ca2+ channels by depolarizing the terminal. On the other hand, GABAergic mIPSC frequency was greatly increased immediately after NH4Cl removal, a condition expected to acidify pHi, and recovered to the control level within 2 min after NH4Cl removal. This explosive increase in mIPSC frequency observed after NH4Cl removal was completely eliminated after depletion of Ca2+ stores with 1 µm thapsigargin in the Ca2+‐free external solution, suggesting that acidification increases in intraterminal Ca2+ concentration via both extracellular Ca2+ influx and Ca2+ release from the stores. However, the acidification‐induced increase in mIPSC frequency had not recovered by 10 min after NH4Cl removal either in the Na+‐free external solution or in the presence of 10 µm 5‐(N‐ethyl‐N‐isopropyl)‐amiloride (EIPA), a specific Na+/H+ exchanger (NHE) blocker. The present results suggest that NHEs are major intraterminal pH regulators on GABAergic presynaptic nerve terminals, and that the NHE‐mediated regulation of pHi under normal physiological or pathological conditions might play an important role in the neuronal excitability by increasing inhibitory tones.
Carbonate apatite crystals in primary normophosphatemic tumoral calcinosis
Authors: TORRALBA Karina D. , JOHNSON Dorothy , QUISMORIO Francisco P. 
Published: October 2006

AbstractA 66‐year‐old woman developed firm, painless, slowly growing nodular masses over her elbows, fingers, toes, and left hip over four years. Aspiration of the elbow mass revealed a white chalky material that was shown to be carbonate apatite on infrared spectroscopy and energy dispersive X‐ray spectroscopy. We discuss the classification of tumoral calcinosis and the nature of the calcium deposits. Tumoral calcinosis should be differentiated from tophaceous gout and calcium pyrophosphate dihydrate crystal deposition disease. Polarizing light microscopy and crystal analysis by X‐ray and infrared spectroscopy, electron or X‐ray diffraction will confirm the diagnosis. Secondary causes of tumoral calcinosis should also be excluded.
Hyperprolactinemia in patients with systemic lupus erythematosus: correlation with disease activity
Authors: HAGHIGHI Anousheh , LAHMI Farhad 
Published: October 2006

AbstractAim:  Recent accumulated evidence suggests that prolactin is an important immunomodulator and may have a role in the pathogenesis of systemic lupus erythematosus (SLE). Our aim was to assess the frequency of hyperprolactinemia in women with SLE and to evaluate its correlation with disease activity.Method:  Plasma prolactin levels were measured in 35 women with SLE and 60 age‐ and sex‐matched healthy controls. Disease activity was assessed using the SLE disease activity index (SLEDAI). Patients with a score > 10 were considered active. In patients and controls prolactin levels were determined by immunoradiometric assay (IRMA).Results:  The prolactin level was higher in SLE than in the control group: 28.5% of SLE patients versus 3.3% of controls had high prolactin levels. Patients with active disease had a trend to higher mean prolactin levels than inactive patients. SLE was active in 90% of hyperprolactinemic patients. In normoprolactinemic patients active disease was found only in 36% of patients. A statistically significant correlation was found between prolactin levels and SLE disease activity index.Conclusion:  This study shows that moderate hyperprolactinemia is present in a subset of patients with SLE and that it is related to increased disease activity and major organ involvement.
Disability, depression and somatization in a low back pain population
Authors: BENER Abdulbari , EL‐RUFAIE Omer F. , KAMRAN Saadat , GEORGIEVSKI Ana B. , FAROOQ Abdulaziz , RYSAVY Martin 
Published: October 2006

AbstractObjective:  The aim of this study was to determine the prevalence of low back pain (LBP) in a primary care setting population and examine its association with the symptoms of depression and somatization.Methods:  This is a cross‐sectional study, utilising a survey carried out in primary health care clinics (PHCs) in Al‐Ain, United Arab Emirates (UAE). A multistage stratified sampling design was used and a representative sample of 1304 UAE nationals aged 18–65 years who attended PHC clinics for any reason were included and 1103 (84.5%) subjects agreed to participate and responded to the questionnaire during a period from June 2001 to January 2002. A specially designed questionnaire with three parts was used for the data collection: socio‐demographic information of the studied subjects, modified version of the Roland‐Morris scale for evaluating back‐related functional disability and SCL‐90 R for depression and somatization subscales was used to assess depressive and somatic symptoms.Results:  Of the total number of subjects surveyed (1103), 586 (53.1%) were men and 517 (46.9%) women. The mean age was 34.9 ± 13.4 years for men and 33.5 ± 11.8 years for women. The prevalence of LBP in the studied subjects was 64.7% (95% CI, 60.7–68.5] with 46.7% among men and 53.3% among women. There were a significant differences between the subjects with LBP and without LBP with respect to gender (P < 0.001), body mass index (BMI) (P < 0.001), occupational status (P < 0.001) and living environment (P = 0.016). Functional disability was higher in patients with LBP. Young patients in aged 15–34 years, patients with preparatory/secondary educational level and students showed higher depressive symptoms. A similar pattern was found in patients with somatic symptoms. Factor analysis revealed a strong association between depression and somatization in LBP patients.Conclusions:  Functional disability was higher in with LBP. Furthermore, symptoms of depression and somatization are prevalent among LBP patients.
Bilateral ankle arthritis with mediastinal lymphadenopathy: a clinician's perspective
Authors: DUGGAL Lalit , KHOSLA Pooja 
Published: October 2006

AbstractAim:  This study is a clinician's perspective of the association of bilateral ankle arthritis with mediastinal lymphadenopathy.Method:  Forty‐three patients with bilateral ankle arthritis with mediastinal lymphadenopathy were included in a 14‐month prospective follow‐up study in our hospital. Complete history, examination and investigations were carried out.Result:  There were 27 female and 16 male patients. Ankle arthritis with tuberculous mediastinal lymphadenopathy was associated in 58.13%, sarcoidosis in 32.5% and 9.3% were non‐specific. The patients were clustered in the spring‐summer months. Erythema nodosum was found in 14.3%, polyarticular presentation in 25%. Thirteen out of 43 patients (28.2%) had biopsy/fine needle aspiration (FNA), of which 69.23% had histopathological evidence of tuberculosis.Conclusion:  The aetiology of bilateral ankle arthritis associated with mediastinal lymphadenopathy may be tuberculosis as opposed to sarcoidosis. There is a seasonal clustering of these cases. FNA of mediastinal lymphadenopathy is a fairly safe procedure and should be carried out when feasible, for confirmation of diagnosis.
Bilateral coronary and renal artery stenosis in a case with limited scleroderma
Authors: EMAD Yasser , GOHARY Tarek El 
Published: October 2006

AbstractA 65‐year‐old woman with long‐standing limited scleroderma over 15 years presented in January 2004 with scleroderma renal crisis with rising blood pressure, worsening of renal function and non‐ST segment acute coronary syndrome. The patient's renal function deteriorated upon receiving angiotensin‐converting enzyme (ACE) inhibitors, prompting coronary and renal angiography, which revealed bilateral coronary and renal artery stenosis. In scleroderma patients with renal crisis and showing deterioration of renal function, the possibility of renal artery stenosis should be excluded because ACE inhibitors in this situation carry risks for deterioration of kidney function.
Ollier's disease with symmetric bony deformities
Authors: MOBINI Maryam , NOROOZY Mohsen , FORGHANIZADEH Jafar 
Published: October 2006

AbstractThis report describes a 33‐year‐old man who presented with short stature, multiple bony swellings in hands and deformities in extremities. He was evaluated with radiography to determine pattern of bone and joint involvement. X‐rays showed multiple enchondromas in hands, forearms, arms, thighs, legs and feet. The vertebral column was not affected.
Successful treatment of extensive muscle calcification in a patient with primary idiopathic polymyositis with diltiazem
Authors: EMAD Yasser , RAGAB Yasser , GHEITA Tamer 
Published: October 2006

AbstractA 25‐year‐old female patient with documented diagnosis of polymyositis developed extensive muscle calcification in the left thigh muscles with overlying skin induration one year after her disease onset, despite well controlled myositis. Plain X‐ray of the left femur and hip revealed extensive calcification involving the periarticular soft tissue shadows around the left hip and left upper thigh. The patient received diltiazem 90 mg/day in divided doses and follow‐up plain X‐ray study after 6 months of treatment revealed almost complete resolution of the muscle calcifications.
Reflections of Medical Students on Visiting Chronically Ill Older Patients in the Home
Authors: Yuen Jacqueline K. , Breckman Risa , Adelman Ronald D. , Capello Carol F. , LoFaso Veronica , Carrington Reid M. 
Published: October 2006

The expanding number of Americans living with chronic illness necessitates educating future physicians about chronic illness care. Weill Cornell Medical College's Chronic Illness Care in the Home Setting Program (CIC‐HSP), a mandatory part of the primary care clerkship, exposes medical students to persons with chronic illness via a half day of house calls with a geriatrics team. The investigators sought to qualitatively assess the effect of the CIC‐HSP on medical students and recent medical graduates. Fifty‐two prospective participants were approached, and 50 (96%) with varying training levels and time since completing the program were interviewed.Most respondents (63%) found that the home visits taught them important approaches to caring for the chronically ill, such as individualizing care to meet patients' individual needs and improving quality of life as a goal of care. Students remarked that the experience enhanced their empathy (18%) and sensitivity (20%) toward chronically ill patients and increased their appreciation for chronic illness care (35%). Many participants reported that patients were more empowered in the home (55%) and perceived greater rapport and warmth between the doctor and patient (57%) in the home (vs office) setting. The vast majority of recent medical graduates (84%) related that this educational exposure continued to positively influence their approach to patient care.A home visit experience with a geriatrics team can help foster medical students' understanding of the psychosocial and medical aspects of chronic illness, teach relevant approaches to patient care, and improve students' attitudes toward caring for the chronically ill.
Metastatic pulmonary calcification in a dialysis patient: Case report and a review
Authors: EGGERT Christoph H. , ALBRIGHT Robert C. 
Published: October 2006

AbstractA 19‐year‐old male presented with chest pain and dyspnea. He was anephric following nephrectomy for focal segmental glomerulosclerosis, had a subsequent failed transplant, and had been dialysis dependent for 3 years. Workup revealed hyperparathyroidism and an abnormal chest X‐ray and computed tomography scan, significant for massive extra‐skeletal pulmonary calcification. A markedly abnormal Technitium99 methylene diphosphonate (Tc99m‐MDP) bone scan confirmed the clinical suspicion of metastatic pulmonary calcification. Metastatic pulmonary calcification (MPC) is common, occurring in 60% to 80% of dialysis patients on autopsy and bone scan series. It may lead to impaired oxygenation and restrictive lung disease. Typically, the calcium crystal is whitlockite rather than hydroxyapatite, which occurs in vascular calcification. Four major predisposing factors may contribute to MPC in dialysis patients. First, chronic acidosis leaches calcium from bone. Second, intermittent alkalosis favors deposition of calcium salts. Third, hyperparathyroidism tends to cause bone resorption and intracellular hypercalcemia. Finally, low glomerular filtration rate can cause hyperphosphatemia and an elevated calcium‐phosphorus product. There may be other factors. Some authors suggest that the incidence of MPC in recent years may be lower due to improved dialysis techniques. The diagnosis is confirmed by biopsy, but can be suspected by typical findings on a Tc99m‐MDP bone scan. Therapy is limited to ensuring adequate dialysis, correcting calcium‐phosphorus product, and hyperparathyroidism; discontinuing vitamin D analogues may help. Conflicting reports show that transplantation may either improve or worsen the situation. MPC should be considered in dialysis patients who have characteristic abnormal chest radiography and/or pulmonary symptoms.
What, me grieve? Grieving and bereavement in daily dialysis practice
Authors: BARTLOW Bruce 
Published: October 2006

AbstractWe seldom consider the terms “grieving” or “bereavement” until faced with an empty dialysis chair. But loss (bereavement) and the process we go through to heal from that loss (grieving) begin with a patient's first puff of edema or abnormal creatinine, and continue throughout the course of an illness. By recognizing the symptoms and developing the tools to deal with loss, we will enrich the value of our practice for ourselves and those with whom we work.
Comparisons of Kt/V evaluated using an online method and calculated from urea measurements in patients on intermittent hemodialysis
Authors: GRZEGORZEWSKA Alicja E. , BANACHOWICZ Wojciech 
Published: October 2006

AbstractKt/Vurea (Kt/V) depends on the method applied for its evaluation. Our aim was to compare Kt/V obtained using the conductivity online method and that calculated from urea measurements. Studies were carried out in 40 patients. A stable dialysis schedule was maintained during the study. Online Kt/V was measured every week or 4 consecutive months. Single pool Kt/V (spKt/V) was calculated from urea estimations in the fourth week of the first month and in the last week of the fourth month of studies, using the formulas:
image

where Ct is the postdialysis urea concentration obtained at the end of dialysis, Co the predialysis urea concentration obtained before the start of the blood pump;
image

where R is the Ct/Co, t the duration of HD session, f=1.0, UF is the ultrafiltration volume (l), W is the body weight after the HD session; and
image
The equilibrated Kt/V (eKt/V) was calculated as Correlation analysis was performed between all obtained Kt/V. Weekly online Kt/V was stable during 4 months of studies. In the first month, the respective values of online Kt/V, (1)spKt/V, (2)spKt/V, (3)spKt/V, and eKt/V were 1.15±0.14, 1.16±0.14, 1.38±0.17, 1.36±0.20, and 1.22±0.13. In the fourth month, these values were 1.17±0.14, 1.16±0.17, 1.38±0.22, 1.35±0.20, and 1.22±0.18. The respective values of Kt/V, estimated in the first and fourth month, were not different and showed a positive correlation: the highest one occurred between online Kt/V estimated at the indicated study periods (r=0.713, p=0.0000). Online Kt/V was significantly lower than (2)spKt/V, (3)spKt/V, and eKt/V. Correlation coefficients between online Kt/V, spKt/V, and urea reduction ratio did not exceed 0.490. Our studies show that Kt/V obtained using online monitoring indicates a lower intermittent hemodialysis adequacy that those calculated from urea measurements. This difference has to be remembered in application of results to clinical practice.
The kidney disease wasting: Inflammation, oxidative stress, and diet‐gene interaction
Authors: KALANTAR‐ZADEH Kamyar , BALAKRISHNAN Vaidyanathapuram S. 
Published: October 2006

AbstractThe 350,000 maintenance hemodialysis (MHD) patients in the United States have an unacceptably high mortality rate of >20%/year. Almost half of all deaths are assumed to be cardiovascular. Markers of kidney disease wasting (KDW) such as hypoalbuminemia, anorexia, body weight and fat loss, rather than traditional cardiovascular risk factors, appear to be the strongest predictors of early death in these patients. The KDW is closely related to oxidative stress (SOX). Such SOX markers as serum myeloperoxidase are associated with pro‐inflammatory cytokines and poor survival in MHD patients. Identifying the conditions that modulate the KDW/SOX‐axis may be the key to improving outcomes in MHD patients. Dysfunctional lipoproteins such as a higher ratio of the high‐density lipoprotein inflammatory index (HII) may engender or aggravate the KDW, whereas functionally intact or larger lipoprotein pools, as in hypercholesterolemia and obesity, may mitigate the KDW in MHD patients. Hence, a reverse epidemiology or “bad‐gone‐good” phenomenon may be observed. Diet and gene and their complex interaction may lead to higher proportions of pro‐inflammatory or oxidative lipoproteins such as HII, resulting in the aggravation of the SOX and inflammatory processes, endothelial dysfunction, and subsequent atherosclerotic cardiovascular disease and death in MHD patients. Understanding the factors that modulate the KDW/SOX complex and their associations with genetic polymorphism, nutrition, and outcomes in MHD patients may lead to developing more effective strategies to improve outcomes in this and the 20 to 30 million Americans with chronic disease states such as individuals with chronic heart failure, advanced age, malignancies, AIDS, or cachexia.