bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of iron chelators on myocardial iron and cardiac function in transfusion‐dependent thalassaemia: a systematic review and meta‐analysis
Authors: Mamtani Manju , Kulkarni Hemant 
Published: March 2008

SummaryIron chelators have dramatically prolonged the life expectancy of patients with transfusion‐dependent thalassaemia, but their precise clinical benefit in reducing the myocardial iron burden and improving cardiac function is unknown. This systematic review and meta‐analysis included published clinical trials that assessed the efficacy of iron chelators in regularly transfused patients of thalassaemia major for two commonly reported outcomes – myocardial iron content and left ventricular ejection fraction (LVEF). The meta‐analysis of 392 patients for myocardial iron content and 291 patients for LVEF showed that (i) iron chelators reduced cardiac iron content by 23·9% (95% confidence interval 17·3–29·8%); (ii) there was no significant difference between the amount of iron reduced by deferoxamine and deferiprone (P = 0·9504); and (iii) LVEF was not significantly influenced by iron chelators – summary Hedge’s g 0·13 (95% confidence interval −0·10–0·36). A significant publication bias existed for LVEF (Egger’s P = 0·049) but not for myocardial iron (Egger’s P = 0·871). Our results indicate that iron chelators significantly reduce myocardial iron content. Further, the choice of deferoxamine versus deferiprone may rest on factors other than their efficacy to reduce cardiac iron load.
PROLACTIN LEVELS AND PITUITARY ENLARGEMENT IN HORMONE‐TREATED MALE‐TO‐FEMALE TRANSSEXUALS
Authors: ASSCHEMAN H. , GOOREN L. J. G. , ASSIES J. , SMITS J. P. H. , DE SLEGTE R. 
Published: March 2008

SUMMARYPRL levels were evaluated during long‐term treatment with cyproterone acetate 100 mg and ethinyloestradiol 100 μg/day orally or depot‐oestrogens in 214 male‐to‐female transsexuals. PRL levels increased above normal in all subjects (normal < 300 mU/l). In 46 (21.4%) subjects PRL levels rose to > 1000 mU/l. The incidence of PRL levels > 1000 mU/l was 3.7–7.2% per treatment year. Grossly elevated PRL levels were associated with high doses of oestrogens (P < 0.05) and advanced age at the start of treatment (P < 0.05). In 23 subjects PRL levels > 1000 mU/l decreased by more than 50% spontaneously (n= 5) or after dose reduction (n= 18). In five of the subgroup of 15 subjects with persistent PRL levels > 1000 mU/l enlargement of the pituitary gland was shown by CT‐scanning. These data suggest that the lowest possible oestrogen dose and lifelong follow‐up of hormone‐treated male‐to‐female transsexuals is essential.
IMMUNOGENETICS OF GRAVES' OPHTHALMOPATHY
Authors: WEETMAN A. P. , SO A. K. , WARNER C. A. , FORONI L. , FELLS P. , SHINE B. 
Published: March 2008

SUMMARYWe have performed an immunogenetic analysis of 53 patients with severe Graves' ophthalmopathy, 51 patients with Graves' disease but little or no clinically apparent eye disease, and 90 controls. The distribution of restriction fragment length polymorphisms was analysed in the three groups, using probes for the HLA‐DQα and DRβ regions, the T‐cell receptor Cx, Kx, Cβ and Jγ genes and the immunoglobulin gene switch regions, Sx and Sμ. There was no abnormal distribution of these polymorphisms in either group of Graves' patients, or differences between the Graves' patients with or without eye disease. It was possible to assign HLA‐DR types in most patients using the polymorphisms found after probing with DQα and DRβ; there was no abnormal distribution of DR types (including HLA‐DR3) assigned by restriction fragment polymorphisms in the two Graves' groups. These results fail to confirm the reported associations between ophthalmopathy and HLA‐DR3 and between Graves' disease and the T‐cell receptor Cβ polymorphism; they also argue against a strong influence of Gm allotypes in Graves' disease since these genes are in linkage disequilibrium with the Sα polymorphisms. The association of Graves' disease with HLA‐DR3, defined hitherto using serological reagents, may be less strong than previously described.
OSMOREGULATION OF VASOPRESSIN SECRETION AND THIRST IN CYCLICAL OEDEMA
Authors: THOMPSON C. J. , BURD J. M. , BAYLIS P. H. 
Published: March 2008

SUMMARYOsmoregulation of vasopressin release and thirst was studied in the mid‐follicular and mid‐luteal phases of the menstrual cycle of five patients with cyclical oedema defined by peripheral oedema and weight gain (> 30 kg) manifest in two consecutive luteal phases. Results are compared to those already obtained in eight healthy women. In the patients, basal plasma osmolality in the mid‐luteal phase was significantly lower than in the mid‐follicular periods (patients, 283 ± 1, 287 ± 1 mOsmol/kg, respectively, mean ± SEM, P < 0.05; controls, 282 ± 1, 286 ± 1 mOsmol/kg, respectively, P < 0.05). Plasma osmolality (pOsm) and plasma arginine vasopressin (pAVP) were measured during hypertonic (850 mmol/l) saline infusion in both phases of the cycle; linear regression analyses of these data gave the following mean regression equations, (i) mid‐follicular, pAVP=0.55 (pOsm — 285), r=0.94 and (ii) mid‐luteal, pAVP=0.42 (pOsm —281), r=0.93. The abscissal intercept was significantly different (P < 0.025). Osmotic threshold for severe thirst onset was lower in the mid‐luteal phase compared to the mid‐follicular value (296 ± 1, 299 ± 1 mOsmol/kg, respectively, P < 0.01). Basal data and results of thirst onset and theoretical threshold for vasopressin release in response to osmotic stimulation obtained in the patients were similar to healthy control women. We conclude that osmoregulation in cyclical oedema is normal.
HETEROZYGOTES FOR 17α‐HYDROXYLASE DEFICIENCY CAN BE DETECTED WITH A SHORT ACTH TEST
Authors: WIT J. M. , VAN ROERMUND H. P. C. , OOSTDIJK W. , BENRAAD T.H. J. , THIJSSEN J. H. H. , BOER P. , JANSEN M. , SPIT M. , VAN DEN BRANDE J. L. 
Published: March 2008

SUMMARYA short ACTH test was performed in the six parents, and four siblings, of three cases with 17α‐hydroxylase deficiency. Baseline steroid levels were all normal in female heterozygotes but in males 17α‐hydroxyprogesterone levels were elevated. After ACTH‐stimulation, plasma levels of corticosterone were elevated in five obligate heterozygotes and 18‐hydroxydeoxycorticosterone levels were increased in four of them. Two of the four siblings had biochemical signs of heterozygosity. The short ACTH test appears to be an efficient method for detecting heterozygosity, but the abnormalities found are more heterogeneous than previously suggested.
Differentiation between adsorbed and precipitated sulphate in soils and at micro‐sites of soil aggregates by sulphur K‐edge XANES
Authors: Prietzel J. , Thieme J. , Herre A. , Salomé M. , Eichert D. 
Published: March 2008

SummaryTo investigate the potential of synchrotron‐based X‐ray Absorption Near‐Edge Structure spectroscopy (XANES) at the sulphur (S) K‐edge for a discrimination of adsorbed and precipitated sulphate in soils and soil particles, XANES spectra of ionic sulphate compounds and Al/Fe hydroxy sulphate minerals were compared with spectra of SO42− adsorbed to ferrihydrite, goethite, haematite, gibbsite or allophane. Ionic sulphate and hydroxy sulphate precipitates had broader white‐lines (WL) at 2482.5 eV (full width at half maximum (FWHM) of edge‐normalized spectra, 2.4–4.2 eV; Al hydroxy sulphates, 3.0 eV) than SO42− adsorbed to Al/Fe oxyhydroxides or allophane (FWHM, 1.8–2.4 eV). The ratio of the white‐line (WL) height to the height of the post‐edge feature at 2499 eV (WL/PEF) was larger for SO42− adsorbed to Al/Fe oxyhydroxides or allophane (8.1–11.9) than for Al/Fe hydroxy sulphates and ionic sulphates (3.9–5.7). The WL/PEF ratio of edge‐normalized S K‐edge XANES spectra can be used to distinguish adsorbed from precipitated SO42− in soils and also at microsites of soil particles. The contribution of adsorbed and precipitated SO42− to the total SO42− pool can be roughly quantified. Adsorbed ester sulphate may result in overestimation of precipitated SO42−. The spectra of most soils could be fitted by linear combination fitting (LCF), yielding a similar partitioning between adsorbed and precipitated SO42− as an evaluation of the WL/PEF ratio. The SO42− pool of German forest soils on silicate parent material in most cases was strongly dominated by adsorbed SO42−; however, in three German forest soils subject to elevated atmospheric S deposition, a considerable portion of the SO42− pool was precipitated SO42−, most likely Al hydroxy sulphate. The same is true for Nicaraguan Eutric and Vitric Andosols subject to high volcanogenic S input. In the subsoil of the Vitric Andosol, adsorbed SO42− and Al hydroxy sulphate coexist on a micron scale.
Gravimetric study of a potential mineral deposit in the Itapororoca region, Brazil
Authors: Mantovani Marta S.M. , Shukowsky Wladimir , De Brito Neves B.B. , Rugenski André 
Published: March 2008

ABSTRACTA semi‐detailed gravity survey was carried out over an area of 650 km2 localized in the Eo‐Neoproterozoic coastal zone of Paraiba State where 548 new gravity stations were added to the existing database. Gravity measurements were made with a LaCoste and Romberg model G meter with a precision of 0.04 mGal. The altitude was determined by barometric levelling with a fixed base achieving a 1.2 m measure of uncertainty, corresponding to an overall accuracy of 0.24 mGal for the Bouguer anomaly. The residual Bouguer map for a 7th degree regional polynomial showed a circumscribed negative anomaly coincident with a localized aero‐magnetic anomaly and with hydro‐thermally altered outcrops, near the city of Itapororoca. The 3D gravity modelling, constrained by geologic mapping was interpreted as a low density, fractured and/or altered material with a most probable volume of approximately 23 km3, extending to about 8,500 m depth. This result is in accordance with a volcanic body associated with hydrothermal processes accompanied by surface mineralization evidence, which may be of interest to the mining industry.
Examination of the potential relationship between droughts, sulphate and dissolved organic carbon at a wetland‐draining stream
Authors: EIMERS M. CATHERINE , WATMOUGH SHAUN A. , BUTTLE JAMES M. , DILLON PETER J. 
Published: March 2008

AbstractRising dissolved organic carbon (DOC) concentrations observed at a number of sites in the northern hemisphere over recent decades are the subject of much debate, and recent reports suggest a link between DOC patterns in surface waters and changes in sulphate (SO4) related to droughts or deposition. In order to investigate the potential influence of changes in SO4 concentration on DOC patterns in south‐central Ontario, we used long‐term (1980–2001) stream monitoring data from a wetland‐dominated catchment (Plastic Lake‐1 subcatchment, PC1) that has been the focus of intensive investigations of both SO4 and DOC dynamics. Annual average volume‐weighted DOC concentration increased significantly between 1980 and 2001, whereas SO4 concentration declined, but the decrease was not significant due to large increases in SO4 that occurred during drought years. There was no relationship between SO4 and DOC in annual data series; however, seasonal analyses indicated significant negative correlations between SO4 and DOC concentrations in spring (March–April–May), summer (June–July–August) and fall (September–October–November). In spring, DOC concentration was negatively correlated with flow whereas SO4 concentrations increased with flow, and their opposing relationships with discharge explain the negative correlation between SO4 and DOC in this season. In summer and fall, low SO4 concentrations occur during periods of low flow as a result of microbial SO4 reduction, whereas correspondingly high DOC concentrations in the summer and fall can be attributed to optimal conditions (i.e. stagnant flow, warm temperatures) for DOC production in the wetland. Increases in SO4 (and acidity) following droughts were not associated with declines in DOC; instead the primary impact of droughts on DOC was to limit DOC export due to diminished stream flow. Rather than an acidification effect, we suggest that negative relationships between SO4 and DOC were either directly (spring) or indirectly (summer/fall) caused by underlying relationships with hydrology.
Differential and cell‐type specific regulation of responses to Toll‐like receptor agonists by ISO‐1
Authors: West Peter W. , Parker Lisa C. , Ward Jon R. , Sabroe Ian 
Published: March 2008

SummaryMacrophage migration inhibitory factor (MIF) plays vital roles in the regulation of responses to stimuli acting via Toll‐like receptor (TLR)‐4. Recently, a specific small molecule inhibitor of MIF (ISO‐1) has been described. We investigated the effects of ISO‐1 on TLR responses in primary human monocytes and monocyte‐derived macrophages (MDM). In monocytes, ISO‐1 caused marked suppression of TLR4‐induced proinflammatory cytokine production, and to a lesser extent suppression of TLR2‐induced responses. The lipopolysaccharide (LPS)‐induced activation of cocultures of monocytes and endothelial cells was strongly inhibited by ISO‐1. Suppression of monocyte TLR4 signalling by ISO‐1 was associated with alterations in extracellular signal‐related kinase (ERK)‐1/2 activation status. Previously, regulation of TLR4 signalling by MIF has been noted to be through control of TLR4 expression, but we observed that the actions of ISO‐1 were mediated without changes in cell surface TLR4 levels. In contrast, ISO‐1 pretreatment did not inhibit responses of MDM to LPS. ISO‐1 is a promising parent molecule which inhibits TLR‐induced ERK activation and inflammatory cytokine production in monocytes, whose role may be complicated by cell‐type specificity.
Patterns of ‘balancing between hope and despair’ in the diagnostic phase: a grounded theory study of patients on a gastroenterology ward
Authors: Giske Tove , Artinian Barbara 
Published: March 2008

AbstractTitle.  Patterns of ‘balancing between hope and despair’ in the diagnostic phase: a grounded theory study of patients on a gastroenterology ward Aim.  The aim of the study was to learn how patients going through the diagnostic phase experienced and handled their situation.Background.  Many studies report about the stressful diagnostic phase; however, none has presented a conceptual theory where the concepts are sufficiently related to each other. The Theory of Preparative Waiting has previously been published as a descriptive grounded theory and describes the experience of a group of gastroenterology patients going through the diagnostic phase.Method.  A classical grounded theory design was used, with data derived from 18 in‐depth interviews with 15 patients in a gastroenterology ward at a Norwegian University Hospital. Interviews were conducted during 2002–2003.Findings.  Participants’ main concern was found to be how they could prepare themselves for the concluding interview and life after diagnosis. The theoretical code of ‘balancing’ had four patterns; controlling pain, rational awaiting, denial, and accepting. These patterns of ‘balancing’ guided how participants used the categories of ‘Preparative Waiting Theory’‘seeking and giving information’, ‘interpreting clues’, ‘handling existential threats’ and ‘seeking respite’. Patterns were strategies, so one person could use more than one pattern.Conclusion.  The diagnostic phase was a difficult time for the participants and the ‘Preparative Waiting Theory’ can assist nurses in assessing how patients prepare themselves differently for getting a diagnosis. All patients would find it helpful to be followed up by a designated contact person at the ward; however, patients using mostly the patterns of controlling pain and denial would benefit most from such support.
Patients’ experiences of learning clean intermittent self‐catheterization: a qualitative study
Authors: Logan Karen , Shaw Chris , Webber Irene , Samuel Sandra , Broome Lynne 
Published: March 2008

AbstractTitle.  Patients’ experiences of learning clean intermittent self‐catheterization: a qualitative study Aim.  This paper is a report of a study to explore the experiences of learning to carry out clean intermittent self‐catheterization and user views of service provision.Background.  This treatment imposes a variety of challenges to users, both physical and emotional. Safety, infection rates and complications have been investigated, but the practicalities of learning and performing self‐catheterization have not been addressed. What is currently known about the topic from a user perspective is based on audit, small projects or anecdotal reports provided by continence advisers.Method.  In‐depth interviews were carried out in 2006 with eight men and seven women, aged 33–81 years (median 65), and carrying out self‐catheterization for a variety of reasons. A grounded theory framework was used.Findings.  Themes identified were psychological issues, physical problems and service interaction. The communication skills of nurses helped facilitate the learning experience. In conjunction with nurses’ skills, a friendly relaxed approach alleviated embarrassment and anxiety, thus facilitating information exchange and retention of information.Conclusion.  Adequate information and thorough instruction by healthcare professionals helps empower people to take control and master the treatment, with potential contribution to ongoing compliance and long‐term urinary tract health. Development of a policy supporting evidence‐based care and a consistent teaching programme is highly recommended for use where this treatment is regularly employed.
The qualitative content analysis process
Authors: Elo Satu , Kyngäs Helvi 
Published: March 2008

AbstractTitle.  The qualitative content analysis process Aim.  This paper is a description of inductive and deductive content analysis.Background.  Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method.Discussion.  When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge.Conclusion.  Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
Turnover intention in new graduate nurses: a multivariate analysis
Authors: Beecroft Pauline C. , Dorey Frederick , Wenten Madé 
Published: March 2008

AbstractTitle.  Turnover intention in new graduate nurses: a multivariate analysis Aim.  This paper is a report of a study to determine the relationship of new nurse turnover intent with individual characteristics, work environment variables and organizational factors and to compare new nurse turnover with actual turnover in the 18 months of employment following completion of a residency.Background.  Because of their influence on patient safety and health outcomes nurse turnover and turnover intent have received considerable attention worldwide. When nurse staffing is inadequate, especially during nursing shortages, unfavourable clinical outcomes have been documented.Method.  Prospective data collection took place from 1999 to 2006 with 889 new paediatric nurses who completed the same residency. Scores on study instruments were related to likelihood of turnover intent using logistic regression analysis models. Relationships between turnover intent and actual turnover were compared using Kaplan–Meier survivorship.Results.  The final model demonstrated that older respondents were more likely to have turnover intent if they did not get their ward choice. Also higher scores on work environment and organizational characteristics contributed to likelihood that the new nurse would not be in the turnover intent group. These factors distinguish a new nurse with turnover intent from one without 79% of the time. Increased seeking of social support was related to turnover intent and older new graduates were more likely to be in the turnover intent group if they did not get their ward choice.Conclusion.  When new graduate nurses are satisfied with their jobs and pay and feel committed to the organization, the odds against turnover intent decrease.
Clinical judgement and decision‐making in nursing – nine modes of practice in a revised cognitive continuum
Authors: Standing Mooi 
Published: March 2008

AbstractTitle. Clinical judgement and decision‐making in nursing – nine modes of practice in a revised cognitive continuumAim. This paper is a report of an evaluation of cognitive continuum theory and identification of revisions required for application to clinical judgement and decision‐making in nursing.Background. The importance of nurses’ developing and applying sound clinical judgement is reflected in an international classification of nursing practice. Cognitive continuum theory synthesizes rival and complementary approaches to decision theory in an accessible format, which has been applied in medicine, and various nursing scholars have advocated its use to enhance the effectiveness of nurses’ clinical judgement and decision‐making.Method. Parse’s structure and process criteria are applied in critiquing the relevance of cognitive continuum theory to nursing.Findings. Cognitive continuum theory illustrates how different judgement tasks are suited to different thought processes and how matching the two can optimize decision‐making. However, existing modes of inquiry applied to medicine emphasize experimental research, ignoring many alternative approaches used in nursing. A revised version of the cognitive continuum is developed, incorporating examples of nursing judgements and decisions, a broader evidence base, an ethical dimension, and evaluative competence criteria.Conclusion. The revised cognitive continuum promotes awareness of the nature and the variety of patient‐centred judgement tasks and decisions in nursing, how to select the most suitable intervention tactic from available options, and the fallibility of all forms of human judgement from intuitive/experiential to analytic/rational. Hence, it is recommended for use as an educational tool and practice guide to facilitate theory development and the practice of judgement and decision‐making in nursing.