bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low‐dose lactose in drugs neither increases breath hydrogen excretion nor causes gastrointestinal symptoms
Authors: MONTALTO M. , GALLO A. , SANTORO L. , D’ONOFRIO F. , CURIGLIANO V. , COVINO M. , CAMMAROTA G. , GRIECO A. , GASBARRINI A. , GASBARRINI G. 
Published: September 2008

SummaryBackground Despite the reported tolerance to a low dose of lactose, many lactose malabsorbers follow a rigorous lactose‐free diet also avoiding lactose‐containing drugs. Up to now, only a few case reports have described the onset of gastrointestinal symptoms in lactose malabsorbers following the ingestion of these drugs. It has been suggested that capsules/tablets contain no more than 400 mg of lactose.Aim To evaluate breath H2 excretion and intolerance symptoms after ingestion of a capsule containing 400 mg of lactose or placebo through a randomized, cross‐over, double‐blind, controlled study.Methods Seventy‐seven lactose maldigesters with intolerance underwent two H2 breath tests with both 400 mg of lactose and 400 mg of placebo. Gastrointestinal symptoms occurring in the 8 h following the ingestion of different substrates were evaluated by a visual‐analogue scale.Results Ingestion of 400 mg of lactose did not cause a significant difference in breath H2 excretion or in the severity of gastrointestinal symptoms compared to placebo.Conclusion In patients with lactase deficiency, drugs containing 400 mg of lactose or less can be used safely.
Clinical trial: effect of active lactic acid bacteria on mucosal barrier function in patients with diarrhoea‐predominant irritable bowel syndrome
Authors: ZENG J. , LI Y.‐Q. , ZUO X.‐L. , ZHEN Y.‐B. , YANG J. , LIU C.‐H. 
Published: September 2008

SummaryBackground  The intestinal permeability is increased in patients with diarrhoea‐predominant irritable bowel syndrome (D‐IBS).Aim  To determine the possible efficacy of lactic acid bacteria on the increased intestinal permeability in D‐IBS.Methods  Treatment was employed for 4 weeks in a randomized single blind placebo controlled study with 30 D‐IBS patients. Patients were given either probiotic fermented milk (Streptococcus thermophilus, Lactobacillus bulgaricus, Lactobacillus acidophilus and Bifidobacterium Longum) or milk beverage containing no bacteria. The clinical symptoms were scored and intestinal permeability was measured by a triple sugar test before and after treatment.Results  Small bowel permeability was measured as the ratio of lactulose and mannitol recovery and colonic permeability was measured as the total mass of sucralose excretion (mg). After probiotics treatment, small bowel permeability decreased significantly from 0.038 (0.024) at baseline to 0.023 (0.020) (P = 0.004), the proportion of patients with increased small bowel permeability was lower than baseline (28.6% vs. 64.3%, P = 0.023). However, colonic permeability improved neither in the probiotics group nor in the placebo group at week 4. Treatment with probiotics significantly decreased the mean global IBS scores compared with the baseline scores (9.62 ± 1.05 vs. 7.64 ± 1.24, P < 0.001).Conclusion  Short‐term active lactic acid bacteria treatment for D‐IBS improved mucosal barrier function.
The cost‐utility of high dose oral mesalazine for moderately active ulcerative colitis
Authors: BUCKLAND A. , BODGER K. 
Published: September 2008

SummaryBackground  Mesalazine (mesalamine) is standard first line treatment for moderately active ulcerative colitis (UC). Recently, doubling the mesalazine dose (Asacol 4.8 g/day) was shown to improve efficacy with no increase in adverse events. The cost‐effectiveness of this strategy remains unknown.Aim  To assess the cost‐utility of high dose (HD) mesalazine (Asacol 4.8 g/day) compared with standard dose (SD) mesalazine (Asacol 2.4 g/day) as first line treatment for moderately active UC.Methods  The costs and benefits associated with a treatment pathway beginning with HD or SD mesalazine were determined over 12 weeks using a decision tree analytical model.Results  A 12‐week treatment pathway starting with HD mesalazine cost an average of £2382 per patient compared with £2474 for SD mesalazine and generated 0.0016 more quality adjusted life years (QALYs). HD mesalazine dominated SD mesalazine, being both more effective and less costly. HD mesalazine treatment resulted in fewer patients requiring surgery or hospitalization for intensive pharmacological treatment. Probabilistic sensitivity analysis indicated a 72% chance that HD mesalazine was cost effective, based on a cost/QALY threshold of £30 000.Conclusions  This study suggests that HD mesalazine represents a cost‐effective alternative to SD mesalazine for moderately active UC, while potentially reducing the need for hospitalization.
Review article: pharmacological therapy for hepatocellular carcinoma with sorafenib and other oral agents
Authors: CHAPARRO M. , GONZÁLEZ MORENO L. , TRAPERO‐MARUGÁN M. , MEDINA J. , MORENO‐OTERO R. 
Published: September 2008

SummaryBackground  Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide. Unresectable disease patients have median survival of few months. There is a substantial need for novel treatments for patients with advanced HCC.Aim  To provide an update review of mechanism of hepatocarcinigenesis and systemic therapies for HCC and the relevant role of Sorafenib in patients with advanced disease.Methods  A Medline search was performed to identify pertinent original research and review articles. Selected references in these articles were also evaluated.Results  Systemic chemotherapy for HCC has been quite ineffective. Preclinical studies demonstrated that Raf/MAPK‐ERK kinase (MEK)/Extracellular signal regulated kinase (ERK) pathway has a role in HCC. HCC tumours are highly vascularized and vascular endothelial growth factor (VEGF) augments HCC development and metastasis. Sorafenib blocks tumour cell proliferation by targeting Raf/MEK/ERK signalling and exerts an antiangiogenic effect by targeting VEGF receptors‐2/3 and platelet derived growth factor receptor β tyrosine kinases.Conclusions  Currently available therapies are not effective for patients with advanced HCC. Sorafenib has demonstrated for the first time to prolong survival in patients with advanced HCC, and it is the new reference standard for systemic treatment in these patients.
Severe obstructive sleep apnoea exacerbates the microvascular impairment in very mild hypertensives
Authors: Nazzaro P. , Schirosi G. , Clemente R. , Battista L. , Serio G. , Boniello E. , Carratù P. L. , Lacedonia D. , Federico F. , Resta O. 
Published: September 2008

AbstractBackground  Different studies have shown that obstructive sleep apnoea syndrome (OSAS), frequently associated with hypertension, represents a harmful and independent risk for cardiovascular diseases. The aim of our study was to ascertain whether the occurrence of OSAS could worsen microcirculatory impairment in very mild hypertensives.Materials and methods  One hundred untreated very mild hypertensives underwent polysomnography and subdivided into 32 non‐OSAS, 33 mild OSAS and 35 severe OSAS patients on standardized criteria. They underwent routine blood chemistry, ambulatory blood pressure monitoring and anthropometric analysis. Skin capillary density (n mm−2) of forearm (FAC) and periungueal (PUC) fields was obtained through videocapillaroscopy. By a venous congestion manoeuvre, PUC was maximized (CVC) and secondary capillary recruitment (GAIN) was calculated. These measurements served as indices of structural and functional capillary rarefaction, respectively.Results  Severe OSAS hypertensives showed reduced FAC (P < 0·001) and PUC (P < 0·001) as compared to those with mild OSAS and non‐OSAS, but a greater CVC (P < 0·01) and GAIN (P < 0·001). Multiple regression analysis showed that PUC was inversely related to total sleep time with oxyhaemoglobin saturation at < 90% (TST90) (P < 0·001) and FAC to the apnoea‐hypopnoea index (AHI) (P < 0·001) and to the sleep propensity (P < 0·01). CVC was positively associated to AHI (P < 0·001) and GAIN to TST90 (P < 0·05).Conclusions  The findings suggest that OSAS, by means of reduced basal and functional capillarity rarefaction, might pose an additional risk of impaired peripheral perfusion in very mild hypertensives. A microcirculation studytherefore should be a part of the clinical approach in patients at high cerebro‐cardiovascular risk such as hypertensives and patients with OSAS.
Apoptotic effect of Helicobacter pylori on oesophageal squamous‐cell carcinoma cells in vitro
Authors: Wu I.‐C. , Wu M.‐T. , Chen Y.‐K. , Hsu M.‐C. , Chou S.‐H. , Lee C.‐H. , Shiea J.‐T. , Wu I.‐L. , Huang C.‐T. , Wu D.‐C. 
Published: September 2008

ABSTRACTBackbround  The relationship between Helicobacter pylori (Hp) infection and oesophageal squamous‐cell carcinoma (ESCC) risk is still inconclusive. Our previous study found an inverse association between the two, but its mechanism is still unknown. Thus, we conducted in vitro studies to clarify the issue.Materials and methods  One ESCC (CE 81T/VGH) cell line was co‐cultured with Hp, using one gastric adenocarcinoma (AGS) cell line as the control. Hp–induced cell apoptosis was determined by flow cytometry, terminal transferase‐mediated dUTP nick end labelling (TUNEL) assay and staining; caspase‐3 protein expressions in cell lysates were detected by Western immunoblot.Results  Increased apoptosis was found in CE 81T/VGH, but not in AGS cells, by flow cytometry and TUNEL assay after being co‐cultured with Hp at the multiplicity of infection of 1/100 (but not at 1/400) for 36 h. The amount of activated caspase‐3 (17/19 kDa) also increased in CE 81T/VGH, but not in AGS cells, after co‐culturing with Hp at MOI of 1/100 for 36 h. The results were confirmed by triplicate experiments in which the different apoptotic assays remained consistent.Conclusions  Our study provides indirect evidence of the inverse association between Hp infection and ESCC risk, which is possibly due to Hp‐induced apoptosis in ESCC cells. A further in vivo study is necessary to confirm our findings.
Effect of weight loss on markers of triglyceride‐rich lipoprotein metabolism in the metabolic syndrome
Authors: Chan D. C. , Watts G. F. , Ng T. W. K. , Yamashita S. , Barrett P. H. R. 
Published: September 2008

ABSTRACTBackgroud  Hypertriglyceridaemia, a consistent feature of dyslipidaemia in the metabolic syndrome (MetS), is related to the extent of abdominal fat mass and altered adipocytokine secretion. We determined the effect of weight loss by dietary restriction on markers of triglyceride‐rich lipoprotein (TRL) metabolism and plasma adipocytokines.Design  Thirty‐five men with MetS participated in a 16 week randomized controlled dietary intervention study. Apolipoprotein (apo) C‐III, apoB‐48, remnant‐like particle (RLP)‐cholesterol, total adiponectin, high‐molecular weight (HMW) adiponectin, and retinol‐binding protein‐4 (RBP‐4) concentrations were measured using immunoassays.Results  Compared with weight maintenance (n = 15), weight loss (n = 20) significantly decreased body weight, plasma insulin, triglycerides, total cholesterol, low‐density lipoprotein (LDL)‐cholesterol and lathosterol (P < 0·05). Weight loss also decreased plasma concentrations of apoC‐III (–33%), apoB‐48 (–37%), very low‐density lipoprotein (VLDL)‐apoB (–43%), RLP‐cholesterol (–48%), and RBP‐4 (–20%), and significantly increased plasma total (+20%) and HMW‐adiponectin (+19%) concentrations. In the weight loss group, reduction in plasma apoC‐III was associated (P < 0·05) with reduction in plasma apoB‐48, VLDL‐apoB, RLP‐cholesterol and triglycerides. Increase in total adiponectin was associated (P < 0·05) with the reduction in plasma VLDL‐apoB and triglycerides. The changes in HMW‐adiponectin and RBP‐4 were not associated with changes in plasma apoB‐48, apoC‐III, VLDL‐apoB, RLP‐cholesterol or triglycerides. In multiple regression analysis including changes in visceral fat, insulin and total adiponectin concentrations, the fall in plasma apoC‐III concentration was an independent predictor of the reductions in plasma apoB‐48, VLDL‐apoB, RLP‐cholesterol and triglycerides concentrations.Conclusions  In men with MetS, weight loss decreases the plasma concentrations of apoB‐48, VLDL‐apoB, RLP‐cholesterol and triglycerides. This effect could partly relate to concomitant changes in plasma apoC‐III and adiponectin concentrations that accelerate the catabolism of TRLs.
A clinically relevant major cross‐reactive allergen from mesquite tree pollen
Authors: Dhyani A. , Singh B. P. , Arora N. , Jain V. K. , Sridhara S. 
Published: September 2008

ABSTRACTBackground  Prosopis juliflora (mesquite) is one of the major sources of pollinosis in tropical and semi‐arid countries of the world. The present study was undertaken to purify and characterize a major cross‐reactive allergen from this tree species.Materials and methods  Mesquite pollen extract was purified using reverse‐phase chromatography. Allergen characterization was done by electrophoresis, enzyme‐linked immunosorbent assay (ELISA) and Western blotting. Clinical relevance of the purified protein was analyzed by in vivo (skin tests) and in vitro experiments such as ELISA, histamine release, peripheral blood mononuclear cells (PBMC) proliferation and cytokine assays. Cross‐reactivity of purified protein with allergenic tree species and lima bean (food) was assessed by inhibition assays.Results  A 66‐kDa protein was purified from mesquite pollen extract using octadecyl silica resin. Purified protein recognized 90% of mesquite‐sensitized patients in skin test and ELISA. It induced significant histamine release in allergic patients’ blood and interleukin‐4 secretion in the PBMC culture supernatants. Inhibition assays suggested close allergenic relationship of this protein with Ailanthus excelsa, Cassia siamea, Salvadora persica pollen and Phaseolus lunatus (lima bean – an edible legume).Conclusions  A 66‐kDa major cross‐reactive allergen was isolated from mesquite pollen using single‐step purification procedure. The protein seems relevant for clinical applications in allergic disorders.
Nuclear receptors, transcription factors linking lipid metabolism and immunity: the case of peroxisome proliferator‐activated receptor gamma
Authors: Varga T. , Nagy L. 
Published: September 2008

ABSTRACTExposure to lipids has a major effect on mammalian cells. Naturally, it has a profound impact on their metabolism, but it can also significantly alter their cellular and molecular phenotypes and responses. This latter is via specific signalling pathways leading to alterations in the expression of genes and gene networks. Multicellular organisms utilize a specialized group of proteins to detect and transduce lipid signals to the level of the expression of the genome. These proteins, termed nuclear hormone receptors, are lipid‐activated transcription factors regulating gene expression upon binding of small fatty ligands. In this review, we discuss the role and contribution of peroxisome proliferator‐activated receptor gamma (PPARγ) to macrophage and dendritic cell biology and also to gut epithelial cell function. We discuss how using different experimental systems and approaches the pathways activating the receptor and its target genes can be identified and complex biological processes unravelled. It appears that PPARγ is part of the macrophage's response to pathogenic lipoproteins and it coordinately regulates lipid uptake and efflux. Intriguingly, in another cell type of the immune system, dendritic cells, the receptor has overlapping, but distinct functions. In these cells, activation of PPARγ leads to altered immune phenotype characterized by increased phagocytic capacity, antigen processing and lipid antigen presenting capacity. This nuclear hormone receptor links lipid metabolism and immune cell function and these links provide unique insights into the regulatory logic of normal physiological responses and certain pathologies, such as atherosclerosis, chronic inflammatory diseases and autoimmunity.
Matrix metalloproteinase 2 improves the transplanted adipocyte survival in mice
Authors: Kuramochi D. , Unoki H. , Bujo H. , Kubota Y. , Jiang M. , Rikihisa N. , Udagawa A. , Yoshimoto S. , Ichinose M. , Saito Y. 
Published: September 2008

AbstractBackground  Fat tissue is a common material for autologous transplantation in plastic and reconstructive surgery. Basic fibroblast growth factor (bFGF) ameliorates the fat graft survival. A transplantation model has shown the gene expression of matrix metalloproteinases (MMPs) to increase in adipocytes. The aim of this study is to investigate the role of MMPs in the amelioration of survival by bFGF.Materials and methods  3T3‐L1 adipocytes were incubated with or without 10 µg mL−1 bFGF for 8 h in the presence or absence of the MMP inhibitor GM6001, vascular endothelial growth factor (VEGF), MMP‐2 or anti‐bFGF antibody to study the effect of bFGF on MMP‐2 mRNA expression, MMP‐2 activity, fat accumulation or 2‐deoxyglucose uptake. Collagen sheets containing l × l07 adipocytes with or without bFGF in the presence or absence of GM6001 were subcutaneously transplanted into mice, and the appearance, histology, mRNA expression and fat accumulation of the grafts were analysed 4 weeks after transplantation.Results  The MMP‐2 expression was drastically induced by bFGF among MMPs in 3T3‐L1 adipocytes. MMP‐2 accelerated fat accumulation, peroxisome proliferator‐activated receptor gamma (PPARγ) mRNA expression, and glucose uptake to an extent similar to those induced by bFGF, respectively. The bFGF‐induced increases were inhibited by the blocking of MMP‐2. The transplantation of adipocytes into mice showed that bFGF ameliorates the appearance and fat accumulation, as well as mRNA expression in grafts. These effects were almost or partly inhibited by a MMP blockade.Conclusions  MMP‐2 may be involved in the mechanism by which bFGF ameliorates the survival of fat grafts.
Self‐reported competence of home nursing staff in Finland
Authors: Grönroos Eija , Perälä Marja‐Leena 
Published: September 2008

AbstractTitle.  Self‐reported competence of home nursing staff in Finland. Aim.  This paper is a report of a study to investigate the self‐reported competence of home nursing staff and whether this is associated with their education, job descriptions, access to help and support and with factors in their psychosocial work environment, such as opportunities for personal growth and development at work.Background.  Home nursing staff face increasing demands on their competence. Advances in information technology and working methods have increased the need for education. Thus, information on the factors associated with the competence of home nursing staff help us to support them in a way that improves the quality of care.Method.  The data were gathered via a questionnaire completed in 2003 by the home nursing staff of 24 municipalities in different regions of Finland. A total of 2366 home care staff (response rate 63%), of whom 790 were home nursing staff (response rate 65%), were sent questionnaires. Univariate and multivariate logistic regression were used as main statistical methods.Findings.  The best predictors for self‐reported competence of home nursing staff were their reading scientific or professional journals, opportunities for skill development, decision‐making latitude and work demands.Conclusion.  Simple and practical ways for updating the competence of home nursing staff should be created. These staff are a very important source of information for home care clients. Supporting the knowledge of home nursing staff is also an efficient way of keeping clients and their informal caregivers informed about care guidelines, health and social services and social benefits.
Education for new role development: the Community Matron in England
Authors: Girot Elizabeth A. , Rickaby Caroline E. 
Published: September 2008

AbstractTitle.  Education for new role development: the Community Matron in England. Aim.  This paper is a report of an evaluation of the English national pilot education programme preparing Community Matrons to fulfil their role.Background.  Investment in community services has been important in introducing new ways of working in the United Kingdom National Health Service, particularly for patients with complex long‐term conditions. Development of the Community Matron role in England is an exemplar in the creation of modern nursing careers that are fit for purpose.Method.  A mixed methods approach to data collection was adopted. This included documentary analysis of a range of sources used in the development and evaluation of the programme. In addition, during 2006, a self‐administered questionnaire was sent to all Community Matrons undertaking the programme (n = 70), with a response rate of 67% (n = 47). Individual telephone interviews were conducted with 17 students and six mentors. A focus group was also undertaken with the education programme Development Team (n = 5). Quantitative data were analysed using SPSS and qualitative data analysed using content and thematic analyses.Findings.  The majority of students (n = 25) believed that the programme had met their expectations and had helped them to achieve the functions of the Community Matron role as defined in national competence statements. However, 17 students experienced difficulties in the level of organisational readiness to support them in their role, including, for example, lack of facilitation of their work‐based learning.Conclusion.  In spite of the successful programme design, there is a need for organisations to develop their infrastructure to support new roles as well as offering protected time to learn in practice.
Complexity Prediction Instrument to detect ‘complex cases’ in respiratory wards: instrument development
Authors: Lobo Elena , Rabanaque Maria‐Jose , De Jonge Peter , Barcones Maria‐Fe , Cazcarra Rosa‐Ana , Huyse Frits J. , Lobo Antonio 
Published: September 2008

AbstractTitle.  Complexity Prediction Instrument to detect ‘complex cases’ in respiratory wards: instrument development. Aim.  This paper is a report of a study to test the hypothesis that the Spanish version of the Complexity Prediction Instrument is a reliable and valid measure of complexity of patients with respiratory disease and to identify the frequency of positive indicators of potential complexity.Background.  Respiratory patients are often disabled and severely ill, with co‐morbid physical conditions and associated psychosocial problems and need complex nursing care.Method.  Trained nurses assessed 299 consecutive adult patients admitted to a respiratory service in Spain from May 2003 until June 2004 with the new, Spanish version of the instrument. Criterion‐related validity was tested by studying its ability to predict complexity of care in terms of: severity of illness, scored using the Cumulative Illness Rating Scale; length of hospital stay; ‘multiple consultations’ during admission; and ‘multiple specialists’ after discharge.Findings.  The hypothesis was supported: patients rating above the standard cut‐off point on the Complexity Prediction Instrument scored statistically significantly higher on most of the measures of care complexity studied. Linear regression models showed that the tool was associated with ‘length of hospital stay’, and predicted both ‘multiple consultations’ and ‘multiple specialists’, after controlling for potential confounders. The proportion of ‘probable complex cases’ was 59·5%. Five positive indicators of potential complexity had a frequency higher than 50%.Conclusion.  The Complexity Prediction Instrument is reliable and valid in a new clinical area, respiratory disease. It may be used by nurses for the early prediction of complexity of care. International comparisons may be facilitated with this new Spanish version.