bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of cyclophosphamide, adriamycin, vincristine, prednisone and rituximab in patients with human immunodeficiency virus‐associated diffuse large B‐cell lymphoma: results of a phase II trial
Authors: Ribera Josep‐Maria , Oriol Albert , Morgades Mireia , González‐Barca Eva , Miralles Pilar , López‐Guillermo Armando , Gardella Santiago , López Andres , Abella Eugenia , García Marta ,   on behalf of the PETHEMA, GELTAMO, GELCAB and GESIDA Groups
Published: May 2008

SummaryImmunochemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab (R‐CHOP) is the standard treatment in non‐immunosuppressed patients with diffuse large B‐cell lymphoma (DLBCL), but its adequacy has not been definitively established in patients with human immunodeficiency virus (HIV)‐related lymphoma. This phase II trial aimed to evaluate the safety and efficacy of six cycles of R‐CHOP in patients with HIV‐related DLBCL and to determine whether response to highly active antiretroviral therapy (HAART) had prognostic impact. Patients were eligible if they had performance status <3 and absence of active opportunistic infections. Eighty‐one patients were enrolled, 57 in stages III or IV, International Prognostic Index (IPI) 0 or 1 (n = 26), 2 (n = 19), 3 (n = 20) and 4 or 5 (n = 16), and median CD4 lymphocyte count of 0·158 × 109/l. The main adverse events were neutropenia (48% of cycles) and infections (10% of cycles), which were fatal in seven patients. Complete response was achieved in 55 (69%) patients, with an estimated 3‐year disease‐free survival of 77% and 3‐year overall survival of 56%. IPI score and virological response to HAART were the prognostic parameters for response and survival. In HIV‐related DLBCL R‐CHOP is feasible, safe and effective. The prognosis depends on lymphoma‐related parameters and on the response to HAART.
Intracranial haemorrhage in haemophilia A and B
Authors: Ljung Rolf C. R. 
Published: May 2008

SummaryIn countries with a good standard of health care, intracranial haemorrhage (ICH) during the neonatal period affects 3·5–4·0% of all haemophilia boys, which is considerably (40–80 times) higher than expected in the normal population. ICHs are also frequent after the neonatal period, affecting 3–10% of the haemophilia population who are mainly treated on demand. The risk is higher in inhibitor patients. Spontaneous haemorrhage is reported more frequently than trauma‐induced haemorrhage in most studies. The prevalence of ICH in patients treated with a prophylactic regimen is not known. Although more frequent in younger patients, a substantial proportion of ICH occur in adults, suggesting that general risk factors because of age, such as hypertension, are increasingly important as the haemophiliac gets older. Some studies have reported a substantial proportion of ICH affecting patients with milder forms of haemophilia. The risk of ICH has to be considered when discussing treatment strategies for haemophilia patients.
Down‐regulation of claudin‐2 in breast carcinomas is associated with advanced disease
Authors: Kim T H , Huh J H , Lee S , Kang H , Kim G I , An H J 
Published: May 2008

Aims:  Claudin 2 (CLDN2) is a family of integral membrane tight junctions. The aim was to determine the influence of CLDN2 expression on tumour behaviour and its role in breast carcinogenesis.Method and results:  Thirty‐seven invasive breast carcinomas and corresponding normal breast tissues were examined for CLDN2 protein and mRNA expression using Western blotting and semiquantitative reverse transcriptase‐polymerase chain reaction. The expression of CLDN2 protein in 118 cases of breast carcinoma was further studied with immunohistochemistry and related to various clinicopathological parameters. CLDN2 protein expression was significantly down‐regulated (0.4‐fold) in tumours compared with corresponding normal breast tissue (P < 0.0001). Down‐regulation of CLDN2 was significantly associated with lymph node metastasis (P = 0.047) by Western blot analysis, and with high clinical stage (P = 0.040) by immunohistochemistry. The expression levels of CLDN2 mRNA in high clinical stages (stages II and III) were lower than those in low clinical stage (stage I) and normal tissue, but not statistically significantly so.Conclusions:  These results suggest that CLDN2 is implicated in the progression as well as the development of breast carcinoma, indicating that CLDN2 is a possible tumour suppressor gene product.
A preliminary study on the technical feasibility and outcome of retrograde root canal treatment
Authors: Jonasson P. , Reit C. , Kvist T. 
Published: May 2008

AbstractAim  To investigate the technical feasibility and outcome of retrograde root canal treatment.Summary  Endodontic access cavity preparation in abutment teeth may jeopardize the retention of the coronal restoration leading to prosthodontic failure. In such cases leaving the crown intact and performing retrograde root canal treatment might be an alternative approach. The potential to promote healing with retrograde endodontic treatment, and the technical feasibility to shape, clean and fill the canal was evaluated retrospectively. The study consisted of 21 incisors, canines and premolar teeth followed‐up clinically and radiographically from 6 to 48 months. In 14 teeth the canals were completely negotiated. These cases were all judged as completely healed. In five cases no canal could be explored by files and a conventional ultrasonic root‐end preparation and filling was performed. Two of these were classified as completely healed and three as ‘uncertain’. In 2 two‐rooted premolars a combination was performed with complete instrumentation of the buccal canal and the ultrasonic root‐end preparation of the palatal root. One case was judged as a failure and the other was classified as completely healed. The results from this preliminary evaluation of retrograde root canal treatment are promising and merit a randomized clinical trial.Key learning points • Abutment teeth with vital pulps may develop pulp necrosis and apical periodontitis in 10% of cases.• Endodontic access preparation through an artificial crown may weaken its retention and jeopardize the longevity of a bridgework.• Retrograde root canal treatment is often feasible in maxillary teeth.• Results from this preliminary study suggest that treatment outcome for retrograde and orthograde root canal treatment is similar.
Mandibular bone necrosis caused by use of arsenic paste during endodontic treatment: two case reports
Authors: Yavuz M. S. , Şimşek Kaya G. , Yalçın E. , Aras M. H. 
Published: May 2008

AbstractAim  To report that arsenical pastes are still employed in endodontics and to highlight the potentially serious consequences of their use.Summary  Chemotherapeutic agents such as arsenic trioxide and paraformaldehyde were once commonly employed as pulp‐necrotizing agents. Their cytotoxic effects are well recognized, and leakage from teeth has been associated with widespread necrosis of periodontal tissues and bone. This report describes two cases of severe bone necrosis affecting the mandible following the use of an arsenical paste.Key learning points • Pulp‐necrotizing agents such as arsenic trioxide can cause severe bone necrosis.• Arsenical pastes have no place in contemporary dental practice.• Dentists should employ appropriate local anaesthetic techniques for pulp extirpation instead of relying on toxic necrotizing agents.
Characterization of human dental pulp‐derived cell lines
Authors: Suguro H. , Asano M. , Kaneko Y. , Omagari D. , Ogiso B. , Moro I. , Komiyama K. 
Published: May 2008

AbstractAim  To establish and characterize different types of fibroblastic cell lines derived from dental pulp tissue.Methodology  Human dental pulp tissue‐derived cells were transfected with SV40 large T antigen by Lipofectamine transfection method. Geneticin (G418)‐resistant cells were selected and different cell lines were established by a limiting dilution method. To characterize the lineages of cells, each clone was immunofluorescently stained by anti‐fibroblast, anti‐vimentin, anti‐collagen type I and type III antibodies. Total RNA was extracted from each clone and subjected to a differential display experiment.Results  By transfecting SV40 large T antigen, nine different cell clones were obtained. All these cell clones were positively stained by anti‐fibroblast, anti‐vimentin, anti‐collagen type I and type III antibodies. With differential display experiment, eight different genes, the expression levels of these genes were varied amongst each cell clone, were detected. After sequencing and database search, one gene was revealed to be identical to T‐cell marker, Thy‐1. Thy‐1 expression in dental pulp tissue was confirmed by immunohistochemical staining.Conclusion  Fibroblastic cell lines derived from human dental pulp tissue possessed different gene expression profiles suggesting the existence of subpopulations.
Euthanasia and assisted suicide in Dutch hospitals: the role of nurses
Authors: Van Bruchem‐van de Scheur GG , Van Der Arend Arie JG , Huijer Abu‐Saad Huda , Van Wijmen Frans CB , Spreeuwenberg Cor , Ter Meulen Ruud HJ 
Published: May 2008

Aim.  To report a study on the role of nurses in euthanasia and physician‐assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end‐of‐life decisions.Background.  Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician‐assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end‐of‐life decisions in hospitals, homecare and nursing homes.Method.  A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76·9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows.Results.  In almost half of the cases (45·1%), the nurse was the first with whom patients discussed their request for euthanasia or physician‐assisted suicide. Consultations between physicians and nurses quite often took place (78·8%). In several cases (15·4%), nurses themselves administered the euthanatics with or without a physician. It is not self‐evident that hospitals have guidelines concerning euthanasia/physician‐assisted suicide.Conclusions.  In the decision‐making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings.Relevance to clinical practice.  Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician‐assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician‐assisted suicide, especially in case these practices should become legalised.
What do mentors find difficult?
Authors: Moseley Laurence G , Davies Moira 
Published: May 2008

Aims.  (i) To assess whether mentors had a positive or negative attitude towards their role; and (ii) to discover what aspects of the role they found easy or difficult.Background.  The fact that mentorship is an important element in nurse training was recognized by Sir Leonard Peach, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting and the Nursing and Midwifery Council which has recently published new standards to support learning and assessment in practice, which include standards for the preparation of Mentors, to be implemented by September 2007. There are many anecdotal reports of the problems which face mentors, but little firm evidence.Method.  This paper reports a study of those problems. It used a Thurstone scale to assess role satisfaction among mentors (n = 86, response rate 89%) and two Likert scales to assess where problems, if any, lay.Results.  Unlike anecdotal reports, the Thurstone scale found that, overall, mentors regarded the role positively. In addition, a principal components analysis of responses to the Likert scales showed that there were two clearly delineated factors. The first (interpersonal/organisational factors) had been widely discussed in the literature. The second (cognitive/intellectual factors) has been rarely discussed and could with profit be more strongly stressed in mentor training.Conclusions.  (i) Mentors had a positive attitude towards their role and enjoyed it. (ii) When looking at what caused mentors difficulty, in addition to the commonly discussed dimensions of organisational constraints (workload, skill mix) and interpersonal factors, there was clearly an additional cognitive one. Knowledge, not just personality, mattered.Implications for clinical practice.  Mentors and those who train them could with profit pay more attention to cognitive components of the role, even if that meant laying a lesser stress on the interpersonal ones.
Pressure ulcers: e‐learning to improve classification by nurses and nursing students
Authors: Beeckman Dimitri , Schoonhoven Lisette , Boucqué Hilde , Van Maele Georges , Defloor Tom 
Published: May 2008

Aims and objectives.  To detect problems when classifying pressure ulcers and to examine whether an e‐learning program is able to increase the classification skills of qualified nurses and nursing students.Background.  Both the distinction between pressure ulcer grades and the differentiation between moisture lesions is difficult. Misclassification and incorrect identification of the lesions results in inadequate preventive and therapeutic measures. Education and training are important for spreading evidence‐based insights about this topic.Design.  Repeated measure design, consisting of one pretest and three posttests.Methods.  The experimental intervention consisted of a one‐hour session during which the participants independently went over an e‐learning program. The control intervention consisted of a one‐hour lecture. Both interventions had the same learning contents. A convenience sample of 212 qualified nurses and 214 final‐year nursing students was randomly assigned to an experimental‐and a control group.Results.  In the pretest, the classification skills were low. After the intervention, these skills improved significantly in both groups. The nursing students achieved better results when using the e‐learning program. Among the qualified nurses, there was no difference between the learning methods. Although the classification skills decreased in the posttests, they did not drop under the level of the pretest.Conclusion.  The actual classification system does not provide the necessary information about the severity of a pressure ulcer. The differential diagnosis between a moisture lesion was complicated. The classification skills of the qualified nurses and nursing students increased by both learning methods. Repetition remains, however, necessary.Relevance to clinical practice.  Both instruction methods are adequate to acquire the knowledge about the differences between moisture lesions and pressure ulcers. E‐learning allows studying in one's own time and place, and could therefore be very suitable for repetition of the training. How to organise this training could be a subject for further research.
Being there: parenting the child with acute lymphoblastic leukaemia
Authors: Kars Marijke C , Duijnstee Mia SH , Pool Aart , Van Delden Johannes JM , Grypdonck Mieke HF 
Published: May 2008

Aims and objectives.  To gain insight into the lived experience of parenting a child with leukaemia during treatment.Background.  Diagnosis of leukaemia in children leads to an existential shock for parents and a reversal of normal family life. Today, in the Netherlands, after diagnosis, children stay at home most of the time. Therefore, their parents face considerable responsibilities for administering home‐based treatment and for the support of their child during illness and treatment.Methods.  A grounded theory study was undertaken at a Dutch University Hospital and involved one‐time individual in‐depth interviews with 12 mothers and 11 fathers (n = 23) of 12 children.Findings.  ‘Being there’, was identified as the core concept. It means: ‘I’ll be there for you; I will never let you down’. ‘Being there’ is described as a parental response to the perceived vulnerability of the child and the parental need to give meaning to parenthood. It serves two purposes: protection and preservation. Protection means guarding the child against the negative aspects of illness and treatment. Preservation refers to the way parents influence the child’s perception of his/her life, thus contributing to his/her coping and willingness to undergo treatment, to maximise the chances for survival. Six aspects were identified: a trusting relationship, presence, emotional support, advocacy, routines and rituals and effacing oneself.Conclusions.  The concept provides a theoretical frame for parenting the child with cancer. It clarifies the actions and reactions of parents and increases insight into the underlying force that enables parents to provide continuing care despite their personal burden.Relevance to clinical practice.  The concept offers an essential insight into parenting the child with acute lymphoblastic leukaemia and has relevance for nursing practice and education. Understanding of the concept would improve the ability to understand, communicate and work pro‐actively in partnership with parents.
A systematic review of the effectiveness of in‐home community nurse led interventions for the mental health of older persons
Authors: Thompson Penelope , Lang Lyn , Annells Merilyn 
Published: May 2008

Aims and objectives.  The aim was to systematically review evidence about the effectiveness of in‐home community nurse‐led interventions for older persons with, or at risk of, mental health disorders, to inform best practice nursing care with this focus. The primary review question was ‘How effective are in‐home community nurse‐led interventions for older persons with or at risk of mental health disorders for improving mental health?’ The outcome indices of interest were nursing actions to determine incidence or prevalence of mental health disorders, any change in a patient’s attitude towards their mental health condition, any change in objective measurement of mental health, or a change in diagnostic status.Background.  The rising incidence of mental health disorders in older persons is a major concern for community nurses in developed countries. Effectively facilitating improved mental health for older persons is necessary in this era of ageing populations with increased demands on health funding. Disseminating systematically reviewed evidence for in‐home community nursing that positively impacts on the mental health of older persons is crucial to ensure effective care is provided to this vulnerable patient group.Results.  This review reveals that there is evidence to support the superiority of applying validated screening tools for mental health disorders over relying on community nurses’ opinions and non‐validated tools about this matter.Design.  Systematic review.Methods.  Search of electronic databases.Conclusion.  A clear need for replication and multi‐centre trials of reviewed pertinent studies is identified.Relevance to clinical practice.  Community nurses should consider using validated screening tools for this focus. Until such time as higher quality evidence is available about other nursing interventions, the reviewers suggest that the prime nursing action should be the identification of whether older persons receiving community nursing care might have a mental health disorder and, if so, then collaborative referral is made to appropriate services.
Lay food and health worker involvement in community nutrition and dietetics in England: definitions from the field
Authors: Kennedy L. A. , Milton B. , Bundred P. 
Published: May 2008

AbstractBackground  Community‐based food initiatives have developed in recent years with the aim of engaging previously ‘hard to reach’ groups. Lay workers engaged in community nutrition activities are promoted as a cost‐effective mechanism for reaching underserved groups. The primary objective of the study was to explore perceptions and definitions of lay helping within the context of National Health Service (NHS) community nutrition and dietetic services to identify existing terms and definitions and propose an overarching term.Methods  Interpretive qualitative inquiry; semi‐structured interviews with lay food and health worker (LFHW) and NHS professionals employed by community‐based programmes, serving ‘hard‐to‐reach’ neighbourhoods, across England.Results  In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Across all the projects, there was a preference for the use of one of two terms, either Community Food Worker or Community Nutrition Assistant, in reference to lay workers. There was no consensus in terms of a unifying term or definition for this new role.Conclusions  Current variation in the terms and definitions used for this role is problematic and is hindering development and effective utilization of lay helping within the broad remit of community food and health and dietetics. The umbrella term ‘Lay Food and Health Worker’ is proposed based upon definitions and interpretations from the field.
Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals
Authors: Kennedy L. A. , Milton B. , Bundred P. 
Published: May 2008

AbstractBackground  Community‐based food initiatives have developed in recent years with the aim of engaging previously ‘hard to reach’ groups. Lay workers engaged in community nutrition activities are promoted as a cost‐effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles.Methods  Interpretive qualitative inquiry; semi‐structured interviews with LFHW and NHS professionals employed by community‐based programmes, serving ‘hard‐to‐reach’ neighbourhoods, across England. A total sampling framework was used to capture all existing and ‘fully operational’ lay food initiatives in England at the commencement of fieldwork (January 2002).Findings  In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice.Conclusions  This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst ‘hard to reach’ communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.