bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of capsaicin in loin pain‐haematuria syndrome
Authors: Uzoh Christopher C. , Kumar Vivekanandan , Timoney Anthony G. 
Published: August 2008

OBJECTIVETo highlight the implications of the use of capsaicin in managing loin pain‐haematuria syndrome (LPHS).PATIENTS AND METHODSBetween February 2002 and February 2007, three patients (one male and two females; mean age 31.7 years) with LPHS were managed with capsaicin and followed up for a period of 8–48 months. All were diagnosed with LPHS after negative urological investigations including urine culture, urine cytology, renal tract ultrasonography, intravenous urography and flexible cystoscopy; and nephrological work‐ups including normal blood pressure measurements, creatinine clearance, urinary protein estimation and serum urea/creatinine.Five original papers were reviewed in detail for this article. Including our own experience, a total of 52 (including five bilateral) cases of LPHS treated with capsaicin are reviewed.RESULTSOur patients received a total of four capsaicin instillations producing an average duration of pain relief per instillation of 17 weeks. There was evidence of renal deterioration in one, while another had worsened symptoms. The third patient continued his pain management within the pain clinic. The former two patients eventually underwent nephrectomy for poor function and extreme symptoms.CONCLUSIONIntrarenal capsaicin at best produces only short‐term pain relief in more than half of patients with LPHS. It produces significant side‐effects, i.e. UTI, bladder pain, and in up to half of patients, deteriorating symptoms. Further loss of functional renal tissue and a nephrectomy rate of 20–67% should be weighed against the benefits. We have therefore abandoned its use in treating LPHS or renal pain, and recommend that patients should be adequately counselled on its potential side‐effects, including nephrotoxicity and increased nephrectomy rate.
Signal transduction pathways of muscarinic receptor mediated activation in the newborn and adult mouse urinary bladder
Authors: Ekman Mari , Andersson Karl‐Erik , Arner Anders 
Published: August 2008

OBJECTIVETo study the role of M2and M3muscarinic receptor subtypes, sources of activator Ca2+, and mechanisms involved in increased force oscillations in muscarinic contractions in the bladders of newborn and adult mice, as in the adult bladder muscarinic M3receptors are considered to mediate the main part of bladder contraction, and this has not been established in the newborn bladder.MATERIALS AND METHODSBladder preparations from newborn (0–2 days) and adult (10–12 weeks) mice were mounted forin vitroforce registration and activated with carbachol and high‐K+solution in the presence of M3(4‐DAMP 30 nm) or M2(methoctramine, 100 nm) receptor antagonists. Thapsigargin (1 µm) or ryanodine (10 µm) were used to inhibit sarcoplasmic reticulum Ca2+release. L‐NAME (300 µm) and 1H‐[1,2,4]oxadiazolo[4,3‐a]quinoxalin‐1‐one (ODQ; 10 µm) were used to inhibit nitric oxide synthase and guanylyl cyclase, respectively. Gap‐junction function was inhibited with by 18‐β‐glycyrrhetinic acid (18‐β‐GA; 0.1–100 µm). Big‐conductance (BK) and small‐conductance (SK) K+channels were inhibited by apamine and charybdotoxin (0.3 µm), respectively.RESULTSConcentration–response relations for carbachol in the presence of 4‐DAMP and methoctramine showed that M3receptors are the main activating pathway also in the newborn bladder. Neither thapsigargin nor ryanodine influenced the muscarinic responses of the newborn and adult bladders. Carbachol‐induced contractions were not influenced by L‐NAME or ODQ. The 18‐β‐GA inhibited carbachol‐induced contractions in both newborn and adult tissue in a similar manner. Apamine and charybdotoxin slightly increased the amplitude of the contractile responses.CONCLUSIONThese results suggest that in the newborn mouse bladder, as in adult bladders, the M3muscarinic receptor subtype is mainly responsible for carbachol‐induced contractile responses. The main mechanism for muscarinic receptor‐induced activation is influx of Ca2+from the extracellular medium, and there seems to be no major contribution of Ca2+release from intracellular stores. The phasic contractile activity induced by carbachol in the newborn bladder is not influenced by gap junction inhibition and does not involve SK and BK channels.
Slovenian midwives' and nurses' views on post‐natal depression: an exploratory study
Authors: Mivšek A.P. , Hundley V. , Kiger A. 
Published: August 2008

Background:  Post‐natal depression affects approximately 10–15% of women. The literature suggests that midwives and nurses are key professionals in dealing with post‐natal mood disorders. However, this would be a new role in Slovenia for which it is not clear whether midwives and nurses are prepared.Aim:  This study explored Slovenian midwives' and nurses' knowledge of, and attitudes towards, post‐natal mood disorders.Methods:  Two focus groups were conducted, each with five participants, working in the maternity hospital and in the community centre in Postojna.Findings:  Data were grouped into three main themes – knowledge of post‐natal mental health disorders, role in the management of these issues, and perceived problems and possible solutions in the health care of post‐natally depressed women. Participants lacked knowledge on post‐natal mental health and did not consider its management to be their role. They saw the main obstacle to caring for these women as being a lack of continuity of carer.Conclusion:  Slovenian midwives and nurses should be appropriately educated regarding this subject in order to become more capable of managing post‐natal mental health. Continuous relationships with women should be encouraged.Limitations:  Further investigation is required and a questionnaire survey involving a larger sample of midwives and community nurses is planned on the basis of the findings of this study.
Causes and management of nursing practice errors: a questionnaire survey of hospital nurses in Iran
Authors: Anoosheh M. , Ahmadi F. , Faghihzadeh S. , Vaismoradi M. 
Published: August 2008

Background:  Some human error in health care is inevitable. Research into the predisposing factors for these errors is an important step in their management.Aim:  To survey nurse perceptions of the contributing factors to nursing practice errors.Methods:  A descriptive survey was carried out in three selected educational hospitals in Tehran city. Data were collected by questionnaire and analysed using descriptive statistics. The study sample consisted of 96 nurses and nursing managers. A multistage sampling strategy was used.Results:  Results showed that from nurses' and nursing managers' perspectives, various factors could contribute to the occurrence of nursing errors in the ‘management’, ‘environment’ and ‘nursing care’ sections. In addition, there were differences between nurses working on various wards about the causes of nursing errors in each section.Conclusion:  A culture of safety recognizes that safety is ‘no accident’. Rather, it requires a change in management practices, providing a suitable environment with the requisite supply of resources and infrastructure, and increasing nurses' knowledge. Outcomes that are identified from the process of practice error management should promote interventions designed to prevent future practice errors based on the above contributing factors.Limitations:  The study relied on self‐report by a sample of nurses. These responses should now be tested by empirical research into actual nursing practice errors in order to test whether the nurses' perceived ideas of causation are substantiated.
Discourses associated with nursing aged people who are dying in the Australian context: a review of the literature
Authors: Allen S. , Chapman Y. , O'Connor M. , Francis K. 
Published: August 2008

Aim: To examine the discourses associated with nursing care of aged people who are dying in the Australian context.Background: The discourses associated with nursing aged people who are dying are not universally understood, and there is confusion regarding the meaning of terminology used to describe specific nursing practices in the aged care setting in Australia.Methods: A literature search was undertaken to identify nursing practices and the discourses associated with nursing aged people who are dying in the Australian context. Words used in the literature to describe practices related to nursing care of the dying were distilled, and a search of the Cummulative Index to Nursing and Allied Health Literature (CINAHL) database using this vocabulary was undertaken to explicate the meanings associated with specific terminology.Findings: The review of literature highlighted a plethora of nursing practices related to caring for people who are aged and dying. Hospice care, palliative care, terminal care, end‐of‐life care and a palliative approach are terms used to describe specific practices associated with nursing people who are dying. These terms have distinct meanings; however, they are often used interchangeably in aged care settings adding to confusion and the potential for compromised nursing practice standards.Implications for practice: Understanding the terminology associated with nursing practice provided to people who are aged and dying allows the profession to engage in dialogue that is universally understood. Dialogue allows for rigorous debate, research and ultimately the evolution of nursing practice, improved outcomes for this group and the avoidance of unnecessary legal challenge to individual and institutional practice standards.Conclusion: The terminology associated with the provision of care to the aged who are dying is reflective of the broader healthcare discourse focused on dying and death. Shared agreement about this terminology will avoid unnecessary litigation resulting from misunderstanding of the discourses that describe and define practice and enhance health outcomes for the aged dying and their families and/or significant others.
Audit of patients with type 2 diabetes following a critical cardiac event
Authors: Wu C.‐J. (Jo) , Chang A.M. 
Published: August 2008

Background:  Evidence indicates that type 2 diabetes leads to complications such as a cardiac event, which often requires admission to a coronary care unit (CCU). Although there is a considerable body of knowledge about the management and characteristics of people with type 2 diabetes and myocardial infraction, there are few reports of the disease and demographic characteristics of the entire group of patients with diabetes admitted to a CCU.Purpose:  To gain greater understanding of the characteristics of patients with diabetes hospitalized for a critical cardiac event in order to assist in the development of an appropriate self‐management programme for CCU patients with diabetes.Methods:  Data were collected retrospectively from computerized records and charts of all patients with diabetes admitted to the CCU from 1 January 2000 to 31 December 2003.Findings:  The proportion of type 2 diabetic patients admitted to CCU with a critical cardiac event over the 4‐year study period was consistent at 14.7%, 233 in 1589 patients. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days compared with only 6% of CCU patients without diabetes. Predictors for readmission and length of stay were also examined.Conclusions:  A considerable proportion of a CCU population had type 2 diabetes and these patients had significantly higher readmission rates. The implications of this study for the development of a self‐management programme for patients with diabetes who experienced a critical cardiac event are discussed.Implications for practice:  Innovative programmes are required to reduce the rate of readmission for patients with both diabetes and a critical cardiac event. These should: 1 ensure transition programmes, such as self‐management, commence within the CCU environment and continue following discharge, and 2 integrate diabetes and cardiac self‐management programmes to condense the large amount of information provided to patients for managing two serious conditions.
Nurse migration: the effects on nursing education
Authors: Hancock P.K. 
Published: August 2008

This paper is an opinion piece based on experience and supported where possible with literature, which addresses an issue of both national and international interest. It focuses on one aspect of the multifaceted social phenomenon of nurse migration, i.e. nurse education.Background:  Much has been written about the direct effects of nurse migration on the nurse migrant, the delivery of health care in the countries that supply the nurses, and the countries that receive them. However, there is little information regarding the direct effects of migration on nurse education within the literature.Aim:  The aim of this paper is to raise awareness of the positive and negative effects of nurse migration on nurse education both in the countries that supply nurses and those which receive them.Methods:  Both scholarly and ‘grey’ literature is used to support the discussion on the ‘real’ challenges faced by nurse educators and clinical nurses in those countries that supply or receive nurses. In addition, practical recommendations for nurse educators are presented. Furthermore, the nursing profession is challenged to become politically active, to become involved and to take responsibility for the decisions made about nurse education in order to protect the integrity of nurse education and patient safety.Conclusion:  The quality of nurse education in many countries has been undermined as a result of rapid, mass migration. There is an urgent need to take practical steps to maintain the integrity of nurse education and the nurse's preparation for practice in order to protect patients' safety.
Does concept‐mapping strategy work for everyone? The levels of generativity and learners' self‐regulated learning skills
Authors: Lim Kyu Yon , Lee Hyeon Woo , Grabowski Barbara 
Published: August 2008

AbstractThe purpose of this study was to examine the effect of concept‐mapping strategies with three different generativity levels (expert‐generated concept map, partially learner‐generated concept map, fully learner‐generated concept map) on knowledge acquisition. Interaction between learners' self‐regulated learning (SRL) skills and different levels of generativity was also tested. One hundred twenty‐four undergraduate students, randomly assigned to three different concept‐mapping groups, were differentiated by high and low levels of SRL skills. The findings suggest that the participants in the fully learner‐generated map group significantly outperformed the participants in the expert‐generated map group, and participants with high SRL skills significantly outperformed those with low SRL skills across all treatment levels.
The blood‐cerebrospinal fluid barrier is a major pathway of cerebral creatinine clearance: involvement of transporter‐mediated process
Authors: Tachikawa Masanori , Kasai Yasuyuki , Takahashi Masato , Fujinawa Jun , Kitaichi Kiyoyuki , Terasaki Tetsuya , Hosoya Ken‐ichi 
Published: August 2008

AbstractThere is still incomplete evidence for the cerebral clearance of creatinine (CTN) which is an endogenous convulsant and accumulates in the brain and CSF of patients with renal failure. The purpose of this study was to clarify the transporter‐mediated CTN efflux transport from the brain/CSF.In vivodata demonstrated that CTN after intracerebral administration was not significantly eliminated from the brain across the blood‐brain barrier. In contrast, the elimination clearance of CTN from the CSF was 60‐fold greater than that of inulin, reflecting CSF bulk flow. Even in renal failure model rats, the increasing ratio of the CTN concentration in the CSF was lower than that in the plasma, suggesting a significant role for the CSF‐to‐blood efflux process. The inhibitory effects of inhibitors and antisense oligonucleotides on CTN uptake by isolated choroid plexus indicated the involvement of rat organic cation transporter 3 (rOCT3) and creatine transporter (CRT) in CTN transport. rOCT3‐ and CRT‐mediated low‐affinity CTN transport withKmvalues of 47.7 and 52.0 mM, respectively. Our findings suggest that CTN is eliminated from the CSF across the blood‐CSF barrier as a major pathway of cerebral CTN clearance and transporter‐mediated processes are involved in the CTN transport in the choroid plexus.
Effects of γ‐secretase cleavage‐region mutations on APP processing and Aβ formation: interpretation with sequential cleavage and α‐helical model
Authors: Tan Jianxin , Mao Guozhang , Cui Mei‐Zhen , Kang Shin‐Chung , Lamb Bruce , Wong Boon‐Seng , Sy Man‐Sun , Xu Xuemin 
Published: August 2008

AbstractOverwhelming evidence supports the amyloid hypothesis of Alzheimer’s disease that stipulates that the relative level of the 42 amino acid β‐amyloid peptide (Aβ42) in relationship to Aβ40 is critical to the pathogenesis of the disease. While it is clear that the multi‐subunit gamma secretase is responsible for cleavage of the amyloid precursor protein (APP) into Aβ42 and Aβ40, the exact molecular mechanisms regulating the production of the various Aβ species remain elusive. To elucidate the underlying mechanisms, we replaced individual amino acid residues from positions 43 to 52 of Aβ with phenylalanine to examine the effects on the production of Aβ40 and Aβ42. All mutants, except for V50F, resulted in a decrease in total Aβ with a more prominent reduction in Aβ for residues 45, 48, and 51, following an every three residue repetition pattern. In addition, the mutations with the strongest reductions in total Aβ had the largest increases in the ratio of Aβ42/Aβ40. Curiously, the T43F, V44F, and T48F mutations caused a striking decrease in the accumulation of membrane bound Aβ46, albeit by a different mechanism. Our data suggest that initial cleavage of APP at the ε site is crucial in the generation of Aβ. The implicated sequential cleavage and an α‐helical model may lead to a better understanding of the γ‐secretase‐mediated APP processing and may also provide useful information for therapy and drug design aimed at altering Aβ production.
DNA polymerase β‐catalyzed‐PCNA independent long patch base excision repair synthesis: a mechanism for repair of oxidatively damaged DNA ends in post‐mitotic brain
Authors: Wei Wei , Englander Ella W. 
Published: August 2008

AbstractOxidative DNA damage incidental to normal respiratory metabolism poses a particular threat to genomes of highly metabolic‐long lived cells. We show that post‐mitotic brain has capacity to repair oxidatively damaged DNA ends, which are targets of the long patch (LP) base excision repair (BER) subpathway. LP‐BER relies, in part, on proteins associated with DNA replication, including proliferating cell nuclear antigen and is inherent to proliferating cells. Nonetheless, repair products are generated with brain extracts, albeit at slow rates, in the case of 5′‐DNA ends modeled with tetrahydrofuran (THF). THF at this position is refractory to DNA polymerase β 5′‐deoxyribose 5‐phosphate lyase activity and drives repair into the LP‐BER subpathway. Comparison of repair of 5′‐THF‐blocked termini in the post‐mitotic rat brain and proliferative intestinal mucosa, revealed that in mucosa, resolution of damaged 5′‐termini is accompanied by formation of larger repair products. In contrast, adducts targeted by the single nucleotide BER are proficiently repaired with both extracts. Our findings reveal mechanistic differences in BER processes selective for the brain versus proliferative tissues. The differences highlight the physiological relevance of the recently proposed ‘Hit and Run’ mechanism of alternating cleavage/synthesis steps, in the proliferating cell nuclear antigen‐independent LP‐BER process.
Leptin protects hippocampal CA1 neurons against ischemic injury
Authors: Zhang Feng , Chen Jun 
Published: August 2008

AbstractLeptin is an adipose hormone with well characterized roles in regulating food intake and energy balance. A novel neuroprotective role for leptin has recently been discovered; however, the underlying mechanisms are not clearly defined. The purpose of this study was to determine whether leptin protects against delayed neuronal cell death in hippocampal CA1 following transient global cerebral ischemia in rats and to study the signaling mechanism responsible for the neuroprotective effects of leptin. Leptin receptor antagonist, protein kinase inhibitors and western blots were used to assess the molecular signaling events that were altered by leptin after ischemia. The results revealed that intracerebral ventricle infusion of leptin markedly increased the numbers of survival CA1 neurons in a dose‐dependent manner. Infusion of a specific leptin antagonist 10 min prior to transient global ischemia abolished the pro‐survival effects of leptin, indicating the essential role of leptin receptors in mediating this neuroprotection. Both the Akt and extracellular signal‐related kinase 1/2 (ERK1/2) signaling pathways appear to play a critical role in leptin neuroprotection, as leptin infusion increased the phosphorylation of Akt and ERK1/2 in CA1. Furthermore, pharmacological inhibition of either pathway compromised the neuroprotective effects of leptin. Taken together, the results suggest that leptin protects against delayed ischemic neuronal death in the hippocampal CA1 by maintaining the pro‐survival states of Akt and ERK1/2 MAPK signaling pathways.
Multiple organ dysfunction syndrome pathogenesis and care: a complex systems’ theory perspective
Authors: Papathanassoglou Elizabeth DE , Bozas Evangelos , Giannakopoulou Margarita D 
Published: August 2008

AbstractAims and objectives:  To discuss multiple organ dysfunction syndrome (MODS) from a complex systems’ theory perspective and to delineate a conceptual framework for the development and care of MODS.Background:  MODS is an intricate and devastating manifestation of critical illness characterized by widespread aberrant molecular, cellular and systemic responses.Design and methods:  Narrative literature review (MEDLINE, CINAHL databases) and knowledge synthesis with the theoretical assertions of chaos and complex systems’ theory. Cellular and systemic response paradoxes in MODS (including cellular hypoxia, cell death and signalling) are reviewed.Results:  The diseased person is depicted as a complex adaptive system. The relevancy of some of the principles of complex chaotic systems’ theory to the proposed model is illustrated, including sensitive dependence on initial conditions, emergence, attractors, self‐organization, self‐organized criticality and emerging order. The transition from life‐supporting to death‐related organismic responses is illustrated as a critical event in MODS and care implications are drawn.Conclusions:  Patient responses in MODS appear to conform to the principles of chaotic systems. Death is illustrated not as a consequence of homeostatic failure but as a ‘deliberate’ self‐organized phenomenon entailing multiple dynamically evolving mechanisms.Relevance to clinical practice:  Some of the principles of chaotic complex systems may need to be taken into account to advance care in MODS. An alternative theoretical perspective may support nurses to conceptualize both MODS and their role in a way that will help them to cope better with this devastating syndrome and develop practice.