bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of cognitive-behavioural, person-centred and psychodynamic therapies as practised in UK National Health Service settings
Authors: STILES WILLIAM B. , BARKHAM MICHAEL , TWIGG ELSPETH , MELLOR-CLARK JOHN , COOPER MICK 
Published: February 2006

Background. Psychotherapy's equivalence paradox is that treatments have equivalently positive outcomes despite non-equivalent theories and techniques. We compared the outcomes of contrasting approaches practised in routine care.Method. Patients (n=1309) who received cognitive-behavioural therapy (CBT), person-centred therapy (PCT) and psychodynamic therapy (PDT) at one of 58 National Health Service (NHS) primary and secondary care sites in the UK during a 3-year period completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. Therapists indicated which treatment approaches were used on an End of Therapy form. We compared outcomes of six groups: three treated with CBT, PCT or PDT only, and three treated with one of these plus one additional approach (e.g. integrative, supportive, art), designated CBT+1, PCT+1 or PDT+1 respectively.Results. All six groups averaged marked improvement (pre–post effect size=1·36). Treatment approach and degree of purity (‘only’ vs. ‘+1’) each accounted for statistically significant but comparatively tiny proportions of the variance in CORE-OM scores (respectively 1% and 0·5% as much as pre–post change). Distributions of change scores were largely overlapping.Conclusions. Results for these three treatment approaches as practised routinely across a range of NHS settings were generally consistent with previous findings that theoretically different approaches tend to have equivalent outcomes. Caution is warranted because of limited treatment specification, non-random assignment, lack of a control group, missing data and other issues.
Is alcopop consumption in Switzerland associated with riskier drinking patterns and more alcohol‐related problems?
Authors: Wicki Matthias , Gmel Gerhard , Kuntsche Emmanuel , Rehm Jürgen , Grichting Esther 
Published: February 2006

ABSTRACTObjectives To examine (a) whether consumers of alcopops compared to consumers of other alcoholic beverages but not alcopops have riskier drinking patterns and more alcohol‐related consequences (e.g. truancy, scuffles, problems with parents) and (b) whether the amount of alcopops consumed is associated independently with risky drinking patterns and alcohol‐related consequences over and above those associated with the amount of other alcoholic beverages consumed.Sample As part of the ESPAD international study, a cross‐sectional national representative sample of 5444 drinkers aged 13–16 years was interviewed by means of an anonymous, self‐report questionnaire administered in a classroom setting.Results Earlier initiation of consumption, more frequent risky single occasion drinking (RSOD), and a higher likelihood of negative consequences for consumers than for non‐consumers of alcopops were due mainly to higher overall consumption. Other alcoholic beverages had similar effects, and whether the same amount of alcohol was consumed as alcopops or as any conventional alcoholic beverage made no difference.Conclusions Alcopops in Switzerland do not seem to be linked to specific riskier drinking patterns or consequencesper se. Like all alcoholic beverages, they add to the problems caused by drinking and seem to be consumed in addition to conventional alcoholic beverages without replacing them. As the alcohol industry will continue to launch new beverages, prevention targeting alcohol consumption in general might be more effective than focusing on new beverages only.
Bioinformatic analysis of expressed sequence tags derived from a compatible Alternaria brassicicola–Brassica oleracea interaction
Authors: CRAMER ROBERT A. , LA ROTA C. MAURICIO , CHO YANGRAE , THON MICHAEL , CRAVEN KELLY D. , KNUDSON DENNIS L. , MITCHELL THOMAS K. , LAWRENCE CHRISTOPHER B. 
Published: February 2006

SUMMARY Alternaria brassicicola is a necrotrophic fungal pathogen that causes black spot disease on members of the Brassicaceae plant family. In order to identify candidate fungal pathogenicity genes and characterize a compatible host response, a suppression subtractive hybridization (SSH) cDNA library enriched for A. brassicicola and Brassica oleracea genes expressed during the interaction was created, along with a fungal cDNA library representing genes expressed during nitrogen starvation (NS). A total of 3749 and 2352 expressed sequence tags (ESTs) were assembled into 2834 and 1264 unisequence sets for the SSH and NS libraries, respectively. We compared two methods to identify the origins (plant vs. fungal) of ESTs in the SSH library using different classification procedures, with and without the availability of a database representing the A. brassicicola whole genome sequence and Brassicaceae‐specific genes. BLASTX analyses of the 2834 unisequence set using the GenBank non‐redundant database identified 114 fungal genes. Further BLASTN analyses of the genes with unidentifiable origin using a database consisting of the 1264 fungal unisequence set from the nitrogen‐starved library identified 94 additional fungal genes. By contrast, BLASTN analyses of the same SSH unisequence set using a partially assembled A. brassicicola whole genome draft sequence identified a total of 310 unisequenes of fungal origin. Our results indicated that even a small number of organism‐specific EST sequences can be very helpful to identify pathogen genes in a library derived from infected tissue, partially overcoming the limitation of the public databases for little studied organisms. However, using the whole genome draft sequence of A. brassicicola we were able to identify approximately 30% more fungal genes in the SSH library than without utilizing this resource. The putative role of specific fungal and plant genes identified in this study in a compatible interaction is discussed.
The effects of changing temperature correction factors on measures of acidity calculated from gastric and oesophageal pH recordings
Authors: GARDNER J. D. , YOUNG W. , SLOAN S. , ROBINSON M. , MINER P. B. 
Published: February 2006

SummaryBackground  Recently, Medtronic notified customers that new correction factors should be used for their Slimline and Zinetics24 single‐use, internal‐standard pH catheters.Aim and Methods  We selected 24‐h recordings of oesophageal and gastric pH with the Zinetics24 from our archives for five healthy subjects and for five gastro‐oesophageal reflux disease subjects who were studied at baseline and again after 8 days of treatment with a proton‐pump inhibitor. All pH values obtained with the old correction factors were rescaled using the new correction factors. Values for median pH, integrated acidity and time pH ≤ 4 were then calculated from pH values with old and new correction factors.Results  The new correction factors changed values for median pH, integrated acidity and time pH ≤ 4. Values for median pH and integrated acidity changed in a predictable, proportionate way, whereas values for time pH ≤ 4 did not.Conclusions  The new correction factors will not change the interpretation of previously published results with median pH or integrated acidity. In contrast, values for time ≤4 cannot be converted in an obvious way with the new correction factors. Instead, the raw pH data will need to be rescaled and values for time pH ≤ 4 recalculated using the rescaled pH data.
Systematic review: adherence issues in the treatment of ulcerative colitis
Authors: KANE S. V. 
Published: February 2006

SummaryUlcerative colitis is a chronic inflammatory and debilitating disease requiring lifelong treatment. First‐line therapy for ulcerative colitis is 5‐aminosalicylic acid, which suffers from poor patient adherence outside the clinical trial setting.Formulations to deliver 5‐aminosalicylic acid to the disease activity site, both orally and topically, are often inconvenient and require multiple daily dosing. Such regimens can interfere with normal life and reduce the overall quality of life, negatively impacting on treatment adherence and leading to poorer long‐term outcomes. These include increased morbidity with an elevated risk of symptomatic relapse, possible greater risk of colorectal cancer and higher overall costs of care.Ulcerative colitis patients cite treatment regimen complexity, tablet quantity and dose frequency as key negative influencers of adherence. Solutions to these issues include addressing patient concerns, simplifying daily regimens and utilizing new formulations such as micropellet and multimatrix oral formulations, rectal gel and once‐daily suppository formulations.This review examines the prevalence and impact of non‐adherence to 5‐aminosalicylic acid therapy among patients with ulcerative colitis, as well as drug delivery strategies that may enhance dosing regimens to improve patient acceptability, adherence and long‐term clinical outcomes. It is a combination of understanding patient behaviour, recognizing signs of non‐adherent behaviour and utilizing management strategies to change behaviour that will improve patient outcomes.
Primary care physician perceptions of non‐steroidal anti‐inflammatory drug and aspirin‐associated toxicity: results of a national survey
Authors: CHEY W. D. , ESWAREN S. , HOWDEN C. W. , INADOMI J. M. , FENDRICK A. M. , SCHEIMAN J. M. 
Published: February 2006

SummaryAim  To assess primary care physician perceptions of non‐steroidal anti‐inflammatory drug (NSAID) and aspirin‐associated toxicity.Methods  A group of gastroenterologists and internal medicine physicians created a survey, which was administered via the Internet to a large number of primary care physicians from across the US.Results  One thousand primary care physicians participated. Almost one‐third of primary care physicians recommended 325 mg rather than 81 mg of aspirin/day for cardioprotection. Fifty‐nine percent thought enteric‐coated or buffered aspirin reduced the risk of upper gastrointestinal (GI) bleeding. Seventy‐six percent believed that Helicobacter pylori infection increased the risk of NSAID ulcers but fewer than 25% tested NSAID users for this infection. More than two‐thirds were aware that aspirin co‐therapy decreased the GI safety benefits of the cyclo‐oxygenase 2 selective NSAIDs. However, 84% felt that aspirin with a cyclo‐oxygenase 2 selective NSAID was safer than aspirin with a non‐selective NSAID. When presented a patient at high risk for NSAID‐related GI toxicity, almost 50% of primary care physicians recommended a proton pump inhibitor and cyclo‐oxygenase 2 selective NSAID.Conclusions  This survey has identified areas of misinformation regarding the risk–benefit of NSAIDs and aspirin and the utilization of gastroprotective strategies. Further education on NSAIDs for primary care physicians is warranted.
Comparative study of characteristics and disease management between subjects with frequent and occasional gastro‐oesophageal reflux symptoms
Authors: BRETAGNE J. F. , HONNORAT C. , RICHARD‐MOLARD B. , CAEKAERT A. , BARTHÉLEMY P. 
Published: February 2006

SummaryBackground  Little is known about the distinctive characteristics of subjects with frequent (at least weekly) and occasional gastro‐oesophageal reflux symptoms.Aim  To compare the characteristics and disease management of subjects complaining of at least weekly and less frequent gastro‐oesophageal reflux symptoms.Methods  Population‐based postal survey carried out in France in 2003 among a representative sample of 8000 subjects.Results  The prevalence of frequent and occasional gastro‐oesophageal reflux symptoms was 7.8% and 23.4%, respectively. Compared to subjects with occasional gastro‐oesophageal reflux symptoms, those with frequent symptoms were older, suffered from more severe symptoms and felt greater impact on daily living, despite a slightly shorter duration of symptoms. These subjects more often sought medical advice. Most of them had treated the last episode of symptoms primarily with a proton‐pump inhibitor and less often with antacids/alginates. The degree of treatment satisfaction was lower in subjects with frequent gastro‐oesophageal reflux symptoms, in relation to a more frequently observed persistence of symptoms irrespective of the medication used except for proton‐pump inhibitors.Conclusions  This survey suggests that subjects complaining of frequent or occasional gastro‐oesophageal reflux symptoms constitute two distinctive groups. Despite greater healthcare use, the former group shows a lower level of satisfaction with disease management. Nevertheless, a substantial subset of subjects with occasional symptoms also complained of impaired health‐related quality of life and sought health care.
Anaesthetic implications of uterine artery embolisation in management of massive obstetric haemorrhage
Authors: Sundaram R. , Brown A. G. , Koteeswaran S. K. , Urquhart G. 
Published: February 2006

SummaryThe latest triennial report on maternal deaths has recommended the consideration of uterine artery embolisation in management of cases of massive obstetric haemorrhage. We have been using interventional radiology to manage both expected and unanticipated postpartum bleeding in our centre. Three case reports are presented to highlight the value of this technique and issues relating to the anaesthetic and postoperative management of these patients are discussed.
Effect‐site targeted patient‐controlled sedation with propofol: comparison with anaesthetist administration for colonoscopy
Authors: Stonell C. A. , Leslie K. , Absalom A. R. 
Published: February 2006

SummaryPatient‐controlled sedation (PCS) allows patients to match their sedation requirement to perceived discomfort. The significant delay in onset of sedation may be overcome with effect‐site steered target controlled infusion, but previously only trials in volunteers have been carried out. We therefore conducted a randomised, double‐blind controlled trial comparing effect‐site steered propofol PCS with anaesthetist‐administered propofol sedation in 40 patients presenting for colonoscopy. The initial effect‐site target in the PCS group was 0.8 μg.ml−1, increment was 0.1 μg.ml−1 and lockout was 3 min. Patient and endoscopist satisfaction and operating conditions were similar between the two groups. PCS patients were sedated more slowly (13 [7.1] vs. 3 [1.1] min; p < 0.0001) and less deeply (minimum BIS value: 71 [16] vs. 58 [15]; p = 0.13) than anaesthetist‐administered propofol sedation patients. More of the latter patients were hypotensive, but all patients had similar recollection of events during the procedure and similar quality of recovery.
Paediatric caudal extradural catheterisation: an evaluation of a purpose designed equipment set
Authors: Bhandal N. , Rogers R. , Berg S. , Mason D. G. 
Published: February 2006

SummaryUsing a purpose designed set of equipment, the Caudal Extradural Catheter Tray, Oxford Set (B Braun Medical Ltd, Sheffield, UK) we have evaluated the ease of cannulation of the caudal space, and the subsequent success in threading extradural catheters and obtaining satisfactory analgesia via the caudal route. The set was evaluated in 91 children (age range: 1 day to 10 years). Cannulation of the caudal space was achieved in all patients, and catheterisation of the extradural space was successful in 96.7% of patients. Postoperative analgesia was satisfactory in 95% of children who had continuous extradural analgesia. There were no major complications or neurological sequelae associated with using the set. We found the Caudal Extradural Catheter Tray provides the necessary equipment to perform extradural anaesthesia and analgesia safely and successfully in children of a wide age range.
Use of a gum elastic bougie to facilitate blind nasotracheal intubation in children: a series of three cases
Authors: Arora M. K. , Karamchandani K. , Trikha A. 
Published: February 2006

SummaryManagement of a difficult paediatric airway is challenging, and the unavailability of a paediatric fibreoptic bronchoscope, a common limitation in developing countries, adds to these difficulties. Children with bilateral temporomandibular joint ankylosis have limited mouth opening and therefore direct laryngoscopy and intubation is not usually possible. In the absence of sophisticated fibreoptic equipment, blind nasal intubation remains the only non‐surgical option for control of the airway. Blind nasal intubation in paediatric anaesthesia is difficult. We describe a novel method of blind nasal intubation in paediatric patients using a gum elastic bougie. We have used this method successfully in three patients in whom tracheal intubation using a conventional blind nasal approach was unsuccessful. In view of its reliability and the absence of any soft tissue injury, we propose the use of this novel technique as an alternative to conventional blind nasal intubation, when more sophisticated fibreoptic equipment is not available.
Ciprofibrate increases paraoxonase activity in patients with metabolic syndrome
Authors: Paragh György , Seres Ildikó , Harangi Mariann , Erdei Annamária , Audikovszky Mária , Debreczeni Lóránd , Kovácsay Anna , Illyés László , Pados Gyula 
Published: February 2006

AimsDiabetic dyslipidaemia with decreased high‐density lipoprotein‐cholesterol (HDL‐C) concentration plays a key role in enhanced atherosclerosis. The antioxidant effect of HDL is due to the influence of human paraoxonase 1 (PON1) and several authors have described decreased activity of this enzyme in Type 2 diabetics and subjects with metabolic syndrome. The goal of this study was to examine the effect of daily ciprofibrate on serum PON1 and lipoprotein concentrations in patients with metabolic syndrome.MethodsFifty‐one patients with metabolic syndrome were enrolled into the study. We examined the effect of 100 mg day−1 ciprofibrate treatment on lipid concentrations, oxidized low‐density lipoprotein (LDL), PON1 concentrations and activity. We also investigated the calculated size of LDL‐cholesterol (LDL‐C).ResultsDuring the 3‐month study, it was observed that following treatment with ciprofibrate, the serum triglyceride concentration decreased significantly (from 2.76 ± 0.9 mmol l−1 to 2.27 ± 1.6 mmol l−1; −18%; P < 0.001), while HDL‐C increased significantly (from 0.95 ± 0.2 mmol l−1 to 1.2 ± 0.3 mmol l−1; 26%; P < 0.001). The oxidatively modified LDL‐C concentration decreased significantly (from 137 ± 19 U l−1 to 117 ± 20 U l−1; P < 0.001), while HDL‐associated apolipoprotein A1 significantly increased (from 1.35 ± 0.2 g l−1 to 1.75 ± 0.3 g l−1; P < 0.001). The LDL‐C/LDL‐apoB ratio, which reflects the size of LDL, increased significantly (from 0.96 ± 0.05 to 1.05 ± 0.06; P < 0.05). Serum PON1 activity was significantly elevated (from 108 ± 34 U l−1 to 129 ± 31 U l−1; P < 0.05), while standardized values for HDL‐C remained significantly unchanged (PON1/HDL‐C) (from 114 ± 21 to 107 ± 20; NS).ConclusionThree months of treatment with ciprofibrate favourably affected the lipid profile, increased LDL resistance to oxidation and improved antioxidant status by increasing serum paraoxonase activity in these patients.
Comparison of the pharmacokinetics, pharmacodynamics and tolerability of tezosentan between caucasian and Japanese subjects
Authors: Dingemanse Jasper , Gunawardena Kulasiri A. , van Giersbergen Paul L. M. 
Published: February 2006

AimTo investigate the pharmacokinetics, pharmacodynamics and tolerability of the dual endothelin receptor antagonist tezosentan in caucasian and Japanese subjects.MethodsTwelve subjects of each ethnic origin were treated in a double‐blind, randomized design with sequential 3‐h infusions of 2.5, 5.0, 12.5 and 25 mg h−1, or placebo. Vital signs, ECG and adverse events were recorded and blood samples collected for determination of plasma concentrations of tezosentan and endothelin‐1 (ET‐1).ResultsTezosentan was well tolerated in both ethnic groups with no clinically significant differences in laboratory measurements, ECG parameters and vital signs. The plasma concentration–time profiles of tezosentan were described by a three‐compartment model with half‐lives of approximately 5 min, 41 min and 3.6 h. Mean clearance and volume of distribution were approximately 35 l h−1 and 20 l, respectively. Differences in the means (95% confidence intervals) between ethnic groups in these two parameters were 6.0 l h−1 (−1.3, 13.3) and 4.3 l (−1.3, 9.9), respectively. Baseline ET‐1 concentrations were similar but increases in response to tezosentan were greater in caucasian than in Japanese subjects. An indirect response model described the relationship between tezosentan and ET‐1 plasma concentrations. The mean concentrations inhibiting 50% of ET‐1 clearance (IC50) in caucasian and Japanese subjects were 243 and 227 ng ml−1, respectively, with a difference in the means of 28.6 ng ml−1 (−52.7, 110).ConclusionsThe data in healthy subjects suggest that caucasian and Japanese patients can be treated with a similar dosing regimen of tezosentan.
Induction of P‐glycoprotein in lymphocytes by carbamazepine and rifampicin: the role of nuclear hormone response elements
Authors: Owen Andrew , Goldring Chris , Morgan Paul , Park B. Kevin , Pirmohamed Munir 
Published: February 2006

AimsCarbamazepine (CBZ) is an inducer of cytochrome P450 enzymes, which have been implicated in many drug interactions. However, for immunosuppressant and anti‐HIV drugs, whose main site of action is the lymphocyte, induction of P‐glycoprotein (Pgp) may also be important. In this study, we have investigated whether CBZ acts as an inducer of Pgp in lymphocytes.MethodsPgp expression was assessed by flow cytometry and real‐time reverse transcriptase‐polymerase chain reaction using lymphocytes from four healthy subjects after incubation with therapeutic concentrations of CBZ, using rifampicin as a positive control. Binding to DR‐4 elements in theMDR1promoter was assessed by electrophoretic mobility shift assay (EMSA) and a luciferase‐reporter construct.ResultsCBZ increasedMDR1mRNA expression at 6 h by 3.7‐fold [95% confidence interval (CI) 0, 7.6) when compared with controls. CBZ increased lymphocyte Pgp expression at 72 h by 7.6‐fold (95% CI 2.1, 13.2) over control values. EMSA revealed a 2.1‐fold (95% CI 1.5, 2.7) increased binding to the DR‐4 element of CBZ when compared with control values. Activation of the DR‐4 element was confirmed using reporter constructs. Rifampicin also had similar effects in all experiments.ConclusionsCarbamazepine induces Pgp in a manner comparable to rifampicin, by increasing binding to the DR4 element. This has implications for interactions involving drugs whose site of action is the lymphocyte.