bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of the clinical characteristics of dying cancer patients on informal caregivers' satisfaction with palliative care
Authors: Fakhoury Walid KH , McCarthy Mark , Addington-Hall Julia 
Published: November 2007

To assess associations between informal caregivers' satisfaction with services delivered to their dying cancer patients and their perceptions of the duration of functional limitation and the duration of various symptoms experienced by these patients, a secondary analysis was conducted on a subsample of the Regional Study of Care for the Dying (RSCD). The RSCD is a retrospective interview survey of family members or others who knew about the last year of life of a random sample of people who died in 20 health districts in the UK in 1990. The subsample consisted of 1858 informal caregivers of people who died from cancer (ICD codes 140-208). More than half (52%) of informal caregivers were highly satisfied with community nurses, compared to 39% and 35% of those who reported high satisfaction with services provided by general practitioners and hospital doctors respectively. Informal caregivers of patients who died from a lymphatic or haematopoietic tissue cancer were more likely than others to report high satisfaction with hospital doctors (47%), while least satisfaction was reported by those who cared for patients who had a neoplasm of the genito-urinary or respiratory/intrathoracic organs (30%). The duration of pain was not significantly related to any of the satisfaction measures. The results suggest the need to take patient clinical characteristics into account in population-based evaluations of palliative care. They also indicate the need for more research to be carried out to assess the reasons behind the dissatisfaction of informal caregivers of patients with respiratory or genito-urinary cancers with services provided by hospital doctors and to detect whether these patients have unmet needs that should be addressed. More research is also needed into the management of symptoms by the general practitioners, especially symptoms pertaining to respiration and incontinence.
HIV infection: the spectrum of symptoms and disease in male and female patients attending a London hospice
Authors: Kelleher Peter , Cox Sarah , McKeogh Maeve 
Published: November 2007

To delineate the demographic features and clinical profile of male and female individuals utilizing a respite, rehabilitation and hospice centre in London, a retrospective study of patient notes was undertaken. The subjects were 59 male and 59 female HIV patients at first admission to the hospice. The study revealed clinically important differences between men and women and also identified special problems for African women and intravenous drug users. Women experienced more constipation, headache and musculoskeletal pain than men. Men suffered more neuropathic pain and visual loss. Lower respiratory tract infections were more common in women, especially in those with a history of injection drug use. Gynaecological morbidity was common. There was no difference in AIDS diagnoses between men and women. HIV encephalopathy developed in 23% of the cohort during the follow-up period which has implications for provider units. There are increasing numbers of HIV-positive women and injection drug users being referred for palliative care services. Multidisciplinary teams should be aware of the particular symptom profile of these groups.
Drug combinations in syringe drivers: the compatibility and stability of diamorphine with cyclizine and haloperidol
Authors: Grassby Paul F , Hutchings Lynne 
Published: November 2007

The compatibility and stability of 28 combinations of diamorphine hydrochloride (5-100 mg/ml) with cyclizine lactate (5-50 mg/ml), eight combinations of diamorphine (10-100 mg/ml) with haloperidol (2-4 mg/ml) and eight combinations of all three drugs was assessed after storage in 1 ml polypropylene syringes. Samples were stored for periods up to seven days in the light and at room temperature (22°C). Five combinations of diamorphine with cyclizine precipitated immediately upon preparation. After analysis and determination of t90% values (the time taken for 10% degradation), 16 of the remaining 23 combinations were judged to be compatible (no signs of crystallization or precipitation) and stable (less than 10% loss of potency of either drug) after storage for 24 h. After seven days storage only four remained compatible and stable. The results indicate that ratios of diamorphine to cyclizine of 1:1 are stable at concentrations up to 20 mg/ml. An increase in diamorphine concentration necessitates a reduction in cyclizine to 10 mg/ml, and an increase in cyclizine concentration necessitates a reduction in concentration of diamorphine to 15 mg/ml to maintain stability over 24 h. All the combinations of diamorphine with haloperidol remained compatible and stable for seven days. The addition of haloperidol (2 mg/ml) to the diamorphine and cyclizine combinations had no detrimental effect on their compatibility and stability. A stability curve is included as an easy way for palliative care personnel to avoid potential problems with incompatibilities and reduced stability when using these combinations. Furthermore, to reduce the possibility of precipitation with mixtures containing cyclizine, the use of 0.9% sodium chloride should be avoided.
Is it cancer or not?
Authors: Johnson MJ , Adam JS 
Published: November 2007

Two cases are reviewed in whom a positive bone scan led to a diagnosis of metastatic bone disease and hospice referral. One of these was subsequently shown on magnetic resonance image (MRI) scanning to have benign metabolic bone disease; in the other, a repeat bone scan 18 months later confirmed benign pathology. The potential impact on patient and family in these situations is considerable and the usefulness of MRI in distinguishing benign from malignant bone disease is discussed.
Difficulty of symptom control and general practitioners' knowledge of patients' symptoms
Authors: Grande GE , Barclay Sig , Todd CJ 
Published: November 2007

The purpose of this study was to investigate barriers to adequate symptom control in palliative care within primary care by surveying health professionals' perceptions of their ability to control symptoms and awareness of their patients' symptoms. General practitioners (GPs) and district nurses were surveyed about general views of symptom control. Interviews with terminally ill patients were conducted, and GPs completed questionnaires about these specific patients. GPs and district nurses differed greatly in the symptoms they felt confident in controlling. There was generally low agreement between patients' and GP's reports of patients' symptoms. GPs were most likely to miss symptoms which were perceived to be difficult to control and which were less prevalent in the patient sample. As GPs and district nurses differ in the symptoms they feel confident in controlling, close teamwork between the two professions may enhance the prospects for adequate control of some symptoms. Perceived ability to control symptoms and the prevalence of symptoms may both influence which symptoms come to the attention of the GP Unless GPs ask directly about symptoms, many symptoms are likely to be missed.
Organic matter in tropical soils: current conditions, concerns and prospects for conservation
Authors: Ross Sheila M. 
Published: November 2007

Soil organic matter (SOM) plays a central role in maintaining tropical soil fertility. Its conservation and maintenance in tropical cultivation systems is imperative if soil degradation is to be halted and cropping made sustainable. Around 22-23% of global carbon is present in tropical ecosystems but only 2-3% of this is present in the soil. Fluxes of CO2 to the atmosphere from tropical soils after deforestation contributes to the greenhouse effect and could represent a 1-4% increase in the overall steady-state annual CO2 release to the atmosphere. The composition of SOM is extremely diverse, with active, or labile, fractions decomposing in a matter of months while the more resistant, or nonlabile, fractions remain in soil for many years. SOM plays a central role in providing good soil structure, in supplying nutrients and in providing ion exchange capacity in tropical soils. Organic matter decomposition rates in tropical soils are generally faster than in temperate soils because decay of the nonlabile fraction is generally faster. Changes in tropical land use have profound effects on SOM status. Tropical deforestation causes significant losses of soil carbon and nitrogen which tend to decline further under continuous cultivation. Reasons for declines in soil fertility include accelerated soil erosion, loss of litter influx after canopy removal and enhanced decomposition and nutrient mineralization rates after forest clearance. A wide range of soil management techniques have been designed to conserve and improve SOM stocks in tropical cultivation systems. These include agroforestry techniques, intercropping with legumes and the use of mulches and other organic inputs. While many of these techniques look promising in terms of improved crop yields, there is urgent need for research on how these practices alter the physical, chemical and biological processes and conditions of tropical soils.
Twentieth-century variability in snow- cover conditions and approaches to detecting and monitoring changes: status and prospects
Authors: Barry R.G. , Fallot J.-M. , Armstrong R.L. 
Published: November 2007

The extent, and variability of seasonal snow cover are important parameters in the climate system. Changes in snow cover may provide an indicator of global climatic trends and are of considerable practical significance. The question of the most suitable indices of changes in snow cover conditions, in terms of their use for change detection and for monitoring applications, is discussed. The use of passive microwave-derived estimates of snow cover extent and water equivalent for continental and regional-scale mapping is illustrated. Problems in interpreting the microwave signatures, as well as difficulties in comparing such data to ground observations, are also noted. Up to now analyses have focused primarily on trends in Northern Hemisphere snow extent based on monthly averages using the NOAA weekly snow charts 1972-present, or on station data spanning 50-100 years. However, the latter are generally less readily available, or accessible. An overview is provided of current information on recent hemispheric trends and, for the former USSR, the relationship of changes in snow depth, to variations in temperature and precipitation since the late nineteenth century are described, based on newly available station records. Interpretation of these changes and comparisons with other records are presented. Model projections of changes in snow cover conditions and associated snowmelt runoff that may occur as a result of greenhouse gas-induced warming are discussed for several mountain regions. Long-term station records of snow depth variability provided a valuable context within which such modeling results can be examined.
Distribution of Two Common Idiotypes of Anticardiolipin Antibodies in Sera of Patients with Primary Antiphospholipid Syndrome, Systemic Lupus Erythematosus and Monoclonal Gammopathies
Authors: Krause I. , Cohen J. , Blank M. , Bakimer R. , Cartman A. , Hohmann A. , Valesini G. , Asherson R.A. , Khamashta M.A. , Hughes G.R.V. , Shoenfeld Y. 
Published: November 2007

The frequency of two common idiotypes of anticardiolipin antibodies (aCL) was determined in sera from three groups of subjects, patients with systemic lupus erythematosus (SLE), with primary antiphospholipid syndrome (PAPS) and with monoclonal gammopathies (MG), as compared to normal population. The idiotype 1.10, which was derived from a patient with active SLE and antiphospholipid syndrome, was found more frequently among patients with PAPS (10.5%, 10.5% and 22.20% in MG, SLE and PAPS, respectively) than the idiotype H3, which was derived from a human hybridoma monoclonal aCL generated from a healthy subject immunized with tetanus and diphtheria. The latter idiotype was detected in 8.7%, 6.5% and 11.7% of patients with MG, SLE and PAPS, respectively. Incidental findings in this study include a high prevalence of aCL among patients with MG (23%) and a high prevalence of anti-dsDNA antibodies, detected only by a sensitive enzyme-linked immunosorbent assay, among patients with PAPS. Our results indicate that idiotypic diversity exists among aCL derived from different sources. Some of these cross-reactive idiotypes may be more pathogenic than others.
Impaired Urinary Excretion of Soluble IL-2 Receptors in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis
Authors: Manoussakis M.N. , Germanidis G.S. , Drosos A.A. , Moutsopoulos H.M. 
Published: November 2007

Several previous studies have demonstrated increased in vivo release of soluble interleukin-2 receptors (sIL-2R) in patients with disorders associated with cellular activation. In this study attempting to understand better the role of sIL-2R released in vivo, we investigated the sIL-2R levels in paired serum and urine samples from 25 patients with systemic lupus erythematosus (SLE), 41 patients with rheumatoid arthritis (RA) and 20 healthy subjects. Using an ELISA for sIL-2R, we detected significantly increased urinary sIL-2R levels in normal individuals (868 ±114 units/ml) compared to the corresponding serum samples (209 ± 25, P < 0.001, mean urine/serum sIL-2R ratio: 4.5 ± 0.6), which suggests that the clearance of sIL-2R from circulation is largely kidney-dependent. The patients with SLE and RA exhibited significantly increased serum sIL-2R levels compared to normals (682 ± 115 and 734 ± 101 units/ml, respectively, P < 0.001) and these levels correlated with disease activity. However, urinary excretion of sIL-2R in these patients (SLE: 620 ±154 units/ml; RA: 1084 ± 148 units/ml) was found to be significantly decreased (mean urine/serum sIL-2R ratio in SLE: 0.9 ± 0.2; in RA: 1.9 ± 0.2; P < 0.001) compared to normals, possibly contributing to the accumulation of these soluble receptors in the serum of autoimmune patients after their release from cells. Our findings can be attributed either to the binding of the sIL-2R to serum protein(s) or to distinct structural features of serum sIL-2R in SLE and RA patients, interfering with the urinary excretion of these molecules.
Serum Apolipoprotein H Levels in Systemic Lupus Erythematosus Are Not Influenced by Antiphospholipid Antibodies
Authors: Ichikawa Yukinobu , Takamatsu Kazunaga , Shimizu Hiroaki , Uchiyama Mitsuaki , Moriuchi Junko , Takaya Masatoshi , Kobayashi Nobumasa , Kawada Tsutomu , Arimori Shigeru 
Published: November 2007

Anticardiolipin antibodies (aCL) were recently discovered to recognize a complex consisting of phospholipids and apolipoprotein H (apo H). In this study, we determined the serum apo H levels in 36 systemic lupus erythematosus (SLE) patients with or without antiphospholipid antibodies (aPL), including aCL and lupus anticoagulants, to clarify the possible effects of aPL on apo H levels in vivo. The apo H levels were low in SLE patients as compared with 22 healthy controls. However, no associations were found between apo H levels and circulating aPL or clinical features of the antiphospholipid antibody syndrome. A secondary hyperlipidemic state, which probably related to lupus nephritis (proteinuria) and/or prednisolone treatment, increased apo H levels in SLE patients.
Can Experienced Clinicians Predict the Outcome of Lupus Nephritis?
Authors: Esdaile John M. , Mackenzie Todd , Barré Paul , Danoff Deborah , Kirk Osterland C. , Somerville Peter , Quintal Hélène , Kashgarian Michael , Suissa Samy 
Published: November 2007

The ability of four experienced clinicians to predict short-term outcome (serum creatinine level at 1 year) and long-term outcome (renal insufficiency) was evaluated in 87 patients with lupus nephritis. The correlational agreement and the accuracy of their predictions were contrasted with the actual outcomes observed and with statistically generated prognostic regression models. In contrast to previously published data, all four clinicians predicted both short-term outcomes (P < 0.001) and long-term outcomes (P < 0.02) well. The clinicians' predictions approximated that of a statistically generated computer model for both agreement and accuracy for renal function at 1 year. The four clinicians identified nearly identical clinical variables as important in determining prognosis. Provision of biopsy data to the clinicians improved short-term and long-term prediction slightly. The value of the statistical models was 'validated' by demonstrating that three of the four clinical variables identified by the models, but not by the clinicians, could enhance clinical prediction (P < 0.05). In addition, the extent of tubulo-interstitial involvement on biopsy, a predictor that has recently received increased attention, could improve the long-term clinical predictions of all four clinicians (P < 0.05).
Prevalence of Anticardiolipin Antibodies in Subacute Cutaneous Lupus Erythematosus
Authors: Fonseca E. , Alvarez R. , Gonzalez M.R. , Pascual D. 
Published: November 2007

We examined the prevalence of the antibodies to cardiolipin measured by solid-phase enzyme immunoassay during a prospective study of patients with subacute cutaneous lupus erythematosus (SCLE). Seven of 44 (16%) consecutive patients with SCLE had positive anticardiolipin antibodies; of these only three satisfied the American Rheumatism Association's revised criteria for the classification of systemic lupus erythematosus. Clinical findings probably associated with the positive anticardiolipin antibodies were found in four cases, including clotting abnormalities, thrombocytopenia, hemolytic anemia, livedo reticularis, chilblain lupus erythematosus lesions, migraine, leg venous thrombosis and pulmonary embolism after surgery, and spontaneous abortion. Our data suggest that it is reasonable to screen SCLE patients for these antibodies to confirm the presence of the antiphospholipid syndrome.
IgG Subclasses in Systemic Lupus Erythematosus and Other Autoimmune Rheumatic Diseases
Authors: Blanco F. , Kalsi J. , Ravirajan C.T. , Speight P. , Bradwell A.R. , Isenberg D.A. 
Published: November 2007

In this study the concentration of the different subclasses of IgG in sera from patients with a range of autoimmune rheumatic diseases (ARD) was detected by radial immunodiffusion. In the second part the IgG subclasses of autoantibodies that recognize single-stranded DNA (ssDNA), double-stranded DNA (dsDNA), Ro, La, Sm and RNP in patients with ARD were measured by enzyme-linked immunosorbent assay. We studied 15 patients with lupus, 20 patients each with primary and secondary Sjögren's syndrome (SS) and 10 each with rheumatoid arthritis (RA), scleroderma and myositis. Twenty healthy controls were also measured. The serum concentration of IgG2 in ARD patients was generally reduced. In contrast, the concentrations of IgG1, IgG3 and IgG4 subclasses were normal or raised. A high degree of correspondence in the IgG1, IgG2 and IgG3 responses to dsDNA and ssDNA in SLE was found. Notable differences in the IgG1 anti-Ro and ssDNA responses compared to the other subclasses were seen in 1° and 2° SS. In addition, an unexpected high level of IgG4 antibodies to ssDNA in 1° SS (65%) and IgG4 antibodies to Sm/RNP in RA was observed.
The Clinical Significance of Autoantibody Profiles in Patients with Systemic Lupus Erythematosus
Authors: Thompson Darren , Juby Angela , Davis Paul 
Published: November 2007

We have evaluated the autoantibody profiles in the sera of 117 patients with systemic lupus erythematosus (SLE) and compared and contrasted the clinical and laboratory features of the disease of patients segregated according to an autoantibody profile. Using this approach we are able to demonstrate that autoantibody profiles identified subsets of patients with SLE. Patients with a negative autoantibody profile had fewer clinical and laboratory features of their disease when compared to the other subsets of patients. In contrast, patients with profile A (anti-nDNA and/or anti-Sm antibodies) had a statistically significant increase in malar rash, renal and hematologic involvement and hypocomplementemia when compared to patients with a negative profile. Patients with profile B (anti-nRNP antibodies) had a clinical pattern of disease different from that of patients with profile A and had a statistically significant increase in Raynaud's phenomenon when compared to patients with a negative profile. Patients with profile C (anti-SSA and/or anti-SSB antibodies) had a statistically significant increase in lupus-related rashes and photosensitivity. None of the lupus patients reviewed in this study had profile D (antibodies to centromere and/or Scl-70), this profile being seen largely in patients with scleroderma or one of its variants. Both patients with profile E (antihistone antibodies) had drug-induced lupus. We conclude that the use of autoantibody profiles defines subsets of patients with lupus that may have clinical, therapeutic and prognostic implications.
Fibrin Deposition in SLE Glomerulonephritis
Authors: Mccutcheon J. , Evans B. , D'Cruz D.P. , Hughes G.R.V. , Davies D.R. 
Published: November 2007

Coagulation and fibrinolytic processes are involved in the pathogenesis of some forms of glomerulonephritis. In human renal disease extensive fibrin deposition is mainly associated with severe diseases such as rapidly progressive glomerulonephritis. Staining methods for fibrin have problems and many immunohistochemical methods do not distinguish fibrinogen from fibrin and its degradation products, which result from coagulation. The presence of cross-linked fibrin in the glomerulus indicates that coagulation has occurred, but the presence of fibrinogen may be a result of non-specific protein permeation. A monoclonal antibody (DD3B6) has been used to demonstrate cross-linked fibrin in 30 renal biopsies in systemic lupus erythematosus. The biopsies were also stained with an 'antifibrinogen' and an antiplatelet antibody. The severity of renal disease in each biopsy was graded by both the World Health Organization (WHO) classification and Austin's Activity and Chronicity Indices. Three of the renal biopsies were shown to stain with DD3B6 and five stained with antiplatelet antibody. Twenty-seven contained fibrinogen and there was no evidence of intraglaynerular coagulation in these biopsies. The biopsies containing cross-linked fibrin were all in WHO group IVc. The severity of disease measured by Austin's Activity Index was no greater in these biopsies than in other biopsies in WHO Group IVc in which cross-linked fibrin was not detected. The presence of cross-linked fibrin may be associated with intraglomerular coagulation and more severe disease.