bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monoclonal gammopathies and malignancies in patients with chronic urticaria
Authors: Karakelides Martha , Monson Kristi L. , Volcheck Gerald W. , Weiler Catherine R. 
Published: August 2006

AbstractBackground Monoclonal gammopathy of undetermined significance (MGUS) has been described in association with chronic urticaria (CU) in patients with Schnitzler syndrome. Chronic urticaria may be a manifestation of hematologic malignancies.MethodsThis study was conducted to evaluate the frequency and characteristics of MGUS or malignancy in patients with CU. The Mayo Clinic electronic database was reviewed to identify patients with the diagnosis of CU.Results Of the 1639 patients presenting with CU between 1994 and 2001, 797 (49%) underwent laboratory evaluation for the presence of a coexisting monoclonal protein. Forty‐seven CU patients had MGUS, 142 had a malignancy, and 24 had both. Fifteen percent of CU patients with MGUS had a hematologic malignancy compared with 0.9% of CU patients without MGUS (P < 0.001). Patients presenting with a new diagnosis of CU at an older age (> 56 years) were more likely to have associated underlying MGUS. The occurrence of MGUS in this group was higher than the reported incidence of MGUS in the general population.Conclusions Patients with CU younger than 43 years were unlikely to have associated MGUS or malignancy. A higher percentage of patients with CU and MGUS had an associated diagnosis of hematologic malignancy.
What choices should we be able to make about designer babies? A Citizens’ Jury of young people in South Wales
Authors: Iredale Rachel , Longley Marcus , Thomas Christian , Shaw Anita 
Published: August 2006

AbstractBackground  Young people will increasingly have the option of using new technologies for reproductive decision making but their voices are rarely heard in debates about acceptable public policy in this area. Capturing the views of young people about potentially esoteric topics, such as genetics, is difficult and methodologically challenging.Design  A Citizens’ Jury is a deliberative process that presents a question to a group of ordinary people, allows them to examine evidence given by expert witnesses and personal testimonies and arrive at a verdict. This Citizens’ Jury explored designer babies in relation to inherited conditions, saviour siblings and sex selection with young people.Participants  Fourteen young people aged 16–19 in Wales.Results  Acceptance of designer baby technology was purpose‐specific; it was perceived by participants to be acceptable for preventing inherited conditions and to create a child to save a sibling, but was not recommended for sex selection. Jurors stated that permission should not depend on parents’ age, although some measure of suitability should be assessed. Preventing potential parents from going abroad was considered impractical. These young people felt the Human Fertilisation and Embryology Authority should have members under 20 and that the term ‘designer baby’ was not useful.Conclusions  Perspectives on the acceptability of this technology were nuanced, and based on implicit value judgements about the extent of individual benefit derived. Young people have valuable and interesting contributions to make to the debate about genetics and reproductive decision making and a variety of innovative methods must be used to secure their involvement in decision‐making processes.
Predicting preferences: a neglected aspect of shared decision‐making
Authors: Sevdalis Nick , Harvey Nigel 
Published: August 2006

AbstractIn recent years, shared decision‐making between patients and doctors regarding choice of treatment has become an issue of priority. Although patients’ preferences lie at the core of the literature on shared decision‐making, there has not been any attempt so far to link the concept of shared decision‐making with the extensive behavioural literature on people's self‐predictions of their future preferences. The aim of the present review is to provide this link. First, we summarize behavioural research that suggests that people mispredict their future preferences and feelings. Secondly, we provide the main psychological accounts for people's mispredictions. Thirdly, we suggest three main empirical questions for inclusion in a programme aimed at enriching our understanding of shared decision‐making and improving the procedures used for putting it into practice.
Decision aids for familial breast cancer: exploring women's views using focus groups
Authors: Rapport Frances , Iredale Rachel , Jones Wendy , Sivell Stephanie , Edwards Adrian , Gray Jonathon , Elwyn Glyn 
Published: August 2006

AbstractBackground There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex choices.Objective Exploration of users’ views and reactions to three decision aids for genetic testing for breast cancer using focus groups.Setting A regional cancer genetics service in the UK.Participants Women over 18 years of age who had been referred to Cancer Genetics Service for Wales (CGSW) and had received a risk assessment for familial breast cancer.Methods Qualitative study involving one pilot and six extended focus groups with 39 women at high, moderate and population risk. Two CD‐ROMs and one paper‐based aid evaluated for: clarity of presentation, ease of handling, emotive response, increased knowledge and greater informed choice.Results Women reported variable preferences for different types of decision aids and mixed emotions, indicating the sensitivity of raising issues in decision support tools, lack of consensus over the most appropriate aid and no systematic differences between risk groups. Women remarked that aids increased their knowledge, particularly about breast cancer genes and risk and wanted a decision aid designed within the context of the NHS, in both paper‐based and CD‐ROM formats from an authoritative source. Mixed views about presentation styles suggest decision aids would be most effective with a user‐selected range of formats.Conclusions Decision aid development should be informed by users and should meet the needs of those concerned about their risk of breast cancer in the UK. Without such aids, patients will continue to search for information from a variety of sources of varying quality.
Ten‐year surveillance of fungal contamination of food within a protected haematological unit
Authors: Brenier‐Pinchart M. P. , Faure O. , Garban F. , Fricker‐Hidalgo H. , Mallaret M. R. , Trens A. , Lebeau B. , Pelloux H. , Grillot R. 
Published: August 2006

SummarySince 1992, we have established a protocol of food management (restrictive diet, food distribution protocol and fungal surveillance) for allogeneic stem‐cell transplant (SCT) recipients hospitalised in protected ward. This study analyses the results of 10‐year surveillance of fungal contamination of this diet. Among the 456 types of foods tested filamentous fungi were isolated in 37 of them (8.1%). Aspergillus fumigatus was isolated in one type of food only, while the majority of the food was contaminated to a lower extent.
A case of mycetoma successfully treated with itraconazole and co‐trimoxazole
Authors: Gündüz Kamer , Örgüç Şebnem , Demireli Peyker , Inanır Işıl , Sürücüoglu Süheyla , Ovalı Gülgün Yılmaz 
Published: August 2006

SummaryA 29‐year‐old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. A single nodule on the sole was excised 15 years ago and since then she has had recurrent attacks of swelling and discharging sinuses that improved partially with antibiotics. Magnetic resonance images (MRI) revealed an ill‐defined mass predominantly with low signal intensity on T2W images. Within the granulomata, multiple unenhancing foci, with low T1W and T2W signal most likely representing the fungal balls or grains were detected. Histopathological examination revealed large clusters of microorganisms resembling fungal hyphae and bacteria, which were surrounded by mixed inflammatory infiltrate cells and stained positively by PAS and Gomori's methenamine silver stain. As minimal regression was seen on MRI with 4 months’ itraconazole (200 mg day−1) treatment, co‐trimoxazole (160 TMP/800 SMX b.i.d.) was added to treatment. Complete remission was established by MRI examination after 10 months with this combination therapy.
Delayed ABLC prophylaxis after allogeneic stem‐cell transplantation
Authors: Jansen Jan , Akard Luke P. , Wack Matthew F. , Thompson James M. , Dugan Michael J. , Leslie Jill K. , Mattison Reid 
Published: August 2006

SummaryInvasive fungal infections (IFI) are frequent causes of mortality after allogeneic stem‐cell transplantation (SCT). A very important risk factor for IFI is the use of steroids. We used a risk‐based chemoprevention in an open‐labelled pilot study. All patients received oral fluconazole or itraconazole (200–400 mg day−1) during their neutropenic episode. Starting on day +30, patients receiving prednisone ≥30 mg day−1 were switched to twice weekly Amphotericin‐B‐lipid‐complex (ABLC) in a dose of 4 mg kg−1. Patients receiving lower steroid doses continued on the fluconazole/itraconazole prophylaxis. Between 1999 and 2002, 100 patients were enrolled and followed for IFI for 1 year. Seven patients were started on therapeutic daily ABLC treatment before day +30 because of documented or suspected IFI; four had definite or probable aspergillosis, and two had candidaemia. Thirty patients did not need prophylactic ABLC; only one developed candidaemia. Sixty‐three patients received ABLC prophylaxis for a median of 52 days (range: 1–289). Seven of these patients developed IFI; one definite and two probable cases of aspergillosis, one case of probable Trichosporon beigelii infection, and three cases of candidaemia. The twice weekly ABLC was well tolerated. This risk‐based chemoprevention appears to be effective and might diminish the role of steroids as risk factor for IFI after allogeneic SCT. The relatively high incidence of early IFI suggests that additional prophylaxis for IFI may be indicated for poor‐risk patients prior to day +30.
Pityriacitrin – a potent UV filter produced by Malassezia furfur and its effect on human skin microflora
Authors: Machowinski Angelika , Krämer Hans‐Joachim , Hort Wiebke , Mayser Peter 
Published: August 2006

SummaryIn Malassezia furfur, tryptophan as the main nitrogen source induces production of the potent ultraviolet‐absorbing indole compound pityriacitrin. An in vitro study about the effects of pityriacitrin on other human skin microorganisms is presented, with special focus on Candida albicans and staphylococci in which its toxicity and UV‐protective capacity were investigated. Candida albicans was irradiated with UVB light either in the presence or in the absence of pityriacitrin (11 mmol) and the growth rate was determined. A UVB dose of 1 J cm−2 caused death of the fungi without pityriacitrin, whereas those in the presence of pityriacitrin showed almost unaffected growth. A diffusion test in staphylococci revealed no antibiotic effects of pityriacitrin. For testing of an ultraviolet‐protective effect, staphylococci were either inoculated and irradiated in a plate model for visual assessment of growth or inoculated and irradiated in square quartz cylinders for quantitative measurement of cell density, each time in the absence or presence of pityriacitrin. Cell density of the bacterial suspensions exhibited nearly no influence of pityriacitrin on growth rates, while again a UV‐protective effect was observed. In summary, pityriacitrin has an ultraviolet‐protective effect on Candida albicans and staphylococci with no toxicity in the range tested.
Mutations in ISDR of NS5A gene influence interferon efficacy in Chinese patients with chronic hepatitis C virus genotype 1b infection
Authors: Shen Chuanlai , Hu Ting , Shen Ling , Gao Lei , Xie Wei , Zhang Jianqiong 
Published: August 2006

AbstractBackground and Aim:  The interferon sensitivity determining region (ISDR) in the non‐structural 5A protein (NS5A) gene of hepatitis C virus genotype 1b (HCV‐1b) has been demonstrated in Japanese patients; however, contradictory data have been reported from other parts of the world, particularly from Europe and the USA. This study investigated whether mutations in the ISDR of NS5A gene influence interferon efficacy in Chinese patients with chronic HCV‐1b infectionMethods:  Forty‐five Chinese patients with chronic HCV infection were enrolled in a retrospective study. Of these patients, 20 with HCV‐1b infection completed an interferon monotherapy course and 6‐month follow‐up. The pretreatment mutations in the nucleic acid sequence of NS5A 2209–2248 (ISDR) of HCV‐1b were identified by sequencing RT‐PCR products followed by comparison with the prototype sequence (HCV‐J). Correlation with the clinical efficacy of interferon alpha therapy was then analyzed retrospectively.Results:  The statistical analysis indicated a significant correlation between the mutations in ISDR of HCV‐1b and sustained virological response to interferon alpha treatment (P < 0.05), and an association of the mutations in ISDR with the pretreatment serum alanine aminotransferase levels (P < 0.01) in Chinese patients with chronic HCV‐1b infection.Conclusions:  The results support the concept that the response of HCV‐1b infected patients towards interferon therapy is influenced by the mutations within the ISDR of NS5A gene.
Effects of octreotide in acute hemorrhagic necrotizing pancreatitis in rats
Authors: Wenger Frank Axel , Kilian Maik , Heukamp Ina , Foitzik Thomas , Jacobi Christoph Andreas , Guski Hans , Schimke Ingolf , Müller Joachim Michael 
Published: August 2006

AbstractBackground and Aim:  Octreotide is considered to reduce exocrine pancreatic secretion in acute hemorrhagic necrotizing pancreatitis decreasing pancreatic autodigestion. The aim of this study was to determine whether octreotide also has antioxidative effects in acute pancreatitis. Additionally time and dose of application were of interest.Method:  Ninety male Sprague‐Dawley rats were randomized into six groups (n = 15). Group 1 underwent a laparotomy, and animals in groups 2–6 received intraductal glycodeoxycholic acid followed by intravenous cerulein. Groups 3 and 4 were injected with 0.5 mg octreotide, while groups 5 and 6 received continuous intravenous infusion of 0.05 mg octreotide/h for 10 h. Treatment was initiated 6 hours after induction of pancreatitis (IP) in groups 3 and 5, and 14 h after IP in groups 4 and 6. At 24 h after IP all animals were killed and each pancreas was analyzed histopathologically. In addition, levels of pancreatic lipid peroxidation protective enzymes glutathione‐peroxidase (GSH‐Px) and superoxide dismutase (SOD) as well as lipid peroxidation via thiobarbituric acid reactive substances (TBARS) were determined.Results:  Early bolus application of octreotide reduced severity of histopathological changes in acute pancreatitis and decreased lipid peroxidation in pancreatic tissue samples; however, late bolus application and continuous intravenous infusion did not influence pancreatitis or lipid peroxidation.Conclusion:  Octreotide seems to have a dose‐ and time‐dependent effect on histopathology and lipid peroxidation in a model of pancreatitis in rats.
Abdominoperineal resection or anterior resection for rectal cancer: patient preferences before and after treatment
Authors: Zolciak A. , Bujko K. , Kepka L. , Oledzki J. , Rutkowski A. , Nowacki M. P. 
Published: August 2006

AbstractObjective  Literature data do not provide any evidence as to whether oncological outcome and quality of life after anterior resection (AR) are superior to those observed after abdominoperineal resection (APR) for low‐lying rectal cancer. In view of this, patient preferences should play an important role in the process of decision making. The aim of this study was to investigate these preferences.Patients and methods  A series of consecutive patients with rectal cancer (60 prior to surgery, 65 after APR and 124 after AR) who attended our outpatient clinic were asked to express their preference as to the type of surgery. The second part of the study was performed 4 years later; 30 patients evaluated before surgery, free of disease, were again asked to express their preference as to the type of treatment.Results  Patient preferences as to performing APR, AR or as to leaving the decision to the surgeon were as follows: (i) the group prior to surgery – 5%, 30% and 65%, respectively, (ii) group after APR – 46%, 22% and 32%, respectively, and (iii) group after AR – 4%, 69% and 28%, respectively. Patients after AR pointed to the type of surgery that they had undergone more frequently than patients after APR (69%vs 46%, respectively, P < 0.001). Sixty per cent of patients evaluated twice had altered their initial preferences, usually choosing the type of surgery that they had undergone.Conclusions  Our results suggest that the sequelae of AR are generally perceived as more acceptable than those of APR. Nevertheless, approximately half of the patients after APR prefer the type of surgery that they have undergone, which suggests the positive reappraisal of APR, once experienced.
Factors predicting early recurrence after transanal endoscopic microsurgery excision for rectal adenoma
Authors: McCloud J. M. , Waymont N. , Pahwa N. , Varghese P. , Richards C. , Jameson J. S. , Scott A. N. D. 
Published: August 2006

AbstractIntroduction  Transanal endoscopic microsurgery (TEM) is an accepted way of excising rectal adenomas with low morbidity and mortality, avoiding major resectional surgery. However, there are no agreed criteria for surveillance following TEM. The purpose of this study was to identify criteria to guide surveillance programmes, thus reducing the surveillance burden for those patients at low risk of recurrence.Patients and methods  Patients who had undergone TEM for rectal adenomas were identified, and a retrospective review of patient, pathological and histological parameters was performed.Results  Seventy‐five (40 male) patients were identified; median age 70 years (39–85). There were seven tubular, 33 tubulo‐villous and 35 villous adenomas. All were considered completely excised by the operating surgeon. Forty‐seven (62.7%) were reported as being completely excised histologically. There was no significant association between recurrence at 6 months and sex, age, type or position of adenoma, height above the anal verge, or degree of dysplasia. Recurrence rates at six months were 0% for the completely excised adenomas and 21.4% for the incompletely excised ones; this was statistically significant (Pearson χ2, P < 0.001). In all there were 12 recurrences, 10 in the incompletely excised group at a median follow up of 31 (6–80) months (P < 0.001).In addition, a significant association for large adenomas to recur was noted at median follow up (Armitage Trend test, P = 0.019).Conclusions  Histological assessment of completeness of excision of rectal adenoma and size of adenoma are important predictors of early recurrence and have potential to guide follow‐up strategies after TEM.
Simple clinical examination predicts complexity of perianal fistula
Authors: Becker A. , Koltun L. , Sayfan J. 
Published: August 2006

AbstractObjective  To investigate the diagnostic value of the distance between external opening of perianal fistula and anal verge and to evaluate its relation to the type of fistula. Preoperative identification of complex fistulae is important for proper planning of treatment.Patients and methods  One hundred and fifteen consecutive patients operated for perianal fistula were studied prospectively. The distance between the external opening and the anal verge was measured. Location of the external opening, demographic and medical history data were correlated with characteristics of the fistulae. Data analysis was performed using the SPSS statistical package. The association between categorical variables was examined using the χ2‐test or Fisher's exact test for small sample. Comparison of continuous variables between two groups was analysed by t‐test.Results  The mean distance between external opening and anal verge in simple fistulae was 2.8 cm (range 1.5–4.3, SD 0.689) and in complex fistulae it was 4.4 cm (range 3.5–6.0, SD 0.526). This difference was statistically significant –P < 0.0001. Age and previous operations (particularly attempted definitive operations) were also significantly related to the complexity of the fistula. Data concerning location and direction of the fistulous tracts confirm the validity of Goodsall's rule.Conclusion  Simple preoperative clinical examination may reliably predict the complexity of a perianal fistula. Identification of these patients permits to select the cases that should have specific sophisticated preoperative work‐up. The first definitive operation is most important to assure a successful outcome, thus such preoperative triage may also permit selective referral to a specialized colorectal team.
Family and personal history in colorectal cancer patients: what are we missing?
Authors: Alberto V. O. , Harocopos C. J. , Patel A. A. , Clark S. K. 
Published: August 2006

AbstractObjective  Family and personal history of colorectal cancer and associated tumours are crucial in identifying families with hereditary nonpolyposis colorectal cancer (HNPCC). The aim of this study was to determine the adequacy of these aspects of history‐taking in the management of colorectal cancer patients.Patients and methods  Colorectal cancer patients attending outpatient follow‐up were interviewed to obtain a detailed family and personal history of cancers. The medical notes were then reviewed to identify whether these had been documented previously.Results  One hundred and one patients took part. In seven, no family history had been recorded; none of these actually had a significant pedigree. In 88, the family history was not significant, a finding correctly documented in the records. Three had a high‐risk family history and another three had a personal history of other possible HNPCC‐related cancers. In each of these patients, the relevant findings had been documented, but no further action had been taken.Conclusions  Family history was taken in the majority of patients, but in the only three with a pedigree indicative of HNPCC, its significance was not appreciated. The potential relevance of multiple HNPCC‐related cancers in the same individual was also overlooked. Improved education and referral pathways are needed to ensure that families with HNPCC have access to appropriate surveillance and genetic testing.
Hyperthermic intraperitoneal chemotherapy and cytoreductive surgery for peritoneal carcinomatosis of colorectal origin: a novel treatment strategy with promising results in selected patients
Authors: Moran B. J. , Meade B. , Murphy E. 
Published: August 2006

AbstractPeritoneal carcinomatosis is a major cause of treatment failure in colorectal cancer with few options for treatment. Recent reports, including a single randomized trial, suggest that localized peritoneal carcinomatosis, in the absence of other metastases, could be considered regional metastatic disease analogous to liver metastases, and thus amenable to locoregional therapy. Optimal treatment involves complete tumour removal by complex surgical techniques, combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment strategy has significant morbidity and mortality risks and careful selection is essential to avoid futile procedures. The best results are achieved in patients with limited disease who have complete macroscopic tumour removal, when the primary and peritoneal metastases are removed synchronously, and when the primary tumour is a cancer of the appendix. Improvements in cross‐sectional imaging and increasing utilization of laparoscopy in colorectal cancer surgery may help in detecting suitable cases for these techniques. Selected patients with localized disease have been shown to have good outcomes with prolonged survival and perhaps a possibility of cure.