bluuebunny/crossref_metadata_2025_split huggingface dataset:
Police and sniffer dogs in psychiatric settings
Authors: Khalifa Najat , Gibbon Simon , Duggan Conor 
Published: June 2008

Aims and MethodTo study the views of staff and patients on the use of sniffer dogs to detect illicit drugs and the prosecution of in-patients suspected of taking illicit drugs. A 15-item self-report questionnaire was given to all in-patients and staff who had any contact with patients in a medium-secure unit. Responses to the individual statements were measured on a five-point Likert scale and staff and patients' responses were compared.ResultsWe achieved a response rate of 63% (patient response rate, 71.6%; staff response rate, 60.7%). Overall there were fewer differences than anticipated, although, as expected, staff viewed the impact of illicit drugs more negatively than patients, and on the other hand, patients viewed the use of sniffer dogs and police involvement more negatively than the staff did.Clinical ImplicationsNotice ought to be taken of the discordance between staff and patients' views (particularly in relation to consent and confidentiality) when attempting to detect and manage illicit drug use among psychiatric in-patients.
Does a business-like letter written for a general practitioner meet the standards for patients?
Authors: Mason Julian , Rice Daphne 
Published: June 2008

Aims and MethodTo gauge the acceptability of copying a business-like clinic letter for general practitioners, written by a doctor working in the Newbury Community Mental Health Team for Older Adults. Between August 2004 and March 2006 every letter written by each doctor was stored electronically. The letters contained a clear statement of the diagnosis, the active problems and a bullet-point care plan. Any concerns or reactions to the letters were documented as they were received. Between September and October 2006, 50 service user or carer recipients of the letters were sent a questionnaire, checking whether the letter met standards of clarity, helpfulness and content.ResultsOver 20 months 427 service users and carers received a total of 731 letters. One carer asked for the letter not to be sent in future; four carers asked for details of the letter to be modified; in only one was the content of the letter to the general practitioner modified before it was sent to the service user. The questionnaire about the suitability of the clinic letter had a 90% reply rate and all respondents said the letters were clear, understandable and that their content was of no surprise to them.Clinical ImplicationsThis report of a successful use of a frank business-like letter copied to service users or carers should be understood in the context of the following factors: the doctor who wrote them was familiar with and confident about the clinical work and comfortable with the style of the letter; he had a good rapport with a generally well-educated population and positive support from his colleagues. With these factors in place, the direct style of the letter was well received by patients and carers.
Referral patterns and acetylcholinesterase inhibitor prescribing for cognitive impairment (1999–2007): impact of NICE guidelines
Authors: Ganeshalingam Yogesh , Cooper Claudia , Livingston Gill 
Published: June 2008

Aims and MethodWe hypothesised that the proportion of people referred to two outer London mental healthcare services for older people with cognitive impairment increased after the 2001 National Institute for Health and Clinical Excellence (NICE) guidelines for acetylcholinesterase (AChE) inhibitor use in Alzheimer's disease, but declined after the amended 2006 guidelines. We reviewed case notes for 546 individuals referred between 1999 and 2007.ResultsThe proportion of individuals with cognitive impairment referred increased between 1999 (56.1%) and 2005 (70.5%, χ2=5.4, P=0.02), as did the proportion prescribed AChE inhibitor (0.8% to 16.1%, χ2=27.5, P<0.001). There were no significant changes between 2005 and 2007.Clinical ImplicationsThe 2006 NICE amendment may have curbed the increase in psychiatric referrals and AChE inhibitor prescribing rates for people with cognitive impairment but so far these rates have not decreased.
Crisis resolution and home treatment teams for older people with mental illness
Authors: Dibben Claire , Saeed Humera , Stagias Konstantinos , Khandaker Golam Mohammed , Rubinsztein Judy Sasha 
Published: June 2008

Aims and MethodWe examined the impact of a crisis resolution and home treatment teams (CRHTT) on hospital admission rates, bed days and treatment satisfaction among older people with mental illness and their carers. We compared these factors in the 6 months before the service started and 6 months after its introduction.ResultsThe CRHTT significantly reduced admissions (P<0.001), but there was no significant difference in the length of hospital stay as compared before and after the introduction of this service. There was a trend towards carers, but not patients, being more satisfied with treatment after the introduction of the CRHTT.Clinical ImplicationsThe CRHTT reduced hospital admissions for older people by 31% and carers preferred the service. Further research on crisis teams in older people with mental illness is needed using randomised controlled methodology.
Doxorubicin, Cardiac Risk Factors, and Cardiac Toxicity in Elderly Patients With Diffuse B-Cell Non-Hodgkin's Lymphoma
Authors: Hershman Dawn L. , McBride Russell B. , Eisenberger Andrew , Tsai Wei Yann , Grann Victor R. , Jacobson Judith S. 
Published: June 2008

Purpose Anthracycline-based chemotherapy, which improves survival for patients with non-Hodgkin's lymphoma, is often withheld from elderly patients because of its cardiotoxicity. We studied the cardiac effects of doxorubicin in a population-based sample of older patients with diffuse large B-cell lymphoma (DLBCL). Patients and Methods Among patients age ≥ 65 years diagnosed with DLBCL from 1991 to 2002 in the Surveillance, Epidemiology, and End Results–Medicare database, we developed logistic regression models of the associations of doxorubicin with demographic, clinical, and cardiac variables. We then developed Cox proportional hazards models of the association between doxorubicin and subsequent congestive heart failure (CHF), taking predictors of CHF into account. Results Of 9,438 patients with DLBCL, 3,164 (42%) received doxorubicin-based chemotherapy. Any doxorubicin use was associated with a 29% increase in risk of CHF (95% CI, 1.02 to 1.62); CHF risk increased with number of doxorubicin claims, increasing age, prior heart disease, comorbidities, diabetes, and hypertension; hypertension intensified the effect of doxorubicin on risk of CHF (hazard ratio = 1.8; P < .01). In the 8 years after diagnosis, the adjusted CHF-free survival rate was 74% in doxorubicin-treated patients versus 79% in patients not treated with doxorubicin. Conclusion Among patients receiving chemotherapy for DLBCL, those with prior heart disease were less likely than others to be treated with doxorubicin, and those who received doxorubicin were more likely than others to develop CHF. Various cardiac risk factors increased CHF risk, but only hypertension was synergistic with doxorubicin. Doxorubicin has dramatically improved survival of DLBCL patients; nonetheless, some subgroups may benefit from efforts to reduce doxorubicin-related CHF risk.
Current and Future Utilization of Services From Medical Oncologists
Authors: Warren Joan L. , Mariotto Angela B. , Meekins Angela , Topor Marie , Brown Martin L. 
Published: June 2008

Purpose There is limited information on the current use of oncologists and projections of future need. This analysis assesses current utilization patterns and projects the number of people with cancer and their use of oncologists’ services through 2020. Methods Data from the Surveillance, Epidemiology, and End Results cancer registries and Medicare physician claims were used to estimate oncologists’ services from 1998 to 2003. We estimated the portion of patients with cancer who saw an oncologist, the mean number of visits, and the clinical setting where care was provided. Care was divided into initial, continuing, and last-year-of-life phases. Projections for future number of patients with cancer and visits were calculated by applying incidence and prevalence rates derived from Surveillance, Epidemiology, and End Results data to census population projections through 2020. Results The percentage of patients who saw an oncologist was 47% during the initial-care phase, 36% during the continuing-care phase, and 70% in the last year of life. The number of visits varied by age, sex, cancer site, and phase. The total number of cancer patients in the United States is projected to increase 55%, from 11.8 million in 2005 to 18.2 million in 2020. Total oncology visits are projected to increase from 38 million in 2005 to 57 million in 2020. Conclusion Utilization of oncologists’ services will increase appreciably between 2005 and 2020; this will be driven predominantly by an increase in survivors of cancer and by the aging of the population. The United States may face an acute shortage of medical oncologists if efforts are not taken to meet this growing need.
Nonplatinum Topotecan Combinations Versus Topotecan Alone for Recurrent Ovarian Cancer: Results of a Phase III Study of the North-Eastern German Society of Gynecological Oncology Ovarian Cancer Study Group
Authors: Sehouli Jalid , Stengel Dirk , Oskay-Oezcelik Guelten , Zeimet Alain G. , Sommer Harald , Klare Peter , Stauch Martina , Paulenz Axel , Camara Oumar , Keil Elke , Lichtenegger Werner 
Published: June 2008

Purpose The management of recurrent ovarian cancer remains controversial. Single-agent topotecan is an established treatment option, and preliminary evidence suggests improved tumor control by combining topotecan with etoposide or gemcitabine. Patients and Methods Women with relapsed ovarian cancer after primary surgery and platinum-based chemotherapy were randomly assigned to topotecan monotherapy 1.25 mg/m2/d, topotecan 1.0 mg/m2 plus oral etoposide 50 mg/d, or topotecan 0.5 mg/m2/d plus gemcitabine 800 mg/m2 on day 1 and 600 mg/m2 on day 8 every 3 weeks. Patients were stratified for platinum-refractory and platinum-sensitive disease according to a recurrence-free interval of less or more than 12 months, respectively. The primary end point was overall survival. Secondary end points included progression-free survival, objective response rates, toxicity, and quality of life (as measured by the European Organisation for Research and Treatment of Cancer [EORTC] 30-item Quality-of-Life Questionnaire). Results The trial enrolled 502 patients with a mean age of 60.5 years (± 10.2 years), 208 of whom were platinum resistant. Median overall survival was 17.2 months (95% CI, 13.5 to 21.9 months) with topotecan, 17.8 months (95% CI, 13.7 to 20.0 months) with topotecan plus etoposide (log-rank P = .7647), and 15.2 months (95% CI, 11.3 to 20.9 months) with topotecan plus gemcitabine (log-rank P = .2344). Platinum-sensitive patients lived significantly longer than platinum-refractory patients (21.9 v 10.6 months). The median progression-free survival was 7.0, 7.8, and 6.3 months, respectively. Objective response rates were 27.8%, 36.1%, and 31.6%, respectively. Patients under combined treatment were at higher risk of severe thrombocytopenia. Conclusion Nonplatinum topotecan combinations do not provide a survival advantage over topotecan alone in women with relapsed ovarian cancer.
Heteropoly Acid as Efficient, Cost-effective, and Recyclable Solid Acid for the Rapid Synthesis of Substituted Imidazolines
Authors: Yadav J S , Subba Reddy B V , Pandurangam T , Subba Reddy U V 
Published: June 2008

Abstract
Aziridines undergo smooth ring opening with a range of nitriles in the presence of 10 mol % of phosphomolybdic acid supported on silica gel (PMA–SiO2) under mild reaction conditions to afford the corresponding imidazolines in good yields and with high regioselectivity. The use of silica gel as solid support facilitates an easy recovery and reuse of the catalyst thereby making the process quite simple, more convenient, and cost-effective.
Substitution Effects of Cp Ring Benzyl Groups on Photoisomerization of a Rhodium Dithionite Complex in the Crystalline State
Authors: Miyano Yousuke , Nakai Hidetaka , Mizuno Motohiro , Isobe Kiyoshi 
Published: June 2008

Abstract
Crystalline-state photoisomerization of a rhodium dithionite complex with benzyltetramethylcyclopentadienyl ligand, [(CpBnRh)2(μ-CH2)2(μ-O2SSO2)] (CpBn = η5-C5Me4Bn), is studied by X-ray crystallography and CP/MAS 13C NMR spectroscopy. The disorder of the CpBn ring in the crystal and the crystal packing of the molecules of isomers produced by photoreaction play an important role for stabilization of the whole crystal.
Lipid external quality assessment: commutability between external quality assessment and clinical specimens
Authors: Cramb Robert , French Jane , Mackness Michael , G Neely R Dermot , Caslake Muriel , MacKenzie Finlay 
Published: June 2008

Background Targets for cholesterol reduction are part of the Quality Outcomes Framework and general practitioners have to meet these targets to fulfil their remuneration package. By contrast, there are no targets for the accuracy of cholesterol or other lipid measurements and no recent surveys on performance of these assays. We have assessed the performance of lipid measurement of the available methods in the UK. Methods Serum samples collected from individual donors attending the national blood service were distributed after values were obtained from a secondary reference laboratory. Samples were sent to participant laboratories to assess different methods' analytical performance on single donation specimens, on routine external quality assessment pooled specimens, on specimens subjected to a range of freeze–thaw cycles and on frozen-stored specimens. Results Differences in measured cholesterol were found that were method-dependent and related to triglyceride content. HDL-cholesterol (HDL-C) showed significant positive bias in all assays. Individual donor specimens showed no significant changes with differing numbers of freeze–thaw cycles. Pooled serum was stable for up to six months. Conclusions Most cholesterol measurements are accurate but some methods are affected by triglyceride interference. HDL-C methods show significant positive bias. Although there are potential matrix effects introduced as a result of specimen preparation, additional work is needed to show if these effects are present in fresh patient samples.
C-reactive protein and procalcitonin concentrations in bronchoalveolar lavage fluid as a predictor of ventilator-associated pneumonia
Authors: Linssen Catharina F M , Bekers Otto , Drent Marjolein , Jacobs Jan A 
Published: June 2008

Background Diagnosis of ventilator-associated pneumonia (VAP) is difficult. The usefulness of high-sensitivity procalcitonin (ProCa-S) and high-sensitivity C-reactive protein (CRPH) in bronchoalveolar lavage (BAL) fluid and serum in the prediction of VAP was determined. Methods The study was conducted over a 28-month period (November 1999–June 2002) at the University Hospital Maastricht. BAL fluid samples were collected from patients admitted to the intensive care unit. Differential cell count and quantitative culture of BAL fluid were performed. C-reactive protein (CRP) and procalcitonin (PCT) on BAL fluid were determined by means of two high-sensitivity kits (CRPH and ProCa-S, respectively). Since both kits were designed for use on serum, validation for use on BAL fluid was performed. Results A total of 117 patients were included. 43.6% (51/117) had microbiologically confirmed VAP. Both CRPH and ProCa-S showed good matrix effect, linearity and intra- and inter-assay variation. No significant differences in PCT and CRP concentrations in serum and BAL fluid were found between the VAP and the non-VAP group. Conclusions Both the ProCa-S and the CRPH kits can be used for assessing the concentration of PCT and CRP in BAL fluid, respectively. PCT and CRP concentrations in BAL fluid appeared to be of no additional value in the diagnosis of VAP.
Interference with serum indices measurement, but not chemical analysis, on the Roche Modular by Patent Blue V
Authors: Darby Denise , Broomhead Christopher 
Published: June 2008

Background Patent Blue V is an inert dye increasingly being used during cancer surgery to identify the sentinel lymph node. We recently discovered three cases with falsely elevated lipaemic indices on the Roche Modular, following intramammary injection of Patent Blue. This, and other potential interferences by Patent Blue, is examined in this study. Methods Serum samples which visually appeared normal, haemolysed or icteric were spiked with Patent Blue to a concentration of 7.3 mg/L and the effect on the lipaemic, haemolysis and icteric indices and routine chemical analyses (sodium, potassium, urea, creatinine, bilirubin, alanine aminotransferase, gamma-glutamyltransferase, aspartate aminotransferase, magnesium, creatine kinase, lactate dehydrogenase, amylase, albumin, calcium and phosphate) undertaken. Dose-response curves in the range of 4.9 mg/L to 22.7 mg/L of Patent Blue were established for normal, icteric and haemolysed pooled serum samples. Results Significant positive interference by 7.3 mg/L of Patent Blue was observed in the lipaemic index, with an increase of 149 ± 6.3 (mean ± standard deviation [SD]; P < 0.001). Significant negative interference was observed in both the haemolysis and icteric indices, with decreases of 71 ± 9.7 ( P < 0.001) and 46 ± 8.9 ( P < 0.001), respectively. Patent Blue had a linear dose-response effect on the serum indices. No significant differences were observed in the chemical analyses assessed. Conclusions The effects observed on the Roche Modular serum index measurements with Patent Blue raises the novel concept of interference in methods routinely used to detect interference. Despite Patent Blue having no direct effect on chemical analysis, failure to reliably detect potential interference, particularly haemolysis, may lead to misleading results being issued.
Performance of the Advia Centaur second-generation troponin assay TnI-Ultra compared with the first-generation cTnI assay
Authors: Kerkhof Daan van de , Peters Berry , Scharnhorst Volkher 
Published: June 2008

Background A cardiac troponin concentration above the 99th percentile limit of a reference population is a sensitive marker of myocardial necrosis. Current guidelines require troponin assays to have a total imprecision of ≤10% at the 99th percentile limit. In this study, the Advia Centaur second-generation TnI-Ultra assay was validated and compared with its predecessor the cardiac troponin I (cTnI) assay, with a focus on the current guidelines for diagnosis of acute myocardial damage. Methods An imprecision profile of the TnI-Ultra assay was evaluated by analysing different pools over 20 days. The imprecision of the cTnI assay was used as comparison. The reference range was established based on TnI-Ultra analysis in 221 individuals. Results The cTnI concentration that could be determined with a total imprecision of 10% was 0.05 µg/L for the TnI-Ultra assay and 0.3 µg/L for the cTnI assay. The 99th percentile limit in the distribution of a reference population was 0.06 µg/L as determined with the TnI-Ultra assay. Conclusions The TnI-Ultra assay provides significantly improved sensitivity when compared with the cTnI assay and a total imprecision of ≤10% is obtained at the 99th percentile limit of value distribution of a reference population. Using the TnI-Ultra assay, slightly increased cTnI concentration can be detected reliably following the current guidelines.
False-positive polyethylene glycol precipitation tests for macroprolactin due to increased serum globulins
Authors: Ram Sweta , Harris Beverley , Fernando Joseph J R , Gama Rousseau , Fahie-Wilson Michael 
Published: June 2008

Background The polyethylene glycol (PEG) precipitation test is widely used to detect hyperprolactinaemia caused by macroprolactin. We report two cases of hyperprolactinaemia in which a low recovery of serum prolactin (PRL) after PEG precipitation indicated the presence of macroprolactin, but no macroprolactin was detected by gel filtration chromatography (GFC). Both cases had elevated concentrations of serum globulin (IgG myeloma and polyclonal hypergammaglobulinaemia due to human immunodeficiency virus [HIV] infection), which prompted us to investigate further the effect of serum globulin on the specificity of the PEG precipitation procedure. Methods The effect of increasing concentrations of gamma globulin on the precipitation of PRL by PEG was studied by adding purified human gamma globulin to serum. Ten samples from HIV-infected patients, which showed a low recovery of PRL after PEG precipitation (<60%) were studied with GFC. Results Addition of gamma globulin decreased the recovery of PRL following precipitation with PEG and gamma globulin concentrations correlated inversely with PRL concentrations ( r = 0.9429, P < 0.0167) and percentage recovery of PRL ( r = −1.000, P < 0.005). Only one out of 10 samples from HIV-infected patients with PRL recoveries of <60% following PEG precipitation showed a substantial macroprolactin component on GFC. Conclusions Monomeric PRL is co-precipitated with serum globulins by PEG. Increased serum globulin concentrations can increase the amount of monomeric PRL precipitated by PEG giving a false estimate of the monomeric PRL and the erroneous impression that macroprolactin is present. The results of the PEG precipitation test should be interpreted with caution in patients with elevated serum globulin concentrations.
Partner Notification of Sexually Transmitted Infections among Pregnant Women
Authors: Thurman Andrea Ries , Holden Alan E C , Shain Rochelle , Perdue Sondra , Piper Jeanna 
Published: June 2008

The object of this study was to determine the factors associated with partner notification (PN) of sexually transmitted infection (STI) exposure among pregnant, low income, Mexican-American (MA) and African-American (AA) women and their male sexual partners. We used a cross-sectional analysis of 166 pregnant women with an STI, enrolled in a randomized controlled trial of behavioural intervention to prevent recurrent STIs. The primary outcome, PN, is notification of, or intent to notify male sexual partner(s) of STI exposure. Pregnant women with one (n = 136) versus multiple (n = 30) partners reported PN for 88.2% and 54.5% of male partners, respectively (P < 0.001). Multivariate logistic regression demonstrated three variables that independently predicted PN: a steady relationship, with one male sexual partner and recent (<30 days) intercourse with the partner. Among the low income, pregnant MA and AA women, the three relationship variables predicted 81.6% of PN and correctly classified 78.5% of males notified and 65.7% of males not notified.
Acknowledging a persistent truth: domestic violence in pregnancy
Authors: Cook Joanna , Bewley Susan 
Published: June 2008

Summary Violence against women has a devastating effect on women's sexual and reproductive health, and also affects the health of their children. Such behaviour is rooted in gender inequality, which is sadly persistent, arguably throughout all societies. This phenomenon is a serious health and development concern, in addition to a violation of a woman's human rights. Violence can begin or escalate in pregnancy and has significant consequences for the woman, fetus and child. Questioning pregnant women about the presence of violence and offering referral to a secondary agency can help to break the pattern of abuse.