bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of patient and doctor gender on diagnosing coronary heart disease
Authors: Adams Ann , Buckingham Christopher D. , Lindenmeyer Antje , McKinlay John B. , Link Carol , Marceau Lisa , Arber Sara 
Published: January 2009

AbstractUsing novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors’ diagnostic decision‐making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re‐examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n = 112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients’ age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free‐recall accounts of their decision‐making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors’ responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients’ age, and consider more age‐related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better‐quality care from female doctors.
‘Ordinary people only’: knowledge, representativeness, and the publics of public participation in healthcare
Authors: Martin Graham P. 
Published: January 2009

AbstractPublic involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self‐selecting members of the public, and those including a more broad‐based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople's expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social‐theoretical perspectives on the relationship between governmental authority and citizens in late‐modern society.
The challenge of fitting in: non‐participation and withdrawal from an online self‐help group for breast cancer patients
Authors: Sandaunet Anne‐Grete 
Published: January 2009

AbstractOnline self‐help groups multiply peoples’ possibilities to exchange information and social support. Such possibilities are expected to be of crucial value for the ‘new’ healthcare user. However, similar to experiences from face‐to‐face based groups, studies of online self‐help groups report high drop‐out rates. Knowledge about why this happens is scarce. By means of qualitative interviews and participant observation, this article examines non‐participation and withdrawal from an online self‐help group for Norwegian breast cancer patients. Five conditions are identified as barriers to use; a need to avoid painful details about cancer, not being ‘ill enough’ to participate, the challenge of establishing a legitimate position in the group, the organisation of everyday life and illness phases that did not motivate for self‐help group participation. I suggest that an adoption of the biomedical explanation model represents an important background for this pattern, an argument which contrasts prominent assumptions about the new healthcare user who does not accept the biomedical ‘restitution story’ in her efforts to make sense of an illness. A further suggestion is that experiences of self‐help groups as arenas for successful coping need to be further considered as a barrier to use.
Producing genetic knowledge and citizenship through the Internet: mothers, pediatric genetics, and cybermedicine
Authors: Schaffer Rebecca , Kuczynski Kristine , Skinner Debra 
Published: January 2009

AbstractThis article analyses data from a longitudinal, ethnographic study conducted in the United States to examine how 100 mothers of children with genetic disorders used the Internet to interpret, produce, and circulate genetic knowledge pertaining to their child's condition. We describe how they came to value their own experiential knowledge, helped shift the boundaries of what counts as authoritative knowledge, and assumed the role of genetic citizen, fighting for specific rights while shouldering and contesting concomitant duties and obligations. This exploration of e‐health use contributes to our understanding of the social practices and power relations that cut across online and off‐line worlds to co‐produce genetic knowledge and genetic citizenship in multiple contexts.
Measuring function in advanced ALS: validation of ALSFRS‐EX extension items
Authors: Wicks P. , Massagli M. P. , Wolf C. , Heywood J. 
Published: January 2009

Background:  With the aid of assistive technology, some patients with amyotrophic lateral sclerosis (ALS) are able to live for several years past the lowest measurable level of function on the Amyotrophic Lateral Sclerosis Functional Rating Scale – Revised (ALSFRS‐R), a widely used end‐point in ALS assessment. There is a research need to monitor patient function at the end of life, particularly in the face of severe impairment or ‘locked in syndrome’.Methods:  We used an online community for people with ALS (PALS) (PatientsLikeMe) to construct and pilot a number of new items to add to the ALSFRS‐R scale to improve its sensitivity at lower levels of physical function in patients with advanced ALS.Results:  Ten new scale items were generated by a survey of PALS with advanced disease. These were added to the existing ALSFRS‐R and data was received from 326 PALS as baseline with 271 PALS (83%) completing a 1‐week test‐retest and 218 PALS (67%), completing a 3‐month retest.Conclusions:  Three new items were selected which conformed to the existing factor structure of the ALFRS‐R. These relate to the ability to use fingers to manipulate devices, ability to show emotional expression in the face, and ability to get around inside the home. Real‐world validation is the next step to assess the utility of the ALFRS‐EX.
Efficacy of natalizumab in multiple sclerosis patients with high disease activity: a Danish nationwide study
Authors: Oturai A. B. , Koch‐Henriksen N. , Petersen T. , Jensen P. E. H. , Sellebjerg F. , Sorensen P. S. 
Published: January 2009

Introduction:  Previous studies of natalizumab (Tysabri®) in relapsing multiple sclerosis (MS) patients have included patients with moderate disease activity. We studied a patient population with high disease activity.Patients and Methods:  We analyzed data from 234 consecutive, natalizumab‐treated patients, followed for at least 3 months. Three groups of patients were eligible for natalizumab therapy: patients with two or more documented relapses or sustained increase of 2 EDSS points on disease modifying therapy (DMT) in the previous year; patients switching from mitoxantrone; and patients with very active MS as de novo therapy.Results:  During a median observation time of 11.3 months (range 3.0–21.5) the annualized relapse rate decreased to 0.68 from a pre‐treatment rate of 2.53 (73% reduction). We assessed the annualized relapse rate in three subgroups: (i) 0.83 in 14 (6.0%) de novo treated patients; (ii) 0.71 in 175 (74.8%) patients with ≥2 relapses or sustained increase in EDSS of ≥2 points on a first‐line DMT; and (iii) 0.56 in 45 (19.2%) patients switching from mitoxantrone. Nine anaphylactoid reactions, two severe, were reported. Out of 215 patients 7 (3%) were persistently positive for antibodies to natalizumab.Conclusions:  Tysabri appears to be effective in MS patients with high disease activity, but the relapse rate was higher than in the pivotal study after the first treatment year. This is likely to reflect differences in disease activity before the initiation of natalizumab treatment.
Pallidal stimulation in cervical dystonia: clinical implications of acute changes in stimulation parameters
Authors: Moro E. , Piboolnurak P. , Arenovich T. , Hung S. W. , Poon Y.‐Y. , Lozano A. M. 
Published: January 2009

Background and purpose:  Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is successful in dystonia, but the role of each electrical parameters of stimulation is unclear. We studied the clinical effects of acute changes of different parameters of GPi–DBS in cervical dystonia (CD).Methods:  Eight CD patients with bilateral GPi–DBS at 28.6 ± 19.2 (mean ± SD) months after surgery were recruited. Mean improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 54.5% compared to before surgery. Ten settings, including a combination of a wide range of pulse widths (PWs), low and high frequencies and voltage, were administered in a randomized double blinded fashion. Clinical benefit was assessed by two raters using the TWSTRS and by the patients using an analogue rating scale.Results:  The TWSTRS severity scores were reduced by 56.7% with stimulation at the best settings. Improvement was significantly associated with high frequency (≥60 Hz) and high voltage. Stimulation at 130 Hz showed the best clinical improvement. Increasing PWs (from 60 to 450 μs) did not result in a significant improvement.Conclusion:  Frequency and amplitude appear to be the most important factors in the acute anti‐dystonic effects in GPi–DBS patients with CD.
Psoriasis associated with ulcerative colitis and Crohn's disease
Authors: Cohen AD , Dreiher J , Birkenfeld S 
Published: January 2009

AbstractBackground  Numerous reports have demonstrated the epidemiological, pathogenic, and genetic association between psoriasis and Crohn's disease. Nevertheless, the association between psoriasis and ulcerative colitis was rarely described.Objective  This study aims to investigate the association between psoriasis and inflammatory bowel disease.Study design  Case‐control study.Setting  The study was performed utilizing the large medical dataset of Clalit Health Services.Methods  Psoriasis patients were compared to controls regarding the prevalence of inflammatory bowel disease in a case–control study using logistic multivariate models.Results  The study included 12 502 psoriasis patients aged 20 years and above and 24 287 age‐ and sex‐matched controls. The prevalence of both Crohn's disease and ulcerative colitis was significantly higher in psoriasis patients compared with the control group. In multivariate analyses, psoriasis was associated with Crohn's disease [odds ratio (OR), 2.49; 95% confidence interval (95% CI), 1.71–3.62] as well as ulcerative colitis (OR, 1.64; 95% CI, 1.15–2.33). This association was independent of anti‐tumour necrosis factor‐α therapy.Conclusion  Psoriasis is associated both with Crohn's disease and ulcerative colitis. Future studies on comorbidities in patients with psoriasis should focus on ulcerative colitis.Conflicts of interestNone declared.
Oxygen stable isotope ratios of tree‐ring cellulose: the next phase of understanding
Authors: Sternberg Leonel da Silveira Lobo O’Reilly 
Published: January 2009

SummaryAnalysis of the oxygen isotope ratio of tree‐ring cellulose is a valuable tool that can be used as a paleoclimate proxy. Our ability to use this tool has gone through different phases. The first began in the 1970s with the demonstration of empirical relationships between the oxygen isotope ratio of tree‐ring cellulose and climate. These empirical relationships, however, did not provide us with the confidence that they are robust through time, across taxa and across geographical locations. The second phase began with a rudimentary understanding of the physiological and biochemical mechanisms responsible for the oxygen isotope ratios of cellulose, which is necessary to increase the power of this tool. This phase culminated in a mechanistic tree‐ring model integrating concepts of physiology and biochemistry in a whole‐plant system. This model made several assumptions about leaf water isotopic enrichment and biochemistry which, in the nascent third phase, are now being challenged, with surprising results. These third‐phase results suggest that, contrary to the model assumption, leaf temperature across a large latitudinal gradient is remarkably constant and does not follow ambient temperature. Recent findings also indicate that the biochemistry responsible for the incorporation of the cellulose oxygen isotopic signature is not as simple as has been assumed. Interestingly, the results of these challenges have strengthened the tree‐ring model. There are several other assumptions that can be investigated which will improve the utility of the tree‐ring model.
Experimental case report: development of a pneumothorax monitored by electrical impedance tomography
Authors: Preis Carsten , Luepschen Henning , Leonhardt Steffen , Gommers Diederik 
Published: January 2009

SummaryElectrical impedance tomography (EIT) is a non‐invasive, radiation‐free functional imaging technique, which allows continuous bedside measurement of regional lung ventilation. Pneumothorax is an uncommon but nevertheless potentially dangerous incident that may arise unexpectedly. We report an incident of an accidental tension pneumothorax during an experimental ventilation study in a pig that was continuously monitored by EIT. The early sign of the occurring pneumothorax, prior to all clinical signs, was a fast increase of end‐expiratory impedance in the ventral part of the right lung indicating that non‐ventilated air entered this part, followed by a disappearance of ventilation in this region. At the same time the ventilation‐related impedance changes of the left lung remained almost unchanged. The pneumothorax onset was localized using a newly introduced pneumothorax dynamics map directly derived from dynamic EIT data. We conclude that non‐invasive EIT may be helpful as a tool to detect the development of a pneumothorax, which could be of particular interest during invasive procedures such as insertion of a central venous catheter.
Comparison of High Resolution Magnifying Endoscopy and Standard Videoendoscopy for the Diagnosis of Helicobacter pylori Gastritis in Routine Clinical Practice: A Prospective Study
Authors: Gonen Can , Simsek Ilkay , Sarioglu Sulen , Akpinar Hale 
Published: January 2009

AbstractBackground:  It has been shown that standard endoscopic features often labeled as gastritis has a poor correlation with histopathology. Recently, high resolution magnifying endoscopy has been reported to be an effective method to diagnose gastritis. The aim of the present study was to compare standard endoscopy with magnifying endoscopy for the diagnosis of Helicobacter pylori gastritis, and to determine whether gastritis can be diagnosed based on findings at magnification endoscopy.Materials and Methods:  A total of 129 patients were enrolled into the study. Erythema, erosions, prominent area gastrica, nodularity, and regular arrangement of collecting venules (RAC) were investigated by standard endoscopy. Standard endoscopy was followed by magnifying endoscopy in all patients, and repeated in 55 patients after indigo carmine spraying.Results:  None of the standard endoscopic features showed a sensitivity of more than 70% for H. pylori gastritis, except RAC pattern analysis. Absence of a corporal RAC pattern had 85.7% sensitivity and 82.8% specificity for predicting H. pylori infection. Under magnification, the sensitivity and specificity of regular corporal pattern (regular collecting and capillary vascular structures with gastric pits resembling pinholes) for predicting normal histology were 90.3% and 93.9%, respectively. Loss of collecting venules, or both collecting and capillary structures was correlated with chronic inflammation and activity. With the progression of mucosal atrophy, irregular collecting venules became visible. The values for irregularly arranged antral ridge pattern for the prediction of antral gastritis were 89.3% and 65.2%, respectively. Indigo carmine staining increased sensitivity and specificity up to 97.6% and 100% for corporal gastritis, and up to 88.4% and 75.0% for antral gastritis, respectively. Indigo carmine staining significantly increases the detection of intestinal metaplasia.Conclusions:  High resolution magnifying is superior to standard endoscopy for the diagnosis of H. pylori gastritis, and identification of specific histopathologic features such as atrophy and intestinal metaplasia seems possible.
Characterization and Application of a New Monoclonal Antibody with High Specificity for Helicobacter hepaticus
Authors: Fukuda Yoshihiro , Shimoyama Tadashi , Ohmura Takeo , Sano Yukari , Nakabayashi Natsuko , Takahashi Ryoki , Fujioka Toshio , Mitchell Hazel M. , Shimoyama Takashi 
Published: January 2009

AbstractBackground and Aims:  Infection with Helicobacter hepaticus is suggested to play a role in the pathogenesis of chronic liver disease in humans. However, reactive antigens among Helicobacter species make the development of an H. hepaticus ELISA test with high specificity difficult. A new monoclonal antibody from a hybridoma clone (HRII‐51) showed high specificity to H. hepaticus without cross‐reaction to other gastrointestinal bacteria.Methods:  The molecular weight of HRII‐51 immunoreactive antigen was examined by Western blot of H. hepaticus probed with the monoclonal antibody HRII‐51. A HRII‐51‐immunoreactive antigen capture ELISA was prepared in which the specific antigen was anchored by HRII‐51‐immobilized ELISA plate. Accuracy of HRII‐51 antigen capture ELISA was examined using sera obtained from mice inoculated with Helicobacter species. Specificity of HRII‐51 antigen capture ELISA was compared to that of H. hepaticus antigen‐based ELISA using human sera with absorption by H. pylori cell lysate.Results:  HRII‐51 immunoreactive antigen had a molecular weight of 15 kDa. Sensitivity and specificity of HRII‐51 antigen capture ELISA were 87.0% and 97.6% in mice inoculated with Helicobacter species. In human sera, modification of the results by absorption with H. pylori lysate was smaller in HRII‐51 antigen capture ELISA comparing with H. hepaticus‐antigen‐based ELISA.Conclusion:  Use of the HRII‐51 antigen capture ELISA would be a useful approach for the serodiagnosis of H. hepaticus infection in both experimental animals and humans.
Childhood Hygienic Practice and Family Education Status Determine the Prevalence of Helicobacter pylori Infection in Iran
Authors: Nouraie Mehdi , Latifi‐Navid Saeid , Rezvan Houri , Radmard Amir‐Reza , Maghsudlu Mahtab , Zaer‐Rezaii Hanieh , Amini Sadigheh , Siavoshi Farideh , Malekzadeh Reza 
Published: January 2009

AbstractBackground: Management of Helicobacter pylori, a causative agent of gastrointestinal diseases is an important health problem in most countries. The main reasons include poorly defined epidemiological status and unrecognized mode of bacterial transmission. Our objective was to investigate the prevalence of H. pylori infection in a representative population of Iran and to evaluate possible risk factors for the H. pylori infection.Materials and methods: In this cross‐sectional study, 2561 healthy individuals aged 18–65 years (mean age, 35.5 years) were selected out of 12,100,000 inhabitants of Tehran province by cluster sampling. Infection with H. pylori was evaluated by detection of anti‐H. pylori IgG antibody in serum. Sociodemographic status of each subject was determined by filling up a questionnaire.Results: Prevalence of H. pylori infection was 69% and was correlated with increasing age. The highest infection rate (79.2%) was seen in individuals 46–55 years old. No association was detected between H. pylori positivity and gender. Low education of the study subjects; low father's and mother's education; poor tooth brushing habit; crowded families in childhood; and lack of household bath, hygienic drinking water, and swage disposal facility in childhood were determined as possible risk factors.Conclusions: The rate of prevalence of H. pylori infection was higher than developed countries. Low socioeconomic status, poor sanitary indications, and crowded families in childhood were related to high prevalence of H. pylori infection in Iran. Accordingly, fecal–oral and oral–oral routes could be considered as the main pathways of transmission of H. pylori.
Toll‐Like Receptor 4 +3725 G/C Polymorphism, Helicobacter pylori Seropositivity, and the Risk of Gastric Atrophy and Gastric Cancer in Japanese
Authors: Hishida Asahi , Matsuo Keitaro , Goto Yasuyuki , Mitsuda Yoko , Hiraki Akio , Naito Mariko , Wakai Kenji , Tajima Kazuo , Hamajima Nobuyuki 
Published: January 2009

AbstractBackground:  Toll‐like receptor 4 (TLR4) Asp299Gly and Thr399Ile polymorphisms were reported to be a risk factor of gastric carcinoma or its precursors in Caucasian and Indian population, but these polymorphisms are absent in Japanese. We investigated the associations of TLR4+3725 G/C polymorphism, another functional polymorphism of TLR4, with risk of gastric cancer and gastric atrophy in Japanese.Materials and Methods:  Study subjects were 583 histologically diagnosed gastric cancer patients and age‐ and sex‐matched 1592 control outpatients, who visited Aichi Cancer Center Hospital from 2001 to 2005. Serum anti‐H. pylori IgG antibody and pepsinogens were measured to evaluate H. pylori infection and gastric atrophy, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by a logistic model.Results:  Among the seropositive subjects, the age‐ and sex‐adjusted OR of gastric atrophy was 1.17 (95%CI: 0.91–1.50) for G/C, 1.20 (95%CI: 0.76–1.89) for C/C, and 1.18 (95%CI: 0.93–1.49) for G/C+C/C relative to G/G genotype. The age‐ and sex‐adjusted OR of severe gastric atrophy among H. pylori seropositive subjects was 1.43 (95%CI: 0.99–2.06) for G/C, 1.47 (95%CI: 0.76–2.88) for C/C, and 1.43 (95%CI: 1.01–2.04) for G/C+C/C. The OR of gastric cancer compared with gastric atrophy controls was not statistically significant.Conclusion:  Our study found that TLR4+3725 G/C polymorphism was a risk factor of severe gastric atrophy in H. pylori seropositive Japanese. Our results underscored the significance of the variations in host innate immunity due to TLR4 polymorphism as genetic predispositions to gastric precancerous lesions in Eastern Asian populations with the same backgrounds.