bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient involvement in patient safety: what factors influence patient participation and engagement?
Authors: Davis Rachel E. , Jacklin Rosamond , Sevdalis Nick , Vincent Charles A. 
Published: July 2007

AbstractBackground Patients can play an important role in improving patient safety by becoming actively involved in their health care. However, there is a paucity of empirical data on the extent to which patients take on such a role. In order to encourage patient participation in patient safety we first need to assess the full range of factors that may be implicated in such involvement.Objective To delineate factors that could affect the participation of the patient in quality and safety issues in their health care.Method Literature review of patient involvement in health care, drawing from direct evidence (specifically from the safety context) and indirect evidence (extrapolated from treatment decision‐making research and the wider patient involvement in health care literature); synthesis and conceptual framework developed, illustrating the known and putative factors that could affect the participation of the patient in safety issues in their health care.Main results Five categories of factors emerged that could affect patient involvement in safety: patient‐related (e.g. patients’ demographic characteristics), illness‐related (e.g. illness severity), health‐care professional‐related (e.g. health care professionals’ knowledge and beliefs), health care setting‐related (e.g. primary or secondary care), and task‐related (e.g. whether the required patient safety behaviour challenges clinicians’ clinical abilities).Conclusion The potential for engaging patients in patient safety is considerable but further research is needed to examine the influences on patient involvement, the limits and the possible dangers. Patients can act as ‘safety buffers’ during their care but the responsibility for their safety must remain with the health care professionals.
The role and value of written information for patients about individual medicines: a systematic review
Authors: Grime Janet , Blenkinsopp Alison , Raynor David K. , Pollock Kristian , Knapp Peter 
Published: July 2007

AbstractObjective To review research on the role and value of written medicines information for patients from the perspective of patients and health professionals.Context Providing written information to patients about their medicines is acknowledged as a priority but there is poor understanding of how best to meet patients’ needs.Method A sensitive search strategy was developed to maximize the identification of relevant studies. We used a data extraction form designed to appraise qualitative research. Findings were synthesized into a narrative account.Main results There were three broad categories of study: those which related to policy initiatives; those where the aim was to increase compliance; and those concerned with using information to support decision‐making (‘informed patient’ studies). While the policy initiative and compliance studies reported that, mostly, patients were positive about written information, the ‘informed patient’ studies showed a more complex picture. Patients valued medicines information tailored to their condition. They did not want it to be a substitute for spoken information from their doctor. Not everyone wanted written information but those who did wanted sufficient detail to meet their need. Need varied over time and between patients. The small number of studies relating to health professionals showed widespread ambivalence towards using written information. Some thought it should be brief and simple, only partially disclose side‐effects and saw its main role as being to increase compliance.Conclusion The different perspectives of patients and health professionals, and the diverse and changing information needs of patients pose a challenge to providers of written medicines information.
Placebo reactions in double‐blind, placebo‐controlled food challenges in children
Authors: Vlieg‐Boerstra B. J. , Van Der Heide S. , Bijleveld C. M. A. , Kukler J. , Duiverman E. J. , Dubois A. E. J. 
Published: July 2007

Background:  A cardinal feature of the double‐blind, placebo‐controlled food challenge (DBPCFC) is that placebo administration is included as a control. To date, the occurrence and diagnostic significance of placebo events have not extensively been documented.Objective:  To analyse the occurrence and features of placebo events in DBPCFCs and to assess their contribution to the diagnostic accuracy of the DBPCFC in children.Methods:  The study population consisted of 132 challenges in 105 sensitized children (age range 0.7–16.6 years, median 5.3 years), who underwent DBPCFCs with cow’s milk, egg, peanut, hazelnut and soy. Placebo and active food challenges were performed on different days.Results:  A total number of 17 (12.9%) positive placebo events occurred, which could be classified as immediate (9/17), late‐onset (8/17), objective (11/17) or subjective (6/17). Four of 74 (5.4%) positive active food challenges were revealed to be false positive by administration of a placebo challenge. This is 3% (4/132) of all challenges. When computed by a statistical model, the false positive rate was 0.129 (12.9% of all challenges).Conclusion:  Placebo events with diverse clinical characteristics occur in DBPCFCs in a significant number of children. The diagnostic significance of the administration of a placebo challenge is first, to identify false positive diagnoses in DBPCFCs by refuting false positive tests in individual patients. Secondly, to allow for blinding of the active food challenge. Thirdly, applying a statistical model demonstrates that some positive challenges may be false positive and that the test may need to be repeated in selected cases.
Comparison of international guidelines for the emergency medical management of anaphylaxis
Authors: Alrasbi M. , Sheikh A. 
Published: July 2007

Background:  Guideline‐based treatment approaches for managing anaphylaxis are widely believed to result in good outcomes, but the strength of evidence underpinning the recommendations made therein is unclear.Objective:  To identify and compare national guidelines for the emergency medical management of anaphylaxis and to describe the extent to which the evidence base in support of key recommendations is made clear.Methods:  We systematically searched key medical databases and contacted the World Allergy Organization and anaphylaxis charities in several countries to identify national guidelines. Full text copies of relevant papers were obtained and, where necessary, translated. Data were abstracted onto a customized data extraction sheet; this process was independently checked by a second reviewer.Results:  Guidelines originating from Australia, Canada, Russia, UK, Ukraine and the USA were identified. While these were in agreement on the broad principles of management, there were important variations in relation to the treatments to be used and the dose and route of administration of these preparations. Most guidelines failed to make clear the strength of evidence underpinning the recommendations being made.Conclusions:  There are important international differences in the recommended emergency management of anaphylaxis. It is important that an agreed core evidence‐based guideline for the management of anaphylaxis is now developed, which can then be adapted for national/local use. Clinicians need to be aware of the limitations of existing guidelines.
Specific immunotherapy has long‐term preventive effect of seasonal and perennial asthma: 10‐year follow‐up on the PAT study
Authors: Jacobsen L. , Niggemann B. , Dreborg S. , Ferdousi H. A. , Halken S. , Høst A. , Koivikko A. , Norberg L. A. , Valovirta E. , Wahn U. , Möller C. ,   (The PAT investigator group)
Published: July 2007

Background:  3‐year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5‐year follow‐up) indicating long‐term preventive effect of SIT.Objective:  We evaluated the long‐term clinical effect and the preventive effect of developing asthma 7‐years after termination of SIT.Methods:  One hundred and forty‐seven subjects, aged 16–25 years with grass and/or birch pollen allergy was investigated 10 years after initiation of a 3‐year course of SIT with standardized allergen extracts of grass and/or birch or no SIT respectively. Conjunctival provocations were performed outside the season and methacholine bronchial provocations were performed during the season and winter. Asthma was assessed by clinical evaluation.Results:  The significant improvements in rhinoconjunctivitis and conjunctival sensitivity persisted at the 10‐year follow‐up. Significantly less actively treated subjects had developed asthma at 10‐year follow‐up as evaluated by clinical symptoms [odds ratio 2.5 (1.1–5.9)]. Patients who developed asthma among controls were 24/53 and in the SIT group 16/64. The longitudinal treatment effect when adjusted for bronchial hyper‐responsiveness and asthma status at baseline including all observations at 3, 5 and 10 years follow‐up (children with or without asthma at baseline, n = 189; 511 observations) was statistically significant (P = 0.0075). The odds ratio for no‐asthma was 4.6 95% CI (1.5–13.7) in favor of SIT.Conclusion:  A 3‐year course of SIT with standardized allergen extracts has shown long‐term clinical effects and the potential of preventing development of asthma in children with allergic rhinoconjunctivitis up to 7 years after treatment.Clinical implication:  Specific immunotherapy has long‐term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination.
Clinical presentation and time course in hypersensitivity reactions to β‐lactams
Authors: Bousquet P. J. , Kvedariene V. , Co‐Minh H.‐B. , Martins P. , Rongier M. , Arnoux B. , Demoly P. 
Published: July 2007

Background:  β‐lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges.Objective:  The time course of the reactions in proven β‐lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course.Method:  All of the patients who consulted between 1996 and 2004 for a suspected β‐lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study.Results:  Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate‐reading skin prick (10.0%) and intradermal tests (38.1%), late‐reading skin tests (19.1%) or provocation tests (32.9%).Conclusion and clinical implication:  Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).
SENSORY NEURAL TARGETS FOR THE TREATMENT OF COUGH
Authors: Mazzone Stuart B , McGovern Alice E 
Published: July 2007

SUMMARYCough is a primary defensive reflex that protects the airways from potentially harmful stimuli.During many respiratory diseases, the cough reflex threshold is lowered and coughing becomes excessive.Currently available therapeutics are mostly ineffective at suppressing excessive coughing.In the present review, we describe the sensory neural pathways involved in cough, how these pathways may become dysfunctional in airway disease and the most recent advances that have been made in identifying future targets for cough suppression.
WHAT MAKES A CGRP2RECEPTOR?
Authors: Hay DL 
Published: July 2007

SUMMARYHeterogeneity in the receptors for the neuropeptide calcitonin gene‐related peptide (CGRP) has been apparent for nearly 20 years. This is most clearly manifested in the observation of CGRP8–37‐sensitive and ‐insensitive populations of CGRP‐activated receptors. The pA2values for CGRP8–37in excess of 7 are widely considered to be the result of antagonism of CGRP1receptors, whereas those below 7 are believed to be the consequence of antagonism of a second population of receptors, namely CGRP2receptors.However, a multitude of pA2values exist for CGRP8–37, spanning several log units, and as such no obvious clusters of values are apparent. Understanding the molecular nature of the receptors that underlie this phenomenon is likely to aid the development of selective pharmacological tools to progress our understanding of the physiology of CGRP and related peptides. Because there is active development of CGRP agonists and antagonists as therapeutics, such information would also further this pursuit.The CGRP1receptor is pharmacologically and molecularly well defined as a heterodimer of the calcitonin receptor‐like receptor (CL) and receptor activity modifying protein (RAMP) 1. The CL/RAMP1 complex is highly sensitive to CGRP8–37. Conversely, the constituents of the CGRP2receptor have not been identified. In fact, there is little evidence for a distinct molecular entity that represents the CGRP2receptor.Recent pharmacological characterization of receptors related to CGRP1has revealed that some of these receptors may explain CGRP2receptor pharmacology. Specifically, AMY1(a)(calcitonin receptor/RAMP1) and AM2(CL/RAMP3) receptors can be activated by CGRP but are relatively insensitive to CGRP8–37.This, along with other supporting data, suggests that the ‘CGRP2receptor’ that has been extensively reported in the literature may, in fact, be an amalgamation of contributions from a variety of CGRP‐activated receptors. The use of appropriate combinations of agonists and antagonists, along with receptor expression studies, could allow such receptors to be separated.
DESENSITIZATION OF GUINEA‐PIG TAENIA CAECI SMOOTH MUSCLE INDUCED BY A LOW CONCENTRATION OF CARBACHOL
Authors: Hishinuma Shigeru , Sato Ryo , Saito Masaki 
Published: July 2007

SUMMARYIn guinea‐pig taenia caeci smooth muscle we have found that 10−4 mol/L carbachol‐induced desensitization to muscarinic agonists develops within 15–30 s, followed by transient resensitization at 1 min, whereas the desensitization to depolarizing high K+develops with maximal desensitization at 1 min followed by sustained resensitization up to 30 min. In both cases, Ca2+‐dependent processes play a crucial role in determining the development of desensitization.To elucidate whether these peculiar processes of desensitization/resensitization may be induced by a lower concentration of carbachol, we examined the development of desensitization induced by 10−6 mol/L carbachol, because at this concentration carbachol is known to induce biphasic changes in intracellular Ca2+concentrations, with a smaller transient increase followed by a larger sustained increase than seen with 10−4 mol/L carbachol.Contractile responses to muscarinic agonists (carbachol or AHR‐602) and high K+were desensitized by pretreatment with 10−6 mol/L carbachol for 30 min in a manner dependent on the presence of extracellular Ca2+.The development of 10−6 mol/L carbachol‐induced desensitization to these muscarinic agonists in the presence of extracellular Ca2+showed three successive phases: fast desensitization within 30 s, followed by transient resensitization at 1 min and the subsequent development of desensitization up to 30 min. In contrast, desensitization to high K+did not develop up to 10 min and significant desensitization occurred at 30 min, with no apparent resensitization phase.These results suggest that the characteristics of the Ca2+‐dependent development of desensitization to muscarinic agonists, but not to high K+, are well maintained in desensitization induced by a lower concentration of carbachol.
RESTORATION OF ANTIBIOTIC SUSCEPTIBILITY IN METHICILLIN‐RESISTANTSTAPHYLOCOCCUS AUREUSBY TARGETINGMECR1WITH A PHOSPHOROTHIOATE DEOXYRIBOZYME
Authors: Hou Zheng , Meng Jing‐Ru , Niu Chao , Wang Hai‐Fang , Liu Jie , Hu Ben‐Quan , Jia Min , Luo Xiao‐Xing 
Published: July 2007

SUMMARYMethicillin resistance inStaphylococcus aureusis mediated by themecAgene. ThemecAgene encodes a penicillin‐binding protein (PBP2a) possessing low β‐lactam affinity. Transcription ofmecAis regulated by a signal transduction system consisting of the sensor/transducer MecR1. Disruption of the MecR1 regulatory pathway may inhibitmecAexpression and restore methicillin‐resistantStaphylococcus aureus(MRSA) susceptibility to β‐lactams.In the present study, a phosphorothioate deoxyribozyme (named PS‐DRz147) specifically targeting MecR1 mRNA was designed, synthesised and introduced into the MRSA strain WHO‐2.The expression ofmecR1andmecAwas inhibited by PS‐DRz147 in a concentration‐dependent manner. Consequently, the susceptibility of WHO‐2 colonies to the antibiotic oxacillin was restored.The results of the present study indicate that blockade of the MecR1–MecI–MecA signalling pathway with anmecR1‐targeted DNAzyme can restore the susceptibility of MRSA to existing β‐lactam antibiotics.
Nodular gastritis in adults: Clinical features, endoscopic appearance, histopathological features, and response to therapy
Authors: Dwivedi Manisha , Misra Sri Prakash , Misra Vatsala 
Published: July 2007

AbstractBackground and Aims:  The present study aims to determine the prevalence of nodular gastritis (NG) and ascertain its clinical presentation and histopathological features in adults. It also assesses its association with Helicobacter pylori and the normalization of endoscopic features, symptoms, and histology after anti H. pylori therapy.Methods:  A total of 7140 patients undergoing upper gastrointestinal endoscopy were studied. Patients showing nodularity of the gastric mucosa at endoscopy and an age‐ and sex‐matched control group with normal gastric mucosa underwent biopsies from the gastric antrum and fundus. The biopsies were assessed for the presence of mucosal inflammation, activity, eosinophils, atrophy, lymphoid follicles, H. pylori, and the presence of intestinal metaplasia. Patients with NG were given triple therapy. Endoscopy and biopsy was repeated after 4 weeks of stopping therapy. The symptoms of the patients and histology were assessed pre‐ and post‐therapy.Results:  Thirty‐two patients with an age range of 20–65 years presenting with NG and 40 age‐ and sex‐matched controls were included in the study. Presenting symptoms were epigastric pain (56%), nausea (75%), vomiting (50%) and abdominal bloating (62.5%). All these symptoms regressed significantly after 2 week of triple therapy against H. pylori. A marked improvement in histopathological features was seen post‐therapy where the presence of lymphoid aggregates, eosinophils in the mucosa, atrophy, and intestinal metaplasia improved significantly (P < 0.05) after therapy, as compared to the control group of patients.Conclusion:  The symptoms of NG and endoscopic features regress significantly after H. pylori therapy with a proton pump inhibitor and two antibiotics and should routinely be given to treat this form of gastritis. This may prevent progression to further complications.
Dominance of Mycoplasma in the guts of the Long‐Jawed Mudsucker, Gillichthys mirabilis, from five California salt marshes
Authors: Bano Nasreen , DeRae Smith Angelique , Bennett William , Vasquez Lydia , Hollibaugh James T. 
Published: July 2007

SummaryWe analysed the gut microflora of the Long‐Jawed Mudsucker, Gillichthys mirabilis by polymerase chain reaction/denaturing gradient gel electrophoresis and cloning and sequencing 16S rRNA gene amplicons. Fish were collected at five sites in northern and southern California, USA. The gut microflora assemblages of all G. mirabilis were similar, very simple and dominated by one or more Mycoplasma ribotypes. Hindguts were dominated by Mycoplasmas that were most similar to a ribotype retrieved from Atlantic salmon guts. A Mycoplasma ribotype that was 95% similar to Mycoplasma mobile was the dominant in the foregut.
Maternal administration of valaciclovir in symptomatic intrauterine cytomegalovirus infection
Authors: Jacquemard F , Yamamoto M , Costa J‐M , Romand S , Jaqz‐Aigrain E , Dejean A , Daffos F , Ville Y 
Published: July 2007

Objectives  To report early experience with treatment of intrauterine cytomegalovirus (CMV) infection using maternal oral administration of valaciclovir (VACV).Design  Observational study of fetuses infected with CMV with or without treatment with valaciclovir.Population  Pregnancies with confirmed fetal CMV infection were treated with oral VACV (8 g/day).Main outcome measures  Fetal viral load and drug concentration were monitored in amniotic fluid and in fetal blood. Data on the course and outcome of a group of untreated symptomatic fetuses infected with CMV are also reported.Results  Therapeutic concentrations were achieved in maternal and fetal bloods. The viral load in the fetal blood (VLFB) decreased significantly after 1–12 weeks of treatment (Wilcoxon paired test P= 0.02). Twenty pregnancies including 21 fetuses were treated at 28 weeks (median, range: 22–34) for 7 weeks (median, range: 1–12). Ten infants were developing normally at between 1 and 5 years of age. Two infants (both aged 2 years) had severe isolated unilateral deafness. One neonate presented with microcephaly and severe deafness but was also diagnosed with incontinentia pigmenti. Six out of seven cases that eventually required termination of pregnancy (TOP) had evidence of in utero progression of the disease with worsening cerebral lesions. One fetus died in utero. The outcome of 14/24 (58.3%) untreated symptomatic infected fetuses was poor with either TOP, intrauterine fetal demise or severe congenital infection disease of the neonate; the remaining ten infants were healthy at follow up.Conclusion  Maternal oral administration of VACV leads to therapeutic concentrations in the maternal and fetal compartments, with a decrease in VLFB. Our results suggest that in cases where TOP is declined, a randomised controlled trial to study this treatment option further is indicated.