bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary subcutaneous zygomycosis due to Rhizopus oryzae in a 71‐year‐old man with normal immune status
Authors: Romano C. , Ghilardi A. , Massai L. , Capecchi P. L. , Miraccco C. , Fimiani M. 
Published: December 2006

SummaryA case of primary subcutaneous zygomycosis due to Rhizopus oryzae is described in a 71‐year‐old man with normal immune status. Diagnosis was based on histological examination and culture of biopsy fragments from skin lesions. The patient recovered after itraconazole therapy (200 mg day−1 for 60 days followed by 100 mg day−1 for 45 days).
Tinea incognito due to Trichophyton mentagrophytes
Authors: Sánchez‐Castellanos María Elena , Mayorga‐Rodríguez Jorge Arturo , Sandoval‐Tress Cecilia , Hernández‐Torres Mercedes 
Published: December 2006

SummaryTinea incognito is a ringworm infection modified by corticosteroids. We report a case of a 2‐year‐old girl who developed tinea incognito due to Trichophyton mentagrophytes after applying methylprednisolone aceponate for 3 months. Diagnosis was confirmed by histopathologic and mycological examination, which led to the identification of Trichophyton mentagrophytes var. mentagrophytes, a zoophilic dermatophyte. Previous corticosteroid use in dermatophyte infections can alter their clinical appearance leading to misdiagnosis and delay in appropriate therapy.
Susceptibility and trailing growth of Candida albicans to fluconazole: results of a Korean multicentre study
Authors: Lee Mi‐Kyung , Kim Hye‐Ryoun , Kang Jung‐Oak , Kim Mi‐Na , Kim Eui‐Chong , Kim Jae‐Seok , Kim Jin‐Ju , Park Yeon‐Joon , Song Wonkeun , Shin Jong‐Hee , Lee Kyu‐Man , Lee Nam‐Yong , Lee Miae , Lee Wee‐Gyo , Lee Chang Kyu , Lee Hee‐Joo , Chang Chulhun L. , Choi Tae Yeal 
Published: December 2006

SummaryThe work reported here is the first nationwide, multicenter surveillance study conducted in Korea to obtain data on fluconazole susceptibility of Candida albicans (C. albicans) isolates. A total of 1137 isolates of C. albicans obtained from 17 university hospitals in South Korea during the 6‐month period, July through December 2004, were tested. No resistant strains were observed in any of the isolates. Only five of the 1137 isolates (0.44%) of C. albicans were found to be susceptible dose dependent, with all remaining strains (99.56%) susceptible to fluconazole. Trailing growth at 48 h was found in only four isolates (0.35%).
Assessment by human research ethics committees of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research
Authors: Newcombe J. P. , Kerridge I. H. 
Published: December 2006

AbstractBackground: Conflicts of interest arising from pharmaceutical industry sponsorship of clinical research have the potential to bias research outcomes and ultimately prejudice patient care. It is unknown how Australian Human Research Ethics Committees (HREC) assess and manage such conflicts of interest. We aimed to gain an understanding of how HREC approach the problem of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research.Method: We conducted a survey of HREC chairpersons in New South Wales.Results: HREC vary widely in their approaches to conflicts of interest, including in their use of National Health and Medical Research Council guidelines, which were often misinterpreted or overlooked. Many committees rely primarily on researchers disclosing potential conflicts of interest, whereas a majority of HREC use disclosure to research participants as the primary tool for preventing and managing conflicts of interest. Almost no HREC place limitations on researcher relationships with pharmaceutical companies.Conclusion: These findings suggest reluctance on the part of HREC to regulate many potential conflicts of interest between researchers and pharmaceutical sponsors, which may arise from uncertainty regarding the meaning or significance of conflicts of interest in research, from ambiguity surrounding the role of HREC in assessing and managing conflicts of interest in research or from misinterpretation or ignorance of current National Health and Medical Research Council guidelines. Further review of policies and practices in this important area may prove beneficial in safeguarding clinical research and patient care while promoting continuing constructive engagement with the pharmaceutical industry.
Anger in palliative care: a clinical approach
Authors: Philip J. , Gold M. , Schwarz M. , Komesaroff P. 
Published: December 2006

AbstractAnger in patients and families is a common problem in the care of persons with advanced disease. Whereas it is widely accepted that anger may be a justifiable reaction to significant illness and loss, it frequently creates difficulties for the doctors involved in care. In particular, there is often a personal impact on the doctor at whom anger is directed. This paper examines results of qualitative research with palliative care workers in the context of the broader published literature and the authors’ clinical experiences. The ability to interact effectively with angry patients is a skill that is often learned with experience and is extremely useful in both transforming the patients’ reaction into a more creative emotion and in developing a therapeutic relationship. Despite conscientious efforts, however, a few patients continue to be angry. A practical approach to anger, useful for the clinician directly involved in care, is outlined along with some strategies to adopt in the face of persistent anger.
Analysis of multidisciplinary lung cancer practice
Authors: Conron M. , Phuah S. , Steinfort D. , Dabscheck E. , Wright G. , Hart D. 
Published: December 2006

AbstractBackground: The aim of this study was to describe the activity of a lung cancer multidisciplinary clinic (MDC) and examine whether this model of clinical practice results in adherence to best‐practice guidelines.Methods: Prospective analysis of demographic and clinical data in 431 patients referred to a lung cancer MDC for the management of known or suspected thoracic malignancy. Adherence was documented to clinically relevant guideline recommendations concerning timely and evidence‐based lung cancer management.Results: Of 431 patients, 257 were diagnosed with primary lung cancer, mean age 68 years, 70% men and 90% current smokers or ex‐smokers. Only 21% were referred with known malignancy and 28% were asymptomatic. Overall, 51% had stages I and II non‐small‐cell lung cancer, with this bias towards early‐stage disease greatest in patients from rural areas. Histological confirmation of lung cancer was obtained in 92%. There was a high rate of adherence to international guideline recommendations concerning timely lung cancer diagnosis, staging and treatment implementation. Similarly, there was adherence to selected key evidence based recommendations for lung cancer management contained in national guidelines.Conclusion: Within a MDC, patients receive timely diagnosis, staging and treatment according to evidence‐based guideline recommendations. The high proportion of patients receiving active treatment has implications for resource allocation. There is a referral bias towards patients with early non‐small‐cell lung cancer, particularly in rural patients, suggesting that further education about advances in metastatic lung cancer management is required. This study would support the establishment of regional lung cancer services with links to fully resourced MDC.
Sudden cardiac death in the young: a clinical genetic approach
Authors: Ingles J. , Semsarian C. 
Published: December 2006

AbstractThe sudden death of a young person is a devastating event for both the family and community. Over the last decade, significant advances have been made in understanding both the clinical and genetic basis of sudden cardiac death in the young. Many of the causes of sudden death in the young are due to genetic heart disorders, which can lead to both structural (e.g. hypertrophic cardiomyopathy) and arrhythmogenic (e.g. familial long QT syndrome) abnormalities. Most commonly, sudden cardiac death in the young can be the first presentation of an underlying heart problem, leaving the family at a loss as to why an otherwise healthy young person has died. Not only is this a tragic event for those involved, but it also presents a medical challenge to the clinician involved in the management of the surviving family members. Evaluation of families requires a multidisciplinary approach, which should include cardiologists, a clinical geneticist, a genetic counsellor and the forensic pathologist directly involved in the sudden death case. This multifaceted cardiac genetic service is crucial in the evaluation and management of the clinical, genetic, psychological and social complexities observed in families in which there has been a young sudden cardiac death.
Characteristics and outcome of type 2 diabetes in urban Aboriginal people: the Fremantle Diabetes Study
Authors: Davis T. M. E. , McAullay D. , Davis W. A. , Bruce D. G. 
Published: December 2006

AbstractWe analysed data from Aboriginal patients with type 2 diabetes recruited to the community‐based Fremantle Diabetes Study and compared them with those from the Anglo‐Celt participants. Diabetes prevalence among Aboriginal people in the Fremantle area was more than double that of Anglo‐Celts and the average age at diagnosis was 14 years or younger. Glycaemic control, urinary albumin :creatinine and the proportion of smokers were all higher in the Aboriginal group and there was evidence of lower diabetes‐related quality of life and high rates of disability at a young age. The Aboriginal patients died 18 years or younger than their Anglo‐Celt counterparts. Specialized, culturally‐sensitive and sustainable programmes are urgently needed to improve the management of diabetes in urban Aboriginal communities.
Effects of inhibition of fatty acid amide hydrolase vs. the anandamide membrane transporter on TRPV1‐mediated calcium responses in adult DRG neurons; the role of CB1 receptors
Authors: Millns P. J. , Chimenti M. , Ali N. , Ryland E. , De Lago E. , Fernandez‐Ruiz J. , Chapman V. , Kendall D. A. 
Published: December 2006

AbstractThe aim of the present study was to investigate the relationship between TRPV1 stimulation and endocannabinoid‐driven CB1 receptor‐mediated inhibition of activity in adult rat dorsal root ganglion (DRG) neurons, a model of primary afferent nociceptors. Calcium‐imaging studies were performed to compare the effects of the fatty acid amide hydrolase (FAAH) inhibitor URB597 (1 µm) vs. the anandamide (AEA) uptake inhibitor UCM707 (1 µm) on capsaicin (100 nm) and N‐arachidonoyl dopamine (NADA; 1 µm)‐evoked changes in intracellular calcium [Ca2+]i in DRG neurons. The ability of the CB1 receptor antagonist AM251 (1 µm) to modulate the effects of URB597 and UCM707 was also determined.Suprafusion of NADA and capsaicin evoked robust increases in [Ca2+]i in DRG neurons (89 ± 4% and 132 ± 6% of the depolarizing KCl response, respectively). Co‐incubation with URB597 significantly attenuated both NADA and capsaicin‐evoked increases in [Ca2+]i (39 ± 3% and 79 ± 4% of KCl response, respectively). Similarly, co‐incubation with UCM707 significantly attenuated both NADA and capsaicin‐evoked increases in [Ca2+]i (59 ± 7% and 72 ± 4% of KCl response, respectively). The CB1 receptor antagonist AM251 significantly attenuated the effects of URB597 on NADA‐evoked increases in [Ca2+]i but not the effects of URB597 on capsaicin‐evoked increases in [Ca2+]i. By contrast, AM251 significantly attenuated the inhibitory effects of UCM707 on both NADA and capsaicin‐evoked increases in [Ca2+]i.These data suggest that transport of both NADA and capsaicin into DRG neurons and the subsequent activation of TRPV1 is partly governed by FAAH‐dependent mechanisms as well as via the putative AEA membrane transporter.
Expression of histamine receptors and effect of histamine in the rat carotid body chemoafferent pathway
Authors: Lazarov Nikolai , Rozloznik Miroslav , Reindl Sebastian , Rey‐Ares Verónica , Dutschmann Mathias , Gratzl Manfred 
Published: December 2006

AbstractChemosensory information from peripheral arterial oxygen sensors in the carotid body is relayed by petrosal ganglion neurons to the respiratory networks in the medulla oblongata. Biogenic amines, including histamine, released from glomus (type I) cells of the carotid body are considered to be primary transmitters in hypoxic chemosensitivity. Immunocytochemistry at light‐and electron‐microscopical levels, and RT‐PCR, revealed the expression of histamine receptors 1 and 3 as well as histidine decarboxylase in the rat carotid body glomus cells and petrosal ganglion neurons. Histamine receptors 1 and 3, but not histidine decarboxylase, were also observed in the ventrolateral, intermediate and commissural subnuclei of the nucleus tractus solitarii in the medulla oblongata. In order to examine the possible role of histamine in the afferent branch of the respiratory system, we applied histamine receptor 1 and 3 agonists to the carotid body, which caused a mildly increased phrenic nerve activity in a working heart–brainstem preparation. Moreover, microinjection of antagonists of histamine receptors 1 and 3 into the nucleus tractus solitarii caused significant changes in the inspiratory timing and the chemoreceptor response. Our data show that histamine acting via histamine receptors 1 and 3 plays an important neuromodulatory role in the afferent control of chemosensitivity.
GSK3α exhibits β‐catenin and tau directed kinase activities that are modulated by Wnt
Authors: Asuni Ayodeji A. , Hooper Claudie , Reynolds C. Hugh , Lovestone Simon , Anderton Brian H. , Killick Richard 
Published: December 2006

AbstractIn the presence of a Wnt signal β‐catenin is spared from proteasomal degradation through a complex mechanism involving GSK3β, resulting in the transcription of Wnt target genes. In this study we have explored whether GSK3α, a related isoform, can also regulate nuclear β‐catenin levels and whether this and the tau‐directed kinase activity of GSK3α are modulated by Wnt. GSK3α or GSK3β and their substrates, β‐catenin and tau, were transiently expressed in mammalian cells. Immunoblotting revealed that GSK3α reduces nuclear levels of β‐catenin, whilst reporter gene assays demonstrated that GSK3α inhibits β‐catenin‐directed Tcf/Lef‐dependent transcription. Moreover, activation of the Wnt pathway was found to attenuate both the β‐catenin‐ and the tau‐directed kinase activities of GSK3α and GSK3β. By immunoprecipitation we also found that axin‐1, the β‐catenin destruction complex scaffold protein, binds GSK3α. In the light of these findings GSK3α warrants further investigation regarding its involvement in Wnt signalling and tauopathies such as Alzheimer's disease.
Effectiveness of Arndt endobronchial blockers in pediatric scoliosis surgery: a case series
Authors: BIRD G.T. , HALL M. , NEL L. , DAVIES E. , ROSS O. 
Published: December 2006

SummaryBackground:  Pediatric scoliosis surgery may require single lung ventilation for surgical access. Current methods of lung isolation are inadequate for some or all of these children. The Arndt endobronchial blocker (EBB) has been described for use in pediatric thoracic surgery to enable single lung ventilation (SLV). There are few data on its use in pediatric spinal deformity surgery. We report the successful use of the Arndt EBB in a series of these patients.Methods:  Any patient undergoing surgical correction of scoliosis involving a lateral thoracotomy for an anterior approach was managed with an Arndt EBB (5, 7 and 9 Fr gauge) to facilitate SLV. All cases were undertaken by a pediatric anesthetist trained in pediatric bronchoscopy; a 2.2 or 2.8 mm pediatric fiberoptic scope was used for placement and positional confirmation.Results:  Patients’ ages and weights ranged from 18 months to 18 years, and from 9.4 to 71 kg. All had idiopathic or congenital scoliosis; one underwent a vertical expansion prosthetic titanium rib (VEPTR) procedure. In all 20 patients, placement was easily and quickly achieved with no incorrect placements. There was one displacement after inflation, quickly corrected. Right upper lobe deflation proved difficult in one patient with high take‐off of the right upper lobe bronchus. The surgical field was excellent in all cases.Conclusions:  In our case series, Arndt EBB provided a safe and highly effective means of single lung isolation for children undergoing pediatric scoliosis surgery.
Childhood obesity and anesthetic morbidity
Authors: SETZER NANCY , SAADE EDOUARD 
Published: December 2006

SummaryBackground:  Obesity is present in a significant proportion of children presenting for anesthesia. Although it is perceived that obese adults have more frequent complications, the incidence of complications in obese children is unknown. Because of anticipated difficulties with mask ventilation, anesthesia is most frequently induced intravenously in obese adults, whereas inhalation induction is usually preferred in uncooperative children with few visible veins. The purpose of this study was to examine and compare anesthetic related complications in obese children undergoing dental surgery with a similar group of nonobese individuals.Methods:  The charts of 1133 American Society of Anesthesiology (ASA) physical status I and II children less than 12 years old who underwent general anesthesia for dental outpatient procedures in 2003 were retrospectively examined for patient height, weight, preoperative evaluation, anesthetic course and postoperative course. Body mass index was calculated and compared with international normative data to identify those children who were obese. Method of induction and perioperative complications were noted.Results:  A total of 100 obese and 1033 nonobese children were identified. Demographically the two groups were comparable. Inhalation induction was used in the vast majority of obese (99%) and nonobese (99.7%) patients. Overall complication rate was low. Minor respiratory complications were more frequently noted in the obese group. These consisted primarily of a higher incidence of intraoperative oxygen desaturation (2% vs 0.19%) and higher requirements for unexpected overnight hospitalization (2% vs 0.19%). The only complication related directly to inhalation induction was noted in a nonobese child who vomited and aspirated on induction.Conclusions:  Our study demonstrated a small increase in minor respiratory complications in obese children who underwent anesthesia. Inhalation induction was not associated with an increase in adverse events in this population.
Risk factors for impaired healing of the perineal wound after abdominoperineal resection of rectum for carcinoma
Authors: Artioukh D. Y. , Smith R. A. , Gokul K. 
Published: December 2006

AbstractObjective  Nonhealing perineal wound is an unpleasant complication of surgical excision of the rectum and anus. The aim of the study was to evaluate the risk factors for impaired perineal wound healing after abdominoperineal resection (APR) of rectum for adenocarcinoma, particularly with the increasing use of neo‐adjuvant chemoradiation.Method  The study included 38 consecutive patients (29 men, nine women; median age 66 years, range: 43–86), who underwent surgical excision of rectum and anus for adenocarcinoma from 1999 to 2004. Thirty‐seven patients underwent APR of rectum and one patient, who developed carcinoma in the background of chronic ulcerative colitis, had panproctocolectomy. Associations between the failure of the perineal wound to heal and a number of patient, tumour and treatment‐related variables were evaluated by Pearson chi‐square test or Fisher's exact test, as appropriate. A P‐value of <0.05 was considered significant. Multivariate statistical technique of principal component analysis was also used to identify risk factors and their relative contribution to impaired healing.Results  Impaired healing of the perineal wound was observed in 10 (26%) of 38 patients. In four of them (11%) the wound remained nonhealed in 1 year after surgery. Preoperative radiotherapy, delayed primary closure of the wound and alcohol consumption in excess of 28 units/week was statistically significantly associated with impaired wound healing. Principal component analysis identified the following seven factors that cumulatively contributed to 96% of impaired healing: (i) distant metastases, (ii) preoperative radiotherapy, (iii) T‐stage of the tumour, (iv) smoking, (v) perioperative blood transfusion, (vi) preoperative chemotherapy and (vii) development of side effects of preoperative chemoradiation.Conclusion  Patients who undergo APR of rectum are prone to impaired healing of the perineal wound if radiotherapy is used to treat malignancy prior to surgery and wound closure is delayed. In addition, the wound may not heal in patients with distant metastases, excessive alcohol consumption, present and past smokers and those who suffer adverse effects of preoperative chemoradiation and require blood transfusion.
Chemoprevention of colorectal cancer – a new target needed?
Authors: Spychalski M. , Dziki L. , Dziki A. 
Published: December 2006

AbstractObjective  Novel treatments for colorectal cancer (CRC) include chemoprevention. Nonsteroidal anti‐inflammatory drugs (NSAIDs) were the first to be studied and an inverse association was proven between their use and the development of invasive CRC. The numerous side effects of NSAIDs led, however, to the search for safer drugs. These have included Coxibs (selective COX‐2 inhibitors). In this study, the role of coxibs in the chemoprevention of CRC is reviewed.Results  Numerous in‐vitro and in‐vivo experiments have shown the effectiveness of coxibs in the chemoprevention of CRC. These have led to the registration of celecoxib by the USA Food and Drug Administration for the treatment of familial adenomatous polyposis. Further studies of coxibs have revealed an increased risk of serious cardiovascular events when compared with placebo. This finding has considerably decreased the opportunities for chemoprevention of CRC.Conclusion  The multi‐directional activity of coxibs, which was the reason for their effectiveness against CRC development may be the key to proposing a new target area for chemoprevention. It has been shown that celecoxib partly inhibits the activity of NF‐κB, transcription factor involved in inflammation and carcinogenesis pathways. Modulation of its activation may be the future of effective CRC chemoprevention.
NOTHING BUT THE TRUTH? ON TRUTH AND DECEPTION IN DEMENTIA CARE
Authors: SCHERMER MAARTJE 
Published: December 2006

ABSTRACTLies and deception are often used in the care for demented elderly and often with the best intentions. However, there is a strong moral presumption against all forms of lying and deceiving. The goal of this article is to examine and evaluate concrete examples of deception and lies in dementia care, while addressing some fundamental issues in the process.It is argued that because dementia slowly diminishes the capacities one needs to distinguish between truths and falsehoods, the ability to be lied to also disappears. When the moral reasons to reject lying are explored, it becomes clear that most of them also hold where demented patients are concerned, though this also depends on the capacities of the patient. Lying, though prima facie wrong, can sometimes be justified with an appeal to well‐being. The relationship between well‐being and the truth is further explored. Two examples of deceiving demented patients for reasons of beneficence are discussed, from which it can be concluded that although in some cases beneficent lies or deception will not enhance patients’ well‐being, there are circumstances in which they do. In general, methods that enhance the well‐being of the patient without deception or lies should be favored above options that use deceit, and methods of getting the truth across without hurting the patient should be favored above blunt honesty. Finally, it is important to note that not only the patient but also the nursing and medical staff can be affected by the use of lies and deception.