bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limitations of the hematocrit level to assess the need for red blood cell transfusion in hypovolemic anemic patients
Authors: Valeri C. Robert , Dennis Richard C. , Ragno Gina , MacGregor Hollace , Menzoian James O. , Khuri Shukri F. 
Published: January 2006

BACKGROUND:  The transfusion trigger that physicians use to determine whether a patient requires a red blood cell (RBC) transfusion is the peripheral venous hematocrit (Hct) value. Although this measurement is an indicator of the concentration of RBCs in the blood, it does not reveal the RBC volume, plasma volume, or total blood volume, nor does it give any indication of whether the patient is hypovolemic, normovolemic, or hypervolemic.STUDY DESIGN AND METHODS:  Two patient populations were studied: 41 consecutive patients subjected to elective vascular surgery and 20 consecutive patients subjected to cardiopulmonary bypass surgery. The RBC volume was measured with 51Cr‐ or 99mTc‐labeled autologous fresh RBCs, and the plasma volume and total blood volume were estimated from the measured RBC volume and the total body Hct level. Measurements made 1 to 2 and 24 hours after surgery were compared to the preoperative values for these two groups of patients.RESULTS:  During the 24‐hour postoperative period, the RBC, plasma, and total blood volumes were reduced compared to the preoperative volumes. These patients were hypovolemic and anemic, and their Hct values during the 24‐hour postoperative period were increased by a mean of 4 to 5 volume‐percent compared to values that would be expected if they were normvolemic and anemic.CONCLUSIONS:  The Hct values in hypovolemic anemic patients are elevated because the plasma volume does not increase to achieve the normovolemic anemic state.
Clinical effects of reverting from leukoreduced to nonleukoreduced blood in cardiac surgery
Authors: Fung Mark K. , Moore Karan , Ridenour Marilyn , Mook William , Triulzi Darrell J. 
Published: January 2006

BACKGROUND:  A reduction in postoperative length of stay (PLOS) was recently demonstrated with the use of leukoreduced (LR) blood in cardiac surgery patients compared to a historical cohort who received non‐LR blood. Follow‐up data are now presented in a similar population after a 12‐month period in which LR blood was no longer routinely used.STUDY DESIGN AND METHODS:  This is an extension of a study in which all patients admitted over a 12‐month period for open heart surgery were given LR blood (Group 2) and were compared against a historical cohort given non‐LR blood (Group 1). This study measures the outcomes of a new cohort of patients admitted during a 12‐month period where LR blood was no longer routinely used (Group 3).RESULTS:  PLOS increased in patients who received transfusions with non‐LR blood (Group 3, n = 595) versus patients with LR blood (Group 2, n = 645; p = 0.045 by nonparametric rank U test). Mean PLOS increased from 9.5 days (95% confidence interval [CI], 8.9‐10.0) to 10.8 days (95% CI, 10.0‐11.6). In comparison, an earlier cohort who received non‐LR blood (Group 1, n = 501) had a mean PLOS of 10.1 days (95% CI, 9.4‐10.7). With the exception of decreased red blood cell (RBC) usage in Group 3, there were no significant differences in non‐RBC blood usage, estimated blood loss, bypass time, mediastinitis rates, operative mortality rate, or overall mix of cases.CONCLUSIONS:  The use of non‐LR blood for cardiac surgery was associated with an increased PLOS compared to the use of LR blood and supports our previous demonstration of the benefits of LR blood in cardiac surgery.
Effects of intraperitoneal vitamin E, melatonin and aprotinin on leptin expression in the guinea pig eye during experimental uveitis
Authors: Kükner Aysel , Çolakoğlu Neriman , Serin Didem , Alagöz Gürsoy , Çelebi Serdal , Kükner A. Şahap 
Published: January 2006

Abstract.Purpose:  To observe ultrastructural changes and leptin expression in the guinea pig eye during experimental uveitis (EU) and the effects of vitamin E, melatonin and aprotinin on leptin expression. Methods:  Thirty male guinea pigs were randomly classified into five groups. Group 1 was the control group. Groups 2, 3, 4 and 5 received intravitreal injections of bovine serum albumin (BSA) to induce EU. At the same time on the third day, groups 3 (EU + vitamin E), 4 (EU + melatonin) and 5 (EU + aprotinin) received intraperitoneal vitamin E (150 mg/kg), melatonin (10 mg/kg) and aprotinin (20 000 IU/kg), respectively. On the sixth day, histopathological and clinical scoring of inflammation were performed, and leptin expression was investigated in the retina, choroid, sclera, episclera and cornea, and compared. Results:  There was a remarkable increase in leptin expression in the retina, choroid, sclera and episclera in the EU group. Leptin expression in the treatment groups was similar to that in the control group. At light and electron microscopic levels, ganglion cells were oedematous and inner plexiform layer thickness had increased in the EU group retinas. Oedema was decreased in the treatment groups. Comparison of the EU and treatment groups revealed significant differences histopathologically and clinically. Conclusion:  Experimental uveitis causes an increase in leptin expression in the retina, choroid, sclera and episclera of guinea pigs. Vitamin E, melatonin and aprotinin inhibit this increase. Leptin seems to be closely related to ocular inflammation.
Socioeconomic differences in glaucoma patients' knowledge, need for information and expectations of treatments
Authors: Hoevenaars Juliette G. M. M. , Schouten Jan S. A. G. , Van Den Borne Bart , Beckers Henny J. M. , Webers Carroll A. B. 
Published: January 2006

Abstract.Purpose:  To study the specific items for which socioeconomic differences in glaucoma patients' knowledge, need for information and expectations of treatments exist, with the aim of developing a patient education programme. Methods:  A total of 44 randomly selected ophthalmologists assigned 166 consecutive outpatient glaucoma patients to complete a questionnaire that had been systematically developed based on focus group interviews, suggestions from several experts and a pilot test. Topics included knowledge about glaucoma and its treatment, need for information and expectations of treatment. Educational level was used as a measure for socioeconomic status. Logistic regression analysis was conducted to adjust for age, sex and duration of glaucoma. Results:  After adjusting for age, sex and duration of glaucoma, knowledge of glaucoma and its treatment was found to be positively correlated with socioeconomic status. Items on knowledge with socioeconomic differences concerned risk factors, pathophysiology and consequences of glaucoma, as well as effects and adverse effects of treatments. The lowest socioeconomic group demonstrated more need for information on public assistance and practical aspects of glaucoma and more often expected that glaucoma damage could be repaired. Conclusion:  Important socioeconomic differences in knowledge, need for information and expectations of treatment exist in glaucoma patients. Patient education should focus on every glaucoma patient, but better information for the lower socioeconomic groups about specific items mentioned in this study might reduce the negative effects of low socioeconomic status on visual impairment.
The pathogenesis of optic disc splinter haemorrhages: a new hypothesis
Authors: Grieshaber Matthias C. , Terhorst Tobias , Flammer Josef 
Published: January 2006

Abstract.Purpose:  To describe a hypothesized relationship between optic disc haemorrhages (ODHs) and primary vascular dysregulation (PVD). Methods:  Observational case report of a patient with classical PVD and five bilateral recurrent ODHs Results:  The ODHs were superotemporal in the right eye and inferotemporal in the left; the eyes were otherwise normal. Intraocular pressure (IOP) never exceeded 17 mmHg. Visual fields were normal. Increased blood flow resistivity, a reduced blood flow of the extraocular vessels, a low systemic blood pressure, a cold‐induced flow stop of the nailfold capillaries, and elevated endothelin‐1 plasma levels were found, all confirming the diagnosis of vascular dysregulation. Conclusions:  Optic disc haemorrhages may be due to a disturbed blood–retina barrier rather than to a mechanical rupture of the vessel. This barrier dysfunction may occur in the context of PVD.
The relationship between mental illness severity and stigma
Authors: Gaebel W. , Zäske H. , Baumann A. E. 
Published: January 2006

Objective:  To investigate influencing factors for lay perception of mental illness severity and their effects on the stigma of mental illness.Method:  Selective review including attitude surveys assessing social distance towards different diagnostic labels, and attitudes towards treatment professions, treatment strategies, and psychopharmacotherapy.Results:  Lays differentiate in their attitudes towards people with mental illness according to the given diagnostic label, the involved treatment professions or institutions, the applied treatment methods, and the perceived psychosocial disability.Conclusion:  Beside perceived treatment intensity and diagnostic label, the perception of social disability of mentally ill people accounts for a differentiated stigma. The question arises how antistigma‐programmes can include the topic of social disability into their messages without risking to strengthen the stigma of mental illness.
The therapeutic relationship in psychiatric settings
Authors: Priebe S. , McCabe R. 
Published: January 2006

Objective:  To discuss the current climate of research on the therapeutic relationship (TR) in mainstream psychiatric settings.Method:  Consideration of theoretical frameworks, quantitative and qualitative research methods, along with potentials for interventions.Results:  Most of the concepts and methods used to investigate the TR in conventional psychiatric settings have been imported from psychotherapy and, despite significant differences between the two, there is little specific research. A distinction is suggested between therapeutic relationships and patient–clinician interactions. Relationships predict outcome and may be assessed with operationalized methods. Specific communicative skills may be helpful in the treatment of particular illnesses. The feasibility and effectiveness of potential interventions in the TR have rarely been studied.Conclusion:  Specific conceptual and methodological work is required to develop a better understanding of TRs in psychiatric settings. Further research should include intervention studies and might support a stronger emphasis on TRs in training and supervision.
Early detection and treatment of schizophrenia: how early?
Authors: Riecher‐Rössler A. , Gschwandtner U. , Borgwardt S. , Aston J. , Pflüger M. , Rössler W. 
Published: January 2006

Objective: Whereas early detection and therapy of schizophrenic psychoses until some time ago concentrated on frank schizophrenia, during the last years some centres have also started to treat patients even before a clear diagnosis could be established. This paper attempts to discuss if and when this is justified in the light of recent research.Method: Mini review of literature.Results: The rationale for early detection and treatment of schizophrenia is based on several observations: diagnosis and treatment of schizophrenia are often seriously delayed. Consequences of the disease are severe already in the early undiagnosed phase of the disorder and early treatment seems to improve the course of the disease. It can therefore be stated quite safely that patients should be treatedas early as possible. However, the question ofhow earlyhas not been sufficiently answered up to now.Conclusion: We are at the moment in an ethical dilemma between either diagnosing and treating this disorder too late or too early. The only way and prerequisite for solving this dilemma is a more reliable identification of individuals at risk and the beginning disease process.
Social psychiatry and public mental health: present situation and future objectives Time for rethinking and renaissance?
Authors: Rutz W. 
Published: January 2006

Objective:  To describe the social psychiatric challenges of modern psychiatry in European societies in the light of recent psychiatric research evidence and to show how these challenges could be conceptualized.Method:  Reviewing aggregate morbidity and mortality data from the WHO European Health for All Database, and summarizing consultations and fact‐finding missions to many European countries during the authors engagement as WHO Regional Advisor for Mental health from 1998 to 2004.Results:  Societal change in Europe is leading to stress and mental ill health for its populations. The consequence is a dramatic increase in burden due to mental illness and stress‐related morbidity and mortality.Conclusion:  A rethought and reconceptualized social and societal psychiatry with focus on public mental health must have a renaissance. Innovative efforts are of crucial and imperative importance seeing mental health in the light of recent experience and science as probably the most important public health issue.
Needs of people with severe mental illness
Authors: Wiersma D. 
Published: January 2006

Objective:  This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care.Method:  Focus is on the definition of the concept of need as what people can benefit from and its measurement by means of two instruments, the Needs for Care Assessment (NCA) and the Camberwell Assessment of Needs (CAN).Results:  The prevalence of needs among patients with SMI varies between 4 and 10, which appears to be rather unrelated to gender, age or education, but not to severity of symptoms, diagnosis or treatment setting. Important is the perspective of the beholder: patient and professional differ significantly from each other in the assessment of number of needs and their adequate fulfilment. One of two to four needs are unmet, in particular in the area of psychological distress, daily activities, social contacts and psychotic symptoms. Prevalence of unmet needs seems to be related to the system of mental health care and to socioeconomic circumstances as well: the less integrated and continuous care and the poorer the life situation, the more unmet needs.Conclusion:  Unmet needs are a strong predictor of less favourable health perceptions and a lower quality of life. Needs are to a certain extent changeable, and thus amenable by treatment or mental health interventions. The prevalence of (un)met needs should be an outcome criterion for the evaluation of mental health service systems and for cross‐cultural comparison.
IL‐9 expression contributes to the cellular composition in Hodgkin lymphoma
Authors: Glimelius Ingrid , Edström Annika , Amini Rose‐Marie , Fischer Marie , Nilsson Gunnar , Sundström Christer , Enblad Gunilla , Molin Daniel 
Published: January 2006

Abstract: Objectives: The presence of numerous mast cells or eosinophils in Hodgkin lymphoma (HL) tumours have both been described as negative prognostic factors. One cytokine related to HL is interleukin‐9 (IL‐9) and it is known to affect both mast cells and eosinophils. The aim of this study was to explore if the expression of IL‐9 correlates to the presence of these inflammatory cells in HL tumours. Methods: In 131 HL biopsies, immunostainings for IL‐9 and IL‐9 receptor (IL‐9R) were performed. The same material was previously stained for mast cells and eosinophils. These data were correlated to clinical and survival data from all patients. Results: Fifty‐three percent of cases were positive for IL‐9 and 19% were positive for IL‐9R in the cytoplasm of the tumour cells. The IL‐9 positive patients had more eosinophils (P = 0.002) and mast cells (P = 0.02) in their tumours, more often a nodular sclerosis histology (P < 0.0001), a higher white‐blood‐cell count (P = 0.006) and a higher erythrocyte sedimentation rate (P = 0.003) at the time of diagnosis. Conclusions: IL‐9 expression is related to the histology, clinical picture and the presence of eosinophils and mast cells in HL. These results indicate that IL‐9 is an important part of the cytokine network and inflammatory infiltrate in HL.
Gene–environment interaction involved in oral carcinogenesis: molecular epidemiological study for metabolic and DNA repair gene polymorphisms
Authors: Sugimura Tomotaka , Kumimoto Hiroshi , Tohnai Iwai , Fukui Takafumi , Matsuo Keitaro , Tsurusako Shinichi , Mitsudo Kenji , Ueda Minoru , Tajima Kazuo , Ishizaki Kanji 
Published: January 2006

Background:  Exposure to environmental carcinogens leads to oral squamous cell carcinoma (OSCC); however, the impact of genetic variations in carcinogen metabolisms and DNA repair on OSCC risk considering environmental exposures has not been clearly elucidated.Methods:  We conducted a case–control study with 122 cases and 241 controls. The risk of OSCC was evaluated in 10 genetic polymorphisms of nine genes, such as CYP1A1, CYP2E1, GSTM1, GSTT1, XPA, XPC, XPC, XPF and ERCC1. Gene–environment interaction was also evaluated.Results:  We found that CYP2E1 and XPA polymorphisms significantly affected the OSCC risk. Gene–environment interactions with smoking were significant for CYP2E1 and ERCC1 polymorphisms. Odds ratios for gene–environment interaction were 7.98 (P = 0.036), 9.67 (P = 0.017) and 8.49 (P = 0.031) for CYP2E1RsaI, DraI and ERCC1 polymorphisms, respectively. No interaction was observed with heavy drinking and any polymorphisms.Conclusion:  CYP2E1, XPA and ERCC1 polymorphisms may affect the risk of OSCC.
Refined characterization of head and neck squamous cell carcinomas expressing a seemingly wild‐type p53 protein
Authors: Leng Katharina , Schlien Simone , Bosch Franz X. 
Published: January 2006

Background:  A fraction of head and neck squamous cell carcinomas (HNSCC) reveal overexpression of the p53 protein although sequence analysis failed to detect mutations in the core region of the protein. The functional and clinical status of p53 in these tumors is unclear.Methods:  In 31 HNSCC, allelic imbalances (AI) at TP53 and other chromosome 17 loci were analyzed by microsatellite marker analysis. Expression of p16INK4a protein was analyzed by immunohistochemistry. Seven tumors were re‐examined for sequence alterations by the Affymetrix p53 GeneChip.Results:  About 54.8% of these tumors showed AI at TP53; 41.9% showed loss of p16, an overlapping fraction of 35.5% demonstrated AI and p16 loss. Six of seven such tumors revealed heterozygous missense mutations.Conclusions:  A large proportion of HNSCC with presumed wild‐type p53 overexpression are false‐negative cases. These results strengthen the established strong association of p53 protein overexpression with missense mutations. AI at TP53 and p16 loss are useful surrogate markers for genetic alterations of TP53 in HNSCC.
Immunohistopathological study of the oral lichenoid lesions of chronic GVHD
Authors: Sato M. , Tokuda N. , Fukumoto T. , Mano T. , Sato T. , Ueyama Y. 
Published: January 2006

Background:  Chronic graft‐vs.‐host disease (cGVHD) is a common and serious complication after bone marrow transplantation (BMT). However, the detailed process of oral lichenoid lesions of cGVHD is still unknown. Therefore, we investigated the immunohistopathological features of cGVHD compared with oral lichen planus (OLP) and healthy controls.Methods:  Nineteen allogenic BMT recipients with a histopathological diagnosis of cGVHD were investigated. We investigated the immunohistopathological features of cGVHD compared with OLP and healthy controls.Results:  Immunohistopathological features showed that the infiltrations of CD4‐positive T cells of cGVHD and OLP were significantly larger than those of the normal oral mucosa (P < 0.005). A larger number of CD8‐positive T cells was infiltrated in cGVHD and OLP compared with the normal oral mucosa (P < 0.001). The difference in the number of CD4‐ and CD8‐positive T cells between cGVHD and OLP was not significant. The infiltrations of Langerhans cells (CD1a) in cGVHD and OLP were significantly larger than those in the normal oral mucosa (P < 0.005). The difference in the number of Langerhans cells between cGVHD and OLP was not significant. CD68‐positive macrophages were more frequently seen in cGVHD and OLP than in the normal oral mucosa (P < 0.0001). The difference in the number of CD68‐positive macrophages between cGVHD and OLP was not significant.Conclusions:  It is suggested that Langerhans cells and CD8‐positive T cell may play a major role in the pathogenesis of the oral lichenoid lesions of cGVHD, and the immune response was inducted in OLP as well as the oral lichenoid lesion of cGVHD in this study.
Decreased expression of p63 in oral lichen planus and graft‐vs.‐host disease associated with oral inflammation
Authors: Ebrahimi Majid , Wahlin Ylva‐Britt , Coates Philip J. , Sjöström Björn , Nylander Karin 
Published: January 2006

Background:  Oral lichen planus (OLP) and graft‐vs.‐host disease (GVHD) are conditions with increased risk of malignant transformation to squamous cell carcinoma of the head and neck (SCCHN). The p63 gene encodes six different proteins and is expressed at high levels in SCCHN.Methods:  Biopsies from patients diagnosed with OLP and GVHD were analysed for p63 protein expression using antibodies distinguishing between the major isoforms expressed in normal epithelia, in parallel with biopsies from normal buccal mucosa and SCCHN.Results:  In OLP and GVHD a decreased expression of all p63 isoforms was seen, while expression of p53 protein was upregulated, compared with normal mucosa. In SCCHN, p63 was abundantly expressed and some tumours showed strong p53 staining, suggestive of p53 mutation.Conclusions:  Decreased p63 and increased p53 expression in OLP and GVHD indicates a coordinated action of these two related proteins to protect the oral mucosae from the damaging effects of underlying inflammation. In SCCHN disruption of the TP53 gene and overrepresentation of certain p63 isoforms has been seen, indicating that this could lead to neoplastic transformation.
Porphyromonas gingivalis heat shock protein vaccine reduces the alveolar bone loss induced by multiple periodontopathogenic bacteria
Authors: Lee Ju‐Youn , Yi Ni‐Na , Kim Ueon‐Suk , Choi Jeoung‐Soon , Kim Sung‐Jo , Choi Jeom‐Il 
Published: January 2006

Objectives:  Heat shock protein (HSP) can be utilized as a vaccine to cross‐protect against multiple pathogenic species. The present study was performed to evaluate Porphyromonas gingivalis heat shock protein 60 (HSP60) as a vaccine candidate to inhibit multiple bacteria‐induced alveolar bone loss.Material and methods:  Recombinant P. gingivalis HSP60 was produced and purified from P. gingivalis GroEL gene. Rats were immunized with P. gingivalis HSP60, and experimental alveolar bone loss was induced by infection with multiple periodontopathogenic bacteria.Results:  There was a very strong inverse relationship between postimmune anti‐P. gingivalis HSP immunoglobulin G (IgG) levels and the amount of alveolar bone loss induced by either P. gingivalis or multiple bacterial infection (p = 0.007). Polymerase chain reaction data indicated that the vaccine successfully eradicated the multiple pathogenic species.Conclusions:  We concluded that P. gingivalis HSP60 could potentially be developed as a vaccine to inhibit periodontal disease induced by multiple pathogenic bacteria.