bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing painful chronic wounds: the Wound Pain Management Model
Authors: Price Patricia , Fogh Karsten , Glynn Chris , Krasner Diane L , Osterbrink Jürgen , Sibbald R Gary 
Published: March 2007

AbstractChronic wound pain is not well understood and the literature is limited. Six of 10 patients venous leg ulcer experience pain with their ulcer, and similar trends are observed for other chronic wounds. Chronic wound pain can lead to depression and the feeling of constant tiredness. Pain related to the wound should be handled as one of the main priorities in chronic wound management together with addressing the cause. Management of pain in chronic wounds depends on proper assessment, reporting and documenting patient experiences of pain. Assessment should be based on six critical dimensions of the pain experience: location, duration, intensity, quality, onset and impact on activities of daily living. Holistic management must be based on a safe and effective mix of psychosocial approaches together with local and systemic pain management. It is no longer acceptable to ignore or inadequately document persistent wound pain and not to develop a treatment and monitoring strategy to improve the lives of persons with chronic wounds. Unless wound pain is optimally managed, patient suffering and costs to health care systems will increase.
Effects of intermittent lower limb ischaemia on coronary blood flow and coronary resistance in pigs
Authors: Shimizu M. , Konstantinov I. E. , Kharbanda R. K. , Cheung M. H. , Redington A. N. 
Published: March 2007

AbstractAim:  Intermittent limb ischaemia prior to cardiac ischaemia is a cardioprotective stimulus. This study was to investigate whether this peripheral stimulus had any effects on basal coronary blood flow and resistance, and to explore its potential mechanisms by studying the effect of femoral nerve transection and Katp blockade by glibenclamide.Methods:  Remote ischaemic preconditioning (rIPC) was induced by four 5‐min cycles of lower limb ischaemia. Coronary resistance was measured using standard formulae and coronary blood flow in the left anterior descending artery (LAD) by a flow probe. In experiment 1, coronary ischaemia was induced by inflation of a cuff placed around the mid‐LAD, and inflated until cessation of flow. Left ventricular (LV) function was assessed using dp/dt and Tau at 1 and 30 min of ischaemia. Experiment 1: 20 pigs were randomized to control (n = 6), rIPC (n = 7) or femoral nerve transection + rIPC (n = 7) groups. The femoral nerve was transected before the rIPC protocol. All data were collected at fixed heart rates of 120 bpm. Coronary resistance was decreased and flow was increased significantly by the rIPC stimulus (P = 0.003, P = 0.016, paired t‐test), and these changes were preserved after femoral nerve transection. Experiment 2: 19 pigs were randomized to control (n = 5), rIPC (n = 8) or glibenclamide‐treated rIPC (n = 6) groups. Data were collected at baseline, and during incremental pacing between 120 and 180 bpm.Results:  Experiment 1: Coronary resistance was decreased and flow was increased significantly by rIPC stimulus (P = 0.003, P = 0.016, paired t‐test), and these changes were preserved after femoral nerve transaction. rIPC was associated with superior LV function (dp/dtmax) at 30 min, compared with controls and the rIPC + femoral nerve transaction group. Experiment 2: Coronary resistance was significantly lower, and LAD flow was significantly higher in rIPC group (P < 0.0001, P = 0.0008, two‐way anova). These effects were reversed in the glibenclamide group.Conclusion:  The rIPC stimulus leads to reduced coronary resistance and increased flow. This effect, while modified by glibenclamide appears to be a generic effect of remote ischaemia rather than a direct preconditioning effect.
Action potential clamp fingerprints of K+ currents in canine cardiomyocytes: their role in ventricular repolarization
Authors: Bányász T. , Magyar J. , Szentandrássy N. , Horváth B. , Birinyi P. , Szentmiklósi J. , Nánási P. P. 
Published: March 2007

AbstractAim:  The aim of the present study was to give a parametric description of the most important K+ currents flowing during canine ventricular action potential.Methods:  Inward rectifier K+ current (IK1), rapid delayed rectifier K+ current (IKr), and transient outward K+ current (Ito) were dissected under action potential clamp conditions using BaCl2, E‐4031, and 4‐aminopyridine, respectively.Results:  The maximum amplitude of Ito was 3.0 ± 0.23 pA/pF and its integral was 29.7 ± 2.5 fC/pF. The current peaked 4.4 ± 0.7 ms after the action potential upstroke and rapidly decayed to zero with a time constant of 7.4 ± 0.6 ms. IKr gradually increased during the plateau, peaked 7 ms before the time of maximum rate of repolarization (V) at −54.2 ± 1.7 mV, had peak amplitude of 0.62 ± 0.08 pA/pF, and integral of 57.6 ± 6.7 fC/pF. IK1 began to rise from −22.4 ± 0.8 mV, peaked 1 ms after the time of V at −58.3 ± 0.6 mV, had peak amplitude of 1.8 ± 0.1 pA/pF, and integral of 61.6 ± 6.2 fC/pF. Good correlation was observed between peak IK1 and V (r = 0.93) but none between IKr and V. Neither IK1 nor IKr was frequency‐dependent between 0.2 and 1.66 Hz. Congruently, IKr failed to accumulate in canine myocytes at fast driving rates.Conclusion:  Terminal repolarization is dominated by IK1, but action potential duration is influenced by several ion currents simultaneously. As Ito was not active during the plateau, and neither IK1 nor IKr was frequency‐dependent, other currents must be responsible for the frequency dependence of action potential duration at normal and slow heart rates in canine ventricular cells.
Prolyl hydroxylase inhibitor treatment confers whole‐animal hypoxia tolerance
Authors: Kasiganesan H. , Sridharan V. , Wright G. 
Published: March 2007

AbstractAim:  Recently a family of O2‐dependent prolyl hydroxylase domain‐containing enzymes (PHD) has been identified as a cellular oxygen‐sensing mechanism. Reduced prolyl hydroxylase activity initiates a signalling cascade that includes the accumulation, as well as the activation, of hypoxia‐inducible factor (HIF‐1α). In turn the transcription factor HIF‐1α, and other targets of the PHD, elicit a myriad of incompletely understood cellular responses. In these studies we have tested: (1) whether a small‐molecule prolyl hydroxylase inhibitor (PHI) can effectively activate the oxygen‐sensing pathway when administered systemically to mice, and (2) whether the activation of the PHD signalling pathway at the cellular level results in whole‐animal hypoxic tolerance.Methods:  Mice received daily injections of the PHI, ethyl‐3,4 dihydroxybenzoate (EDHB, 100–250 mg kg−1) or vehicle. Tissue levels of HIF‐1α and the serum levels of the HIF‐inducible gene, erythropoietin (EPO), were measured to evaluate PHD‐pathway activation. To evaluate hypoxic tolerance, the endurance and survival ability of these animals was tested in sublethal (8% O2) and lethal hypoxia (5% O2) respectively.Results:  Systemic treatment of mice with the PHD inhibitor, EDHB, leads to elevated levels of HIF‐1α in liver and HIF‐inducible EPO in serum, indicating activation of the cellular oxygen‐sensing pathway. Animals treated with EDHB display significantly increased viability and enhanced exercise performance in hypoxia.Conclusion:  These results demonstrate a novel pharmacological strategy to induce hypoxic tolerance and are the first to demonstrate that the activation of the PHD oxygen‐sensing pathway at the cellular level is sufficient to produce a hypoxic‐tolerant phenotype at the physiological level of the whole animal.
Treadmill but not wheel running improves fatigue resistance of isolated extensor digitorum longus muscle in mice
Authors: Jeneson J. A. L. , De Snoo M. W. , Verlinden N. A. T. , Joosten B. J. L. J. , Doornenbal A. , Schot A. , Everts M. E. 
Published: March 2007

AbstractAim:  The present study is the first to compare the physiological impact of either forced treadmill or voluntary wheel running exercise on hindlimb muscle in mice.Methods:  Male C57BL/6 mice were subjected to either 6 weeks of forced treadmill or voluntary wheel running exercise. Mice in the treadmill running exercise group (TRE; n = 8) ran 1.9 km day−1 at a speed of 16 m min−1 against an uphill incline of 11 °. In the running wheel exercise group (RWE; n = 8) animals ran 8.8 ± 0.2 km per day (average speed 42 ± 2 m min−1). After the experimental period, animals were killed and mechanical performance and oxygen consumption of isolated extensor digitorum longus (EDL) muscle were determined during serial electrical stimulation at 0.5, 1 and 2 Hz.Results:  Steady‐state half‐width time (HWT) of twitch contraction at 0.5 Hz was significantly shorter in TRE and RWE than controls (CON) (41.3 ± 0.2, 41.3 ± 0.1 and 44.3 ± 0.1 s respectively; P < 0.05). The rate of fatigue development and HWT lengthening at 2 Hz was the same in RWE and CON but lower in TRE (1.2‐fold and twofold respectively; P < 0.05). EDL oxygen consumption, mitochondrial content and myosin heavy chain (MyHC) composition were not different between the groups.Conclusion:  These results indicate that both exercise modalities have an effect on a hindlimb fast‐twitch muscle in mice, with the greatest impact seen with forced treadmill running.
Preliminary experience for reducing biliary complication in adult‐to‐adult living donor liver transplantation using right lobe graft
Authors: Yan Lunan , Li Bo , Zeng Yong , Wen Tianfu , Zhao Jichun , Wang Wentao , Yang Jiayin , Xu Mingqing , Ma Yukui , Chen Zheyu , Liu Jiangwen , Wu Hong 
Published: March 2007

Aim:  To report the author’s preliminary experience with adult‐to‐adult living donor liver transplantation (LDLT) using right lobe liver grafts.Methods:  From January 2002 to July 2006, 50 adult patients underwent LDLT using right lobe grafts at West China Hospital, Sichuan University Medical School, China. At present, 24 recipients have been followed up for over nine months.Results:  There were no deaths amongst the donors. Biliary reconstruction for 35 hepatic duct orifices from 24 donor grafts was performed, which included 19 reconstructions of duct‐to‐duct anastomoses and 16 cholangio‐jejunostomy. Two recipients had biliary complications including one bile leakage and one slight biliary stricture.Conclusion:  With the improved methods for biliary reconstruction, we achieved good results in 24 recipients of adult‐to‐adult LDLT. We consider that microsurgical technique and fixed operator could decrease the biliary complications of LDLT.
Correlation of hepatic steatosis with body mass index, serum ferritin level and hepatic fibrosis in Japanese patients with chronic hepatitis C
Authors: Sumida Yoshio , Kanemasa Kazuyuki , Fukumoto Kohei , Yoshida Naohisa , Sakai Kyoko 
Published: March 2007

Aims:  The present study was aimed at determining the predictors of hepatic steatosis and fibrosis in Japanese patients with chronic hepatitis C.Methods:  The relationship between the degrees of hepatic steatosis or fibrosis and several clinical parameters was evaluated using univariate and multivariate analyses.Results:  Steatosis was observed in 117 out of 184 patients (64%), including 45 patients (25%) with grade 1 (<10% of hepatocytes affected), 56 patients (30%) with grade 2 (10–30%), 12 patients (7%) with grade 3 (30–50%), and four patients (2%) with grade 4 (>50%). In the multivariate analysis, body mass index (BMI) (P = 0.0038) and serum ferritin (P < 0.0001) were selected as independent predictors of hepatic steatosis. Six of the 184 patients (3%) had stage 0 fibrosis (no fibrosis), 87 patients (47%) had stage 1, 55 patients (30%) had stage 2 and 36 patients (20%) had stage 3. In the multivariate analysis, platelet count (P = 0.0012), aspartate aminotransferase (AST) (P = 0.0219), hyaluronic acid (P < 0.0001) and the grade of steatosis (P = 0.0008) were selected as independent predictors of hepatic fibrosis.Conclusion:  Obesity and iron storage, as evaluated by BMI and serum ferritin level, respectively, have important roles in the pathogenesis of hepatic steatosis, which is a factor responsible for the development of hepatic fibrosis in Japanese patients with chronic hepatitis C.
Interleukin‐17 as a new marker of severity of acute hepatic injury
Authors: Yasumi Yuki , Takikawa Yasuhiro , Endo Ryujin , Suzuki Kazuyuki 
Published: March 2007

Aim:  To determine cytokines associated with the progression of acute hepatic injury (AHI), we comprehensively evaluated the serum levels of 17 cytokines.Methods:  We simultaneously measured serum levels of 17 cytokines on admission using a newly developed suspension array protein assay system in 51 patients with AHI, including 15 conventional AHI (CAHI), 15 severe AHI (SAHI) and 21 fulminant hepatic failure (FHF).Results:  Interleukin (IL)‐6, IL‐8 and IL‐17 levels were significantly different among the three disease types as determined by one‐way analysis of variance, and only the IL‐17 level showed a significant elevation in SAHI and FHF than in CAHI. Namely, the IL‐17 levels in SAHI and FHF patients were 4.4 (2.0–11.0) (mean [1 .s.d. range]) and 5.6 (2.0–18.5) pg/mL, respectively, whereas all CAHI patients showed levels lower than the lower limit of detection (2.0 pg/mL). In multiple regression analysis for each factor of model for end‐stage liver disease (MELD) score, only IL‐10 level was selected as the significant independent variable for total bilirubin level, only IL‐17 level for prothrombin time, and TNF‐α and IL‐1β levels for creatinine level.Conclusion:  These data suggest the usefulness of serum IL‐17 level in evaluating the severity of AHI, thus emphasizing the necessity for the basic investigation of the pathological role of IL‐17 in acute hepatitis.
Characteristics of geographic distributions and route of infection for hepatitis B virus genotype D in Ehime area in western Japan
Authors: Matsuura Kana , Michitaka Kojiro , Yamauchi Kazuhiko , Nadano Seijin , Okada Shinichi , Matsuura Bunzo , Hiasa Yoichi , Horiike Norio , Onji Morikazu 
Published: March 2007

Aims:  Hepatitis B virus genotype D (HBV/D) is rare in Japan, and has been shown to circulate in Ehime prefecture in western Japan. HBV/D is suspected to have been transferred into Ehime from Russia as a result of the Japanese–Russian War. This study examined the current geographic spread and infectious route for HBV/D in Ehime.Methods:  HBV genotype was determined for 508 patients with chronic HBV infection and 46 patients with acute HBV infection hepatitis (acute hepatitis, AH), all of whom were living in Ehime. Ehime was divided into three areas and genotypic distributions were studied.Results:  The ratio of genotypes A,B,C and D in chronically infected patients were 1.8%, 4.5%, 87.8% and 5.9%, respectively. Most patients chronically infected with HBV/D lived in the central area. Only two patients lived in the east and south‐west areas, and both had lived in the central area in childhood. Patients with AH due to HBV/D were found only in the central area.Conclusion:  HBV/D has not yet spread widely to areas other than central Ehime, although small numbers of infected people have moved to other areas. The major infectious route for patients with AH is sexual transmission, regardless of HBV genotype.
Financial incentives for antipsychotic depot medication: ethical issues: Table 1
Authors: Claassen Dirk 
Published: March 2007

Background:Giving money as a direct incentive for patients in exchange for depot medication has proved beneficial in some clinical cases in assertive outreach (AO). However, ethical concerns around this practice have been raised, and will be analysed in more detail here.Method:Ethical concern voiced in a survey of all AO teams in England were analysed regarding their content. These were grouped into categories.Results:53 of 70 team managers mentioned concerns, many of them serious and expressing a negative attitude towards giving money for depot adherence. Four broad categories of ethical concern following Christensen’s concept were distinguished: valid consent and refusal (n = 5), psychiatric paternalism (n = 31), resource allocation (n = 4), organisational relationships (n = 2), with a residual category others and unspecified (n = 11).Discussion:The main concerns identified are discussed on the background of existing ethical theories in healthcare and the specific problems of community mental health and AO. Points for practice are derived from this discussion. A way forward is outlined that includes informed consent and an operational policy in the use of incentives, further randomised controlled trials and qualitative studies, and continuing discussions with all stakeholders, especially service users.
“Do-not-resuscitate” orders in patients with cancer at a children’s hospital in Taiwan
Authors: Jaing Tang-Her , Tsay Pei-Kwei , Fang En-Chen , Yang Shu-Ho , Chen Shih-Hsiang , Yang Chao-Ping , Hung Iou-Jih 
Published: March 2007

Objectives:To quantify the use of do-not-resuscitate (DNR) orders in a tertiary-care children’s hospital and to characterise the circumstances in which such orders are written.Design:Retrospective study conducted in a 500-bed children’s hospital in Taiwan.Patients:The course of 101 patients who died between January 2002 and December 2005 was reviewed. The following data were collected: age at death, gender, disease and its status, place of death and survival. There were 59 males and 42 females with a median age of 103 months (range 1–263 months). 50 children had leukaemias, and 51 had malignancies other than leukaemia. The t test and the χ2test were applied as appropriate.Results:The study found that 44% of patient deaths occurred in the paediatric oncology ward; 29% of patient deaths occurred in the intensive care unit; and 28% of patients died in their home or at another hospital. Other findings included the following: 46 of 101 (46%) patients died after attempted cardiopulmonary resuscitation and 55 (54%) died with a DNR order in effect. The mean age at death was 9.8 years in both groups with or without DNR orders.Conclusions:From the study of patient deaths in this tertiary-care children’s hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward.
Women’s smoking history prior to entering the US Navy: a prospective predictor of performance
Authors: Conway Terry L , Woodruff Susan I , Hervig Linda K 
Published: March 2007

Objective:To examine whether women’s tobacco use prior to entering the US Navy is predictive of subsequent career performance. A priori predictions were that smoking at entry into the Navy would be related to early attrition, poorer job performance, more disciplinary problems and lower likelihood of re-enlistment.Methods:A prospective cohort analysis of 5487 women entering the US Navy between March 1996 and March 1997 was conducted. Navy attrition/retention and career performance measures, such as time in service, early attrition, type of discharge, misconduct, number of promotions, demotions and unauthorised absences, highest paygrade achieved, and re-enlistment were examined.Results:Compared with never smokers, daily smokers at entry into the US Navy had subsequent career outcomes consistently indicating poorer job performance (eg, early attrition prior to serving a full-term enlistment, more likely to have a less-than-honourable discharge, more demotions and desertions, lower achieved paygrade and less likely to re-enlist). Other types of smokers consistently fell between never and daily smokers on career outcome measures.Conclusions:For women entering the US Navy, being a daily smoker is a prospective predictor of poorer performance in the Navy. Future research should evaluate the effectiveness of cessation intervention with smoker-enlistees prior to their entering the Navy, to assess the impact on subsequent career outcomes.
The California Tobacco Control Program’s effect on adult smokers: (1) Smoking cessation
Authors: Messer Karen , Pierce John P , Zhu Shu-Hong , Hartman Anne M , Al-Delaimy Wael K , Trinidad Dennis R , Gilpin Elizabeth A 
Published: March 2007

Objectives:To estimate national population trends in long-term smoking cessation by age group and to compare cessation rates in California (CA) with those of two comparison groups of states.Setting:Retrospective smoking history of a population sample from the US: from CA, with a comprehensive tobacco-control programme since 1989 with the goal of denormalising tobacco use; from New York and New Jersey (NY & NJ), with similar high cigarette prices but no comprehensive programme; and from the tobacco-growing states (TGS), with low cigarette prices, no tobacco-control programme and social norms relatively supportive of tobacco use.Participants:Respondents to the Current Population Survey–Tobacco Use Supplements (1992–2002; n = 57 918 non-Hispanic white ever-smokers).Main outcome measures:The proportion of recent ever-smokers attaining long-term abstinence (quit ⩾1 year) and the successful-quit ratio (the proportion of all ever-smokers abstinent ⩾1 year).Results:Nationally, long-term cessation rates increased by 25% from the 1980s to the 1990s, averaging 3.4% per year in the 1990s. Cessation increased for all age groups, and by >40% (p<0.001) among smokers aged 20–34 years. For smokers aged <50 years, higher cigarette prices were associated with higher quitting rates. For smokers aged <35 years, quitting rates in CA were higher than in either comparison group (p<0.05). Half of the ever-smokers had quit smoking by age 44 years in CA, 47 years in NY & NJ, and by age 54 years in TGS.Conclusion:Successful smoking cessation increased by 25% during the1990s in the US. Comprehensive tobacco-control programmes were associated with greater cessation success than were with high cigarette prices alone, although both effects were limited to younger adults.
The California Tobacco Control Program’s effect on adult smokers: (2) Daily cigarette consumption levels
Authors: Al-Delaimy Wael K , Pierce John P , Messer Karen , White Martha M , Trinidad Dennis R , Gilpin Elizabeth A 
Published: March 2007

Objective:To investigate the association of the California Comprehensive Tobacco Control Program with self-reported population trends of cigarette consumption during 1992–2002.Setting and Participants:Participants were non-Hispanic white daily smokers (aged 20–64 years, n = 24 317) from the Tobacco Use Supplements to the Current Population Survey (1992–2002). We compared age-specific trends in consumption among daily smokers in three groups of states with differing tobacco control initiatives: California (CA; high cigarette price/comprehensive programme), New York and New Jersey (high cigarette price/no comprehensive programme), and tobacco-growing states (TGS; low cigarette price/no comprehensive programme).Results:There was a general decline in cigarette consumption across all age groups in each category of states between 1992 and 2002, except the oldest age group in the TGS. The largest annual decline in the average number of cigarettes per day was observed among daily smokers in CA who were aged ⩾35 years (−0.41 cigarettes/day/year (95% CI −0.52 to −0.3)). This rate was significantly higher than the −0.22 cigarettes/day/year (95% CI −0.3 to −0.16; p<0.02) observed in same-age daily smokers from New York and New Jersey, and significantly higher than the rate in same-age daily smokers from the TGS (−0.15 cigarettes/day/year (95% CI −0.22 to −0.08; p<0.002)). There were no significant differences across state groups in the decline observed in daily smokers aged 20–34 years. In 2002, only 12% of daily smokers in CA smoked more than a pack per day, which was significantly lower than the 17% in New York and New Jersey, which again was significantly lower than the 25% in the TGS.Conclusions:The California Tobacco Control Program was associated with significant declines in cigarette consumption among daily smokers aged ⩾35 years of age, which in turn should lead to declines in tobacco-related health effects. The decline in consumption among young adult smokers was a national trend.