bluuebunny/crossref_metadata_2025_split huggingface dataset:
The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases
Authors: Ozkalemkas Fahir , Ali Rıdvan , Ozkocaman Vildan , Ozcelik Tulay , Ozan Ulku , Ozturk Hulya , Kurt Ender , Evrensel Turkkan , Yerci Omer , Tunali Ahmet 
Published: November 2005

Abstract

Background
Although bone marrow metastases can be found commonly in some malignant tumors, diagnosing a nonhematologic malignancy from marrow is not a usual event.

Methods
To underscore the value of bone marrow aspiration and biopsy as a short cut in establishing a diagnosis for disseminated tumors, we reviewed 19 patients with nonhematologic malignancies who initially had diagnosis from bone marrow.

Results
The main indications for bone marrow examination were microangiopathic hemolytic anemia (MAHA), leukoerythroblastosis (LEB) and unexplained cytopenias. Bone marrow aspiration was not diagnostic due to dry tap or inadequate material in 6 cases. Biopsy results were parallel to the cytological ones in all cases except one; however a meticulous second examination of the biopsy confirmed the cytologic diagnosis in this patient too. The most common histologic subtype was adenocarcinoma, and after all the clinical and laboratory evaluations, the primary focus was disclosed definitively in ten patients (5 stomach, 3 prostate, 1 lung, 1 muscle) and probably in four patients (3 gastrointestinal tract, 1 lung). All work up failed in five patients and these cases were classified as tumor of unknown origin (TUO).

Conclusion
Our series showed that anemia, thrombocytopenia, elevated red cell distribution width (RDW) and hypoproteinemia formed a uniform tetrad in patients with disseminated tumors that were diagnosed via bone marrow examination. The prognosis of patients was very poor and survivals were only a few days or weeks (except for 4 patients whose survivals were longer). We concluded that MAHA, LEB and unexplained cytopenias are strong indicators of the necessity of bone marrow examination. Because of the very short survival of many patients, all investigational procedures should be judged in view of their rationality, and should be focused on treatable primary tumors.
Homeopathic medical practice: Long-term results of a cohort study with 3981 patients
Authors: Witt Claudia M , Lüdtke Rainer , Baur Roland , Willich Stefan N 
Published: November 2005

Abstract

Background
On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions.

Methods
In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year) consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10) and quality of life at baseline, and after 3, 12, and 24 months.

Results
A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years) and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years). Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p < 0.001) between baseline and 24 months (adults from 6.2 ± 1.7 to 3.0 ± 2.2; children from 6.1 ± 1.8 to 2.2 ± 1.9). Physicians' assessments yielded similar results. For adults and young children, major improvements were observed for quality of life, whereas no changes were seen in adolescents. Younger age and more severe disease at baseline were factors predictive of better therapeutic success.

Conclusion
Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.
Pharmacovigilance program to monitor adverse reactions of recombinant streptokinase in acute myocardial infarction
Authors: Betancourt Blas Y , Marrero-Miragaya María A , Jiménez-López Giset , Valenzuela-Silva Carmen , García-Iglesias Elizeth , Hernández-Bernal Francisco , Debesa-García Francisco , González-López Tania , Alvarez-Falcón Leovaldo , López-Saura Pedro A ,   the Cuban National Network of Pharmacoepidemiology
Published: November 2005

Abstract

Background
Streptokinase (SK) is an effective fibrinolytic agent for the treatment of acute myocardial infarction (AMI). The objective of the present study was to assess the adverse drug reactions (ADRs) associated with intravenous recombinant SK in patients with AMI in routine clinical practice.

Methods
A national, prospective and spontaneous reporting-based pharmacovigilance program was conducted in Cuba. Patient demographics, suspected ADR description, elements to define causality, and outcomes were documented and analyzed.

Results
A total of 1496 suspected ADRs identified in 792 patients out of the 1660 (47.7 %) prescriptions reported in the program, were received from July 1995 to July 2002. Most of the patients (71.3%) were male, 67.2% were white and mean age was 61.6 ± 13.0 years. The mean time interval between the onset of symptoms and the start of the SK infusion was 4.9 ± 3.7 h. The most frequently reported ADRs were hypotension, arrhythmias, chills, tremors, vomiting, nauseas, allergy, bleeding and fever. ADR severity was 38% mild, 38% moderate, 10% severe, and 4% very severe. Only 3 patients with hemorrhagic stroke were reported. Seventy-two patients died in-hospital mainly because of cardiac causes associated with the patient's underlying clinical condition. Mortality was 3 times more likely in patients suffering arrhythmias than in those without this event (odds ratio 3.1, 95% CI: 1.8 to 5.1). Most of the reported ADRs were classified as possibly or probably associated with the study medication.

Conclusion
Recombinant SK was associated with a similar post-marketing safety profile to those suggested in previous clinical trials.
Translating research into policy and practice in developing countries: a case study of magnesium sulphate for pre-eclampsia
Authors: Aaserud Morten , Lewin Simon , Innvaer Simon , Paulsen Elizabeth J , Dahlgren Astrid T , Trommald Mari , Duley Lelia , Zwarenstein Merrick , Oxman Andrew D 
Published: November 2005

Abstract

Background
The evidence base for improving reproductive health continues to grow. However, concerns remain that the translation of this evidence into appropriate policies is partial and slow. Little is known about the factors affecting the use of evidence by policy makers and clinicians, particularly in developing countries. The objective of this study was to examine the factors that might affect the translation of randomised controlled trial (RCT) findings into policies and practice in developing countries.

Methods
The recent publication of an important RCT on the use of magnesium sulphate to treat pre-eclampsia provided an opportunity to explore how research findings might be translated into policy. A range of research methods, including a survey, group interview and observations with RCT collaborators and a survey of WHO drug information officers, regulatory officials and obstetricians in 12 countries, were undertaken to identify barriers and facilitators to knowledge translation.

Results
It proved difficult to obtain reliable data regarding the availability and use of commonly used drugs in many countries. The perceived barriers to implementing RCT findings regarding the use of magnesium sulphate for pre-eclampsia include drug licensing and availability; inadequate and poorly implemented clinical guidelines; and lack of political support for policy change. However, there were significant regional and national differences in the importance of specific barriers.

Conclusion
The policy changes needed to ensure widespread availability and use of magnesium sulphate are variable and complex. Difficulties in obtaining information on availability and use are combined with the wide range of barriers across settings, including a lack of support from policy makers. This makes it difficult to envisage any single intervention strategy that might be used to promote the uptake of research findings on magnesium sulphate into policy across the study settings. The publication of important trials may therefore not have the impacts on health care that researchers hope for.
Assessment of pulse rate variability by the method of pulse frequency demodulation
Authors: Hayano Junichiro , Barros Allan Kardec , Kamiya Atsunori , Ohte Nobuyuki , Yasuma Fumihiko 
Published: November 2005

Abstract

Background
Due to its easy applicability, pulse wave has been proposed as a surrogate of electrocardiogram (ECG) for the analysis of heart rate variability (HRV). However, its smoother waveform precludes accurate measurement of pulse-to-pulse interval by fiducial-point algorithms. Here we report a pulse frequency demodulation (PFDM) technique as a method for extracting instantaneous pulse rate function directly from pulse wave signal and its usefulness for assessing pulse rate variability (PRV).

Methods
Simulated pulse wave signals with known pulse interval functions and actual pulse wave signals obtained from 30 subjects with a trans-dermal pulse wave device were analyzed by PFDM. The results were compared with heart rate and HRV assessed from simultaneously recorded ECG.

Results
Analysis of simulated data revealed that the PFDM faithfully demodulates source interval function with preserving the frequency characteristics of the function, even when the intervals fluctuate rapidly over a wide range and when the signals include fluctuations in pulse height and baseline. Analysis of actual data revealed that individual means of low and high frequency components of PRV showed good agreement with those of HRV (intraclass correlation coefficient, 0.997 and 0.981, respectively).

Conclusion
The PFDM of pulse wave signal provides a reliable assessment of PRV. Given the popularity of pulse wave equipments, PFDM may open new ways to the studies of long-term assessment of cardiovascular variability and dynamics.
Towards understanding the presence/absence of Human African Trypanosomosis in a focus of Côte d'Ivoire: a spatial analysis of the pathogenic system
Authors: Courtin Fabrice , Jamonneau Vincent , Oké Emmanuel , Coulibaly Bamoro , Oswald Yohan , Dupont Sophie , Cuny Gérard , Doumenge Jean-Pierre , Solano Philippe 
Published: November 2005

AbstractBackgroundThis study aimed at identifying factors influencing the development of Human African Trypanosomosis (HAT, or sleeping sickness) in the focus of Bonon, located in the mesophile forest of Côte d'Ivoire. A previous study mapping the main daytime activity sites of 96 patients revealed an important disparity between the area south of the town- where all the patients lived- and the area north of the town, apparently free of disease. In order to explain this disparity, we carried out a spatial analysis of the key components of the pathogenic system, i.e. the human host, the tsetse vector and the trypanosomes in their environment using a geographic information system (GIS).ResultsThis approach at the scale of a HAT focus enabled us to identify spatial patterns which linked to the transmission and the dissemination of this disease. The history of human settlement (with the rural northern area exploited much earlier than the southern one) appears to be a major factor which determines the land use pattern, which itself may account for differences found in vector densities (tsetse were found six times more abundant in the southern rural area than in the northern). Vector density, according to the human and environmental context in which it is found (here an intense mobility between the town of Bonon and the rural areas), may explain the observed spatial differences in HAT prevalence.ConclusionThis work demonstrates the role of GIS analyses of key components of the pathogenic system in providing a better understanding of transmission and dissemination of HAT. Moreover, following the identification of the most active transmission areas, and of an area unfavourable to HAT transmission, this study more precisely delineates the boundaries of the Bonon focus. As a follow-up, targeted tsetse control activities starting north of Bonon (with few chances of reinvasion due to very low densities) going south, and additional medical surveys in the south will be proposed to the Ivoirian HAT control program to enhance the control of the disease in this focus. This work also shows the evolution of HAT regarding time and environment, and the methodology used may be able to predict possible sleeping sickness development/extinction in areas with similar history and space organization.
Human leukocyte antigen class I, class II, and tumor necrosis factor-alpha polymorphisms in a healthy elder Mexican Mestizo population
Authors: Soto-Vega Elena , Richaud-Patin Yvonne , Llorente Luis 
Published: November 2005

Abstract

Background
There is strong evidence that an individual's genetic background is an important predisposing factor to longevity. In the present study we analysed the frequency of HLA class I, class II, as well as the TNF-α -308 polymorphism that may be related to an increased life span in Mexican Mestizo healthy elders.

Results
HLA typing was performed by polymerase chain reaction sequence specific oligonucleotide (PCR SSO) reverse dot blot. The TNF-α -308 polymorphism was assessed by PCR restriction fragment length polymorphism. A significant increased frequency of HLA-DRB1*11 was found in elderly women whereas this allele was not present in elderly males. The TNF2 allele was also increased in the elder group when compared to young controls. The frequencies of the remaining alleles tested were not statistically different among groups.

Conclusion
These data suggest an ethnicity independent tendency of HLA-DRB1*11 in elder females to increase life span and a possible role of the TNF2 allele with the successful remodelling of senescent immune system.
General practice and the New Zealand health reforms – lessons for Australia?
Authors: McAvoy Brian R , Coster Gregor D 
Published: November 2005

Abstract
New Zealand's health sector has undergone three significant restructures within 10 years. The most recent has involved a Primary Health Care Strategy, launched in 2001. Primary Health Organisations (PHOs), administered by 21 District Health Boards, are the local structures for implementing the Primary Health Care Strategy. Ninety-three percent of the New Zealand population is now enrolled within 79 PHOs, which pose a challenge to the well-established Independent Practitioner Associations (IPAs).
Although there was initial widespread support for the philosophy underlying the Primary Health Care Strategy, there are concerns amongst general practitioners (GPs) and their professional organisations relating to its implementation. These centre around 6 main issues:
1. Loss of autonomy
2. Inadequate management funding and support
3. Inconsistency and variations in contracting processes
4. Lack of publicity and advice around enrolment issues
5. Workforce and workload issues
6. Financial risks
On the other hand, many GPs are feeling positive regarding the opportunities for PHOs, particularly for being involved in the provision of a wider range of community health services. Australia has much to learn from New Zealand's latest health sector and primary health care reforms.
The key lessons concern:
• the need for a national primary health care strategy
• active engagement of general practitioners and their professional organisations
• recognition of implementation costs
• the need for infrastructural support, including information technology and quality systems
• robust management and governance arrangements
• issues related to critical mass and population/distance trade offs in service delivery models
Knowledge and use of medicinal plants by local specialists in an region of Atlantic Forest in the state of Pernambuco (Northeastern Brazil)
Authors: Gazzaneo Luiz Rodrigo Saldanha , de Lucena Reinaldo Farias Paiva , de Albuquerque Ulysses Paulino 
Published: November 2005

Abstract
The study of local knowledge about natural resources is becoming increasingly important in defining strategies and actions for conservation or recuperation of residual forests. This study therefore sought to: collect information from local populations concerning the use of Atlantic Forest medicinal plants; verify the sources of medicinal plants used; determine the relative importance of the species surveyed, and; calculate the informant consensus factor in relation to medicinal plant use. Data was obtained using semi-structured forms to record the interviewee's personal information and topics related to the medicinal use of specific plants. The material collected represent 125 plants, distributed among 61 botanical families, with little participation of native plants. This study demonstrated that local people tend to agree with each other in terms of the plants used to treat blood-related problems, but cite a much more diverse group of plants to treat problems related to the respiratory and digestive systems – two important categories in studies undertaken in different parts of the world. The local medicinal flora is largely based on plants that are either cultivated or obtained from anthropogenic zones, possibly due to the use and access restrictions of the legally protected neighboring forest. Despite these restrictions, the species with the highest use-value by this community was Pithecellobium cochliocarpum (Gomez) Macb., a native plant of the Atlantic Forest.
The progestational and androgenic properties of medroxyprogesterone acetate: gene regulatory overlap with dihydrotestosterone in breast cancer cells
Authors: Ghatge Radhika P , Jacobsen Britta M , Schittone Stephanie A , Horwitz Kathryn B 
Published: November 2005

Abstract
Introduction
Medroxyprogesterone acetate (MPA), the major progestin used for oral contraception and hormone replacement therapy, has been implicated in increased breast cancer risk. Is this risk due to its progestational or androgenic properties? To address this, we assessed the transcriptional effects of MPA as compared with those of progesterone and dihydrotestosterone (DHT) in human breast cancer cells.

Method
A new progesterone receptor-negative, androgen receptor-positive human breast cancer cell line, designated Y-AR, was engineered and characterized. Transcription assays using a synthetic promoter/reporter construct, as well as endogenous gene expression profiling comparing progesterone, MPA and DHT, were performed in cells either lacking or containing progesterone receptor and/or androgen receptor.

Results
In progesterone receptor-positive cells, MPA was found to be an effective progestin through both progesterone receptor isoforms in transient transcription assays. Interestingly, DHT signaled through progesterone receptor type B. Expression profiling of endogenous progesterone receptor-regulated genes comparing progesterone and MPA suggested that although MPA may be a somewhat more potent progestin than progesterone, it is qualitatively similar to progesterone. To address effects of MPA through androgen receptor, expression profiling was performed comparing progesterone, MPA and DHT using Y-AR cells. These studies showed extensive gene regulatory overlap between DHT and MPA through androgen receptor and none with progesterone. Interestingly, there was no difference between pharmacological MPA and physiological MPA, suggesting that high-dose therapeutic MPA may be superfluous.

Conclusion
Our comparison of the gene regulatory profiles of MPA and progesterone suggests that, for physiologic hormone replacement therapy, the actions of MPA do not mimic those of endogenous progesterone alone. Clinically, the complex pharmacology of MPA not only influences its side-effect profile; but it is also possible that the increased breast cancer risk and/or the therapeutic efficacy of MPA in cancer treatment is in part mediated by androgen receptor.
Intensity Differences of Copper Lines Depending on Impurity Contents
Authors: Danielsson A. , Petersson S. 
Published: November 2005

Differences in copper line intensities depending on changes in minor impurity contents of anode copper have been observed. A statistical investigation of this phenomenon has been made. The base for this statistical investigation is 400 plates and corresponding analytical records from our routine spectrochemical work. For the excitation condition used, namely an interrupted arc, a regression equation for the depending of copper line intensity on impurity amounts has been calculated according to the method of least squares. Differences in thermal conductivity depending on impurity contents are regarded as the main cause for this phenomenon. This interpretation is confirmed by further investigations. The significant differences in copper line intensity between different anode copper specimens diminish as the excitation gets more spark-like. Less heat is deliberated, and thus the influence from the difference in thermal conductivity diminishes. The globule arc technique gives hardly any significant intensity difference for different specimens. This is also in conformity with the above explanation, as in this case the influence of thermal conductivity of solid copper is eliminated. Furthermore, the influence of the intensity variations on the spectrochemical results are discussed.
Multivariable State-space Adaptive Control (Adaptive Mehrgrößenzustandsregelung)
Authors: Gambier Adrian , Nazaruddin Yul Y. 
Published: November 2005

Abstract
The field of indirect adaptive control has been intensively studied for single input/single output (SISO) system as well as multivariable (MIMO) systems based on I/O models. State-space approaches for SISO system can also be found in the literature. Although the state-space representation is a very convenient description for multivariable systems, only few times it was applied to design indirect adaptive control systems. In this paper, the most important approaches are presented and analysed including advantages and drawbacks. Finally, the most common adaptive control schemes are illustrated with real-time results obtained from experiments carried out on a turbogenerator pilot plant.
Contribution of hyphenated CE-ICP/MS in metal/protein interactions studies
Authors: Chamoun J. , Hagège A. 
Published: November 2005

Summary
By introducing a preliminary in-capillary preconcentration step, CE-ICP/MS was applied to trace metal speciation in proteins. Emphasis was put on metal/protein interactions where CE-ICP/MS is demonstrated to provide informations concerning metal binding and metal exchanges occuring in proteins. Preliminary studies on the fate of several metals in the presence of a mixture of standard proteins were performed. Cadmium was shown to bind mainly to albumin and ceruloplasmin. Cobalt and nickel were detected only in carbonic anhydrase and ceruloplasmin in the mixture of proteins but also in albumin when injected alone.