bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey of Chinese nurses’ guidance to parents in children's postoperative pain relief
Authors: He Hong‐Gu , Pölkki Tarja , Pietilä Anna‐Maija , Vehviläinen‐Julkunen Katri 
Published: April 2006

Aims and objectives.  The aim of the study was to describe parental guidance provided by Chinese nurses regarding non‐pharmacological methods in children's surgical pain relief as well as factors related to this.Background.  Parental involvement in children's pain management has been acknowledged and encouraged in recent years. However, parents’ lack of related information has been pointed out and little is known about how parents are guided to use non‐pharmacological methods to relieve the pain.Methods.  A previously validated European questionnaire survey was conducted in 2002. Structured questionnaires were distributed to all 187 nurses working at 12 surgical wards in five hospitals of Fujian Province, China. The average response rate was 98%.Results.  The results show that nurses informed parents of the majority of cognitive information. The most commonly guided non‐pharmacological methods were distraction, positive reinforcement, comforting/reassurance, positioning and relaxation. Nurses’ background factors, including age, education, nursing position, professional work experience, number of their own children and experiences of earlier hospitalizations of their children, were significantly related to their perceptions regarding parental guidance.Conclusions.  Chinese nurses provided much guidance to parents on non‐pharmacological methods. However, the results show that sensory information and physical methods were poorly conveyed to parents, which needs future attention to reinforce parents’ active role in pain management.Relevance to clinical practice.  This study provides new information on Chinese nurses’ guiding parents to use non‐pharmacological methods in pain alleviation, thereby contributing to the body of knowledge on this subject. Furthermore, the study makes the respondents aware of the importance of involving parents in their child's pain management.
Categorization of major and minor complications in the treatment of patients with resectable rectal cancer using short‐term pre‐operative radiotherapy and total mesorectal excision: a Delphi round
Authors: Bakx R. , Emous M. , Legemate D. A. , Machado M. , Zoetmulder F. A. N. , Van Tets W. F. , Bemelman W. A. , Slors J. F. M. , Van Lanschot J. J. B. 
Published: April 2006

AbstractBackground  To properly balance the benefit (reduction of local recurrence) of short‐term pre‐operative radiotherapy for resectable rectal cancer against its harm (complications), a consensus concerning the severity of complications is required. The aim of this study was to reach consensus regarding major and minor complications after short‐term radiotherapy followed by total mesorectal excision in the treatment of rectal carcinoma, using the Delphi technique.Methods  A Delphi round was performed in cooperation with 21 colo‐rectal surgeons from the Netherlands, United Kingdom and Sweden. The key‐question was: ‘Which of the predefined complications, caused or substantially aggravated by radiotherapy, are so important (major) that they might lead to the decision to abandon short‐term pre‐operative radiotherapy (5 × 5Gy) when treating patients with resectable rectal cancer (T1−3N0−2M0)?’Results  After three rounds, consensus was reached for 37 (68%) of 54 complications of which 13 were considered major and 24 considered minor. The following complications were considered to be major: mortality, anastomotic leakage managed by relaparotomy, anastomotic leakage resulting in persisting fistula, postoperative haemorrhage managed by relaparotomy, intra‐abdominal abscess without healing tendency, sepsis, pulmonary embolism, myocardial infarction, compartment syndrome of the lower legs, long‐term incontinence for solid stool, long‐term problems with voiding, pelvic fracture with persisting pain, and neuropathy with persisting pain (legs). Three of 17 complications without consensus showed a tendency to be considered as major: perineal wound dehiscence managed by surgical treatment, small bowel obstruction leading to relaparotomy and long‐term incontinence for liquid stool.Conclusion  The 13 major and three ‘accepted as major’ complications can be used to properly balance the benefit and harm of short‐term pre‐operative radiotherapy in resectable rectal cancer. This may eventually lead to improved treatment strategies for these patients.
Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta‐analysis
Authors: Karliczek A. , Jesus E. C. , Matos D. , Castro A. A. , Atallah A. N. , Wiggers T. 
Published: April 2006

AbstractBackground  There is little agreement on prophylactic use of drains in anastomoses in elective colorectal surgery despite many randomized clinical trials. Once anastomotic leakage occurs it is generally agreed that drains should be used for therapeutic purposes. However, on prophylactic use no such agreement exists.Aim  To compare the safety and effectiveness of routine drainage and nondrainage regimes after elective colorectal surgery. The primary outcome was clinical anastomotic leakage.Methods  A systematic search was undertaken to identify randomized clinical trials. Of the 1140 patients who were enrolled (six randomized controlled trials), 573 were allocated for drainage and 567 for no drainage. Outcome measures were: (i) mortality: 3% (18 of 573 patients) compared with 4% (25 of 567 patients); (ii) clinical anastomotic dehiscence: 2% (11 of 522 patients) compared with 1% (7 of 519 patients); (iii) radiological anastomotic dehiscence: 3% (16 of 522 patients) compared with 4% (19 of 519 patients); (iv) wound infection: 5% (29 of 573 patients) compared with 5% (28 of 567 patients); (v) reintervention: 6% (34 of 542 patients) compared with 5% (28 of 539 patients); (vi) extra‐abdominal complications: 7% (34 of 522 patients) compared with 6% (32 of 519 patients). None of these differences in outcome was significant.Conclusion  There is insufficient evidence showing that routine drainage after colorectal anastomoses prevents anastomotic and other complications.
The effects of exercise on human articular cartilage
Authors: Eckstein F. , Hudelmaier M. , Putz R. 
Published: April 2006

AbstractThe effects of exercise on articular hyaline articular cartilage have traditionally been examined in animal models, but until recently little information has been available on human cartilage. Magnetic resonance imaging now permits cartilage morphology and composition to be analysed quantitativelyin vivo. This review briefly describes the methodological background of quantitative cartilage imaging and summarizes work on short‐term (deformational behaviour) and long‐term (functional adaptation) effects of exercise on human articular cartilage. Current findings suggest that human cartilage deforms very littlein vivoduring physiological activities and recovers from deformation within 90 min after loading. Whereas cartilage deformation appears to become less with increasing age, sex and physical training status do not seem to affectin vivodeformational behaviour. There is now good evidence that cartilage undergoes some type of atrophy (thinning) under reduced loading conditions, such as with postoperative immobilization and paraplegia. However, increased loading (as encountered by elite athletes) does not appear to be associated with increased average cartilage thickness. Findings in twins, however, suggest a strong genetic contribution to cartilage morphology. Potential reasons for the inability of cartilage to adapt to mechanical stimuli include a lack of evolutionary pressure and a decoupling of mechanical competence and tissue mass.
The response of bone, articular cartilage and tendon to exercise in the horse
Authors: Firth Elwyn C. 
Published: April 2006

AbstractHorses can gallop within hours of birth, and may begin training for athletic competition while still growing. This review cites studies on the effects of exercise on bone, tendon and articular cartilage, as detected by clinical and research imaging techniques, tissue biochemical analysis and microscopy of various kinds. For bone, alterations in bone mineral content, mineral density and the morphology of the mineralized tissue are the most common end‐points. Apparent bone density increases slightly after athletic training in the cortex, but substantially in the major load paths of the epiphyses and cuboidal bones, despite the lower material density of the new bone, which is deposited subperiosteally and on internal surfaces without prior osteoclastic resorption. With training of greater intensity, adaptive change is supervened by patho‐anatomical change in the form of microdamage and frank lesions. In tendon, collagen fibril diameter distribution changes significantly during growth, but not after early training. The exact amount and type of protracted training that does cause reduction in mass average diameter (an early sign of progressive microdamage) have not been defined. Training is associated with an increase in the cross‐sectional area of some tendons, possibly owing to slightly greater water content of non‐collagenous or newly synthesized matrix. Early training may be associated with greater thickness of hyaline but not calcified articular cartilage, at least in some sites. The age at which adaptation of cartilage to biomechanical influences can occur may thus extend beyond very early life. However, cartilage appears to be the most susceptible of the three tissues to pathological alteration. The effect of training exercise on the anatomical or patho‐anatomical features of connective tissue structures is affected by the timing, type and amount of natural or imposed exercise during growth and development which precedes the training.
Adaptability of elderly human muscles and tendons to increased loading
Authors: Narici Marco V. , Maganaris Constantinos N. 
Published: April 2006

AbstractSenile sarcopenia, the loss of muscle mass associated with aging, is one of the main causes of muscle weakness and reduced locomotor ability in old age. Although this condition is mainly driven by neuropathic processes, nutritional, hormonal and immunological factors, as well as a reduction in physical activity, contribute to this phenomenon. Sarcopenia alone, however, does not fully account for the observed muscle weakness, as the loss of force is greater than that accounted for by the decrease in muscle size. As a consequence, a reduction in the force per unit area, both at single fibre and at whole muscle level, is observed. We recently suggested that at whole muscle level, this reduction in intrinsic force is the result of the combined effect of changes in (1) muscle architecture, (2) tendon mechanical properties, (3) neural drive (reduced agonist and increased antagonist muscle activity) and (4) single fibre‐specific tension. Whereas several studies support the role of the last two factors in the loss of intrinsic muscle force with aging, alterations in muscle architecture and in tendon mechanical properties have also been shown to contribute to the above phenomenon. Indeed, sarcopenia of the human plantarflexors, represented by a 25% reduction in muscle volume, was found to be associated with a 10% reduction in fibre fascicle length and 13% reduction in pennation angle. These architectural alterations were accompanied by a 10% decrease in tendon stiffness, attributable to alterations in tendon material properties, as suggested by a 14% decrease in Young's modulus. Most of these changes may be reversed by 14 weeks of resistive training; both fibre fascicle length and tendon stiffness were found to be increased by 10 and 64%, respectively. Surprisingly, however, training had no effect on the estimated relative length–tension properties of the muscle, indicating that the effects of greater tendon stiffness and increased fascicle length cancelled out each other. It seems that natural strategies may be in place to ensure that the relative operating range of muscle remains unaltered by changes in physical activity, in old age.
Truth hurts – hard lessons from Australia's largest mass casualty exercise with contaminated patients
Authors: Edwards Nicholas A , Caldicott David GE , Eliseo Tony , Pearce Andrew 
Published: April 2006

AbstractIn response to the increasing threat of a mass casualty incident involving chemical, biological or radiological agents, and concern over the preparedness of our hospital system to cope with patients from such an incident, we conducted the largest hospital‐based field exercise involving contaminated patients that has been held in Australia. In the present paper, we outline the background to, and methodology of, Exercise Supreme Truth, and the efforts made to increase its realism. We focus our discussion on three issues highlighted by the exercise, which we believe have enormous implications for the development of hospital chemical, biological or radiological plans and the likelihood of their success – hospital security, crowd control and decontamination.
Bacterial Sinusitis and Otitis Media following Influenza Virus Infection in Ferrets
Authors: Peltola Ville T. , Boyd Kelli L. , McAuley Julie L. , Rehg Jerold E. , McCullers Jonathan A. 
Published: April 2006

ABSTRACT

Streptococcus pneumoniae
is the leading cause of otitis media, sinusitis, and pneumonia. Many of these infections result from antecedent influenza virus infections. In this study we sought to determine whether the frequency and character of secondary pneumococcal infections differed depending on the strain of influenza virus that preceded bacterial challenge. In young ferrets infected with influenza virus and then challenged with pneumococcus, influenza viruses of any subtype increased bacterial colonization of the nasopharynx. Nine out of 10 ferrets infected with H3N2 subtype influenza A viruses developed either sinusitis or otitis media, while only 1 out of 11 ferrets infected with either an H1N1 influenza A virus or an influenza B virus did so. These data may partially explain why bacterial complication rates are higher during seasons when H3N2 viruses predominate. This animal model will be useful for further study of the mechanisms that underlie viral-bacterial synergism.
Expression of
Haemophilus ducreyi
Collagen Binding Outer Membrane Protein NcaA Is Required for Virulence in Swine and Human Challenge Models of Chancroid
Authors: Fulcher Robert A. , Cole Leah E. , Janowicz Diane M. , Toffer Kristen L. , Fortney Kate R. , Katz Barry P. , Orndorff Paul E. , Spinola Stanley M. , Kawula Thomas H. 
Published: April 2006

ABSTRACT

Haemophilus ducreyi
, the etiologic agent of the sexually transmitted genital ulcer disease chancroid, has been shown to associate with dermal collagen fibers within infected skin lesions. Here we describe NcaA, a previously uncharacterized outer membrane protein that is important for
H. ducreyi
collagen binding and host colonization. An
H. ducreyi
strain lacking the
ncaA
gene was impaired in adherence to type I collagen but not fibronectin (plasma or cellular form) or heparin. The mutation had no effect on serum resistance or binding to HaCaT keratinocytes or human foreskin fibroblasts in vitro.
Escherichia coli
expressing
H. ducreyi
NcaA bound to type I collagen, demonstrating that NcaA is sufficient to confer collagen attachment. The importance of NcaA in
H. ducreyi
pathogenesis was assessed using both swine and human experimental models of chancroid. In the swine model, 20% of lesions from sites inoculated with the
ncaA
mutant were culture positive for
H. ducreyi
7 days after inoculation, compared to 73% of wild-type-inoculated sites. The average number of CFU recovered from mutant-inoculated lesions was also significantly reduced compared to that recovered from wild-type-inoculated sites at both 2 and 7 days after inoculation. In the human challenge model, 8 of 30 sites inoculated with wild-type
H. ducreyi
progressed to the pustular stage, compared to 0 of 30 sites inoculated with the
ncaA
mutant. Together these results demonstrate that the collagen binding protein NcaA is required for
H. ducreyi
infection.
Splenic γδ T Cells Regulated by CD4+T Cells Are Required To Control ChronicPlasmodium chabaudiMalaria in the B-Cell-Deficient Mouse
Authors: van der Heyde Henri C. , Batchelder Joan M. , Sandor Matyas , Weidanz William P. 
Published: April 2006

ABSTRACTLittle is known about the function and regulation of splenic γδ T cells during chronicPlasmodium chabaudimalaria. The splenic γδ T-cell population continues to expand, reaching levels equal to 4 times the number of splenocytes in an uninfected mouse. Splenic γδ T cells from JH−/−mice with chronic malaria expressed Vγ1+or Vδ4+in the same ratio as uninfected controls with Vγ1 cells dominating, but the Vγ2 ratio declined about twofold. γδ T cells from G8 mice specific for the TL antigen increased only 2-fold in number, compared with 10-fold in BALB/c controls, but G8 γδ T cells failed to express the B220 activation marker. Elimination of the parasite by drug treatment caused a slow depletion in the number of splenic γδ, CD4+, and CD8+T cells. Following challenge, drug-cured JH−/−mice exhibited nearly identical parasitemia time courses as naïve controls. Depletion of either CD4+T cells or γδ T cells from chronically infected JH−/−mice by monoclonal antibody treatment resulted in an immediate and significant (P< 0.05) exacerbation of parasitemia coupled with a marked decrease in splenic γδ T-cell numbers. The number of CD4+T cells, in contrast, did not decrease in mice after anti-T-cell receptor γδ treatment. The results indicate that cell-mediated immunity against blood-stage malarial parasites during chronic malaria (i) requires the continued presence of blood-stage parasites to remain functional, (ii) is dependent upon both γδ T cells and CD4+T cells, and (iii) lacks immunological memory.
Toll-Like Receptor 2 Is Required for Inflammatory Responses toFrancisella tularensisLVS
Authors: Katz Jannet , Zhang Ping , Martin Michael , Vogel Stefanie N. , Michalek Suzanne M. 
Published: April 2006

ABSTRACTFrancisella tularensis, a gram-negative bacterium, is the etiologic agent of tularemia and has recently been classified as a category A bioterrorism agent. Infections withF. tularensisresult in an inflammatory response that plays an important role in the pathogenesis of the disease; however, the cellular mechanisms mediating this response have not been completely elucidated. In the present study, we determined the role of Toll-like receptors (TLRs) in mediating inflammatory responses toF. tularensisLVS, and the role of NF-κB in regulating these responses. Stimulation of bone marrow-derived dendritic cells from C57BL/6 wild-type (wt) and TLR4−/−but not TLR2−/−mice, with liveF. tularensisLVS elicited a dose-dependent increase in the production of tumor necrosis factor alpha.F. tularensisLVS also induced in a dose-dependent manner an up-regulation in the expression of the costimulatory molecules CD80 and CD86 and of CD40 and the major histocompatibility complex class II molecules on dendritic cells from wt and TLR4−/−but not TLR2−/−mice. TLR6, not TLR1, was shown to be involved in mediating the inflammatory response toF. tularensisLVS, indicating that the functional heterodimer is TLR2/TLR6. Stimulation of dendritic cells withF. tularensisresulted in the activation of NF-κB, which resulted in a differential effect on the production of pro- and anti-inflammatory cytokines. Taken together, our results demonstrate the role of TLR2/TLR6 in the host's inflammatory response toF. tularensisLVS in vitro and the regulatory function of NF-κB in modulating the inflammatory response.
Intestinal Shiga Toxin-Producing
Escherichia coli
Bacteria Mitigate Bovine Leukemia Virus Infection in Experimentally Infected Sheep
Authors: Ferens Witold A. , Cobbold Rowland , Hovde Carolyn J. 
Published: April 2006

ABSTRACT

Ruminants often carry gastrointestinal Shiga toxin (Stx)-producing
Escherichia coli
(STEC). Stxs belong to a large family of ribosome-inactivating proteins (RIPs), found in many plants and some bacteria. Plant RIPs, secreted into extracellular spaces, limit the spread of viruses through plant tissues by penetrating and killing virally infected cells. Previously, we showed Stx activity against bovine leukemia virus (BLV)-infected cells in vitro and hypothesized that STEC bacteria have antiviral activity in ruminant hosts. Here, we investigated the impact of STEC on the initial phases of BLV infection in sheep. Sheep were treated with biweekly oral doses of
E. coli
O157:H7 (an STEC) or an isogenic
stx
mutant strain. A different group of sheep were similarly treated with five naturally occurring ovine STEC isolates or
stx
-negative
E. coli
. Intestinal STEC bacteria were enumerated and identified by standard fecal culture and DNA hybridization. Oral STEC treatment did not always result in carriage of STEC, although many animals consistently presented with >10
4
CFU/g feces. BLV viremia was assessed by spontaneous lymphocyte proliferation (SLP) in cultures of blood mononuclear cells and by syncytium formation in cocultures of the same with F-81 indicator cells. SLP was lower (
P
< 0.05) and syncytia were fewer (
P
< 0.05) in STEC-treated sheep than in untreated sheep. Both lower SLP and fewer syncytia positively correlated with fecal STEC numbers. Average weight gain post-BLV challenge was higher in STEC-treated sheep than in untreated sheep (
P
< 0.05). These results support the hypothesis that in ruminants, intestinal STEC bacteria have antiviral activity and mitigate BLV-induced disease.
Enterotoxigenicity of Mature 45-Kilodalton and Processed 35-Kilodalton Forms of Hemagglutinin Protease Purified from a Cholera Toxin Gene-Negative
Vibrio cholerae
Non-O1, Non-O139 Strain
Authors: Ghosh A. , Saha D. R. , Hoque K. M. , Asakuna M. , Yamasaki S. , Koley H. , Das S. S. , Chakrabarti M. K. , Pal A. 
Published: April 2006

ABSTRACT

Cholera toxin gene-negative
Vibrio cholerae
non-O1, non-O139 strain PL-21 is the etiologic agent of cholera-like syndrome. Hemagglutinin protease (HAP) is one of the major secretory proteins of PL-21. The mature 45-kDa and processed 35-kDa forms of HAP were purified in the presence and absence of EDTA from culture supernatants of PL-21. Enterotoxigenicities of both forms of HAP were tested in rabbit ileal loop (RIL), Ussing chamber, and tissue culture assays. The 35-kDa HAP showed hemorrhagic fluid response in a dose-dependent manner in the RIL assay. Histopathological examination of 20 μg of purified protease-treated rabbit ileum showed the presence of erythrocytes and neutrophils in the upper part of the villous lamina propria. Treatment with 40 μg of protease resulted in gross damage of the villous epithelium with inflammation, hemorrhage, and necrosis. The 35-kDa form of HAP, when added to the lumenal surface of rat ileum loaded in an Ussing chamber, showed a decrease in the intestinal short-circuit current and a cell rounding effect on HeLa cells. The mature 45-kDa form of HAP showed an increase in intestinal short-circuit current in an Ussing chamber and a cell distending effect on HeLa cells. These results show that HAP may play a role in the pathogenesis of PL-21.