bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative convergence of three nursing concepts: art of nursing, presence and caring
Authors: Finfgeld‐Connett Deborah 
Published: March 2008

AbstractTitle.  Qualitative convergence of three nursing concepts: art of nursing, presence and caring. Aim.  This paper is a report of the development of a theoretical framework of nursing practice based on the convergence of the concepts art of nursing, presence and caring.Background.  Convergence of similar concepts to form broad yet useful theories is a relatively unexplored area, despite the fact that systematically examining and integrating nursing concepts can help to build theory and leads to enhanced understanding of the discipline. Research results suggest that unarticulated similarities exist among the art of nursing, presence and caring; thus, qualitative convergence of these concepts is justified.Data sources.  Findings from qualitative studies of the art of nursing (published between 1993 and the third quarter of 2006) and meta‐syntheses of presence and caring (published in 2006 and 2007 respectively) were inductively analysed and integrated.Results.  A theoretical framework of nursing practice was developed to illustrate the areas of convergence among the concepts art of nursing, presence and caring. Nursing involves an intimate relationship‐centred partnership between the nurse and patient. Situation‐specific nursing actions result from multiple forms of personal and professional knowledge and are based on a value system of holistic beneficence and patient empowerment. Nursing actions are promoted by a conducive work environment and result in enhanced well‐being among patients and nurses.Conclusion.  Results of this concept convergence provide an enhanced understanding of nursing practice and offer insight into areas of nursing practice that are not encompassed within the concepts art of nursing, presence and caring. Further work is recommended to expand the proposed framework, especially in terms of the wide variety of nurse–patient relationships that exist.
Borrelia burgdorferi membranes are the primary targets of reactive oxygen species
Authors: Boylan Julie A. , Lawrence Kevin A. , Downey Jennifer S. , Gherardini Frank C. 
Published: March 2008

SummarySpirochetes living in an oxygen‐rich environment or when challenged by host immune cells are exposed to reactive oxygen species (ROS). These species can harm/destroy cysteinyl residues, iron‐sulphur clusters, DNA and polyunsaturated lipids, leading to inhibition of growth or cell death. Because Borrelia burgdorferi contains no intracellular iron, DNA is most likely not a major target for ROS via Fenton reaction. In support of this, growth of B. burgdorferi in the presence of 5 mM H2O2 had no effect on the DNA mutation rate (spontaneous coumermycin A1 resistance), and cells treated with 10 mM t‐butyl hydroperoxide or 10 mM H2O2 show no increase in DNA damage. Unlike most bacteria, B. burgdorferi incorporates ROS‐susceptible polyunsaturated fatty acids from the environment into their membranes. Analysis of lipoxidase‐treated B. burgdorferi cells by Electron Microscopy showed significant irregularities indicative of membrane damage. Fatty acid analysis of cells treated with lipoxidase indicated that host‐derived linoleic acid had been dramatically reduced (50‐fold) in these cells, with a corresponding increase in the levels of malondialdehyde by‐product (fourfold). These data suggest that B. burgdorferi membrane lipids are targets for attack by ROS encountered in the various stages of the infective cycle.
The functional divergence of short‐chain dehydrogenases involved in tropinone reduction
Authors: Brock Andrea , Brandt Wolfgang , Dräger Birgit 
Published: March 2008

SummaryTropane alkaloids typically occur in the Solanaceae and are also found in Cochlearia officinalis, a member of the Brassicaceae. Tropinone reductases are key enzymes of tropane alkaloid metabolism. Two different tropinone reductases form one stereoisomeric product each, either tropine for esterified alkaloids or pseudotropine that is converted to calystegines. A cDNA sequence with similarity to known tropinone reductases (TR) was cloned from C. officinalis. The protein was expressed in Escherichia coli, and found to catalyze the reduction of tropinone. The enzyme is a member of the short‐chain dehydrogenase enzyme family and shows broad substrate specificity. Several synthetic ketones were accepted as substrates, with higher affinity and faster enzymatic turnover than observed for tropinone. C. officinalis TR produced both the isomeric alcohols tropine and pseudotropine from tropinone using NADPH + H+ as co‐substrate. Tropinone reductases of the Solanaceae, in contrast, are strictly stereospecific and form one tropane alcohol only. The Arabidopsis thaliana homologue of C. officinalis TR showed high sequence similarity, but did not reduce tropinone. A tyrosine residue was identified in the active site of C. officinalis TR that appeared responsible for binding and orientation of tropinone. Mutagenesis of the tyrosine residue yielded an active reductase, but with complete loss of TR activity. Thus C. officinalis TR presents an example of an enzyme with relaxed substrate specificity, like short‐chain dehydrogenases, that provides favorable preconditions for the evolution of novel functions in biosynthetic sequences.
Imaging of adenomyomatosis of the gall bladder
Authors: Stunell H , Buckley O , Geoghegan T , O’Brien J , Ward E , Torreggiani W 
Published: March 2008

SummaryAdenomyomatosis is a relatively common abnormality of the gall bladder, with a reported incidence of between 2.8 and 5%. Although mainly confined to the adult study group, a number of cases have been reported in the paediatric study group. It is characterized pathologically by excessive proliferation of the surface epithelium and hypertrophy of the muscularis propria of the gall bladder wall, with invagination of the mucosa into the thickened muscularis forming the so‐called ‘Rokitansky–Aschoff’ sinuses. The condition is usually asymptomatic and is often diagnosed as an incidental finding on abdominal imaging. The radiological diagnosis is largely dependent on the visualization of the characteristic Rokitansky–Aschoff sinuses. As the condition is usually asymptomatic, the importance of making a correct diagnosis is to prevent misinterpretation of other gall bladder conditions such as gall bladder cancer, leading to incorrect treatment. In the past, oral cholecystography was the main imaging method used to make this diagnosis. In most institutions, oral cholecystography is no longer carried out, and the diagnosis is now more commonly seen on cross‐sectional imaging. In this review article, we describe the manifestations of adenomyomatosis on the various imaging methods, with an emphasis on more modern techniques such as magnetic resonance cholangiopancreatography. A brief section on oral cholecystography to aid readers familiar with this technique in understanding the comparable imaging features on more modern imaging techniques is included.
Clinical and endorectal ultrasound staging of circumferential rectal cancers
Authors: Smith A , Farmer KC , Chapple K 
Published: March 2008

SummaryCircumferential rectal cancers present at a more advanced stage than those located in a single quadrant. Although accurate staging is an important aspect of the preoperative management of the patient with a rectal cancer, the clinical and radiological staging of this subgroup of rectal cancer patients has been poorly studied. All patients with a rectal cancer were assessed clinically (by digital rectal examination and rigid sigmoidoscopy) before the radiological assessment by endorectal ultrasound (ERUS). Data collected included tumour height (distance from anal verge in centimetre) and tumour type (circumferential or non‐circumferential). Radiological tumour staging was with the TNM system. Fifty‐nine subjects (33 men, 26 women; median age 65 years (range 38–86 years)) were identified with a circumferential rectal cancer. Mean height of the cancer was 8 ± 0.4 cm (standard error of the mean; range 2–13 cm). Forty‐two cancers were palpable, and 17 cancers were impalpable. All cancers assessed clinically as circumferential were confirmed as circumferential on ERUS scanning. Tumour stage as assessed by ERUS was either T3 (n = 57) or T4 (n = 2). Nodal status was N0 (n = 29) and N1 (n = 30). All rectal cancers assessed as circumferential on clinical examination have an ERUS stage of T3 or greater.
The History of James Parkinson and His Disease
Authors: Mulhearn R. J. 
Published: March 2008

Summary: James Parkinson was born over 200 years ago. Although he is remembered in medicine for his monograph on The Shaking Palsy, his interests were broadly divided between social reform, the natural sciences and the teaching and practice of medicine.Born to the great literary era of Samuel Johnson, Goldsmith and Burke, Parkinson knew an upper class sense of excellence in art, literature, knowledge and good taste which was being compared to the achievements of the Roman Empire.Against this historical background James Parkinson was a general practitioner, a surgeon, a social reformer and a pamphleteer. His medical writings include Observations on the Nature and Cure of Government, The Chemical Pocket‐Book1, and the renowned case report of perforation of the appendix2.He was a foundation member of the Geological Society of London and his publication Organic Remains of a Former World3 records his studies on geology and fossil research. Medical Admonitions4 and The Villagers' Friend5 were especially prepared for the laity since he felt a compelling need to promote knowledge of the prevention and treatment of disease to all men.
The Biochemistry of Catecholamines in Relation to Parkinson's Disease
Authors: Hinterberger H. 
Published: March 2008

Summary: The effect of oral doses of 2–9 g L‐3, 4‐dihydroxyphenylalanine (L‐dopa) on the metabolism of catecholamines was studied in 14 patients with Parkinson's Disease being treated simultaneously with cholinolytic medication.Comparison of the excretion in urine of free and conjugated noradrenalin and adrenalin showed no significant differences before and after three months of medication with L‐dopa. Vanilmandelic acid was moderately increased, indicating stimulation of catecholamine turnover well controlled by homeostatic mechanisms. The excretion of free and conjugated 3, 4‐dihydroxyphenylethyla‐mine (dopamine) and its acidic metabolites 3, 4‐dihydroxyphenylacetic acid and homovanillic acid was increased by a factor of 103‐104.Peak levels of L‐dopa in plasma were observed 1 ‐5‐3 hours after an oral dose and were found to vary considerably between patients. No relation between plasma levels and improvement scores could be observed.Levels of L‐dopa, homovanillic acid, 3, 4‐dihydroxyphenylacetic acid and 5‐hydroxyindoleacetic acid were measured in lumbar fluid obtained 4–6 hours after ingestion of an oral dose. These levels increased with increasing daily dose (mg/kg). Although the absolute amount of homovanillic acid did not closely follow clinical improvement, absence of homovanillic acid in the CSF was noted in two patients who failed to improve.
Electromyographic Studies of Parkinsonian Patients
Authors: Andrews C. J. 
Published: March 2008

Summary: A quantitative electromyographic study of rigidity in 20 Parkinsonian patients demonstrated that the stretch reflex in biceps was more affected than that of triceps, and of hamstrings more than quadriceps.Increasing disability from Parkinsonian rìgìdity was found to be associated with a lowered sensitivity of the stretch reflex to the dynamic phase of stretch and an increase in the static response to maintained stretch. Treatment with L‐dopa for six months reversed this pattern in extensor muscles much more readily than in flexor muscles. Since animal experiments have shown that L‐dopa diminishes the fusimotor activity of dynamic flexor muscles by its action on the spinal cord, and that the spinal action of L‐dopa can be blocked by phenoxy‐benzamine, the latter agent has been used in Parkinsonian patients who were under treatment with L‐dopa.Phenoxybenzamine was given to five Parkinsonian patients intravenously and one patient orally. In all patients the dynamic sensitivity of the stretch reflex in flexor muscles improved and rigidity was diminished. Three patients treated with oral phenoxybenzamine showed subjective and objective clinical improvement. This study suggests that the effect of L‐dopa on the spinal cord limits its effectiveness in the treatment of Parkinson's Disease and that this undesirable action may be eliminated by the concomitant use of phenoxybenzamine.
Glibenclamide (HB 419, Daonil) in the Clinical Practice of Diabetes*
Authors: Krall L. P. , Sinha S. , Goldstein H. H. 
Published: March 2008

Summary1. Eighty‐nine patients were observed for periods up to two years by the same observer in nearly every case. After eliminating failures and those unsuited to the study, the remaining 58 have continued for periods up to 24 months with a mean duration of 17.4 months.2. Overall, HB 419 was effective in lowering blood glucose levels in only 27 of the 58 (46.5 %) who continued, however, when the 22 persons also treated with biguanide were eliminated, of the 36 who continued with HB419 alone, 27 (75.0 %) were classified as “satisfactory”. This compares most favourably with the experience using other oral hypoglycaemic agents.3. Surprisingly, the patient who did not respond to HB 419 (Daonil) alone, did not improve with the addition of biguanide. This is contrary to previous reports and suggests that when this preparation is effective, the effect is maximal, but when it fails, adding other compounds adds nothing.4. A dosage of 5 to 20 mg is sufficient for most patients and increased dose levels beyond 20 mg does little or nothing for those who did not respond. Twenty‐nine of the 36 using only Daonil compound continue with a single daily dose.5. HB 419 was only rarely effective in patients who had been failures with maximal doses of other sulphonylurea compounds in this series.6. There have been no side effects or drug‐related toxicity in this series.7. At present the secondary failure rate is remarkably low although this may increase over a longer period of time.8. According to this clinical investigation of HB 419 (Daonil) while there does not appear to be a clear‐cut advantage over other available sulphonylurea compounds there are enough promising facets such as low dose, freedom from side effects and toxicity, single dosage and low rate of secondary failure that longer term observations may prove this to be the equal of, and possibly superior to, the other presently known sulphonylurea compounds.
Acinetobacter Anitratus Infections in Man
Authors: Thong M. L. 
Published: March 2008

Summary: Acinetobacter anitratus infections in man. M. L Thong, Aust. N.Z. J. Med., 1975, 5, pp. 435–439.During a period of 17 months, 142 strains of Acinetobacter anitratus were isolated from 140 patients. They were examined for biochemical characteristics, antibiotic susceptibilities to 15 chemotherapeutic drugs and clinical and epidemiologic features. Biochemical studies were necessary for positive identification of this gram negative rod. Many isolates were susceptible to kanamycin, gentamicin, polymixin B, cotrimoxazole and nalidixic acid. Most isolates were hospital acquired and had been cultured from a number of anatomic sites in the presence of a variety of clinical situations. Acinetobacter anitratus was the primary infecting organism in two cases of septicaemia (one fatal), two pneumonias, two wound infections and six urinary tract infections. Because of its potential pathogenicity this organism should not be dismissed as a harmless commensal by laboratory staff and clinicians.
Acute Coronary Artery Disease and Oral Contraceptives
Authors: Friedlander D. H. , Snell A. P. 
Published: March 2008

Summary: The Waikato Hospital experience of women admitted or seen in the Cardiology Outpatient Clinic who were under the age of 40 and whose diagnosis was a recent acute coronary occlusive episode was reviewed. It was found that there were nine admissions in eight women in this category between December 1971 and November 1973, plus one further patient who was seen with a recent acute ischaemic episode as an outpatient. The histories of these patients were reviewed and their risk factors surveyed. Of the nine women in the study, seven were taking oral contraceptives.As opposed to previous studies, not all the women in this study showed risk factors other than oral contraceptive usage. Three patients in this group taking oral contraceptives and who were thought to have definite coronary ischaemic episodes had no other major risk factor though two of the three were obese. It is thought probable that oral contraceptives containing oestrogens should be considered as a coronary risk factor in young women.
Observations on Maori‐European Lung Function Differences
Authors: de Hamel F. A. , Glass W. J. 
Published: March 2008

Summary: One hundred and twenty‐one regular soldiers between the ages of 18 and 34 years, who had lived and worked under identical conditions for the two previous years were examined. All subjects with respiratory symptoms of wheeze, dyspnoea, persistent cough or sputum were excluded. Smoking, per se, was not a reason for exclusion. Eighty‐three “respiratorily fit” men, comprising 47 Maoris and 36 Europeans, were studied to see whether height, weight or obesity could account for the ethnic differences in lung function.The forced vital capacity in the Maoris was found to be about 9% lower than in the Europeans. The one‐second forced expiratory volume of the Maoris was about 8% lower than in the Europeans. No significant difference could be found in the peak expiratory flow rates between the two ethnic groups.The only significant physical difference found between the two ethnic groups was that the Maoris were heavier for their height than the Europeans. Statistical tests showed that neither weight nor an obesity index accounted for the ethnic differences in lung function. Full laboratory investigation of these ethnic differences is recommended.
The Spectrum of Liver Disease in Alcoholism
Authors: Bhathal P. S. , Wilkinson Patricia , Clifton Sheila , Rankin J. G. , Santamaria J. N. 
Published: March 2008

Summary: Liver biopsies obtained from 100 alcoholic patients attending a clinic primarily for the management of their alcoholism, have been reviewed. The morphological appearances have been correlated with histories of alcohol consumption and with clinical and biochemical findings.There were 77 men and 23 women. Eight biopsies appeared normal, 62 showed fatty liver with or without fibrosis, 17 had alcoholic hepatitis with or without fibrosis and 13 had alcoholic hepatitis with established cirrhosis.Patients with fatty liver had drunk as long and as heavily as those with alcoholic hepatitis, suggesting that some other factor in addition to alcohol is of importance in the development of alcoholic hepatitis.Clinical and biochemical abnormalities showed no constant relationship to histological findings. Thus liver biopsy would seem to be an essential part of the full clinical assessment of the alcoholic patient.
Cold Agglutinin Formation in Patients Undergoing Haemodialysis. A Possible Relationship to Dialyser Re‐use
Authors: Harrison Pamela Brawdley , Jansson Kay , Kronenberg Harry , Mahony John Francis , Tillert David 
Published: March 2008

Summary: Cold agglutinin formation in patients undergoing haemodialysis. A possible relationship to dialyser re‐use.Cold agglutinins with anti‐N characteristics were shown to develop in as short a time as four months in patients on home dialysis. It appeared that the development of such antibodies is related to dialyser re‐use. Those who were treated without re‐using their dialyser did not develop these antibodies.Anti‐N may cause early graft failure associated with agglutination in a cold allograft. Moreover, if these antibodies develop in patients on dialysis there may be problems with extracorporeal dialysis and blood transfusion.
The Effect of Impairment of Renal Function and Dialysis on the Serum and Urine Levels of Clindamycin*
Authors: Peddie Barbara A. , Darin Elsie , Bailey Ross R. 
Published: March 2008

Summary: The effect of impairment of renal function and dialysis on the serum and urine levels of clindamycin.A single 150 mg oral dose of clindamycin was given to three healthy volunteers and 13 patients with varying degrees of renal functional impairment. The mean peak serum levels in the two groups were 2.55±0.92 μg/ml and 3.39±0.68 μg/ml respectively. In all patients the levels greatly exceeded the minimum inhibitory concentration for sensitive pathogens. The serum half‐life was extremely variable in patients with renal failure and bore no relationship to the glomerular filtration rate. In the normal subjects 11.9% of the administered dose was excreted in the urine but in severe renal failure less than 1% of the bioactivity was detected in the urine in 24 hours. The drug was not removed by haemodialysis.In patients with mild to moderate impairment of renal function no dosage adjustment of clindamycin is necessary. However, in those with severe renal failure some modification to dosage would be prudent and this should be monitored by measuring serum levels of the antibiotic.
A Study of Serum and Myocardial Digoxin Concentrations in Man During Cardiac Arrest
Authors: Schapel G. J. , Hawkins M. R. , Edwards K. D. G. 
Published: March 2008

Summary: A study of serum and myocardial digoxin concentrations in man during cardiac arrest.In 22 digitalized (of a total of 39) patients studied at random by radioimmunoassay during cardiac arrest, the mean serum digoxin concentration was 2·6 (±1·86, range 0·6–8·2) ng/ml, significantly higher (P < 0·001) than the “eudigitalized” concentration (1·3±0·52, range 0·5–2·3 ng/ml) determined under carefully standardized conditions in a non‐toxic population. Half of the arrest patients had serum digoxin levels in the toxic range (2·4 ng/ml or above), mainly due to significant renal failure (mean serum creatinine concentration 2·9±2·66 v. 1·0±26 mg/dl for non‐toxic subjects, P < 0·001), partly due to a higher mean daily digoxin dose (0·40 v. 0·31 mg/day, P < 0·05) and frequently associated with potent diuretic therapy (73 v. 54%). A smaller fraction of digitalized patients survived, both short‐(27%) and long‐term (14%), than did non‐digitalized subjects (35% and 26%, respectively). The mean myocardial digoxin concentration was 150 (·63±3, range 52–252) ng/g with an average myocardial/serum ratio of 62·5 (range 38–91). There were significant positive correlations between the serum digoxin and left‐ventricular myocardial digoxin concentration (r= 0·8107, P < 0·01) or serum creatinine concentration (r= 0·4637 P < 0·001).The research program was supported by a grant from the National Health and Medical Research Council of Australia.
The Effect of Multiphasic Biochemical Screening on the Diagnosis of Primary Hyperparathyroidism*
Authors: Aitken R. E. , Bartley Paul C. , Bryant S. J. , Lloyd H. M. 
Published: March 2008

Summary: The effect of multiphasic biochemical screening on the diagnosis of primary hyperparathyroidismExperience of primary hyperparathyroidism (PHPT) at the Royal Brisbane Hospital was reviewed to determine the effect of multiphasic biochemical screening, introduced during 1970, on the rate of diagnosis of this disease. In the period 1959–1970, there were 28 proved cases and, in the period 1971–1974, 41 cases, an increase from 2·5 to 11·7 cases per annum. The main factor contributing to this increase was the inclusion of plasma calcium in the multiphasic screening programme, together with correction of the plasma calcium for the total protein concentration in the same blood sample.