bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Handing Over’: transmission of information between nurses in an intensive therapy unit
Authors: Philpin Susan 
Published: February 2006

AbstractTransferring end of shift information between nurses via both verbal and written routes in an intensive therapy unit (ITU) setting is complex and multifaceted. Some authors have taken ethnographic approaches and explored the verbal handover as an example of a nursing ritual. The written route involves various textual materials, which, in addition to conveying essential information about the patient's status, also represent other messages. This article considers two key areas of end of shift information transmission – verbal bedside handovers and written accounts – arguing that in addition to the manifest purposes of transferring essential information between nurses, both modes of reporting also have important latent functions. It will explore and interpret elements of ritual and symbolism inherent in both forms of handover. The article reports on particular findings from a larger ethnographic study of nursing culture, which was accomplished through participant observation over a 12‐month period in ITU. Subsidiary components of the ethnography were the interviews with 15 nurses and the examination of documentary material. The findings suggest that both verbal and written reports, in addition to ensuring that nurses taking over the care of the patient receive the necessary information to enable them to safely provide continuity of care, also convey essential meanings and articulate group values. Both modes of handover reporting are also visual and/or audible symbolic representations of nursing care in ITU and as such confirm and validate that care, expressing the value of nursing work in this unit.
The nursing role in ICU outreach: an international exploratory study
Authors: Endacott Ruth , Chaboyer Wendy 
Published: February 2006

AbstractIt is widely acknowledged that many critically ill patients are managed outside of designated critical care units. One strategy adopted in Australia and England to assess and manage risk in these patients is the intensive care unit (ICU) outreach or liaison nurse service. This article examines how ICU outreach/liaison roles in Australia and England operate in the context of Manley's theoretical framework for advanced nursing practice. Descriptive case study design using semi‐structured interviews and job descriptions as sources of evidence. Findings of interviews with six Australian ICU Liaison nurses are already published; this study replicated the Australian study with four ICU Consultant Nurses in England and mapped interview and job description data from both countries onto Manley's conceptual framework for advanced practice/consultant nurse. Four themes emerged from the English data: patient interventions, support for ward staff, liaison between ward and ICU staff and hospital‐wide impact. The first three of these comprised the core service common to the roles in both countries. Manley's four subroles (expert practitioner, consultant, educator and researcher) were present across both countries. However, the interview and job description data demonstrated that there were lower expectations in Australia that the roles would lead to staff development and build capacity across the hospital system. Similarly, formal education for ward staff such as ALERT and CRiSP courses were more developed in UK. Our data demonstrate that the role undertaken in England and Australia is sufficiently comparable to use as a research intervention in international studies across the two countries. However, the macro service level differs. Job descriptions across both countries emphasized the need to influence hospital policy; however, the ICU consultant nurses in England might be considered better placed to achieve this through role title and access to the hospital executive. In both countries, the roles would benefit from systematic evaluation of the impact on outcomes. This is particularly important for longer‐term integration of the role in the health services in both countries.
Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma)
Authors: SALLAM H. , MCNEARNEY T. A. , CHEN J. D. Z 
Published: February 2006

SummaryGastrointestinal dysmotility in systemic sclerosis (scleroderma) is prevalent in 90% of patients, increasing morbidity and in some cases mortality. The resultant gastrointestinal complications are usually extensive, involving many regions of the gut from the oesophagus to the anus. Collagen replacement of vascular and enteric smooth muscle results in hypomotility, lumen dilatation, tensile rigidity and eventual loss of organ functions.The aim of this paper is to provide an overview of systemic sclerosis‐related gastrointestinal dysmotility and available/potential therapeutic options.We evaluated published data on the pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis patients using the MEDLINE database for English and non‐English articles from 1966 to July 2005.Based on this systematic review, lifestyle and medical therapy approaches are preferred as they often improve and/or ameliorate symptoms. Surgery is only recommended with serious, rare complications such as bowel perforation or ischaemia.Alternative therapies such as acupuncture‐based therapies are well tolerated, with clinical improvement and may be of potential therapeutic benefit for systemic sclerosis gastrointestinal dysmotility.Further elucidation of initiating and persistent mechanisms of systemic sclerosis‐related gastrointestinal dysmotility will optimize the development of a multidisciplinary and more directed treatment regimen.
Diverticular disease and migration – the influence of acculturation to a Western lifestyle on diverticular disease
Authors: HJERN F. , JOHANSSON C. , MELLGREN A. , BAXTER N. N. , HJERN A. 
Published: February 2006

SummaryBackgroundDiverticular disease of the colon is more common in the Western world, compared with non‐Western countries.AimTo investigate the risk of diverticular disease in immigrants of diverse ethnicity and in different phases of acculturation.MethodsSocio‐demographic indicators and the risk of diverticular disease were investigated. The study population was a prospectively followed national cohort of 4 million residents born between 1925 and 1965. Risk ratios (RRs) of hospital admissions and deaths because of diverticular disease and acute diverticulitis from 1991 through 2000 were calculated.ResultsThe risk of hospital admission because of diverticular disease, after adjustment for age, sex and socio‐economic indicators, was lower in non‐Western immigrants (RRs = 0.5–0.7) compared with natives and the risk increased with time after the settlement. Women of all origins had a higher risk compared with men (RR = 1.5). This sex‐difference increased with age (P < 0.001). Socio‐economic status, residency or housing situation were not risk factors.ConclusionThis population‐based study found that immigrants from non‐Westernized countries had lower relative risks for hospitalization because of diverticular disease than natives, but the risk increased during a relatively short period of time after settlement. Diverticular disease of the colon appears to be an acquired disorder and acculturation to a Western lifestyle has an impact on the risk.
Sustained virological response rates and health‐related quality of life after interferon and ribavirin therapy in patients with chronic hepatitis C virus infection and persistently normal alanine aminotransferase levels
Authors: BINI E. J. , MEHANDRU S. 
Published: February 2006

SummaryBackgroundFew studies have evaluated interferon and ribavirin therapy in hepatitis C virus‐infected patients with persistently normal alanine aminotransferase (ALT) levels.AimTo determine the efficacy and safety of combination therapy in this population, and to evaluate the impact of treatment on health‐related quality of life.MethodsForty‐six hepatitis C virus‐infected patients with persistently normal ALT levels and 92 matched subjects with elevated ALT levels were treated with interferon‐α2b plus ribavirin for up to 48 weeks. Health‐related quality of life was measured prior to therapy and 24 weeks after completion of treatment using the Hepatitis Quality of Life Questionnaire.ResultsOverall, 32.6% of patients with normal ALT levels and 28.3% of those with elevated ALT levels had undetectable hepatitis C virus RNA at 24 weeks after completion of treatment (P = 0.60). Three patients in the normal ALT group had mild transient ALT elevations during therapy. Compared with baseline, treatment was associated with significant improvements in nearly all domains of health‐related quality of life in both groups of patients.ConclusionsIn hepatitis C virus‐infected patients with persistently normal ALT levels, interferon‐α and ribavirin therapy is efficacious, safe, and associated with significant improvements in health‐related quality of life.
Continuous treatment of Barrett's oesophagus patients with proton pump inhibitors up to 13 years: observations on regression and cancer incidence
Authors: COOPER B. T. , CHAPMAN W. , NEUMANN C. S. , GEARTY J. C. 
Published: February 2006

SummaryBackgroundThere is little evidence that treatment of patients with Barrett's oesophagus with proton pump inhibitors over periods up to 6 years results in major regression of Barrett's oesophagus.AimTo determine if longer periods of treatment with proton pump inhibitors lead to significant regression of Barrett's oesophagus, and to determine the incidence of oesophageal adenocarcinoma in the proton pump inhibitor‐treated patients.MethodsWe analysed prospectively‐collected data on Barrett's oesophagus patients treated with proton pump inhibitors for 1–13 years.Results188 patients with Barrett's oesophagus and intestinal metaplasia, were treated for 1–13 years with a proton pump inhibitor (966 years of treatment; mean 5.1 years). No change in length was seen during treatment but 48% of patients developed squamous islands (25% after 1–3 years; 100% at 12–13 years). Squamous islands correlated with treatment duration and male sex but not with proton pump inhibitor dose or patient age. Six patients developed dysplasia and three males developed adenocarcinoma during treatment (cancer incidence 0.31%).ConclusionsProton‐pump inhibitor treatment over 1–13 years does not shorten the Barrett's oesophagus segment but squamous islands appear in many patients. The incidence of oesophageal adenocarcinoma was low in these proton pump inhibitor‐treated patients compared with published series.
Clinical and endoscopic presentation of primary gastric lymphoma: a multicentre study
Authors: ANDRIANI A. , ZULLO A. , DI RAIMONDO F. , PATTI C. , TEDESCHI L. , RECINE U. , CARUSO L. , BONANNO G. , CHIARENZA A. , LIZZANI G. , MIEDICO A. , ROMANELLI A. , COSTA A. , LINEA C. , MARRONE C. , MIRTO S. , MISTRETTA A. , MONTALBANO L. , RESTIVO G. , VINCI M. , BIBAS M. , HASSAN C. , STELLA F. , COTTONE M. , MORINI S. 
Published: February 2006

SummaryBackgroundAlthough the stomach is the most frequent site of intestinal lymphomas, few data are available on both clinical endoscopic presentation of gastric lymphoma and possible differences between low‐grade and high‐grade lymphomas.MethodsClinical, histological and endoscopic records of consecutive patients with primary low‐grade or high‐grade lymphoma diagnosed were retrieved. Symptoms were categorized as ‘alarm’ or ‘not alarm’. The endoscopic findings were classified as ‘normal’ or ‘abnormal’.ResultsOverall, 144 patients with primary gastric lymphoma were detected, including 74 low‐grade and 70 high‐grade lymphoma. Alarm symptoms, particularly persistent vomiting and weight loss, were more frequently present in patients with high‐grade lymphoma than in those with low‐grade lymphoma (54% vs. 28%; P = 0.002). Low‐grade lymphomas presented as ‘normal’ appearing mucosa (20% vs. 0%; P = 0.0004) or petechial haemorrhage in the fundus (9% vs. 0%; P = 0.02) more frequently than high‐grade lymphomas, being also more often confined to the antrum (47% vs. 27%, P = 0.03) and associated with Helicobacter pylori infection (88% vs. 52%, P < 0.0001). On the contrary, high‐grade lymphomas presented more commonly as ulcerative type (70% vs. 52%; P = 0.03), being also more frequently diagnosed in stage >I when compared with low‐grade lymphomas (70% vs. 21%, P < 0.0001).ConclusionsThe overall prevalence of alarm symptoms is quite low and may be absent in more than 70% of patients with low‐grade lymphoma.
Predictive factors of irritable bowel syndrome improvement: 1‐year prospective evaluation in 400 patients
Authors: MEARIN F. , BADÍA X. , BALBOA A. , BENAVENT J. , CABALLERO A. M. , DOMÍNGUEZ‐MUÑOZ E. , GARRIGUES V. , PIQUÉ J. M. , ROSET M. , CUCALA M. , FIGUERAS M. ,   FOR THE RITMO GROUP
Published: February 2006

SummaryBackgroundThe natural history of the irritable bowel syndrome is poorly understood.AimTo assess the clinical course of the irritable bowel syndrome and the factors that might predict it.MethodsAn observational prospective study, involving 400 irritable bowel syndrome patients meeting Rome II criteria. Symptoms were recorded in a diary over four non‐consecutive months (1, 4, 7 and 10). Demographic data, associated disorders, psychological status and health‐related quality of life were obtained.ResultsAt 1‐year follow‐up, half of the patients and half of their physicians considered irritable bowel syndrome to have improved, but improvement was minor. Diary data showed that, according to the type of symptom, improvement was small and quite different: diarrhoea in 19% of patients, abdominal pain frequency in 26%, constipation in 33% and abdominal pain intensity in 60%. Factors related to improvement at one year were: severe symptoms and poor health‐related quality of life at first visit, irritable bowel syndrome‐constipation, good improvement at 3 months, anxiety/depression, stress, symptoms related to meals and absence of comorbidity. By multivariate logistic regression, predictors were: severe basal symptoms and good improvement at 3 months (OR:CI 95%, 1.32:1.09–1.59 and 4.44:2.81–7.05).ConclusionsAt 1‐year follow‐up, half the patients and their physicians considered the irritable bowel syndrome to have had some improvement but, symptom diaries demonstrated that improvement was small and heterogeneous. Severe basal symptoms and improvement at 3 months were related to better prognosis.
The prevalence of risk factors for gastrointestinal complications and use of gastroprotection among persons hospitalized for cardiovascular disease
Authors: TARGOWNIK L. E. , AL‐MAMFUD A. 
Published: February 2006

SummaryBackgroundAspirin is often used in patients with cardiovascular disease, but it can also cause gastrointestinal complications. Proton pump inhibitors reduce the risk of gastrointestinal complications in aspirin users with a history of gastrointestinal complications.AimTo determine the prevalence of gastrointestinal risk factors in aspirin users and the prevalence of proton pump inhibitor utilization in high‐risk patients.MethodsWe reviewed all patients admitted to hospital between April and October 2004 with a diagnosis of cardiovascular disease. We collected data on demographics, medication use, comorbid illnesses, previous gastrointestinal complications, and medication use on admission and discharge.ResultsA total of 324 patients were admitted with cardiovascular disease of whom 94% were discharged on aspirin. Seventy‐eight per cent of patients admitted had at least one gastrointestinal risk factor in addition to having cardiovascular disease, and 15% had three or more additional gastrointestinal risk factors. Patients with additional gastrointestinal risk factors were more likely to be prescribed proton pump inhibitor therapy (27% vs. 10%, P < 0.001). Only 10% of proton pump inhibitor‐naíve high‐risk aspirin users were prescribed a proton pump inhibitor upon discharge.ConclusionsThe majority of high‐risk aspirin users are not receiving proton pump inhibitors for gastroprotection. Further work is required to encourage providers to consider the use of gastroprotective strategies in appropriate patients.
Characterization of two parvalbumin genes and their association with growth traits in Asian seabass (Lates calcarifer)
Authors: Xu Y. X. , Zhu Z. Y. , Lo L. C. , Wang C. M. , Lin G. , Feng F. , Yue G. H. 
Published: February 2006

SummaryParvalbumins are extremely abundant in fish muscle and play an important role in muscle relaxation. In this study, two parvalbumin genes (PVALB1 and PVALB2) were cloned from Asian seabass (Lates calcarifer). The cDNAs for PVALB1 and PVALB2 were 840 and 667 bp respectively. Both genes consisted of five exons and four introns, encoded 109 amino acids, and were of beta lineage. Using real‐time polymerase chain reaction, expression of PVALB1 was detected in all 10 tissues tested, with expression in brain, kidney, muscle and small intestine being 15‐ to 322‐fold higher than in the other tissues. Expression of PVALB2 was detected only in muscle, brain and intestine, and was up to 10‐fold lower than PVALB1 expression. A (CT)17 microsatellite in the 3′‐untranslated region of PVALB1 and three single nucleotide polymorphisms (SNPs) in the third intron of PVALB2 were identified. The microsatellite in PVALB1 was significantly associated with body weight and body length at 90 days post‐hatch (P < 0.01), whereas the SNPs in PVALVB2 were not associated with these traits.
A comparison of the effect of ciclosporin and sirolimus on the pharmokinetics of mycophenolate in renal transplant patients
Authors: Picard Nicolas , Prémaud Aurélie , Rousseau Annick , Le Meur Yannick , Marquet Pierre 
Published: February 2006

AimTo compare the pharmacokinetics of mycophenolic acid when given with either ciclosporin or sirolimus, and investigate in vitro the potential effect of ciclosporin, sirolimus, tacrolimus and everolimus on mycophenolic acid metabolism.MethodsIn renal transplant patients given mycophenolate mofetil in combination with ciclosporin (n = 19) or sirolimus (n = 12), concentration‐time profiles of mycophenolic acid, mycophenolic‐acid‐phenyl‐glucuronide, mycophenolic‐acid‐acyl‐glucuronide and mycophenolic‐acid‐phenyl‐glucoside were determined at one month post‐transplant. The effect of immunosuppressive drugs on mycophenolic acid glucuronidation and glycosylation was investigated in vitro using human liver microsomes.ResultsThe mean mycophenolic acid AUC0−9 h in the sirolimus group was 44.9 mg h−1 L−1 (95% CI: 34.7–55.1), vs. 30.5 mg h−1 L−1 (95% CI: 25.4–35.6) in the ciclosporin group, corresponding to 1.5‐fold dose‐normalized difference (95% CI: 1.1–1.9; P < 0.05). In addition, the metabolite/mycophenolic acid AUC0−9 h ratios were significantly higher in patients cotreated with ciclosporin than with sirolimus, giving values of 1.8‐fold (95% CI: 1.3–2.3; P = 0.0009), 2.6‐fold (95% CI: 2.0–3.3; P < 0.0001) and 4.3‐fold (95% CI: 2.6–6.0; P = 0.0016) for mycophenolic‐acid‐phenyl‐glucuronide, mycophenolic‐acid‐acyl‐glucuronide and mycophenolic‐acid‐phenyl‐glucoside, respectively. In vitro, none of the immunosuppressive drugs tested inhibited mycophenolic acid metabolism.ConclusionPatients taking mycophenolate mofetil and sirolimus experience a higher exposure to mycophenolic acid and a lower exposure to mycophenolic acid metabolites than those being treated with mycophenolate mofetil and ciclosporin. This interaction is probably not caused by inhibition of mycophenolic acid glucuronidation or glycosylation, but is more likely to be due to the influence of ciclosporin on the excretion of mycophenolic acid metabolites into bile.
Genetic variants in the enhancer region of the thymidylate synthase gene in the Chilean population
Authors: Acuña M. , Eaton L. , Cifuentes L. , Massardo D. 
Published: February 2006

AimsThymidylate synthase (TYMS) is an important target enzyme for the fluoropyrimidines. The TYMS gene enhancer region possesses tandemly repeated (TSER) sequences that are polymorphic in humans and different among ethnic groups. The aims of this study were to estimate the frequencies of the TSER variants in two hospital samples located in the northern (HSJ) and eastern (CLC) parts of Santiago, Chile, and compare them with the frequencies in other populations of different ethnic origin.MethodsGenotyping of TSER variants in 368 Chilean subjects (HSJ = 178 and CLC = 190) by polymerase chain reaction; products of amplification were electrophoresed, obtaining fragments of 250 bp for allele TSER*3 and 220 bp for allele TSER*2.ResultsThe two hospital samples had different degrees of Amerindian admixture (HSJ 34.5%; CLC 15.9%), which was not reflected in the observed frequencies of the CLC TSER*3: 56.8% and HSJ TSER*3: 53.4%.ConclusionsOur results are unexpected, considering that genetic markers in the Chilean population generally show allele frequencies between those observed in European Caucasians and Amerindians and that the percentage of Amerindian admixture in CLC is lower than in HSJ. Both hospitals should have had greater frequencies of TSER*3 than were found and the frequency should have been greater in HSJ than in CLC; the only logical explanation of our results is that the frequency of this allele in aboriginal Chilean people is much lower than the 80% estimated for Mongoloid populations.
The effect of chronic tobacco smoking on arterial stiffness
Authors: Rehill Nirandeep , Beck Charles R. , Yeo Karen Rowland , Yeo Wilfred W. 
Published: February 2006

AimsCardiovascular disease caused by smoking is related to the pathophysiological burden placed on the vascular endothelium. We studied the effect of chronic cigarette smoking on arterial wave reflection (study 1) and smoking cessation on pulse wave analysis (study 2).MethodsFifty smokers and 50 age‐ and sex‐matched nonsmokers participated in study 1. Study 2 recruited 20 volunteers from the stop smoking clinic at the Royal Hallamshire Hospital, Sheffield, UK. Systemic augmentation index (AIx) and carotid‐femoral pulse wave velocity (PWV) were measured using the SphygmoCor system. Brachial blood pressure (BP) (Omron 705‐CP‐E), AIx and PWV were recorded at a single visit in study 1. Study 2 measured these variables on ‘quit day’ and 4 weeks later.ResultsIn study 1, AIx was significantly higher in smokers than in nonsmokers (median 17.25 vs. 11.75%, P = 0.004). Multiple regression analysis showed a significant correlation between AIx and age, diastolic BP, smoking status (P < 0.001), blood glucose (P = 0.045) and weight (P = 0.049). In study 2, AIx significantly reduced after 4 weeks of abstinence in successful quitters (n = 10) compared with relapsed smokers (n = 4) (median 5.0 vs.− 9.5; P = 0.013). PWV did not reach significance in either study.ConclusionsChronic tobacco smoking is associated with endothelial dysfunction and increased AIx in subjects of a wide age range free from additional cardiovascular risk factors, which is partially reversible after 4 weeks of smoking cessation.