bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Patients With Multiantibiotic‐Resistant Bacteria
Authors: Ronk Linda L. 
Published: August 2006

ABSTRACTAlthough antibiotics can cure most bacterial infections, there is an increasing number of bacteria that are resistant to antibiotics. Methicillin‐resistantStaphylococcus aureus(MRSA) is becoming increasingly prevalent in US health care facilities. The majority of these infections are found in patients who have extensive burns or surgical wounds. As a result, perioperative nurses must be knowledgeable about MRSA and its implications for the OR. There are many theories on how to control the spread of MRSA but not one definitive set of control measures. Perioperative nurses, in cooperation with infection control practitioners, must develop policies that detail how patients with MRSA will be treated.AORN J61 (June 1995) 1023–1034.
Using a Computerized Scheduling System to Predict Procedure Lengths
Authors: Bross Bill , Gamblin Brenda B. , Holtzclaw Sandra Lyn , Johnston Sue Ellen 
Published: August 2006

ABSTRACTTo determine the effectiveness of our computerized OR scheduling system and database, we compared scheduled surgical procedure lengths to actual procedure lengths for a large, multispecialty sample (1,103 procedures in 14 surgical subspecialties). We were able to accurately predict procedure lengths, within 15 minutes, 65% of the time. The estimated procedure lengths were more accurate in some surgical sub‐specialties than others, and four specific factors accounted for a large percentage (ie, 84%) of all delayed start times. AORN J 61 (June 1995) 1054–1061.
Characteristics of the psychoses of late onset in children and adolescents (A comparative study of hallucinating children)
Authors: Garralda M.E. 
Published: August 2006

In a retrospective design, 20 children and adolescents with psychoses of late onset and hallucinations were compared with 20 children with conduct or emotional disorders who also had hallucinations. Marked differences emerged between the two groups.Psychotic subjects showed significantly more delusions, abnormalities in language production, inappropriate affect, bizarre behaviour, hypoactivity, and social withdrawal. Some subjects had symptoms which indicated a specially profound breakdown in personality functioning, but schneiderian and other schizophrenic symptoms were relatively rare. This questions their diagnostic value in the psychoses of late onset of children and adolescents.
Adolescent and parent perceptions of family cohesion and adaptability
Authors: Noller Patricia , Callan Victor J. 
Published: August 2006

This study examined across 281 families of different aged adolescents the similarity of parent‐adolescent perceptions of levels of adaptability and cohesion in families. Compared to parents, adolescents of almost all age groups (13–17 years) were less satisfied with levels of adaptability in families and so the ability of the family to change its roles and rules in relation to stress. Adolescents judged the present state of the family as more inflexible to changes in its structure than did parents. Asked about ideal levels of adaptability, fathers with 14 and 16 year old adolescents of both sexes, and fathers with 17 year old sons were least flexible about changes to the power and role structure of families. Scores on cohesion or the emotional bonding in families indicated that across family types parents judged the family as more cohesive than did adolescents.Adolescents, however, still showed fairly high levels of cohesion, although below their parents. Adolescents desire changes to power and roles in the family system, but still want a relatively cohesive and supportive family environment.
Comparison of mammalian cell lines expressing distinct isoforms of divalent metal transporter 1 in a tetracycline-regulated fashion
Authors: Garrick Michael D. , Kuo Hung-Chieh , Vargas Farida , Singleton Steven , Zhao Lin , Smith Jaime J. , Paradkar Prasad , Roth Jerome A. , Garrick Laura M. 
Published: August 2006

DMT1 (divalent metal transporter; also known as SLC11A2, DCT1 or Nramp2) is responsible for ferrous iron uptake in the duodenum, iron exit from endosomes during the transferrin cycle and some transferrin-independent iron uptake in many cells. Four protein isoforms differ by starting in exon 1A or 2 and ending with alternative peptides encoded by mRNA that contains or lacks an IRE (iron responsive element; ±IRE). We have compared 1A/+IRE and 2/−IRE DMT1 during regulated ectopic expression. HEK-293-F (human embryonic kidney-293-fast growing variant) cells were stably transfected with each construct expressed from a tetracycline-regulated CMV promoter. Reverse transcriptase-PCR analysis showed that construct expression responded to doxycycline. Immunofluorescence staining of cells, using antibodies specific for DMT1 isoforms, confirmed an increase in expression in the plasma membrane and cytosolic vesicles after doxycycline treatment, but with isoform specific distributions. Immunoblotting also revealed stimulation of expression. Nevertheless, both DMT1 isoforms performed similarly in assays for functional properties based on 54Mn2+ and 59Fe2+ uptake. Mn incorporation after doxycycline treatment was ∼10-fold greater than that of untreated cells, while expression in the untreated cells was ∼5-fold greater than in the untransfected cells. Uptake of Mn depended on addition of doxycycline, with half maximal response at ∼1 nM doxycycline. Doxycycline-stimulated Mn and Fe uptake was linear with time for 10 min but not over longer periods. Transport exhibited a pH optimum at ∼5.5 and dependence on incubation temperature and Mn or Fe concentration. The new cell lines should prove useful for research on metal homoeostasis, toxicological studies and efforts to identify distinctive properties of the isoforms.
Identification and characteristics of the structural gene for the Drosophila eye colour mutant sepia, encoding PDA synthase, a member of the Omega class glutathione S-transferases
Authors: Kim Jaekwang , Suh Hyunsuk , Kim Songhee , Kim Kiyoung , Ahn Chiyoung , Yim Jeongbin 
Published: August 2006

The eye colour mutant sepia (se1) is defective in PDA {6-acetyl-2-amino-3,7,8,9-tetrahydro-4H-pyrimido[4,5-b]-[1,4]diazepin-4-one or pyrimidodiazepine} synthase involved in the conversion of 6-PTP (2-amino-4-oxo-6-pyruvoyl-5,6,7,8-tetrahydropteridine; also known as 6-pyruvoyltetrahydropterin) into PDA, a key intermediate in drosopterin biosynthesis. However, the identity of the gene encoding this enzyme, as well as its molecular properties, have not yet been established. Here, we identify and characterize the gene encoding PDA synthase and show that it is the structural gene for sepia. Based on previously reported information [Wiederrecht, Paton and Brown (1984) J. Biol. Chem. 259, 2195–2200; Wiederrecht and Brown (1984) J. Biol. Chem. 259, 14121–14127; Andres (1945) Drosoph. Inf. Serv. 19, 45; Ingham, Pinchin, Howard and Ish-Horowicz (1985) Genetics 111, 463–486; Howard, Ingham and Rushlow (1988) Genes Dev. 2, 1037–1046], we isolated five candidate genes predicted to encode GSTs (glutathione S-transferases) from the presumed sepia locus (region 66D5 on chromosome 3L). All cloned and expressed candidates exhibited relatively high thiol transferase and dehydroascorbate reductase activities and low activity towards 1-chloro-2,4-dinitrobenzene, characteristic of Omega class GSTs, whereas only CG6781 catalysed the synthesis of PDA in vitro. The molecular mass of recombinant CG6781 was estimated to be 28 kDa by SDS/PAGE and 56 kDa by gel filtration, indicating that it is a homodimer under native conditions. Sequencing of the genomic region spanning CG6781 revealed that the se1 allele has a frameshift mutation from ‘AAGAA’ to ‘GTG’ at nt 190–194, and that this generates a premature stop codon. Expression of the CG6781 open reading frame in an se1 background rescued the eye colour defect as well as PDA synthase activity and drosopterins content. The extent of rescue was dependent on the dosage of transgenic CG6781. In conclusion, we have discovered a new catalytic activity for an Omega class GST and that CG6781 is the structural gene for sepia which encodes PDA synthase.
Health as a consumption object: research notes and preliminary investigation
Authors: Gould Nicholas , Gould Elizabeth 
Published: August 2006

AbstractThrough the processes of commodification and marketization, materials and human activities are brought within the domain of market exchange. The results of these accelerating processes are observed in the consumer culture centred on objects of consumption. We contend that, in addition to healthcare, health itself has become yet another object incorporated within consumption space. This contention is consistent with the perspective of consumption as the dominant social paradigm in the structuring of health and healthcare practices. In this paper we present the conceptual backdrop for our contentions, together with details of a heuristic study. Our findings support the view that people regard health as a consumption object. Furthermore, the evidence suggests a patterning of responses by social grade and gender. Given our wider interest in class‐based health inequalities, we use our results to comment on the broader policy debate concerning this phenomenon in relation to consumerism.
Review article: genetic susceptibility and application of genetic testing in clinical management of inflammatory bowel disease
Authors: VERMEIRE S. 
Published: August 2006

SummaryThe volume of research undertaken on the genetic susceptibility of inflammatory bowel disease (IBD) has been tremendous, and over 10 chromosomal regions have been identified by genome‐wide scanning.Fine‐mapping approaches and candidate gene studies have already led to the identification of several susceptibility genes, including CARD15 (NOD2), DLG5, novel organic cation transporter (OCTN) 1 and 2, and CARD4 (NOD1). The CARD15 gene is the most understood at present and explains around 20% of the genetic predisposition to Crohn's disease.Although the clinical implications of genetic testing are limited at present, genetic research has advanced our understanding of the clinical heterogeneity and the complex interactions between genetic and environmental risk factors in IBD.Genes also interfere with the metabolism of drugs and may influence the clinical response and drug‐related toxicity. Ultimately, researchers and clinicians aim to personalize medicine based on a patient's genotype, although azathioprine (thiopurine methyltransferase polymorphisms) is the only drug to date where pharmacogenetics has shown clinical relevance in IBD.In the future, it is anticipated that genetic markers will be implemented in an integrated molecular diagnostic and prognostic approach to managing our patients.
Review article: high‐dose aminosalicylates to induce and maintain remissions in ulcerative colitis
Authors: HANAUER S. B. 
Published: August 2006

SummarySulfasalazine was the first aminosalicylate to be used for induction and maintenance therapy of ulcerative colitis (UC). Initial trials demonstrated a dose response that was compromised by dose‐related intolerance.Recognition that the 5‐aminosalicylic acid moiety (5‐ASA, mesalazine) is the active ingredient of sulfasalazine has allowed the development of sulpha‐free formulations of mesalazine and alternative azo‐bond derivatives (olsalazine, balsalazide) that substantially reduce the dose‐related (and allergic) consequences of the sulfapyridine moiety of sulfasalazine.Dose‐ranging studies of mesalazine formulations for induction of remission have demonstrated increased efficacy of oral mesalazine up to 4–4.8 g/day, particularly in patients with more moderate disease activity. Combination therapy with oral and rectal mesalazine provide additional efficacy for patients with both distal and extensive colitis.The mesalazine formulations have dose‐related benefits without dose‐related side effects. In contrast, the azo‐bond formulations are compromised by secretory diarrhoea at doses providing greater than 2–2.4 g/day of mesalazine. There are less data regarding dose‐related benefits of aminosalicylates to maintain remissions in UC greater than 1.6 g/day of mesalazine, although the absence of dose‐related side effects allows continuation of the same inductive dose through maintenance treatment without dose‐related toxicity.
Review article: colorectal cancer surveillance in ulcerative colitis – what should we be doing?
Authors: OBRADOR A. , GINARD D. , BARRANCO L. 
Published: August 2006

SummaryDifferent societies have published guidelines for colorectal cancer (CRC) surveillance in ulcerative colitis (UC). While it would seem that most gastroenterologists and endoscopists agree with these guidelines, different studies have shown that in clinical practice, the concept of dysplasia is not fully understood, and therefore, the guidelines are not always followed. According to some studies, the reason why gastroenterologists do not follow the recommendations is inadequate education.The main advance in recent years in this subject is in endoscopic diagnosis of dysplasia. The magnification and chromoendoscopy allow targeted biopsies to be taken. Some studies indicate that nontargeted biopsies are not useful in ruling out dysplasia. It is also important to realize that most dysplasia is visible in conventional colonoscopy. In colonoscopy, it is not only significant to detect dysplasia‐associated lesions or masses; the endoscopist should also be trained to detect, in the course of conventional exploration, subtle changes in colour or in mucosal surfaces that imply dysplasia.Adherence to guidelines had been extensively assessed in other disease conditions (asthma, hypertension, etc.). According to our knowledge there are no such data regarding CRC surveillance in UC.Some barriers that may affect physicians include: (i) knowledge (lack of awareness or lack of familiarity); (ii) attitudes (lack of agreement, lack of self‐efficacy, lack of outcome expectancy, or the inertia of previous practice) and (iii) behaviour (external barriers).In conclusion, we need new guidelines for CRC surveillance in UC, which must take into account the advances in risk factors of dysplasia and new technologies to study colon dysplasia.
‘The important thing in science is not so much to obtain new facts as to discover new ways of thinking about them’ Sir William Bragg (1862–1942)
Review article: the effect of aminosalicylates and immunomodulation on cancer risk in inflammatory bowel disease
Authors: STANGE E. F. 
Published: August 2006

SummaryUlcerative colitis and, maybe to a similar extent, Crohn's disease are associated with an increased risk of colorectal carcinoma. As a consequence of this increased risk, surveillance strategies have been proposed to prevent colorectal carcinoma through early detection of dysplasia, which may herald malignant disease. These surveillance strategies are controversial for several reasons discussed in this review.It may be concluded from the relevant studies that regular use of at least 1.2 g of mesalazine per day may effectively prevent about two out of three colon cancers in ulcerative colitis. In contrast, there seems to be no role for either mercaptopurine or folic acid in protection from colon cancer.
Review article: gastrointestinal bleeding with low‐dose aspirin – what's the risk?
Authors: LAINE L. 
Published: August 2006

SummaryThis review examines ulcers and gastrointestinal bleeding with low‐dose aspirin, focusing on randomized placebo‐controlled trials.The single endoscopic trial assessing ulcers showed no significant difference in 12‐week ulcer incidence: 6% of 381 given placebo vs. 7% of 387 given 81 mg enteric‐coated aspirin.The relative risk of major gastrointestinal bleeding with low‐dose aspirin in a meta‐analysis of placebo‐controlled trials of vascular protection was 2.07 (95% CI: 1.61–2.66). The absolute rate increase with aspirin above placebo was 0.12% per year (95% CI: 0.07–0.19%) with a number‐needed‐to‐harm of 833 patients (95% CI: 526–1429). A meta‐analysis of aspirin 50–1500 mg daily reported an odds ratio for any gastrointestinal bleeding of 1.68 (95% CI: 1.51–1.88) with an number‐needed‐to‐harm at 1 year of 247. The relative risk of hospitalization for upper gastrointestinal bleeding with low‐dose aspirin in a large Danish cohort study was 2.6 (95% CI: 2.2–2.9) with an absolute annual incidence of 0.6%.Factors that may increase the risk of gastrointestinal bleeding include prior history of ulcers or gastrointestinal bleeding, corticosteroid use, anticoagulant therapy and addition of a non‐aspirin non‐steroidal anti‐inflammatory drug.When determining whether low‐dose aspirin is appropriate for an individual patient, the cardiovascular benefit must be weighed against the potential for clinical events such as gastrointestinal bleeding.
Review article: modulation of the brain–gut axis as a therapeutic approach in gastrointestinal disease
Authors: MAYER E. A. , TILLISCH K. , BRADESI S. 
Published: August 2006

SummaryBackgroundThe importance of bi‐directional brain‐gut interactions in gastrointestinal illness is increasingly being recognized, most prominently in the area of functional gastrointestinal disorders. Numerous current and emerging therapies aimed at normalizing brain–gut interactions are a focus of interest, particularly for irritable bowel syndrome and functional dyspepsia.MethodsA literature search was completed for preclinical and clinical studies related to central modulation of gastrointestinal functions and published in English between 1980 and 2006.ResultsExisting data, while sparse, support the use of different classes of antidepressant drugs, including tricyclics, and selective and non‐selective serotonin reuptake inhibitors in irritable bowel syndrome. Serotonin receptor agonists and antagonists with peripheral and possibly central effects are effective in treating specific subtypes of irritable bowel syndrome. Based largely on theoretical and preclinical evidence, several novel compounds that selectively target receptors at multiple levels within the brain–gut axis such as neurokinin, somatostatin and corticotropin‐releasing factor receptor antagonists are promising.ConclusionsThis review discusses the rationale for modulation of the brain–gut axis in the treatment of functional gastrointestinal disorders and highlights the most promising current and future therapeutic strategies.
Discontinuation of proton pump inhibitors in patients on long‐term therapy: a double‐blind, placebo‐controlled trial
Authors: BJÖRNSSON E. , ABRAHAMSSON H. , SIMRÉN M. , MATTSSON N. , JENSEN C. , AGERFORZ P. , KILANDER A. 
Published: August 2006

SummaryBackgroundThe proportion of proton pump inhibitor users on long‐term therapy who can discontinue proton pump inhibitor (PPI) medication without developing symptoms is unknown.AimTo determine the proportion of patients on long‐term PPI therapy who are able to discontinue PPIs without developing symptoms.MethodsPatients on long‐term PPIs, without a history of peptic ulcer or esophagitis underwent upper endoscopy. Patients were randomized double‐blindly to taper down or continue a constant dosage of omeprazole for three weeks. Thereafter, all patients discontinued PPIs.ResultsOf the 97 patients enrolled, had used PPIs for 48 months, 78% had GERD. A total of 27% did not use PPIs during the year after discontinuation, 31% of the patients randomized to tapering discontinued PPIs and 22% of those who did not could discontinue therapy (NS). Gastro‐oesophageal reflux disease (GERD) patients were more prone to continue PPIs than non‐GERD patients. Only 16 (21%) of GERD patients were off PPIs vs. 48% of patients without GERD (p < 0.05). Serum gastrin was higher at baseline in GERD patients who resumed PPIs versus non‐resumers (p < 0.05). GERD and serum gastrin were independent predictors of PPI requirement.ConclusionsDiscontinuation of PPI was successful in 27% of long‐term PPI users. GERD patients had more difficulty discontinuing PPIs than non‐GERD patients.
Meta‐analysis: terlipressin therapy for the hepatorenal syndrome
Authors: FABRIZI F. , DIXIT V. , MARTIN P. 
Published: August 2006

SummaryBackgroundThe hepatorenal syndrome is a severe and well‐known complication of end‐stage liver disease, but its management is controversial. Recent reports have shown the efficacy of terlipressin therapy, a vasopressin analogue, in hepatorenal syndrome patients.AimTo evaluate the efficacy and safety of terlipressin in the treatment of hepatorenal syndrome.MethodsWe performed a systematic review of the literature with a meta‐analysis of clinical trials. The primary outcome (as a measure of efficacy) was the rate of responder patients (i.e. patients who had hepatorenal syndrome reversal after terlipressin therapy). The secondary outcomes were the rate of responders who had hepatorenal syndrome recurrence after terlipressin withdrawal, and the drop‐out rate (as a measure of tolerability). We used the random effects model of DerSimonian and Laird with heterogeneity and sensitivity analysis.ResultsWe identified 10 clinical trials (154 unique patients); two (20.0%) were randomized, controlled trials. The pooled rate of patients who reversed hepatorenal syndrome after terlipressin therapy was 0.52 (95% CI, 0.42; 0.61), P = 0.0001; I2 = 24.6%. The pooled frequency of responder patients who showed hepatorenal syndrome recurrence after terlipressin withdrawal was 0.55 (95% CI, 0.40; 0.69), P = 0.00001; I2 = 44.3%. The pooled rate of patients who showed side‐effects to terlipressin therapy was 0.29 (95% CI, 0.17; 0.42), P < 0.0001, I2 = 66.6%. The drop‐out rate was 0%. The pooled OR for mortality rate in hepatorenal syndrome patients who were not responders to terlipressin vs. responder patients was 5.746 (95% CI, 1.5; 21.9). We did not find any predictive factor of response to terlipressin therapy.ConclusionsThis meta‐analysis shows efficacy and safety of terlipressin in the treatment of hepatorenal syndrome. However, a significant number of responder patients relapsed after terlipressin withdrawal. Further studies are in progress to address the link between terlipressin and survival in hepatorenal syndrome patients.
Risk factors for cardiopulmonary events during propofol‐mediated upper endoscopy and colonoscopy
Authors: VARGO J. J. , HOLUB J. L. , FAIGEL D. O. , LIEBERMAN D. A. , EISEN G. M. 
Published: August 2006

SummaryBackgroundPropofol‐mediated sedation for endoscopy is popular because of its rapid onset and recovery profile.AimTo examine procedure‐specific occurrence and risk factors for cardiopulmonary events during propofol‐mediated upper endoscopy (EGD) and colonoscopy.DesignA cohort study using the Clinical Outcomes Research Initiative database was used to determine the frequency of cardiopulmonary events. Clinical Outcomes Research Initiative consisted of 69 practice sites comprising 593 US endoscopists. Multivariate logistic regression analysis used variables, such as age, ASA classification and propofol administration by monitored anaesthesia care or gastroenterologist‐administered propofol to determine the risk of cardiopulmonary events.ResultsThe overall cardiopulmonary event rate for 5928 EGDs and 11 683 colonoscopies was 11.7/1000 cases. For colonoscopy, ascending ASA classification was associated with an increased risk. Monitored anaesthesia care was associated with a decreased adjusted relative risk (0.5, 95% CI: 0.36–0.72). ASA I and II patients receiving monitored anaesthesia care for EGD exhibited a significantly lower relative risk (ARR 0.29, 95% CI: 0.14–0.64). For subjects with ASA class III or greater, there was no difference in the risk between monitored anaesthesia care and gastroenterologist‐administered propofol.ConclusionsThere are procedure‐specific risk factors for cardiopulmonary events during propofol‐mediated EGD and colonoscopy. These should be taken into account during future prospective comparative trials.