bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review : Antiphospholipid antibodies and retinal vascular disease
Authors: Dunn JP , Noorily SW , Petri M. , Finkelstein D. , Rosenbaum JT , Jabs DA 
Published: November 2007

Background. Antiphospholipid antibody retinopathy is a rare and poorly defined clinical entity in which the proper diagnosis has important ocular and systemic implications. The clinical course of five patients with antiphospholipid antibody retinopathy is described and the role of such antibodies in idiopathic retinal venous occlusive disease is investigated. Methods. Five case reports are presented highlighting the presentation, course, therapy, associations and outcomes of patients with antiphospholipid antibody retinopathy. In addi tion, twenty additional patients presenting with idiopathic retinal venous occlusive disease were tested for the presence of antiphospholipid antibodies. Results. All five patients with antiphospholipid antibody retinopathy had diffuse retinal vascular occlusion. All five patients presented with associated rheumatologic disease, includ ing three with lupus or lupus-like disease. Antibodies to antiphospholipid were not detected in any of the twenty patients with idiopathic retinal venous occlusive disease. Prompt pan- retinal photocoagulation together with varying regimens of corticosteroids, immunosup pressives, or warfarin was partially successful in stabilizing the ocular and systemic disease. Conclusion. The diagnosis of antiphospholipid antibody retinopathy should be suspected in patients with diffuse retinal vaso-occlusion, particularly when characterized by involvement of both arteries and veins, neovascularization at presentation, and symptoms of systemic rheumatologic disease. Antiphospholipid antibodies do not appear to play an important role in idiopathic retinal vein occlusions.
Review : Modulation of experimental systemic lupus erythematosus with linomide
Authors: Zandman-Goddard G. , George J. , Levy Y. , Blank M. , Slavin S. , Shoenfeld Y. 
Published: November 2007

Objective. The objective of this study was to assess the beneficial effects of an early adminis tration of low dose linomide, a new immunomodulator, in an animal model of experimental systemic lupus erythematosus (SLE). Methods. Experimental SLE was induced in naive BALB/c mice, by immunization with anti-DNA mAb (MIV-7). Control Mice immunized with irrelevant human IgM served as controls. The immunized mice were treated with linomide (0.1 mg/ml in the drinking water), four weeks prior to the first immunization, at an early stage of the disease induction (one month after boost injection), or at a later stage (3 months following boost immunization). The treatment duration was 3 months in all schedules. The follow-up studies continued for 8 weeks after discontinuation of the treatment. The presence in the serum of autoantibodies against ssDNA, dsDNA, histones, phospho lipids and an irrelevant autoantigen - pyruvate dehydrogenase, was determined by enzyme- linked immunosorbent assay (ELISA). The clinical parameters assessed included erythrocyte sedimentation rate, peripheral blood cell counts and proteinuria. Results. There was a 50-64% decrease in autoantibody levels in the sera of mice immunized with anti-DNA (MIV-7) mAb at the early stage of experimental SLE in mice which received linomide for a period of 3 months. No effect of linomide was noted in mice which received the drug during the later stages of experimental SLE when the disease was fully developed. Linomide had a preventive effect on the induction of experimental SLE in naive mice, when the treatment was initiated before the induction of the disease. This effect was abolished following cessation of the treatment. Conclusions. Linomide proved to be effective at the early stages of induction of the experi mental SLE. However, the autoantibody levels rose following discontinuation of the therapy.
Autonomic nerve dysfunction in systemic lupus erythematosus: evidence for a mild involvement
Authors: Altomonte L. , Mirone L. , Zoli A. , Magaro M. 
Published: November 2007

Neurologic manifestations are known to occur in patients with systemic lupus erythematosus (SLE) and significantly affect the clinical course of the disease. Nevertheless, the prevalence, pattern and severity of autonomic impairment in such patients have yet to be defined. In the present study a series of 38 female SLE patients was assessed for the presence of autonomic dysfunction. Five noninvasive standardized cardiovascular reflex tests were used. The grading system proposed by Ewing and Clarke was applied to classifying autonomic impairment according to severity. Seventeen out of 38 patients, that is 44.7%, had evidence of autonomic impairment. Most of the patients had a mild degree of dysfunction. No correlation was found for the duration of the disease while an apparent lack of the commonly described chronological sequence of autonomic involvement was observed. We suggest that in SLE patients the prevalence of autonomic impairment, when investigated, does not significantly differ from that of other SLE-associated neurological events. The contribution of a direct immunological damage to components of neural pathways in the pathogenesis of the autonomic involvement can be postulated. Clinical consequences of autonomic impairment in patients with systemic lupus erythematosus need to be elucidated.
Pulmonary hemorrhage in systemic lupus erythematosus
Authors: Barile LA , Jara LJ , Medina-Rodriguez F. , Garcia-Figueroa JL , Miranda-Limón JM 
Published: November 2007

In order to assess the clinical characteristics and survival rate of pulmonary hemorrhage (PH) in systemic lupus erythematosus (SLE), we studied SLE patients who developed this complication. We found 34 patients within a total lupus cohort of 630 patients. A11 the patients had severe respiratory failure. We identified three different treatment regimens: (a) oral prednisone (1 mg/kg); (b) conventional methylprednisolone (3 g total dose) and (c) massive methylprednisolone ( > 4 g). The overall survival rate was 38.2% and it was correlated with the massive regimen and early treatment (within the first 48 h after the onset of the acute event).
Review : A peculiar form of amicrobial pustulosis of the folds associated with systemic lupus erythematosus and other auto-immune diseases
Authors: Lagrange S. , Chosidow O. , Piette JC , Wechsler B. , Godeau P. , Frances C. 
Published: November 2007

Amicrobial pustulosis of the folds is a new entity which was initially described in association with systemic lupus erythematosus (SLE). We report four cases of this rare pustulosis occurring in the course of various auto-immune disorders. Dermatological features were similar in all patients. The primary lesions were small pustules which coalesced and formed erosive areas underlined with pustular lesions. They were localized in the folds. Three of the four patients had also isolated pustules on the scalp. Spongiform pustules were histologically present. A primary bacterial or fungal infection was ruled out by cultures on appropriate media. Serum calcium level was normal. Associated auto-immune diseases were: systemic lupus erythematosus, incomplete systemic lupus erythematosus, 'idiopathic' thrombocy topenic purpura and myasthenia gravis without thymoma (one of each). The relationship between this peculiar form of pustulosis and autoimmunity remains to be elucidated. The pustulosis did not respond to antibiotics but disappeared with systemic or topical corticosteroids.
Review : Anti-endothelial cell antibodies in systemic autoimmune diseases: prevalence and clinical significance
Authors: Navarro M. , Cervera R. , Font J. , Reverter JC , Monteagudo J. , Escolar G. , López-Soto A. , Ordinas A. , Ingelmo M. 
Published: November 2007

Objective: To investigate the prevalence and characteristics of anti-endothelial cell antibodies (AECA) in a large cohort of patients with several well defined systemic autoimmune diseases, in order to determine their relationship with the clinical and laboratory features of these diseases. Methods: Clinical and laboratory features of 216 consecutive Caucasian patients were prospectively studied. One hundred and seven patients had been diagnosed as having a primary systemic vasculitis-specifically, 39 had temporal arteritis (TA), 25 polyarteritis nodosa (PAN), 9 Wegener's granulomatosis (WG), and 34 Behçet's disease (BD)-, 90 patients had systemic lupus erythematosus (SLE), and 19 had a primary Sjögren's syndrome (SS). The AECA were determined by ELISA. Results: One hundred and four (48%) patients with systemic autoimmune diseases were found to have a positive titre of AECA. Specifically, AECA were detected in 41 (38%) patients with a primary systemic vasculitis (13 (33%) with TA, 14 (56%) with PAN, 5 (56%) with WG and 9 (26%) with BD), in 58 (63%) patients with SLE, and in 5 (26%) patients with a primary SS. In patients with a primary systemic vasculitis, those with AECA were found to have an increased prevalence of disease activity ( P < 0.05). In SLE patients, those with AECA were found to have an increased prevalence of vascular lesions ( P < 0.05), lupus nephropathy ( P < 0.05), and antic ardiolipin antibodies (aCL) ( P < 0.001). Conclusions: Patients with systemic autoimmune diseases have a high prevalence of AECA and they are associated with the presence of vascular lesions, nephropathy, and aCL in SLE, as well as with disease activity in several primary systemic vasculitis (TA, PAN, WG and BD).
Autologous marrow stem cell transplantation for severe systemic lupus erythematosus of long duration
Authors: Marmont AM , van Lint MT , Gualandi F. , Bacigalupo A. 
Published: November 2007

A 46 year woman with severe long-lasting SLE received an autologous bone marrow transplantation utilising CD34+ haematopoietic progenitors following a 3 log T-lymphocyte depletion. The immunosuppressive regimen (conditioning) consisted of 15mg/kg Thiotepa followed by 100 mg/kg of cyclophosphamide over 2 d. Granulocytic recovery was aided by G- CSF. The post-transplant course was uneventful, and a good clinical and immunologic remission (ANA negativisation) was achieved. This is the first case of SLE having received an autologous progenitor cell transplant for the autoimmune disease by itself, unaccompanied by a haematologic condition requiring transplantation. The potential, advantages and limits of this procedure, which are currently being explored worldwide, are briefly discussed.
Subclinical multisystemic autoimmunity presenting as a progressive myelopathy
Authors: Linardaki G. , Skopouli FN , Koufos C. , Moutsopoulos HM 
Published: November 2007

Autoimmunity can manifest clinically in many ways; however, despite the various efforts to classify autoimmune disorders into specific disease entities, the borders between these disorders remain, in many cases, unclear. In this report we describe a young woman with subclinical Sjögren's syndrome and biliary cirrhosis, who presents clinically with symptoms exclusively from the central nervous system. This neurological syndrome is consistent with a progressive myelopathy. Although the patient has a serologically and histologically confirmed multisystemic autoimmune disorder, she fulfills none of the classification criteria for the diagnosis of a specific connective tissue disease.
Professional Nurses Should Have Their Own Ethics: the Current Status of Nursing Ethics in the Dutch Curriculum
Authors: Kanne Mariël 
Published: November 2007

Should nurses have their own ethics to match specific problems met in their daily routines? How do nurses act in a society that is changing from a 'monocultural' to an 'intercultural' structure? What are the ethical consequences of these changes for their many tasks? How can the ethical aspects be taught to nurses? This article describes the current status of nursing ethics in the curriculum taught in schools of higher education for nurses in The Netherlands. Aspects of the debate on nursing ethics are outlined and ideas about its future as a subject and discipline in nurse education are offered. Est-ce que le personnel infirmier doit avoir son éthique à soi pour faire face aux problèmes spécifiques dans la routine journalière? Et comment les infirmiers/ères se comportent-ils dans une société qui est en train de changer de la 'monoculture' en 'interculture'? Quels sont les conséquences éthiques de leur tâches? Comment peuvent ces aspets éthiques être enseignés aux infirmiers/ères? Cet article parle de l'état courant de l'éthique infirmier dans l'enseignement dans les écoles de l'education supérieure pour infirmiers/ères en Hollande. En plus, il donne une esquisse de la discussion sur l'éthique infirmier et donne quelques idées pour le futur de l'éthique infirmier comme sujet et discipline en soi dans l'éducation des infirmiers/ères. Sollte das Pflegepersonal seine eigene Ethik haben um den spezifischen Problemen seiner täglichen Routine gewachsen zu sein? Wie soll das Pflegepersonal in einer Gesellschaft handeln, die im Wechsel ist von einer 'Monokultur' zu einer 'Interkultur'? Was sind die ethischen Konsequenzen ihres handeln? Wie können diese ethischen Aspekte dem Pflegepersonal gelehrt werden? Dieser Artikel beschreibt den gegenwärtigen Zustand der Krankenpflege-Ethik im Lehrplan der Schulen für Höhere Ausbildung für Pflegepersonal in Holland. Er gibt auch einen Umriss über die Debatte über Krankenpflege-Ethik und formuliert einige Ideen für die Zukunft der Krankenpflege- Ethik als ein Thema und eine Disziplin in der Ausbildung des Pflegepersonals.
Building Bridges: Teaching Ward-Based Ethics
Authors: Kendrick Kevin 
Published: November 2007

Ethics has traditionally been taught in the 'ivory towers' of academia. Recent develop ments and reforms in nurse education have given ethics a prominent position in most curricula. However, the vast majority of ethics teaching continues to take place in academic departments. This approach fuels the practitioner's views that nursing is a pragmatic activity whilst ethics is a cognitive endeavour; such perspectives entrench ethics firmly in the traditional gap between theory and practice. The focus of this paper presents an argument that the teaching of ethics must be versed in clinical reality if bridges are ever to be built and the theory-practice gap crossed. Suivant la tradition, l'éthique est enseigné dans les tours d'ivoire des universités. Des développements et réformes récents dans l'éducation infirmier donnent à l'éthique une position prominante dans la plupart des programmes d'études. Mais la majorité de l'enseignement éthique continue dans les départements académiques. Cette façon d'enseigner alimente la vue des infirmiers/ères que soigner est une activité pragmatique pendant que l'éthique est un effort intellectuel. Ces attitudes retranchent l'éthique dans le vide traditionel entre la théorie et le pratique. Le thème de cet article présent l'argument que l'enseignement de l'éthique doit être posé dans la réalité clinique, si des ponts peuvent jamais être bâtis et le vide entre théorie et pratique peut être traversve. Ethik wurde traditionsmässig im Elfenbeinturm einer Universität gelehrt. Neuliche Entwicklungen und Reformen in der Ausbildung des Pflegepersonals haben der Ethik eine prominente Position gegeben in ihren Lehrplänen. Die meiste Lehre von Ethik findet jedoch weiterhin in akademischen Abteilungen statt. Dieses Vorgehen treibt die Ansicht des praktizierenden Pflegepersonals, dass Krankenpflege eine pragmatische Aktivitat ist und Ethik eine wissenschaftliche Bemühung. Solche Ansichten verwurzeln die Ethik in der traditionellen Kluft zwischen Theorie und Praxis. Das Zentrum dieses Artikels ist die These, dass die Lehre von Ethik auf klinischer Realität basiert sein muss so dass Brücken gebaut werden können und die Kluft zwischen Theorie und Praxis überschritten werden kann.
Practical Ethical Issues Related To the Care of Elderly People With Dementia
Authors: Watson Roger 
Published: November 2007

The care of elderly people with dementia poses ethical problems in several respects. This paper considers the problems in relation to treatment, withdrawal of treatment (including nutrition and hydration) in terminal care, and consent to involvement in research. It is ultimately the responsibility of the physician to take the decision about whether or not to proceed with treatment, according to the best interests of the patient, but nurses, families and significant others can be involved in making the decision. When withdrawal of treatment or withdrawal of nutrition and hydration in the terminal stages of dementia are being considered it is necessary to take into account the nature of the treatment, whether or not it is extraordinary, and the goals of continued nutrition. In some circumstances it may be possible for them to be withdrawn. Only research which is aimed at evaluating treatment for dementia may involve subjects who are suffering from dementia. Soigner des personnes âgés souffrant de la démence pose plusieurs problèmes éthiques. Cet article considère les problèmes concernant le traitement, cessation de traitement (y inclus nutrition et hydration) dans la phase terminale, et consentement de participation dans les recherches. C'est ultimement la décision du docteur si oui ou non de continuer avec le traitement selon les meilleurs intérêts du malade, mais les infirmiers/ères, les familles et les personnes importantes autour du malade peuvent jouer un rôle dans les décisions. Si la cessation de traitement ou cessation de nutrition et hydration dans la phase terminale de démence est envisagée il est nécessaire de tenir compte de la nature du traitement, s'il est 'extraordinaire' ou non, et le but de nutrition si on continuait. Dans quelques circonstances il est possible de les discontinuer. Seuls les recherches qui ont pour but d'évaluer les traitements pour la démence peuvent utiliser des personnes souffrant de démence. Die Pflege von älteren Personen mit Demenz stellt einige ethische Probleme. Dieser Artikel betrachtet die Probleme in Beziehung auf die Pflege, Zurückziehung von Pflege (auch von Nahrung und Getrank) der Sterbenden und der Entscheidung, in der Forschung beteiligt zu sein. Der Arzt hat die schlussendliche Verantwortung über die Entscheidung ob mit der Pflege weitergefahren werden soll oder nicht nach dem besten Interesse der Patienten. Aber das Krankenpflegepersonal, die Familie und bedeutende Andere können auch an dieser Entscheidung teilnehmen. Wenn es sich um Zurückziehung der Pflege, oder Zurückziehung von Nahrung oder Getrank in der Sterbepflege von Personen mit Demenz handelt, is es nötig, das Wesen der Pflege und die Ziele einer fortfahrenden Nahrung zu kennen. In gewissen Fällen ist es möglich, diese zurück zu ziehen. Es sollen nur Patienten mit Demenz an Forschungen teilnehmen die über die Pflege der Demenz einschätzt.
Achieving a Better Life On the Planet. Are We Our 'Brothers' Keepers'?
Authors: Sofaer Beatrice 
Published: November 2007

All living human beings have the moral right not to be denied reasonable help in life threatening situations. Disasters take on many forms, but their consequences for individuals may be prolonged and stretch into the next generation. We have a moral obligation to create a better life for people by speaking out and trying to prevent man-made disasters and their consequences. To do this the commitment to life and its value must be reinforced. A number of suggestions are made, particularly in relation to the role of nurses. Toutes les personnes ont le droit moral de recevoir l'aide raisonable dans des situations menaceant à la vie. Des désastres se présentent sous multiples formes, mais leur conséquences peuvent être prolongées pour des individus jusqu'à la prochaine génération. Nous avons une obligation morale de créér une meilleure vie pour tous les peuples en parlant en faveur de la prévention de désastres et leur conséquences. Un engagement à la vie et ses valeurs doit donc être renforcé. Quelques suggestions concernant le rôle des infirmiers/eres sont faites ici. Alle lebenden Menschen haben das morlaische Recht, in lebensdrohenden Situationen angemessene Hilfe zu erhalten. Katastrophen sind vielseitig, aber ihre Konsequenzen können sich für einzelne Menschen verlängern bis in die nächste Generation. Wir haben eine moralische Verpflichtung, ein besseres Leben zu erarbeiten für alle Menschen, in dem wir eintreten um künstliche Katastrophen und deren Konsequenzen zu verhüten. Eine Verpflichtung zum Leben und seinen Werten muss deshalb verstärkt werden. Eine Anzahl von Vorschlagen, besonders was die Rolle des Krankenpflegepersonals anbetricht, sind hier gemacht.
Patient Advocacy At the End of Life
Authors: Love Mary Brewer 
Published: November 2007

Caring for the competent, fragile, elderly patient at the end of life is becoming increasingly challenging. This case explores several ethical areas of concern that arise when caring for patients who have written durable powers of attorney for health care decisions and face life or death choices. Areas covered are informed consent with the elderly patient, the family's right to be involved in decision-making, futility of treatment, and the nurse's role as patient advocate during times of difficult decision-making. Recommendations for increased nursing intervention during these times are incorporated. Les soins des personnes âgés, fragiles mais toujours compétentes et dont la vie touche à sa fin, posent des problèmes de plus en plus urgents. Cet article discute de plusieurs aspets qui se manifestent dans les soins des malades ayant écrit des mandats concernants leurs soins et qui doivent maintenant prendre des décisions graves concernant la vie ou la mort. Les aspets dont il s'agit dans cet article sont: le consentement informé des personnes âgés: le droit de la famille de participer à la décision; les traitements inutiles; et le rôle des infirmiers/ères pour plaider leur cause pendant des moments difficles de prises de décisions. Des recommendations pour de plus importantes interventions infirmières sont comprises. Die Pflege der geistig kompetenten aber hinfälligen Personen im hohen Alter stellt immer grössere Anforderungen. Dieser Artikel untersucht verschiedene ethische Aspekte, die bei der Pflege von Patienten, die eine schriftliche Vollmacht über medizinische Behandlung ausgestellt haben für ihre Pflege und jetzt Entscheidungen über Leben oder Tod treffen müssen. Der Artikel umfasst folgende Bereiche: informierten Zustimmung des Patienten, das Mitbestimmungsrecht der Familie, Zwecklosigkeit der Behandlung, und die Rolle des Pflegepersonals als Fürsprecher der Patienten bei schwierigen Entscheidungen. Empfehlungen für eine grössere Beteiligung oder Mitbestimmung des Pflegepersonals in diesen Fällen sind eingeschlossen.