bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of the need for safe storage of Methadone at home is not improved by the use of protocols on recording information giving
Authors: Mullin Annemarie , McAuley Rosanna J , Watts Derrett J , Crome Ilana B , Bloor Roger N 
Published: April 2008

Abstract

Background
Methadone is a synthetic, narcotic analgesic used in the treatment of drug misuse. Tragedies involving children being poisoned by the accidental ingestion of methadone are no longer a rare occurrence. Following an audit of the effectiveness of the provision and recall of information to patients attending an NHS Methadone Clinic a protocol was introduced to ensure that staff documented the provision of such information and patients gave a written confirmation that they had received the information.

Methods
The study was undertaken in the setting of an NHS methadone clinic with the aim of re- auditing the storage of methadone at home following the introduction of the new protocols. 174 patients completed an anonymous questionnaire regarding where they store methadone at home and whether they recall being given advice about safe storage. Community pharmacists were contacted by telephone to assess the level of advice given to methadone patients regarding safety.

Results
Only 49 (28.2%) patients recalled being given advice about safe storage, 24 (13.8%) recalled that information was provided by clinic staff. 170 (97.7%) patients regard methadone as being dangerous. (28.2%). Methadone is most commonly stored in a cupboard (37.9%). All methadone is dispensed in a bottle with a child resistant cap on it. All patients reported they stored their methadone in the original bottle provided by the pharmacist.

Conclusion
Recall of information on safety issues is very poor. Provision of written as well as verbal information is needed. The use of printed safety information cards which patients can take away for future reference may be of use. It is the responsibility of health professionals to ensure they provide information and advice to methadone users on the safe storage of their methadone at home.
Genetic diversity and silencing suppression effects of Rice yellow mottle virus and the P1 protein
Authors: Siré Christelle , Bangratz-Reyser Martine , Fargette Denis , Brugidou Christophe 
Published: April 2008

Abstract

Background
PTGS (post-transcriptional gene silencing) is used to counter pathogenic invasions, particularly viruses. In return, many plant viruses produce proteins which suppress silencing directed against their RNA. The diversity of silencing suppression at the species level in natural hosts is unknown.

Results
We investigated the functional diversity of silencing suppression among isolates of the African RYMV (Rice yellow mottle virus) in rice. The RYMV-P1 protein is responsible for cell-to-cell movement and is a silencing suppressor. Transgenic gus-silencing rice lines were used to investigate intra-specific and serogroup silencing suppression diversity at two different levels: that of the virion and the P1 silencing suppressor protein. Our data provide evidence that silencing suppression is a universal phenomenon for RYMV species. However, we found considerable diversity in their ability to suppress silencing which was not linked to RYMV phylogeny, or pathogenicity. At the level of the silencing suppressor P1 alone, we found similar results to those previously found at the virion level. In addition, we showed that cell-to-cell movement of P1 was crucial for the efficiency of silencing suppression. Mutagenesis of P1 demonstrated a strong link between some amino acids and silencing suppression features with, one on the hand, the conserved amino acids C95 and C64 involved in cell-to-cell movement and the strength of suppression, respectively, and on the other hand, the non conserved F88 was involved in the strength of silencing suppression.

Conclusion
We demonstrated that intra-species diversity of silencing suppression is highly variable and by mutagenesis of P1 we established the first link between silencing suppression and genetic diversity. These results are potentially important for understanding virus-host interactions.
Differential Activation of p38 and Extracellular Signal-Regulated Kinase in Spinal Cord in a Model of Bee Venom-Induced Inflammation and Hyperalgesia
Authors: Cui Xiu-Yu , Dai Yi , Wang Sheng-Lan , Yamanaka Hiroki , Kobayashi Kimiko , Obata Koichi , Chen Jun , Noguchi Koichi 
Published: April 2008

Background: Honeybee's sting on human skin can induce ongoing pain, hyperalgesia and inflammation. Injection of bee venom (BV) into the intraplantar surface of the rat hindpaw induces an early onset of spontaneous pain followed by a lasting thermal and mechanical hypersensitivity in the affected paw. The underlying mechanisms of BV-induced thermal and mechanical hypersensitivity are, however, poorly understood. In the present study, we investigated the role of mitogen-activated protein kinase (MAPK) in the generation of BV-induced pain hypersensitivity. Results: We found that BV injection resulted in a quick activation of p38, predominantly in the L4/L5 spinal dorsal horn ipsilateral to the inflammation from 1 hr to 7 d post-injection. Phosphorylated p38 (p-p38) was expressed in both neurons and microglia, but not in astrocytes. Intrathecal administration of the p38 inhibitor, SB203580, prevented BV-induced thermal hypersensitivity from 1 hr to 3 d, but had no effect on mechanical hypersensitivity. Activated ERK1/2 was observed exclusively in neurons in the L4/L5 dorsal horn from 2 min to 1 d, peaking at 2 min after BV injection. Intrathecal administration of the MEK inhibitor, U0126, prevented both mechanical and thermal hypersensitivity from 1 hr to 2 d. p-ERK1/2 and p-p38 were expressed in neurons in distinct regions of the L4/L5 dorsal horn; p-ERK1/2 was mainly in lamina I, while p-p38 was mainly in lamina II of the dorsal horn. Conclusion: The results indicate that differential activation of p38 and ERK1/2 in the dorsal horn may contribute to the generation and development of BV-induced pain hypersensitivity by different mechanisms.
Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: Population-based study
Authors: Oberlander Tim F. , Warburton William , Misri Shaila , Aghajanian Jaafar , Hertzman Clyde 
Published: April 2008

BackgroundLate-gestational serotonin reuptake inhibitor (SRI) exposure has been linked to adverse neonatal outcomes; however, the impact of timing and duration of exposure is unknown.AimsTo determine whether late-gestational exposure to an SRI is associated with increased risk of adverse neonatal outcome relative to early exposure.MethodPopulation-based maternal and neonatal health records were linked to prenatal maternal prescription records for an SRI medication (n=3500).ResultsAfter controlling for maternal illness and duration of exposure, using propensity score matching, neonatal outcomes did not differ between late and early exposure (PIQ>0.05). After controlling for maternal illness, longer prenatal exposure increased the risks of lower birth weight, respiratory distress and reduced gestational age (P<0.05).ConclusionsUsing population health data, length of gestational SRI exposure, rather than timing, increased the risk for neonatal respiratory distress, lower birth weight and reduced gestational age, even when controlling for maternal illness and medication dose. These findings highlight the importance of distinguishing the specific impact of medication exposure from exposure to maternal illness itself.
Medical disorders in people with recurrent
depression
Authors: Farmer Anne , Korszun Ania , Owen Michael J. , Craddock Nick , Jones Lisa , Jones Ian , Gray Jo , Williamson Richard J. , McGuffin Peter 
Published: April 2008

BackgroundFew studies have examined the rates of physical disorders in those with
recurrent depression.AimsTo examine self-reported physical disorders in people with recurrent
depression compared with a psychiatrically healthy control group.MethodAs part of a genetic case-control association study, 1546 participants
with recurrent depression and 884 controls were interviewed about
lifetime ever treatment for 16 different physical health disorders.ResultsThe cases group had a significantly higher frequency of 14 physical
disorders and more obesity than the control group. After controlling for
age, gender, body mass index (BMI) and multiple testing, those in the
cases group had significantly higher rates of gastric ulcer, rhinitis/hay
fever, osteoarthritis, thyroid disease, hypertension and asthma.ConclusionsPeople with recurrent depression show high rates of many common physical
disorders. Although this can be partly explained by BMI, shared
aetiological pathways such as dysfunction of the hypothalamic–pituitary
axis may have a role.
Invited commentary on … Proposals for massive expansion of
psychological therapies would be counterproductive across
society
Authors: King Michael 
Published: April 2008

SummaryWill an expansion of access to cognitive-behavioural therapy lead to greater
happiness? Summerfield and Veale debate this question by focusing on the
nature of mental distress and the best evidence for ameliorating it.
Stimulating though it is, their debate left me wondering about the wider
philosophical and ethical implications behind our rush to therapy.
Building capacity for leadership and teamwork: developing, delivering and evaluating an experiential group relations conference
Authors: Bryson Sandy , Asher Carolyn J. 
Published: April 2008

Aim and MethodsSpecialist registrars in psychotherapy, at various stages of their training, attended a 1-day experiential group relations conference. The aim was to provide a training context in which trainees could reflect, through direct experience, on their capacity for leadership and teamwork, and the difficulties in taking up one's own authority in role.ResultsParticipants rated (on a 5-point Likert scale) the various structured elements of the conference as being greater than moderately useful for their learning. At 9-month follow-up, median scores were 4, indicating that the conference had a moderate to high impact on the participants' learning in four key dimensions: effective communication, taking up a leadership role, dealing with task-and role-related anxiety, and containing others' psychological projections.Clinical ImplicationsThere is often little time to reflect on one's experiences or behaviour in professional environment. The study demonstrates that learning about one's behaviour, capacity for leadership, performing various roles and the ability to act with authority, in a facilitated experiential learning environment can make a significant contribution to the development of future consultant psychiatrists in psychotherapy. In the light of the new curriculum (Royal College of Psychiatrists, 2006), this training model may facilitate the achievement of core and general competencies for all trainee psychiatrists.
Growth Hormone Deficiency by Growth Hormone Releasing Hormone-Arginine Testing Criteria Predicts Increased Cardiovascular Risk Markers in Normal Young Overweight and Obese Women
Authors: Utz Andrea L. , Yamamoto Ami , Hemphill Linda , Miller Karen K. 
Published: April 2008

AbstractContext: Little is known about the relationship between GH and cardiovascular risk markers in women without organic hypothalamic/pituitary disease.Objective: The objective of the study was to determine whether healthy young overweight and obese women, who would be classified as having GH deficiency (GHD) based on standard criteria used in hypopituitarism (peak GH after stimulation with GHRH and arginine &lt; 5 ng/ml), have increased cardiovascular risk markers.Design: This was a cross-sectional study.Setting: The study was conducted at the General Clinical Research Center.Study Participants: Forty-five women of reproductive age, mean age 33.1 ± 1.2 yr and mean body mass index (BMI) 30.9 ± 1.0 kg/m2.Intervention: There was no intervention.Main Outcome Measures: Measures included carotid intima-medial thickness, high-sensitivity C-reactive protein (hsCRP), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein, triglycerides, E-selectin, soluble intercellular adhesion molecule-1, TNF-α receptor I, TNF-α receptor II, fasting insulin levels, and oral glucose tolerance testing.Results: Twenty-six percent of overweight or obese subjects and none with BMI less than 25 kg/m2 met criteria for GHD. Subjects who met GHD criteria had a mean BMI of 37.0 ± 1.7 kg/m2 (range 28.6–43.6 kg/m2), and their mean waist circumference (110.1 ± 3.5 cm) was higher than in overweight/obese women with GH sufficiency (P = 0.007). Mean carotid intima-media thickness, hsCRP, soluble intercellular adhesion molecule-1, TNF-α receptor I, and TNF-α receptor II levels were higher, and HDL lower, in women meeting GHD criteria than in GH sufficiency. Differences in HDL, hsCRP, and TNF-α receptor II remained after controlling for age plus BMI, waist circumference, or trunk fat. There were no differences in measures of insulin resistance.Conclusions: There may be a relative GHD syndrome in overweight and obese women without organic pituitary or hypothalamic disease that confers increased cardiovascular risk, independent of weight.
Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis?
Authors: Forward D. P. , Davis T. R. C. , Sithole J. S. 
Published: April 2008

Fractures of the distal radius occurring in young adults are treated increasingly by open surgical techniques, partly because of concern that failure to restore the alignment of the fracture accurately may cause symptomatic post-traumatic osteoarthritis in future years. We reviewed 106 adults who had sustained a fracture of the distal radius between 1960 and 1968 and who were below the age of 40 years at the time of injury. We carried out a clinical and radiological assessment at a mean follow-up of 38 years (33 to 42).No patient had required a salvage procedure. While there was radiological evidence of post-traumatic osteoarthritis after an intra-articular fracture in 68% of patients (27 of 40), the disabilities of the arm, shoulder and hand (DASH) scores were not different from population norms, and function, as assessed by the Patient Evaluation Measure, was impaired by less than 10%. Ordinal logistic regression analysis showed a significant relationship between narrowing of the joint space and extra-articular malunion (dorsal angulation and radial shortening) as well as intra-articular injury. Multivariate analysis revealed that grip strength had fallen to 89% of that of the uninjured side in the presence of dorsal malunion, but no measure of extra-articular malunion was significantly related to either the Patient Evaluation Measure or DASH scores.While anatomical reduction is the principal aim of treatment, imperfect reduction of these fractures may not result in symptomatic arthritis in the long term, and this should be considered when counselling patients on the risks and benefits of the many treatment options available.
Multimodal thromboprophylaxis following primary hip arthroplasty
Authors: Daniel J. , Pradhan A. , Pradhan C. , Ziaee H. , Moss M. , Freeman J. , McMinn D. J. W. 
Published: April 2008

We report a retrospective review of the incidence of venous thromboembolism in 463 consecutive patients who underwent primary total hip arthroplasty (487 procedures). Treatment included both total hip replacement and hip resurfacing, and the patients were managed without anticoagulants. The thromboprophylaxis regimen included an antiplatelet agent, generally aspirin, hypotensive epidural anaesthesia, elastic compression stockings and early mobilisation. In 258 of these procedures (244 patients) performed in 2005 (cohort A) mechanical compression devices were not used, whereas in 229 (219 patients) performed during 2006 (cohort B) bilateral intermittent pneumatic calf compression was used. All operations were performed through a posterior mini-incision approach. Patients who required anticoagulation for pre-existing medical problems and those undergoing revision arthroplasty were excluded. Doppler ultrasonographic screening for deep-vein thrombosis was performed in all patients between the fourth and sixth post-operative days. All patients were reviewed at a follow-up clinic six to ten weeks after the operation. In addition, reponse to a questionnaire was obtained at the end of 12 weeks post-operatively. No symptomatic calf or above-knee deep-vein thrombosis or pulmonary embolism occurred. In 25 patients in cohort A (10.2%) and in ten patients in cohort B (4.6%) asymptomatic calf deep-vein thromboses were detected ultrasonographically. This difference was statistically significant (p = 0.03). The regimen followed by cohort B offers the prospect of a low incidence of venous thromboembolism without subjecting patients to the higher risk of bleeding associated with anticoagulant use.
Identifying the cellular basis for reimplantation failure in repair of the rotator cuff
Authors: Simon D. W. N. , Clarkin C. E. , Das-Gupta V. , Rawlinson S. C. F. , Emery R. J. , Pitsillides A. A. 
Published: April 2008

We examined cultured osteoblasts derived from paired samples from the greater tuberosity and acromion from eight patients with large chronic tears of the rotator cuff. We found that osteoblasts from the tuberosity had no apparent response to mechanical stimulation, whereas those derived from the acromion showed an increase in alkaline phosphatase activity and nitric oxide release which is normally a response of bone cells to mechanical strain. By contrast, we found that cells from both regions were able to respond to dexamethasone, a well-established promoter of osteoblastic differentiation, with the expected increase in alkaline phosphatase activity. Our findings indicate that the failure of repair of the rotator cuff may be due, at least in part, to a compromised capacity for mechanoadaptation within the greater tuberosity. It remains to be seen whether this apparent decrease in the sensitivity of bone cells to mechanical stimulation is the specific consequence of the reduced load-bearing history of the greater tuberosity in these patients.
The treatment of benign lesions of the proximal femur with non-vascularised autologous fibular strut grafts
Authors: George B. , Abudu A. , Grimer R. J. , Carter S. R. , Tillman R. M. 
Published: April 2008

We report our experience of treating 17 patients with benign lesions of the proximal femur with non-vascularised, autologous fibular strut grafts, without osteosynthesis. The mean age of the patients at presentation was 16.5 years (5 to 33) and they were followed up for a mean of 2.9 years (0.4 to 19.5). Histological diagnoses included simple bone cyst, fibrous dysplasia, aneurysmal bone cysts and giant cell tumour. Local recurrence occurred in two patients (11.7%) and superficial wound infection, chronic hip pain and deep venous thrombosis occurred in three. Pathological fracture did not occur in any patient following the procedure. We conclude that non-vascularised fibular strut grafts are a safe and satisfactory method of treating benign lesions of the proximal femur.
The creep and wear of highly cross-linked polyethylene
Authors: Glyn-Jones S. , McLardy-Smith P. , Gill H. S. , Murray D. W. 
Published: April 2008

The creep and wear behaviour of highly cross-linked polyethylene and standard polyethylene liners were examined in a prospective, double-blind randomised, controlled trial using radiostereometric analysis.We randomised 54 patients to receive hip replacements with either highly cross-linked polyethylene or standard liners and determined the three-dimensional penetration of the liners over three years.After three years the mean total penetration was 0.35 mm (SD 0.14) for the highly cross-linked polyethylene group and 0.45 mm (SD 0.19) for the standard group. The difference was statistically significant (p = 0.0184). From the pattern of penetration it was possible to discriminate creep from wear. Most (95%) of the creep occurred within six months of implantation and nearly all within the first year. There was no difference in the mean degree of creep between the two types of polyethylene (highly cross-linked polyethylene 0.26 mm, SD 0.17; standard 0.27 mm, SD 0.2; p = 0.83). There was, however, a significant difference (p = 0.012) in the mean wear rate (highly cross-linked polyethylene 0.03 mm/yr, SD 0.06; standard 0.07 mm/yr, SD 0.05). Creep and wear occurred in significantly different directions (p = 0.01); creep was predominantly proximal whereas wear was anterior, proximal and medial.We conclude that penetration in the first six months is creep-dominated, but after one year virtually all penetration is due to wear. Highly cross-linked polyethylene has a 60% lower rate of wear than standard polyethylene and therefore will probably perform better in the long term.
Is return to professional rugby union likely after anterior cervical spinal surgery?
Authors: Andrews J. , Jones A. , Davies P. R. , Howes J. , Ahuja S. 
Published: April 2008

We have examined the outcome in 19 professional rugby union players who underwent anterior cervical discectomy and fusion between 1998 and 2003. Through a retrospective review of the medical records and telephone interviews of all 19 players, we have attempted to determine the likelihood of improvement, return to professional sport and the long-term consequences. We have also attempted to relate the probability of symptoms in the neck and radicular pain in the arm to the position of play. Neck and radicular pain were improved in 17 patients, with 13 returning to rugby, the majority by six months after operation. Of these, 13 returned to their pre-operative standard of play, one to a lower level and five have not played rugby again. Two of those who returned to the game have subsequently suffered further symptoms in the neck, one of whom was obliged to retire. The majority of the players with problems in the neck were front row forwards. A return to playing rugby union after surgery and fusion of the anterior cervical spine is both likely and safe and need not end a career in the game.