bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical views on postpartum care expressed by new mothers
Authors: Rudman Ann , Waldenström Ulla 
Published: November 2007

Abstract
Background
Women's evaluation of hospital postpartum care has consistently been more negative than their assessment of other types of maternity care. The need to further explore what is wrong with postpartum care, in order to stimulate changes and improvements, has been stressed. The principal aim of this study was to describe women's negative experiences of hospital postpartum care, expressed in their own words. Characteristics of the women who spontaneously gave negative comments about postpartum care were compared with those who did not.

Methods
Data were taken from a population-based prospective longitudinal study of 2783 Swedish-speaking women surveyed at three time points: in early pregnancy, at two months, and at one year postpartum. At the end of the two follow-up questionnaires, women were asked to add any comment they wished. Content analysis of their statements was performed.

Results
Altogether 150 women gave negative comments about postpartum care, and this sample was largely representative of the total population-based cohort. The women gave a diverse and detailed description of their experiences, for instance about lack of opportunity to rest and recover, difficulty in getting individualised information and breastfeeding support, and appropriate symptom management. The different statements were summarised in six categories: organisation and environment, staff attitudes and behaviour, breastfeeding support, information, the role of the father and attention to the mother.

Conclusion
The findings of this study underline the need to further discuss and specify the aims of postpartum care. The challenge of providing high-quality follow-up after childbirth is discussed in the light of a development characterised by a continuous reduction in the length of hospital stay, in combination with increasing public demands for information and individualised care.
Multiple treatment comparisons in epilepsy monotherapy trials
Authors: Tudur Smith Catrin , Marson Anthony G , Chadwick David W , Williamson Paula R 
Published: November 2007

Abstract

Background
The choice of antiepileptic drug for an individual should be based upon the highest quality evidence regarding potential benefits and harms of the available treatments. Systematic reviews and meta-analysis of randomised controlled trials should be a major source of evidence supporting this decision making process. We summarise all available individual patient data evidence from randomised controlled trials that compared at least two out of eight antiepileptic drugs given as monotherapy.

Methods
Multiple treatment comparisons from epilepsy monotherapy trials were synthesized in a single stratified Cox regression model adjusted for treatment by epilepsy type interactions and making use of direct and indirect evidence. Primary outcomes were time to treatment failure and time to 12 month remission from seizures. A secondary outcome was time to first seizure.

Results
Individual patient data for 6418 patients from 20 randomised trials comparing eight antiepileptic drugs were synthesized. For partial onset seizures (4628 (72%) patients), lamotrigine, carbamazepine and oxcarbazepine provide the best combination of seizure control and treatment failure. Lamotrigine is clinically superior to all other drugs for treatment failure but estimates suggest a disadvantage compared to carbamazepine for time to 12 month remission [Hazard Ratio (95% Confidence Interval) = 0.87(0.73 to 1.04)] and time to first seizure [1.29(1.13 to 1.48)]. Phenobarbitone may delay time to first seizure [0.77(0.61 to 0.96)] but at the expense of increased treatment failure [1.60(1.22 to 2.10)]. For generalized onset tonic clonic seizures (1790 (28%) patients) estimates suggest valproate or phenytoin may provide the best combination of seizure control and treatment failure but some uncertainty remains about the relative effectiveness of other drugs.

Conclusion
For patients with partial onset seizures, results favour carbamazepine, oxcarbazepine and lamotrigine. For generalized onset tonic clonic seizures, results favour valproate and phenytoin.
Mycophenolate sodium treatment in patients with primary Sjögren syndrome: a pilot trial
Authors: Willeke Peter , Schlüter Bernhard , Becker Heidemarie , Schotte Heiko , Domschke Wolfram , Gaubitz Markus 
Published: November 2007

AbstractThe aim of this study was to evaluate the efficacy and safety of mycophenolate sodium (MPS) in patients with primary Sjögren syndrome (pSS) refractory to other immunosuppressive agents. Eleven patients with pSS were treated with MPS up to 1,440 mg daily for an observation period of 6 months in this single-center, open-label pilot trial. At baseline, after 3 months, and after 6 months, we examined the clinical status, including glandular function tests, as well as different laboratory parameters associated with pSS. In addition, subjective parameters were determined on the basis of different questionnaires. Treatment with MPS was well tolerated in 8 of 11 patients. Due to vertigo or gastrointestinal discomfort, two patients did not complete the trial. One patient developed pneumonia 2 weeks after treatment and was withdrawn. In the remaining patients, MPS treatment resulted in subjective improvement of ocular dryness on a visual analogue scale and a reduced demand for artificial tear supplementations. However, no significant alterations of objective parameters for dryness of eyes and mouth were observed, although a substantial improvement of glandular functions occurred in two patients with short disease duration. In addition, treatment with MPS resulted in significant reduction of hypergammaglobulinemia and rheumatoid factors as well as an increase of complement levels and white blood cells. MPS promises to be an additional therapeutic option for patients with pSS, at least in those with shorter disease duration. Further investigations about the efficacy and safety of MPS in pSS have to be performed in larger numbers of patients.
Challenges for modeling and interpreting the complex biology of severe injury and inflammation
Authors: Lowry Stephen F , Calvano Steve E 
Published: November 2007

AbstractHuman injury is associated with inflammatory responses that are modulated by the acute and chronic activity of endogenous factors and exogenous interventions. A characteristic feature of chronic, severe inflammatory states is the diminished signal output variability of many organ systems, including innate immune responsiveness and endogenous neural and endocrine-mediated functions. The attenuation of signal/response variability and integration of feedback capacity may contribute to systemic and tissue-specific deterioration of function. Some well-intentioned therapies directed toward support of systemic and tissue functions may actually promote the loss of system(s) adaptability and contribute to adverse outcomes in severely stressed patients. In vivo and in silico models of stress, injury, and infection have yet to fully define the influences of ongoing stressful stimulae as well as genetic variation and epigenetic factors in the context of an evolving inflammatory state. Experimental and human models incorporating variable, antecedent stress(es) and altered neuroendocrine rhythms might approximate the altered adaptability in immune and organ function responses. Such models may also provide insights into the salient mechanisms of risk and outcome more precisely than do the constrained study conditions of current animal or human models of systemic inflammation.
Significance of Multifocality in Ductal Carcinoma In Situ: Outcomes of Women Treated With Breast-Conserving Therapy
Authors: Rakovitch Eileen , Pignol Jean-Philippe , Hanna Wedad , Narod Steven , Spayne Jacqueline , Nofech-Mozes Sharon , Chartier Carole , Paszat Lawrence 
Published: November 2007

Purpose There is concern that women with multifocal ductal carcinoma in situ (DCIS; confined to one quadrant) who are treated with breast-conserving surgery face a high risk of local recurrence; therefore, many are treated with mastectomy. The objective of this study is to evaluate the significance of multifocality and the outcomes of women with multifocal DCIS treated with breast-conserving therapy. Methods The records of patients treated with breast-conserving surgery for DCIS between 1982 and 2000 were reviewed. Multivariate analyses were performed to evaluate the effects of multifocality and other prognostic factors on the rate of local recurrence. Results Of 615 cases of DCIS reviewed, 310 (41%) received breast-conserving surgery and 305 (40%) received breast-conserving surgery plus radiation (n = 260 with multifocality, n = 314 without multifocality, and n = 31 focality unreported). On multivariate analysis, multifocality (hazard ratio [HR] = 1.80; 95% CI, 1.15 to 2.80; P = .01), radiation treatment (HR = 0.46; 95% CI, 0.29 to 0.74; P = .001), margin width 4 mm or smaller (HR = 1.74; 95% CI, 1.03 to 2.92; P = .04), and high nuclear grade (HR = 1.65; 95% CI, 1.02 to 2.65; P = .04) were associated with risk of local recurrence. The detrimental effect of multifocality was limited to women who did not receive radiotherapy; the local recurrence–free survival rate at 10 years was 59% for women with multifocal disease and 80% for women without multifocality (P = .02). Among women treated with breast-conserving surgery plus radiation, there was no difference in 10-year local recurrence–free survival (80% v 87%; P = .35). There was no association between multifocality and the development of invasive recurrence. Conclusion Multifocality is a significant predictor of local recurrence in women who receive breast-conserving surgery for DCIS without radiotherapy; however, low recurrence rates can be achieved if adjuvant radiation is administered.
Involved-Field Radiation Therapy for Inoperable Non–Small-Cell Lung Cancer
Authors: Rosenzweig Kenneth E. , Sura Sonal , Jackson Andrew , Yorke Ellen 
Published: November 2007

Purpose Dose escalation has been shown to improve local control in non–small-cell lung cancer (NSCLC) treated with definitive radiation therapy, but with increased complications. We implemented the use of involved-field radiotherapy (IFRT) in an effort to reduce toxicity while treating the gross tumor to higher doses. This analysis reports failure rates in uninvolved nodal regions with the use of IFRT. Patients and Methods A total of 524 patients with NSCLC treated with three-dimensional conformal radiotherapy at Memorial Sloan-Kettering Cancer Center between 1991 and 2005 were reviewed. Only lymph node regions initially involved with tumor by either biopsy or radiographic criteria were included in the clinical target volume. Elective nodal failure (ENF) was defined as a recurrence in an initially uninvolved lymph node in the absence of local failure. Results Only 32 patients (6.1%) with ENF were identified. The 2-year actuarial rates of elective nodal control and primary tumor control were 92.4% and 51%, respectively, with a median follow-up of 41 months in survivors. In patients who achieved local disease control, the 2-year elective nodal control rate was 91%. The median time to ENF was 6 months (range, 0 to 56 months). Many patients experienced treatment failure in multiple lymph node regions simultaneously. Conclusion The use of IFRT did not cause a significant amount of failure in lymph node regions not included in the tumor volume. Therefore, IFRT remains an acceptable method of treatment that allows for dose escalation while minimizing toxicity.
Az álműtét és annak orvosi és etikai kérdéseir
Authors: Antal János 
Published: November 2007

Absztrakt
Etikai érvekkel nem tartható álláspont az álműtétnek mint klinikai, vizsgálati, kontrollcsoportnak a kategorikus elutasítása.
A bevezetés előtt álló, új sebészeti eljárás esetében az evidencián alapuló orvoslás alapelveinek alkalmazásával kell eldönteni, hogy az adott invazív technika rendelkezik-e a megfelelő, tudományos bizonyítékokkal, valamint azt is, hogy az új, invazív eljárás objektív megítéléséhez az álműtétes csoport vagy más viszonyítási alap fogadható-e el. Az álműtéti csoporttal végzett klinikai vizsgálatok szakmai szükségszerűsége és orvosszakmai, etikai elfogadhatósága mindig eseti döntést igényel.
Az (álműtéttel) kontrollált sebészeti beavatkozás kockázatának megítélésekor mérlegre kell tennünk azt is, hogy mi a következménye annak, ha nem végzünk a szakmai szabályai szerinti, kontrollált vizsgálatot az invazív beavatkozás hatásosságának és biztonságosságának megállapítására.
Közös nevezőre lehet és kell hozni két alapvetően fontos orvosi feladatot: az egyén gyógyítását, valamint a közösség igényét a bizonyított, hatásos és biztonságos eljárásokra.
Extrém nagy hasfali sérvek előkészítése preoperatív pneumoperitoneum képzésévelr
Authors: Szekeres Pál , Krémer Ildikó , Bukovácz Róbert , Varga János 
Published: November 2007

Absztrakt
A kifejezetten nagy hasfali sérvek gondos preoperatív előkészítésével megelőzhetők olyan posztoperatív szövődmények, mint az abdominal compartment syndroma, légzési elégtelenség, befolyásolhatatlan keringési elégtelenség. Osztályaink évek óta foglalkoznak az extrém nagy hasfali sérvekhez társuló kóros állapotok (eventration disease) vizsgálatával és a rekonstrukció okozta kóros zsigeri következmények-szövődmények megelőzésével. Két eset kapcsán mutatjuk be a progresszív preoperatív pneumoperitoneumképzés indikációját, technikáját és eredményeit.
Pneumonectomiát követően végzett pulmonalis metastasectomiákr
Authors: Vincze Károly , Balogh Gábor , Bátor Győző , Kecskés László , Patak Krisztina , Muskát Judit 
Published: November 2007

Absztrakt
Szerzők 2 hazai mellkassebészeti osztályon malignus betegség miatt végzett pneumonectomiákat követő pulmonalis metastasectomiás gyakorlatukat ismertetik.
Hat beteget operáltak pneumonectomiát követően a residualis tüdőfélen észlelhető egy vagy több áttét miatt. A betegek átlagéletkora 52,5 év volt, köztük 3 férfi és 3 nő szerepelt. Ismertetik az alkalmazott diagnosztikai módszereket (mellkas-rtg, CT, MR, PET-CT, perfúziós tüdőscintigraphia, bronchologiai, terheléses légzésfunkciós és EKG-vizsgálat, szív-UH-, vérgáz- és laborvizsgálat). A műtétre történő kiválogatás érdemi onkológiai és cardiorespiratoricus kritériumainak felhasználásával döntöttek a műtétek elvégezhetőségéről. Ismertetik az alkalmazott műtéttechnikát (atípusos gépi resectio).
A műtétek után az intenzív ápolás tartama 3–7 nap volt (átlag 5 nap). A kórházi ápolás ideje 13–18 nap (átlag 15,2 nap). Egy beteg szorult átmeneti – 5 napig tartó – mesterséges gépi lélegeztetésre. Két elveszített betegük 18, illetve 25 hónappal élte túl a tüdőáttétel eltávolítását. A 4 jelenleg is élő beteg átlag túlélése 33,5 hónap. Onkológiai ellenőrzés, illetve kezelés alatt állnak, állapotuk, életvitelük megfelelőnek mondható.
A ritkán, nagyfokú szelekciót követő metastasectomiák sikerének titka a betegek teherbíró képességének gondos, egyénre szabott megtélése, melyben a betegek “thoracotomiaképes” állapota, stabil cardiopulmonalis funkciói, a residualis tüdőfél épsége meghatározó jelentőségű. A gyors, kíméletes atípusos gépi resectio, valamint az anaesthesiologiai és intenzív terápiás szakemberek összehangolt munkája vezethet sikerre, s adhat reményt a megoperáltak számára elfogadható életminőségű és időtartamú túlélésre.
Use of T-plates for the stabilisation of supracotyloid ilial fractures in 18 cats and five dogs
Authors: Viguier E. , Troger J.-C. 
Published: November 2007

SummaryThe use of the AO (Arbeitgemeinschaft fur Osteosynthe- senfragen) veterinary T-plates (1.5/2 mm and 2.7/3.5 mm) forstabilisation ofsupracotyloid ilial fractures in 18 cats and five dogs was evaluated in a retrospective study. The distal fragment from the coxofemoral joint ranged from 0.5 cm to 1 cm with a mean distance of 0.85 cm. Twenty out of 23 (87%) ilial fractures healed in original alignment. Three out of 23 (13%) animals had two loosened screws of the distal fragment with fracture malunion and minor medial displacement of the acetabular fragment. Screw or plate breakage was not observed and the implants were not removed. The clinical result was ‘excellent’ for 18 animals (78%), ‘good’ for four animals (17%), and ‘poor’ for one animal (5%). The use of T-plates permits good correction ofsupracotyloid fractureswith minimal approach and minimizes post-operative complications.
Radiographic examination and outcome in consecutive feline trauma patients
Authors: Kaser-Hotz B. , Hässig M. , Voss K. , Montavon P. M. , Zulauf D. 
Published: November 2007

SummaryUsing univariate analysis, the correlation between signalment, history, outcome and radiographic diagnosis made on whole-body radiographs was investigated in 100 consecutive feline trauma patients of an urban clinic. The radiographic findings included: 53 thoracic injuries, 39 abdominal injuries, 34 pelvic injuries, 28 soft tissue injuries, 26 spinal injuries, and 19 cases with signs of hypovolemia. Only four radiographs were considered normal. Surgical intervention was carried out in 51 cases. Of the 100 cases, 73 survived, 23 were euthanatized, and four died. A significant positive correlation with euthanasia was found when compared to patient age (p=0.0059), abdominal trauma (P=0.0500), spinal fractures (P=0.0468), and soft tissue injuries (P=0.0175). A significant negative correlation with survival was found when compared to patient age (P=0.0358), abdominal trauma (P=0.0439), intraperitoneal free air (P=0.0041), and soft tissue injury (P=0.0288). The results of this study indicate that whole-body radiographs are useful in detecting injury in the thorax, abdomen, spine, pelvis and soft tissues, and are valuable in the diagnostic work-up of feline trauma patients.
Vertebral canal location of a broken drill bit
Authors: Etchepareborde S. , Mills J. 
Published: November 2007

SummaryA 2 mm drill broke during plate fixation of an ilial fracture. Postoperative radiographs showed the tip of the drill bit to be within the L7 vertebral canal. It was retrieved 10 days later via dorsal laminectomy, immediately restoring weight bearing.
Magnetic Nanoparticle‐Supported Morita–Baylis–Hillman Catalysts
Authors: Luo Sanzhong , Zheng Xiaoxi , Xu Hui , Mi Xueling , Zhang Long , Cheng Jin‐Pei 
Published: November 2007

AbstractA magnetic nanoparticle‐supported quinuclidine was prepared and evaluated as a recoverable Morita–Baylis–Hillman catalyst. The supported catalyst 2 demonstrated comparable activity with that of DABCO and could be simply recycled with the assistance of an external magnet. The thus recycled catalyst could be reused for 7 times without significant loss of activity.
Chiral Bicyclic Guanidine as a Versatile Brønsted Base Catalyst for the Enantioselective Michael Reactions of Dithiomalonates and β‐Keto Thioesters
Authors: Ye Weiping , Jiang Zhiyong , Zhao Yujun , Goh Serena Li Min , Leow Dasheng , Soh Ying‐Teck , Tan Choon‐Hong 
Published: November 2007

AbstractA chiral bicyclic guanidine was developed as a versatile Brønsted base catalyst for the enantioselective Michael reactions of dithiomalonates and β‐keto thioesters using a range of acceptors including maleimides, cyclic enones, furanone and acyclic 1,4‐dicarbonylbutenes.
Clinical epidemiologic study of holoprosencephaly in South America
Authors: Orioli Iêda M. , Castilla Eduardo E. 
Published: November 2007

AbstractECLAMC: Latin American Study of Congenital Malformations examined 4,157,224 births (1967–2000), detecting 370 newborns with suspected holoprosencephaly (HPE): 182 (49.2%) had only craniofacial defects; 99 (26.8%) had defects in other systems; (15.1%) had chromosomal anomalies; 5 (1.4%) had recognized syndromes; and 28 (7.6%) had isolated median cleft lip. The latter group was excluded from subsequent analyses because of epidemiological differences from the other groups. The birth prevalence rate (BPR) of isolated HPE was homogeneous among the 11 sampled countries, increasing from 0.5/10,000 births to 1/10,000 births between 1967 and 2000, suggesting improved ascertainment, mainly after 1996. Microtia, cleft lip/palate, and microstomia were preferentially associated with HPE, but cleft palate only was not. Maternal diabetes was more prevalent in HPE than in controls when adding the isolated and associated groups (OR: 3.5; 95% CI: 0.9–16.2). Maternal flu was more prevalent in isolated HPE (OR: 3.6; 0.9–16.6) and in isolated plus associated HPE (OR: 2.8; 1.0–7.9) than in controls. A second series of better documented HPE cases, 179 in number (2.2/10,000), ascertained from 827,968 births occurring from 2000 to 2003, was used for phenotypic definition of cerebral and facial anomalies. In 83 of 174 HPE cases with specified cerebral defects, 40% were alobar, 43% were semilobar, and 17% were lobar. All cases of cyclopia, ethmocephaly, and cebocephaly were of the alobar or semilobar types. Female excess occurred in the total sample, but not within the subgroups themselves because of their small sample sizes. Neither alobar HPE nor cyclopia was associated with female predilection. Among the 174 HPE cases, 39% had neither oral clefting nor a severe dysmorphic face. Of facial phenotypes, 26% had cyclopia, ethmocephaly, or cebocephaly; 25% had premaxillary agenesis; and 10% had cleft lip and palate or cleft palate only. Cyclopia was not associated with oral clefts; 6 of 8 cases of ethmocephaly had cleft palate; 6 of 20 cases of cebocephaly had oral clefts; 4 of 20 cases had premaxillary agenesis; and 2 of 20 cases had cleft palate. © 2007 Wiley‐Liss, Inc.
The relationship of 5HTT (SLC6A4) methylation and genotype on mRNA expression and liability to major depression and alcohol dependence in subjects from the Iowa Adoption Studies
Authors: Philibert Robert A. , Sandhu Harinder , Hollenbeck Nancy , Gunter Tracy , Adams William , Madan Anup 
Published: November 2007

AbstractSerotonin Transporter (5HTT or SLC6A4) mRNA transcription is regulated by both genetic and epigenetic mechanisms. Unfortunately, despite intense scrutiny, the exact identity and contribution of each of these regulatory mechanisms, and their relationship to behavioral illness remain unknown. This lack of knowledge is critical because alterations in SLC6A4 function are posited to be central to a wide variety of CNS disorders. In order to address this shortcoming, we quantified 5HTTLPR genotype, SLC6A4 mRNA production and CpG methylation using biomaterial from 192 lymphoblast cell lines derived from subjects who participated in the latest wave of the Iowa Adoption Studies. We then analyzed the resulting data with respect to clinical characteristics. We confirmed prior findings that the short (s) 5HTTLPR allele is associated with lower amounts of mRNA transcription, but there was no significant effect of the “Long G” allele on mRNA transcription. We also found that CpG methylation was higher (P < 0.0008) and mRNA production (P < 0.0001) was lower in females as compared to males. Those subjects with a lifetime history of Alcohol Dependence had higher levels of SLC6A4 mRNA. There was a trend for an association of increased overall methylation with lifetime history of major depression. Finally, we confirm our prior findings that the exact levels of 5HTT mRNA expression are dependent on how it is measured. We conclude that both genetic variation and epigenetic modifications contribute to the regulation of SLC6A4 function and that more in‐depth studies of the molecular mechanisms controlling gene activity and the relationship of these mechanisms to behavioral illness are indicated. © 2007 Wiley‐Liss, Inc.