bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review: nutritional support in acute pancreatitis
Authors: PETROV M. S. , PYLYPCHUK R. D. , EMELYANOV N. V. 
Published: September 2008

SummaryBackground  There has been controversy concerning the merits of enteral and parenteral nutrition compared with no supplementary nutrition in the management of patients with acute pancreatitis.Aim  To perform a systematic review of the data from randomized controlled trials (RCTs) in acute pancreatitis that compares enteral nutrition with no supplementary nutrition, parenteral nutrition with no supplementary nutrition and enteral nutrition with parenteral nutrition.Methods  A search was undertaken in the MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials.Results  Fifteen RCTs were included. Enteral nutrition, when compared with no supplementary nutrition, was associated with no significant change in infectious complications: ratio of relative risks (RR) 0.56, 95% confidence interval (CI) 0.07–4.32, P = 0.58, but a significant reduction in mortality: ratio of RR 0.22, 95% CI 0.07–0.70, P = 0.01. Parenteral nutrition, when compared with no supplementary nutrition, was associated with no significant change in infectious complications: RR 1.36, 95% CI 0.18–10.40; P = 0.77, but a significant reduction in mortality: RR 0.36, 95% CI 0.13–0.97, P = 0.04. Enteral nutrition, when compared with parenteral nutrition, was associated with a significant reduction in infectious complications: RR 0.41, 95% CI 0.30–0.57, P < 0.001, but no significant change in mortality: RR 0.60, 95% CI 0.32–1.14, P = 0.12.Conclusions  The use of either enteral or parenteral nutrition, in comparison with no supplementary nutrition, is associated with a lower risk of death in acute pancreatitis. Enteral nutrition is associated with a lower risk of infectious complications compared with parenteral nutrition.
Clinical trial: oral feeding with a soft diet compared with clear liquid diet as initial meal in mild acute pancreatitis
Authors: SATHIARAJ E. , MURTHY S. , MANSARD M. J. , RAO G. V. , MAHUKAR S. , REDDY D. N. 
Published: September 2008

SummaryBackground  In mild acute pancreatitis, traditional treatment has been initial fasting and oral refeeding with clear liquids to prevent adverse gastrointestinal events such as pain. The diet is gradually progressed to soft solids and hospital discharge is planned based on patients’ tolerance to a solid diet.Aim  To determine the length of hospitalization and tolerance to oral refeeding when initiated on a soft diet as compared to a clear liquid diet.Methods  One hundred and one patients with mild acute pancreatitis were randomized to receive either a clear liquid diet or soft diet when oral feeding was initiated. Frequency of pain, total and postrefeeding length of hospitalization, and dietary intake were monitored. Hospital discharge was decided by the medical team without input from the study coordinators.Results  A statistically significant decrease in the length of hospitalization (total and postrefeeding) of a median of 2 days was seen in patients receiving a soft diet (P < 0.001). No significant difference in the need for cessation of diet because of pain was observed between the two groups. Patients initiated on a soft diet consumed significantly more calories and fats on study day 1 (P < 0.001).Conclusion  Oral refeeding with a soft diet in patients with mild acute pancreatitis can be considered safe and can result in shorter length of hospitalization.
Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care
Authors: DUGGAN A. E. , ELLIOTT C. A. , MILLER P. , HAWKEY C. J. , LOGAN R. F. A. 
Published: September 2008

SummaryBackground  Early endoscopy, Helicobacter pylori eradication and empirical acid suppression are commonly used dyspepsia management strategies in primary care but have not been directly compared in a single trial.Aim  To compare endoscopy, H. pylori test and refer, H. pylori test and treat and empirical acid suppression for dyspepsia in primary care.Methods  Patients presenting to their general practitioner with dyspepsia were randomized to endoscopy, H. pylori‘test and treat’, H. pylori test and endoscope positives, or empirical therapy with symptoms, patient satisfaction, healthcare costs and cost effectiveness at 12 months being the outcomes.Results  At 2 months, the proportion of patients reporting no or minimal dyspeptic symptoms ranged from 74% for those having early endoscopy to 55% for those on empirical therapy (P = 0.009), but at 1 year, there was little difference among the four strategies. Early endoscopy was associated with fewer subsequent consultations for dyspepsia (P = 0.003). ‘Test and treat’ resulted in fewer endoscopies overall and was most cost‐effective over a range of cost assumptions. Empirical therapy resulted in the lowest initial costs, but the highest rate of subsequent endoscopy. Gastro‐oesophageal cancers were found in four patients randomized to the H. pylori testing strategies.Conclusions  While early endoscopy offered some advantages ‘Test and treat’ was the most cost‐effective strategy. In older patients, early endoscopy may be an appropriate strategy in view of the greater risk of malignant disease.
The effect of mesalazine therapy on quality of life in patients with mildly and moderately active ulcerative colitis
Authors: IRVINE E. J. , YEH C.‐H. , RAMSEY D. , STIRLING A. L. , HIGGINS P. D. R. 
Published: September 2008

SummaryBackground  Ulcerative colitis (UC) has a major impact on the quality of life (QoL) of affected patients. Patient‐reported outcomes have not been thoroughly evaluated in patients with UC receiving oral mesalazine (mesalamine).Aim  To examine the effect of mesalazine on QoL of patients with mildly and moderately active UC and assess the time course of change, baseline disease severity, mesalazine dose and responder status on QoL parameters.Methods  Inflammatory Bowel Disease Questionnaire (IBDQ) data were combined from two double‐blind, randomized, multicentre, active‐controlled trials assessing 2.4 and 4.8 g/day oral delayed‐release mesalazine in 687 patients. Mean score changes from baseline were compared at 3 and 6 weeks and effects of baseline severity, mesalazine dose and response to therapy were examined.Results  Mesalazine significantly improved IBDQ scores at 3 and 6 weeks (mean increase, 29.6 and 39.7 points, respectively; P < 0.0001 for both). Improvement was greater for patients with moderate disease. Greater week 6 changes occurred in clinical responders than nonresponders (50.1 vs. 23.6 points, respectively; P < 0.0001).Conclusions  Delayed‐release oral mesalazine produces significant clinical and statistical improvements in QoL of patients with UC by 3 weeks, with further improvement at 6 weeks.
High frequency jet ventilation through the laryngeal mask airway in a critically obstructed airway
Authors: Williams A. , Patel A. , Ferguson C. 
Published: September 2008

SummaryA 72 year‐old man with an anticipated difficult airway secondary to a large, obstructing supraglottic tumour was scheduled for a panendoscopy. An elective pre‐induction transtracheal catheter was placed to allow oxygenation if airway maintenance proved difficult. Following induction of anaesthesia, tracheal intubation was impossible and ventilation via both a facepiece and a laryngeal mask airway became progressively more difficult. An emergency tracheostomy was attempted whilst oxygenation was maintained with transtracheal jet ventilation, but the position of the transtracheal catheter made tracheostomy impossible. The catheter was removed and high frequency jet ventilation was then used via the laryngeal mask airway to maintain oxygenation. To our knowledge, the use of high frequency jet ventilation through the laryngeal mask airway in a critically obstructed airway has not been described before.
4β‐Hydroxycholesterol as an endogenous marker for CYP3A4/5 activity. Stability and half‐life of elimination after induction with rifampicin
Authors: Diczfalusy Ulf , Kanebratt Kajsa P. , Bredberg Eva , Andersson Tommy B. , Böttiger Ylva , Bertilsson Leif 
Published: September 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • We have suggested that 4β‐hydroxycholesterol may be used as an endogenous marker of CYP3A activity.• Recently, we found unexpectedly that the plasma concentration of 4β‐hydroxycholesterol continued to increase for several weeks after complete induction of CYP3A4/5 by carbamazepine.• In the present study we investigated the time course of elimination of 4β‐hydroxycholesterol from the circulation following CYP3A induction with rifampicin. WHAT THIS STUDY ADDS • 4β‐Hydroxycholesterol is eliminated very slowly from the circulation with an apparent half‐life of 17 days.• The long half‐life results in a low variation in plasma concentration with time, but excludes 4β‐hydroxycholesterol as a marker for rapid changes in CYP3A activity.AIMSThe oxysterol 4β‐hydroxycholesterol has been suggested as a marker for CYP3A4/5 activity. We have previously shown that plasma 4β‐hydroxycholesterol continues to increase for several weeks after maximal induction of CYP3A4/5 by carbamazepine at the dose given. In the present study we aimed to determine the time course of the decrease in plasma 4β‐hydroxycholesterol after termination of induction of CYP3A4/5 by rifampicin. An additional aim was to determine the variation in plasma level of 4β‐hydroxycholesterol with time in 12 untreated healthy volunteers.METHODSTwenty‐four healthy subjects were allocated into three study groups of equal sizes. The volunteers were treated with rifampicin (either 20 mg day–1, 100 mg day–1 or 500 mg day–1) for 2 weeks. Blood samples were taken before, during and after rifampicin treatment. In another group of 12 untreated volunteers blood samples were collected at different time points in order to determine the intraindividual variations in plasma 4β‐hydroxycholesterol concentrations. Plasma levels of 4β‐hydroxycholesterol were determined by isotope‐dilution gas chromatography–mass spectrometry.RESULTSRifampicin treatment increased plasma 4β‐hydroxycholesterol levels. After termination of rifampicin treatment plasma levels of 4β‐hydroxycholesterol decreased slowly with an apparent half‐life of 17 days. The intraindividual variation in plasma levels of 4β‐hydroxycholesterol in untreated subjects was low, with coefficients of variation of between 4.8 and 13.2% over a period of 3 months.CONCLUSIONSAfter termination of induction of CYP3A4/5, plasma 4β‐hydroxycholesterol levels decreased slowly during 8 weeks. The half‐life of elimination (17 days) resembled that of cholesterol rather than other oxysterols. The long half‐life results in stable plasma concentrations with time.
Reduction of dietary fat absorption by the novel gastrointestinal lipase inhibitor cetilistat in healthy volunteers
Authors: Bryson Andrew , De La Motte Stephan , Dunk Christopher 
Published: September 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Obesity is a significant and growing problem for which many patients seek pharmacological intervention.• Orlistat, a lipase inhibitor, is licensed for the treatment of obesity.• In combination with diet, orlistat is an effective product, but is associated with a number of adverse gastrointestinal adverse events. WHAT THIS STUDY ADDS • This study demonstrates that cetilistat is an effective inhibitor of gastrointestinal lipases, substantially increasing the amount of faecal fat excreted at all doses studied.• In addition, cetilistat is well tolerated, and a comparison with orlistat suggests an improved tolerability profile.AIMSTo assess the efficacy, pharmacodynamics, safety and tolerability of a range of doses of cetilistat, a novel inhibitor of gastrointestinal lipases, in healthy volunteers.METHODSThree Phase I, randomized, placebo‐controlled, parallel‐group studies were conducted. Enrolled subjects in the three studies (n = 99) received a controlled calorie diet (total intake 2160 calories daily, 30% from fat). Twenty‐four subjects were randomized to placebo and 66 were randomized to the following cetilistat doses: 50 mg three times daily [t.i.d. (n = 7)], 60 mg t.i.d. (n = 9), 100 mg t.i.d. (n = 7), 120 mg t.i.d. (n = 9), 150 mg t.i.d. (n = 16), 240 mg t.i.d. (n = 9) and 300 mg t.i.d. (n = 9). Nine subjects received the approved orlistat dose (120 mg t.i.d.). Treatment was for 5 days, with a 2‐day run‐in period and 1‐day post‐treatment follow‐up. The primary outcome measure was daily faecal fat excretion. Secondary outcomes included plasma lipid levels, tolerability [gastrointestinal adverse events (AEs)] and safety.RESULTSCetilistat increased faecal fat excretion relative to baseline at all doses. Cetilistat was well tolerated, with gastrointestinal AEs the most common (51%). Steatorrhoea (oily stool) was more frequent in the orlistat group (4.11 events per subject) than in any cetilistat dose group (0.14–1.81 events per subject). Most AEs (98%) were mild or moderate in intensity.CONCLUSIONSCetilistat increased dietary fat excretion in healthy volunteers receiving a controlled calorie diet. Cetilistat was well tolerated at all doses examined and tolerability appeared to be improved relative to orlistat. Faecal fat excretion in the cetilistat groups was at least comparable to the orlistat 120 mg t.i.d. group.
Benthic metabolism in two turbid dryland rivers
Authors: FELLOWS CHRISTINE S. , BUNN STUART E. , SHELDON FRAN , BEARD NERIDA J. 
Published: September 2008

Summary1. Australian dryland rivers have among the most variable discharge of any rivers worldwide and are characterized by extended periods of no flow during which aquatic habitat contracts into isolated waterholes. Despite naturally high turbidity, benthic primary production is known to be the main source of carbon to waterhole food webs. The objective of this study was to quantify rates of benthic metabolism and identify factors influencing these rates in two Australian dryland rivers, the Cooper Creek and the Warrego River.2. Both rivers have similar variable hydrology and high levels of turbidity (photic depths < 0.4 m), but fish abundance in Cooper Creek is 10 times than that of the Warrego River. Therefore, an additional aim of the study was to determine if fish abundances reflected underlying differences in benthic primary production.3. Benthic gross primary production (GPP), benthic respiration, nutrient concentrations and light penetration were measured immediately after flow had ceased (‘post‐flow’) and after at least 2 months of zero flow (‘no‐flow’) in 15 waterholes from each river. A subset of four waterholes from each river was sampled on two additional occasions to determine if patterns were consistent over time.4. Cooper Creek generally had higher rates of GPP and a more autotrophic benthic zone than the Warrego River. As a result, the expected positive relationship between fish abundance and GPP was generally observed at a broad catchment scale.4. Light was the major control in benthic GPP in both rivers, as nutrient concentrations were high on all sampling occasions. However, for similar values of photic depth, GPP was greater in Cooper Creek than in the Warrego River. This suggests that more frequent disturbance of the littoral zone may inhibit biofilm development in waterholes of the Warrego River.5. Although flow variability in dryland rivers is extreme compared with other rivers worldwide, cycles of expansion and contraction of aquatic habitat in these two rivers were associated with a shift in the dominance of regional scale (subcatchments contributing to river flow) versus local scale (waterhole morphology) influences on ecosystem functioning, similar to floodplain rivers in tropical and temperate regions.
Ripening stage influenced the expression of polyphenol oxidase, peroxidase, pectin methylesterase and polygalacturonase in two melon cultivars
Authors: Chisari Marco , Silveira Ana C. , Barbagallo Riccardo N. , Spagna Giovanni , Artés Francisco 
Published: September 2008

SummaryThe changes in degradative enzymatic activities (polyphenol oxidase, peroxidase, pectin methylesterase and polygalacturonase) as well as in the main physical and chemical attributes during ripening of two melon types (C. melo var. cantalupensis‘Galia’ cv. and inodorus‘Piel de sapo’ cv.), harvested at three ripening stages were studied. A general decrease of enzymatic activities during ripening of both melon types was found. A high correlation between cell wall degrading activities and melon softening was established. In particular, an increase of PG/firmness ratio in both melon types (r2 coefficients of 0.99 and 0.83 for ‘Galia’ and ‘Piel de sapo’, respectively) was found. Results obtained confirm the role of PG in ripening‐associated cell wall disassembly, in contrast with previous attempts to demonstrate that ripening‐associated pectin degradation in melon is PG independent. As far as we know, the PPO changes during melons ripening have not previously reported. It was remarkable that in ‘Galia’ cv. PPO activity showed a very high correlation with colour changes and the PME/firmness ratio highly correlated with the ripening stage. However in ‘Piel de sapo’ cv. any of these correlations was found.
Systematic review and meta‐analysis of the efficacy of tuina for cervical spondylosis
Authors: Wang Mei‐Yeh , Tsai Pei‐Shan , Lee Pi‐Hsia , Chang Wen‐Yin , Yang Che‐Ming 
Published: September 2008

Aims and objectives.  This study performed a meta‐analysis of seven parallel‐group comparison studies evaluating the efficacy of tuina in treating cervical spondylosis.Background.  Tuina is a form of Chinese manipulative therapy. It has been used as a modality for the treatment of symptoms associated with such a musculoskeletal condition as cervical spondylosis. However, evidence regarding the efficacy of tuina for cervical spondylosis has yet to be determined.Design.  Systematic review.Methods.  Cochrane library, Pubmed, MEDLINE, EBM review, ProQuest Medical Bundle and SCOPUS databases were searched using the following medical subject headings or key words: tuina, tuinaology, manual medicine, massotherapy, cervical spondylopathy, cervical spondylosis and cervical vertebrae. Chinese research papers were searched through the Chinese electronic periodical services and Wangfane database. The publication date was limited from 1996–2007. Studies were selected if they were written in English or Chinese, used tuina as a stand‐alone modality, used a parallel‐group comparison design and explicated raw data regarding symptoms relief. Two independent reviewers reviewed the selected studies based on the evidence rating system of the US Preventive Services Task Force. Studies with an evidence rating of II‐2 fair or above were included in this review.Results.  The direction of the effect size for the improvement of blood flow velocity of vertebral artery and basilar artery was not consistent across studies. Moreover, the pooled effect size was negligible. No evidence supported that tuina could improve headache and vertigo. A small effect of tuina on the viscosity of blood and plasma was found.Conclusion.  Based on the results of this systematic review, a definitive conclusion regarding the effects of tuina on cervical spondylosis remains to be determined.Relevance to clinical practice.  The efficacy of tuina is not supported by parallel‐group comparison studies.
Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital Territory
Authors: Arbon Paul , Bail Kasia , Eggert Marlene , Gardner Anne , Hogan Sonia , Phillips Christine , Van Dieman Nicole , Waddington Gordon 
Published: September 2008

Aim.  This paper reports a project investigating the potential role of the nurse practitioner in aged care across residential, community and acute care venues in the Australian Capital Territory.Background.  Australia, like many other countries, faces unprecedented challenges in the provision of health care. Escalating health care costs, an ageing population, increasing prevalence of comorbidities and chronic illnesses, inefficient health care delivery, changing models of health care and shifting professional role boundaries are factors that have contributed to the development of advanced practice roles for nursing.Design.  This was a mixed methods study using multiple data sources.Methods.  Student aged care nurse practitioners were examined across the continuum of care in the acute, community and residential aged care settings. The potential role of the nurse practitioner in these areas was evaluated qualitatively and quantitatively to identify a model of care to enhance the delivery of efficient and effective health care.Results.  The project findings have demonstrated that there is potential for significant improvement in client outcomes arising from a transboundary aged care nurse practitioner model. The improved outcomes are associated with a decrease in acute hospital admissions for residential care clients, timely intervention for a range of common conditions and strengthened multidisciplinary approaches to care provision for older people.Conclusions.  Overall the project findings strongly support the potential of a transboundary aged care nurse practitioner role. This role would focus on skilled assessment, timely assessment and intervention, brokering around access to care and clinical leadership and education for nurses.Relevance to clinical practice.  This paper offers further evidence of support for the role of nurse practitioners in complementing existing health services and improving delivery of care.
The constitution of ‘lavender families’: a LGB perspective
Authors: Neville Stephen , Henrickson Mark 
Published: September 2008

Aim. To explore and describe lesbian, gay and bisexual people’s families of origin and families of choice.Background. As a family group lesbian, gay and bisexual people engage with nurses when they interface with any health care service. All health practitioners need to be aware of the existence and constitution of lesbian, gay and bisexual families to provide appropriate health care, including health promotion and education.Design. Survey.Method. From April to July 2004 a national survey of lesbian, gay and bisexual persons was carried out. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues. A total of 2269 participants completed the survey instrument either electronically or via hard copy. The 133‐item instrument included a range of closed‐response questions in a variety of domains of interest. The article reports on results from the family and relationships domain.Results. Findings identified that lesbian, gay and bisexual families present with a variety of both constructed and biological kinship ties and relationships. These relationships vary from supported to estranged in terms of biological family and exclusivity through to non‐exclusivity with regard to partners. Variations also exist in relation to the presence or absence of children and whether these were born before or after ‘coming out’.Conclusions. Lesbian, gay and bisexual families bring with them to health care services a wide array of life experiences. Therefore it is vital that when interacting with this group of people nurses avoid making assumptions about how gay, lesbian and bisexual people construct their identities and relationships. Furthermore, it may be difficult to ascertain a person’s sexual identity when meeting them for the first time.Relevance to clinical practice. Nurses need to ensure that they do not assume families seeking healthcare are heterosexual. Providing lesbian, gay and bisexual families with opportunities to disclose sexual identity without fear of disapproval or prejudice is integral to providing a quality and appropriate health service.