bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review : Obstetric outcome in antiphospholipid syndrome
Authors: Granger KA , Farquharson RG 
Published: November 2007

The presence of lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) are associated with recurring pregnancy loss. Of 387 consecutive patients investigated at a Recurring Miscarriage Clinic over a three year period, 63 (16%) were positive for LA and ACA or both. Fifty-nine patients by definition were classified as having antiphospholipid syndrome and four also had systemic lupus erythematosus (SLE). Fifty-three subsequent pregnancies occurred in 63 patients and of these 37 ended in a live birth giving an overall livebirth rate of 70% Treatment included low dose aspirin alone in 37 pregnancies and low dose aspirin and low molecular weight heparin (L11WH) in 16 pregnancies. The decision for treatment was made empirically on past obstetric history and level of LA and ACA, and past history of venous thromboembolic disease. Obstetric outcome was worst in the group who were positive for both LA and ACA, with a success rate of 53%, compared to 72 or 81% in the single parameter groups. Complications in the 37 successful pregnancies included eight Caesarean sections, four cases of intra-uterine growth restriction, one case of pregnancy induced proteinuric hypertension, one deep vein thrombosis and one pulmonary embolism. Patients with antiphospholipid syndrome are at high risk of pregnancy loss as well as maternal morbidity, especially thrombo-embolic disease. A randomised prospective controlled trial is necessary to determine the optimum therapy for pregnancy conservation and thrombprophylaxis.
Cerebral microemboli in patients with antiphospholipid syndrome
Authors: Specker Ch , Rademacher J. , Söhngen D. , Sitzer M. , Janda I. , Siebler M. , Steinmetz H. , Schneider M. 
Published: November 2007

CNS involvement is one of the hallmarks underlying poor prognosis in SLE and for therapeutic strategies it is difficult to assess which patients are at risk. As detectability of cerebral microembolic signals (MES) using long-term transcranial Doppler ultrasonography (TCD) proved to be predictive of past and future thromboembolic events in patients with carotid artery stenosis, we investigated whether MES might be similarly useful in patients with antiphospholipid syndrome (APS). Our study population consisted of 46 SLE patients and five with primary APS (pAPS). Twelve of the 46 patients with SLE, 10 of them with secondary APS (sAPS), and four of five patients with pAPS had a history of cerebrovascular ischaemia (CVI). MES in the middle cerebral artery were detected in 14 of 16 patients with and in one of 35 without CVI ( P < 0.001). Antiphospholipid antibodies (aPL) were positive in 12 of 15 patients with and 18 of 36 without MES, and the rate of MES correlated to the titre of aPL. MES from APS patients resembled in their energy distribution those from patients with symptomatic carotid disease and were significantly different from those associated with artificial heart valves. In conclusion, cerebral MES are detectable in APS patients and correlate with a history of CVI. Whether this innovative method may provide individual risk assessment in APS patients has to be addressed in prospective studies.
Atherosclerosis in LDL-receptor knockout mice is accelerated by immunization with anticardiolipin antibodies
Authors: George J. , Afek A. , Gilburd B. , Levy Y. , Blank M. , Kopolovic J. , Harats D. , Shoenfeld Y. 
Published: November 2007

Atherosclerosis is a process initiated by accumulation of macrophages in distinct areas of endothelial cell damage and uptake of large amounts of lipids. Recently, it has been shown that the immune system plays an active part in the progression of the atherosclerotic plaque although its precise role has not yet been elucidated. Anticardiolipin antibodies (aCL) are generally found in the sera of patients with the antiphospholipid syndrome (APS) and are associated with a prothrombotic state. Several authors have demonstrated that aCL can activate platelets and endothelial cells as well as increase oxidized low density lipoprotein (LDL) uptake by macrophages. In the present study we sought to assess the effect of immunization with aCL (Ab1, leading to the production of mouse aCL-Ab3) on the progression of atherosclerosis. Two groups of 8-weeks old female LDL-receptor knockout mice (n = 13 per group) were immunized with IgG purified from the serum of an APS patient or with normal human IgG, respectively. The aCL immunized mice developed high titres of 'self' aCL (detected using the standard aCL ELISA) as compared with the normal human IgG immunized mice, whereas no differences were noted between both study groups with respect to the serum lipid levels. The extent of fatty streak formation was significantly higher in the aCL immunized mice in comparison with the human IgG injected mice (mean aortic lesion size of 5308 ± 471 μm2 vs 1027 ± 184 μm2, respectively, P < 0.01). The immunohistochemical analysis of the atherosclerotic plaques from both mouse groups did not display differences in cellular composition. The results of the study show that mouse aCL induced by immunization with human aCL from an APS patient enhance atherogenesis in LDL-RKO mice and imply that these antibodies may play a role in atherosclerosis development in patients with the APS.
Ethical Reasoning Concerning the Feeding of Severely Demented Patients: an International Perspective
Authors: Norberg A. , Hirschfeld M. , Davidson B. , Davis A. , Lauri S. , Lin J.Y. , Phillips L. , Pittman E. , Vander Laan R. , Ziv L. 
Published: November 2007

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit.
Ethics and Research in Nursing
Authors: Rogero-Anaya P. , Carpintero-Avellaneda J.L. , Vila-Blasco B. 
Published: November 2007

Considering the importance of research in the development of nursing, we examine the ethical principles governing nurses' investigative activity, as well as the different codes regulating biomedical investigation with human beings, amongst which are the Nuremberg Code, the Declaration of Human Rights, and the Declaration of Helsinki. From the perspective of the central points of the article reference is made to different codes proposed by international nursing associations, as well as reviewing the Deontological Code of Spanish Nursing. The ethical principles a nurse has to bear in mind in research are analysed, with respect to patients, society and the profession. Finally, we refer to certain ethical aspects to be considered in the elaboration and development of a research project, as well as publication of the results.
Provider Choice: Essential To Autonomy or Advertising Gimmick?
Authors: Olsen Douglas P. 
Published: November 2007

Free choice of provider is heralded as a right of autonomy, but the goals of autonomy are better served in today's health care environment when there is informed choice of the care delivery system. The principle of liberty is distinguished from respect for auton omy. Free choice of provider would be demanded only by liberty, except that allocation of health care resources does not meet criteria for the application of liberty. Patients attempting to choose the best practitioner do not have data to support the decision. If data were available, access to these superior practitioners would become an allocation problem. A mythology of the wise practitioner fosters the concept of provider choice as a personal judgement about clinical knowledge. The emerging trends of collaborative care, standardization of practice guidelines and diversity of delivery systems among reimbursers create a situation where a patient's autonomy to choose goals for treatment is respected through the choice of delivery sys tem.
Exploring Ethical Dilemmas in Perioperative Nursing Practice Through Critical Incidents
Authors: von Post Iréne 
Published: November 2007

This article describes the nature of ethical dilemmas in perioperative nursing practice. Using the Critical Incident Technique, common ethical dilemmas experienced by periop erative nurses are explored. The aim of the study was to elicit the ethical dilemmas that arise in perioperative nurses' practice. The study has a descriptive design and the data are critical incidents described by 48 anaesthetic nurses and 76 operating theatre nurses. An analysis of the critical incidents gave four domains of ethical dilemmas: those arising as value conflicts in the intraoperative phase of surgery; those emanating from the patient's right of self- determination ; those arising in caring for patients; and those resulting from the alloca tion of scarce resources and the demands of increased effectiveness.
Significance and impact of bisphosphonate-induced acute phase responses
Authors: Olson Karin , Van Poznak Catherine 
Published: November 2007

Background: Bisphosphonates are synthetic analogs of inorganic pyrophosphates with high avidity for bone, where they bind to hydroxyapatite crystals. Bisphosphonates are effective in decreasing bone resorption, the incidence of skeletal-related events, and pain from bone metastases. These agents have recently become incorporated into the treatment regimen of patients with osteolytic and osteoblastic metastatic bone disease. Although relatively well tolerated, the initial dose(s) of intravenous aminobisphosphonates can be associated with an acute phase response, a nonspecific physiologic reaction associated with increased levels of inflammatory cytokines, fever, and flu like symptoms including fatigue, nausea, and myalgia. Objective: The purpose of this article is to provide an updated review of the literature in this field. Data Sources: A search of PubMed was performed using the key terms bisphosphonate, acute phase response, and cancer, and limited to publications in English. The published literature on acute phase response with bisphosphonate therapy was reviewed. Results and Conclusions: Approximately 40% of patients receiving aminobisphosphonates experience an acute phase response, which generally occurs only on first exposure to the drug and typically last <72 h. Not all bisphosphonates induce acute phase responses to the same extent. This article reviews acute phase response in patients with metastatic bone disease treated with aminobisphosphonates. J Oncol Pharm Practice (2007) 13: 223—229.
Age-related subproteomic analysis of mouse liver and kidney peroxisomes
Authors: Mi Jia , Garcia-Arcos Itsaso , Alvarez Ruben , Cristobal Susana 
Published: November 2007

Abstract

Background
Despite major recent advances in the understanding of peroxisomal functions and how peroxisomes arise, only scant information is available regarding this organelle in cellular aging. The aim of this study was to characterize the changes in the protein expression profile of aged versus young liver and kidney peroxisome-enriched fractions from mouse and to suggest possible mechanisms underlying peroxisomal aging. Peroxisome-enriched fractions from 10 weeks, 18 months and 24 months C57bl/6J mice were analyzed by quantitative proteomics.

Results
Peroxisomal proteins were enriched by differential and density gradient centrifugation and proteins were separated by two-dimensional electrophoresis (2-DE), quantified and identified by mass spectrometry (MS). In total, sixty-five proteins were identified in both tissues. Among them, 14 proteins were differentially expressed in liver and 21 proteins in kidney. The eight proteins differentially expressed in both tissues were involved in β-oxidation, α-oxidation, isoprenoid biosynthesis, amino acid metabolism, and stress response. Quantitative proteomics, clustering methods, and prediction of transcription factors, all indicated that there is a decline in protein expression at 18 months and a recovery at 24 months.

Conclusion
These results indicate that some peroxisomal proteins show a tissue-specific functional response to aging. This response is probably dependent on their differential regeneration capacity. The differentially expressed proteins could lead several cellular effects: such as alteration of fatty acid metabolism that could alert membrane protein functions, increase of the oxidative stress and contribute to decline in bile salt synthesis. The ability to detect age-related variations in the peroxisomal proteome can help in the search for reliable and valid aging biomarkers.
An uncommon presentation and course of metastatic malignant melanoma: a case report
Authors: Dalhaug Astrid , Pawinski Adam , Norum Jan , Nieder Carsten 
Published: November 2007

Abstract
Most patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches. Here we discuss an unusual case where a 45-year old patient presented with a brain metastasis as the first symptom of disease and where the presumed primary lesion later was found in the gastro-intestinal tract. Treatment consisted of sequential surgical removal of a total of 4 tumor sites (2 extracranially), whole-brain radiotherapy and two radiosurgery procedures within 13 months. Following her last treatment, the patient has now been in remission for 20 months. This case illustrates that some patients with multi-organ melanoma manifestations may benefit from the repeated use of effective local therapeutic approaches and may experience a quite favourable prognosis.
Transport Policy in Britain and the Soviet Union: A Political Paradox
Authors: Crouch Martin 
Published: November 2007

Popular images of political systems can often be appropriately reinforced by specific case studies. But not always. This is an attempt to illustrate the fact that such imagescan be inappropriate, with a comparative case study of British and Soviet transport policy. The ‘totalitarian’ image of the Soviet political system, with all that this implies in terms of autocracy, central direction of state power and a controlling ideology, is well enough established. Equally clear is the converse image of modem British government as democratic, open, pluralist, often to the extent of being unnecessarily buffeted by pressure groups and dominated, in consequence, by decision making of an ad hoc and incremental kind.
The concern of this study is to show that, in at least the field of road passenger transport policy, these images are far from accurate. Indeed, paradoxically, it may be that they are applied precisely the wrong way round; that Soviet policy making towards road passenger transport is characterised by irnmobilism and ad hocery, while, as the 1980 Transport Act shows, in Britain the executive can be relatively singleminded enough to disregard powerful state and other established interests in the legislativeprocess. Let us take the Soviet case first.
Strategic Planning: Metaphor or Method?
Authors: Solesbury William 
Published: November 2007

The term ‘strategy’ is now inescapably fixed in the vocabulary of politics. No manifesto, statement of public policy or policy analysis is complete without it. Political parties develop vote-winning strategies, governments commit themselves to industrial strategies, environmental strategies or health strategies, analysts urge the adoption of more strategic approaches to the resolution of political issues.
Nor is this just rhetoric. In the last decade or so public authorities of many kinds have engaged in strategic policy making or planning. The practice has become regarded as a proper part of management responsibility. Planning units have been established in many organisations, systematic procedures for strategic monitoring and review have been widely produced. The practice of strategic planning has become sufficiently widespread and sufficiently significant in the public sector to enable and merit some examination.
The concept of strategy, and the distinction between it and tactics, is military in its origin and developed through the 19th century. The most widely accepted military definition is that strategy is the means of bringing forces into contact with the enemy while tactics is the means of defeating him in battle.
Pharmacokinetics of Oral Posaconazole in Allogeneic Hematopoietic Stem Cell Transplant Recipients with Graft‐versus‐Host Disease
Authors: Krishna Gopal , Martinho Monika , Chandrasekar Pranatharthi , Ullmann Andrew J. , Patino Hernando 
Published: November 2007

Study Objective. To analyze the pharmacokinetics of posaconazole administered as prophylaxis for invasive fungal infections in recipients of hematopoietic stem cell transplants (HSCTs) who have graft‐versus‐host disease (GVHD).Design. Pharmacokinetic analysis in a subset of posaconazole‐treated patients from a large, multicenter, phase III, randomized, double‐blind, double‐dummy, parallel‐group trial that compared posaconazole with fluconazole.Setting. Ninety international medical centers.Patients. The subset of patients comprised 246 HSCT recipients for whom pharmacokinetic data were available.Intervention. All patients received posaconazole 200 mg oral suspension 3 times/day for a maximum of 16 weeks.Measurements and Main Results. Blood samples were collected after dosing on day 2; at weeks 2, 4, 8, and 12; and on the last day of oral treatment. After patients had received posaconazole for at least 7 days (i.e., after achieving steady state), both maximum observed posaconazole concentration (Cmax) and average posaconazole concentration (Cav) were determined. Five patients developed invasive fungal infections while receiving treatment. Median Cav and Cmax were 611 and 635 ng/ml, respectively, in these five patients and were 922 and 1360 ng/ml, respectively, in the 241 patients without invasive fungal infection. In patients without invasive fungal infection, posaconazole concentrations were not clinically affected by race, body weight, or age. Median plasma posaconazole concentrations were higher in patients with chronic GVHD than in those with acute GVHD. In 18 patients without invasive fungal infection who experienced diarrhea on the day of sampling, posaconazole concentrations were lower than the concentrations in patients without diarrhea. No relationship was observed between alanine aminotransferase, aspartate aminotransferase, or bilirubin levels and posaconazole concentrations.Conclusion. Posaconazole 200 mg 3 times/day resulted in median plasma drug concentrations sufficiently high to prevent invasive fungal infections in HSCT recipients with GVHD, without compromising patient safety. Plasma posaconazole concentrations are generally unaffected by demographic variables, including race, sex, body weight, and age.
The Naming of British Columbia
Authors: Martin Ged 
Published: November 2007

Selecting a name for the gold rush colony of British Columbia, although apparently trivial, embarrassed the government, threatened to become the focus for a groundswell of opposition to the whole idea of establishing a new colony, and offers a curious sidelight on the role of the Crown.On 24 June 1858 Sir Edward Bulwer Lytton, the Colonial Secretary in Lord Derby's second ministry, wrote to the Queen to inform her that “in consequence of the recent discovery of Gold in the Neighbourhood of Fraser's River, on the Western Coast of British North America, rendering expedient the immediate establishment of Civil Government,” the government had decided “to erect at once a New Colony there.” Parliament had to authorize this, “& it is desirable that the name of the new Colony shall be inserted in the Bill.” Since the measure was to be introduced within a week, the procedure was slapdash. In asking the Queen to select a name, Lytton informed her that explorers had used the name “New Caledonia,” but did point out that the name had been used elsewhere, most notably for “the chief island of the New Hebrides Group in the South Seas where the French have lately signified their intention to form an establishment.” He added that the names New Cornwall and New Hanover had also been applied to parts of the coast by some mapmakers. While the monarch retained a significant role in mid-nineteenth century government, this hardly extended to, acting as a cartographical research institute for the Colonial Office. On 27 June the Queen informed her minister that she had settled on New Caledonia as the most generally accepted name.