bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infrequent use of antidepressants in depressed individuals (an interview and prescription database study in a defined Swedish population 2001–2002)
Authors: Henriksson S. , Asplund R. , Boëthius G. , Hällström T. , Isacsson G. 
Published: June 2006

AbstractPurpose:To investigate whether antidepressants are over-used, under-used, or misused, by determining to what extent the depressed individuals in a defined population are treated with antidepressant medication and, from the other end, to what extent prescribed antidepressants are aimed for the treatment of depression.Subjects and method:From an individual based prescription database in the County of Jämtland, 2048 individuals representative for the general population were selected. The presence of current depression in these individuals was screened by a mailed self-screening questionnaire. Individuals with depression according to the questionnaire were interviewed by a psychiatrist using a structured interview (SCAN) to confirm the diagnosis. Their use of antidepressants was obtained from the prescription database.Results:Sixty-two (4.5%) out of 1375 were diagnosed with depression and 17 (27%) of these were taking an antidepressant. In addition 44 individuals, currently not depressed, were taking antidepressants. Twenty-five of these were interviewed per telephone and it was found that the indications for 18 of them were continuation treatment of depression, and for seven of them pain, sleep disturbance or anxiety.Conclusion:Antidepressants appear to be under-used in the population. Only one in four of the depressed individuals was treated with antidepressant medication. Those who had antidepressant medication without being currently depressed had, with few exceptions, either continuation treatment for depression in remission or treatment on other approved indications.
The Histologic Fate of Autologous Collagen Injected into the Canine Vocal Fold
Authors: Staskowski Paul A. , Ford Charles N. , Inagi Katsuhide 
Published: June 2006

Collagen is a functionally essential component of the five‐layered structure of the vocal fold. Soluble bovine collagen has previously been shown to be an effective injectable bioimplant for vocal fold defects, paralysis, and, especially, scarred larynges. Although bovine collagen appears to be well tolerated, the concern for possible adverse immunologic responses has deterred approval from the Food and Drug Administration for its clinical use in the larynx. Currently we are investigating the use of injectable autologous collagen for vocal fold augmentation. The purpose of this study is to examine the histologic fate of autologous collagen injected into the canine vocal fold at multiple intervals after injection. An ellipse of skin measuring 3 × 6cm was harvested from each of three dogs and processed into a naturally cross‐linked injectable solution of collagen (Autologen). This autologous collagen was injected into one vocal fold and a control injection of buffer solution was injected contralaterally. The injections were well tolerated and no dog appeared to suffer any immediate or delayed ill effects. The dog larynges were harvested 1, 3, and 6 months after collagen injection and examined grossly and histologically. Injected autologous collagen material persisted in these experimental animals and appeared to be well tolerated. Based on this preliminary study, we anticipate autologous collagen to be at least as suitable as bovine chemically cross‐linked collagen as an injectable bioimplant for vocal fold augmentation. It may also have the advantage of added safety and stability.
Titration Streptomycin Therapy in Meniere's Disease: Long‐Term Results
Authors: Balyan Fatih R. , Taibah Abdelkader , Donato Giuseppe de , Aslan Asim , Falcioni Maurizio , Russo Alessandra , Sanna Mario 
Published: June 2006

As soon as the use of streptomycin was started for the treatment of tuberculosis, its ototoxic effect was discovered. Initial reports demonstrated that streptomycin was successful in reducing vestibular responses while preserving cochlear activity. Streptomycin sulfate has been used for almost half a century for the treatment of vertigo in patients with Meniere's disease. At the Gruppo Otologico, Piacenza, Italy, between 1987 and 1995 we treated 16 patients with either bilateral Meniere's disease or with Meniere's disease in their only hearing ear, adopting the titration streptomycin therapy protocol of Graham et al. Three patients with follow‐up periods of less than 2 years were not included in this study. The ages of the patients ranged from 36 to 64 years with a mean of 49.2 years. The patients were observed for 2 to 8.8 years. The dose of administered streptomycin varied from 14 to 49 gm. Episodic vertigo was totally relieved in all of the patients after initial treatment, whereas hearing remained the same or was improved when compared with the pretreatment levels. Five of the patients experienced recurring vertigo during a period of 4 to 24 months after initial treatment. Oscillopsia persisted in two patients and ataxia in darkness persisted in another two patients. Hearing was unchanged in 14 ears, improved in 2 ears, and worsened in 4 ears at the last follow‐up evaluation. The overall outcome indicated that intramuscular titration streptomycin therapy seems to be one of the most important therapeutic options in the treatment of disabling vertigo in patients with either bilateral Meniere's disease or Meniere's disease in an only hearing ear.
Caring or uncaring – meanings of being in an oncology environment
Authors: Edvardsson David , Sandman P.O. , Rasmussen Birgit 
Published: June 2006

Aim.  This paper reports a study illuminating meanings of being in the physical environment of an oncology centre as narrated by patients, significant others and staff.Background.  The physical environment of hospitals can convey different messages. For example, landscape pictures, plants and comfortable chairs can convey positive messages, while sparsely decorated and run‐down environments can convey negative values. Traditional healthcare environments may be experienced as unfamiliar, strange and alienating, fostering feelings of stress and vulnerability. The majority of research on care environments has employed experimental designs to test different environmental variables, for example sound, colour and architecture, in relation to patient outcomes such as recovery, pain and blood pressure. There is, however, little research‐based understanding of the meanings of being in these environments.Methods.  A phenomenological hermeneutic approach was applied to analyse 17 interviews with patients, significant others and staff carried out during the spring of 2004 at an oncology centre in Sweden.Findings.  The physical environment was found to influence experiences of care in four ways: first, by being a symbol expressing messages of death and dying, danger, shame and stigma, less social value and worth; second by containing symbols expressing messages of caring and uncaring, life and death; third, by influencing interaction and the balance between being involved and finding privacy; and fourth, by containing objects that could facilitate a shift of focus away from the self: being able to escape the world of cancer, and finding light in the midst of darkness. The comprehensive understanding illuminates the physical environment as not merely a place for caring, but as an important part of caring that needs to be accounted for in nursing care.Conclusion.  To promote well‐being among patients, we need to ask ourselves if the environment imposes rather than eases suffering. Our findings also suggest the importance of not limiting our conceptions of nursing to nurse–patient relationships, but of using the therapeutic potential of the total environment in nursing care.
Exploring knowledge work and leadership in online midwifery communication
Authors: Brooks Fiona , Scott Peter 
Published: June 2006

Aim. This paper reports a study to answer the following question: if given a user‐friendly online system, that enabled communication across the practice community, would midwives function as knowledge workers?Background. Globally, the demand for quality‐led and innovative service delivery requires that nurses and midwives shift from being ‘information workers’, or passive receivers of managerial and organizational decisions, to become ‘knowledge workers’ who are able to create, lead and communicate service innovation and practice development. New communication technologies may offer a means for healthcare professionals to interact as knowledge workers and develop supportive communities of practice.Methods. An online discussion forum was implemented as a low‐cost technological intervention, deploying existing hardware and a standard hospital intranet. The evaluation of the forum was constructed as case‐study organizational research. The totality of online communication, both traffic and content, was analysed over a 3‐month period (193 messages downloaded 2003/2004), and 15 in‐depth interviews were undertaken with forum users.Findings. Given simple, facilitative, innovative technology, supported by a positive working culture and guided by effective leadership, midwives could function as ‘knowledge workers’, critically reflecting upon their practice and translating knowledge into action designed to achieve change in practice. Participation occurred across all staff grades, and midwives were predominantly supportive and facilitative towards the contributions made by colleagues.Conclusion. Midwives may be well placed to exemplify the ‘ideal’ characteristics of the knowledge worker being demanded of modern healthcare professionals. The deployment of online interactive technologies as part of strategic vision to enhance knowledge work among healthcare professionals should be given attention within health systems.
Identity and resistance: why spiritual care needs ‘enemies’
Authors: Swinton John 
Published: June 2006

Aims.  This paper explores certain key critiques of spirituality‐in‐nursing as they have been offered by people outside of the discipline. It argues that nurses have not taken seriously enough the recent criticism of the nature and role of spirituality in nursing. Not to listen to the ‘enemies’ of spirituality‐in‐nursing is to risk stagnation and a drift into obscurity.Background.  The area of spirituality has become a growing field of interest for nurses and has produced a burgeoning body of research literature. Yet, whilst much has been written about the positive aspects of spirituality, nurses have offered almost no critique of the ways in which spirituality and spiritual care are understood, despite the fact that there are clearly certain key issues that require robust critique and thoughtful reflection. Almost all of the major criticisms of spirituality‐in‐nursing have come from people outside of the discipline of nursing. The paper argues that nurses need to listen carefully to the criticisms of spirituality and spiritual care offered by the ‘enemies’ of spiritual care in nursing. When listened to constructively, they highlight issues that are vital for the development and forward movement of this important area of nursing practice.Methods.  Literature review and critical reflection on current critiques of spirituality in nursing practice.Conclusions.  The paper concludes that nurses need to begin to develop spirituality as a specific field of enquiry with its own bodies of knowledge, methodologies, assumptions and core disciplines.Relevance to clinical practice.  In listening to and taking seriously its ‘enemies’, nursing has the opportunity to establish spirituality as an important, creative and vibrant aspect of nursing practice that has the capacity to grow and respond constructively to its ‘enemies’, in ways that make whole‐person‐care a real possibility.
How general are positive relationships between plant population size, fitness and genetic variation?
Authors: LEIMU ROOSA , MUTIKAINEN PIA , KORICHEVA JULIA , FISCHER MARKUS 
Published: June 2006

SummaryRelationships between plant population size, fitness and within‐population genetic diversity are fundamental for plant ecology, evolution and conservation. We conducted meta‐analyses of studies published between 1987 and 2005 to test whether these relationships are generally positive, whether they are sensitive to methodological differences among studies, whether they differ between species of different life span, mating system or rarity and whether they depend on the size ranges of the studied populations.Mean correlations between population size, fitness and genetic variation were all significantly positive. The positive correlation between population size and female fitness tended to be stronger in field studies than in common garden studies, and the positive correlation between genetic variation and fitness was significantly stronger in DNA than in isoenzyme studies.The strength and direction of correlations between population size, fitness and genetic variation were independent of plant life span and the size range of the studied populations. The mean correlations tended to be stronger for the rare species than for common species.Expected heterozygosity, the number of alleles and the number or proportion of polymorphic loci significantly increased with population size, but the level of inbreedingFISwas independent of population size. The positive relationship between population size and the number of alleles and the number or proportion of polymorphic loci was stronger in self‐incompatible than in self‐compatible species. Furthermore, fitness and genetic variation were positively correlated in self‐incompatible species, but independent of each other in self‐compatible species.The close relationships between population size, genetic variation and fitness suggest that population size should always be taken into account in multipopulation studies of plant fitness or genetic variation.The observed generality of the positive relationships between population size, plant fitness and genetic diversity implies that the negative effects of habitat fragmentation on plant fitness and genetic variation are common. Moreover, the stronger positive associations observed in self‐incompatible species and to some degree in rare species, suggest that these species are most prone to the negative effects of habitat fragmentation.
CRB‐65 predicts death from community‐acquired pneumonia*
Authors: BAUER T. T. , EWIG S. , MARRE R. , SUTTORP N. , WELTE T. ,   THE CAPNETZ STUDY GROUP
Published: June 2006

Abstract.Objective.  The study was performed to validate the CURB, CRB and CRB‐65 scores for the prediction of death from community‐acquired pneumonia (CAP) in both the hospital and out‐patient setting.Design.  Data were derived from a large multi‐centre prospective study initiated by the German competence network for community‐acquired pneumonia (CAPNETZ) which started in March 2003 and were censored for this analysis in October 2004.Setting.  Out‐ and in‐hospital patients in 670 private practices and 10 clinical centres.Subjects.  Analysis was done for n = 1343 patients (n = 208 out‐patients and n = 1135 hospitalized) with all data sets completed for the calculation of CURB and repeated for n = 1967 patients (n = 482 out‐patients and n = 1485 hospitalized) with complete data sets for CRB and CRB‐65.Intervention.  None. 30‐day mortality from CAP was determined by personal contacts or a structured interview.Results.  Overall 30‐day mortality was 4.3% (0.6% in out‐patients and 5.5% in hospitalized patients, P < 0.0001). Overall, the CURB, CRB and CRB‐65 scores provided comparable predictions for death from CAP as determined by receiver–operator‐characteristics (ROC) curves. However, in hospitalized patients, CRB misclassified 26% of deaths as low risk patients. Availability of the CRB‐65 score (90%) was far superior to that of CURB (65%), due to missing blood urea nitrogen values (P < 0.001).Conclusions.  Both the CURB and CRB‐65 scores can be used in the hospital and out‐patients setting to assess pneumonia severity and the risk of death. Given that the CRB‐65 is easier to handle, we favour the use of CRB‐65 where blood urea nitrogen is unavailable.
Plasma ghrelin concentrations are positively associated with carotid artery atherosclerosis in males
Authors: PÖYKKÖ S. M. , KELLOKOSKI E. , UKKOLA O. , KAUMA H. , PÄIVÄNSALO M. , KESÄNIEMI Y. A. , HÖRKKÖ S. 
Published: June 2006

Abstract.Background.  Ghrelin, a peptide hormone from stomach, stimulates food intake and decreases fat utilization. Ghrelin binds to growth hormone secretagogue receptor (GHSR). GHSR density has been shown to be upregulated in atherosclerotic lesions, but the relationship between ghrelin concentration and atherosclerosis has not yet been studied. We, therefore, characterized the association between ghrelin concentration and carotid artery intima‐media thickness (IMT) in a population‐based cohort of 1024 middle‐aged (40–60 years) men and women.Methods.  Intima‐media thickness and the number of atherosclerotic plaques were determined ultrasonographically. Fasting plasma ghrelin concentrations were analysed using RIA‐kit (PhoenixPeptide).Results.  There was a positive association between mean IMT and ghrelin concentration in the analysis of males before and after adjustments for the traditional risk factors of atherosclerosis [age, systolic blood pressure, LDL cholesterol, body mass index (BMI), and smoking (ancova, P = 0.004 and P = 0.007, respectively)]. However, no such association was found in females (P = 0.985 and P = 0.915). There was no correlation between ghrelin and CRP concentrations or ghrelin and smoking.Conclusion.  Ghrelin concentrations and carotid artery atherosclerosis are positively associated in males even after adjustment for the commonly recognized risk factors of atherosclerosis. Experimental and prospective studies are warranted to elucidate the role of ghrelin in atherosclerosis.
Fracture risk associated with the use of morphine and opiates
Authors: VESTERGAARD P. , REJNMARK L. , MOSEKILDE L. 
Published: June 2006

Abstract.Objectives.  To study the effect of morphine and opiates on fracture risk.Design.  Case–control study.Setting.  Nationwide register‐based study.Subjects.  Cases were all subjects with any fracture sustained during the year 2000 (n = 124 655). For each case, three controls (n = 373 962) matched on age and gender were randomly drawn from the background population. The primary exposure variables were use of morphine and opiates. Morphine and other opiates had been used by 10 015 (8.0%) of the case subjects and 12 108 (3.2%) of the controls. Adjustments were made for several confounders including prior fracture, and use of weak analgesics [nonsteroidal anti‐inflammatory drugs, acetylsalicylic acid (ASA) and acetaminophene]. The effect of dose was examined by stratifying for cumulated dose (defined daily dose).Main outcome measure.  Fracture.Results.  Morphine (1.47, 95% CI 1.37–1.58), fentanyl (2.23, 95% CI 1.89–2.64), methadone (1.39, 95% CI 1.05–1.83), oxycodone (1.36, 95% CI 1.08–1.69), nicomorphine (1.57, 95% CI 1.38–1.78), ketobemidone (1.07, 95% CI 1.02–1.13), tramadol (1.54, 95% CI 1.49–1.58) and codeine (1.16, 95% CI 1.12–1.20) were all associated with an increase in overall fracture risk. No increase was present for buprenorphine (0.86, 95% CI 0.79–0.95), pethidine (0.98, 95% CI 0.89–1.08), dextropropoxiphene (1.02, 95% CI 0.90–1.16), and combinations of ASA and codeine (0.94, 95% CI 0.88–1.01).Conclusions.  An increased fracture risk is seen in users of morphine and opiates. The reason for this may be related to the risk of falls due to central nervous system effects such as dizziness.
Use of a marker plasmid to examine differential rates of growth and death between clinical and environmental strains of Vibrio vulnificus in experimentally infected mice
Authors: Starks Angela M. , Bourdage Keri L. , Thiaville Patrick C. , Gulig Paul A. 
Published: June 2006

Summary Vibrio vulnificus is Gram‐negative bacterium that contaminates oysters, causing highly lethal sepsis after consumption of raw oysters and wound infection. We previously described two sets of V. vulnificus strains with different levels of virulence in subcutaneously inoculated iron dextran‐treated mice. Both virulent, clinical strains and attenuated, environmental strains could be recovered in high numbers from skin lesions and livers; however, the attenuated environmental strains required significantly higher numbers of colony‐forming units (cfu) in the inoculum to produce lethal infection. Using some of these strains and an additional clinical strain, we presently asked if the different abilities to cause infection between the clinical and environmental strains were due to differences in rates of growth or death of the bacteria in the mouse host. We therefore constructed a marker plasmid, pGTR902, that functions as a replicon only in the presence of arabinose, which is not present in significant levels in animal tissues. V. vulnificus strains containing pGTR902 were inoculated into iron dextran‐treated and untreated mice. Measuring the proportion of bacteria that had maintained the marker plasmid recovered from mice enabled us to monitor the number of in vivo divisions, hence growth rate; whereas measuring the number of marker plasmid‐containing bacteria recovered enabled the measurement of death of the vibrios in the mice. The numbers of bacterial divisions in vivo for all of the strains over a 12–15 h infection period were not significantly different in iron dextran‐treated mice; however, the rate of death of one environmental strain was significantly higher compared with the clinical strains. Infection of non‐iron dextran‐treated mice with clinical strains demonstrated that the greatest effect of iron dextran‐treatment was increased growth rate, while one clinical strain also experienced increased death in untreated mice. V. vulnificus inoculated into iron dextran‐treated mice replicated extremely rapidly over the first 4 h of infection with doubling times of approximately 15–28 min. In contrast, one of the environmental strains exhibited a reduced early growth rate. These results demonstrate that differences in virulence among naturally occurring V. vulnificus can be explained by diverse abilities to replicate rapidly in or resist defences of the host. The marker plasmid pGTR902 should be useful for examining virulence of bacteria in terms of differentiating growth verses death in animal hosts for most Gram‐negative bacteria.
RA domain‐mediated interaction of Cdc35 with Ras1 is essential for increasing cellular cAMP level for Candida albicans hyphal development
Authors: Fang Hao‐Ming , Wang Yue 
Published: June 2006

SummaryMany Ras GTPases activate their effectors through binding at a conserved Ras association (RA) domain. An example is the activation of the budding yeast adenylate cyclase Cyr1 by Ras1 and Ras2. Candida albicans Ras1 is speculated to similarly activate Cdc35, the orthologue of Cyr1, for hyphal development. Here, we have investigated whether the RA domain mediates Ras1–Cdc35 interaction and how this interaction regulates cAMP levels and morphogenesis. Yeast two‐hybrid assays suggested that Ras1 interacts only with the RA but not any other identifiable domains of Cdc35. The Ras1–RA interaction was further confirmed by in vitro binding assays of purified RA domain and Ras1 and by co‐immunoprecipitation of Ras1 and Cdc35 from cell lysates. Substituting Ala for the conserved residue K338 or L349 in the RA domain or deleting the RA domain abolished the Ras1–RA or Ras1–Cdc35 interactions. cdc35 mutants with the RA domain deleted or carrying K388A or L349A mutation exhibited rather normal yeast growth but were completely defective in hyphal morphogenesis. Further, the mutants contained nearly wild‐type levels of cAMP during yeast growth but were unable to increase it upon hyphal induction. These results suggest an essential role for the RA‐mediated Ras1–Cdc35 interaction in raising cellular cAMP levels for hyphal morphogenesis.