bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoxia causes permeability oedema in the constant-pressure perfused rat lung
Authors: Dehler M. , Zessin E. , Bärtsch P. , Mairbäurl H. 
Published: February 2006

Alveolar hypoxia causes pulmonary oedema associated with increased lung capillary pressure and decreased alveolar fluid reabsorption. However, the role of altered permeability is unclear. The aim of the present study was to test whether hypoxia affects alveolar permeability and induces pulmonary oedema in rat lungs, and whether terbutaline affects oedema formation.Isolated lungs of normoxic rats were perfused at a constant pressure (12 cmH2O) and exposed to different levels of oxygenation (1.5–35% O2). Terbutaline (10−5 M) was applied as an aerosol or with the perfusate. Online measurements indicate an earlier onset of weight gain with an increasing degree of hypoxia and a shortened lung survival time (35% O2: ∼220 min; 1.5% O2: ∼120 min). Terbutaline did not prevent oedema formation in hypoxic lungs. The terbutaline-induced formation of cyclic adenosine monophosphate was decreased by 50% in hypoxia (1.5% O2).In experiments terminated after 75 min, bronchoalveolar lavage fluid of hypoxic lungs contained protein that originated from perfusate indicating alveolar leakage. Since lactate dehydrogenase in perfusate was not increased at the onset of oedema formation, cell damage does not explain the increased permeability.In conclusion, these results indicate the formation of a leak for macromolecules of the isolated perfused rat lung, which is accelerated by hypoxia and causes alveolar flooding even at low perfusion pressure at a rate that exceeds absorption even after stimulation with terbutaline.
The link between fungi and severe asthma: a summary of the evidence
Authors: Denning D. W. , O'Driscoll B. R. , Hogaboam C. M. , Bowyer P. , Niven R. M. 
Published: February 2006

There is current evidence to demonstrate a close association between fungal sensitisation and asthma severity. Whether such an association is causal remains to be confirmed, but this is explored by means of a detailed literature review. There is evidence from two randomised controlled trials that, in the example of allergic bronchopulmonary aspergillosis (ABPA), treatment with systemic antifungal therapy can offer a therapeutic benefit to ∼60% of patients. ABPA is only diagnosed if a combination of clinical and immunological criteria is achieved. It is not known whether such cases are a discrete clinical entity or part of a spectrum of the pulmonary allergic response to fungi or fungal products.This paper describes the epidemiological evidence that associates severity of asthma with fungi and discusses possible pathogenetic mechanisms. Many airborne fungi are involved, including species ofAlternaria,Aspergillus,CladosporiumandPenicillium, and exposure may be indoors, outdoors or both. The potential for a therapeutic role of antifungal agents for patients with severe asthma and fungal sensitisation is also explored.Not only are many patients with severe asthma desperately disabled by their disease, but, in the UK alone, asthma accounts for 1,500 deaths per yr. The healthcare costs of these patients are enormous and any treatment option merits close scrutiny. Within this report, the case for the consideration of a new term related to this association is put forward. The current authors propose the term “severe asthma with fungal sensitisation”. However, it is recognised that enhanced and precise definition of fungal sensitisation will require improvements in diagnostic testing.
Influence of body mass index on the response to asthma controller agents
Authors: Peters-Golden M. , Swern A. , Bird S. S. , Hustad C. M. , Grant E. , Edelman J. M. 
Published: February 2006

The incidence of asthma has been positively associated with obesity. Asthma comprises diverse “phenotypes” reflecting heterogeneity in a number of characteristics, including response to therapy. The present authors examined whether body mass index (BMI) influenced the response to placebo, as well as to two asthma controller medications.Apost hocanalysis was performed, pooling data from four double-blind, placebo-controlled studies randomising 3,073 moderate asthmatic adults to montelukast (n = 1,439), beclomethasone (n = 894) or placebo (n = 740). The primary end point was asthma control days; other end points were forced expiratory volume in one second, β-agonist use and nocturnal awakening. Analyses were conducted using BMI classification into normal (<25.0 kg·m−2; 52% of patients), overweight (25–29.9 kg·m−2; 32%) and obese (≥30.0 kg·m−2; 16%) categories, as well as BMI as a continuous variable.The treatment groups were balanced for BMI, demographic characteristics and parameters of asthma control. The placebo response for all end points was generally lower with increasing BMI. Similarly, the response to the inhaled corticosteroid decreased, whereas the response to the leukotriene antagonist remained stable.In conclusion,post hocdata from the present study suggested that body mass index may influence the natural history of asthma control (as reflected by response to placebo) and may differentially influence response to the two active agents, warranting explicit testing in future prospective studies.
Aspirationversustube drainage in primary spontaneous pneumothorax: a randomised study
Authors: Ayed A. K. , Chandrasekaran C. , Sukumar M. 
Published: February 2006

This randomised study was designed to compare clinical outcomes for simple aspirationversustube thoracostomy, in the treatment of the first primary spontaneous pneumothorax (PSP) attack. A randomised trial, comparing simple aspiration with tube thoracostomy, in 137 patients with a first episode of PSP was carried out.Immediate success was obtained in 40 out of the 65 patients (62%) randomly assigned to undergo simple aspiration and in 49 out of the 72 patients (68%) who had been randomly assigned to undergo tube thoracostomy. The 1-week success rates were: 58 (89%) patients in the intention-to-treat simple aspiration group and 63 (88%) patients in the tube thoracostomy group. In the aspiration group, there were more recurrences during the 3-month follow-up period (15versus8%), though the difference was not significant. Recurrence rates at 1 and 2 yrs were 16 (22%) and 20 (31%) for patients who had undergone simple aspiration, respectively, and 17 (24%) and 18 (25%) for patients who had undergone tube thoracostomies, respectively. Complications occurred in 5 (7%) patients who had undergone a tube thoracostomy and 1 (2%) patient who had undergone simple aspiration. Analgesia was required in 22 (34%) patients of the simple aspiration groupversus40 (56%) patients of the tube thoracostomy group.These findings suggest that simple aspiration could be an acceptable alternative to tube thoracostomy in the treatment of primary spontaneous pneumothorax.
Effectiveness and costs of acute day hospital treatment compared with conventional in-patient care
Authors: Priebe Stefan , Jones Gemma , McCabe Rosemarie , Briscoe Jane , Wright Donna , Sleed Michelle , Beecham Jennifer 
Published: February 2006

BackgroundData on effectiveness of acute day hospital treatment for psychiatric illness are inconsistent.AimsTo establish the effectiveness and costs of care in a day hospital providing acute treatment exclusively.MethodIn a randomised controlled trial, 206 voluntarily admitted patients were allocated to either day hospital treatment or conventional wards. Psychopathology, treatment satisfaction and subjective quality of life at discharge, 3 months and 12 months after discharge, readmissions to acute psychiatric treatment within 3 and 12 months, and costs in the index treatment period were taken as outcome criteria.ResultsDay hospital patients showed significantly more favourable changes in psychopathology at discharge but not at follow-up. They also reported higher treatment satisfaction at discharge and after 3 months, but not after 12 months. There were no significant differences in subjective quality of life or in readmissions during follow-up. Mean total support costs were higher for the day hospital group.ConclusionsDay hospital treatment for voluntary psychiatric patients in an inner-city area appears more effective in terms of reducing psychopathology in the short term and generates greater patient satisfaction than conventional in-patient care, but may be more costly.
Influence of age on outcome of psychological treatments in first-episode psychosis
Authors: Haddock Gillian , Lewis Shôn , Bentall Richard , Dunn Graham , Drake Richard , Tarrier Nicholas 
Published: February 2006

BackgroundPsychological treatments have been shown to be effective in patients with psychosis. However, the studies published to date have included participants across wide age ranges, so few conclusions can be reached about the effectiveness of such treatments in relation to age.AimsTo evaluate outcomes by age in a randomised controlled trial designed to evaluate the effectiveness of cognitive-behavioural therapy (CBT), supportive counselling and treatment as usual.MethodOutcomes were evaluated in terms of symptoms, social functioning, insight and therapeutic alliance according to age at 3- and 18-month follow-up.ResultsYounger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months. Older participants responded better to CBT than to supportive counselling over 18 months. Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling, and were more difficult to engage in therapy.ConclusionsYoung people may have different needs with regard to engagement in psychological treatments. Treatment providers need to take age-specific factors into account.
Rechallenge with clozapine following leucopenia or neutropenia during previous therapy
Authors: Dunk Louisa R. , Annan Linda J. , Andrews Christopher D. 
Published: February 2006

BackgroundFurther treatment with clozapine is contraindicated in any patient who has previously experienced leucopenia or neutropenia during clozapine therapy.AimsTo investigate the results of such a rechallenge in 53 patients.MethodAn analysis was made of the demographic, haematological and outcome data of patients in the UK and Ireland who were rechallenged with clozapine following leucopenia or neutropenia during previous clozapine therapy.ResultsOf 53 patients who were rechallenged, 20 (38%) experienced a further blood dyscrasia. In 17 of these 20 patients (85%) the second blood dyscrasia was more severe(P<0.001), in 12(60%) it lasted longer (P=0.0368) and in 17 (85%) it occurred more quickly on rechallenge (P<0.001). Of the original 53 patients, 55% (29 patients) are still receiving clozapine.ConclusionsNo clear risk factor for repeat blood dyscrasias was identified. Despite this, after risks and benefits have been considered, rechallenge may well be justified in some patients.
Effect of a structured educational intervention on explanatory models of relatives of patients with schizophrenia
Authors: Das S. , Saravanan B. , Karunakaran K. P. , Manoranjitham S. , Ezhilarasu P. , Jacob K. S. 
Published: February 2006

SummaryWe examined the effect of a structured educational programme on explanatory models of illness among the relatives of people with schizophrenia, in a randomised controlled trial. Participants were assessed at baseline (n=100) and after 2 weeks (n=75) using a vignette from the Short Explanatory Model Interview. There was a reduction in non-biomedical causal explanatory models at follow-up among those who had completed the structured educational programme compared with the control group. There was no significant difference in non-biomedical treatment explanatory models between the two groups.
Violence in women with psychosis in the community: Prospective study
Authors: Dean Kimberlie , Walsh Elizabeth , Moran Paul , Tyrer Peter , Creed Francis , Byford Sarah , Burns Tom , Murray Robin , Fahy Tom 
Published: February 2006

BackgroundLittle is known about the determinants of violence in women with psychosis.AimsTo identify predictors of violence in a community sample of women with chronic psychosis.MethodThe 2-year prevalence of physical assault was estimated for a sample of 304 women with psychosis. Baseline socio-demographic and clinical factors were used to identify predictors of assault.ResultsThe 2-year prevalence of assault in the sample was 17%. Assaultive behaviour was associated with previous violence (OR=5.87, 95% CI 2.42–14.25), non-violent convictions (OR=2.63, 95% CI 1.17–5.93), victimisation (OR=2.46, 95% CI 1.02–5.93), African–Caribbean ethnicity (OR=2.24, 95% CI 1.02–4.77), cluster B personality disorder (OR=2.66, 95% CI 1.11–6.38) and high levels of unmet need (OR=1.17, 95%C11.01–1.35). An interaction between African–Caribbean ethnicity and cluster B personality disorder was identified in relation to violent outcome. Violent women were found to be more costly to services.ConclusionsNearly a fifth of community-dwelling women with chronic psychosis committed assault over a period of 2 years. Six independent risk factors were found to predict violence.
Risk for coronary heart disease in people with severe mental illness
Authors: Osborn David P. J. , Nazareth Irwin , King Michael B. 
Published: February 2006

BackgroundDespite concern about the incidence of coronary heart disease (CHD) in people with severe mental illness (SMI), there is little systematic research on CHD risk factors in this population.AimsTo compare the main risk factors for CHD in people with and without SMI in primary care, to investigate the role of socio-economic variables, and to examine any association between antipsychotic medication and CHD risk.MethodCross-sectional screening.ResultsIn total, 75 of 182 general practice patients with SMI and 150 of 313 such patients without SMI attended the interview. SMI was associated with: raised 10-year CHD risk scores (OR= 1.8, 95% CI 1.0–3.1); high-density-lipoprotein (HDL)-cholesterol levels <l.0 mmol/l (OR=4.0, 95% CI 1.5–10.7); raised cholesterol/HDL-cholesterol ratios (OR=1.8, 95% CI 1.0–3.2); diabetes mellitus (OR=3.8, 95% CI 1.1–13.3) and smoking (OR=3.0, 95% CI 1.7–3.4). These associations varied significantly with age. Adjustment for unemployment did not fully explain the associations.ConclusionsExcess risk factors for CHD are not wholly accounted for by medication or socio-economic deprivation. There is an urgent need for CHD screening and for relevant interventions for smoking cessation and diabetes, as well as advice on diet and exercise, in patients with SMI.
Life events, first depression onset and the serotonin transporter gene
Authors: Wilhelm Kay , Mitchell Philip B. , Niven Heather , Finch Adam , Wedgwood Lucinda , Scimone Anna , Blair Ian P. , Parker Gordon , Schofield Peter R. 
Published: February 2006

BackgroundA relationship between the serotonin transporter gene, adverse events and onset of major depression has been reported.AimsTo replicate a gene × environment interaction in a cohort with longitudinal data for life events, experience of depression, parental bonding and neuroticism.MethodAtthe 25-year follow-up, genomic DNA was obtained from 127 cohort members (mean age 48 years) to determine the genotype of the serotonin transporter gene-linked promoter region (5-HTTLPR). Associations were investigated between the 5-HTTLPR genotype, positive and adverse life events and the gene × environment interaction, and also between the 5-HTTLPR genotype and risk factors for depression.ResultsNo relationship was found between 5-HTTLPR genotype and either risk factors for depression or positive life events. Adverse life events had a significantly greater impact on the onset of depression for individuals with the s/s genotype.ConclusionsThe 5-HTTLPR genotype is a significant predictor of onset of major depression following multiple adverse events. This is one of the more robust findings concerning specific biological risk factors for depression.
Painful symptoms in depression: Under-recognised and under-treated?
Authors: Peveler Robert , Katona Cornelius , Wessely Simon , Dowrick Christopher 
Published: February 2006

SummaryCurrent diagnostic systems maintain an artificial division between ‘physical’ and ‘psychological’ disorders. This is exemplified by the way in which pain symptoms are dealt with in the context of depressive illness. The consequences of this are discussed, and ways to enhance the clinical care of patients with depression and pain are suggested.
Children with learning disabilities and related needs placed out of borough: parents' perspective
Authors: Shuwa Amma , Fitzgerald Brian , Clemente Carmen , Grant Denny 
Published: February 2006

Aims and MethodTo investigate parental experience of children with learning disability being placed out of borough. The parents of 70 children were interviewed.ResultsParents would prefer in-borough provision but 90% were satisfied with the current school. The main problems experienced in-borough were poor advice, delays, lack of information and family stress. After out-of-borough placement there was a reported increase in the use of speech and language therapy, occupational therapy and sensory facilities and a decrease in the use of paediatric services, social services, and mental health services.Clinical ImplicationsSpecialist services should be helpful and reduce family burden by keeping children in-borough.
Reducing hypnotic use on two older adult functional wards: an effective audit?
Authors: Caswell Lucy , Hoosen Imthiaz , Vassilas Christopher A. , Haque Sayeed 
Published: February 2006

Aims and MethodWe undertook an audit of hypnotic use on two functional older adult wards, followed by an educational intervention to all nursing staff and junior doctors. We then repeated the audit.ResultsOur pre-intervention audit showed a hypnotic use of 48%. This decreased to 26% for the first month following the educational intervention. Usage increased gradually in proportion to time from intervention. However, over the 4-month post-intervention period hypnotic use remained significantly lower than pre-intervention throughout the time period studied.Clinical ImplicationsAs the study is an audit there is no control group, but our results suggest regular staff education is needed to sustain a reduction in hypnotic use.
What's in a name? Views on psychiatric services for older people
Authors: Kelly Fionnuala , Reidy Julianne , Swanwick Gregory 
Published: February 2006

Aims and MethodThe aim of this study was to provide a name for a psychiatric service for older people in Dublin. A total of 296 individuals (167 doctors, 129 workshop attendees) were surveyed regarding their views on a name for the service.Results‘Age-related psychiatry’ was a universally popular term. It was chosen by 43% of general practitioners, 56% of hospital doctors and 44% of the workshop attendees, as one of their top three choices. ‘Psychiatry of old age’, ‘geriatric psychiatry’ and ‘psychogeriatrics' were unpopular with all three groups.Clinical ImplicationsNames can gradually become stigmatising over time. This applies to the terms for ‘old’ and ‘psychiatry’. In this survey all groups surveyed rejected some of the terms in widespread clinical use.
Phase III Study of Two Different Dosing Schedules of Erythropoietin in Anemic Patients With Cancer
Authors: Steensma David P. , Molina Roy , Sloan Jeff A. , Nikcevich Daniel A. , Schaefer Paul L. , Rowland Kendrith M. , Dentchev Todor , Novotny Paul J. , Tschetter Loren K. , Alberts Steven R. , Hogan Thomas F. , Law Amy , Loprinzi Charles L. 
Published: February 2006

Purpose To compare maintenance epoetin alfa administered once every 3 weeks with continued weekly epoetin alfa for patients with cancer-associated anemia. Patients and Methods Eligible patients were randomly assigned at enrollment to receive three weekly doses of epoetin alfa 40,000 U subcutaneously (SC), followed by either standard weekly epoetin alfa (40K arm) or 120,000 U of epoetin alfa (120K arm) SC every 3 weeks for 18 additional weeks. Results Three hundred sixty-five patients were enrolled. One hundred eighty-three patients were assigned to the 40K arm, and 182 were assigned to the 120K arm. There was no difference in the proportion of patients requiring transfusions during the study (23% in 40K arm and 18% in 120K arm, P = .22) or specifically during the maintenance phase (13% in 40K arm v 15% in 120K arm, P = .58). Patients randomly assigned to the 40K arm were more likely to have a ≥ 2 or ≥ 3 g/dL hemoglobin (Hb) increment, were more likely to have a drug dose held because of high Hb, and had higher mean end-of-study Hb levels. Toxicities, including thromboembolism, and overall survival were similar. Patients in the 40K arm had a higher global quality of life (QOL) at baseline for unclear reasons, whereas patients in the 120K arm had a greater global QOL improvement during the study, so end-of-study QOL was equivalent. Conclusion After three weekly doses of epoetin alfa 40,000 U, a dose of 120,000 U can be administered safely once every 3 weeks without increasing transfusion needs or sacrificing QOL. The Hb increment is somewhat greater with continued weekly epoetin alfa. Lack of blinding as a result of different treatment schedules may have confounded results.
Addition of Epirubicin As a Third Drug to Carboplatin-Paclitaxel in First-Line Treatment of Advanced Ovarian Cancer: A Prospectively Randomized Gynecologic Cancer Intergroup Trial by the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group and the Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens
Authors: du Bois Andreas , Weber Beatrice , Rochon Justine , Meier Werner , Goupil Alain , Olbricht Sigrid , Barats Jean-Claude , Kuhn Walther , Orfeuvre Hubert , Wagner Uwe , Richter Barbara , Lueck Hans-Joachim , Pfisterer Jacobus , Costa Serban , Schroeder Willibald , Kimmig Rainer , Pujade-Lauraine Eric 
Published: February 2006

Purpose Despite the progress that has been achieved, long-term survival rates in patients with advanced ovarian cancer are still disappointing. One attempt to improve results could be the addition of non–cross-resistant drugs to platinum-paclitaxel combination regimens. Anthracyclines were among the candidates for incorporation as a third drug into first-line regimens. Patients and Methods We performed a prospectively randomized phase III study comparing carboplatin-paclitaxel (TC; area under the curve 5/175 mg/m2, respectively) with epirubicin 60 mg/m2 added to the same combination (TEC) in previously untreated patients with advanced epithelial ovarian cancer. All drugs were administered intravenously on day 1 of a 3-week schedule for a planned minimum of six courses. Results Between November 1997 and February 2000, 1,282 patients were randomly assigned to receive either TC (635 patients) or TEC (647 patients), respectively. Grade 3/4 hematologic and some nonhematologic toxicities (nausea/emesis, mucositis, and infections) occurred significantly more frequently in the TEC arm. Accordingly, quality-of-life analysis showed inferiority of TEC versus TC. Median progression-free survival time was 18.4 months for the TEC arm and 17.9 months for the TC arm (hazard ratio [HR], 0.95; 95% CI, 0.83 to 1.07; P = .3342). Median overall survival time was 45.8 months for the TEC arm and 41.0 months for the TC arm (HR, 0.93; 95% CI, 0.81 to 1.08; P = .3652). Similar nonsignificant differences were observed when strata were analyzed separately. Conclusion Addition of epirubicin to TC did not improve survival or time to treatment failure in patients with advanced epithelial ovarian cancer; therefore, it cannot be recommended for clinical use in this population.