bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ Observation Scale for Inpatient Evaluation: reliability update
Authors: Lyall Dawn , Hawley Chris , Scott Kusam 
Published: April 2004

Background.  The Nurses’ Observation Scale for Inpatient Evaluation is a 30‐item scale designed in 1965 for behavioural and observational rating of psychiatric inpatients.Aim.  This paper reports a re‐evaluation of the Nurses’ Observation Scale for Inpatient Evaluation carried out to confirm that it remains reliable in a modern United Kingdom (UK) setting.Method.  The scale is a joint‐rated one and we tested the degree of agreement between two individual raters and not, as in previous studies, between two pairs of raters. A total of 100 patients were each rated by two nurses, and a least‐squares simple regression model was used to describe the average level of agreement between the pairs of ratings.Results.  The correlation in total scale scores was 0·76 (F = 136, P < 0·0001). The correlations for Negative and Positive Factors were 0·68 (P < 0·001) and 0·75 (P < 0·001), respectively.Conclusion.  This study has shown that the Nurses’ Observation Scale for Inpatient Evaluation retains satisfactory inter‐rater reliability with current clinical populations, and we suggest that it remains a useful tool for everyday clinical practice and a basis for meaningful communication between staff about patient status.
Subtypes of α1‐ and α2‐Adrenoceptors Mediating Noradrenergic Modulation of Spontaneous Inhibitory Postsynaptic Currents in the Hypothalamic Paraventricular Nucleus
Authors: Chong W. , Li L. H. , Lee K. , Lee M. H. , Park J. B. , Ryu P. D. 
Published: April 2004

AbstractNoradrenergic inputs to the hypothalamic paraventricular nucleus (PVN) play important roles in the regulation of neuroendocrine and autonomic functions. Previous reports show that noradrenaline increases the frequency of spontaneous inhibitory postsynaptic currents (sIPSCs) in a subpopulation of type II neurones, acting via α1‐adrenoceptors (ARs), but reduces this frequency in most type I and another subpopulation of type II neurones, via α2‐ARs on presynaptic GABA neurones. Here, we identified the subtypes of α‐ARs mediating noradrenaline‐induced increases and decreases in the sIPSC frequency of PVN neurones, by using slice patch recordings from PVN neurones. In both type I and II neurones, the noradrenaline‐induced decrease in sIPSC frequency was completely blocked by BRL44408 (α2A‐AR antagonist) at 1–3 µM, which is approximately 1/100 of its equilibrium dissociation constant (pA2 = 8.0), but not by prazosin (20–100 µM, α2B/C‐AR antagonist; pA2 = 7.5). The effect of noradrenaline was mimicked by guanfacine (α2A‐AR agonist) with an EC50 of 0.1 µM. In type II neurones, the noradrenaline‐induced increase in sIPSC frequency was not blocked by any of the following antagonists: RS17053 (10 µM, α1A‐AR antagonist), BMY7378 (2 µM, α1D‐AR antagonist), prazosin (0.1 µM, α1‐AR antagonist; pA2 = 10.5), or chloroethylclonidine (10 µM, α1B/D‐AR antagonist). However, the effect of noradrenaline was blocked by higher concentrations of prazosin (1 µM) or RS17053 (100 µM), suggesting the involvement of α1L‐subtype, a low affinity form of α1A‐ARs. Collectively, our results indicate that the α2A‐, or α1L‐ARs on the GABA neurones mediate the noradrenaline‐induced decreases, or increases in the frequencies of the sIPSCs of PVN neurones, respectively.
Open randomized study of pyrimethamine–sulphadoxine vs. pyrimethamine–sulphadoxine plus probenecid for the treatment of uncomplicated Plasmodium falciparum malaria in children
Authors: Sowunmi A. , Fehintola F. A. , Adedeji A. A. , Gbotosho G. O. , Falade C. O. , Tambo E. , Fateye B. A. , Happi T. C. , Oduola A. M. J. 
Published: April 2004

SummaryBackground  Increasing drug resistance in Plasmodium falciparum has necessitated renewed search for cheap, effective alternatives to commonly available antimalarials, chloroquine and pyrimethamine–sulphadoxine, for the treatment of malaria in Africa. Probenecid, an inhibitor of organic anion transporters and multiresistance‐associated proteins, can chemosensitize P. falciparum to pyrimethamine and sulphadoxine in vitro, but the clinical significance is unclear. We assessed the safety, treatment efficacy, and effects on gametocyte carriage of adding probenecid to pyrimethamine–sulphadoxine.Methods  We evaluated 151 children aged 12 years or younger who had uncomplicated P. falciparum malaria. Patients were randomly assigned pyrimethamine–sulphadoxine (25 mg/kg of the sulphadoxine component) or pyrimethamine–sulphadoxine as above plus probenecid 20–25 mg/kg of bodyweight in two divided doses daily for 3 days. The primary endpoints were parasitological cure rates on days 14 and 28.Results  Both regimens were well tolerated; no child was withdrawn because of drug intolerance. Fever (1.9 ± 1.1 vs. 2.4 ± 1.2 days, P = 0.02) and parasite clearance (2.3 ± 0.9 vs. 2.7 ± 1.1 days, P = 0.04) were significantly shorter, and the parasitological cure rate on day 14 (96.2%vs. 83.5%, P = 0.02) but not day 28 (79.4%vs. 72.6%, P = 0.4), was significantly higher in children treated with pyrimethamine–sulphadoxine–probenecid than in those treated with pyrimethamine–sulphadoxine. Gametocyte carriage was similar with both treatment regimens.Conclusions  The combination of pyrimethamine–sulphadoxine, and probenecid, at a relatively moderate dose, improved treatment efficacy but had no effect on gametocyte carriage. The pyrimethamine–sulphadoxine–probenecid combination merits further evaluation as a potential treatment for use in Nigeria.
Rapid epidemiologic assessment of glucose‐6‐phosphate dehydrogenase deficiency in malaria‐endemic areas in Southeast Asia using a novel diagnostic kit
Authors: Jalloh A. , Tantular I. S. , Pusarawati S. , Kawilarang A. P. , Kerong H. , Lin K. , Ferreira M. U. , Matsuoka H. , Arai M. , Kita K. , Kawamoto F. 
Published: April 2004

SummaryWe recently reported a new rapid screening method for glucose‐6‐phosphate dehydrogenase (G6PD) deficiency. This method incorporates a new formazan substrate (WST‐8) and is capable of detecting heterozygous females both qualitatively and quantitatively. Here, we report its evaluation during field surveys at three malaria centres and in malaria‐endemic villages of Myanmar and Indonesia, either alone or in combination with a rapid on‐site diagnosis of malaria. A total of 57 severe (45 males and 12 females) and 34 mild (five males and 29 females) cases of G6PD deficiency were detected among 855 subjects in Myanmar whilst 30 severe (25 males and five females) and 23 mild (six males and 17 females) cases were found among 1286 subjects in Indonesia. In all cases, severe deficiency was confirmed with another formazan method but due to limitations in its detection threshold, mild cases were misdiagnosed as G6PD‐normal by this latter method. Our results indicate that the novel method can qualitatively detect both severely deficient subjects as well as heterozygous females in the field. The antimalarial drug, primaquine, was safely prescribed to Plasmodium vivax‐infected patients in Myanmar. Our new, rapid screening method may be essential for the diagnosis of G6PD deficiency particularly in rural areas without electricity, and can be recommended for use in malaria control programmes.
The effectiveness of active population screening and treatment for sleeping sickness control in the Democratic Republic of Congo
Authors: Robays Jo , Bilengue Miaka Mia C. , Stuyft Patrick Van der , Boelaert Marleen 
Published: April 2004

SummaryBackground  The human African trypanosomiasis (HAT) control programme of the Democratic Republic of Congo (DRC) uses mass screening with the card agglutination test for trypanosomes (CATT). We looked at the contribution of CATT and improved parasitological confirmation to the effectiveness of screening and treatment.Method  The effectiveness of the screening and treatment process is measured by the percentage of HAT cases that is effectively cured after a single round of screening. The process is analysed in five steps: (i) the attendance at the screening, (ii) the sensitivity of the screening procedure, (iii) the sensitivity of the parasitological confirmation, (iv) the proportion of the confirmed cases that effectively receive treatment and (v) the cure rate of the treatment. We used a simplified model that multiplies proportions of infected persons that go through each step. We estimated these parameters using a combination of routine data collected by the national control programme over the period January 1997 to December 1998 and published data. For varying attendance rates we compared the effectiveness of screening strategies based on CATT or on CATT combined with improved parasitological confirmation by mini anion exchange column technique (mAECT) with the previously used strategy based on palpation of neck glands and microscopy alone.Results  The model shows that overall effectiveness of the active case detection and treatment strategy is <50% under most scenarios. Attendance rates averaged 74% but showed considerable regional variability and are a major problem in some areas of DRC. The CATT and replacing traditional parasitology by mAECT increases the sensitivity of the screening but a substantial part of the gains are lost at other stages of the screening process.Conclusion  Improvements of the HAT screening process such as introduction of CATT or mAECT only make sense if other parameters and attendance rate in particular are optimized at the same time.
Kikuchi–Fujimoto disease: immediate remission with ciprofloxacin
Authors: Mahajan Vikram K. , Sharma Nand L. 
Published: April 2004

An 18‐year‐old, human immunodeficiency virus (HIV)‐negative, male patient was referred for dermatologic opinion for reactive hyperplasia of the cervical lymph nodes on fine needle aspiration cytology. History revealed multiple, painful, progressively enlarging, left cervical lymph nodes associated with episodes of moderate to high fever for more than 1 year. There was no history of previous cutaneous lesions. On examination, the patient was afebrile and showed three left supraclavicular lymph nodes, 2–4 cm in size, which were discrete, tender, of firm to hard consistency but with normal overlying skin. Cutaneous and systemic examination was normal. Hemogram, hepatorenal function, and chest X‐ray film showed no significant abnormality, and the Mantoux test was negative. With the clinical possibilities of lymphoma, sarcoidosis, or tubercular lymphadenitis, one of the excised lymph nodes was subjected to histopathologic examination and acid‐fast bacilli (AFB) culture. The patient was given ciprofloxacin, 500 mg orally twice daily.The histopathology report became available 1 week later and showed a thickened capsule infiltrated by chronic inflammatory cells. There were large areas of necrosis with nuclear debris palisaded by histiocytes and a peripheral rim of lymphocytes. Occasional vessels also showed fibrinoid necrosis. Features of lymphoma, sarcoidosis, and tuberculosis were absent and the stain for AFB was negative. Despite the histopathology, suggesting histiocytic necrotizing lymphadenitis, tests performed for antinuclear antibodies were negative. Culture of the lymph node specimen on Lowenstien Jensen (LJ) medium for AFB did not show any growth.After 10 days of treatment with ciprofloxacin, the patient showed complete regression of lymphadenopathy. He is being regularly followed up.
Localized blastomycosis‐like pyoderma with good response to cotrimoxazol and cryotherapy
Authors: Su Özlem , Demirkesen Cuyan , Onsun Nahide 
Published: April 2004

AbstractBlastomycosis‐like pyoderma is an unusual, exaggerated, vegetative‐tissue reaction to a prolonged primary or secondary bacterial infection. It is a rare disease, usually seen in immunocompromized patients. We report a case of localized blastomycosis‐like pyoderma responding poorly to classic treatments, but that gave a dramatic response to a combination treatment of cotrimoxazol and cryotherapy.
Clinical management of obsessive‐compulsive‐bipolar comorbidity: a case series
Authors: Raja Michele , Azzoni Antonella 
Published: April 2004

Objective:  To assess the clinical characteristics and the optimal treatment of obsessive compulsive symptoms in patients with familial background, current or past symptoms consistent with a bipolar spectrum diagnosis.Methods:  Longitudinal clinical observation of seven cases with obsessive‐compulsive‐bipolar comorbidity.Results:  In the cases presented that met the DSM‐IV‐TR criteria for obsessive compulsive disorder (OCD), the concurrent symptoms and the clinical course pointed to a different principal diagnosis and suggested therapeutic strategies different from those currently recommended in OCD. Clear‐cut onset of symptoms, high prevalence of mood disorders in relatives, revaluation of their history, switch into mania induced by antidepressants, and clinical follow‐up suggested a hierarchical priority of bipolar diagnosis.Conclusions:  The presence of the aforementioned atypical symptoms should alert the physician about the possibility of bipolar comorbidity in OCD patients. If the suspicion is confirmed, bipolar diagnosis should have priority, at least from a therapeutic point of view. The first choice in treatment should be with mood stabilizers or second generation antipsychotics. Mood stabilization should be achieved as a first objective.
Management Buyouts and Human Resource Management
Authors: Bacon Nicolas , Wright Mike , Demina Natalia 
Published: April 2004

AbstractThis paper reports the findings from a survey of the effects of management buyouts on human resource management (HRM). Buyouts resulted in increased employment, the adoption of new reward systems, and expanded employee involvement. These developments support the resource‐based view that buyouts develop internal assets over agency theory predictions that managers will adopt a cost reduction approach. The type of buyout influences the subsequent development of HRM. Buyouts report more commitment‐orientated employment policies where employees own shares, and where the buyout pursues a ‘buy and build’ corporate strategy and adopts a business strategy of enhancing customer service and developing markets.
A Critical Assessment of the High‐Performance Paradigm
Authors: Godard John 
Published: April 2004

AbstractThis paper assesses research on the effects of high‐performance systems on employer, worker and union outcomes. It concludes that, compared with what has long been thought of as good management practice, claims that these systems yield superior performance outcomes may be unwarranted, and their implications for both workers and unions are at best uncertain. Conventional explanations for these findings are found to be insufficient. Alternative explanations involving the nature of the employment relation are proposed, and the need for an alternative paradigm, which promotes legal and institutional reforms, is established.
Raising the Quality of Home Care: A Study of Service Users’ Views
Authors: Francis Jennifer , Netten Ann 
Published: April 2004

Abstract Raising standards is one of the key objectives of the British government's Modernizing Agenda. The quality of life of vulnerable older people who are being maintained at home is fundamentally dependent on the quality of the home‐care services they receive, so raising standards of home care is clearly central to this agenda. This paper draws on a small‐scale study of service users and providers to examine the aspects of quality of home care of importance to older people, their experiences and barriers to improvement. Six key aspects of quality were investigated: reliability, continuity, flexibility, communication, staff attitudes and skills and knowledge. If performance indicators are to have the desired effect, more work needs to be done to ensure they reflect key aspects of quality from the user perspective. We identify potential areas for improvement in commissioning and organization but these all have resource implications that will need to be met if home care is to realize its full potential in maintaining and improving quality of life for older people.
The Use of Colonic Irrigation to Control Fecal Incontinence in Dogs With Colostomies
Authors: Williams Fred A. , Bright Ronald M. , Daniel Gregory B. , Hahn Kevin A. , Patton Steve A. 
Published: April 2004

ObjectiveTo determine if once‐daily colonic irrigation results in fecal continence for a 24‐hour period in dogs with colostomies and if colonic volume increased in response to the irrigation.Study DesignA prospective controlled experimental study.AnimalsFour intact male and one intact female mixed breed dogs.MaterialsAll dogs received left end‐on paralumbar colostomies. Four dogs received once‐daily colonic irrigation for 8 weeks, whereas the control dog did not. Daily fecal weights were recorded for the length of the study in all dogs. Barium enema studies and volumetric studies were used to determine colonic volumes.ResultsDaily fecal weights were significantly decreased in treatment dogs compared with the control dog. Colonic volume increased in irrigated dogs in response to daily irrigation over the 8 week period of the study.ConclusionsColonic irrigation resulted in significantly decreased fecal production over a 24‐hour period. Therefore management of dogs with colostomies would be more practical and cost effective. It did not result in complete fecal continence in this study. Further clinical studies are indicated to determine if longer periods of irrigation would result in complete continence.Clinical RelevanceIndications for colostomy in dogs are limited, but more radical surgical procedures for the treatment of colorectal neoplasia, trauma, and strictures might be possible if colostomy could be made more acceptable for owners. Colonic irrigation can make management of colostomies in dogs easier.
Surgical Palliation of Severe Tricuspid Valve Stenosis in a Dog by Use of Fontan's Procedure
Authors: Robertson Sheilah A. , Eyster George , Perry Ruby , Patterson V. 
Published: April 2004

Objective To describe surgical treatment of tricuspid valve stenosis using the Fontan procedure in a young dog.Study Design Case report.Sample Population One client‐owned dogResults A six month old female Labrador retriever was diagnosed with tricuspid obstruction. The dog had a displaced tricuspid valve and small right ventricle and had progressed to right‐sided (backward) cardiac failure. A Fontan procedure (connection of the right atrium to the pulmonary artery with a prosthetic conduit) was performed. Within three days the right atrial pressure had dropped from a preoperative value of 33 mmHg to 8 mmHg and the ascites was significantly reduced. The dog died suddenly two months after surgery. Postmortem examination of the heart showed a greatly enlarged right atrium and hypoplastic right ventricle. The tricuspid valve leaflets were fused and displaced ventrally leaving an opening measuring 3 × 5 mm between the chambers. The conduit was intact with no evidence of leakage or thrombosis.Conclusions Palliation of tricuspid stenosis using the Fontan procedure can be performed in dogs. Sudden death may occur and is most likely because of cardiac arrythmias.
Caudal Vena Cava Obstruction and Ascites in a Cat Treated by Balloon Dilation and Endovascular Stent Placement
Authors: Holt David , Saunders H. Mark , Aronson Lillian , Peikes Heather , Goldschmidt Micheal , Haskal Ziv J 
Published: April 2004

ObjectiveTo present details of an unusual case of caudal vena caval obstruction and its management in a cat.Study DesignClinical case report.Study PopulationA 15 month old male castrated domestic shorthaired cat.ResultsThe diagnostic evaluation included the use of digital subtraction angiography and ultrasonography to locate the caudal vena caval obstruction. Treatment initially involved puncture and balloon dilation of the obstructed area of the cava. After reobstruction, the stenotic area was redilated and stented. The cat was euthanatized 4 weeks later because of vomiting, anorexia, and abnormal behavior, presumed to be associated with liver disease.Conclusion and Clinical RelevanceInterventional radiography provided a minimally invasive way to manage this unusual vascular anomaly.
Keratinocyte Growth Factor Enhances Early Gut Adaptation in a Rat Model of Short Bowel Syndrome
Authors: Johnson Will F. , DiPalma Christopher R. , Ziegler Thomas R. , Scully Sheila , Farrell Catherine L. 
Published: April 2004

Objective— To evaluate the effects of keratinocyte growth factor (KGF) on intestinal adaptation after resection of 85% of the small intestine and consider its potential application in short bowel syndrome (SBS).Study Design— Experimental study using a known model of SBS.Animal Population— Thirty male Sprague Dawley rats.Methods— Four groups of animals were designated. Two groups underwent 85% resection of the small intestine, while the other two groups were sham‐operated, undergoing transection and reanastomosis. Resected and sham‐operated groups then received either 3 mg/kg KGF or vehicle subcutaneously daily for 3 days. Gut adaptation was evaluated by measurements of mucosal cellularity and biochemical activity in duodenal, jejunal, and ileal segments.Results— Significant small intestinal growth after bowel resection alone was confirmed in resected versus sham‐operated rats. KGF further augmented this growth in the resected animals. Mucosal wet weight of the small intestine increased with resection and was further increased (by 20% or more) with KGF administration. Mucosal thickness, villus length, and crypt depth exhibited similar patterns of response. The KGF‐induced increase in mucosal morphology was accompanied by increased mucosal DNA and protein content, followed by a trend toward increased mucosal enzyme activity. Histology demonstrated an increase in goblet cells in KGF‐treated animals. In situ hybridization analysis demonstrated that KGF markedly increased mucosal expression of intestinal trefoil protein (ITF) mRNA.Conclusions— KGF enhances gut growth, differentiation, and gene regulation during adaptation in rat small intestine after massive resection.Clinical Relevance— KGF may be beneficial in the management of veterinary and human patients undergoing massive intestinal resection.
Evaluation of a Bioresorbable Hyaluronate‐Carboxymethylcellulose Membrane for Prevention of Experimentally Induced Abdominal Adhesions in Horses
Authors: Mueller P.O. Eric , Hay William P. , Harmon Barry , Amoroso Lisa 
Published: April 2004

Objective—To evaluate the efficacy of a bioresorbable hyaluronate‐carboxymethylcellulose membrane (HA‐membrane) for prevention of experimentally induced abdominal adhesions in horses.Study Design—Experimental study.Animal Population—Twelve healthy adult horses.Methods—The effect of an HA‐membrane on adhesion formation was evaluated in 12 healthy horses using an established model of serosal trauma to induce adhesions. A ventral median celiotomy and two jejunal resections and end‐to‐end anastomoses were performed. Two separate jejunal areas were abraded, and three 2–0 chromic gut sutures placed in the abraded areas. In treated horses (n = 6), HA‐membranes were applied to the jejunum to completely cover the anastomoses and abraded areas of jejunum. Nontreated horses (n = 6) served as controls. All horses were killed 10 days after surgery. The abdominal cavity was evaluated for adhesion formation. The frequency of intra‐abdominal adhesions between groups was compared with ax2test with statistical significance set atP< .05..Results—All control horses had intra‐abdominal adhesions; fibrous adhesions were associated with both jejunal abrasion sites in 5 horses. One treated horse developed adhesions. There were significantly fewer adhesions in the HA‐membrane‐treated group (P< .0034).Conclusions—In this experimental model, application of an HA‐membrane to a localized area of serosal trauma reduced the frequency of intra‐abdominal adhesion formation.Clinical Relevance—Application of an HA membrane may decrease the frequency of adhesions in horses at an increased risk of postoperative adhesion formation.