bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kindler syndrome
Authors: Sharma Ramesh Chander , Mahajan Vikram , Sharma Nand Lal , Sharma Ashok K. 
Published: September 2003

AbstractKindler syndrome is a rare genodermatosis characterized by acral bullae and photosensitivity. The photosensitivity improves with advancing age and results in progressive poikiloderma and cutaneous atrophy, and many additional features have also been described. This report describes two male Kindler syndrome patients with classical features of acral blistering and photosensitivity in childhood, and subsequent development of poikiloderma, leukokeratosis of oro‐ano‐genital mucosae, phimosis and meatal stenosis. The first patient had additional ophthalmic features of chronic simple conjunctivitis caused by persistent irritation, multiple stromal nebular corneal opacities and thickened corneal nerves. The second patient showed skeletal changes, namely a dome‐shaped skull (turri‐cephaly), bifid fourth rib, missing fifth rib, short fourth and fifth metacarpals and mandibular abnormalities. This is the first report of such ophthalmic and skeletal features of Kindler syndrome.
The presence of trichodynia in patients with telogen effluvium and androgenetic alopecia
Authors: Kivanç‐Altunay İlknur , Savaş Canan , Gökdemir Gonca , Köşlü Adem , Ayaydin Eşber Baki 
Published: September 2003

AbstractBackground  Trichodynia refers to pain, discomfort, and/or paresthesia in the skin of the scalp or the hair. There may be an associated psychologic comorbidity. Although androgenetic alopecia (AGA) and telogen effluvium (TE) are different entities in terms of pathogenesis, etiology, and clinical picture, both may be influenced by psychologic stress and may be the cause of secondary stress.Aims  To investigate the presence of trichodynia in patients with TE and AGA and to evaluate psychologic comorbidity in patients with trichodynia.Materials and methods  A total of 248 patients (153 females, 95 males), presenting with hair loss due to either TE or AGA, were enrolled in this study. The prevalence of trichodynia in these two groups was compared with that in controls (n = 184). In addition, psychiatric evaluation was performed in 25 patients with trichodynia (13 females, 12 males) and in 25 controls (16 females, nine males) without alopecia and trichodynia by a psychiatrist; Diagnostic and Statistical Manual of Mental Disorders (DSM)IV criteria were used for the assessment.Results  Trichodynia was found in 72 patients (29%) with hair loss and in six controls (3.3%; P < 0.0001); 25 of the 72 patients with trichodynia underwent psychiatric evaluation and 19 of the 25 patients were found to have psychopathologic signs (76%). In the control group, only five patients had psychopathologic signs (20%; P = 0.0004). Of those with hair loss, trichodynia was more frequent in the TE group than in the AGA group (P < 0.0071).Conclusions  Trichodynia is a common symptom in patients with TE and AGA, and often coexists with psychopathologic findings, including depression, obsessive personality disorder, and anxiety.
Nurse initiated thrombolysis in the accident and emergency department: safe, accurate, and faster than fast track
Authors: Heath S M , Bain R J I , Andrews A , Chida S , Kitchen S I , Walters M I 
Published: September 2003

Objective:To reduce the time between arrival at hospital of a patient with acute myocardial infarction and administration of thrombolytic therapy (door to needle time) by the introduction of nurse initiated thrombolysis in the accident and emergency department.Methods:Two acute chest pain nurse specialists (ACPNS) based in A&E for 62.5 hours of the week were responsible for initiating thrombolysis in the A&E department. The service reverts to a “fast track” system outside of these hours, with the on call medical team prescribing thrombolysis on the coronary care unit. Prospectively gathered data were analysed for a nine month period and a head to head comparison made between the mean and median door to needle times for both systems of thrombolysis delivery.Results:Data from 91 patients were analysed; 43 (47%) were thrombolysed in A&E by the ACPNS and 48 (53%) were thrombolysed in the coronary care unit by the on call medical team. The ACPNS achieved a median door to needle time of 23 minutes (IQR=17 to 32) compared with 56 minutes (IQR=34 to 79.5) for the fast track. The proportion of patients thrombolysed in 30 minutes by the ACPNS and fast track system was 72% (31 of 43) and 21% (10 of 48) respectively (difference=51%, 95% confidence intervals 34% to 69%, p<0.05).Conclusion:Diagnosis of acute myocardial infarction and administration of thrombolysis by experienced cardiology nurses in A&E is a safe and effective strategy for reducing door to needle times, even when compared with a conventional fast track system.
Objective evaluation of ERCP procedures: a simple grading scale for evaluating technical difficulty
Authors: Ragunath K , Thomas L A , Cheung W Y , Duane P D , Richards D G 
Published: September 2003

Abstract

Background and objective
Endoscopic retrograde cholangiopancreatography (ERCP) is a technically demanding endoscopic procedure that varies from a simple diagnostic to a highly complex therapeutic procedure. Simple outcome measures such as success and complication rates do not reflect the competence of the operator or endoscopy unit, as case mix is not taken into account. A grading scale to assess the technical difficulty of ERCP can improve the objectivity of outcome data.

Methods
A I to IV technical difficulty grading scale was constructed and applied prospectively to all ERCPs over a 12 month period at a single centre. The procedures were performed by two senior trainees and two experienced consultants (trainers). The grading scale was validated for construct validity and inter-rater reliability at the end of the study using the χ2 test and κ statistics.

Results
There were 305 ERCPs in 259 patients over the 12 months study period (males: 112, females: 147, age range 17–97, mean 70.3 years). There was overall success in 244 (80%) procedures with complications in 13 (4%): bleeding in five (1.6%), cholangitis in one (0.3%), pancreatitis in five (1.6%), and perforation in two (0.7%). Success rate was highest for grade I, 49/55 (89%), compared with grade IV procedures, 8/11 (73%). There was a significant linear trend towards a lower success rate from grade I to IV (p=0.021) for trainees, but not for trainers. Complications were low in grade I, II, and III procedures, 12/295(4%), compared with grade IV procedures, 1/11(9%). The inter-rater reliability for the grading scale was good with a substantial agreement between the raters (κ=0.68, p&lt;0.001).

Conclusion
Success and complications of ERCP by trainees are influenced by the technical difficulty of the procedure. Outcome data incorporating a grading scale can give accurate information when auditing the qualitative outcomes. This can provide a platform for structured objective evaluation.
Retrospective audit of the value of the pancreolauryl test in a district general hospital
Authors: Murray I A , Clenton S , McGeorge B A , Safe A F 
Published: September 2003

Abstract

Objectives
To audit the specificity and value of the pancreolauryl test (PLT) for the diagnosis of pancreatic insufficiency.

Design
A retrospective case note review of 47 patients who had a PLT during three consecutive years.

Setting
A 650 bedded district general hospital.

Main outcome measures
Patient demographics, symptoms, baseline blood, endoscopic and radiological investigations, and alcohol consumption were related to the results of the PLT to determine if the test could be better targeted. Response to therapy and final diagnoses were noted to determine the specificity of the test.

Results
Forty seven patients had a PLT during the three years studied. All successfully performed the test as outpatients. Seven inconclusive tests were repeated. Thirty eight patients (81%) had diarrhoea, of whom 10 (21%) described steatorrhoea; 23 (49%) had an abnormal PLT. All with an abnormal test had diarrhoea, more frequently describing watery stools than steatorrhoea. Those treated with pancreatic enzyme supplements had an excellent response, although two of these had a final diagnosis of coeliac disease. Nineteen patients with an abnormal PLT were thought to be suffering from pancreatic insufficiency. All patients with a normal PLT were clinically thought not to have pancreatic insufficiency. Age, sex, and alcohol intake correlated poorly with final diagnosis.

Conclusions
The PLT can be used in a district general hospital setting as an outpatient test for pancreatic insufficiency and has a specificity of 83%–91%. Its use should be restricted to thse presenting with diarrhoea, not necessarily steatorrhoea, and not restricted to those with a history of high alcohol consumption.
Generation of Superoxide by Synthetic Polymers Containing Reducing Sugar Branches
Authors: Kitagawa Masaru , Tokiwa Yutaka 
Published: September 2003

Abstract
Generation of superoxide from a polymer containing reducing sugar branches, poly(6-O-vinyladipoyl-D-glucose), was observed by the reduction of nitroblue tetrazolium (NBT), and the activity tended to increase with increasing molecular weight of the polymer.
Control of Hydrophobic Character of Super-water-repellent Surface by UV Irradiation
Authors: Sasaki Hiroshi , Shouji Mitsuyoshi 
Published: September 2003

Abstract
The hydrophobic character of a super-water-repellent surface (the contact angle for water is more than 150 degrees) can be changed by UV irradiation due to photoisomerization of malachite green carbinol base coated on the surface.
Formation and Spectroscopic Characterization of the PeroxoFeIII-CuII Complex. A Modeling Reaction of the Heme-Cu Site in Cytochrome c Oxidase
Authors: Sasaki Takao , Nakamura Nobuhumi , Naruta Yoshinori 
Published: September 2003

Abstract
Formation of a unique peroxo complex FeIITPP(O2)-CuITPA 2 was observed in the oxygenated reaction of FeIITPP-CuITPA 1 with O2 at ambient temperature. This complex was characterized by electronic absorption, ESI-MS, resonance Raman, and ESR spectroscopies.
Formation of Ruthenium Colloid in Ethylene Glycol
Authors: Miyazaki Akane , Takeshita Kenji , Aika Ken-ichi , Nakano Yoshio 
Published: September 2003

Abstract
Ruthenium metal colloid was produced by the reduction of RuCl3 in ethylene glycol. The metal particles observed by TEM had uniform shape and size, less than 5 nm in diameter. The particles agglomerated easily at pH higher than 3. When the pH value of the solution was decreased to 2, the colloidal particles were dispersed well due to the increase of the surface charge.
Cycloreductions via Alkylpalladium Intermediates: Substrate Dependent Cyclopropanations of Palladium Catalyzed Enediyne Cyclizations
Authors: Oh Chang Ho , Kang Ji Hye , Rhim Chul Yun , Kim Ji Hyang 
Published: September 2003

Abstract
We have found for the first time that enediynes possessing an etheral oxygen in the appropriate position have been successfully cyclized via the alkylpalladium intermediates to the corresponding cyclopropane compounds.
Mapping the ancient port at the archaeological site of Itanos (Greece) using shallow seismic methods
Authors: Vafidis A. , Manakou M. , Kritikakis G. , Voganatsis D. , Sarris A. , Kalpaxis Th. 
Published: September 2003

AbstractA shallow seismic survey was carried out at the archaeological site of Itanos, Crete to locate and map the ancient port. The target layer in the area surveyed consists of Permian–Triassic phyllites covered by alluvial deposits. Seismic refraction and reflection experiments were carried out along eight profiles with a total length 580 m.The seismic refraction data depict two refractors. Shear‐wave velocities indicate that the first refractor, at depths ranging from 1 to 2 m, corresponds to the water table. The second one corresponds to the top of phyllites. The stacked section from the seismic reflection survey shows two major reflectors, attributed to the top and bottom of the eroded phyllites. A three‐dimensional image of the basement relief indicated the potential shape and extent of Itanos port.This result is further supported by anthropogenic anomalies on the resistivity maps and sections observed at locations where the depth to the top of the basement is small. The integration of the seismic data, aerial imagery and archaeological findings indicated that the ancient port, now covered by recent deposits, was surrounded by the sea, the two acropolis to the north, a well to the east and a hill to the south. Copyright © 2003 John Wiley & Sons, Ltd.
How welfare reform affects young children: Experimental findings from Connecticut—A research note
Authors: Loeb Susanna , Fuller Bruce , Kagan Sharon Lynn , Carrol Bidemi 
Published: September 2003

AbstractAs welfare‐to‐work reforms increase women's labor market attachment, the lives of their young children are likely to change.
This
note draws on a random‐assignment experiment in Connecticut to ask whether mothers' rising employment levels and program participation
are
associated with changes in young children's early learning and cognitive growth. Children of mothers who entered Connecticut's Jobs First
program, an initiative with strict 21‐month time limits and work incentives, displayed moderate advantages in their early learning, compared
with those in a control group. A number of potential mechanisms for this effect are explored, including maternal employment and income, home
environment, and child care. Mothers in the new welfare program are more likely to be employed, have higher income, are less likely to be married,
have
more children's books in their home, and take their children to libraries and museums more frequently. However, these effects explain little of
the observed gain in child outcomes. Other parenting practices and the home's social environment do explain early learning, but these remained
unaffected by welfare reform. © 2003 by the Association for Public Policy Analysis and Management
Adolescents’ attributions about aggression: an initial investigation
Authors: Boxer Paul , Tisak Marie S 
Published: September 2003

AbstractThis study examined causal attributions about aggression made by 362 participants from three age groups: early (138 7th and 8th graders), middle (121 11th and 12th graders), and late (103 college students through age 22) adolescence. Participants read a brief vignette describing a peer who displayed either proactive (non‐emotional, instrumental) or reactive (emotional, undercontrolled) aggression. Participants then rated the extent to which they attributed each of 48 descriptors to be causes for the peer's aggressive behaviour. Confirmatory factor analyses of the attribution questionnaire supported the hypothesized model of causal beliefs. The strength of endorsements of internally oriented causal factors increased with age. Findings are discussed with regard to social–cognitive development in adolescence and implications for future research on aggression in the peer context.
Myosin heavy chain isoforms in postnatal muscle development of mice
Authors: Agbulut Onnik , Noirez Philippe , Beaumont Françoise , Butler‐Browne Gillian 
Published: September 2003

AbstractIn this study, using a high‐resolution gel electrophoresis technique, we have characterized the myosin heavy chain composition in different skeletal muscle of the mouse during postnatal development. The pattern of myosin heavy chain expression was studied in four hind limb muscles, the diaphragm, the tongue and the masseter. All of these muscles displayed the usual sequential transitions from embryonic to neonatal and to adult myosin heavy chain isoforms but more interestingly these transitions occur with a distinct chronology in the different muscles. In addition, our results demonstrated a transitory pattern of expression for certain adult myosin heavy chain isoforms in the soleus and the tongue. In the soleus muscle IIB and in the tongue IIA myosin heavy chain isoforms were detected only for a short time during postnatal life. Our results demonstrate that muscles of the mouse with different functions are subjected to a distinct programs of myosin isoform transitions during postnatal muscle development. This study describes new data which will help us to understand both postnatal muscle development in transgenic mouse muscles as well as in muscle pathology.
New insight into the mechanism of hip prosthesis loosening: Effect of titanium debris size on osteoblast function
Authors: O'Connor Daniel T. , Choil Moon G. , Kwon Soon Y. , Sung K.‐L. Paul 
Published: September 2003

AbstractThe incidence of rheumatoid arthritis and osteoarthritis is on the rise due to our expanding elderly population. Total joint arthroplasty is the most successful, prevalent treatment modality for these and other degenerative hip conditions. Despite the wide array of prosthetic devices commercially available, hip prostheses share a common problem with a gradual and then accelerating loss of bone tissue and bone–implant interface integrity, followed by implant instability and loosening. Implant failure is largely the result of inevitable wear of the device and generation of wear debris. To provide information for the development of improved prosthetic wear characteristics, we examined the effects of size‐separated titanium particles on bone forming cell populations. We demonstrate unequivocally that particle size is a critical factor in the function, proliferation, and viability of bone‐forming osteoblasts in vitro. In addition, we have elucidated the time‐dependent distribution of the phagocytosed particles within the osteoblast, indicating an accumulation of particles in the perinuclear area of the affected cells. The report finds that particle size is a critical factor in changes in the bone formation‐related functions of osteoblasts exposed to simulate wear debris, and that 1.5–4 μm titanium particles have the greatest effect on osteoblast proliferation and viability in vitro. The size of titanium particles generated through wear of a prosthetic device may be an important consideration in the development of superior implant technology. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
Three case reports of emergent dyskinesia with clozapine
Authors: Gafoor Rafael , Brophy Justin 
Published: September 2003

AbstractClozapine is indicated for the treatment of patients intolerant of conventional antipsychotic agents. It is often used to treat those patients who have developed movement disorders while on conventional antipsychotics. We report three cases of dyskinesia associated with clozapine induction. We suggest a mechanism that might explain an underlying dopaminergic hypersensitivity during this transitional period. Further, we identify groups that might be at high risk of developing dyskinesia and suggest strategies to reduce risk especially in these groups.
The challenge of chronic insomnia: is non-nightly hypnotic treatment a feasible alternative?
Authors: Hajak G. , Cluydts R. , Allain H. , Estivill E. , Parrino L. , Terzano M.G. , Walsh J.K. 
Published: September 2003

AbstractThe adverse effects of insomnia on health and quality of life are matters receiving increasing attention. Yet, surveys have consistently shown that most people suffering from insomnia do not seek medical help, perhaps, in part, because of a concern of becoming dependent on hypnotic medication. The treatment of chronic insomnia poses a particular dilemma in that continuous hypnotic treatment is restricted in many countries to a maximum of 4 weeks, and behavioural treatment is not readily available. Non-nightly hypnotic treatment of chronic insomnia offers a promising alternative option for the many patients whose symptoms do not necessitate nightly drug intake, allaying fears of psychological dependence on medication and respecting regulatory constraints on hypnotic use while providing patients with adequate symptom relief. The practical feasibility and efficacy of this approach has been demonstrated with zolpidem using various treatment regimens and study designs. So far, six clinical trials have been completed on over 4000 patients. Published results show effective treatment of insomnia without any evidence of either adverse event associated with a discontinuous regimen or increased hypnotic use over the treatment period.
Blending Specialist and Practitioner Roles in Psychiatric Nursing: Experiences of Graduates
Authors: Scharer Kathleen , Boyd Mary , Williams Carol A. , Head Kathleen 
Published: September 2003

BACKGROUND: Blended roles in advanced practice nursing have generated much discussion but little study. As role modifications emerge in nursing, there is a need to explore their implementation. OBJECTIVE: This descriptive study examined the experiences of nurses who were implementing blended roles as psychiatric clinical specialists and adult nurse practitioners. DESIGN: Four master of science in nursing and 10 postmasters nurses who had been practicing in blended roles for 1 to 2 years were interviewed about their experiences in implementing their roles. Interviews were tape recorded, transcribed, and content analyzed. RESULTS: Respondents believed they were practicing holistically, were able to appropriately integrate physical and psychological care of the patient, and found chronic psychiatric patients to have more complex physical illnesses than they had anticipated. In addition, the advanced practice nurses were satisfied with their roles, felt supported by their physician preceptors, and described cross-consultation with physicians and nonpsychiatric nurse practitioners. CONCLUSIONS: There are roles for advanced practice nurses who blend clinical specialist and adult nurse practitioner skills in the care of psychiatric and primary care patients.
A prospective study of maternal smoking and spontaneous abortion
Authors: Wisborg Kirsten , Kesmodel Ulrik , Henriksen Tine Brink , Hedegaard Morten , Secher Niels Jørgen 
Published: September 2003

Background.  Cigarette smoking has been considered a risk factor for spontaneous abortion, but conclusions from many studies may be impaired by methodological problems. Studies are required that use data on smoking habits collected before knowledge about outcome of pregnancy and in which adjustment is made for potential confounders.Methods.  All Danish‐speaking pregnant women booking for delivery at the Department of Obstetrics and Gynecology, Aarhus University Hospital, from September 1989 to August 1996 were invited to participate in the study (n = 24 608 pregnancies, including 321 spontaneous abortions and 100 induced abortions). Information about smoking habits before pregnancy and during the first trimester was obtained from self‐administered questionnaires before the knowledge about pregnancy outcome. Information about spontaneous and induced abortions was obtained from the Danish National Patient Registry. We used Cox regression analyses with delayed entry (left truncation) for analyses, and hazard ratios to express the association between smoking and spontaneous abortion. Multivariate analyses were performed using a model including alcohol and coffee intake during pregnancy, maternal age, marital status, occupation, education, prepregnancy body mass index, and parity.Results.  Overall, 104 (1.3%) of those contributing time at risk in the first trimester experienced a spontaneous abortion in the first trimester, and 217 (0.9%) of those contributing time at risk in the second trimester experienced a second‐trimester abortion. We found no association between smoking and first‐ and second‐trimester abortions. Adjustment for alcohol, coffee, maternal age, marital status, occupation, education, prepregnancy body mass index and parity did not change the result substantially.Conclusion.  Our study did not support findings from previous studies of an association between smoking and spontaneous abortion.