bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lycopene from two food sources does not affect antioxidant or cholesterol status of middle-aged adults
Authors: Collins JK , Arjmandi BH , Claypool PL , Perkins-Veazie P , Baker RA , Clevidence BA 
Published: September 2004

Abstract
Background
Epidemiological studies have reported associations between reduced cardiovascular disease and diets rich in tomato and/or lycopene. Intervention studies have shown that lycopene-containing foods may reduce cholesterol levels and lipid peroxidation, factors implicated in the initiation of cardiovascular disease. The objective of this study was to determine whether consumption of lycopene rich foods conferred cardiovascular protection to middle-aged adults as indicated by plasma lipid concentrations and measures of ex vivo antioxidants.

Methods
Ten healthy men and women consumed a low lycopene diet with no added lycopene (control treatment) or supplemented with watermelon or tomato juice each containing 20 mg lycopene. Subjects consumed each treatment for three weeks in a crossover design. Plasma, collected weekly was analyzed for total cholesterol, high density lipoprotein cholesterol (HDL-C) and triglyceride concentrations and for the antioxidant biomarkers of malondialdehyde formation products (MDA), plasma glutathione peroxidase (GPX) and ferric reducing ability of plasma (FRAP). Data were analyzed using Proc Mixed Procedure and associations between antioxidant and lipid measures were identified by Pearson's product moment correlation analysis.

Results
Compared to the control diet, the lycopene-containing foods did not affect plasma lipid concentrations or antioxidant biomarkers. Women had higher total cholesterol, HDL-C and triglyceride concentrations than did the men. Total cholesterol was positively correlated to MDA and FRAP while HDL-C was positively correlated to MDA and GPX. GPX was negatively correlated to triglyceride concentration.

Conclusions
The inclusion of watermelon or tomato juice containing 20 mg lycopene did not affect plasma lipid concentrations or antioxidant status of healthy subjects. However, plasma cholesterol levels impacted the results of MDA and FRAP antioxidant tests.
Variable Surface Glycoprotein RoTat 1.2 PCR as a specific diagnostic tool for the detection of Trypanosoma evansiinfections
Authors: Claes Filip , Radwanska Magda , Urakawa Toyo , Majiwa Phelix AO , Goddeeris Bruno , Büscher Philip 
Published: September 2004

Abstract
Background
Based on the recently sequenced gene coding for the Trypanosoma evansi (T. evansi) RoTat 1.2 Variable Surface Glycoprotein (VSG), a primer pair was designed targeting the DNA region lacking homology to other known VSG genes. A total of 39 different trypanosome stocks were tested using the RoTat 1.2 based Polymerase Chain Reaction (PCR).

Results
This PCR yielded a 205 bp product in all T. evansi and in seven out of nine T. equiperdum strains tested. This product was not detected in the DNA from T. b. brucei, T. b. gambiense, T. b. rhodesiense, T. congolense, T. vivax and T. theileri parasites. The Rotat 1.2 PCR detects as few as 10 trypanosomes per reaction with purified DNA from blood samples, i.e. 50 trypanosomes/ml.

Conclusion
PCR amplification of the RoTat 1.2 VSG gene is a specific marker for T. evansi strains, except T. evansi type B, and is especially useful in dyskinetoplastic strains where kDNA based markers may fail to amplify. Furthermore, our data support previous suggestions that some T. evansi stocks have been previously misclassified as T. equiperdum.
Incidence, risk factors and mortality of nosocomial pneumonia in Intensive Care Units: A prospective study
Authors: Alp Emine , Güven Muhammet , Yıldız Orhan , Aygen Bilgehan , Voss Andreas , Doganay Mehmet 
Published: September 2004

AbstractTo determine the frequency, risk factors and mortality of nosocomial pneumonia a prospective study was conducted in the intensive care units. In the study period, 2402 patients were included. The nosocomial pneumonia was defined according to the Centers for Disease Control Criteria. Overall, 163 (6.8%) of the patients developed nosocomial pneumonia and 75.5% (n = 123) of all patients with nosocomial pneumonia were ventilator-associated pneumonia. 163 patients who were admitted to the intensive care unit during the same period but had no bacteriologic or histologic evidence of pneumonia were used as a control group. The APACHE II score, coma, hypoalbuminemia, mechanical ventilation, tracheotomy, presence of nasogastric tube were found as independent risk factors. Crude and attributable mortality were 65% and 52.6%, respectively. The mortality rate was five times greater in the cases (OR: 5.2; CI 95%: 3.2–8.3). The mean length of stay in the intensive care unit and hospital in the cases were longer than controls (p < 0.0001). Patients requiring mechanical ventilation have a high frequency of nosocomial pneumonia.
Assessing response bias from missing quality of life data: The Heckman method
Authors: Sales Anne E , Plomondon Mary E , Magid David J , Spertus John A , Rumsfeld John S 
Published: September 2004

Abstract
Background
The objective of this study was to demonstrate the use of the Heckman two-step method to assess and correct for bias due to missing health related quality of life (HRQL) surveys in a clinical study of acute coronary syndrome (ACS) patients.

Methods
We analyzed data from 2,733 veterans with a confirmed diagnosis of acute coronary syndromes (ACS), including either acute myocardial infarction or unstable angina. HRQL outcomes were assessed by the Short-Form 36 (SF-36) health status survey which was mailed to all patients who were alive 7 months following ACS discharge. We created multivariable models of 7-month post-ACS physical and mental health status using data only from the 1,660 survey respondents. Then, using the Heckman method, we modeled survey non-response and incorporated this into our initial models to assess and correct for potential bias. We used logistic and ordinary least squares regression to estimate the multivariable selection models.

Results
We found that our model of 7-month mental health status was biased due to survey non-response, while the model for physical health status was not. A history of alcohol or substance abuse was no longer significantly associated with mental health status after controlling for bias due to non-response. Furthermore, the magnitude of the parameter estimates for several of the other predictor variables in the MCS model changed after accounting for bias due to survey non-response.

Conclusion
Recognition and correction of bias due to survey non-response changed the factors that we concluded were associated with HRQL seven months following hospital admission for ACS as well as the magnitude of some associations. We conclude that the Heckman two-step method may be a valuable tool in the assessment and correction of selection bias in clinical studies of HRQL.
Caring for family members with chronic physical illness: A critical review of caregiver literature
Authors: Lim Jung-won , Zebrack Brad 
Published: September 2004

AbstractThis article reviews 19 studies (1987–2004) on quality of life for family caregivers helping those with chronic physical illness. Here we explore the concepts of and instruments used to measure caregivers' quality of life. We were particularly interested in understanding stress-related variables and documenting factors influencing quality of life based on family stress theory. Findings show that various positive and negative terms equated with quality of life were used to measure them. Results indicate that stress-related variables as possible predictors influencing caregivers' quality of life include: patient and caregiver characteristics, stressors, stress appraisal, stress coping methods, and social support. Our recommendations touch upon applying theory for intervention, developing measurement, making operable the concepts for measuring, and the need for longitudinal and comprehensive study.
Imbalance in the health workforce
Authors: Zurn Pascal , Dal Poz Mario R , Stilwell Barbara , Adams Orvill 
Published: September 2004

AbstractImbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. The framework emphasizes the number and types of factors affecting health workforce imbalances, and facilitates the development of policy tools and their assessment. Moreover, to facilitate comparisons between health workforce imbalances, a typology of imbalances is proposed that differentiates between profession/specialty imbalances, geographical imbalances, institutional and services imbalances and gender imbalances.
Preoperative Sensitivity and Specificity for Early-Stage Ovarian Cancer When Combining Cancer Antigen CA-125II, CA 15-3, CA 72-4, and Macrophage Colony-Stimulating Factor Using Mixtures of Multivariate Normal Distributions
Authors: Skates Steven J. , Horick Nora , Yu Yinhua , Xu Feng-Ji , Berchuck Andrew , Havrilesky Laura J. , de Bruijn Henk W.A. , van der Zee Ate G.J. , Woolas Robert P. , Jacobs Ian J. , Zhang Zhen , Bast Robert C. 
Published: September 2004

Purpose In CA-125–based ovarian cancer screening trials, overall specificity and screening sensitivity of ultrasound after an elevated CA-125 exceeded 99.6% and 70%, respectively, thereby yielding a positive predictive value (PPV) exceeding 10%. However, sensitivity for early-stage disease was only 40%. This study aims to increase preoperative sensitivity for early-stage ovarian cancer while maintaining the annual referral rate to ultrasound at 2% by combining information across CA-125II, CA 15-3, CA 72-4, and macrophage colony-stimulating factor (M-CSF). For direct comparisons between marker panels, all sensitivity results correspond to a 98% fixed first-line specificity (referral rate 2%). Patients and Methods Logistic regression, classification tree, and mixture discriminant analysis (MDA) models were fit to a training data set of preoperative serum measurements (63 patients, 126 healthy controls) from one center. Estimates from the training set applied to an independent validation set (60 stage I to II patients, 98 healthy controls) from two other centers provided unbiased estimates of sensitivity. Results Preoperative sensitivities for early-stage disease of the optimal panels were 45% for CA-125II; 67% for CA-125II and CA 72-4; 70% for CA-125II, CA 72-4, and M-CSF; and 68% for all four markers (latter two results using MDA). Conclusion Efficiently combining information on CA-125II, CA 72-4, and M-CSF significantly increased preoperative early-stage sensitivity from 45% with CA-125II alone to 70%, while maintaining 98% first-line specificity. Screening trials with these markers using MDA followed by referral to ultrasound may maintain previously high levels of specificity and PPV, while significantly increasing early-stage screening sensitivity. MDA is a useful, biologically justified method for combining biomarkers.
Incidence and Predictors of Low Chemotherapy Dose-Intensity in Aggressive Non-Hodgkin's Lymphoma: A Nationwide Study
Authors: Lyman Gary H. , Dale David C. , Friedberg Jonathan , Crawford Jeffrey , Fisher Richard I. 
Published: September 2004

Purpose To assess the incidence of and risk factors for reduced relative dose-intensity (RDI) in patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma (NHL). Methods A nationwide survey was conducted of 567 oncology practices with data extracted from the records of 4,522 patients with aggressive NHL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP); CHOP-rituximab (CHOP-R); or cyclophosphamide, mitoxantrone, vincristine, and prednisone (CNOP). The primary outcome was the average RDI for each regimen based on both planned and reference standards. Other assessments included the incidence of febrile neutropenia and patterns of colony-stimulating factor (CSF) use, as well as the average RDI in high-risk subgroups. Results Dose reductions ≥ 15% occurred in 40% of patients and treatment delays ≥ 7 days occurred in 24% of patients, resulting in 53% and 48% of patients receiving an RDI less than 85% of the minimum six-cycle and National Comprehensive Cancer Network guideline standards, respectively. Reduced RDI was more prevalent in older patients, with 60% of patients older than 60 years receiving RDI less than 85%. Multivariate analysis identified several independent predictors for reduced RDI, including age older than 60 years, advanced disease stage, poor performance status, and no prophylactic CSF use. Age was no longer a significant risk factor in patients who received prophylactic CSF. Conclusion Patients with aggressive and potentially curable NHL treated with CHOP, CHOP-R, or CNOP frequently receive reduced RDI. Predictive models based on the risk factors identified for reduced RDI should enable the targeted use of appropriate supportive care, facilitating the delivery of full chemotherapy doses on schedule.
Evaluation of Bleeding Complications Associated with Glycoprotein IIb/IIIa Inhibitors
Authors: Brouse Sara D , Wiesehan Vanessa G 
Published: September 2004

BACKGROUND Platelet glycoprotein IIb/IIIa inhibitors are used with aspirin and heparin to decrease rates of death, myocardial infarction, and urgent revascularization in patients with acute coronary syndromes. OBJECTIVE To determine whether bleeding event rates differed among 3 glycoprotein IIb/IIIa inhibitors prescribed in a high-risk, elderly veteran population and identify risk factors for bleeding. METHODS A retrospective chart analysis of patients who received abciximab, eptifibatide, or tirofiban was conducted. χ2 Analysis evaluated the incidence of bleeding complications, and stepwise regression analysis was utilized to identify bleeding risk factors. Parameters evaluated as possible risk factors for bleeding included age, renal function, weight, heparin and glycoprotein IIb/IIIa inhibitor dosing and infusion duration, concomitant antiplatelet and/or anticoagulant medications or disease states, and baseline hemoglobin, hematocrit, or platelet counts. RESULTS Of 348 patients whose charts were reviewed, 79 patients were included. There were 37.9% who received abciximab (n = 30), 30.3% who received eptifibatide (n = 24), and 31.6% who received tirofiban (n = 25). Twenty-one bleeding events not related to coronary artery bypass grafting occurred: only 1 major bleed (tirofiban) and 20 minor bleeds. Bleeding rates were not significantly different between groups: abciximab 30% (n = 9), eptifibatide 21% (n = 5), and tirofiban 28% (n = 7). Significant risk factors for bleeding included patient weight, infusion duration, and baseline platelet count (p = 0.024). Patients who bled received significantly more transfusions of packed red blood cells and platelets than patients with no bleeding (p = 0.047). CONCLUSIONS Although bleeding complications did not differ significantly between the 3 drugs, several risk factors for bleeding events were identified. A considerable rate of bleeding events occurred in this high-risk patient population.
Hypotension Due to Interaction Between Lisinopril and Tizanidine
Authors: Kao Chuen-Der , Chang Jiun-Bin , Chen Jen-Tse , Wu Zin-An , Shan Din-E , Liao Kwong-Kum 
Published: September 2004

OBJECTIVE To report a case in which significant hypotension occurred after initiation of tizanidine in a patient using the antihypertensive agent lisinopril. CASE SUMMARY A 48-year-old woman was admitted due to cerebral hemorrhage at the midbrain and pons, with extension to the fourth ventricle. Consciousness disturbance (Glasgow coma scale 4) with a decerebrate posture improved 5 days after stroke onset. As the BP was fairly high, antihypertensive agents, including lisinopril, were initiated. Three weeks later, the decerebrate rigidity and high BP remained, and tizanidine was initiated to see whether the decrease in muscle tone could facilitate hypertension control and motor recovery. However, the BP dropped dramatically within 2 hours after the first dose of tizanidine. The tizanidine and all of the antihypertensive medications were withdrawn. Tizanidine was used again after her BP had stabilized, but did not produce similar problems. DISCUSSION A similar event was reported in 2000. The reaction in our patient appeared after tizanidine initiation and improved after both lisinopril and tizanidine were discontinued. According to the Naranjo probability scale, this was classified as a possible drug interaction. This kind of reaction is seldom mentioned as occurring during co-administration with tizanidine. With its characteristics, tizanidine has the potential to compromise hemodynamic stability during concomitant angiotensin-converting enzyme inhibitor use. CONCLUSIONS Based upon the literature review, the hypotension in this patient was possibly due to the interaction between tizanidine and lisinopril.
Recurrent Acute Hepatitis Associated with Use of Cetirizine
Authors: Pompili Maurizio , Basso Maria , Grieco Antonio , Vecchio Fabio M , Gasbarrini Giovanni , Gian Ludovico Rapaccini  
Published: September 2004

OBJECTIVE To describe a case of recurrent acute hepatitis related to the use of cetirizine, a selective histamine1-receptor antagonist approved for the treatment of common allergic diseases. CASE SUMMARY A 26-year-old man was hospitalized with a week-long history of weakness, nausea, anorexia, and hyperchromic urine, which had developed after 6 days of therapy with oral cetirizine 10 mg/day for allergic rhinitis. Admission laboratory testing revealed evidence of acute hepatitis and seropositivity for liver–kidney microsome antibodies. Liver biopsy findings of diffuse portal tract and lobular inflammation with a prominent eosinophilic infiltrate were consistent with drug-related hepatitis. The patient was discharged after one week of treatment with tocopherol and glutathione. Three months after discharge, transaminase levels were normal. At 6 months, seropositivity for liver–kidney microsome antibodies was still present, but considerably less intense. The patient had suffered 2 previous episodes of “acute hepatitis of unknown origin,” and both had occurred after cetirizine use. DISCUSSION Use of the Naranjo probability scale indicated cetirizine as the probable cause of acute hepatitis, and the positivity for liver–kidney microsome antibodies is suggestive of an autoimmune mechanism for liver damage. As of September 13, 2004, ours is the fourth reported case of acute hepatitis associated with cetirizine and the second in which liver–kidney microsome antibodies have been documented. CONCLUSIONS Although cetirizine is considered to have low potential for severe hepatic toxicity, the possibility that it can provoke autoimmune-mediated hepatotoxicity should be considered.
Combating the Obesity Epidemic: Community Pharmacists Counseling on Obesity Management
Authors: Dastani Homa B , Brown Carolyn M , O'Donnell Dannielle C 
Published: September 2004

BACKGROUND Obesity is reaching an epidemic proportion in the US. Nearly two-thirds (64.7%) of US adults are overweight or obese. Given the myriad of issues related to the management of obesity, community pharmacists can facilitate weight loss among their patients. OBJECTIVE To identify factors that influence the frequency of counseling obese patients by community pharmacists. METHODS A mail survey was sent to a random sample of 400 Texas community pharmacists. The questionnaire collected information on frequency of counseling obese patients, perceived comfort level with counseling obese patients, perceived effectiveness of various obesity treatments, and perceived confidence in achieving positive outcomes as a result of counseling. Demographic information was also collected. Descriptive statistics, correlational analyses, and t-tests were used to examine the data. RESULTS A usable response rate of 35.2% was obtained (139 completed surveys out of 395 assumed delivered). Overall, pharmacists counseled patients rarely to sometimes about various aspects of obesity management. Correlational analyses revealed that pharmacists’ frequency of counseling about obesity management was significantly and positively associated with their comfort level with counseling obese patients (r = 0.47; p < 0.001). Higher levels of confidence in achieving positive outcomes as a result of counseling (r = 0.39; p < 0.001) and higher levels of perceived effectiveness of obesity management options (r = 0.18; p = 0.037) were also significantly associated with higher levels of counseling about obesity management. CONCLUSIONS Obesity counseling by pharmacists was positively correlated with their perceived comfort with counseling obese patients, confidence in achieving positive outcomes, and effectiveness of obesity management options.
Heterogeneous mixed-layer clays from the Cretaceous Greensand, Isle of Wight, southern England
Authors: McCarty Douglas K. , Drits Victor A. , Sakharov Boris , Zviagina Bella B. , Ruffell Alastair , Wach Grant 
Published: September 2004

AbstractThe sea-cliffs of the Isle of Wight were deposited during a period of overall sea-level rise starting in the Barremian (Lower Cretaceous) and continuing into the Aptian and Albian. They consist of fluvial, coastal and lagoonal sediments including greensands and clays. Numerous episodes of erosion, deposition and faunal colonization reflect condensation and abandonment of surfaces with firmgrounds and hardgrounds. This study focused mainly on shallow marine cycles where variations in clay mineralogy would not be expected, because overall system composition, sediment source, and thermal history are similar for all the samples in the studied section. Instead we found a wide variety of clay assemblages even in single samples within a 200 m interval.In this interval, distinct clay mineral assemblages were found and can be described as consisting of Al-rich, Fe-richand intermediate Fe and Al compositions withrespect to 2:1 and 1:1 layers in mixed-layer arrangements. Nearly pure glauconite-nontronite clays exist in the <2 µm fraction only when the bulk rock is free of K- and plagioclase feldspar. Conditions favorable to glauconite-nontronite formation are interpreted to result from a hiatus in volcanoclastic sedimentation, thus providing a stable substrate for glauconitization.The Fe-bearing mixed-layer clay assemblages consist of glauconite, nontronite and berthierine-like layers in various proportions with several mixed-layer clays often coexisting in the same sample. In different samples, Al-richand Fe-Mg-rich mixed-layer clays are similar in their content and distribution of 1:1 and 2:1 layers. This suggests that the original clay assemblages were similar and later diagenesis affected certain horizons resulting in substitution of Al by Fe + Mg while preserving the original layer structure and arrangement.Structural formulae for the berthierine-like phase and berthierine-like layers in these mixed-layer clays show their layer cation composition is intermediate between odinite and standard berthierine. The total sum of octahedral cations varies from 5.26 to 5.55 whereas the amount of Fe2+ cations varies from 2.12 to 2.22 per O10(OH)8. A feature of the berthierine-like phase as well as of berthierine-like layers is that they are di-trioctahedral and Fe2+ and Fe3+ are the prevalent cations. Moreover, in these berthierine-like components, the amount of Fe2+ is greater than that of Mg (in contrast to odinite) and Fe3+ cations prevail over Al (in contrast to berthierine). The presence of authigenic ferrous Fe clays and the relationship between glauconite-nontronite and bulk mineralogy has implications for sedimentological processes and geochemical conditions during and shortly after deposition.