bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life in Patients With Colorectal Cancer 1 Year After Diagnosis Compared With the General Population: A Population-Based Study
Authors: Arndt Volker , Merx Henrike , Stegmaier Christa , Ziegler Hartwig , Brenner Hermann 
Published: November 2004

Purpose Quality of life (QOL) has become an important outcome measure for patients with cancer, but long-term results from population-based studies are rare. The objective of our study was to identify specific limitations of QOL in survivors of colorectal cancer in comparison with men and women from the general population 1 year after diagnosis when acute treatment effects are expected to have declined. Patients and Methods QOL was assessed 1 year after diagnosis in a population-based cohort of 439 patients with colorectal cancer from Saarland (Germany) using the EORTC-QLC30 questionnaire. Specific functional and symptom QOL scores were compared with published reference data from the general population. Results Of 439 patients, 378 of them survived the first year after tumor diagnosis (86.1%). Of these, 309 returned the questionnaire (response rate, 81.7%). Compared with the general population, colorectal cancer patients scored their physical, role, cognitive, and global health functioning only slightly worse. More severe limitations were observed for the emotional and social functioning scales and for the symptom subscales of fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties. The differences regarding functional and symptom scores were predominantly found in younger age groups whereas older cancer patients and controls rated their health and QOL similarly. Conclusion Deficits in emotional and social functioning and specific limitations like fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties are main factors hampering the QOL among colorectal cancer patients and seem to affect predominantly younger patients.
European Intergroup Studies (MMT4-89 and MMT4-91) on Childhood Metastatic Rhabdomyosarcoma: Final Results and Analysis of Prognostic Factors
Authors: Carli M. , Colombatti R. , Oberlin O. , Bisogno G. , Treuner J. , Koscielniak E. , Tridello G. , Garaventa A. , Pinkerton R. , Stevens M. 
Published: November 2004

Purpose Final results are presented from two consecutive European studies for patients with metastatic rhabdomyosarcoma (RMS) to identify prognostic variables and determine the value of high-dose chemotherapy (HDCT) in complete remission. Patients and Methods A total of 174 patients aged 3 months to 18 years participated. From 1989 to 1991, patients received four cycles of intensive multiagent chemotherapy. From 1991 to 1995, patients achieving complete remission received consolidation with HDCT. All received local therapy (surgery, radiation therapy) according to response. Results At a median follow-up of 8 years, 5-year overall survival (OS) and event-free survival (EFS) for the whole group were 24% and 20%, respectively. No statistical difference was found between HDCT and standard chemotherapy (5-year OS, 36% v 27%; EFS 29% v 23%). Univariate analysis identified primary tumor in parameningeal, extremity, or other sites; age younger than 1 year and older than 10 years; bone or bone marrow metastases; multiple metastases; and multiple sites of metastases as unfavorable prognostic factors for OS and EFS. Multivariate analysis identified unfavorable site, bone or bone marrow involvement, and unfavorable age as independently unfavorable factors. Two subgroups were identified. Those with fewer than two unfavorable factors had 5-year EFS and OS of 40% and 47%, respectively. Patients with ≥ two unfavorable factors had 5-year EFS and OS of 7.5% and 9%, respectively. Conclusion A minority of patients with metastatic RMS have better survival than overall results for this population suggest. Those in the highest risk group have such poor survival that they are candidates for first-line novel therapies. There is no evidence that consolidation with HDCT improves outcome.
Short-Term Efficacy of Methylphenidate: A Randomized, Double-Blind, Placebo-Controlled Trial Among Survivors of Childhood Cancer
Authors: Mulhern Raymond K. , Khan Raja B. , Kaplan Stuart , Helton Susan , Christensen Robbin , Bonner Melanie , Brown Ronald , Xiong Xiaoping , Wu Sengjie , Gururangan Sridharan , Reddick Wilburn E. 
Published: November 2004

Purpose Children surviving acute lymphoblastic leukemia (ALL) and malignant brain tumors (BTs) have a higher incidence of attention and learning problems in school than do their healthy peers. The present study tests the hypothesis that the psychostimulant methylphenidate (MPH) improves cognitive and social functioning among these patients. Patients and Methods We report on 83 long-term survivors of ALL and BT identified as having attentional deficits on behavioral testing and parent or teacher report, and problems with academic achievement. The 47 male and 36 female patients ranged from 0.6 to 14.3 years (median, 5.4 years) of age at diagnosis and 6.7 to 17.9 years (median, 11.9 years) of age at participation. The patients (40 ALL, 43 BT) participated in a randomized, double-blind, 3-week home cross-over trial of placebo (bid), low-dose MPH (0.3 mg/kg; maximum dose, 10 mg bid), and moderate-dose MPH (0.6 mg/kg; maximum dose, 20 mg bid). The primary end points were weekly teacher and parent reports on the Conners’ Rating Scales and Social Skills Rating System. Results Compared to placebo, significant improvement with MPH was reported by teachers and parents on the Conners’ Rating Scales and by teachers on the Social Skills Rating System. However, no consistent advantage of moderate dose over low dose was observed. Of those participating, 66 (79.5%) of the 83 patients continued on best clinical management. Conclusion Treatment with MPH can at least temporarily reduce some attentional and social deficits among survivors of childhood ALL and BT. Long-term follow-up will reveal those subsets of patients who are more likely to benefit from MPH.
Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science
Authors: Gruen Russell , Bailie Ross 
Published: November 2004

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of “state of the art” specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.
Pricing of general practice in Australia: some recent proposals to reform Medicare
Authors: Jones Glenn , Savage Elizabeth , Hall Jane 
Published: November 2004

In the Australian Medicare system, general practitioners (GPs) are paid on a fee-for-service basis. A practitioner can choose to bill the government directly (termed bulk billing) and receive 85% of a regulated fee as full payment. Bulk billed consultations are free to the patient. However, GPs are free to charge above the regulated fee. The patient can then claim a rebate from the government but only the equivalent of 85% of the regulated Medicare fee. Such co-payments for GP consultations cannot be covered by private health insurance. In the ten years following the introduction of Medicare in 1984, the bulk billing rate for GP consultations steadily increased to 84%. Since then the rate has fallen to below 68%. In April 2003 the Minister for Health announced a reform package under the title A Fairer Medicare which aimed, among other things, to increase the availability of bulk billing for some patients. A key feature of the proposal involved changes to the way that GPs are reimbursed. Following political opposition that would have prevented it passing both houses of the federal parliament, a revised version, MedicarePlus, was released in November 2003. This paper describes the factors influencing a GP's choice to bulk bill and examines the two proposals, in this context.
Equity of access to elective surgery: reflections from NZ clinicians
Authors: Mcleod Deborah , Dew Kevin , Morgan Sonya , Dowell Anthony , Cumming Jackie , Cormack Donna , Mckinlay Eileen , Love Tom 
Published: November 2004

Objectives To explore factors potentially influencing equitable access to elective surgery in New Zealand by describing clinicians’ perceptions of equity and the factors they consider when prioritising patients for elective surgery. Methods A qualitative study in selected New Zealand localities. A purposive sample of 49 general practitioners, specialists and registrars were interviewed. Data were analysed thematically. Results General practitioners described unequal opportunities for patients to access primary and secondary care and, in particular, private sector elective surgery. They felt that socio-economically disadvantaged patients were less able to advocate for themselves and were more vulnerable to being lost to the elective surgical booking system as well as being less able to access private care. Both GPs and secondary care clinicians described situations where they would personally advocate for individual patients to improve their access. Advocacy was related to clinicians’ perceptions of the “value” that patients would receive from the surgery and patients” needs for public sector funding. Conclusions The structure of the health system contributes to inequities in access to elective care in New Zealand. Subjective decision making by clinicians has the potential to advantage or disadvantage patients through the weighting clinicians place on socio-demographic factors when making rationing decisions. Review of the potential structural barriers to equitable access, further public debate and guidance for clinicians on the relative importance of socio-demographic factors in deciding access to rationed services are required for allocation of services to be fair.
Comparison of private for-profit with private community-governed not-for-profit primary care services in New Zealand
Authors: Crampton Peter , Davis Peter , Lay-Yee Roy , Raymont Antony , Forrest Christopher , Starfield Barbara 
Published: November 2004

Objective To compare the characteristics of patients, their disease patterns, and the investigation and referral patterns in private community-governed not-for-profit and private for-profit primary care practices in New Zealand. Methods Observational study using a representative survey of visits to general practitioners in New Zealand. Practices were categorised according to their ownership: private for-profit or private community-governed not-for-profit. Patient socio-demographic characteristics, treated prevalence and other characteristics of presenting problems, morbidity burden, numbers of investigations and referral patterns were compared. Results Compared with for-profit practices, community-governed not-for-profit practices served a younger, largely non-European population, nearly three-quarters of whom had a means-tested benefit card (community services card), 10.5% of whom were not fluent in English, and the majority of whom lived in the 20% of areas ranked as the most deprived (by the NZDep2001 index of socio-economic deprivation). Patients visiting not-for-profit practices were diagnosed with more problems, including higher rates of asthma, diabetes and skin infections, but lower rates of chest infections. The duration of visits was also significantly longer. No differences were observed in the average number of laboratory tests ordered. The odds of specialist referral were higher in for-profit patients when confounding variables were controlled for. Conclusions Community-governed not-for-profit practices in New Zealand serve a poor, largely non-European population who present with somewhat different rates of various problems compared with patients at for-profit practices. The study highlights for communities, policy-makers and purchasers the importance of community-governed not-for-profit practices in meeting the needs of low-income and minority population groups.
Hematopoietic cytokines as tumor markers
Authors: Mroczko Barbara , Szmitkowski Maciej 
Published: November 2004

AbstractStem cell factor (SCF), interleukin 3 (IL-3), granulocyte-macrophage-colony stimulating factor (GM-CSF), granulocyte-colony stimulating factor (G-CSF) and macrophage-colony stimulating factor (M-CSF) are members of a group of glycoproteins called hematopoietic cytokines (HCs). These cytokines regulate the growth and differentiation of hematopoietic progenitor cells and functionally activate mature neutrophils or macrophages. The effect of HCs is not limited to bone marrow cells. Some studies have shown that HCs can also stimulate the proliferation of non-hematopoietic cells. The receptors for HCs have been detected in cancer cell lines, and stimulation of HCs receptors induced proliferation of tumor cells. Moreover, some investigations have shown HC mRNA expression in these cell lines and recent studies have demonstrated that HCs can stimulate tumor progression. Several cells of malignant tumors have been observed to secrete large amounts of HCs and increased concentrations of HCs have been found in the sera of cancer patients. There are a number of situations in which the measurement of HCs may provide clinically useful information, particularly regarding prognosis and response to treatment. In this paper we discuss the results of studies that have examined the potential use of HCs as tumor markers.
The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk
Authors: Walldius Göran , Jungner Ingmar , Aastveit Are H. , Holme Ingar , Furberg Curt D. , Sniderman Allan D. 
Published: November 2004

AbstractBackground: The apolipoprotein B (apoB)/apoA-I ratio represents the balance of proatherogenic and antiatherogenic lipoproteins. The purpose of this study was to determine whether the apoB/apoA-I ratio was superior to any of the cholesterol ratios – total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), low-density lipoprotein cholesterol (LDL-C)/HDL-C and non-HDL-C/HDL-C – in predicting the risk of coronary disease. Moreover, we examined whether any lipids, lipoproteins or cholesterol ratios add significant predictive information beyond that provided by the apoB/apoA-I ratio.Methods: Plasma lipids, lipoproteins, apoB, and apoA-I were measured in 69,030 men and 57,168 women above 40years of age. After a mean follow-up of 98months, 1183 men and 560 women had died from a myocardial infarction in this prospective apolipoprotein-related mortality risk (AMORIS) study.Results: High apoB and a high apoB/apoA-I ratio were strongly related to increased coronary risk, while high apoA-I was inversely related to risk. The apoB/apoA-I ratio was superior to any of the cholesterol ratios in predicting risk. This advantage was most pronounced in subjects with LDL-C levels <3.6mmol/l. Addition of lipids, lipoproteins or any cholesterol ratio to apoB/apoA-I in risk models did not further improve the strong predictive value of apoB/apoA-I.Conclusions: These results indicate that the apoB/apoA-I ratio is at present the best single lipoprotein-related variable to quantitate coronary risk. Given the additional advantages apolipoproteins possess – fasting samples are not required, apoB/apoA-I is a better index of the adequacy of statin therapy than LDL-C, and the measurement of apoB and apoA-I are standardized, whereas LDL-C and HDL-C are not – there would appear to be considerable advantage to integrating apolipoproteins into clinical practice.
Determination of asymmetric dimethylarginine (ADMA) using a novel ELISA assay
Authors: Schulze Friedrich , Wesemann Reinhard , Schwedhelm Edzard , Sydow Karsten , Albsmeier Jennifer , Cooke John P. , Böger Rainer H. 
Published: November 2004

AbstractAsymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase (NOS). Elevated ADMA plasma levels have been reported in connection with diseases associated with an impaired endothelial L-arginine-NO pathway and endothelial dysfunction, such as atherosclerosis, hypercholesterolemia, chronic heart failure, diabetes mellitus, and hypertension. NO production by NOS is decreased due to elevated ADMA levels. In fact, there is increasing interest in determination of ADMA levels in samples of various origins. The aim of this work was to develop a precise and easy immunoassay in contrast to the existing methods, such as HPLC, liquid chromatography-mass spectrometry (LC-MS) and gas chromatography (GC)-MS. We determined cross-reactivity in our immunoassay of 1.2% for symmetric dimethylarginine and <0.02% for L-arginine. The limit of quantitation was 0.05μmol/l. We found good correlation of the values measured when we compared our assay with LC-tandem MS (n=29; r=0.984; p<0.0001). We determined ADMA levels in human serum and plasma, mouse and rat plasma, and cell culture supernatant. For human plasma we found a mean of 0.65μmol/l in healthy subjects. In the plasma of mice and rats we found mean concentrations of 1.05 and 1.09μmol/l, respectively.
HDL and clinical and biochemical correlates in Italian non-smoker women
Authors: Bigazzi Federico , Pino Beatrice Dal , Forastiere Francesco , Pistelli Riccardo , Rossi Giuseppe , Simoni Marzia , Baldacci Sandra , Viegi Giovanni , Bionda Alberto , Sampietro Tiziana 
Published: November 2004

AbstractHigh-density lipoprotein (HDL)-cholesterol levels, inversely related to the risk of myocardial infarction, are determined by genetic and environmental factors. The aim of this study was to evaluate the prevalence of low and high HDL plasma levels and the influence of environmental factors and lipid profile in an Italian non-smoker female population. HDL, apolipoprotein A-I, apolipoproteins, lipids and estrogen plasma levels were measured in a population of 1471 women with a mean age of 45±14years. HDL values ≤35mg/dl were noted in 11.2% of the subjects, showing 2.4% coronary heart disease (CHD) prevalence. The 90th percentile was characterized by HDL levels ≥66mg/dl and the absence of coronary atherosclerosis. Total cholesterol, apolipoprotein B and triglycerides (r=−0.31, p<0.0001) were the main determinants of HDL levels; apolipoprotein E, estrogen use, body mass index (BMI), alcohol consumption and age showed a weaker correlation. Apolipoprotein A-I concentration was influenced more notably by estrogen use, total cholesterol and apolipoprotein E; levels of triglycerides, apolipoprotein B, BMI, age and alcohol consumption are less important. The parameters considered here, taken together, explain HDL and apolipoprotein A-I variability of approximately 31% and 24%, respectively. A surprisingly high prevalence of very low (≤35mg/dl) and high (≥66mg/dl) HDL levels in Italian women further confirms the importance of studies on the HDL distribution in different population groups.
Insights into the Oxidation Chemistry of 2‐Hydroxypurine by Electrochemical Methods
Authors: Goyal Rajendra N. , Sangal Aditi 
Published: November 2004

AbstractThe oxidation chemistry of 2‐hydroxypurine has been investigated in phosphate containing supporting electrolytes at pH 1.4–9.8 at a pyrolytic graphite electrode by voltammetric studies, spectral studies, controlled potential electrolysis and related techniques. The kinetics of decay of the UV‐absorbing intermediate generated during electrooxidation was followed spectrophotometrically and the decay occurred in a pseudo‐first‐order reaction. The course of the electrode reaction has been deduced to involve a 6e, 6H+ oxidation of 2‐hydroxypurine via the formation of 2, 8‐dihydroxypurine. The electrooxidation of 2‐hydroxypurine has been found to be an EC reaction (electrode reaction followed by chemical reactions) in which charge transfer is followed by competitive chemical reactions. A detailed interpretation of the redox mechanism of 2‐hydroxypurine has been presented.
Synthesis of [3H], [13C215N] and [14C]Sch 66336 (Sarasar™)
Authors: Hesk D. , Cesarz D. , Magatti C. , Voronin K. , Lavey C. , McNamara P. , Koharski D. , Saluja S. , Hendershot S. , Pham H. , Truong V. 
Published: November 2004

Abstract[3H]Sch 66336 was prepared at a specific activity of 1.35 Ci/mmol by Ru(Ph3P)3Cl2 catalysed exchange with tritiated water. [13CN]Sch 66336 was synthesized from potassium [13C]cyanide and [13C15N2]urea in 29% overall yield from potassium [13C]cyanide. [14C]Sch 66336 was synthesized from potassium [14C]cyanide in 31% yield. A second synthesis, from N‐Boc‐4‐hydroxy[14C]piperidine, gave [14C]Sch 66336 labelled in a different site in 19% overall yield. Copyright © 2004 John Wiley & Sons, Ltd.
Stereoselective synthesis of radiolabelled avermectins
Authors: McKillican Bruce P. , Perine Jeffrey W. , Simmons Dana P. , Wilson Timothy E. 
Published: November 2004

AbstractThe natural products avemectin B1a 1a and B1b 1b were each site‐specifically 14C labelled at carbon 23 in a convergent synthesis for metabolism, residue, and environmental studies. The 12‐step radiosynthesis involved a stereoselective aldol condensation and later a coupling to a protected avermectin degradate 2 in a one‐pot Wittig condensation/spiroketalization to reconstitute the dioxaspirane configuration found in the natural products. Copyright © 2004 John Wiley & Sons, Ltd.