bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Pain After Mastectomy/Lumpectomy
Authors: Carpenter Janet S. , Sloan Paul , Andrykowski Michael A. , McGrath Patrick , Sloan David , Rexford Tracy , Kenady Daniel 
Published: March 2003

purpose
: Careful study of risk factors that predispose an individual to developing postmastectomy pain (PMP) after breast cancer surgery has not been reported. This study examined potential risk factors for PMP including demographic, disease, and treatment variables, as well as surgical factors, such as surgical technique and number of lymph nodes removed.
description of the study
: Data were collected via telephone interviews and review of medical records. Pain was assessed using the Brief Pain Inventory. The sample included 134 breast cancer survivors who were a mean age of 55 years (SD = 9) and a mean of 35 months postsurgery (SD = 19).
results
: Women with PMP (n = 36) were not significantly different from women without PMP (n = 98) on demographic, disease, treatment, or surgical variables. PMP intensity was not significantly associated with age at diagnosis, time postsurgery, or time post‐treatment. Contrary to expectation, PMP was found in women postlumpectomy without axillary dissection, women whose intercostobrachial nerve was spared, and women without documented postoperative complications.
clinical implications
: Findings suggest that cases of PMP cannot uniformly be identified based on the presence or absence of certain factors. Findings also underscore the need to screen all women for PMP after breast cancer surgery, particularly given the availability of effective pain management therapies.
Premature Menopause After Cancer Treatment
Authors: Muscari Lin Esther , Aikin Jennifer L. , Good Barbara C. 
Published: March 2003

purpose
: The purpose of this report is to examine the impact that cancer therapies have on ovarian function.
overview
: Symptoms of and conditions due to estrogen deficiency after cancer therapy are described, and interventions are proposed. The consequences of short‐term as well as prolonged estrogen deficiency—including vasomotor instability, infertility, genitourinary atrophy, coronary artery disease, and osteoporosis—are discussed.
clinical implications
: Symptoms and conditions associated with premature menopause may cause additional stress for women who undergo cancer therapy. Knowledge about what happens to these women can enable healthcare providers to help them make decisions about cancer treatment, engage in self‐care activities, and explore options for preserving fertility.
Findings from an Educational Support Course for Patients with Leukemia
Authors: McGrath Pam 
Published: March 2003

objectives: Recent evidence indicates that patients with leukemia are a distinct subset of cancer patients with specific adjustment issues and special needs for support and follow‐up. This article shares recent research findings on an Australian educational support course, appropriately named Taking Control, designed specifically for patients with leukemia and associated disorders.materials and methods: The material presented in this article represents the findings from the retrospective arm of a descriptive study designed to evaluate this course. Participants in the course during the calendar year of 1997 were surveyed with an author‐designed, self‐report questionnaire requesting feedback on their experience of the course.results: Although the majority of participants were seeking information, there was strong evidence that the provision of information needs to be coupled with an understanding of the psychosocial reasons that motivated individuals to attend the course. The findings indicate that the course is perceived by participants to be an effective psychosocial intervention for assisting patients and their families cope with the serious diagnosis of leukemia.conclusions: Even though information seeking was an important reason for attending this educational course, there were many other significant emotional concerns that individuals brought to the experience. When exposed to the stress of leukemia and its treatment, patients and their significant others may become preoccupied with information gathering. Therefore, it is important to not only explore the issue of the informational needs of participants, but also to examine the emotional needs they associate with this information gathering. The hope and expectation about sharing the findings of this program is that it will assist with the development of similar programs elsewhere and will stimulate further research on the importance of educational support groups in oncology.
Screening Mammography for Elderly Women
Authors: Johs‐Artisensi Jennifer , McGill Jerry 
Published: March 2003

Purpose: Breast cancer is one of the most common and deadly cancers among elderly women, but there is little consensus in the literature about appropriate screening guidelines for the elderly. In this report, evidence‐based studies addressing the efficacy and effectiveness of mammography screening programs for elderly women are analyzed and interpreted.Overview: Although there is little direct scientific evidence to support (or to disavow) the benefits of mammography screening for elderly women, a review of the relevant literature supports the benefits of screening mammography for this population. The authors believe that the current evidence supports the efficacy and effectiveness of mammography screening programs for women up to at least age 80 and also suggests that women older than age 80 who are in good general health will also benefit from screening.Clinical implications: Most individuals rely on their healthcare providers' recommendations to aid them in making decisions regarding their health. When healthcare professionals are equipped with evidence‐supported guidelines, they can ensure that appropriate recommendations are being made for their patients. Healthcare professionals who treat the elderly should implement the authors' recommendations, supported by current evidence. The lack of direct evidence should not be interpreted as evidence against the use of screening mammography for the elderly but rather as a call for clinical research on preventive healthcare for senior citizens.
Lake Superior Rural Cancer Care Project
Authors: Elliott Thomas E. , Elliott Barbara A. , Regal Ronald R. , Renier Colleen M. , Haller Irina V. , Crouse Byron J. , Witrak Martha T. , Jensen Patricia B. 
Published: March 2003

purpose: Effective methods that encourage rural primary‐care physicians to adopt state‐of‐the‐art cancer‐management practices are needed. The purpose of this study was to evaluate educational and systems strategies to improve rural primary‐care physicians' cancer practice behaviors.description of study: The Lake Superior Rural Cancer Care Project was a group‐randomized, controlled trial conducted with 18 rural communities in the North Central United States over 4 years. Although the unit of analysis was the community, the subjects were 104 primary‐care physicians and 2089 rural patients with cancer. The intervention was educational and comprised systems strategies that targeted rural primary‐care physicians and their healthcare delivery systems. The outcome measures reported here were physician practice behaviors regarding cancer diagnosis, staging, treatment, clinical trial participation, and post‐treatment surveillance.results: The intervention significantly improved 5 of the 37 cancer practice end points. The overall result of the study did not support the majority of the study hypotheses. Because 16 practice end points were found to be at acceptable performance levels, the possibility of a measurable intervention effect was limited.clinical implications: Earlier, the authors reported the results of the intervention on providers' cancer management knowledge, which showed significant improvement. The present study findings demonstrated that improving provider knowledge does not necessarily improve practice performance. Changing practice behaviors requires much more effort. Furthermore, interventions found to be effective in other diseases, types of providers, or settings may not work on rural providers for cancer management.
Exercise Counseling and Programming Preferences of Cancer Survivors
Authors: Jones Lee W. , Courneya Kerry S. 
Published: March 2003

purpose: Exercise has emerged as an important quality‐of‐life intervention for cancer survivors, but exercise motivation is a challenge. The purpose of this study was to provide a comprehensive assessment of the exercise preferences of cancer survivors.description of study: A mailed, self‐administered survey was completed by 307 survivors of prostate, breast, colorectal, or lung cancer. The survey contained questions on demographic and medical variables, past exercise, and various exercise counseling and programming preferences.results: For exercise counseling, 84% of participants said they preferred or maybe preferred to receive exercise counseling at some point during their cancer experience. Moreover, 85% preferred to receive exercise counseling face to face, and 77% preferred to receive it from an exercise specialist affiliated with a cancer center. For exercise programming, 98% preferred recreational exercises, 8!% preferred walking, 57% preferred unsupervised exercise (57%), and 56% preferred moderate‐intensity exercise. In addition, 48% preferred to exercise in the morning, 44% preferred to exercise alone, 40% preferred to exercise at home, and 32% preferred to start their exercise program before treatment. Chi‐square analyses revealed that a small number of exercise preferences were moderated by demographic, medical, and exercise variables.clinical implications: The results of this study indicate that cancer survivors have unique and varied exercise counseling and programming preferences. Fifty‐six percent of cancer survivors preferred to exercise at moderate intensity rather than at high intensity. Moderate‐intensity exercise has been shown previously to be relatively safe even for cancer survivors who are advanced in age. The key to success for inactive cancer survivors may be to provide reassurance that exercise is a safe and beneficial modality for cancer survivors and to prescribe an exercise program that builds their confidence by slowly increasing the level of exercise intensity.
Toward an Ecological Approach for the Assessment of Ecosystem Health
Authors: Belaoussoff Svenja , Kevan Peter G. 
Published: March 2003

ABSTRACTMany ecologists express difficulty with the concept of ecosystem health. Ecosystem health must have definable and objective norms that allow for rigorous hypothesis testing for it to be acceptable to those ecologists. One step toward objective measurement of ecosystem health is to characterize ecosystem health by diversity–abundance relationships. The log‐normal relationship between diversity and abundance characterizes taxocenes (i.e., taxonomically related groups that have similar ecological functions). Under conditions of stress, the patterns of diversity and abundance often change and are no longer log‐normal. This change in patterns has been shown for some, but not all, marine and terrestrial taxocenes tested. The interdisciplinary possibilities for using log‐normality, and deviation from it, as a measure of natural and anthropogenic ecosystem health are discussed. The interdisciplinarity of ecosystem health is illustrated with an example of blueberry pollinator decline caused by insecticide spraying in New Brunswick, Canada, and related economic and human health costs.
Ecosystem Health and the Political Process: Ullsten and Rapport Revisited
Authors: Wilcox Bruce A. , Fowler Cynthia T. 
Published: March 2003

AbstractDeclining ecosystem health worldwide arguably is partly a consequence of a cultural and political economic disconnect between policy makers and scientists. Previous authors of “Viewpoint” describe this gap in terms of the relative inaction of policy makers in response to warnings from the scientific community. We provide an expanded perspective by considering the sociocultural evolution of political economies, and by contextualizing this dilemma within our overspecialized contemporary society. Our commentary suggests the ecosystem health community can work toward narrowing the policy‐science disjunction despite the disparate cultures of these communities.
Methods for Mapping Forest Sensitivity to Acid Deposition for Northeastern North America
Authors: Arp Paul A. , Leger Wendy , Moayeri Mohammad H. , Hurley J.E. 
Published: March 2003

ABSTRACTFor comparison purposes, two methods are proposed for mapping sustainable acid deposition within the context of natural and managed (harvested) forest biomass growth in Northeastern North America. One method uses existing geospatial data for forest cover type, soil type, local climate, topography, and atmospheric deposition. The other method uses data specific to well‐studied sites. Maps will be developed that show the spatial distributions of sustainable acid deposition rates by tree type, eco‐unit, and local forest disturbance regimes (by harvest method). Additional maps will be produced to show where these rates are likely exceeded, and by how much. The information so generated will be presented to policy and decision makers who deal with forest health and abatement control measures regarding regional sulfur (S) and nitrogen (N) emissions.
Analgesic Use in Cluster Headache
Authors: Gallagher R. Michael , Mueller Loretta , Ciervo Carman A. 
Published: March 2003

Cluster headache is a brutal affliction characterized by excruciating pain with relatively brief, but frequent attacks. Because of the short duration of the attacks and the tremendous intensity of pain, symptomatic analgesics are often not effective. However, inhalation oxygen, while being cumbersome, is reported to be effective in the majority of sufferers.To assess the practical effectiveness and use of analgesics and/or oxygen, a review of 60 cluster patients was conducted. At initial evaluation, 48 patients had accepted oral analgesics and 51 patients accepted inhalation oxygen for breakthrough headaches. After acceptable prophylactic treatment was established, 65% of patients who accepted analgesics continued their use, although most reported only minimal relief. Only 31% of patients who accepted oxygen continued its use, in spite of the fact that most sufferers reported significant relief..this brief study, it appears that cluster headache patients prefer to use analgesics for reasons that are not solely for relief of pain, and that patients decline the use of oxygen for reasons other than lack of effectiveness.
The Confirmation of a Biochemical Marker for Women's Hormonal Migraine: The Depo‐Estradiol Challenge Test
Authors: Lichten Edward M. , Lichten Jason B. , Whitty Albert , Pieper David 
Published: March 2003

Precis: Will estrogen withdrawal cause migraines in post‐menopausal women?Objective: To record the changes in serum estradiol and total estrogen levels after an intramuscular estradiol injection in menopausal subjects and then record any subsequent migraine occurrence.Design: Open selection process, comparative trial.Patients: Twenty‐eight postmenopausal women volunteers were given 5 mg depo‐estradiol cyprionate as an intramuscular injection. Sixteen (migraine group) had a history of severe, cyclic, menstrually related migraine attacks before becoming menopausal. Twelve (control group) had no history of migraine or headache. All volunteers were on continuous estrogen replacement therapy at the beginning of the study. Progestins were not used in the study.Main Outcome Measures: Serum estradiol and total estrogen levels were measured prior to the depo‐estradiol injection and on subsequent days 4, 7, 14, 21, and 28.Results: Total estrogen and estradiol levels varied greatly at every measured interval. Menopausal complaints of vasomotor symptoms were relieved for at least the first 2 weeks of the study. No member of the control group reported a migraine during the month. However, a severe migraine was reported by all 16 women with a history of migraine. The average day of the migraine occurrence was 18.5 ± 2.8. The serum level of estradiol on the day of the worst migraine was 46.4 ±± 5.6 pg/mL. The significance of these findings was at the 95% confidence level.Conclusions: This study confirms two factors about menopausal hormonal migraine: (1) it can be precipitated by a drop in serum estrogen levels, and (2) a period of estrogen priming is a necessary prerequisite. This study also identifies that there are two biologically different populations of postmenopausal women: (1) those who developed migraine after a single depo‐estradiol injection, and (2) those who did not. By understanding that in addition to the biological predisposition to migraine there exists the biochemical cofactor of falling estrogen levels, we may better understand this phenomenon and develop means to prevent its occurrence.
Serotonin Syndrome Presenting With Migrainelike Stroke
Authors: Molaie Majid 
Published: March 2003

Serotonin syndrome is the result of the drug interaction that enhances serotonergic tone in the central nervous system. The neurological manifestations are transient in most of the reported cases with rare fatality.Case Description.—A 30‐year‐old woman developed ischemic infarction of the right temporoparietal and cerebellar hemispheres 48 hours after administration of a large dose of clomipramine. This drug was given within 24 hours of discontinuation of high‐dose fluoxetine, both of which are known to enhance serotonergic tone in the central nervous system.The distribution of the ischemic infarction in this case did not respect the major territorial arteries and was similar to spreading oligemia/ischemia that is described in migraine. A similar pathogenesis may exist for stroke in serotonin syndrome and in migraine.
Safety and Efficacy of Combined Lysine Acetylsalicylate and Metoclopramide: Repeated Intakes in Migraine Attacks
Authors: Pradalier A. , Chabriat H. , Danchot J. , Baudesson G. , Joire J.E. 
Published: March 2003

The efficacy of the combination of lysine acetylsalicylate and metoclopramide in the treatment of migraine attacks has been established previously. The value of repeated doses of such a combination has been reported in a recent study.The purposes of this open‐label study performed by general practitioners on a very large sample of migraine sufferers were to confirm that repeated doses of the combined treatment are efficient and well‐tolerated, and to assess the efficacy of treatment according to the initial headache intensity.Three thousand seven hundred twenty‐seven general practitioners entered 7259 migraine sufferers. Patients had to use a first dose, the efficacy of which was assessed 2 hours later. In the case of failure, they were then able to take a second dose and possibly a third dose, 2 hours after the second, in the case of persistent failure. Twelve thousand five hundred sixty‐two migraine attacks were analyzed. Tolerance, as assessed by the patients, was considered as good in more than 85% of attacks, whatever the number of doses utilized. Five hundred thirty‐five adverse effects were reported after the use of 22 697 sachets. Of 12 515 attacks documented for efficacy, patients considered the treatment as good or excellent in 80% of attacks treated with one dose, 55% of those treated with two doses, and 27% of those treated with three doses. Relief of headache (reduction of its severity from grade 3 or 2 to 1 or 0) was observed in 51% of episodes after the first sachet, 51% of episodes treated with a second sachet, and 56% of episodes treated with a third sachet. The first dose of treatment was found to be more effective when the initial severity of the headache was moderate (improvement in 66% of attacks) than when it was severe (improvement in 30% of attacks). Efficacy appeared to increase according to the number of doses when headache was initially severe.This trial confirms that repeated doses of this combination is well‐tolerated and effective. Our results show that repeated doses are particularly useful for severe attacks.
Prothrombotic Genetic Risk Factors in Patients With Coexisting Migraine and Ischemic Cerebrovascular Disease
Authors: Iniesta J.A. , Corral J. , González‐Conejero R. , Rivera J. , Vicente V 
Published: March 2003

The role of hemostatic elements in stroke has been clearly defined but several prothrombotic polymorphisms of hemostatic factors, important for other thromboembolic disorders, seem not to be very significant in stroke. Recently, the high prevalence of factor V Leiden in patients with stroke and a history of migraine has suggested an association between migraine and prothrombotic genetic risk factors. Stroke being a multifactorial disease, the aim of this study was to test whether prothrombotic tendencies increase the risk of stroke in patients with migraine.We determined the prevalence of four prothrombotic genetic risk factors (factor V R/Q 506, factor II 20210 G/A, decanucleotide insertion/deletion in the factor VII promoter, and the platelet HPA‐1 alloantigen system) in 17 patients with coexisting ischemic cerebrovascular disease and migraine, 107 patients with ischemic cerebrovascular disease, 106 patients with migraine, and 202 control subjects. Genotyping for all polymorphisms analyzed in our study were performed after specific genomic polymerase chain reaction, and confirmed by single‐strain conformation polymorphism analysis.In the group of patients with coexisting ischemic cerebrovascular disease and migraine, the prevalence of prothrombotic genotypes (factor V Leiden, 5.8%; factor II 20210 A, 0%; factor VII A1, 70.6%; and HPA‐1b, 35.3%) was similar to that obtained in all other groups. We can conclude that the studied polymorphisms do not seem to be associated with the development of ischemic cerebrovascular disease in those patients with migraine.
Objective Behavior Associated With an “Ordinary” Mild Headache: A Surprising Failure of Pain Onset to Signal Self‐protective or Self‐regulatory Behavior
Authors: Hovanitz Christine A. , Reynolds David J. , Cote Max P. , Christianson Amy , Stokes‐Crowe Linda A. , Altum Shari , Chase‐Carmichael Cheryl Ann 
Published: March 2003

Objective.—The goal of this study was to determine whether onset of an “ordinary” headache initiated self‐protective behavior or self‐regulation, as indexed by a reduction in effort expenditure.Methods.—A nonclinical sample was employed. The ambition and performance accuracy of a headache‐developing group (n=23) and a sex‐matched, headache‐free group (n=23) was compared during a series of mental arithmetic problems. Embedded within the series of math problems was a task involving recall of a stressor previously found to induce headache in many subjects.Results.—Onset of mild head pain did not lead to effort conservation; instead, heightened ambition appeared to characterize the headache‐developing participants before as well as after headache onset. Headache‐developing subjects also displayed a performance accuracy deficit.Conclusions.—The data suggest unusually ambitious, effortful task engagement may contribute to the onset of mild “ordinary” headache. This possibility requires further examination under other controlled conditions as well as in the natural environment.