bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphocyte T helper‐specific reactivity in sustained responders to interferon and ribavirin with negativation (seroreversion) of anti‐hepatitis C virus
Authors: Marinho Rui T. , Pinto Ruth M. , Santos Maria L. , De Moura Miguel Carneiro 
Published: October 2004

Abstract: Background:Seroreversion, negativation of anti‐hepatitis C virus previously positive, is sometimes found in some chronic hepatitis C‐sustained responders (SRs) to antiviral therapy.Aims:To determine the probability of seroreversion in SR treatment with Interferon and Ribavirin, and lymphocyte T helper (CD4+) reactivity to HCV antigens.Methods:Thirty SR were followed on average for 54.8 months. Anti‐HCV was tested by third generation test. Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood and cultured to evaluate CD4+ proliferation in response to 2 μg/ml of eight HCV recombinant antigens from core, NS3, NS4, NS5 regions.Results:Seroreversion was verified in 23% of patients (7/30), appearing at 47.5±24.0 months. The probability of anti‐HCV loss in this group was 25% at 56 months after ending therapy. In 57% (4/7), anti‐HCV returned to positive. These 7 SR patients with seroreversion also showed weaker CD4+ reactivity in 5% of tests (3/56) than the remaining 23 anti‐HCV‐positive SRs who showed stronger reactivity in 18% of tests (33/184),P=0.036.Conclusions:One‐quarter of the SR showed seroreversion of anti‐HCV and weaker CD4+ specific HCV proliferation than those who remained anti‐HCV positive. The data suggest that complete viral eradication is a possible and achievable clinical objective.
Can inclusion of serum creatinine values improve the Child–Turcotte–Pugh score and challenge the prognostic yield of the model for end‐stage liver disease score in the short‐term prognostic assessment of cirrhotic patients?*
Authors: Giannini Edoardo , Botta Federica , Fumagalli Alessandra , Malfatti Federica , Testa Emanuela , Chiarbonello Bruno , Polegato Simone , Bellotti Michele , Milazzo Sara , Borgonovo Giacomo , Testa Roberto 
Published: October 2004

Abstract: Background: The model for end‐stage liver disease (MELD) score is a useful tool to assess prognosis in critically ill cirrhotic patients. However, its short‐term prognostic superiority over the traditional Child–Turcotte–Pugh (CTP) score has not been definitely confirmed. The creatinine serum level is an important predictor of survival in patients with liver cirrhosis.Aims: To evaluate and compare the short‐term prognostic accuracy of the CTP, the creatinine‐modified CTP, and the MELD scores in patients with liver cirrhosis.Methods: CTP, creatinine‐modified CTP, and MELD scores were calculated in a cohort of 145 cirrhotic patients. The creatinine‐modified CTP was calculated as follows: we assessed the mean creatinine serum level and standard deviation (SD) of the 145 study patients, then assigned a score of 1 to patients with creatinine serum levels ≤ to the mean, a score of 2 to patients with creatinine levels between the mean and the mean+1 SD, and a score of 3 to patients with creatinine levels above the mean+1 SD. The creatinine‐modified CTP was then calculated by simply adding each patients' creatinine score to their traditional CTP scores. We calculated and compared the accuracy (c‐index) of the three parameters in predicting 3‐month survival.Results: The creatinine‐modified CTP score showed better prognostic accuracy as compared with the traditional CTP (P=0.049). However, the MELD score proved to be better at defining patients' prognosis in the short‐term as compared with both the traditional CTP score (P=0.012) and the creatinine‐modified CTP (P=0.047). The excellent short‐term prognostic accuracy of the MELD score was confirmed even when patients with abnormal creatinine serum levels were excluded from the analysis (c‐index=0.935).Conclusions: Adding creatinine values to the CTP slightly improves the prognostic usefulness of the traditional CTP score alone. The MELD score has a short‐term prognostic yield that is better than what is provided by both the CTP and CTP creatinine‐modified scores, even in cirrhotic patients who are not critically ill. The positive results obtained by using the MELD score were confirmed even after excluding patients with impaired renal function.
Halofuginone can worsen liver fibrosis in bile duct obstructed rats
Authors: Van de Casteele Marc , Roskams Tania , Van der Elst Ingrid , Van Pelt Jos F. , Fevery Johan , Nevens Frederik 
Published: October 2004

Abstract: Background/aims: Halofuginone (HF) is an antifibrotic agent in rat models of liver fibrosis caused by repetitive intoxications. A beneficial effect of HF on a biliary type of liver fibrosis has not been proven yet.Methods: Bile duct‐obstructed rats were given HF from the moment of obstruction onwards and compared with no treatment. After 3 weeks, respectively, 6 weeks, aminopyrine breath test (ABT) and haemodynamic measurements including of portal pressure were carried out. Liver pieces were taken for Sirius red quantitative scoring, as well as for semiquantitative determinations of collagen type I and III RNA levels.Results: ABT was significantly worse in HF‐treated rats as compared with no treatment (P=0.02). Haemodynamic data and collagen type I and III determinations were not significantly different between groups. Biliary fibrosis scores were significantly higher in HF‐treated rats as compared with no treatment (P=0.03). More Sirius red staining was associated with more proliferation of bile ductules.Conclusions: HF may worsen biliary fibrosis. This contrasts sharply with antifibrotic effects in other models of liver fibrosis. Distinctive cellular mechanisms in biliary fibrosis may explain this discrepancy. One should be cautious for chronic application of HF in man with cholestasis.
Incomplete septal cirrhosis: an enigmatic disease
Authors: Schinoni Maria I. , Andrade Zilton , De Freitas Luiz A.R. , Oliveira Rubem , Paraná Raimundo 
Published: October 2004

Abstract: Incomplete septal cirrhosis is a form of macronodular cirrhosis characterized by fine and incomplete septa, which delimit rudimentary regeneration nodules. Its etiopathogeny is uncertain and is associated with various diseases such as regenerative nodular hyperplasia, idiopathic portal hypertension, and partial non‐cirrhotic nodular transformation, as well as with progression and regression of cirrhosis of any etiology. Few studies are available in the literature describing the clinical and biological characteristics of incomplete septal cirrhosis.Goal: The objective of the present descriptive study was to study this entity in the city of Salvador, Bahia, Brazil, and to compare the histopathological, biological and clinical data obtained with those reported in the specialized literature.Materials and Methods: We reviewed eight cases of incomplete septal cirrhois of varieties etiologies. Hepatitis C, autoimmune hepatitis, alcoholic liver disease and criptogenic liver disease were present in our cases. Fibrosis progression as well as cirrhosis regression could be identified in these patients.Conclusions: We concluded that Incomplete septal cirrhosis is not a disease itself but it could be considered as a stage of progression and regression of liver fibrosis.
Clinical characteristics and outcome of patients with cirrhosis and refractory ascites
Authors: Moreau Richard , Delègue Paul , Pessione Fabienne , Hillaire Sophie , Durand François , Lebrec Didier , Valla Dominique‐Charles 
Published: October 2004

Abstract: Background: In patients with cirrhosis, refractory ascites is associated with a poor prognosis and is an indication for liver transplantation. However, factors that determine prognosis remain unclear.Aims: To investigate the predictive factors of prognosis in patients with refractory ascites.Methods: Seventy‐five patients with refractory ascites were followed‐up for 18±13 months (mean±SD) and survival was analyzed.Results: The 1‐year probability of survival was 52%. Univariate analyses showed that older patients, hepatocellular carcinoma and diabetes, all assessed at entry, were associated with significantly increased risk ratios of death. The risk ratio of death was significantly lower in abstinent alcoholics than in patients with nonalcoholic cirrhosis. The risk ratio of death did not significantly differ between patients with nonalcoholic cirrhosis and nonabstinent alcoholics. Child–Pugh score at entry had no prognostic value. Multivariate analysis showed that older age, hepatocellular carcinoma, diabetes and abstinence were independent prognostic factors.Conclusions: In patients with cirrhosis and refractory ascites, older age, hepatocellular carcinoma and diabetes, but not Child–Pugh score at entry, were independent predictive factors of poor survival while abstinence was an independent predictive factor of good survival. These findings should be taken into account when deciding on liver transplantation in patients with refractory ascites.
Cardiac troponin‐I and its prognostic significance in a dialysis population
Authors: Hussein Magdi , Mooij Jaap , Roujouleh Haysam , AL Shenawi Omer 
Published: October 2004

AbstractBackground:  The objective was to study the prevalence and specificity of elevated levels of cardiac troponin‐I (cT‐I) in patients on maintenance hemodialysis in relation to creatine kinase (CK), the CK‐MB fraction, and the ratio CK‐MB of total CK and to assess its significance for the long‐term prognosis in these patients, compared to other parameters known to influence the outcome.Methods:  Predialysis blood samples were taken from 93 asymptomatic hemodialysis patients for cT‐I, total CK, the CK‐MB fraction, and the ratio of CK‐MB to total CK. cT‐I was measured by a microparticle enzyme immunoassay. The patients were followed for 1 year, after which baseline levels of cT‐I and age, duration of dialysis, and the presence of diabetes mellitus and ischemic heart disease were correlated by linear regression analysis with the outcome parameter all‐cause mortality.Results:  None of the patients had a cT‐I level higher than the manufacturer's indicated cutoff point of 2.0 ng/mL for myocardial infarction, indicating a specificity of 100%. Nine of the 93 patients (9.7%) had detectable cT‐I levels (>0.0 ng/mL). Twelve patients died within 1 year, among which 4 had baseline cT‐I levels above 0 ng/mL. From the study variables, an elevated baseline cT‐I was found to be the only factor that significantly correlated with the outcome all‐cause mortality (p = 0.029).Conclusions:  cT‐I has a high specificity for the diagnosis of myocardial infarction in dialysis patients. Despite the relatively low number of positive test results, cT‐I was found to be significantly correlated with the outcome all‐cause mortality at 1 year.
The opposing actions of the two parathyroid hormones, 1‐84 PTH and 7‐84 PTH: Improvement in renal bone and calcium metabolism management
Authors: Cantor Thomas L 
Published: October 2004

AbstractBone biopsy, while invasive, is the gold standard for assessing bone status. According to published bone biopsy studies, half of the end‐stage renal disease patients have adynamic bone disease. Compared to high‐bone‐turnover disease, adynamic bone disease has the higher mortality and is associated with arterial calcification. The treatment for high‐bone‐turnover disease is divergent from the treatment for adynamic bone disease. The parathyroid hormone (PTH) assay has been relied on as the routine, noninvasive diagnostic method to assess bone status. According to bone biopsy studies, the intact PTH assay has been demonstrated as ineffective at differentiating adynamic bone disease from normal and high‐bone‐turnover disease. For example, bone biopsy studies found the normal range for iPTH to be 451 to 1339 pg/mL and the range for adynamic bone disease to be 400 to 919 pg/mL. Intact PTH measures the sum of the two PTH hormones 1‐84 PTH and 7‐84 PTH. Specific 1‐84 PTH assays neglect the role of the 7‐84 PTH hormone, which is to lower bone turnover. According to independent bone biopsy studies, the 1‐84 PTH/7‐84 PTH ratio is 94% accurate in identifying adynamic bone disease and 94% accurate in assessing bone‐turnover status.
Convective renal replacement therapies for acute renal failure and end‐stage renal disease
Authors: Huang Zhongping , Li Baochun , Zhang Weiming , Gao Dayong , Kraus Michael A , Clark William R 
Published: October 2004

AbstractAlthough hemodialysis remains the primary treatment modality for the management of patients with end‐stage renal disease (ESRD), its clearance of relatively large‐sized uremic toxins is limited due to its primarily diffusive nature. Moreover, recent studies suggesting conventional, diffusion‐based therapies may be limited in their ability to influence outcome in ESRD patients indicate the need for alternative chronic dialysis approaches, an example of which is convective therapies. In an analogous manner, a reassessment of the dialytic management of critically ill patients with acute renal failure (ARF) has also occurred recently based on clinical evidence that high‐dose continuous hemofiltration improves survival. These recent clinical results suggest the utilization of convective therapies in both ARF and ESRD will increase in the future. This article provides a review of convective therapies, with an initial discussion of the determinants of convective solute removal. This is followed by a comprehensive overview of the manner in which hemofiltration and hemodiafiltration are applied clinically.
Retinoic acid disintegrated desmosomes and hemidesmosomes in stratified oral keratinocytes
Authors: Hatakeyama S. , Hayashi S. , Yoshida Y. , Otsubo A. , Yoshimoto K. , Oikawa Y. , Satoh M. 
Published: October 2004

Background:  Although it is known that retinoic acid (RA) regulates the cellular differentiation of skin keratinocytes, the effects of RA on the anchoring junction have not been clarified. The effects of all‐trans RA on cell–cell and cell–matrix connections of gingival epithelial (GE)1 cells in a multilayered culture were investigated.Methods:  Ultrastructures of GE1 cells were observed and immunohistochemistry was used to detect keratin 4, keratin 13, and desmoglein expression. Reverse transcription‐polymerase chain reaction was performed to detect expression of desmosome and hemidesmosome‐associating adhesion molecules, keratin 13, and keratin14.Results:  Retinoic acid caused immunohistochemical diminution of keratin 4, keratin 13, and desmoglein. Ultrastructurally, RA induced drastic loss of typical desmosomes and complete loss of hemidesmosomes. RA significantly decreased the transcript levels of keratin 13, keratin 14, desmoglein 1, and desmocollin 1 in a dose‐dependent manner. The 230‐kD bullous pemphigoid antigen (BPAG1) gene expression was also reduced by RA, whereas transcript levels of integrin α6, integrin β4, the 180‐kD bullous pemphigoid antigen (BPAG2), and laminin 5 were not affected.Conclusion:  These results indicated that RA disintegrated not only desmosomes by depriving the cells of desmoglein 1, desmocollin 1, keratin 13, and keratin 4, but also hemidesmosomes by reducing the expression of BPAG1 and keratin 14 in basal keratinocytes.
Role of angiogenic and non‐angiogenic mechanisms in oral squamous cell carcinoma: correlation with histologic differentiation and tumor progression
Authors: Shieh Yi‐Shing , Lee Herng‐Sheng , Shiah Shine‐Gwo , Chu Yi‐Wen , Wu Cheng‐Wen , Chang Long‐Chang 
Published: October 2004

Background:  Angiogenesis has been demonstrated to associate with various measures of tumor aggressiveness in many human malignancies. However, studies of tumor angiogenesis in oral squamous cell carcinoma (SCC) are still unclear. Recent studies indicate non‐angiogenesis mechanism (tumor‐lined vessel) may exist in certain tumors. Therefore, we investigate microvessel density (MVD) and tumor‐lined vessel in oral SCC.Methods:  Peritumoral and intratumoral MVD were measured by immunohistochemical staining. Tumor‐lined vessels were identified by double staining. Statistical analysis of peritumoral and intratumoral MVD and presence of tumor‐lined vessels with clinicopathologic parameters was performed.Results:  The results showed peritumoral MVD increased with disease progression and further increases of intratumoral MVD was detected by CD31 and CD34. Non‐angiogenesis, tumor‐lined vessel, presented in oral SCC and correlated significantly with tumor size, stage, and histologic differentiation.Conclusion:  Our results suggest at the initiation of oral SCC, increasing vascularity is observed at the periphery of the tumor. As the tumor continues to grow, further increases of intratumoral vascularity and the presence of tumor‐lined vessels are associated with cancer progression.
Dental hygiene in Australia: a global perspective
Authors: Luciak‐Donsberger C , Aldenhoven S 
Published: October 2004

Abstract:Aim:  This article reports on the practice of dental hygiene in Australia from a global perspective. The aim is to examine how access to qualified dental hygiene care could be improved and how current professional challenges might be met.Method:  Secondary source data were obtained from a survey questionnaire presented to members of the House of Delegates of the IFDH or by fax and e‐mail to experts involved in the national professional and educational organization of dental hygiene in non‐IFDH member countries. Responses were followed‐up by interviews, e‐mail correspondence, visits to international universities, and a review of supporting studies and reference literature.Results:  The introduction of dental hygiene in Australia was inspired by the delivery of preventive care in Great Britain. Today dental hygiene is a paramedical profession, generally studied at institutions of higher education. Study duration is 2 (diploma and associate degree programmes) and 3 years (Bachelor of Oral Health Programs). A recent trend to combine dental therapy and dental hygiene education poses the challenge to maintain a stand‐alone degree in dental hygiene as it is practiced worldwide. Low access to qualified dental hygiene care may be a result of insufficient funding for preventive services, social and cultural lack of awareness of the benefits of preventive care, and of limitations inherent in the legal constraints preventing unsupervised dental hygiene practice. These may be a result of gender politics affecting a female dominated profession and of a perception that dental hygiene is auxiliary to dental care. Changes are expected to reflect the global trend towards a decrease in supervision and towards higher education. An example of innovative practice of public health is the involvement of dental hygienists in the educational process of aboriginal health workers in order to promote access to oral health education for indigenous populations.
Evidence‐based practice and the professionalization of dental hygiene
Authors: Cobban Sandra J 
Published: October 2004

Abstract:The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence‐based decision making in practice. The purpose of this paper is to explore the development of the evidence‐based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research–practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence‐based dental hygiene practice.
Knowledge on gingivitis and oral hygiene practices among secondary school adolescents in rural and urban Morogoro, Tanzania*
Authors: Masanja IM , Mumghamba EGS 
Published: October 2004

Abstract:Objectives:  To assess and compare knowledge on gingivitis and oral hygiene practices among rural and urban secondary school students.Design:  A cross‐section descriptive study involving secondary school students aged between 13 and 17 years in Morogoro rural and urban districts.Methods:  Questionnaire was used to collect information about knowledge on causes, signs, symptoms, complications, treatment modalities and prevention of gingivitis, as well as on oral hygiene practices.Results:  A total of 196 students participated in this study, of which 58.7% were females, and 52% were from urban schools. The responses were graded into three criteria namely ‘lack of knowledge’, ‘partial knowledge’ and ‘total or full knowledge’. There was a partial knowledge about gingivitis and full knowledge of the basic oral hygiene measures among secondary school teenagers. The difference between rural and urban residence on the level of understanding was statistically significant in relation to tooth brushing practices (P = 0.0088), necessity of using toothpaste (P = 0.0204), reasons for using toothpaste (P = 0.0057), signs and symptoms of gingivitis (P = 0.0261) and treatment of gingivitis (P = 0.0106). However, there were no statistically significant differences in distribution of study participants, understanding of tooth brushing practices, reasons for tooth brushing, causes, prevention and complications of gingivitis.Conclusion:  Secondary school teenagers have partial knowledge about gingivitis and a good knowledge of the basic oral hygiene measures necessary to maintain proper oral health. A small difference on knowledge in specific areas was noted among rural and urban respondents.