bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of selective cyclooxygenase‐2 inhibitors on anti‐ulcer medication and non‐steroidal anti‐inflammatory drug use in patients with rheumatic disease
Authors: Joshua F. F. , Oakley S. P. , Major G. A. 
Published: November 2004

Abstract Background : Anti‐inflammatory medications are the most common treatment for rheumatic disease in Australia. Recent years have seen large increases in the use of selective cyclooxygenase‐2 (COX‐2) inhibitors. Predictors of use, costs and benefits of the new medications have not been evaluated.Aims : To determine trends in selective COX‐2 inhibitor, non‐steroidal anti‐inflammatory drug (NSAID) and anti‐ulcer medication (AUM) prescription following the introduction of selective COX‐2 inhibitors; to determine predictors of selective COX‐2 inhibitor, NSAID and AUM prescribing and to perform a limited evaluation of the costs and benefits associated with the introduction of selective COX‐2 inhibitors.Methods : Groups of consecutive patients attending a hospital rheumatology clinic, private rooms of consulting rheumatologists and a dermatology outpatient clinic were surveyed by investigator‐administered questionnaire on three separate occasions. Information was sought about AUM, NSAID and selective COX‐2 use and about factors likely to influence selective COX‐2 prescribing. Sampling was carried out at 3, 10 and 16 months after the release of COX‐2 selective inhibitors in Australia. The final survey was 3 months after Pharmaceutical Benefits Scheme (PBS) listing of celecoxib in Australia. Costs of treatment were calculated from survey findings of frequency of drug use as well as published drug prices and hospitalisation costs.Results : Four‐hundred and fifty‐eight patients were surveyed. From the 3 months post‐release to the 3 months post‐PBS listing, a period of 13 months, COX‐2 use in rheumatology patients increased from 18 to 57%. De novo prescription of selective COX‐2 inhibitors increased from 42 to 61%. During the same period there was a fall in both NSAID (43−20%) and AUM use (41−27%). Neither selective COX‐2 inhibitor nor NSAID prescription was related to risk factors for gastro­intestinal (GI) complications, but AUM use was found to correlate strongly to histories of gastroscopy, GI ulceration or GI bleed. The calculated increase in the cost of treatment was $1 033 002/10 000 patients per year. The net cost per serious GI event prevented was $71 736, compared with the normal cost of treatment of $2004.Conclusions : Among rheumatology patients, selective COX‐2 inhibitors have largely replaced NSAIDs and have resulted in a reduction in AUM consumption, but prescribing patterns for selective COX‐2 inhibitors have not been related clearly to risk factors for GI compli­cations. The introduction of selective COX‐2 inhibitors has been associated with a significant increase in expenditure. (Intern Med J 2004; 34: 153−161)
Impact of hydroxychloroquine therapy on chronic urticaria: chronic autoimmune urticaria study and evaluation
Authors: Reeves G. E. M. , Boyle M. J. , Bonfield J. , Dobson P. , Loewenthal M. 
Published: November 2004

Abstract Background:  Chronic urticaria (CU) imposes profound impairment on quality of life. Up to 60% of idiopathic CU is associated with autoimmune phenomena, and may respond to immunomodulation. Hydroxychloroquine offers potential efficacy for CU and is relatively benign compared with most other therapeutic approaches.Objective:  The aim of the chronic autoimmune urticaria study and evaluation was to evaluate the efficacy of hydroxychloroquine in patients with chronic idiopathic urticaria.Methods:  Twenty‐one patients referred to the Immunology and Allergy Unit at John Hunter Hospital, New South Wales, Australia, with idiopathic CU were randomised to receive treatment with standard urticaria therapies (corticosteroids, H2‐antihistamines, H1‐­antihistamines, doxepin) with or without hydroxychloroquine. Markers of autoimmunity, thyroid disease and mast‐cell autoreactivity (autologous serum skin‐prick testing (ASPT)) were assessed. Measures of urticaria control were compared at baseline and at 12 weeks for the 18 individuals who completed the study. These included urticaria scores, medication scores and quality‐of‐life indices.Results:  The hydroxychloroquine‐treated group achieved significant improvements in quality of life as assessed by the global symptom severity score and the LAMY‐7 (a quality of life index designed by Lamy, 7th revision) at 12 weeks (P < 0.01 and P < 0.05, respectively). No significant treatment effect on medication requirements or urticaria score was detected, although differences between treatment groups approached statistical significance for urticaria score and medication requirements (0.05 < P < 0.10). ASPT‐reactivity did not correlate to hydroxychloroquine‐responsiveness. Hydroxychloroquine was well tolerated.Conclusion:  Immunomodulation with hydroxychloroquine is safe and appears to offer some efficacy as an intervention in CU. (Intern Med J 2004; 34: 182−186)
The Wellcome Trust in Australasia: return on investment
Authors: Whitworth J. A. , Phillips M. , Jack J. 
Published: November 2004

Abstract The Wellcome Trust is the world's largest medical research charity. Investment by the Trust in research in Australia and New Zealand has contributed very substantially to local research capacity through support of people, equipment and programmes. Further, the Trust's funding has ­successfully leveraged additional investment from both government and charitable foundations. Current initiatives are focused on development of research partnerships between Australasia and our regional neighbours. (Intern Med J 2004; 34: 211−214)
Clinical features in the emergency department can identify patients with suspected acute coronary syndromes who are safe for care in unmonitored hospital beds
Authors: Kelly A.‐M. , Kerr D. 
Published: November 2004

AbstractBackground: Standard practice for patients requiring hospital admission with suspected acute coronary syndromes (ACS) is admission to a monitored cardiology bed. The Western Hospital Chest Pain Protocol was developed to identify a subset of these patients who could be safely managed in an unmonitored bed.Aim: The objective of this prospective study of chest pain patients classified as ‘high’ or ‘intermediate’ risk by the Agency for Health Care Policy and Research/National Health and Medical Research Council guidelines was to further evaluate the safety of this protocol.Methods: This study was a prospective, observational, cohort study investigating the outcomes of patients admitted to hospital with suspected ACS. The primary outcome of interest was death or life‐threatening arrhythmia within 24 h of hospital admission.Results: If the Western Hospital Chest Pain Protocol had been strictly applied, there would have been one death in the group assigned to unmonitored beds (1/750; 0.13%, 95% confidence interval 0.01−0.85%) and no other life‐threatening arrhythmias.Conclusion: There is a subgroup of patients with suspected ACS who require hospital admission who can, based on clinical and biochemical features in the emergency department, be safely assigned to unmonitored beds. (Intern Med J 2004; 34: 594−597)
Unobvious wounds: the suffering of hospice patients
Authors: Terry W. , Olson L. G. 
Published: November 2004

AbstractBackground:  The suffering of palliative care patients is ordinarily thought of in terms of symptoms, and these are identified by medical terms (pain, nausea, depression). The problematic issue of relief of patients’ pain meaning the same thing as the ‘relief of the suffering and distress of terminally ill patients’ has been raised.Aim:  The aim of this study was to estimate the frequency with which medically defined suffering matched the reported suffering of our patients.Methods:  One hundred patients admitted to a hospice were asked ‘In what way are you suffering?’ The patients’ diagnoses, their pain scores and the reasons for admission as defined by the treating clinicians were recorded. The mean age of the patients was 68 years (range 28−93 years), 92 had advanced malignant disease and 51 were women.Results:  Twenty‐four patients were unable to state the reason for hospice admission, but none had any uncertainty in identifying the nature of their own suffering. There was a weak correlation between the patient's view of their suffering and the reason for admission. The identification of pain as the cause of suffering was weakly correlated with pain scores. Some patients with pain scores of 8−10/10 did not mention pain as a cause of suffering, and others with scores of 0/10 did identify pain as the cause of suffering.Conclusion:  Asking hospice patients about suffering in a simple open‐ended way can expose a different dimension of distress, and the views of the 100 patients of this study support the statement that relief of pain and relief of suffering are not the same. (Intern Med J 2004; 34: 604−607)
Trust and confidence: towards mutual acceptance of ethics committee approval of multicentre studies
Authors: Sarson‐Lawrence M. , Alt C. , Mok M. T. , Dodds M. , Rosenthal M. A. 
Published: November 2004

AbstractAims:  To compare issues raised by Human Research Ethics Committees (HREC) during the ethics review process and to determine the length of time taken to gain HREC approval for multicentre research studies.Methods:  Review and analysis of HREC documentation and correspondence for all multicentre research studies were conducted through three HREC under the auspices of Cancer Trials Australia, Melbourne, Victoria, Australia, between November 1997 and March 2001 to determine the variance of documentation, correspondence and recommendations across the three HREC and the time taken for study approval.Results:  Thirty‐one projects were submitted to any two of the HREC (16 studies) or all three HREC (15 studies). The median time for study approval at an individual HREC was 75 days, but it was 111 days for approval at all participating sites. There were 554 clarifications or comments made by the reviewing HREC, the majority of which had no significant bearing on the ethical or scientific calibre of the study. There was only one study in which a significant protocol change was requested by a HREC.Conclusions:  Multicentre study approvals are delayed when submitted to multiple HREC. The three HREC raised similar issues without substantive differences in their recommendations. A process for the mutual acceptance of HREC recommendations could facilitate multicentre research. (Intern Med J 2004; 34: 598−603)
Input and frequency‐specific entrainment of postsynaptic firing by IPSPs of perisomatic or dendritic origin
Authors: Tamás Gábor , Szabadics János , Lörincz Andrea , Somogyi Peter 
Published: November 2004

AbstractCorrelated activity of cortical neurons underlies cognitive processes. Networks of several distinct classes of γ‐aminobutyric acid (GABA)ergic interneurons are capable of synchronizing cortical neurons at behaviourally relevant frequencies. Here we show that perisomatic and dendritic GABAergic inputs provided by two classes of GABAergic cells, fast spiking and bitufted interneurons, respectively, entrain the timing of postsynaptic spikes differentially in both pyramidal cells and interneurons at beta and gamma frequencies. Entrainment of pyramidal as well as regular spiking non‐pyramidal cells was input site and inhibitory postsynaptic potential frequency dependent. Gamma frequency input from fast spiking cells entrained pyramidal cells on the positive phase of an intrinsic cellular theta oscillation, whereas input from bitufted cells was most effective in gamma frequency entrainment on the negative phase of the theta oscillation. The discharge of regular spiking interneurons was phased at gamma frequency by dendritic input from bitufted cells, but not by perisomatic input from fast spiking cells. Action potentials in fast spiking GABAergic neurons were phased at gamma frequency by both other fast spiking and bitufted cells, regardless of whether the presynaptic GABAergic input was at gamma or beta frequency. The interaction of cell type‐specific intrinsic properties and location‐selective GABAergic inputs could result in a spatio‐temporally regulated synchronization and gating of cortical spike propagation in the network.
Involvement of corticostriatal glutamatergic terminals in striatal dopamine release elicited by stimulation of δ‐opioid receptors
Authors: Billet Fabrice , Dourmap Nathalie , Costentin Jean 
Published: November 2004

AbstractWe have previously shown that striatal dopamine release induced locally by a δ‐opioid receptor agonist was totally inhibited by a glutamate N‐methyl‐d‐aspartate receptor antagonist, indicating the involvement of glutamatergic receptors in this effect. The aim of the present study was to specify this mechanism. Firstly, we investigated the effect of [D‐Pen2,D‐Pen5]‐enkephalin (DPDPE) on glutamate release in rats by intrastriatal microdialysis. The infusion of DPDPE (10 µm) enhanced the glutamate content in dialysate by approximately 34%, an effect which did not appear to result from inhibition of glutamate uptake. We then considered the consequences of a unilateral thermocoagulation of the frontal cortex on either glutamate or dopamine release induced by stimulation of δ‐opioid receptors 2 days later. This lesion, which decreased the glutamate content in ipsilateral striatum by approximately 30%, totally prevented the increase in dialysate levels of glutamate induced by DPDPE. Moreover, whereas DPDPE (10 µm) was found to increase the striatal dopamine release in intact animals by approximately 59%, this effect was also completely suppressed by the cortical lesion. Finally, we studied the effect of the lesion on the [3H]‐DPDPE binding to striatal membranes prepared from the whole striatum. In the ipsilateral striatum a significant decrease in this [3H]‐DPDPE binding (by approximately 18%) was found 2 days after the lesion. Our results indicate that the increase in striatal dopamine release induced by DPDPE probably depends on glutamate release from corticostriatal glutamatergic afferents in response to the stimulation of δ‐opioid receptors located on terminals of these neurons.
The extracellular matrix glycoprotein Tenascin‐C is expressed by oligodendrocyte precursor cells and required for the regulation of maturation rate, survival and responsiveness to platelet‐derived growth factor
Authors: Garwood Jeremy , Garcion Emmanuel , Dobbertin Alexandre , Heck Nicolas , Calco Valerie , Ffrench‐Constant Charles , Faissner Andreas 
Published: November 2004

AbstractAnalysis of Tenascin‐C (TN‐C) knockout mice revealed novel roles for this extracellular matrix (ECM) protein in regulation of the developmental programme of oligodendrocyte precursor cells (OPCs), their maturation into myelinating oligodendrocytes and sensitivity to growth factors. A major component of the ECM of developing nervous tissue, TN‐C was expressed in zones of proliferation, migration and morphogenesis. Examination of TN‐C knockout mice showed roles for TN‐C in control of OPC proliferation and migration towards zones of myelination [E. Garcion et al. (2001) Development, 128, 2485–2496]. Extending our studies of TN‐C effects on OPC development we found that OPCs can endogenously express TN‐C protein. This expression covered the whole range of possible TN‐C isoforms and could be strongly up‐regulated by leukaemia inhibitory factor and ciliary neurotrophic factor, cytokines known to modulate OPC proliferation and survival. Comparative analysis of TN‐C knockout OPCs with wild‐type OPCs reveals an accelerated rate of maturation in the absence of TN‐C, with earlier morphological differentiation and precocious expression of myelin basic protein. TN‐C knockout OPCs plated on poly‐lysine displayed higher levels of apoptosis than wild‐type OPCs and there was also an earlier loss of responsiveness to the protective effects of platelet‐derived growth factor (PDGF), indicating that TN‐C has anti‐apoptotic effects that may be associated with PDGF signalling. The existence of mechanisms to compensate for the absence of TN‐C in the knockout is indicated by the development of oligodendrocytes derived from TN‐C knockout neurospheres. These were present in equivalent proportions to those found in wild‐type neurospheres but displayed enhanced myelin membrane formation.
Nucleus accumbens neurons in the rat exhibit differential activity to conditioned reinforcers and primary reinforcers within a second‐order schedule of saccharin reinforcement
Authors: Wilson David I. G. , Bowman Eric M. 
Published: November 2004

AbstractThe nucleus accumbens has been associated with processing information related to primary reinforcement and reward. Most neurophysiological studies report that nucleus accumbens neurons are phasically excited in response to the onsets of salient events during the seeking of reinforcement and to the delivery of primary reinforcers. However, a minority of studies report inhibition during primary reinforcement. We recorded from 65 neurons in the nucleus accumbens whilst thirsty rats performed under a second‐order schedule of saccharin reinforcement. This allowed us to analyse neural activity and behaviour during reinforcer‐seeking in the presence of conditioned reinforcers (second‐order stimuli, also called ‘conditioned stimuli’), and during primary reinforcer consumption. Specifically, we sought to examine the valence of potential neural responses to primary reinforcement, to compare these responses to second‐order stimulus‐evoked responses, and to determine whether responses were differential to second‐order stimuli presented at different time points within the schedule. Fifty out of 65 neurons we sampled responded to the second‐order stimulus and/or consumption of the primary reinforcer. Most neurons in our sample exhibited excitation following the second‐order stimulus and inhibition to the primary reinforcer, a pattern also present over the average response of the neural population. However, there was no systematic variation in neural responses evoked by second‐order stimuli presented at different temporal proximities to primary reinforcement. Our results provide evidence that partially overlapping mechanisms within the nucleus accumbens differentially process conditioned reinforcers and primary reinforcers.
Putative NMDA receptors in Hydra: a biochemical and functional study
Authors: Pierobon Paola , Sogliano Cristiana , Minei Rosario , Tino Angela , Porcu Patrizia , Marino Giuseppe , Tortiglione Claudia , Concas Alessandra 
Published: November 2004

AbstractThe feeding behaviour of the freshwater polyp Hydra vulgaris (Cnidaria, Hydrozoa) is modulated by a number of molecules acting as neurotransmitters in other nervous systems. Here we present biochemical and functional evidence of the occurrence of putative NMDA receptors in Hydra tissues. Saturation experiments showed the presence of one population of binding sites with nanomolar affinity and low capacity for [3H]MK‐801. Before equilibrium, [3H]MK‐801 binding was increased by the agonists glutamate and glycine as well as by reduced glutathione (GSH). In vivo the glutamate receptor agonist NMDA markedly decreased the duration of the response to GSH. This effect was linearly related to ligand doses in the nanomolar concentration range and was counteracted by either the NMDAR‐specific antagonist D‐AP5 or by the d‐serine antagonist DCKA. When NMDA concentration was increased to 10 or 100 µm, duration of the response to GSH was no longer affected unless the lectin concanavalin A, which prevents receptor desensitization in other systems, was added to the test medium. Simultaneous administration of ineffective doses of NMDA and strychnine, glycine or d‐serine, an agonist at the glycine binding site of the NMDA receptor in vertebrate CNS, resulted in a strong reduction of response duration. Both D‐AP5 and DCKA suppressed this effect. These results, together with the decrease in response duration produced by d‐serine, support the hypothesis that NMDA‐like glutamate receptors may occur in Hydra tissues where they are involved in modulation of the response to GSH with opposite actions to those of GABA and glycine.
Peripherally inserted central venous catheters in preterm newborns: two unusual complications
Authors: Pigna A. , Bachiocco V. , Fae M. , Cuppini F. 
Published: November 2004

SummaryThis report describes the case of two newborns who suffered unusual complications after peripheral insertion of a central venous catheter. In one baby a fragment of the catheter tip became embolized in a peripheral branch of the left pulmonary artery. In the other baby, the catheter perforated a peripheral branch of the pulmonary artery, giving rise to chemical pneumonitis with extensive pleural effusion. The outcome was positive for both babies. A large clinical series is necessary to establish the complications of this procedure, their prevention and management.
Anaesthetic experiences in three sets of conjoined twins in King Chulalongkorn Memorial Hospital
Authors: Leelanukrom Ruenreong , Somboonviboon Wanna , Bunburaphong Pavena , Kiatkungwanklai Predee 
Published: November 2004

SummaryWe describe the anaesthetic management for magnetic resonance image scanning, angiography and surgical operations in three sets of conjoined twins (ischiopagus, throracopagus and pygopagus) in King Chulalongkorn Memorial Hospital during 1996–2002. The anaesthetic technique and associated problems are summarized.
Unexpectedly high clonal diversity of two salt marsh perennials across a severe environmental gradient
Authors: Richards Christina L. , Hamrick J. L. , Donovan Lisa A. , Mauricio Rodney 
Published: November 2004

AbstractIn salt marsh habitats, noted for their extreme environments, a widely held assumption is that a few large clones dominate plant populations. Using a large number of polymorphic genetic markers, we were able to test this assumption for two salt marsh plants known to span extreme salinity gradients. For both species, clonal diversity was surprisingly high across populations: Simpson's diversity indices were 0.96 and 0.99. Although clonal diversity was high, there was no pattern of association between specific clones or alleles with salt microhabitat. Our findings suggest that sexual reproduction and recruitment from seeds may have been generally underappreciated as an important ecological force in the salt marsh. Furthermore, clonal diversity has implications for conservation and restoration of these critical coastal habitats, particularly with regard to buffering environmental change or disease. Recent studies also suggest that high levels of intraspecific diversity can affect a variety of community and ecosystem processes.
The coincidence of rarity and richness and the potential signature of history in centres of endemism
Authors: Jetz Walter , Rahbek Carsten , Colwell Robert K. 
Published: November 2004

AbstractWe investigate the relative importance of stochastic and environmental/topographic effects on the occurrence of avian centres of endemism, evaluating their potential historical importance for broad‐scale patterns in species richness across Sub‐Saharan Africa. Because species‐rich areas are more likely to be centres of endemism by chance alone, we test two null models: Model 1 calculates expected patterns of endemism using a random draw from the occurrence records of the continental assemblage, whereas Model 2 additionally implements the potential role of geometric constraints. Since Model 1 yields better quantitative predictions we use it to identify centres of endemism controlled for richness. Altitudinal range and low seasonality emerge as core environmental predictors for these areas, which contain unusually high species richness compared to other parts of sub‐Saharan Africa, even when controlled for environmental differences. This result supports the idea that centres of endemism may represent areas of special evolutionary history, probably as centres of diversification.