bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caesarean section increases the risk of hospital care in childhood for asthma and gastroenteritis
Authors: Håkansson S. , Källén K. 
Published: June 2003

SummaryObjective To investigate if caesarean section (CS) increases the risk for childhood asthma and gastroenteritis with reference made to children born with vaginal delivery (VD).Methods Retrospective study of data from linked Swedish medical service registers – Medical Birth Registry (MBR) and Hospital Discharge Registry (HDR). Data were obtained from women without any background/perinatal morbidity noted, and from children without any neonatal complications. Children that had reached at least 1 year of age and were found in the HDR were considered as cases, whereas children not found in the HDR or hospitalized for other causes than asthma or gastroenteritis were defined as controls. Odds ratios (OR) stratified for year of birth, maternal age, parity and smoking in early pregnancy were calculated. Investigations were made comparing the risk for in hospital treatment for asthma or gastroenteritis in CS children and in VD siblings of CS children. The overall inpatient morbidity in CS and VD children were also investigated.Results The OR for asthma in CS children was 1.31 [95% confidence interval (CI) 1.23–1.40]. The same OR, 1.31, was found for gastroenteritis (95% CI 1.24–1.38). The OR for CS children having experienced both asthma and gastroenteritis was further increased (1.74, 95% CI 1.36–2.23). The risk for asthma in VD siblings of CS children was not significantly increased, whereas VD siblings experienced a slightly increased risk for gastroenteritis. CS children had an increased overall in hospital morbidity when compared to VD children.Conclusion There is a significant increase of the risk for developing symptoms of asthma and/or gastroenteritis that motivates admission for hospital care in CS children older than 1 year. It is speculated that a disturbed intestinal colonization pattern in CS children may be a common pathogenic factor.
Neonatal head circumference, neonatal weight, and risk of hayfever, asthma and eczema in a large cohort of adolescents from Sheffield, England
Authors: Katz K. A. , Pocock S. J. , Strachan D. P. 
Published: June 2003

SummaryBackground Neonatal physical characteristics, including head circumference and birth weight, have been hypothesized to be markers of in utero thymic development. Greater head circumference and lower birth weight have been linked in previous studies to subsequent development of asthma, and greater birth weight has been associated with subsequent development of eczema.Objective To investigate potential associations between neonatal head circumference and weight and hayfever, asthma and eczema in a cohort of adolescents from Sheffield, England.Methods Responses to a questionnaire inquiring about physician‐diagnosed hayfever, asthma and eczema among adolescents in Sheffield, England, were linked to previously recorded measurements of weight at birth and at 1 month and head circumference at 1 month. Logistic regression methods were used to relate diagnoses to neonatal measurements and potential confounders.Results The cohort consisted of 10 809 adolescents, of whom 16.5% reported hayfever, 18.0% asthma, and 16.2% eczema. After adjusting for sex, age at the time of the questionnaire, maternal age and gestational age at birth, number of older and younger siblings, time since birth of next older sibling, neonatal sickness, type of neonatal feeding, and maternal and paternal educational backgrounds, hayfever was the only disease associated with neonatal measurements. Comparing the highest with the lowest fifths of distributions, lifetime prevalence of hayfever was positively associated with neonatal head circumference (adjusted odds ratio 1.23, 95% CI 1.03 to 1.47) and with birth weight (1.17, 0.99 to 1.39). Hayfever was inversely related to the ratio of head circumference to birth weight (0.89, 0.75 to 1.05) and to gestational age. The associations with head circumference and birth weight were not substantially altered by further adjustment for gestational age.Conclusion Greater neonatal head circumference may be associated with an increased risk of hayfever, but the inverse relationship between hayfever prevalence and the ratio of head circumference to birth weight challenges the prior hypothesis that greater head circumference relative to body mass reflects abnormal thymic development in utero, increasing the likelihood of allergic sensitization.
Pranlukast inhibits NF‐κB activation in human monocytes/macrophages and T cells
Authors: Ichiyama T. , Hasegawa S. , Umeda M. , Terai K. , Matsubara T. , Furukawa S. 
Published: June 2003

SummaryBackground Pranlukast is a leukotriene 1 (LT1) receptor antagonist and is effective against bronchial asthma. Pranlukast inhibits contraction of the tracheal muscle, and thereby antagonizes the binding of LTC4, LTD4 and LTE4. However, the action of pranlukast on monocytes/macrophages and T cells is unknown.Objective We examined whether or not pranlukast inhibits TNF‐α‐induced activation of nuclear transcription factor NF‐κB, a factor that is essential for the expression of proinflammatory cytokines, on human monocytic 1.3% dimethylsulphoxide (DMSO)‐differentiated U‐937 cells, which have cysteinyl LT1 (CysLT1) receptors on their membranes, and T cells (Jurkat), which do not.Methods We examined whether or not LTC4, LTD4 or LTE4 induced NF‐κB activation in 1.3% DMSO‐differentiated U‐937 cells by Western blotting. The inhibitory effects of pranlukast and MK‐571, which is an LTD4 receptor‐selective antagonist, on TNF‐α‐induced NF‐κB activation was evaluated by Western blotting and flow cytometry, and those on lipopolysaccharide (LPS)‐induced interleukin‐6 (IL‐6) production in peripheral blood mononuclear cells (PBMC) were evaluated by enzyme‐linked immunosorbent assaying.Results LTC4, LTD4 or LTE4 did not induce NF‐κB activation in 1.3% DMSO‐differentiated U‐937 cells. Western blotting demonstrated that 10−5 M pranlukast inhibits NF‐κB activation in 1.3% DMSO‐differentiated U‐937 and Jurkat cells by about 40% & 30%, respectively. Flow cytometry demonstrated that pranlukast and MK‐571 inhibit NF‐κB activation in 1.3% DMSO‐ differentiated U‐937 and Jurkat cells in a dose‐related manner. Moreover, 10−5 M pranlukast and MK‐571 inhibited LPS‐induced IL‐6 production in PBMC by about 65% and 15%, respectively.Conclusion Pranlukast and MK‐571 partially inhibited NF‐κB activation in 1.3% DMSO‐ differentiated U‐937 and Jurkat cells, and IL‐6 release in PBMC. These findings are consistent with the idea that, independently of CysLT1 receptor antagonism, micromolar concentrations of pranlukast suppress the production of proinflammatory cytokines via inhibition of NF‐κB activation in monocytes/macrophages and T cells, but the contribution of this effect to the anti‐inflammatory activity of pranlukast at oral therapeutic doses in asthmatic patients is unclear.
Safety of nasal budesonide in the long‐term treatment of children with perennial rhinitis
Authors: Möller C. , Ahlström H. , Henricson K.‐Å. , Malmqvist L.‐Å. , Åkerlund A. , Hildebrand H. 
Published: June 2003

SummaryBackground Intranasal budesonide is an efficacious treatment for perennial allergic rhinitis. Long‐term effects on safety, particularly in children, need further investigation.Objective To investigate the long‐term safety of intranasal budesonide in children.Methods In an open trial, 78 children (5–15 years) with perennial rhinitis were treated with intranasal budesonide pressurized metered dose inhaler 200 µg twice daily (delivered daily dose 256 µg) for 12 months; 43 children stayed in the study for 12 additional months and were switched to aqueous suspension (400 µg delivered daily dose) for 6 months. Statural growth, bone age, ophthalmologic and rhinoscopic status, cortisol and biochemical analyses in blood and urine were monitored during the first and second years, and adverse events (AEs) were continuously recorded.Results No significant effects on statural growth and bone age, compared with reference values, were observed. Morning plasma cortisol and 24‐h urinary cortisol were not changed during treatment. Patients reported 195 AEs, most commonly nasal dryness (30%), blood‐tinged secretions (21%) and, among non‐nasal AEs, headache (13%). Rhinoscopy revealed no signs of mucosal atrophy, ulceration, or candidiasis but some nasal dryness. No treatment‐related ophthalmological or biochemical aberrations were found. Reduction of blood eosinophils and nasal symptom scores, compared with pre‐treatment values, indicated the efficacy of budesonide treatment.Conclusion Long‐term treatment for 1–2 years with intranasal budesonide 256–400 µg daily in children with perennial rhinitis revealed no negative effects on growth or endogenous cortisol production. Local side‐effects were mild and patient symptoms decreased.
Age‐related changes in blood capillary endothelium of human dental pulp: an ultrastructural study
Authors: Espina A. I. , Castellanos A. V. , Fereira J. L. 
Published: June 2003

AbstractAim  To describe the ultrastructural changes that occur in pulpal blood capillaries as a result of ageing.Methodology  Thirty samples of healthy dental pulps were obtained from functional human permanent teeth. Two age groups were examined: young (10–17 years) and old (>60 years). The teeth were extracted under local anaesthesia using mepivacaine without adrenaline (Scandonest 3%, Septodont, Saint‐Maur des Fossés, France) and split longitudinally in a bench press. The pulps were gently removed, immersed in fixative solution, sectioned and processed by conventional transmission electron microscopic techniques. Micrographs were taken from the endothelium, and the whole capillary area of each vessel was examined.Results  In young pulps, the endothelial cell layer was characterized by the presence of numerous pinocytotic vesicles and microvesicles, RER cisterns, free ribosomes, a small Golgi complex, centrioles, microtubules, microfilaments and mitochondria. In the endothelial cell cytoplasm of older pulpal vessels, pinocytotic vesicles and microvesicles, as well as microfilaments, were more numerous. In addition, lipid‐like vacuoles, monogranular glycogen granules and extensive Golgi complexes with dilated cisterns were also present. Weibel‐Palade bodies were observed in both age groups without showing variations related with age.Conclusions  The results obtained in capillaries of aged pulpal tissue suggest that the endothelium experiences morphological changes that could be associated with advancing age.
Immunolocalization of bone extracellular matrix proteins (type I collagen, osteonectin and bone sialoprotein) in human dental pulp and cultured pulp cells
Authors: Garcia J. M. Q. , Martins M. D. , Jaeger R. G. , Marques M. M. 
Published: June 2003

AbstractAim  To simultaneously analyse the expression of type I collagen, osteonectin and bone sialoprotein (BSP) in human dental pulp of different ages.Methodology  Cultured dental pulp fibroblasts (FP1 cell line), pulps from dental germs with incomplete root formation (n = 4) and pulps of erupted teeth with total root formation (n = 4) were used. Bone proteins were searched by immunohistochemistry and immunofluorescence using polyclonal antibodies and compared among the three groups assessed.Results  Immunohistochemistry detected the three proteins in dental pulp tissue, as it labelled extracellular matrix, predentine and odontoblasts. The BSP label was weaker, when compared to both type I collagen and osteonectin. The presence of type I collagen was more evident in pulps from erupted teeth, when compared to germ dental pulps. On the other hand, a strong expression of osteonectin in germ dental pulps was observed.Conclusions  Regardless of the degree of maturation, dental pulps present type I collagen, osteonectin and BSP in the extracellular matrix (ECM) and in the odontoblastic layer. Thus, the results suggest that these proteins are related to the production and mineralization of dentine.
Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions
Authors: Grawehr M. , Sener B. , Waltimo T. , Zehnder M. 
Published: June 2003

AbstractAim  To evaluate interactions of ethylenediamine tetraacetic acid (EDTA) with sodium hypochlorite (NaOCl).Methodology  Solutions consisting of 8.5% EDTA and 0.5% NaOCl were compared to a 1 : 1 (w/w) mixture of 17% EDTA and 1% NaOCl for their calcium‐chelating, tissue‐dissolving, and antimicrobial properties. Amounts of available chlorine were determined in the EDTA/NaOCl solutions with an iodine/thiosulphate titration method. Calcium chelation capacity was titrated with a pure calcium solution using a murexide indicator. Weight loss of porcine palatal mucosal specimens incubated in the test solutions was measured over time. Antimicrobial potential of pure solutions and the combination was recorded using an agar diffusion test in plates incubated with Enterococcus faecalis or Candida albicans.Results  The presence of hypochlorite had little effect on the calcium‐chelating ability or on the antimicrobial potential of EDTA. Available chlorine content decreased to 0.06% in the combined EDTA–NaOCl solution compared to 0.50% in an equivalent NaOCl mixture with deionized water. The EDTA–NaOCl solution did not dissolve more tissue than an equivalent pure EDTA solution at any time (anova, P > 0.05).Conclusions  Ethylenediamine tetraacetic acid retained its calcium‐complexing ability when mixed with NaOCl, but EDTA caused NaOCl to lose its tissue‐dissolving capacity and virtually no free chlorine was detected in the combinations. Clinically, this suggests that EDTA and NaOCl should be used separately. In an alternating irrigating regimen, copious amounts of NaOCl should be administered to wash out remnants of the EDTA.
Comparison of antibacterial and toxic effects of various root canal irrigants
Authors: Önçağ Ö. , Hoşgör M. , Hilmioğlu S. , Zekioğlu O. , Eronat C. , Burhanoğlu D. 
Published: June 2003

AbstractAim  To compare the antibacterial properties and toxicity of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate and 0.2% chlorhexidine gluconate plus 0.2% cetrimide (Cetrexidin®; Vebas, San Giuliano, Milan, Italy).Methodology  The antibacterial effects of the irrigants in vitro were examined after 5 min and 48 h in freshly extracted human teeth with single roots, whose canals were infected by Enterococcus faecalis ATCC 29212. In a separate in vivo study, bacterial culture samples were collected before treatment from the infected root canals of deciduous teeth containing necrotic pulp tissue. Irrigants were used to clean the canals which were then left empty for 48 h. Aerobic/facultative anaerobic and anaerobic bacterial growth were compared before and 48 h after irrigation. Finally, the toxic effects of the irrigants were assessed by injecting them into the subcutaneous tissues of rats. The inflammatory reactions that occurred 2 h, 48 h and 2 weeks after the injections were evaluated.Results  In the laboratory study, the 2% chlorhexidine gluconate and Cetrexidin® were significantly more effective on E. faecalis than the 5.25% NaOCl at 5 min (P < 0.05). Similarly, in the in vivo study, 2% chlorhexidine gluconate and Cetrexidin® were significantly more effective on anaerobic bacteria than the 5.25% NaOCl at 48 h (P < 0.05). At the end of 2 weeks, the toxicity of the NaOCl solution was greater than that of the other irrigants (P < 0.05).Conclusions  Cetrexidin® and 2% chlorhexidine gluconate were more effective, and had more residual antibacterial effects and lower toxicity than 5.25% NaOCl solution.
Deconstructing risk assessment and management in mental health nursing
Authors: Crowe Marie , Carlyle Dave 
Published: June 2003

Rationale.  Risk assessment and management have a taken a central position in the delivery of contemporary mental health services. However, these concepts are generally taken‐for‐granted as necessary and unavoidable aspects of mental health nursing practice. This deconstructive analysis explores some of the assumptions and values that underpin these concepts.Aims.  The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services.Design.  This paper takes a deconstructive approach to the exploration of the historical, clinical, cultural, political and economic context of the concept of risk and its assessment and management. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and mangement in clinical practice.Findings.  The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organization.Conclusion.  The mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Ethical issues in qualitative health research with homeless youths
Authors: Ensign Josephine 
Published: June 2003

Background. There is a need for increased guidance for the ethical conduct of qualitative research with vulnerable populations such as homeless youths.Aim. The purpose of this paper is to provide an overview of the main ethical challenges of conducting qualitative research with homeless youths and to propose possible solutions to these challenges.Methods. This paper was informed by a review of professional guidelines for the ethical conduct of adolescent health research, national (US) and international bioethics bibliographical searches, and personal experience with qualitative research with homeless youths.Findings. The main ethical challenges of conducting qualitative research with homeless youths include establishing and maintaining healthy researcher roles and boundaries, addressing the risks of researcher burn‐out and safety issues, assuring optimal confidentiality, and avoiding sensationalism and voyeurism.Conclusion. It is important for qualitative researchers who work with vulnerable populations to ensure that research is conducted in the most ethical way possible.
Follow‐up for people with cancer: nurse‐led services and telephone interventions
Authors: Cox Karen , Wilson Eleanor 
Published: June 2003

Background. Questions about the suitability of traditional outpatient follow‐up clinics as a way of providing on‐going monitoring for patients following serious illness have led to the development of a range of nurse‐led services. However, there has been little attempt to draw some of this knowledge together formally and consider the weight of evidence on the necessity and value of nurse‐led follow‐up.Aim. To provide a review of literature evaluating the impact of nurse led follow‐up in cancer care, with particular focus on the use and value of telephone interventions.Method. A literature search was conducted of nursing, medical and social science databases and the following keywords: cancer follow‐up, nurse‐led follow‐up, telephone follow‐up, telephone‐based interventions and telephone survey. The search yielded over 150 papers, of which 37 were relevant to this review.Findings. The literature suggests that nurse‐led follow‐up for people with cancer meets their needs for psychological support and information. The telephone is identified as a suitable means of providing this kind of service.Conclusion. This review demonstrates that nurse‐led follow‐up services are acceptable, appropriate and effective. Combined with use of the telephone, such services can be an efficient means of maintaining contact with a large client group, providing vital support to vulnerable patients during their move into aftercare and beyond.
Self‐directed learning in nurse education: a review of the literature
Authors: O'Shea Ellen 
Published: June 2003

Rationale.  Self‐directed learning is essential in assisting nurses to meet the challenges presented in today's health care environment. Nurse educators have an important role to play in assisting nurses to acquire the skills for self‐directed learning, and to do this they need to understand the concept of self‐directed learning.Aim.  The aim of this review is to explore the concept of self‐directed learning and its use in nurse education.Methods. A review of the literature was conducted using CINAHL, Medline and other databases and the keywords ‘self‐directed learning’, ‘student nurses’, ‘classroom’, ‘nursing education’ and ‘adult education’.Findings. The concept of self‐directed learning is based on the principles of adult education and can take many different formats. Self‐directed learning has many benefits. However, acquiring the necessary skills is dependent on a students’ preference and readiness for self‐directed learning and nurse educators’ implementation of the concept. In implementing self‐directed learning, nurse educators become facilitators of learning and require ongoing staff development. Not all students are self‐directed and a variety of teaching methods should be used in curricula.Conclusions. A consensus definition of the concept of lifelong learning does not exist, and students and teachers may have different perspectives on it. Mature students may be more self‐directing than school‐leavers, and learning styles and readiness to learn need to be assessed when judging the appropriateness of using self‐directed learning approaches. However, there are many potential benefits, including increased confidence, autonomy, motivation and preparation for lifelong learning.
A longitudinal cohort study of burnout and attrition in nursing students
Authors: Deary Ian J , Watson Roger , Hogston Richard 
Published: June 2003

Background. It is well‐established that stress is likely to contribute to attrition in nursing students. Attrition from nursing programmes and retention of nurses in the profession are international concerns and steps are currently being taken in the United Kingdom to tackle these issues.Aim. The aim of this study was to investigate prospectively the determinants of, and relationships among, stress, burnout and attrition in nursing students.Method. A longitudinal design involving a complete cohort of nursing students was employed, using a battery of instruments to measure personality, intelligence, psychological morbidity, stress, coping and burnout. Data were gathered on entry, at12 and 24 months, and at the end of the nursing programme.Findings. Students experienced increasing levels of stress and use of negative coping mechanisms as the programme progressed and psychological morbidity increased. Positive aspects of personality were more likely to lead to aspects of burnout, and personality was a more important indicator of attrition than cognitive ability.Conclusions. Stress, burnout and attrition may not be directly linked. Personality factors at course entry contributed significantly to the prediction of burnout and programme completion, but the relationships were not strong enough to be practically useful.