bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of hepatitis C infection on tacrolimus doses and blood levels in liver transplantation recipients
Authors: TROTTER J. F. , OSBORNE J. C. , HELLER M. , CHRISTIANS U. 
Published: June 2005

SummaryBackground : In our cohort of patients with hepatitis‐C virus, which is the most common indication for liver transplantation, we have noted higher relative blood levels of tacrolimus compared to patients without hepatitis‐C virus.Aim : To verify this observation and determine its clinical significance, we performed a comparison of doses and blood levels of tacrolimus in hepatitis‐C virus and non‐ hepatitis‐C virus liver transplantation recipients.Methods : Tacrolimus dose and trough level, as well as mean alanine aminotransferase, for all patients transplanted at our center with a deceased donor between 1/1995 and 12/1999 with hepatitis‐C virus were recorded at monthly intervals during the first 24 months following transplantation and compared to patients without hepatitis‐C virus.Results : The tacrolimus levels for hepatitis‐C virus and non‐hepatitis‐C virus patients were not significantly different at any of the monthly intervals, except month 9. In addition, the overall mean tacrolimus levels for hepatitis‐C virus and non‐hepatitis‐C virus patients were not significantly different (P = ns). However, the mean tacrolimus dose (mg/kg) was significantly higher for hepatitis‐C virus patients at 12, 15, 18, 21 and 24 months, P < 0.01. The total mean tacrolimus dose in hepatitis‐C virus patients was lower during year one by 39% (P = 0.018) and by 73% (P = 0.001) during year two. The total difference in cost of tacrolimus (for year one and two) administered to hepatitis‐C virus patients was $4920, P = 0.03. The serum alanine aminotransferase was significantly higher in hepatitis‐C virus patients at each monthly interval except month 1, P ≤ 0.01.Conclusions : Liver transplant recipients with hepatitis‐C virus require significantly lower oral doses of tacrolimus to achieve the same blood levels compared to non‐hepatitis‐C virus patients. This difference may result in a significant reduction in the cost of tacrolimus in hepatitis‐C virus patients. The most likely explanation for these findings is decreased hepatic clearance of tacrolimus caused by mild hepatic injury from recurrent hepatitis‐C virus.
Self‐care strategies for depressive symptoms in people with HIV disease
Authors: Eller Lucille Sanzero , Corless Inge , Bunch Eli Haugen , Kemppainen Jeanne , Holzemer William , Nokes Kathleen , Portillo Carmen , Nicholas Patrice 
Published: June 2005

Aim. This paper reports a study with people living with HIV to examine the experience of depressive symptoms, self‐care symptom management strategies, symptom outcomes in response to those strategies, and sources from which the strategies were learned.Background. Depressive symptoms are common, under‐diagnosed and under‐treated in people living with HIV. These symptoms have been associated with lower medication adherence, risky behaviours and poorer health outcomes.Methods. The study was based on the model of symptom management developed by the University of California San Francisco School of Nursing Symptom Management Faculty. Thirty‐four HIV+ men and women from a larger study of symptom self‐care strategies (n = 422) reported experiencing depressive symptoms. Data were collected from this subset on the Web, by mail and in‐person using the critical incident technique.Results. Depressive symptoms were described using 80 words and phrases clustered into eight categories: futility, sadness, loneliness/isolation, fatigue, fear/worry, lack of motivation, suicidal thoughts and other. A total of 111 self‐care strategies were coded into six categories: practising complementary/alternative therapies, talking to others, using distraction techniques, using antidepressants, engaging in physical activity, and using denial/avoidant coping. Sources of information for strategies used were trial and error (31%), healthcare providers (28%), family and friends (20%), classes/reading (8%), clergy (8%), support groups (4%) and other (3%). Overall, 92% of the self‐care strategies used were reported as helpful, 4% were sometimes helpful and 4% were not helpful.Conclusions. People living with HIV use numerous effective self‐care strategies to manage depressive symptoms. Further study is needed to validate the use of these strategies across populations, to standardize dose, duration and frequency, and to measure their effectiveness.
Older people's willingness to use home care nursing services
Authors: Cho Sung‐Hyun 
Published: June 2005

Aim.  This paper reports a study exploring willingness to use home care nursing services among older people and discussing the implications for long‐term and home care nursing policies.Background.  The proportion of older people is increasing in all societies across the world. Correspondingly, Korean society has experienced a rapid growth in its population of older people, and this is expected to increase from 7·2% in 2000 to 14·4% in 2019. The government is in the process of developing publicly‐financed long‐term care for older people, and home care nursing services are expected to be provided as an element of this care.Methods.  A cross‐sectional study design was used, employing data from a nationally representative interview survey with 1834 respondents conducted during May and July, 2001. Univariate and logistic regression analyses were conducted.Results.  Willingness to use home care nursing services differed according to whether co‐payment was required. About half the respondents answered that they would not use the services; 43% expressed a willingness to use them without co‐payment; and 5% were very willing to use them even with co‐payment. People with lower incomes showed greater willingness to use the services with no co‐payment, while the high income group showed the greatest willingness under co‐payment. Sex, living with adult children, living area, activities of daily living, and chronic conditions were associated with willingness. Older people who had known about or used home care nursing services previously showed greater willingness.Conclusions.  Co‐payment guidelines for minimizing unmet needs are required, especially for older people with low incomes. A positive evaluation from those who knew about or had used such services is expected to contribute to the use of home care nursing services by older people.
Extracorporeal application of high‐intensity focused ultrasound for prostatic tissue ablation
Authors: Häcker Axel , Köhrmann Kai Uwe , Back Walter , Kraut Oliver , Marlinghaus Ernst , Alken Peter , Michel Maurice Stephan 
Published: June 2005

Authors from Mannheim describe their experience with high‐intensity ultrasound for locally confined prostatic carcinoma. This was essentially an in vivo efficacy and safety study, as well as a clinical feasibility study. They found a positive answer to all questions asked. It will be interesting to see if further evaluation leads to a potential clinical use for this technology.A study from the Cleveland Clinic is presented, of the 2‐year follow‐up results in 34 patients who had an outpatient mid‐urethral sling using porcine small intestine submucosa. The technique is described, with cure of incontinence in 27 of the 34 women. There was no prolonged retention or erosion.OBJECTIVETo investigate the efficacy and safety of extracorporeal prostatic tissue ablation using high‐intensity focused ultrasound (HIFU) in vivo in animals, and in a clinical feasibility study in men, as this is an investigational minimally invasive treatment alternative for locally confined prostatic carcinoma, but may have significant side‐effects.PATIENTS, MATERIALS AND METHODSUltrasound (1.04 MHz excitation frequency) was generated by an extracorporeal cylindrical piezo‐ceramic element and focused by a paraboloidal reflector to a focal size of 32 × 4 mm. The focal distance and aperture diameter were both 100 mm. HIFU was applied extracorporeally at different intensities and pulse duration (up to 6 s) to 11 dog prostates in vivo (median intensity 1192 W/cm2) and eight patients (median intensity 3278 W/cm2, range 2384–3576) under general anaesthesia. The lesions were assessed macroscopically and histologically after HIFU and any side‐effects evaluated.RESULTSThermoablation was feasible in vivo and in all patients. Macroscopic analysis and histology showed sharply demarcated coagulative necrosis. Side‐effects, including skin and rectal burns, occurred only after transvesical application in the in vivo study. There were no side‐effects in patients after perineal application.CONCLUSIONExtracorporeal HIFU is technically feasible and induces sharply demarcated tissue damage in the prostate. From the early results of this phase 1 study, the perineal approach seems to be safe.
Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: findings from the third National Health And Nutrition Examination Survey
Authors: Rohrmann Sabine , Crespo Carlos J. , Weber Jason R. , Smit Ellen , Giovannucci Edward , Platz Elizabeth A. 
Published: June 2005

OBJECTIVESTo examine the association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms (LUTS) in older men.SUBJECTS AND METHODSThe study included 2797 men participating in the Third National Health and Nutrition Examination Survey (NHANES III), who were aged ≥ 60 years. During an interview, LUTS, smoking history, alcohol consumption and physical activity were assessed. Cases comprised men with at least three of the symptoms of nocturia, hesitancy, weak stream and incomplete emptying. Men who had had prostate surgery unrelated to cancer were not included as cases. Controls were men with no symptoms or surgery. We adjusted for age and race in logistic regression models and used sampling weights to account for selection probability.RESULTSCurrent cigarette smokers had no higher odds of LUTS than ‘never’ smokers, but former heavy smokers (≥ 50 pack‐years) had a higher odds of LUTS than never smokers (odds ratio 2.01; 95% confidence interval 1.04–3.89). Men who drank alcohol daily had a lower chance of LUTS than non‐drinkers (0.59; 0.37–0.95; P trend, 0.07). All levels of moderate and vigorous activity were statistically significantly inversely associated with LUTS (P trend, 0.06), whereas men who reported no leisure‐time physical activity had a greater odds of LUTS (2.06; 1.26–3.39).CONCLUSIONSModerate alcohol consumption and physical activity may be protective against LUTS. Current cigarette smoking was not consistently associated with the condition. The possible association in former smokers warrants further investigation.
Treatment of pelvic fracture‐related urethral trauma: a survey of current practice in the UK
Authors: Andrich Daniela E. , Greenwell Tamsin J. , Mundy Anthony R. 
Published: June 2005

Authors from London carried out a survey of current practice for treating urethral trauma associated with pelvic fracture in the UK. The interesting findings are described, and it is suggested that even within specialised units such cases are uncommon, and that surgical management often differs significantly from what might be published by so‐called experts in the field.OBJECTIVETo quantify experience of pelvic fracture‐related urethral trauma (PFUT), a condition not often encountered and managed by urologists.METHODSThe consultant urologists of the UK and Ireland were contacted informally to establish their experience with PFUT and its management, both immediate and delayed. In addition, particular individuals thought to have a specific interest in PFUT were targeted for more data.RESULTSThe overall response rate was 49% (235 responders), representing 78% of urological departments, including all the targeted individuals. Of the responders, 129 (55%) had never seen PFUT in 1–25 years of consultant practice. Only four urologists (2% of responders) saw three or more cases a year. Another four (2%) saw one or two cases per year and the remaining 98 (41%) saw PFUT less frequently. Acutely, 69% of urologists who treated PFUT did so by placing a urethral catheter. Subsequent strictures were treated endoscopically for as long as this was possible. The other 31% inserted a suprapubic catheter and referred the patient for reconstructive surgery if needed. Those who used urethroplasty for strictures after PFUT were identified and targeted; half used urethral mobilization and spatulated anastomosis alone. Only three surgeons performed more than five procedures a year.CONCLUSIONWhatever a specialist reconstructive unit might do, practice in the wider urological community is different. Even within specialized units, PFUT is rare and the surgical management is often significantly different from published ‘expert’ opinion.
An objective assessment of the results of hypospadias surgery
Authors: Ververidis Moschos , Dickson Alan P. , Gough David C.S. 
Published: June 2005

OBJECTIVETo compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair.SUBJECTS AND METHODSPhotographs of the penis after hypospadias repair in 32 boys were assessed by a panel of five independent health professionals, including four surgeons with variable paediatric urological experience and a urology nurse. Twenty patients had a distal and 12 a proximal meatus. The Snodgrass technique was applied by one paediatric urologist for either distal (10) or proximal (six) hypospadias. A Mathieu repair was used for distal hypospadias (10) and an onlay preputial island flap for proximal hypospadias (six) by a second paediatric urologist. The panel was asked to grade cosmesis as poor, unsatisfactory, satisfactory or very good (points 1–4) for each of the following aspects of penile appearance: meatus, glans, shaft and overall appearance. Photographs were taken in a standard way, with a standard distance, lighting and two views, one of the dorsal surface and one ventral, for each patient. Signed written consent for the study was obtained from each family.RESULTSThe mean assessment score for any aspect of cosmesis was significantly higher for the Snodgrass technique (P < 0.05). The mean score (95% confidence interval) for the meatus was 0.76 (0.4–1.1) points higher for the patients with a Snodgrass repair than those with a Mathieu or onlay island flap repair (P = 0.002). Correspondingly, the values for the glans were 0.67 (0.38–0.97) (P = 0.003), shaft 0.42 (0.16–0.69) (P = 0.01) and overall appearance 0.62 (0.24–1.0) (P = 0.01) points higher for the Snodgrass repair. The Snodgrass technique was more effective in producing a vertically orientated meatus (87.5%) than the Mathieu and Duckett onlay repairs (37.5%; P = 0.009).CONCLUSIONThe Snodgrass technique, as assessed by this panel, had a better cosmetic outcome than the Mathieu and Duckett onlay island flap repairs. The assessment of cosmesis in hypospadias surgery is potentially more objective when several health professionals, not involved in the surgery, compared the various methods of repair.
Apoptosis: a key effector mechanism of lymphocyte action in human nonseminomatous testicular carcinoma?
Authors: Schmelz Hans U. , Port Matthias , Hauck Ekkehard W. , Schwerer Michael J. , Weidner Wolfgang , Sparwasser Christoph , Abend Michael 
Published: June 2005

OBJECTIVETo correlate the number of tumour‐infiltrating T lymphocytes (TILs) with the extent of apoptosis in testicular germ cell tumours, as TILs are considered to be a favourable prognostic factor of human testicular tumours, especially of seminomas, but the mechanism by which TIL contribute to an improved outcome is unclear.MATERIALS AND METHODSTissue samples from 47 patients with nonseminomatous germ cell tumour (NSGCT) and 15 with seminomatous GCT were investigated immunohistochemically for lymphocyte infiltration and apoptosis. The apoptotic index (AI) was assessed in various categories (DNA condensation and fragmentation) using in‐situ end‐labelling to identify typical apoptotic DNA strand breaks, and nuclear staining to identify typical apoptotic morphology.RESULTSIn seminomatous GCT there was no correlation between the number of TILs and any AI. In NSGCT there was only a relationship between lymphoid infiltration and those AIs showing morphological criteria of apoptosis in a small subgroup of NSGCT, i.e. metastasized embryonal cell carcinomas. Only 1.2% (AI, chromatin condensation) and 0.8% (AI, fragmentation and condensation) of all tumour cells showed these features of apoptosis. The overall AI in NSGCT was 7.9%.CONCLUSIONSTILs do not seem to induce apoptosis in testicular tumours. Embryonal cell carcinomas might be susceptible to lymphocyte attack, resulting in apoptosis of the tumour cell. The mechanisms of interaction between lymphocytes and testis tumour cells need further investigation.
Continuous infusion of ketamine in hypovolemic dogs anesthetized with desflurane
Authors: Duque M. Juan C. , Souza Almir P. , Nunes Newton , Honsho Cristiane S. , Talieri Ívia C. 
Published: June 2005

AbstractObjective:To evaluate the cardiorespiratory effects of continuous infusion of ketamine in hypovolemic dogs anesthetized with desflurane.Design:A prospective experimental study.Animals:Twelve mixed breed dogs allocated into 2 groups: saline (n=6) and ketamine (n=6).Interventions:After obtaining baseline measurements (time [T] 0) in awake dogs, hypovolemia was induced by the removal of 40 mL of blood/kg over 30 minutes. Anesthesia was induced and maintained with desflurane (1.5 minimal alveolar concentration) and 30 minutes later (T75) a continuous intravenous (IV) infusion of saline or ketamine (100 μg/kg/min) was initiated. Cardiorespiratory evaluations were obtained 15 minutes after hemorrhage (T45), 30 minutes after desflurane anesthesia, and immediately before initiating the infusion (T75), and 5 (T80), 15 (T90), 30 (T105) and 45 (T120) minutes after beginning the infusion.Measurements and main results:Hypovolemia (T45) reduced the arterial blood pressures (systolic arterial pressure, diastolic arterial pressure [DAP] and mean arterial pressure [MAP]), cardiac (CI) and systolic (SI) indexes, and mean pulmonary arterial pressure (PAP) in both groups. After 30 minutes of desflurane anesthesia (T75), an additional decrease of MAP in both groups was observed, heart rate was higher thanT0 atT75,T80,T90 andT105 in saline‐treated dogs only, and the CI was higher in the ketamine group than in the saline group atT75. Five minutes after starting the infusion (T80), respiratory rate (RR) was lower and the end‐tidal CO2(ETCO2) was higher compared with values atT45 in ketamine‐treated dogs. Mean values of ETCO2were higher in ketamine than in saline dogs betweenT75 andT120. The systemic vascular resistance index (SVRI) was decreased betweenT80 andT120 in ketamine when compared withT45.Conclusions:Continuous IV infusion of ketamine in hypovolemic dogs anesthetized with desflurane induced an increase in ETCO2, but other cardiorespiratory alterations did not differ from those observed when the same concentration of desflurane was used as the sole anesthetic agent. However, this study did not evaluate the effectiveness of ketamine infusion in reducing desflurane dose requirements in hypovolemic dogs or the cardiorespiratory effects of ketamine–desflurane balanced anesthesia.
Carvacrol and p-cymene inactivate Escherichia coli O157:H7 in apple juice
Authors: Kiskó Gabriella , Roller Sibel 
Published: June 2005

Abstract

Background
Outbreaks of food poisoning associated with drinking un-pasteurised apple juice contaminated with enterohaemorrhagic Escherichia coli O157:H7 are a cause of serious illness and occasionally death. Whilst a well-established heat process (pasteurisation) will readily eliminate the pathogen, some consumers are demanding more fresh-like foods that have not been subjected to processing methods that are perceived as severe and may lead to loss of flavour and vitamins. Therefore, alternative methods are being investigated to replace pasteurisation and improve the safety of minimally-processed juices. The addition of natural antimicrobial substances such as the phenolic substances carvacrol and p- cymene (derived from the essential oils of herbs and spices) provides a potential new route to assure safety and extend the shelf-life of raw fruit juices.
The aim of this study was to evaluate the addition of very low concentrations (0.25–1.25 mM) of carvacrol and p- cymene both individually and in combination as a novel means of controlling Escherichia coli O157:H7 in un-pasteurised apple juice.

Results
When inoculated at a level of 4 log CFU/ml into un-pasteurised apple juice (pH 3.20 ± 0.06), Escherichia coli O157:H7 survived for up to 3 and 19 days at 25° and 4°C, respectively. Treatment of the juice with 1.25 mM carvacrol or p- cymene reduced the numbers of E. coli O157:H7 to undetectable levels within 1–2 days at both storage temperatures. The effective concentrations of carvacrol could be reduced even further by combining it at 0.5 mM with cymene at 0.25 mM. The phenolic compounds were biocidal against both spoilage yeasts and E. coli O157:H7 thereby increasing the shelf-life and improving the safety of un-pasteurised apple juice, particularly when stored at chill temperatures.

Conclusion
The results showed that the natural antimicrobial compounds carvacrol and p-cymene could potentially be used to extend the shelf life and improve the safety margins in un-pasteurised chilled fruit juices.
Zinc-finger domains of the transcriptional repressor KLF15 bind multiple sites in rhodopsin and IRBP promoters including the CRS-1 and G-rich repressor elements
Authors: Otteson Deborah C , Lai Hong , Liu Yuhui , Zack Donald J 
Published: June 2005

Abstract

Background
In the retina, many of the genes that encode components of the visual transduction cascade and retinoid recycling are exclusively expressed in photoreceptor cells and show highly stereotyped temporal and spatial expression patterns. Multiple transcriptional activators of photoreceptor-specific genes have been identified, but little is known about negative regulation of gene expression in the retina. We recently identified KLF15, a member of the Sp/Krüppel-like Factor family of zinc-finger containing transcription factors, as an in vitro repressor of the promoters of the photoreceptor-specific genes rhodopsin and IRBP/Rbp3. To gain further insight into the mechanism of KLF15-mediated regulation of gene expression, we have characterized the binding characteristics and specificity of KLF15's DNA binding domains and defined the KLF15 binding sites in the rhodopsin and IRBP promoters.

Results
In EMSA and DNAseI footprinting assays, a KLF15-GST fusion protein containing the C-terminal zinc-finger domains (123 amino acids) showed zinc-dependent and sequence-specific binding to a 9 bp consensus sequence containing a core CG/TCCCC. Both the bovine rhodopsin and IRBP promoters contained multiple KLF15 binding sites that included the previously identified CRS-1 and G-rich repressor elements. KLF15 binding sites were highly conserved between the bovine, human, chimp and dog rhodopsin promoters, but less conserved in rodents. KLF15 reduced luciferase expression by bRho130-luc (containing 4 KLF15 sites) and repressed promoter activation by CRX (cone rod homeobox) and/or NRL (neural retina leucine zipper), although the magnitude of the reduction was smaller than previously reported for a longer bRho225-luc (containing 6 KFL15 sites).

Conclusion
KLF15 binds to multiple 9 bp consensus sites in the Rhodospin and IRBP promoters including the CRS-1 and G-rich repressor elements. Based on the known expression pattern of KLF15 in non-photoreceptor cells, we hypothesize an in vivo role for KLF15 in repressing photoreceptor-specific gene expression in the inner retina.