bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the correct primary diagnostic tool in the ‘one‐stop’ clinic for the investigation of abnormal menstrual bleeding?
Authors: Jones Kevin D. , Jermy Karen , Bourne Tom H. 
Published: March 2003

AbstractObjective To review the management in the ‘one‐stop’ clinic of abnormal menstrual bleeding.Design Review.Results The combination of transvaginal ultrasonography (TVS) with s‐HS (saline hydrosonography) has made ultrasound without hysteroscopy a potential primary diagnostic tool in the one‐stop abnormal menstrual bleeding clinic. This is particularly true if outpatient hysteroscopy is carried out with blind endometrial sampling, rather than a directed biopsy. In the detection of focal endometrial pathology, compared with TVS alone, TVS plus s‐HS increases the sensitivity from 67% to 87%, the specificity from 89% to 91%, the positive predictive value from 88% to 92% and the negative predictive value from 71% to 86%. Furthermore, TVS facilitates the diagnosis of adnexal and intramural pathology.Conclusion We believe that a critical appraisal of the evidence supports TVS as the correct primary diagnostic tool in the evaluation of abnormal menstrual bleeding in a one‐stop clinic.
Metal fume fever: A case report and literature review
Authors: Merchant John , Webby Rosalind 
Published: March 2003

AbstractMetal fume fever is a relatively uncommon presentation to the emergency department. Resulting from inhalation of metal oxides, it presents as an acute, self‐limiting, flu‐like symptom complex often misdiagnosed as a viral illness. We report a case of a 26‐year‐old male presenting with metal fume fever 4 h after oxycutting galvanized steel. The literature is reviewed with respect to pathogenesis, the common presenting symptom complex, investigations and current accepted management of metal fume fever.
FOSTERING HOPE IN PEOPLE LIVING WITH AIDS IN AFRICA: THE ROLE OF PRIMARY HEALTH‐CARE WORKERS
Authors: Akinsola Henry Abayomi 
Published: March 2003

ABSTRACT:Today the medical literature is dominated by discussions on issues related to HIV/AIDS. This is not surprising considering the fact that in the history of humankind, the HIV/AIDS scenario has posed one of the greatest challenges. The reality of the physical, socioeconomic and psychological problems associated with the AIDS epidemic has become obvious to the general populace in Africa. Currently, both the AIDS victims and several others in the society continue to entertain the fear of dying from AIDS. The situation has become a source of concern to almost everyone, including primary health‐care (PHC) workers. While several options are being examined to address the AIDS problem in Africa, one area that is often neglected is how to foster hope in people living with AIDS (PLWA) and their caregivers. In an attempt to examine this issue, this paper discusses the concept of hope, the cultural construct of HIV/AIDS in African countries and the role of PHC workers in fostering hope in PLWA. The paper concludes that by assisting the PLWA to develop a good sense of hope, PHC workers will be able to meet an important challenge: how to improve the quality of life for PLWA.
DEVELOPING BETTER CASEMIX EDUCATION FOR RURAL NEW SOUTH WALES
Authors: Bridges John F. P. , Mazevska Deniza , Haas Marion 
Published: March 2003

ABSTRACT:Casemix is now an important mechanism for the planning, evaluation and funding of health services in Australia. In New South Wales (NSW) it was believed that while staff from most hospitals in metropolitan Sydney had become both literate and vocal about casemix, staff from rural areas were less familiar and much less likely to participate in casemix initiatives. In conjunction with the NSW Casemix Clinical Committee (NCCC), NSW Health considered a special program of casemix education for rural NSW. Before an education program was attempted, NSW Health inquired into the specific needs for casemix education in rural NSW. Qualitative and quantitative methods of analysis were used. Results of the quantitative analysis indicate that the understanding of casemix classifications is highest among managers. Of concern were the relatively low proportion of Allied Health staff who had more than a vague understanding of the Sub‐ and Non‐Acute Patient (SNAP) classification; the lack of any knowledge of the Mental Health Costing And Service Classification (MH‐CASC) by nursing staff; and the lack of any knowledge of the emergency department classification: Urgency, Disposition and Age‐related Groups (UDAG), either by clinical or nursing staff. The results of the qualitative analysis show that casemix education for rural areas needs to differ from metropolitan education programs. The analysis also highlights the perception of casemix in rural areas and the special circumstances in rural hospitals that place limits on the ability to use casemix more fully.
PREVENTIVE SOCIAL HEALTH PROGRAMS: ARE THEY AUSTRALIA’S ANSWER TO RISING HEALTH CARE COSTS IN RURAL COMMUNITIES?
Authors: Harvey Peter 
Published: March 2003

ABSTRACT: Although we have good evidence to support the notion that early intervention, prevention and community education programs can mitigate the impact of preventable disease, expanded primary health care is also being promoted by Australian governments as a panacea for reducing growth in demand generally. While preventive programs do reduce acute demand, they may not do so to the extent that resources, currently allocated to the acute sector, can be substituted to provide the additional primary care services necessary to reduce acute demand permanently. These developments have particular relevance for rural and isolated communities where access to acute services is already very limited. What appears to be occurring, in rural South Australia at least, is that traditional acute services are being reduced and replaced with lower level care and social intervention programs. This is well and good, but eventually the acute care being provided in rural health units now will still need to be provided by other units elsewhere and probably at much higher cost to the system and to consumers. Where rural communities have previously managed much of their own acute service demand, they may now be forced to send patients to more distant centres for care but at much greater social and economic cost to individuals and the system.
Food plant selection by the wild Japanese serow (Capricornis crispus) with reference to the traces eaten
Authors: DEGUCHI Yoshitaka , SATO Shusuke , SUGAWARA Kazuo 
Published: March 2003

ABSTRACTVegetation and plants eaten by the serow were investigated once a month from spring to autumn in two areas with different vegetative composition of deciduous broad‐leaved trees and forbs. Then we calculated Ivlev's electivity indices (EI) for some plant species and six plant groups: the deciduous broad‐leaved tree, the evergreen broad‐leaved tree, the conifer, the forb, the graminoid and the fern. In Area 1, the frequency of deciduous broad‐leaved trees and forbs was 78.2% and 1.1%, respectively. The proportion of deciduous broad‐leaved trees and forbs eaten was 65.9% and 33.1%, respectively. In Area 2, the frequency of deciduous broad‐leaved trees and forbs was 32.4% and 23.1%, respectively. The proportion of deciduous broad‐leaved trees and forbs eaten was 46.9% and 52.0%, respectively. In Area 1, the deciduous broad‐leaved tree was eaten in proportion to its frequency in the habitat (EI, 0.06–0.05) except in May (−0.32) and June (−0.11). The deciduous broad‐leaved tree was a little selected in Area 2 (0.02–0.46) except in June (−0.41) when serows selected some forb species. In Area 2, forbs were selected throughout the observational period (0.16–0.97), except during July (−0.05) when serows fed mainly on deciduous broad‐leaved trees (0.46).
Comparative study of the innervation of acetylcholinesterase‐positive nerves in the cerebral arterial tree of birds
Authors: KUSABA Haruo , ANDŌ Koichi , NOBORU Masayuki , HAYASHI Kiyonori , FUJIHARA Noboru , IWAMOTO Hisao 
Published: March 2003

ABSTRACTAcetylcholinesterase (AChE) histochemistry and quantitative analysis were used to investigate and compare the projections and densities of cerebral perivascular AChE nerves in five avian species. In the society finch, AChE nerves arising from the cerebral carotid, internal ethmoidal and vertebral arteries generally have no overlap with each other. This is different from AChE neuronal projections via these three vascular routes reported previously for the pigeon, duck, chicken and quail. AChE nerves supplying the pigeon cerebral arterial tree are the highest in density, predominate in the anterior circulation (AC) rather than in the posterior circulation (PC). Similar differential supply of nerves is also found in the duck, with a marked low density in the PC. In contrast, the chicken PC has a substantial amount of AChE nerves that is larger than the fiber amount contained in the AC. The reduction of nerves is far greater in both the AC and PC of the finch. It is not so prominent as that seen in the quail. The significant difference in the distribution and density of cerebral perivascular AChE nerves presented here may indicate that there are some species‐specific cholinergic controlling mechanisms responsible for the cerebral circulation of birds.
Impact of fermented milk on human health: Cholesterol‐lowering and immunomodulatory properties of fermented milk
Authors: HOSONO Akiyoshi , OTANI Hajime , YASUI Hisako , WATANUKI Masaaki 
Published: March 2003

ABSTRACTIn this review, we focus on the cholesterol‐lowering activity of Lactobacillus gasseri, the immunomodulatory function of casein phosphopeptides (CPPs) and lactic acid bacteria as starters for fermented milk, and the probability and difficulty of creating immunomodulatory fermented milk as a ‘food for specified health use’. Among the starter bacteria used for the preparation of fermented milk, L. gasseri SBT0270 could exert a hypocholesterolemic effect in rats fed a diet high in cholesterol through deconjugation of bile salts. On the other hand, CPPs, having a tripeptide sequence consisting of two phosphoserine residues at N‐ and C‐terminal positions, stimulated lymphocyte proliferation and IgA formation via the increase of interleukin‐5 and interleukin‐6 produced by type 2 helper T cells. The oral ingestion of CPPs enhanced the level of antigen‐specific and total intestinal IgA. Moreover, one strain of bifidobacteria (Bifidobacterium breve YIT4064) and one strain of Lactobacilli (Lactobacillus casei strain Shirota), used as a starter for fermented milk, activated the humoral and cellular immune system, respectively, and prevented various diseases. It is important to elucidate what components modulate and what mechanisms are responsible for the physiological function of fermented milk in order for it to be accepted as a ‘food for specified health use’ claiming immunomodulatory activity.
Effect of enzymes of microbial origin on in vitro digestibilities of dry matter and crude protein in soybean meal
Authors: SALEH Fuad , OHTSUKA Akira , TANAKA Tsuneo , HAYASHI Kunioki 
Published: March 2003

ABSTRACTThe effects of supplementation with cellulase, xylanase, pectinase, hemicellulase, glucanase, phytase and protease of microbial origin on digestibility of crude protein (CP) and dry matter (DM) of soybean meal in vitro were examined in the present study. Changes in viscosity during in vitro digestion were also examined as an index of carbohydrate digestibility. Hemicellulase and all enzyme combinations without protease showed significant improvement of CP digestibility. Cellulase, xylanase, phytase and glucanase tended to improve CP digestibility. Dry matter digestibility was improved significantly by pectinase and all enzyme combinations. Cellulase and phytase tended to improve DM digestibility. Crude protein and DM digestibilities were the highest when all the enzymes except protease were added. Protease, cellulase, pectinase, xylanase, glucanase and hemicellulase significantly reduced viscosity, while phytase had no effect on viscosity. Viscosity was increased unexpectedly when all the enzymes were added. These results strongly suggest that a combination of carbohydrases improves the CP and DM digestibility of soybean meal while protease inhibits the actions of these enzymes. The present study also suggests that viscosity is not always a good index of digestibility. Moreover, excluding the protease from commercial crude enzyme preparations may improve digestibility.
Smoking cessation among daily smokers, aged 45–69 years: a longitudinal study in Malmö, Sweden
Authors: Lindström Martin , Isacsson Sven‐Olof , The Malmö Shoulder–Neck Study Group  
Published: March 2003

ABSTRACTObjective To investigate differences in snuff consumption, socio‐demographic and psychosocial characteristics between baseline daily smokers who had remained daily smokers, become intermittent smokers or stopped smoking at the 1‐year follow‐up.Design, setting, participants and measurements A population of 12 507 individuals aged 45–69 years, interviewed at baseline in 1992–94 and at a 1‐year follow‐up, was investigated in this longitudinal study. The three groups of baseline daily smokers were compared to the total population according to socio‐demographic, psychosocial and snuff consumption characteristics. A multivariate logistic regression model was used to assess differences in psychosocial conditions, adjusting for age, sex, country of origin, marital status, education and snuff consumption.Findings Eighty‐six per cent of all baseline daily smokers remained daily smokers, 6.5% had become intermittent smokers and 7.3% had stopped smoking at the 1‐year follow‐up. The daily smokers who remained daily smokers were more likely to be born in other countries than Sweden, not married, have a lower educational level and poorer psychosocial conditions than the total population, while the socio‐demographic characteristics and psychosocial resources of those daily smokers who had become intermittent smokers or had stopped smoking were much more similar to the general population, with the exception of a higher snuff consumption, especially for intermittent smokers.Conclusions Daily smokers who remained daily smokers at the 1‐year follow‐up had poorer psychosocial assets, especially social participation, than baseline daily smokers who had become intermittent smokers or had stopped smoking, and the general population. The results suggest that low levels of social participation are a potent barrier against smoking cessation. Snuff consumption may explain a part of the increase in smoking cessation among men as opposed to women in Sweden.
Central and peripheral cardiovascular adaptations to exercise in endurance‐trained children
Authors: NOTTIN S. , VINET A. , STECKEN F. , N'GUYEN L.‐D. , OUNISSI F. , LECOQ A.‐M. , OBERT P. 
Published: March 2003

ABSTRACTStroke volume (SV) response to exercise depends on changes in cardiac filling, intrinsic myocardial contractility and left ventricular afterload. The aim of the present study was to identify whether these variables are influenced by endurance training in pre‐pubertal children during a maximal cycle test. SV, cardiac output (Doppler echocardiography), left ventricular dimensions (time–movement echocardiography) as well as arterial pressure and systemic vascular resistances were assessed in 10 child cyclists (VO2max: 58.5 ± 4.4 mL min−1 kg−1) and 13 untrained children (UTC) (VO2max: 45.9 ± 6.7 mL min−1 kg−1). All variables were measured at the end of the resting period, during the final minute of each workload and during the last minute of the progressive maximal aerobic test. At rest and during exercise, stroke index was significantly higher in the child cyclists than in UTC. However, the SV patterns were strictly similar for both groups. Moreover, the patterns of diastolic and systolic left ventricular dimensions, and the pattern of systemic vascular resistance of the child cyclists mimicked those of the UTC. SV patterns, as well as their underlying mechanisms, were not altered by endurance training in children. This result implied that the higher maximal SV obtained in child cyclists depended on factors influencing resting SV, such as cardiac hypertrophy, augmented myocardium relaxation properties or expanded blood volume.
Surgical manipulation, but not moderate exercise, is associated with increased cytokine mRNA expression in the rat soleus muscle
Authors: SchiØtz Thorud H.‐M. , WislØff U. , Lunde P. K. , Christensen G. , Ellingsen Ø. ,   O. M., Sejersted  
Published: March 2003

ABSTRACTInterleukin (IL)‐6 production in contracting skeletal muscle and IL‐6 concentration in plasma are increased after prolonged and strenuous exercise. However, as tissue stress or damage are unspecific triggers of increased cytokine levels, we examined whether moderate muscle activity is an independent stimulus for cytokine expression, and to which extent invasive procedures might affectthe results. Soleus muscles were isolated from sedentary rats or from rats that had been running on a treadmill at moderate intensity (70% of maximal oxygen uptake) for 1 h. In another group the soleus muscle was prepared in situ and stimulated intermittently at 5 Hz for 1 h, so that maximal developed force declined by 30%. In situ prepared soleus muscles not subjected to electrical stimulation were used as controls. Messenger RNA (mRNA) expression of 11 cytokines was analysed in the soleus muscles using multiprobe RNAse protection assay, and IL‐6 plasma concentration was measured by enzyme‐linked immunosorbent assay. Treadmill exercise did not affect the mRNA expression of any of the measured cytokines in the soleus muscle. Irrespective of electrical stimulation, mRNA expression of IL‐6 and IL‐1β were significantly increased in the surgically manipulated soleus muscles. Interleukin‐6 plasma concentration was not affected by treadmill running or electrical stimulation. Conclusion, gentle surgical manipulation is a strong stimulus for IL‐6 and IL‐1β mRNA synthesis in skeletal muscle, whereas exercise or electrical muscle stimulation at moderate intensity does not independently affect cytokine mRNA levels in the contracting soleus.
Cortical blood flow autoregulation revisited using laser Doppler perfusion imaging
Authors: Kimme P. , Ledin T. , Sjöberg F. 
Published: March 2003

ABSTRACTMethods of laser Doppler perfusion monitoring (LDPM) and imaging (LDPI) have been validated and found useful for measurements of brain blood flow in several studies. The present work was undertaken to examine the cortical blood flow autoregulatory phenomenon as it has lately been questioned and claimed to be method‐dependent and related to sample volume. Spatial variations in cerebral cortical blood flow (CBFcortex) in the pressure range 20–140 mmHg (static cerebral autoregulation; caval block/angiotensin infusion) were studied in six mechanically ventilated (hypocapnic, normocapnic and hypercapnic) pigs anaesthetized with propofol and fentanyl. Although the cortical blood flow values sampled were highly heterogeneously distributed, they were strongly pressure‐dependent as well as CO2‐dependent (P < 0.001). A cumulative cerebral blood flow (CBF)–pressure (MAP) plot comprising all values obtained indicated a pressure range between 70 and 120 mmHg where CBF remained almost constant. However, at the local level in the cortex (mm2) the same type of ‘classic’ autoregulatory flow : pressure graphs (FPG) were found in only a few of the cases of the cortical areas examined (n = 96). Alterations in blood PaCO2 saturation did not affect the pressure : flow relationship at low perfusion pressures, whereas at normal or above normal values, and as anticipated, hypercapnia considerably increased CBF (P < 0.001). ‘Classic’ autoregulatory FPGs were found only when all values sampled were clustered together, whereas, as a new finding, data are presented indicating that autoregulatory capacity is lacking at the local level at some cortical surface areas.
Assessment of veld conditions with multivariate techniques in mixed bushveld, South Africa
Authors: DÖrgeloh W. G. 
Published: March 2003

SummaryThe species composition of the herbaceous layer was surveyed in eight plant communities with a small‐quadrat method. Ordination techniques were applied to these data to identify relative homogenous grazing areas, assess the veld condition of each unit and to identify indicator species, based on a grazing gradient. Five relative homogenous grazing areas were identified and should be treated as such for management purposes. The veld in the Nylsvlei Nature Reserve was generally in a good condition due to the low stocking densities of game (≈0.29 animals ha−1) which have been maintained for many years. Nine indicator species, i.e. Cynodon dactylon, Digitaria eriantha, Ischaemum afrum, Leersia hexandra, Oryza longistaminata, Setaria sphacelata, Sporobolus ioclados, Sporobolus pyramidalis, and forbs, were identified which may be used for future monitoring of veld condition in the different vegetation units.
Factors influencing the distribution of the mole rat, Cryptomys zechi (Rodentia, Bathyergidae) in Ghana
Authors: Yeboah S. , Akyeampong S. 
Published: March 2003

AbstractFactors influencing the distribution of the Ghana mole rat Cryptomys zechi were investigated in a small part of the middle Volta basin of Ghana where it is endemic. Soil type appeared to be the most important factor controlling mole rat distribution in the area; the mole rats preferred areas where the soil was silt loam. In areas where mole rats were found, local distribution was influenced by food availability and land preparation methods for farming. The highest concentrations of mole rat colonies were found in farmlands where traditional hoe ploughing is used for land preparation and where plants with underground storage organs were more diverse; the lowest concentration was in farms where mechanized ploughing is used for land preparation.
Proton pump inhibitor modifies inflammatory reaction in human gastric mucosa infected by Helicobacter pylori
Authors: Suzuki M. , Suzuki H. , Kitahora T. , Miyazawa M. , Nagahashi S. , Suzuki K. , Ishii H. 
Published: March 2003

Aim:To examine whether proton pump inhibitors modify the production of oxygen‐derived free radicals and related cytokines in the human gastric mucosa infected with H. pylori.Methods:Thirty‐four H. pylori‐positive peptic ulcer patients (23 gastric ulcer, 11 duodenal ulcer) were enrolled. Biopsy tissue samples were obtained endoscopically from the antrum and corpus. Tissue content of neutrophil myeloperoxidase (myeloperoxidase) and IL‐8 was measured by ELISA. Mucosal production of oxygen‐derived free radical was measured using luminol‐dependent chemiluminescence (ChL). A proton pump inhibitor (either lansoprazole 30 mg, omeprazole 20 mg, or rabeprazole 10 mg) was administered daily by mouth to all patients for 8 weeks. Endoscopic examination was then repeated, and biochemical analysis was performed.Results:Antral myeloperoxidase decreased significantly after proton pump inhibitor treatment (5.23 ± 7.00–2.76 ± 5.11 ng/mg, P < 0.02), but corpus myeloperoxidase was unchanged. IL‐8 was also modified by proton pump inhibitors and these changes were parallel to those of myeloperoxidase. Corpus ChL was significantly increased from 88.5 ± 69.8–159 ± 172 counts/10 s/mg after proton pump inhibitor treatment, whereas antrum ChL was not altered. H. pylori infection rate was decreased in the antrum as well as the corpus.Conclusions:Proton pump inhibitor treatment stimulated oxygen‐derived free radical production in the corpus mucosa.