bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ciprofloxacin-induced acute psychosis in a patient with multidrug-resistant tuberculosis
Authors: Norra Christine , Skobel Erik , Breuer Christian , Haase Gerhard , Hanrath Peter , Hoff Paul 
Published: September 2003

AbstractTuberculosis (TB) increasingly appears in a multidrug-resistant form (MDR-TB) in Europe, too. Treatment remains difficult due to various side effects of the multi-drug-regimens. Ciprofloxacin is widely used as one of the few TB-second-line drugs. We report on the course of a ciprofloxacin-induced acute psychosis in a patient with MDR(isoniazid, streptomycin)-TB which resolved after cessation of ciprofloxacin treatment and introduction of a novel oxazolidone. Careful treatment considerations particularly in patients with additional predisposing factors to neuropsychiatric symptoms are recommended in the potentially dangerous MDR-TB, thus creating an enormous therapeutic challenge.
Obstetric sphincter tears and anal incontinence: an observational follow‐up study
Authors: Zetterström Jan , López Annika , Holmström Bo , Nilsson Bengt Y. , Tisell Åke , Anzén Bo , Mellgren Anders 
Published: September 2003

Background.  Persistent defects after primary sphincter repair and occult sphincter tears are common after vaginal deliveries. Anal incontinence may be associated with these morphological defects.Material and methods.  Forty‐six primiparous women were evaluated with ultrasonography, manometry and electrophysiology. Twenty‐four women had undergone primary repair of obstetric sphincter tears (sphincter group), 16 women had no clinical sphincter tear but developed anal incontinence postpartum (symptom group), and six were delivered by elective cesarean section (cesarean group).Results.  In the sphincter group, 50% had anal incontinence at follow‐up. At ultrasonography, 70% had injuries anteriorly in the midanal canal. At manometry, 4% had decreased resting pressure and 50% decreased squeeze pressure. At electrophysiology, 19% had pathologic pudendal latency and 25% pathologic fiber density.In the symptom group, 44% had injuries anteriorly in the midanal canal at ultrasonography. At manometry, all women had normal resting pressure and 19% had a decreased squeeze pressure. At electrophysiology, 46% had pathologic pudendal latency and 29% pathologic fiber density.In the cesarean group, 33% had mild anal incontinence at follow‐up. Ultrasonography and manometry were normal in all women. At electrophysiology, 33% had pathologic pudendal latency and 17% pathologic fiber density.Conclusion.  Anal sphincter injuries at childbirth are often inadequately diagnosed and primary repair frequently results in persisting defects in the anal sphincter. Anatomic injuries to the anal sphincter play an important role in the development of anal incontinence after delivery, but a significant proportion of symptomatic women also demonstrate neurologic impairment at electrophysiologic testing.
Measurement of both native and inactivated forms of α1 proteinase inhibitor in human inflammatory extracellular fluids
Authors: Petropoulou P. , Zhang Z. , Curtis M. A. , Johnson N. W. , Hughes F. J. , Winyard P. G. 
Published: September 2003

AbstractBackground: Inactivation of the elastase inhibitor, α1 proteinase inhibitor (α1PI), may be of pathogenic significance in inflammatory diseases like periodontal disease. Two key mechanisms of inactivation appear to be (a) the formation of an α1PI–elastase complex and (b) proteolytic cleavage by elastase or other enzymes such as metalloproteinases of host origin or enzymes of bacterial origin. Based on the different heat stabilities of the intact, complexed and proteolytically cleaved forms of α1PI, an enzyme‐linked immunosorbent assay (ELISA) that allowed the simultaneous measurement of native and inactive forms of α1PI was developed.Methods: The ELISA method described employs a commercially available antibody and represents a rapid, reproducible and sensitive method for studying α1PI inactivation in human inflammatory diseases. The assay was applied to normal human plasma and to human extracellular fluids obtained from patients with inflammatory diseases such as adult periodontitis and rheumatoid arthritis. Samples from patients with osteoarthritis, a “non‐inflammatory” joint disease, were also studied.Results: The findings expressed as the mean percentage (±SD) of the total α1PI that was inactivated were as follows: gingival crevicular fluid from adult periodontitis patients: 73.5±16.6% (n=12); normal human plasma: 8.4±4.9% (n=13); knee‐joint synovial fluid (SF) from rheumatoid arthritis patients: 12.5±4.5% (n=15); plasma from rheumatoid arthritis patients: 8.0±1.8% (n=15); knee‐joint SF from osteoarthritis patients: 8.6±8.2% (n=14); plasma from osteoarthritis patients: 5.7±4.8% (n=14). The results obtained by ELISA were in good agreement with those obtained by the semi‐quantitative method of SDS–PAGE and Western blotting.Conclusions: We have shown that the differential heat stability of α1PI may be utilised as the basis for a rapid, sensitive and reproducible ELISA assay of α1PI inactivation. In gingival crevicular fluid from periodontal disease patients, α1PI is mainly inactivated and the extent of this inactivation is much higher than in inflammatory fluids from other chronic diseases such as rheumatoid arthritis. This assay could be useful in monitoring the progression of periodontal disease.
Periodontal attachment loss over 14 years in cleft lip, alveolus and palate (CLAP, CL, CP) subjects not enrolled in a supportive periodontal therapy program
Authors: Salvi Giovanni E. , Brägger Urs , Lang Niklaus P. 
Published: September 2003

AbstractObjectives: (i) To assess the overall and (ii) cleft‐associated rate of periodontal disease (PD) progression in subjects with cleft lip, alveolus and palate (CLAP) and (iii) to compare these rates with those of subjects with cleft lip (CL) and cleft palate (CP).Material and methods: Twenty‐six subjects not enrolled in a supportive periodontal therapy (SPT) program were examined in 1979, 1987 and 1993. PD progression was assessed as increase in pocket probing depth (PPD in mm) and probing attachment loss (PAL in mm).Results: Extensive plaque accumulation and high frequencies of gingival units bleeding on probing were observed at all three examinations. A statistically significant increase in mean PPD of 0.57±0.21 mm (SD) in both groups as well as a statistically significant loss of PAL of 1.85±0.23 mm (SD) in the CLAP group and of 1.72±0.21 mm (SD) in the CL/CP group occurred over the observation period (p<0.05). In subjects with CLAP, statistically significant increases in PPD and loss of PAL were recorded over time at sites adjacent to the cleft as well as at control sites (p<0.05). Over 14 years, however, PPD increased 1.72±1.08 mm (SD) at cleft sites versus 0.72±1.14 mm (SD) at control sites (p<0.05), and PAL amounted to 3.19±1.35 mm (SD) at cleft sites versus 2.41±1.52 mm (SD) at control sites (p<0.05).Conclusion: Both the CLAP and the CL/CP subjects are at high risk for PD progression if no SPT program is provided. This also suggests that alveolar cleft sites in subjects with high plaque and gingival inflammation scores underwent more periodontal tissue destruction than control sites over a 14‐year period.
Pharmacokinetic properties of zolpidem in elderly and young adults: possible modulation by testosterone in men
Authors: Olubodun Joel O. , Ochs Hermann R. , Von Moltke Lisa L. , Roubenoff Ronenn , Hesse Leah M. , Harmatz Jerold S. , Shader Richard I. , Greenblatt David J. 
Published: August 2003

Aims  The influence of ageing on the pharmacokinetics of zolpidem, an extensively prescribed hypnotic medication, was evaluated in healthy human volunteers.Methods  A series of 16 elderly (age: 61–85 years) and 24 young (age: 22–42 years) volunteers received single 5 mg oral doses of zolpidem tartrate. Serum zolpidem concentrations were determined by HPLC with fluorescence detection in samples drawn during 8 h after dosage. The effect of testosterone on zolpidem biotransformation was evaluated in vitro using human liver microsomes. Possible induction of CYP3A protein expression and function was studied in cultured human hepatocytes.Results  Among men, apparent oral clearance of zolpidem was decreased in elderly compared to young subjects (3.8 vs 11.0 ml min−1 kg−1, P < 0.01), Cmax was increased (93 vs 40 ng ml−1, P < 0.01), and half‐life increased (2.7 vs 1.5 h, P < 0.03). Among women, zolpidem oral clearance was decreased in the elderly (3.0 vs 5.8 ml min−1 kg−1, P < 0.02), Cmax increased (108 vs 60 ng ml−1, P < 0.001), with no difference in t1/2 (2.3 vs 2.4 h). Among male subjects, free serum testosterone concentrations were lower in the elderly (10.5 vs 19.0 pg ml−1, P < 0.01), and were significantly correlated with zolpidem clearance (r2 = 0.46, P < 0.001). Multiple regression analysis indicated a greater relative contribution of serum testosterone than age to the oral clearance of zolpidem among men. In human liver microsomes, co‐incubation of zolpidem (10 µm) with varying concentrations of testosterone produced activation of biotransformation of zolpidem to its principal hydroxylated metabolite. Maximum activation was achieved at equimolar concentrations of testosterone (10 µm). However, testosterone did not induce immunoactive CYP3A4 expression or catalytic function in cultured human hepatocytes.Conclusions  The increased Cmax and lower oral clearance of zolpidem in the elderly are consistent with recommendations of lower clinical doses of zolpidem in the elderly. Our clinical and in vitro data both suggest that reduced free serum testosterone may have a modulatory role in age‐dependent changes in zolpidem pharmacokinetics in men.
Parent–nurse interactions: care of hospitalized children
Authors: Espezel Hilary J.E. , Canam Connie J. 
Published: September 2003

Background. An essential component of quality nursing care is nurses’ ability to work with parents in the hospital care of their children. However, changes in the health care environment have presented nurses with many new challenges, including meeting family‐centred care expectations.Aim of the paper. To report a research study examining the experiences of parents who interacted with nurses in a hospital setting regarding the care of their children.Methods. A qualitative approach was employed for this study. In‐depth audiotaped interviews were conducted with eight parents representing seven families. Data collection was completed over a 7‐month period in 2001.Findings. Parents characterized their experiences with nurses caring for their children as interactions, and identified the elements of establishing rapport and sharing children's care as key to a positive perception of the interactions. These elements were influenced by parental expectations of nurses. Changes in nurses’ approach were reported by parents as the children's conditions changed.Conclusion. Nurses were able to work with families in the hospital care of their children in ways that parents perceived as positive. However, in parents’ views, their interactions with nurses did not constitute collaborative relationships. A deeper understanding of these interactions may provoke new thinking about how to promote an agency's philosophy, and how nurses enact this philosophy in practice.
Interpreting trauma radiographs
Authors: Hardy Maryann , Barrett Christine 
Published: September 2003

Background. Many accident and emergency clinicians regard the radiographic image as an extension of the clinical examination, as a provisional diagnosis, based on clinical signs and symptoms, can be confirmed or refuted by inspection of X‐rays. However, the value of radiography in this context is not determined by the actual presence of trauma or pathology on the radiograph, but is dependent on the ability of a clinician to identify any trauma or pathology present. Traditionally, the responsibility for interpreting radiographic images within the accident and emergency environment in the United Kingdom (UK) has been with medical clinicians. However, expansion of the nursing role has begun to change the boundaries of professional practice and now many nurses are both requesting and interpreting trauma radiographs.Aim. To ascertain the ability of accident and emergency doctors and nurses to interpret trauma radiographs, and identify whether there is a consistent standard of interpretive accuracy that could be used as a measure of competence.Methods. A literature review was conducted using the Cochrane Library, Medline and CINAHL databases and the keywords radiographic interpretation, radiographic reporting, accident and emergency and emergency/nurse practitioner.Findings. The ability of accident and nursing doctors and nurses to interpret trauma radiographs accurately varies markedly, and no identified published study has established an appropriate level of accuracy that should be achieved in order to demonstrate satisfactory competence in the interpretation of radiographic images.Conclusions. Determining a measure of interpretive accuracy that can be used to assess ability to interpret radiographic trauma images is fraught with difficulties. Consequently, nurses may attempt to prove their skills by directly comparing their abilities to those of their medical colleagues. However, as a result of marked variation in the ability of senior house officers to interpret trauma radiographs, a similar ability does not automatically imply that a satisfactory level of ability has been achieved.
Local understandings of adult diarrhoeal disease and its treatment in an area of high HIV‐seroprevalence in Zambia
Authors: Ndubani Phillimon , Kelly Paul , Farthing Michael JG , Wallman Sandra 
Published: August 2003

SummaryWe set out to investigate the extent to which cultural constructs might determine treatment‐seeking for diarrhoea in the poorer populations of Lusaka, Zambia. This paper describes these concepts and perceptions and outlines a classification of such illnesses, together with an analysis of its implications for understanding treatment choice. Data were derived from focus group discussions, a household survey, a survey of practitioners of traditional medicine and interviews with local residents attending an urban health centre with persistent diarrhoea. The classification is based on symptoms and perceptions of aetiology. While resulting categories convey imperatives for treatment choice, it is clear that individuals with diarrhoeal illnesses seek treatment from multiple sources. This may be because any single illness may fit more than one category, or because unrelenting ill‐health engenders desperate behaviour. The cultural constructs do not fully explain treatment choice and attitudes to prevention, but could be used to improve communication regarding public health and treatment strategies.
Relapsing polychondritis
Authors: Liu Clive M. , Hata Tissa R. , Swinyer Leonard , Petersen Marta J. 
Published: September 2003

A 43‐year‐old Chilean man presented with a 5‐month history of progressive hypertrophy of the ears bilaterally. He was seen initially by a dermatologist in Chile for complaints of erythema and swelling of the ears, and had been treated unsuccessfully with topical steroids and antimicrobial ointments. On presentation to our clinic, the hypertrophy had stabilized and the erythema had resolved, but he complained of decreased hearing due to narrowing of the external auditory canal. Associated symptoms included occasional pruritus, but he denied any pain. He also denied a history of sinus problems, respiratory symptoms, ocular pain, chest pain, and arthralgias. Physical examination revealed firm hypertrophy of the collagenous areas of both ears, sparing the ear lobes (Fig. 1). No pain was elicited on palpation. No conjunctivitis was noted and the nasal passages were clear. His chest was clear to auscultation.Hypertrophy of the cartilaginous area of the ear with sparing of the ear lobesimageHistologic examination revealed a minimal perivascular infiltrate of lymphocytes and plasma cells in the dermis with fibrosis of the subcutis (Fig. 2).Low‐power view showing inflammation and fibrosis of the subcutisimageBlood tests showed a normal complete blood count, antinuclear antibody, and rheumatoid factor. Anti‐collagen II antibodies were elevated at 29.2 Eu/ml (normal, 0–20 Eu/ml; borderline, 20–25 Eu/ml; elevated, > 25 Eu/ml).
Seasonal effect upon excision of acquired melanocytic proliferations
Authors: Hall Glenda , Hull Cheryl , Siegel Eric R. , Smoller Bruce R. , Johnson Sandra Marchese 
Published: September 2003

AbstractBackground   Acquired melanocytic proliferations (AMPs) are excised throughout the year. Questions exist concerning seasonal variation in these excisions.Objective   To investigate whether AMPs are removed more often during the spring–summer seasons than in the fall–winter and whether the percentage of benign nevi, dysplastic nevi and melanoma varies according to season.Design   Retrospective analysis of 4794 histologically confirmed biopsies of AMPs was performed.Results   A total of 2802 of the 4794 lesions (58%) were removed during the spring–summer season. These results confirm that seasonal variation in removal of AMPs does occur, and that removal peaks during the warmer months. In addition, the increased numbers of removals were accounted for by increases in benign pigmented lesion removals.Conclusions   Many etiologic factors can be suggested for increased removal of AMPs during the warmer months. Reasons may include the cosmetic desires of the patient and clothing choices resulting in increased awareness of pigmented lesions. Increases in the number of skin cancer prevention programs offered by dermatologists in the spring also have a large impact on the awareness of the general population and potentially contribute to the seasonal variation.
Along these lines …
Authors: Wolf Ronni , Matz Hagit , Orion Edith 
Published: September 2003

Non‐melanotic discoloration of the skin can result from the accumulation of various internal agents (ingestion, inhalation, or injection), chemicals or drugs, such as heavy metals, amiodarone, tetracycline, clofazimine and others, or exogenous (topical) substances.Identifying the causative agent frequently requires a thorough investigation and clever detective work, including visits to the home and workplace. It is, however, rare that the patient presents at a clinic with the corpus delicti, and it is even more rare when neither the patient nor the treating physician are initially aware of it.“What is the hardest of all? That which you hold the most simple; seeing with your own eyes what is spread out before you.”[J.W. Goethe quoted by J.P. Eckermann in Converstions with Goethe, May 18, 1824.]
Asymmetric formation and possible function of the primary pore canal in plutei of Temnopleurus hardwicki
Authors: Hara Yoshinobu , Kuraishi Ritsu , Uemura Isao , Katow Hideki 
Published: September 2003

The development and possible function of the primary pore canal (PPC) in plutei of the sea urchin Temnopleurus hardwicki was examined by immunochemistry, electron microscopy and microsurgery. Left and right PPC that extended from coelomic sacs in plutei contained a bundle of cilia with a 9 + 2 structure that was initially detected as a group of anti‐acetylated tubulin antibody‐binding granules in the epithelium of coelomic sacs in 28 h postfertilization (PF) prism larvae. The granules extended to be a bundle of fibers toward the larval dorsal surface, concurrent with formation of the PPC on both sides, over the next 4 h. The cilia in both PPC beat actively. However, the PPC on the right side disappeared by approximately 55 h PF, establishing left–right asymmetry by 60 h PF (the four‐arm pluteus stage). The numbers of cilia in the left and right PPC in 56 h PF plutei were five and eight, respectively. Microsurgical removal of the coelomic sac from both sides or the left side only from 26 h PF prism larvae decreased body width to 64 and 91% of normal width by 50 h PF pluteus stage, respectively, whereas that of the right PPC did not. These observations suggest that PPC contribute to the maintenance of normal body width, and that there is asymmetrical activity between the left and right PPC.
Tissue sensitivity to thyroid hormone in athyroid Xenopus laevis larvae
Authors: Rot‐Nikcevic Irena , Wassersug Richard J. 
Published: September 2003

Tadpoles that spontaneously arrest development and remain as larvae occur occasionally in Xenopus laevis populations. These non‐metamorphosing tadpoles continue to grow, and they develop into grossly deformed giant individuals which come as close as any anurans to being truly neotenic. Giant X. laevis tadpoles that fail to metamorphose lack thyroid glands. In this study, the hypothesis that the tissues of these tadpoles nevertheless remain thyroid hormone sensitive was tested, by exposing isolated tadpole tail tips to exogenous thyroid hormone in tissue culture. The tail tips from giant tadpoles significantly shrank in response to the thyroid hormone treatment, showing that their tissue was still capable of metamorphosis. However, the amount of shrinkage was less than that observed in tail tissue from normal tadpoles. It was hypothesized that complete induction of metamorphosis may not be possible in the giant tadpoles due to a disproportionate growth and development of tissues and organs.
Characterization of bacterial pectinolytic strains involved in the water retting process
Authors: Tamburini Elena , León Alicia Gordillo , Perito Brunella , Mastromei Giorgio 
Published: August 2003

SummaryPectinolytic microorganisms involved in the water retting process were characterized. Cultivable mesophilic anaerobic and aerobic bacteria were isolated from unretted and water‐retted material. A total of 104 anaerobic and 23 aerobic pectinolytic strains were identified. Polygalacturonase activity was measured in the supernatant of cell cultures; 24 anaerobic and nine aerobic isolates showed an enzymatic activity higher than the reference strains Clostridium felsineum and Bacillus subtilis respectively. We performed the first genotypic characterization of the retting microflora by a 16S amplified ribosomal DNA restriction analysis (ARDRA). Anaerobic isolates were divided into five different groups, and the aerobic isolates were clustered into three groups. 84.6% of the anaerobic and 82.6% of the aerobic isolates consisted of two main haplotypes. Partial 16S rRNA gene sequences were determined for 12 strains, representative of each haplotype. All anaerobic strains were assigned to the Clostridium genus, whereas the aerobic isolates were assigned to either the Bacillus or the Paenibacillus genus. Anaerobic isolates with high polygalacturonase (PG) activity belong to two clearly distinct phylogenetic clusters related to C. acetobutylicum–C. felsineum and C. saccharobutylicum species. Aerobic isolates with high PG activity belong to two clearly distinct phylogenetic clusters related to B. subtilisT and B. pumilusT.
Diversity and significance of Burkholderia species occupying diverse ecological niches
Authors: Coenye Tom , Vandamme Peter 
Published: August 2003

SummaryMembers of the genus Burkholderia are versatile organisms that occupy a surprisingly wide range of ecological niches. These bacteria are exploited for biocontrol, bioremediation and plant growth promotion purposes, but safety issues regarding human infections, especially in cystic fibrosis patients, have not been solved. This minireview gives an overview of the taxonomic and ecological diversity of the genus with particular emphasis on strains belonging to the Burkholderia cepacia complex and addresses the important question whether ‘good’ and ‘bad’ strains are actually the same.