bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic cholangiocarcinoma and testicular mesothelioma in a wild‐caught blue shark, Prionace glauca (L.)
Authors: Borucinska J D , Harshbarger J C , Bogicevic T 
Published: March 2003

AbstractAn adult male blue shark, Prionace glauca (L.), caught in July 2000 by a recreational fisherman off Long Island, New York, USA, had a retained fishing hook from a previous capture. The hook penetrated the gastric wall and lacerated the right liver lobe. Macroscopic lesions consisted of transmural gastritis and peritonitis. Alteromonas sp. and Vibrio alginolyticus were isolated from the peritoneal fluid. In addition, a well delineated, sessile mass was found on the otherwise normal serosa of the right testis. Histopathological findings included mesothelial hyperplasia and hypertrophy involving diffusely the gastric, hepatic and parietal serosae, and forming a discrete testicular capsular mass compatible with mesothelioma. In the liver an intrahepatic cholangiocarcinoma, chronic hepatitis, biliary hyperplasia and increased numbers of melanomacrophages were found. In addition organisms compatible with histozoic and coelozoic myxosporeans were found within the skeletal muscle of the abdomen and intrahepatic bile ducts, respectively. This is the third literature report of a liver tumour and the first report of a coelomic mesothelioma from a shark.
Influence of enteric helminths on the distribution of intestinal endocrine cells belonging to the diffuse endocrine system in brown trout, Salmo trutta L.
Authors: Dezfuli B S , Giari L , Arrighi S , Domeneghini C , Bosi G 
Published: March 2003

AbstractThe presence of intestinal helminths in the alimentary canal of brown trout, Salmo trutta L., can alter the number of cells that synthesize modulatory peptides. A total of 167 brown trout were collected from tributaries of the River Brenta (northern Italy), of which 119 (71.3%) specimens were infected with enteric helminths, 28 with the acanthocephalan Pomphorhynchus laevis Müller, 1776 with intensity of infection ranging from 1 to 162 (18.57 ± 30.79) worms per host and 67 fish with the cestode Cyathocephalus truncatus Pallas, 1781. Intensity of infection with C. truncatus ranged from 1 to 85 (6.87 ± 12.59) per fish. In 24 fish there were concurrent infections of both species of helminths. The caecal and middle regions of the intestine were the most heavily parasitized. Immunohistochemical tests showed a decrease in endocrine cells (ECs) of the diffuse endocrine system (DES) positive to gastrin, cholecystokinin‐8, bombesin and secretin antisera in the intestine of the infected trout. The number of ECs immunoreactive to anti‐glucagon serum did not show differences in the digestive tract of uninfected brown trout and in conspecifics parasitized with P. laevis. The density of cells containing glucagon‐like material was low in the fish parasitized with C. truncatus. The results suggest that endoparasitic helminths induce alterations in the DES of infected S. trutta.
Bacterial contamination of enteral feeding systems due to faulty handling procedures—a comparison of a new system with two established systems
Authors: Beattie  , Anderton  
Published: March 2003

Background: The purpose of this study was to compare the risks of introducing microbial contamination when assembling and running two commonly used, ready‐to‐hang, enteral feeding systems (Nutrison glass bottles and Steriflo) with a newly introduced system (Nutrison pack).Methods: The nutrient container tops of all systems were deliberately touched during assembly by a researcher wearing gloves contaminated with
Klebsiella aerogenes. After touching, half the containers were immediately connected to giving sets, the other half were disinfected using alcohol wipes before connection to the giving sets. Systems were run for 24 h, with a change of nutrient container at 12 h for the Steriflo (2×1000 ml), Nutrison pack (2×1000 ml) and Nutrison glass bottles (2×500 ml), and at 6 h for the Nutrison glass bottles (4×500 ml). Feed samples for microbiological analysis were taken from feed in the systems at the 0 h assembly, and from residual feed in all discarded nutrient containers. Each protocol was repeated five times.Results: The percentage of feed samples in which K. aerogenes was detected reduced significantly from 68% for non‐disinfected Nutrison glass bottles changed every 6 h, to 59% after disinfection, and from 51% to 0% after disinfection of Steriflo systems (Mann–Whitney,
P< 0.05). For Nutrison glass bottles changed every 12 h the fall from 51% with no disinfection to 49% after disinfection was not significant (Mann–Whitney,
P< 0.05). Nutrison packs were not disinfected and yet K. aerogenes was only detected in 2% of feed samples. This rate of contamination was significantly less than that for all the other non‐disinfected systems (Mann–Whitney,
P< 0.05).Conclusion: The results show a reduction in the incidence of bacterial contamination of the feed samples when systems were disinfected subsequent to being exposed to faulty handling procedures, thus supporting manufacturers recommendations to disinfect systems during assembly. The results particularly highlight the important role played by system design in reducing the levels and incidence of bacterial contamination of enteral tube feeds.
Gastrostomy feeding in advanced Huntington's disease
Authors: Wilson J. 
Published: March 2003

SummaryThis case study reports the progress of a 41‐year‐old man with advanced Huntington's disease (HD) during a 12‐week period when he was fed a high‐energy regimen via percutaneous endoscopic gastrostomy (PEG). The regimen consisted of a low‐protein, low‐mineral, energy‐dense (2 kcal mL−1) carbohydrate polymer. Achieving weight gain with a 1.5 kcal mL−1 feed and carbohydrate polymer had produced steady but slow results (52–56 kg – a rise of 4 kg in 15 months). It was concluded that a more energy‐dense regimen would facilitate faster weight gain.
A9. A study of nutritional intake in surgical patients, pre‐ and post‐operatively
Authors: Trick L. M. J. 
Published: March 2003

Background Those who undergo major surgery are at a greater risk of malnutrition than most because of the stress and the concomitant increase in metabolic rate (
Edington, 1997). Malnutrition often goes unrecognized in hospitals (
Lennard Jones, 1992) increasing morbidity and mortality as well as the length of hospital stay and cost to the NHS. Treatment of the malnourished patient by nutritional support (
Rana et al., 1992
) and artificial nutritional support (
Beiser‐Holgeren et al., 1996
) has produced beneficial results.Aim To examine the nutritional intakes of surgical patients pre‐ and post‐operatively and identify the factors associated with nutritional intake.Methods The study identified the nutritional intakes of surgical patent’s 1 day preoperatively and on two occasions postoperatively (3–5 days and 7–12 days). Also investigated were reasons why, if any, surgical patients were not meeting their nutritional requirements, the contribution of artificial nutritional support to patients’ requirements and patients’ acceptability of the hospital catering system. 50 surgical patients undertook a 24‐h dietary recall at the stated assessment periods. Statistical tests were used to analyse the variance (anova) and correlation of all data.Results It was found that only 24% of patients were meeting nutritional requirements preoperatively. Only 6% met their requirements in the first postoperative period and only 18% in the second.Patients undergoing gastro‐intestinal surgery were found to be at the greatest nutritional risk.Patients who received artificial nutritional support (naso‐gastric and naso‐jejunal) had the highest nutritional intakes in the postoperative periods.Supplementary drinks substantially increased nutritional intakes.Medical and surgical reasons were identified for patients’ reduced intakes not patient dissatisfaction with the hospital catering system.Conclusion These results show that malnutrition is still apparent on today’s surgical wards. Patients continue to be nutritionally deficient whilst in hospital. The education of all health care professionals on the subject of nutrition must therefore be seen as of paramount importance.
A16. A study of nutritional knowledge and supplement use in pregnant women
Authors: Johnson K. 
Published: March 2003

Background Current research recognizes a good nutritional state as essential for the well‐being of the foetus in pregnancy and there is an increasing body of evidence linking nutritional knowledge with an improved nutritional state. Folic acid is of particular importance in pregnancy due to its role in preventing neural tube defects.Aim This study aimed to determine the effect of the recent Department of Health folic acid campaign on the knowledge and use of folic acid supplements in a group of pregnant women, as well as assessing their use and means of access to other vitamin and mineral preparations. It also aimed to identify the main sources from which parents obtain nutritional information and establish the effect of the St. George’s Hospital ’Guide to Nutrition in Pregnancy’ booklet on the nutritional knowledge of the women using this group.Methods A self‐administered questionnaire was randomly distributed to 100 pregnant women attending subsequent ante‐natal appointments at St. George’s Hospital in Tooting of which 67 were fully completed and returned. Relationships between variables were investigated using Chi‐squared.Results 100% of women were aware of folic acid and 66% knew its exact role in preventing neural tube defects, with this knowledge being higher in those who had a job (P = 0.01). 61% of women were taking folic acid supplements with use being higher in those who had planned their pregnancy (P < 0.01), didn’t smoke (P < 0.05), had a job (P < 0.01) and in higher social classes (P < 0.01). 78% of women were taking nutritional supplements with more being taken during pregnancy (60%) than on a regular basis (40%) and most being taken once a day (58%). Supplements were most frequently bought from a chemist (50%) or supermarket (22%) or obtained on prescription from a GP (22%). The most common sources of information on nutrition in pregnancy were The BOUNTY book on having a baby, ’Mum‐to be’ magazines and ’St George’s Guide to Nutrition in Pregnancy’ with the latter two being regarded as giving the best, most useful information. Those who had received the St George’s booklet had better overall nutritional knowledge about pregnancy than those who hadn’t (P < 0.05).Conclusions The relaunch of the folic acid campaign has succeeded in raising awareness and use of folic acid supplements in this group and the publication of St. George’s ’Guide to Nutrition in Pregnancy’ has increased their general knowledge of the nutrition issues relating to pregnancy.
A4. A retrospective review of the effect of insulin therapy on metabolic control, weight, lipid levels and blood pressure in people with type II diabetes
Authors: Economides C. 
Published: March 2003

Background The role of insulin in the treatment of type II diabetes has been the subject of many debates. Exogenous insulin has been suggested to have both beneficial and detrimental effects in the health and well‐being of diabetic patients (
Genuth, 1996). The beneficial effect is the result of reducing hyperglycaemia (
Henry, 1996). On the other hand, insulin treatment is considered to accelerate the development of cardiovascular disease by increasing cardiovascular disease risk factors (
Turner, 1996).Aim The aim of this retrospective review was to monitor the effect of insulin therapy on metabolic control, and in addition to monitor the contact with a dietitian on starting insulin.Methods The study involved 202 patients with type II diabetes. Group A: 149 subjects (mean age 64 years) poorly controlled patients who had switched to insulin treatment and Group B: 53 subjects (mean age 68 years) who were maintained on oral hypoglycaemic agents. All variable were collected (a) on starting insulin (or reference date) and (b) one year later.Changes within each group in glycaemic control, weight serum lipid levels and blood pressure were evaluated using Two‐sample t‐test assuming equal variances. Changes in the two groups were compared using the Two‐sample t‐test assuming unequal variances.Results Type II diabetic patients who had switched to insulin treatment had experienced a significant increase in body weight (5.4 kg) in comparison to control subjects at the year after insulin commencement. Mean HbA1c and fasting blood glucose (FBG) decreased significantly in the insulin group (from 9.9 ± 2.1 to 8.5 ± 1.6% and from 14.6 ± 5.6 to 10.3 ± 3.9 mmol L−1, respectively). In contrast no statistically significant difference was noted in the control group for either HbA1c or FBG. Blood lipids did not change significantly in either group, and blood pressure also remained statistically unchanged. 36% of the insulin treated patients had dietetic input at the time of insulin commencement.Conclusions Weight gain and improvement in glycaemic control, has been demonstrated in previous studies. Even though the current study did not show changes in lipid levels, other studies have shown a reduction in both triglyceride and cholesterol levels.The introduction of insulin treatment in individuals with poorly controlled type II diabetes appears to positively affect metabolic control. Long‐term improvement in metabolic control has been shown to have many effects on the health and longevity of diabetic individuals, as has a reduction in the individual’s weight. Prospective studies in this area could fully determine the effects of insulin introduction on these variables, enabling fuller conclusions to be made with respect to longevity and future disease risks.
Meal patterns and meal quality in patients with leg ulcers
Authors: Wissing U. , Lennernäs M. A‐C. , Ek A‐C. , Unosson M. 
Published: March 2003

Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food‐related factors, meal patterns and meal quality in relation to nutritional status in elderly out‐patients with leg ulcers.Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty‐six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.Results Thirty‐six patients were classified as well‐nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well‐nourished patients.Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.
An audit of the theoretical basis of education during dietetic consultations with diabetic patients
Authors: Parkin T. 
Published: March 2003

BackgroundThis article describes my attempts to reflect my current practice. It was conducted in order to determine which of three educational models, Empowerment, Motivational Interviewing and Helping People to Change, were being used during a diabetic dietetic consultation.MethodAnalysis of interviews with 15 patients selected at random from an outpatient clinic was undertaken. Each consultation was assessed and relevance to steps in each model noted.ResultsOverall the results suggest that all three models were used for different reasons. Therefore, I conclude that any one of a number of educational approaches may be used within a consultation, as there may be elements that overlap. The different skills required by each of the models are invaluable at different times to assist patients at different phases in their life.ConclusionsAn understanding of different educational models is therefore useful and has helped to clarify my practice. In future, I anticipate a more formal evaluation of the educational process to help identify steps used. These could then be formally assessed for their impact on patient outcomes, and so identify specific aspects of educational models that assist patient education and help to improve outcomes.
Audit and comprehensive health assessment programme in the primary healthcare of adults with intellectual disability: a pilot study
Authors: Lennox N. G. , Green M. , Diggens J. , Ugoni A. 
Published: March 2003

AbstractInternational research has demonstrated significant shortcomings in the health of adults with intellectual disability (ID). Because general practitioners (GPs) are the main providers of primary healthcare for this population, strategies to improve general practice care are an important aspect of rectifying these shortcomings. The present pilot study aimed to determine the effect of various interventions on health maintenance activities and to assess their acceptability to GPs, with a view to informing larger scale studies. The GPs were recruited through an earlier questionnaire‐based postal survey. The GPs identified all their adult patients with ID, then obtained consent for participation from three patients randomly selected by the investigators. The GPs completed two self‐evaluation forms and case note audits 12 months apart, read a synopsis of the relevant literature provided by the researchers, and completed a comprehensive health assessment (CHA) of their three patients. Forty‐five GPs agreed to participate in the CHA programme (CHAP), and 15 completed the project. Thirty‐eight patients completed the project. The number of patient–GP dyads who completed the project was too small to demonstrate statistically significant changes in health issues over time. The GPs found that the synopsis of the literature was the best intervention for increasing knowledge and was also the most practical to use in general practice. The CHAP was the intervention that prompted the most action from the GP which would not have been undertaken otherwise. The CHAP appeared to provide a superior review process compared to the other interventions used in the present study. The numbers of health maintenance activities found to be overdue and the number of health issues detected as a result of the process were considerable. The CHAP served as a communication tool and an educative instrument, providing a basis for future studies and strategies to improve the general practice care of adults with ID.
Utilization of medical care among children with Down’s syndrome
Authors: Frid C. , Annerén G. , Rasmussen F. , Sundelin C. , Drott P. 
Published: March 2003

AbstractBackground The present authors have previously found an increased mortality rate in children with Down’s syndrome (DS) and a congenital heart defect (CHD). The aim of the present study was to investigate the utilization of medical care in relation to congenital malformations in DS.Method Retrospectively, 211 children with DS born between 1973 and 1980 in the northern part of Sweden were followed up for at least 17 years (1973–1997). The duration of neonatal care was compared with that of children with DS born between 1995 and 1998 in the same region.Results Neonatal care was reduced over time. Almost 50% of the children had CHD, and before 10 years of age, these subjects were admitted for inpatient care twice as often as children with DS who did not have malformations, and had more than 12 times as many inpatient days per month. The existence of a gastrointestinal or other malformation increased inpatient days per month four and two times, respectively, compared to healthy children with DS. During the first 10 years of life, children with DS and a CHD accounted for 71% of all inpatient days caused by infections. No gender differences were observed.Conclusions At a group level, the presence of a CHD was the most important congenital abnormality in determining utilization of medical care and the burden of infections in the population of children with DS.
Low prevalence of abnormal cervical cytology in an institutionalized population with intellectual disability
Authors: Jaffe J. S. , Timell A. M. , Eisenberg M. S. , Chambers J. T. 
Published: March 2003

AbstractBackgroundThe present study was designed to determine the prevalence of abnormal cervical cytology in an institutionalized population with intellectual disability.MethodA retrospective review of charts for 162 women at a large state‐owned facility was performed. Slides from 310 cervical Papanicolau smears were re‐screened by a cytotechnologist and then reviewed by a pathologist.ResultsThe prevalence of abnormal cytology (three out of 162 participants) and biopsy confirmed that the prevalence cervical dysplasia (one out of 310 smears) was low.ConclusionThe present preliminary study suggests that further investigation of the optimal interval for cervical cancer screening is warranted in this population.
Thyroid hormone treatment aiming at reduced, but not suppressed, serum thyroid‐stimulating hormone levels in nontoxic goitre: effects on bone metabolism amongst premenopausal women
Authors: Knudsen  , Faber  , SierbÆk‐nielsen  , Badstrup  , SØrensen  , HegedÜs  
Published: March 2003

Knudsen N, Faber J, Siersbæk‐Nielsen K, Vadstrup S, Sørensen HA, Hegedüs L.(Frederiksberg Hospital; Herlev University Hospital; Copenhagen Municipal Hospital; Denmark). Thyroid hormone treatment aiming at reduced, but not suppressed, serum TSH levels in nontoxic goitre: effects on bone metabolism among premenopausal women. J Intern Med 1998; 243: 149‐54.ObjectivesTo study the effects of six months' treatment with either T4 or T3, aiming at reduced but not totally suppressed serum TSH levels, as measured by a third generation TSH assay, on biochemical bone turnover parameters as well as bone mass in patients with nontoxic goitre.DesignProspective randomized study with a matched control group, not blinded.SettingTwo University Hospital Clinics in Copenhagen.Subjects and InterventionTwenty‐four consecutive premenopausal women with moderate sized non‐toxic goitre. Fourteen patients randomized to T4 or T3 treatment for six months with monthly titration of the dose, aiming at TSH values between 0.005 and 0.2 mUL−1. Ten controls.Main outcome measuresSerum parathyroid hormone (PTH), serum procollagen I C‐terminal propeptide (PICP), serum alkaline phosphatase, serum osteocalcin, u‐pyridinoline, u‐deoxypyridinoline, u‐hydroxyproline. Bone mass (BMD) at the lumbar spine and at both femoral necks.ResultsSerum TSH was generally kept within the desired interval. There was no difference in any marker of bone metabolism between the effects of T4 and T3. Consequently, these groups were combined in order to evaluate the effect of thyroid hormones on the bone and mineral metabolism. Thyroid hormone treatment resulted in increased levels of serum ionized calcium (Ca) (P=0.02), serum alkaline phosphatase (P=0.007), serum‐PICP (P=0.003), serum osteocalcin (P=0.02) and urinary excretion of deoxypridinoline (P=0.03) compared to untreated controls. Bone mass did not change.ConclusionSix months treatment with either T4 or T3 of premenopausal women with nontoxic goitre, aiming at reduced but not totally suppressed TSH values, resulted in biochemical signs of increased bone turnover, whereas bone mass remained unaltered. No differences were found between the effects of T4 or T3 treatment.