bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Adherence of cagG‐DeletedHelicobacter pylori to Gastric Epithelial Cells in Japanese Clinical Isolates
Authors: Mizushima Takuji , Sugiyama Toshiro , Kobayashi Takahiko , Komatsu Yoshito , Ishizuka Jun , Kato Mototsugu , Asaka Masahiro 
Published: March 2003

ABSTRACTBackground. The cag pathogenicity island (cag PAI) is a major virulence factor. The ability of Helicobacter pylori to adhere to gastric epithelial cells is an important initial step for virulence. The aim of this study was to evaluate the relationship between genetic variations of cag PAI in Japanese clinical isolates and the ability of H. pylori to adhere to gastric epithelial cells.Materials and Methods. The polymerase chain reaction and Southern blot analysis were used to verify the presence or absence of cagA, cagE, cagG, cagI and cagM in the cag PAI in 236 Japanese clinical isolates. The ability of H. pylori to adhere to KATOIII cells was examined by flow cytometry.Results. Seven (3.0%) cag PAI partial‐deleted strains were found in 236 clinical isolates, and these strains showed three patterns in the deleted region within the cag PAI. All of the cagG‐deleted strains showed decreased adherence to KATOIII cells, in comparison with cagG‐positive strains. These strains had abolished IL‐8 induction despite the presence of cagE, which is essential for IL‐8 induction.Conclusions. Our results suggest that cagG or surrounding genes in the cag PAI has a function related to adhesion to epithelial cells.
Antral Nodularity and Positive CagA Serology are Distinct and Relevant Markers of Severe Gastric Inflammation in Children with Helicobacter pylori Infection
Authors: Luzza Francesco , Pensabene Licia , Imeneo Maria , Mancuso Maria , Giancotti Laura , La Vecchia Anna M. , Costa Maria C. , Strisciuglio Pietro , Pallone Francesco 
Published: March 2003

ABSTRACTBackground. The aim of this study was to assess whether the endoscopic finding of antral nodularity and serum IgG antibodies to CagA are associated with higher grades of gastric inflammation.Materials and methods. The comprehensive data of two previously published trials were reanalysed. One hundred and fifty‐three children (median age 9.5 years) who underwent gastroscopy were included. Biopsy specimens from the antrum and corpus were taken to assess Helicobacter pylori status, gastritis score and lymphoid follicles. During endoscopy, antral nodularity was noted. Serum samples were assayed for IgG antibodies to CagA.Results. The presence of antral nodularity (nod+) and positive CagA serology (CagA+) were each found in 32 of the 77 (41.5%) children who had evidence of H. pylori infection. Crosstabulation showed that 20 children (26%) were nod+/CagA+, 12 (15.5%) nod+/CagA−, 12 (15.5%) nod‐/CagA+ and 33 (43%) nod−/CagA−. Gastritis score was significantly lower in nod−/CagA−children than in nod+/CagA− (p = .004), nod−/CagA+ (p = .002) and nod+/CagA+ (p < .001), both in the antrum and corpus. Completely normal gastric histology was only found in the nod−/CagA−subgroup of H. pylori‐infected children (eight of 33, 24%). Regression analysis showed that antral nodularity and positive CagA serology were related to severe gastric inflammation independently of each other and age. Separate analysis showed that inflammation (p < .001), activity (p < .001) and H. pylori density (p = .002) scores were significantly lower in nod−/CagA−children compared with nod+/CagA+ children. The number of lymphoid follicles in the gastric mucosa was related to antral nodularity (p = .003) and positive CagA serology (p = .043), independently of each other.Conclusions. Antral nodularity and positive CagA serology are distinct and relevant markers of severe gastric inflammation in children with H. pylori infection. The lack of both findings in the same child reflects low‐grade or no gastritis.
Helicobacter pylori inflammation and immunity
Authors: Nedrud John G. , Blanchard Samra S. , Czinn Steven J. 
Published: March 2003

AbstractGastric inflammation is a significant contributor to the disease process associated with Helicobacter pylori infection. It appears that both bacterial genes and differential host responses make interrelated contributions to gastritis and disease outcome after H. pylori infection. While the cag pathogenicity island (PAI) continues to be a focus for much of this investigation on the bacterial side, other bacterial genes/proteins are certainly important as well. On the host cell side, significant progress is being made defining the eucaryotic signaling cascades induced after host cells interact with H. pylori. The role of host cell cytokines, gastric acid, and mast cells is also being actively studied. Prospects for control of H. pylori associated disease continue to include vaccination. The mechanism(s) for vaccine‐mediated control of H. pylori infection and disease remain ill‐defined but recent evidence from animal models suggests that the inflammatory response may be involved. Manipulating the host response to H. pylori infection in humans to take advantage of the possible beneficial effects of inflammation, while minimizing its detrimental effects is a significant challenge for the future.
Age, Self‐Efficacy, and Change in Patients' Adjustment to Cancer
Authors: Lev Elise L. , Paul Diane , Owen Steven V. 
Published: March 2003

objectives:The purpose of this secondary analysis was to investigate cancer patients' self‐care self‐efficacy and measures of adjustment over time, as well as the role of self‐care self‐efficacy with measures of adjustment. The primary study was a longitudinal study of cancer patients and family members' adjustments.materials and methods:Three hundred seven cancer patients at all stages of cancer completed study instruments on one occasion; 181 completed the instruments 4 months later; and 124, 8 months later. Instruments included the Strategies Used by Patients to Promote Health (SUPPH) to measure self‐care self‐efficacy, the Functional Assessment of Cancer Treatment (FACT) to measure quality of life, the Profile of Mood States (POMS) to measure patients' mood disturbances, and the Symptom Distress Scale (SDS) to measure patients' concerns.results:Using analysis of variance, a series of one‐way repeated measures used to investigate changes in cancer patients' self‐care self‐efficacy and measures of adjustment revealed significant decreases in patients' self‐care self‐efficacy (P= .01) and quality of life (P= .001) over time. Patients' symptoms and mood disturbances did not significantly change over time. The role of self‐care self‐efficacy with measures of adjustment was investigated using canonical correlations. For the predictor variables, subscores for coping and enjoying life on the SUPPH showed the strongest loadings, 0.83 and 0.94, respectively. On the dependent variables, the FACT was by far the most important variable, with a loading of 0.92.conclusions:Results demonstrate that without intervention, cancer patients' measures of self‐efficacy and adjustment decrease over time, and patients' self‐efficacy influences their adjustment. Psychosocial interventions have been designed to increase self‐efficacy and to enhance adjustment. Longitudinal study of efficacy‐enhancing interventions is needed.
Processes of Change Related to Smoking Behavior Among Cancer Patients
Authors: Schnoll Robert A. , Malstrom Michael , James Calvin , Rothman Randi L. , Miller Suzanne M. , Ridge John A. , Movsas Benjamin , Langer Corey , Unger Michael , Goldberg Melvyn 
Published: March 2003

purpose: The purpose of this study was to examine the degree to which transtheoretical model processes of change (methods and strategies for cessation) were associated with smoking status and quitting behavior (ie, intentions and attempts to quit) among pa‐ tients with head and neck or lung cancer. The relationship between medical variables and processes of change was also explored.description of study: Twenty‐nine smokers and 45 abstainers who were recruited from treatment clinics within a comprehensive cancer center completed a brief survey. Multivariate analysis of variance and Pearson correlation procedures were used to evaluate hypothesized relationships.results: As hypothesized, quitters used behavioral processes such as counter‐conditioning and reinforcement management significantly more than smokers and used self‐reevaluation, an experiential process, significantly less than smokers. Contrary to the hypothesis, however, quit attempts and intentions were associated with both experiential (ie, consciousness raising and self‐reevaluation) and behavioral (ie, reinforcement management and self‐liberation) processes of change. Use of the processes of change was not influenced by medical variables, including cancer type, illness phase, disease stage, type of current medical treatment, and duration of illness.clinical implications: These findings suggest that behavioral counseling to promote smoking cessation for patients with cancer should involve assisting the patient to do the following: develop an awareness of the health risks related to continued smoking; devise and use alternative behaviors; implement the use of reinforcement strategies for cessation successes; and develop a sense of confidence and commitment about quitting as well as healthy lifestyle values. These strategies are discussed within the context of models and guidelines for smoking cessation in clinical practice.
Factors in Making the Decision to Forgo Conventional Cancer Treatment
Authors: Verhoef Marja J. , White Margaret A. 
Published: March 2003

purpose: The purpose of this study was to explore why and how patients with cancer decide to forgo conventional cancer treatments in favor of alternative treatments and which factors influence such decisions.description of study: Due to the exploratory nature of the study, this was a qualitative study using focus groups and in‐depth interviews in a convenience sample of patients. All patients had received diagnoses of cancer and had refused one or more conventional treatments offered to them by their cancer healthcare professionals.results: Thirty‐one persons with cancer, widely varying in age and tumor sites, volunteered to take part in the study. Of these, 12 refused all conventional treatment, 13 refused most or some of the treatments recommended, and 6 discontinued conventional treatment. The decision‐making model, which emerged from the data, identifies several groups of variables. These include factors that predispose participants to the decision to forgo conventional treatment(s), such as having a close relative or friend who has died from cancer when receiving conventional treatment; experiences around the diagnosis; and factors relevant after the diagnosis, such as beliefs, need for control, side effects of conventional cancer treatment, and communication with physicians. Last, perceived outcomes of the decision proved to be an important theme in the focus groups and interviews.clinical implications: Patients with cancer may benefit from counseling to help them explore the difference between their diagnosis and treatment plan and those of family members or friends who died of cancer while receiving conventional treatment. Counseling also may be helpful in resolving emotional issues underlying the decision to forgo treatment. Last, patients should have access to healthcare professionals, including physicians and counselors, who would assist them with their decision making without judging or intimidating them.
Colorectal Cancer Screening Barriers in Persons with Low Income
Authors: Holmes‐Rovner Margaret , Williams Gilbert A. , Hoppough Susan , Quillan Lisa , Butler Rishan , Given C. William 
Published: March 2003

purpose: The purpose of this study was to provide insight into the modest success of a physician and patient education and reminder program that improved screening rates from 37% to 49% among rural Medicaid‐eligible patients in western Michigan.description of study: The following four focus groups were conducted: African American men, African American women, White men, and White women, matched with moderators by gender and ethnicity. The sample was selected by contacting prior eligible screening refusers, completing groups with a convenience sample who had accepted screening. Twenty‐one patients participated who were ages >50 years. The screening refusal rates were 19% for men and 9% for women. Open‐ended questions guided the discussion of colorectal cancer (CRC) attitudes, beliefs, and practices.results: All participants believed in the efficacy of cancer screening. White women were better informed about screening purposes and procedures. The major barriers to screening were quality of care (ie, the perceived lack of offering screening and the follow‐up of test results) and the potential for pain from screening or treatment of CRC, should it be discovered.clinical implications: Successful efforts to improve awareness of the importance and efficacy of screening must further address deeply held skepticism and fears about CRC screening in this population. A fruitful direction for this difficult problem appears to be improved communication (both negative and positive test results). Without feedback, patients with negative results may assume lack of provider follow‐through.
Viatical Settlements
Authors: Badreshia Sonia , Bansal Vivek , Houts Peter S. , Ballentine Noel 
Published: March 2003

purpose: This study was performed to assess the knowledge, attitudes, and experiences with viatical settlements among hospice staff who provide financial counseling to terminally ill patients and their families.description of study: A random sample of 300 hospices in the 50 states was selected from the National Hospice Directory. Staff members who provide financial counseling to patients and families were interviewed by phone using a 31‐item structured questionnaire.results: The response rate was 80%. The results showed that only 4% of hospices provide information about viatical settlements to all patients, while 32% provide information only if asked. Only 9% of respondents rated themselves as very informed about viatical settlements, and 53% rated themselves as moderately informed. Of the 47 hospices where at least one patient had used a viatical settlement, 92% felt the patient had a positive experience using the resource. In response to a hypothetical case of a terminally ill patient considering a viatical settlement, 40% responded positively, while 51% were neutral.clinical implications: Among hospice financial counselors who have had experience with viatical settlements, most report positive experiences. When asked to respond to a hypothetical case, most respondents were either neutral or positive. However, lack of knowledge about viatical settlements may limit the availability of this resource for terminally ill patients and their families.
Adherence to Moderate‐Intensity Exercise During Breast Cancer Therapy
Authors: Pickett Mary , Mock Victoria , Ropka Mary E. , Cameron Lane , Coleman Meghan , Podewils Laura 
Published: March 2003

purpose: The aims of this pilot study were the following: 1) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospective, randomized, controlled experimental design; 2) to examine the influence of disease symptoms and treatment side effects on exercise levels; and 3) to suggest methods that may improve future clinical trials of moderate‐intensity exercise in similar populations.description of study: Fifty‐two patients with newly diagnosed breast cancer were randomly assigned to one of two treatment arms: usual care or usual care plus exercise. Those assigned to the exercise group received a standardized, self‐administered, home‐based brisk walking intervention in addition to usual care. Each day subjects completed self‐report diary forms that elicited information about activity levels, and the occurrence of symptoms and side effects during cancer treatment.results: Analyses of self‐reported daily activity levels revealed a diffusion of treatment effect. Fifty percent of the usual‐care group reported maintaining or increasing their physical activity to a moderate‐intensity level, while 33% of the exercise group did not exercise at the prescribed levels. Analyses of self‐reported disease symptoms and treatment side effects did not reveal clinically meaningful differences between the two groups.clinical implications: The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs. Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies.
Bladder Cancer
Authors: Pashos Chris Leo , Botteman Marc F. , Laskin Benjamin Lewis , Redaelli Alberto 
Published: March 2003

purpose: The purpose of this article is to present an overview of the epidemiology diagnosis, and management of bladder cancer, with a focus on the early stage of this disease.overview: English‐language articles published between 1990 and 2000, as well as selected abstracts published in non‐English languages before 1990, were reviewed. Epidemiologic data clearly indicate that bladder cancer is much more common in men, White persons, and the elderly. Cigarette smoking appears to be the most significant environmental risk factor. Screening for the disease is currently not standard in the United States or Canada. Potential tests include urine cytology, hematuria dipstick, and the urinary biomarkers. Diagnosis is made most often on the basis of the findings of cystoscopy, tumor biopsy, and urine cytology. Transurethral resection (TUR) of the tumor is generally the first‐line treatment for superficial disease. Cystectomy is the “gold standard” treatment for invasive disease in many countries, although trimodality therapy (TUR, radiation, systemic chemotherapy) has shown promise as a bladder‐preserving strategy. Intravesical therapy is effective for preventing disease recurrence, although its role in slowing disease progression is uncertain. Chemotherapy and radiation also can be used with cystectomy to treat or prevent pelvic recurrence of invasive disease or to prolong life in patients with metastatic disease.clinical implications: Bladder cancer is a commonly occurring disease. Prevention efforts must focus on the avoidance or cessation of cigarette smoking and on public education relating to known environmental risk factors. Patient and disease factors must be considered in making treatment decisions and determining prognosis. Careful follow‐up after treatment is essential. It is hoped that ongoing research on potential tumor markers and tumor‐specific therapies ultimately will result in improved clinical outcomes for patients with this malignancy.
Headache in a Population‐Based Elderly Cohort. An Ancillary Study to the Italian Longitudinal Study of Aging (ILSA)
Authors: Franceschi Massimo , Colombo Bruno , Rossi Paolo , Canal Nicola 
Published: March 2003

The aims of this ancillary study to the Italian Longitudinal Study of Aging were: (1) to provide reliable prevalence data on headache in an elderly population, (2) to classify the subtypes of headache according to International Headache Society criteria, and (3) to identify possible risk factors and associated pathologies in the elderly.A total of 312 subjects were examined, 148 women and 164 men, with a mean age of 73 years (SD 5.5). For 236 subjects (75.7%), 141 men (85.9%) and 95 women (64.2%), headache had never been a problem; 57 subjects (18.3%), 21 men (12.8%) and 36 women (24.3%), reported troublesome headache only in the past. Nineteen subjects (6%), 6 men (3.6%) and 13 women (8.8%), reported current headache: in this group tension‐type headache was the most prevalent, accounting for 2.6%; secondary headaches ranked second, accounting for 2.2%; and only 1% had current migraine.Our data indicate female sex and younger age as risk factors for headache, and associate migraine and secondary headaches with hypertension, tension‐type headaches and secondary headaches with diabetes, and tension‐type headaches with myocardial ischemia.
Therapeutic Blockade of Greater Occipital and Supraorbital Nerves in Migraine Patients
Authors: Caputi Claudio A. , Firetto Vincenzo 
Published: March 2003

A disturbance in the region of the head can provoke pain in the distribution of the trigeminal and upper cervical nerves due to a convergence of the afferent fibers of the three superior cervical roots on the neurones of the spiral nucleus of the trigeminal nerve. The therapeutic value of greater occipital and supraorbital nerve blockade in 27 patients with migraine, unresponsive to several combinations of pharmacological treatments, was investigated. Patients were given repeated anesthetic blocks, on alternate days, up to a maximum of 10 blocks. Perineural injections of 0.5 to 1.0 mL of 0.5% bupivacaine were given at the epicranial emergence points of the above nerves in relation to the distribution of the cephalic pain only if such nerves were conspicuously pain sensitive to pressure. Clinical evaluation was determined by a monthly Total Pain Index and recording of the number of migraine attacks and analgesic consumption each month. A patient was considered responsive when the Total Pain Index decreased by 50% or more in the first month after treatment. Twenty‐three patients (85%) responded beneficially and maintained a favorable response for the 6‐month period of observation. The treatment was considered to be of long‐lasting effectiveness and without any side effects. Four patients (15%) were unresponsive to treatment.We hypothesize that the anesthetic blocks extinguished presumed foci of nociceptor discharges maintained by perivascular neurogenic inflammation, thereby reestablishing normal central neurone sensitivity.In conclusion, blockade of the supraorbital and greater occipital nerves appears to be effective in the treatment of migraine; however, controlled studies are needed to confirm these preliminary findings.
Study of Pressure Pain and Cellular Concentration of Neurotransmitters Related to Nociception in Episodic Tension‐Type Headache Patients
Authors: Mazzotta Giovanni , Sarchielli Paola , Gaggioli Alessandro , Gallai Virgilio 
Published: March 2003

The pressure pain threshold of 30 patients affected by tension‐type headache was assessed and the values compared with those of a group of 30 age‐matched control subjects. In the patient group, pressure pain threshold values were related to the blood cell concentration of some neurotransmitters which are considered to be involved in the genesis and modulation of pain (β‐endorphin levels in peripheral blood mono‐nuclear cells [PBMCs], substance P and serotonin concentrations in platelets). The pressure pain thrashold was significantly lower in tension‐type headache patients than in control subjects (P<0.0006). Significantly lower levels of B‐endorphins‐in PBMCs and substance P in platelets, as well as significantly higher levels of serotonin in platelets were found in tension, type headache patients compared to the control subjects (P<0.0001). A significant positive correlation was found between pressure pain threshold values and b b‐endorphin levels in both control and patient groups (P<0.0001). On the contrary, a statistically significant negative correlation was evident between pressure pain threshold values and substance P levels in platelets in both patients and control subjects (P<0.01 and P<0.001, respectively). In both groups, there was a negative correlation between b b‐endorphins in PBMCs and substance P in platelets (patientsP<0.02, controls P<0.001 ).The findings of altered β‐endorphin levels in blood mono‐nuclear cells and substance P levels in platelets could be the peripheral biochemical reflection of the low pressure paid threshold values in tension‐type headache patients, and support the hypothesis of an impairment of the antinociceptive systems in this form of headache.