bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEDICATION PRACTICE AND FEMINIST THOUGHT: A THEORETICAL AND ETHICAL RESPONSE TO ADHERENCE IN HIV/AIDS
Authors: BROYLES LAUREN M. , COLBERT ALISON M. , ERLEN JUDITH A. 
Published: August 2005

ABSTRACTAccurate self‐administration of antiretroviral medication therapy for HIV/AIDS is a significant clinical and ethical concern because of its implications for individual morbidity and mortality, the health of the public, and escalating healthcare costs. However, the traditional construction of patient medication adherence is oversimplified, myopic, and ethically problematic. Adherence relies on existing social power structures and western normative assumptions about the proper roles of patients and providers, and principally focuses on patient variables, obscuring the powerful socioeconomic and institutional influences on behaviour. Some professionals advocate for alternate approaches to adherence, but many of the available alternatives remain conceptually underdeveloped. Using HIV/AIDS as an exemplar, this paper presents medication practice as a theoretical reconstruction and explicates its conceptual and ethical evolution. We first propose that one of these alternatives, medication practice, broadens the understanding of individuals’ medication‐taking behaviour, speaks to the inherent power inequities in the patient‐provider interaction, and addresses the ethical shortcomings in the traditional construal. We then integrate medication practice with feminist thought, further validating individuals’ situated knowledge, choices, and multiple roles; more fully recognizing the individual as a multidimensional, autonomous human being; and reducing notions of obedience and deference to authority. Blame is thus extricated from the healthcare relationship, reshaping the traditionally adversarial components of the interaction, and eliminating the view of adherence as a patient problem in need of patient‐centred interventions.
Vacuolating Cytotoxin A is Associated with Increased Thrombin Generation in Gastric Mucosa
Authors: Suzuki Yuko , Gabazza Esteban Cesar , Imoto Ichiro , James Roger F.L. , Hirayama Toshiya , Wada Akihiro , Horiki Noriyuki , Nakamura Misaki , Inoue Hiroyuki , Kuroda Mikito , Ogura Ayumi , Taguchi Yukiko , Yano Yutaka , Taguchi Osamu , Suzuki Koji , Adachi Yukihiko 
Published: August 2005

ABSTRACTBackground.  Activation of the coagulation system is a critical response for both the repair of tissue injury and the host defense against microbial pathogens. Activation of the coagulation cascade culminates with the generation of thrombin. In vitro studies have shown that thrombin protects gastric epithelial cells from injury. The present study was undertaken to assess in vivo the relationship between gastric intramucosal generation of thrombin and Helicobacter pylori infection.Materials and methods.  This study comprised 59 patients with gastroduodenal disorders. There were 27 patients with H. pylori infection (Hp+), 14 without it (Hp–), and 18 patients with cured H. pylori infection (Hp c). The gastric intramucosal concentrations of thrombin–antithrombin complex (TAT), epidermal growth factor (EGF), prostaglandin E2 (PGE2), and vacuolating cytotoxin A (VacA) were measured by specific immunoassays.Results.  The level of TAT was significantly increased in patients with Hp+ compared to Hp– and Hp c. The levels of TAT, EGF and PGE2 were higher in VacA (+) patients than in those with VacA (–). VacA induced significant expression of tissue factor in gastric epithelial cells in vitro. The gastric intramucosal level of VacA antigen was proportionally and significantly correlated with TAT, EGF and PGE2 in Hp+ patients. The level of TAT was proportionally and significantly correlated with EGF in Hp+ patients but not in Hp– and HP c patients.Conclusions.  These results showed that VacA produced by H. pylori is associated with increased thrombin generation, and that thrombin may play a protective role in H. pylori‐associated gastroduodenal disorders.
Cellular Mucosal Defense During Helicobacter pylori Infection: A Review of the Role of Glutathione and the Oxidative Pentose Pathway
Authors: Matthews Geoffrey M. , Butler Ross N. 
Published: August 2005

ABSTRACT Helicobacter pylori is the primary cause of gastritis and peptic ulcer disease and is known to infect greater than 50% of the world's population. It is also known to lead to the onset of gastric cancer and unless treated, lasts throughout life in most individuals. Mouse models of H. pylori infection have improved our ability to study this organism and can be used to investigate the host mucosal response to the infection, particularly the early events postinoculation. Previous studies have shown that H. pylori infection leads to an increased production of reactive oxygen species within the gastric mucosa which are thought to play a major role in the mediation of associated disease. Recent studies have shown differences in the availability of an important antioxidant, glutathione, during chronic H. pylori infection. The availability of glutathione is primarily controlled by the activity of the oxidative pentose pathway. This review proposes that the severity of inflammation and damage associated with H. pylori infection is dependent on the ability of mucosal cells to counteract the increased load of reactive oxygen species. It is hypothesized that the oxidative pentose pathway and glutathione availability are important factors modulating this response. It is suggested that the therapeutic regulation of glutathione availability could provide a novel method for preventing or reducing the damage caused during H. pylori infection.
Incidence and Predictors of Pulmonary Vein Stenosis Following Catheter Ablation of Atrial Fibrillation Using the Anatomic Pulmonary Vein Ablation Approach: Results from Paired Magnetic Resonance Imaging
Authors: DONG JUN , VASAMREDDY CHANDRASEKHAR R. , JAYAM VINOD , DALAL DARSHAN , DICKFELD TIMM , ELDADAH ZAYD , MEININGER GLENN , HALPERIN HENRY R. , BERGER RONALD , BLUEMKE DAVID A. , CALKINS HUGH 
Published: August 2005

Introduction: There are currently no studies systematically evaluating pulmonary vein (PV) stenosis following catheter ablation of atrial fibrillation (AF) using the anatomic PV ablation approach. Methods and Results: Forty‐one patients with AF underwent anatomic PV ablation under the guidance of a three‐dimensional electroanatomic mapping system. Gadolinium‐enhanced magnetic resonance (MR) imaging was performed in all patients prior to and 8–10 weeks after ablation procedures for screening of PV stenosis. A PV stenosis was defined as a detectable (≥3 mm) narrowing in PV diameter. The severity of stenosis was categorized as mild (<50% stenosis), moderate (50–70%), or severe (>70%). A total 157 PVs were analyzed. A detectable PV narrowing was observed in 60 of 157 PVs (38%). The severity of stenosis was mild in 54 PVs (34%), moderate in five PVs (3.2%), and severe in one PV (0.6%). All mild PV stenoses displayed a concentric pattern. Moderate or severe PV stenosis was only observed in patients with an individual encircling lesion set. Multivariable analysis identified individual encircling lesion set and larger PV size as the independent predictors of detectable PV narrowing. All patients with PV stenosis were asymptomatic and none required treatment. Conclusions: The results of this study demonstrate that detectable PV narrowing occurs in 38% of PVs following anatomic PV ablation. Moderate or severe PV stenosis occurs in 3.8% of PVs. The high incidence of mild stenosis likely reflects reverse remodeling rather than pathological PV stenosis. The probability of moderate or severe PV stenosis appears to be related to creation of individual encircling rather than encircling in pairs lesion.
Assessment of the Proarrhythmic Potential of the Novel Antiarrhythmic Agent AZD7009 and Dofetilide in Experimental Models of Torsades De Pointes
Authors: WU YING , CARLSSON LEIF , LIU TENGXIAN , KOWEY PETER R. , YAN GAN‐XIN 
Published: August 2005

Background: This study examined the proarrhythmic potential of the novel antiarrhythmic agent AZD7009 and dofetilide. Methods and Results: The electrophysiological and proarrhythmic effects of AZD7009 and dofetilide were assessed in the arterially perfused canine and rabbit left ventricular wedge preparation. The proarrhythmic potential of AZD7009, dofetilide, and azimilide was further assessed in the methoxamine‐sensitized rabbit model of torsades de pointes (TdP) in vivo. AZD7009 lengthened the action potential duration (APD) and the QT interval in a bell‐shaped manner (15.9 ± 1.3% in canine wedge and 46.1 ± 2.9% in rabbit wedge) occurring at 3 and 1 μM. In contrast, dofetilide did not show the bell‐shaped concentration response and the QT interval was lengthened more extensively (27.7 ± 1.6% and 100.8 ± 10.0%). Furthermore, whereas dofetilide prolonged the midmyocardial and endocardial APD predominantly, resulting in an increased transmural dispersion of repolarization (TDR), AZD7009 prolonged the APD more homogenously in all cell layers. At 1 μM, AZD7009 produced phase 2 early afterdepolarizations (EADs) in 1/4 rabbit preparations but without ventricular R‐on‐T extrasystoles or TdP. In contrast, starting at 0.03 μM, dofetilide‐induced EADs, R‐on‐T extrasystoles and TdP in 6/6, 5/6, and 4/6 preparations. Following intravenous infusion of AZD7009 (210 nmol/kg/minute), dofetilide (2 nmol/kg/minute) or azimilide (3.33 μmol/kg/minute), TdP was induced in 0/8, 5/8, and 5/8 rabbits (P = 0.026 vs AZD7009), respectively. In 5/5 rabbits, AZD7009 promptly suppressed TdP induced by dofetilide. Conclusions: In animal models of TdP, AZD7009 delays ventricular repolarization in a self‐limited way associated with a low risk of repolarization‐related proarrhythmia.
Comparison of Induced and Spontaneous Atrial Tachyarrhythmias in Patients with a History of Spontaneous Atrial Tachyarrhythmias
Authors: WOLLMANN CHRISTIAN G. , BIRNIE DAVID , TANG ANTHONY , BORIANI GIUSEPPE , KÜHL MARTIN , BÖCKER DIRK 
Published: August 2005

Introduction: This retrospective study investigated whether induced episodes could be used to predict the morphology of future spontaneous atrial episodes. Methods: Eighty‐two patients (64 ± 12 years; 77% male; CAD in 60%; left ventricular ejection fraction 45 ± 16%) with a history of atrial tachycardia or atrial fibrillation (AT/AF) were implanted with a dual‐chamber implantable cardioverter defibrillator (ICD) and followed for 6 months. A total of 224 episodes of induced and spontaneous AT/AF were classified into type I, II, and III according to the method of Israel et al. and then compared based on average cycle length (CL) and atrial amplitude. Episodes were also grouped as “pace‐terminable” or “nonpace‐terminable” based on the CL definition of Gillis et al. Results: The analysis of 121 induced episodes (from 80 patients) and 103 spontaneous episodes (from 43 patients) showed that within each arrhythmia type, there were no significant differences in CL or mean amplitude between induced and spontaneous episodes. Additional analysis of patients that had both induced and spontaneous episodes (n = 41) showed 78% had at least one spontaneous episode that matched the induced episode. Fifty‐seven percent of spontaneous episodes were considered to be pace‐terminable based on CL. Conclusions: Our data suggest that there is no significant difference between induced and spontaneous episodes of AT/AF of the same type. The majority of patients had at least one spontaneous episode of the same type as the induced episode, showing that induced atrial arrhythmias may be useful in predicting the morphology of future spontaneous episodes and in identifying patients potentially benefiting from atrial antitachycardia pacing.
Action Potential Duration and QT Interval During Pinacidil Infusion in Isolated Rabbit Hearts
Authors: WU SUHUA , HAYASHI HIDEKI , LIN SHIEN‐FONG , CHEN PENG‐SHENG 
Published: August 2005

Introduction: Acute myocardial ischemia, which opens KATP channel, is associated with shortened action potential duration (APD) but prolonged QT interval. This discrepancy has not been adequately explained. We hypothesize that the duration of intracellular calcium (Cai) transient (DCaT) may play a role in determining QT interval. Methods and Results: We performed simultaneous optical mapping of voltage and Cai in 15 isolated rabbit hearts during a KATP channel opener (pinacidil) infusion. Anterior epicardial mapping (n = 7) showed no difference of APD90, QT interval, and the DCaT90 at baseline. When perfused with 80 μM pinacidil, the APD90, the QT interval, and the DCaT90 were 105 ± 10 msec, 199 ± 14 msec, and 189 ± 13 msec, respectively, during right ventricular (RV) pacing (P < 0.05). Posterior epicardial mapping (n = 4) showed that the APD90 was significantly (P < 0.05) shorter than QT interval and DCaT90 during pinacidil infusion. The results of the transmural mapping studies (n = 4) showed that the QT interval during RV pacing was not different than the DCaT90 in the epicardium, midmyocardium, and endocardium, but was significantly (P < 0.01) longer than the APD90 in epicardium, midmyocardium, and endocardium, respectively. There was a good correlation between the DCaT90 and QT interval at baseline (r = 0.92, P < 0.0001) and during pinacidil infusion (r = 0.74, P < 0.0001). Conclusion: We conclude that KATP channel opening shortened APD but not the QT interval. Because Cai did not return to diastolic level at the end of action potential, it may have created a heterogeneous membrane potential distribution that determined the QT interval.
Creating Continuous Linear Lesions in the Atria: A Comparison of the Multipolar Ablation Technique Versus the Conventional Drag‐and‐Burn
Authors: SU WILBER W. , JOHNSON SUSAN B. , JAIN MUDIT K. , HALL JEFFREY , PACKER DOUGLAS L. 
Published: August 2005

Introduction: Catheter‐based treatment of atrial fibrillation (AF) requires the isolation of the triggering foci as well as modification of the atria with substrate that sustains AF. The creation of linear lesions in the left atrium with standard radiofrequency ablative methods requires long procedural times with unpredictable results. Methods: The simultaneous delivery of phase‐shifted radiofrequency energy from a multipolar catheter was compared to the conventional drag‐and‐burn technique for creating linear lesions in 10 dogs. Four atrial sites were targeted under intracardiac ultrasound and fluoroscopic guidance in each of 10 dogs. The conventional drag‐and‐burn technique or the multipolar phase‐shifted ablation catheter was randomly applied for 60 seconds and compared. Results: Creating linear lesions using the simultaneous multipolar phase‐shifted ablation catheter was on average 11.0 minutes faster (33.6 minutes vs 44.6 minutes, P < 0.01) than the drag‐and‐burn method. The fraction of the lesion length achieved using phase‐shifted ablation compared to that intended was 23% greater (76% vs 53%, P < 0.01), and has less discontinuities (0.1 compared to 0.8 discontinuities/line, P < 0.003). There was no significant difference in either the lesion transmurality, or fluoroscopy times. Conclusion: The simultaneous delivery of phase‐shifted, radiofrequency energy using a multipolar catheter is more effective and efficient in producing linear lesions than the traditional drag‐and‐burn technique. Using the multipolar ablative method to create linear lesions may be a useful technique in the treatment of patients with substrate‐mediated atrial fibrillation.
Spatial Resolution of Pacemapping and Activation Mapping in Patients with Idiopathic Right Ventricular Outflow Tract Tachycardia
Authors: AZEGAMI KOJI , WILBER DAVID J. , ARRUDA MAURICIO , LIN ALBERT C. , DENMAN RUSSELL A. 
Published: August 2005

Background: The purpose of this study was to compare the spatial resolution of activation mapping and pacemapping in patients undergoing ablation of idiopathic ventricular tachycardia (VT) arising from the right ventricular outflow tract (RVOT). A direct comparison of the two techniques has not been undertaken. Methods and Results: Electroanatomical activation maps of the RVOT were obtained during VT in 15 patients. Pacemaps were obtained from multiple sites, tagged on the activation map, and scored according the degree of concordance between the paced QRS configuration and that of VT. The site of successful ablation was considered the VT site of origin. Initial endocardial activation away from the site of origin was rapid; the mean area of myocardium activated within the first 10 msec (early activation area, EAA) was 3.0 ± 1.6 cm2 (range: 1.3–6.4 cm2). Best pacemap scores were always obtained adjacent to the site of origin. Pacemap concordance, and the probability of an exact pacemap match significantly decreased with increasing distance of the pacing site from the site of origin (P < 0.01). All patients had more than one pacing site yielding a best pacemap score. The greatest distance between such sites in an individual patient ranged from 11 to 26 mm (mean: 18 ± 5 mm), and was strongly correlated with the size of the EAA (r = 0.77, P < 0.001). Conclusions: Pacemapping and activation mapping provide similar localizing information. The spatial resolution of each technique is modest, varies between patients, and may be optimized by three‐dimensional data display
Cytokine Profile of Natural Killer Cells in Early Human Pregnancy
Authors: Higuma‐Myojo Subaru , Sasaki Yasushi , Miyazaki Satomi , Sakai Masatoshi , Siozaki Arihiro , Miwa Naoko , Saito Shigeru 
Published: August 2005

Problem:  To examine whether the NK1/NK2/NK3/NKr1 paradigm can be adapted in natural killer (NK) cells.Method of study:  Mononuclear cells were isolated from peripheral blood and/or decidua in healthy non‐pregnant women (n = 17), early pregnant women (6–12 weeks of gestation, n = 17) and miscarriage cases (6–11 weeks of gestation, n = 10). We investigated the production of transforming growth factor (TGF)‐β, interleukin (IL)‐4, IL‐5, IL‐10, IL‐13, interferon (IFN)‐γ and tumor necrosis factor‐α from peripheral blood‐ and decidual‐CD56bright NK cells and ‐CD56dim NK cells by flow cytometry.Results:  In the peripheral blood of the non‐pregnant subjects, the main populations of CD56bright NK cells and CD56dim NK cells were IFN‐γ‐producing NK1 type cells. Populations of IL‐10‐producing NKr1 type cells in peripheral blood CD56bright NK cells and CD56dim NK cells in early pregnant women were significantly greater compared with those in non‐pregnant women, and these cells population decreased in miscarriage cases. In the early pregnancy decidua, the main populations of CD56bright NK cells and CD56dim NK cells were TGF‐β‐producing NK3 type cells, and NK1 type cells were rare. NK3 type cells in decidua were significantly decreased in miscarriage cases compared with those in normal pregnant subjects. IL‐4‐, IL‐5‐ or IL‐13‐producing NK2 type cells were rare in peripheral blood and decidua.Conclusion:  These data support the NK1/NK2/NK3/NKr1 hypothesis. NKr1 type cells in peripheral blood and NK3 type cells in decidua might play some important roles in the maintenance of pregnancy by regulation of maternal immune function.
Decreased Proinflammatory Cytokines in Cervicovaginal Fluid, as Measured in Midgestation, are Associated with Preterm Delivery
Authors: Kalinka Jarosław , Sobala Wojciech , Wasiela Małgorzata , Brzezińska‐Błaszczyk Ewa 
Published: August 2005

ProblemThe main aim of this study was to investigate the relationship between selected proinflammatory cytokines [interleukin IL‐1 alpha (IL‐1α), IL‐1 beta (IL‐1β), IL‐6 and IL‐8] concentrations in cervicovaginal fluid, as measured in midgestation, and the risk of subsequent preterm delivery.Method of studyCervicovaginal fluids were obtained from a cohort of 114 pregnant women at 22–34 weeks’ gestation and analyzed for the concentrations of IL‐1α, IL‐1β, IL‐6 and IL‐8 using enzyme‐linked immunosorbent assay technique. Lower genital tract microbiology was diagnosed using Gram stain method and by culture.ResultsMean gestational age at the time of sampling was 29.0 weeks. Mean time between sampling and delivery was 9.3 weeks (S.D. 4.7). Median cervicovaginal concentrations of IL‐1α, IL‐1β, IL‐6 and IL‐8 did not differ between preterm and term delivery group. Women with lower genital tract pathological flora and IL‐1α concentration below 25th percentile presented significant risk of subsequent preterm delivery as compared with women with no low cytokines (OR = 10.7; 95% CI, 2.0–58.1). Women with more than one cytokine’ low concentration (below 25th percentile) presented an increased risk of preterm delivery – OR = 11.8 (95% CI, 1.8–78.0).ConclusionsThe midgestation cytokines’ measurement in cervicovaginal fluid of pregnant women could be useful for prediction of preterm delivery only among women with lower genital tract pathological flora.
Serum Levels of Macrophage Colony Stimulating, Vascular Endothelial, and Placenta Growth Factor in Relation to Later Clinical Onset of Pre‐Eclampsia and a Small‐for‐Gestational Age Birth
Authors: Bersinger Nick A. , Ødegård Rønnaug A. 
Published: August 2005

ProblemThe multisystem disorder of pre‐eclampsia (PE) becomes manifest in late gestation, but the pathology originates in early pregnancy by the deleterious action of placental substances to the maternal endothelial system. These factors were searched for in the attempt to identify, as early as possible, the pregnancies with an increased risk of developing pre‐eclampsia. The literature is equivocal regarding the usefulness of various markers including vascular endothelial growth factor (VEGF) and macrophage colony‐stimulating factor (M‐CSF). Results are often confounded by a varying fraction of pregnancies affected by foetal growth restriction (FGR) amongst the case and control groups.Method of studyIn a nested case–control study we compared the serum levels of M‐CSF, VEGF, and placenta growth factor (PLGF) in 23 pregnancies with subsequent mild PE without FGR and nine FGR pregnancies without PE with 40 matched controls at 17, 25, and 33 weeks of gestation cross‐sectionally and longitudinally.ResultsVEGF levels were reduced in FGR but not in subsequently pre‐eclamptic pregnancies at 17, 25, and 33 weeks. In contrast, PLGF was reduced in the PE but not in the FGR group. M‐CSF did not differ between the three groups.ConclusionDepending on which growth factor is found to be reduced, an early distinction can be made in terms of an increased risk for PE or FGR. Inconsistencies in the literature may reflect differences in PE disease severity between studies and the presence of a varying fraction of cases with FGR.