bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency management of the morbidly obese
Authors: Grant Peter , Newcombe Mark 
Published: July 2004

AbstractObjectives:  To identify the difficulties encountered with the emergency management of morbidly obese patients and formulate recommendations to streamline care.Methods:  An English language literature search was undertaken using Medline (1966–2003) with key words ‘morbid obesity’‘anaesthesia’‘imaging’‘obesity’‘emergency’‘transportation’‘retrieval’‘critical illness’ and ‘monitoring’. Potential articles were selected for content applicable to emergency medicine based on title and abstract and reviewed in detail. Reference lists were manually searched for further relevant articles. In view of the very limited systematic study in this area, all information deemed by the authors’ to be of assistance to the emergency physician was included regardless of evidence level. Additional information was sought from standard critical care textbooks and their bibliographies and through personal communication with local ambulance and retrieval services. The authors’ unpublished personal experience in providing emergency care to the morbidly obese was included for aspects of management not documented in medical literature.Results:  Obesity levels and associated health problems are rapidly rising in Australia. Few studies were identified dealing with critical illness in the morbidly obese and none specifically addressing ED management. Problems identified included size related logistical issues, and limitations of physical assessment, monitoring and routine investigations. Invasive procedures, intubation and ventilation can be particularly problematic, and modified techniques may be required. Limited data indicates a poorer outcome from critical illness most marked in the case of blunt traumatic injury.Conclusion:  Very obese patients present a variety of logistical and medical challenges for EDs. A series of recommendations are made based on available data. Further studies in this area would be desirable to more specifically address ED issues.
Family member presence during resuscitation in the emergency department: An Australian perspective
Authors: Redley Bernice , Botti Mari , Duke Maxine 
Published: July 2004

AbstractObjective:  The practice of family member presence during resuscitation in the ED has attracted widespread attention over the last few decades. Despite the recommendations of international organizations, clinical staff remain reluctant to engage in this practice in many EDs. This paper separates the evidence from opinion to determine the current state of knowledge about this practice.Methods:  A search strategy was developed and used to locate research based publications, which were subsequently reviewed for the strength of evidence providing the basis for recommendations.Results:  The literature was examined to reveal what patients and their family members want; the outcomes of family presence during resuscitation for patients and their family members; staff views and practices regarding family presence during resuscitation. Findings suggest that providing the opportunity to be with their critically ill family member is both important to and beneficial for families, however, disparity in staff views has been identified as a major obstacle to family presence during resuscitation. Examination of published guidelines and staff practices described in the literature revealed consistent elements.Conclusion:  Although critics point to the lack of rigour in this body of literature, the current state of knowledge suggests merit in pursuing future research to examine and measure effects of family member presence during resuscitation on patients, family members and healthcare providers.
Phenytoin overdose complicated by prolonged intoxication and residual neurological deficits
Authors: Craig Simon 
Published: July 2004

AbstractThis report describes a case of massive phenytoin deliberate self‐poisoning, notable for delayed peak serum concentrations, multiple general complications, and permanent cerebellar injury. A 38‐year‐old 70 kg male patient presented to the ED after ingestion of at least 10 g of phenytoin 12–16 h earlier. Marked cerebellar dysfunction and persistent vomiting were observed, with an initial serum phenytoin concentration of 181 µmol/L. Initial conservative treatment (activated charcoal, whole bowel irrigation), and later attempts at charcoal haemoperfusion were unsuccessful. The serum phenytoin concentration peaked on day 15 (354 µmol/L). The patient developed seizures followed by a prolonged depression in conscious state requiring intubation. Multiple medical sequelae occurred and the patient was discharged to a rehabilitation facility 100 days after admission exhibiting signs consistent with permanent cerebellar dysfunction.
The role of physician staffing of helicopter emergency medical services in prehospital trauma response
Authors: Garner Alan A 
Published: July 2004

AbstractThe crewing of Helicopter Emergency Medical Service (HEMS) for scene response to trauma patients is generally considered to be controversial, particularly regarding the role of physicians. This is reflected in HEMS in Australia with some services utilizing physician crewing for all prehospital missions. Others however, use physicians for selected missions only whilst others do not use physicians at all. This review seeks to determine whether the literature supports using physicians in addition to paramedics in HEMS teams for prehospital trauma care.Studies were excluded if they compared physician teams with basic life support teams (BLS) teams rather than paramedics. Ambulance officers were considered to be paramedics where they were able to administer intravenous fluids and use a method of airway management beyond bag‐valve‐mask ventilation. Studies were excluded if the skill set of the ambulance team was not defined, the level of staffing of the helicopter service was not stated, team composition varied without reporting outcomes for each team type, patient outcome data were not reported, or the majority of the transports were interhospital rather than prehospital transports.
Effects of Hypericum Extract (LI160) on the Change of Auditory Evoked Potentials by Cortisol Administration
Authors: Murck Harald , Uhr Manfred , Schaffler Klaus , Seibel Klaus 
Published: July 2004

Target symptoms treated with Hypericum extract, i.e. somatisation, fatigue and depression could be related to an increased activity of glucocorticoids in the brain. One potential mechanism is the increased permeability of the blood-brain barrier for glucocorticoids. Hypericum extract LI160 reduces intracerebral glucocorticoid concentration possibly by its action to induce the expression of the transport protein P-glycoprotein (P-gp). To test this hypothesis directly, we performed a randomised double-blind crossover study to examine the effect of intravenously administered cortisol on auditory evoked potentials (AEPs) and salivary cortisol concentration. Nineteen healthy subjects were treated for 2 weeks with 300 mg LI160 twice a day or placebo. On the 14th day, AEPs were recorded every 30 min, at times –60, –30 and 0 min before the start of the infusion and at +30, +60 and +90 min after starting the infusion. The rate of infusion was 20 mg cortisol/h. No changes in the AEP, especially the N<sub>1</sub>-P<sub>2</sub> component, could be observed under cortisol infusion and consequently no modification with the treatment of Hypericum extract. The salivary concentration of cortisol under cortisol infusion was slightly but significantly decreased in the Hypericum condition compared to placebo. The results of the present study are therefore inconclusive with respect to the influence of LI160 treatment on the expected cortisol-induced AEP changes, but support the concept of an action of Hypericum on P-gp function by the observed changes in salivary cortisol.
A Tale of Two Times: Preaching in the Latter Age of the Dharma
Authors: Hubbard Jamie 
Published: July 2004

AbstractSharing a cyclical cosmogony with other Indian worldviews, Buddhism is ordinarily thought to be unconcerned with specific historical events, looking instead towards the individual transcendence of temporal becoming as the goal of religious practice. One counterpoint to this prevailing attitude is the tradition of the decline of the dharma, premised upon the historical uniqueness or specificity of Śākyamuni's teachings and an attendant eschatological consciousness of temporal distance from the time of the teacher and his teachings. Interestingly, the Lotus Sutra presents both a transcendent and historically unique interpretation of Śākyamuni's lifetime. Nichiren, among others, attached importance to the historical specificity of Śākyamuni and his teachings, and hence understood the Lotus Sutra to demand attention to the preaching or evangelical spread of the true teachings.
Pop Goes the Arab World: Popular Music, Gender, Politics, and Transnationalism in the Arab World
Authors: Choucair Julia , Mikdashi Maya , Agha Jehan , Abdel-Nabi Shereen 
Published: July 2004

AbstractAssumptions are often made as to the static nature of contemporary Arab politics and societies. Authors, scholars and commentators look for sociopolitical dynamism in the arenas they are used to: newspapers, television and parliament/congress, to name but a few. When they do not see or hear these debates taking place in the formal institutions that they are familiar with, they are quick to assume that these reassessments are simply not occurring. Nothing could be further from the truth. The Arab world is debating itself on matters of politics, identity and gender roles, to name but a few subjects. The debate space that is being utilized, however, is easily unnoticeable to those who are not adept at finding these forums and are instead used to being presented with them. When public space is limited, any opening will be used to the utmost. The ways in which the Arab world imagines and recreates itself is often through art. Satellite television and the strengthening of transnational media has helped the populations of this widely defined nation come into contact with each other in a realm outside of state control. Artists can become peoples' most important and trusted politicians. A medium readily accessible for consumption and easy to understand, popular music addresses important themes that speak to a collective audience and tie it together as a community. This paper seeks to examine the political, identity and gender debates that are currently occurring within the realm of popular music.
Forgotten Women: Prostitution and Social Representations of Immigrants with Muslim Origin
Authors: Treppete Mariangela , Bertani Michele 
Published: July 2004

AbstractThis paper is an introduction containing general reflections on on-going research where the aim is to analyze how in Italy the prostitution of persons coming from countries with a Muslim religion or culture is organized. Given the newness of the subject, presenting a description of the work carried out so far seemed like a suitable starting point with this paper; only after all research has been completed will it be possible to attempt a more significant sociologically closer linked reflection.
TWO MASTERS OF EGYPTIAN 'AMMIYYA POETRY
Authors: Radwan Noha 
Published: July 2004

AbstractAlthough verse forms in the colloquial dialects of Arabic have been attested at least since the twelfth century, it is still fair to say that the advent of shi'r al-'ammiyya in the late 1950s was an unprecedented movement in Arabic poetry. Until then, colloquial Arabic was the register of folkloric and 'low' arts produced by and for the uneducated masses. Even when educated literati chose to write in the colloquial, their choice was always motivated by such limited purposes as the wish to satirize the literary establishment and its 'elite' literature or to reach a mass audience. Didactic and politically charged poetry reached its height in the works of Bayram al-Tunisi, who denounced fusha as elitist and championed 'ammiyya for its accessibility to the Egyptian masses. In contrast, the poets of shi'r al-ammiyya believe that both the standard fush&a and the colloquial 'ammiyya are fit for poetic expression. Their poetry is the product of the cross-fertilization of the literary and the oral traditions. It is a poetry that can only be appreciated in the context of the goals and accomplishments of the modernist movement in Arabic poetry. This article provides a reading of a poem by each of the two early masters of shi'r al-'ammiyya, Fu'ad Haddad and Salah Jahin, with the purpose of illustrating the nature of the genre, its distinctiveness from previous forms of colloquial poetry, and the wide and diverse spectrum of modern poetic expression in Egyptian colloquial.
THE HISTORIC ENCOUNTER BETWEEN AL-MUTANABBI AND AL-HATIMI ITS CONTRIBUTION TO THE DISCOURSE ON GHULUWW (HYPERBOLE) IN ARABIC LITERARY THEORY
Authors: Sanni Amidu 
Published: July 2004

AbstractLiterary seances historically served as platforms for discussions and intellectual competitions. The discussion arising from the encounter between al-Mutanabbi (d. 965) and al-Hatimi (d. 998) concerning hyperstatement, metaphor, and aesthetic emphasis in poetic expression betrays a familiar but not an uncommon hiatus in perception and conceptualization between the Arab poet and his evaluator in the literary tradition. This study attempts to chart the course of development of a coherent theory on hyperbole from the earliest period of theoretical speculation in Arabic until the emergence of a formal theory. The study uses the text and the subtext of the recorded encounter between the two protagonists as contained in al-Hatimi's work.
Enhanced phagocytosis of ring-parasitized mutant erythrocytes: a common mechanism that may explain protection against falciparum malaria in sickle trait and beta-thalassemia trait
Authors: Ayi Kodjo , Turrini Franco , Piga Antonio , Arese Paolo 
Published: July 2004

AbstractHigh frequency of erythrocyte (red blood cell [RBC]) genetic disorders such as sickle cell trait, thalassemia trait, homozygous hemoglobin C (Hb-C), and glucose-6-phosphate dehydrogenase (G6PD) deficiency in regions with high incidence of Plasmodium falciparum malaria and case-control studies support the protective role of those conditions. Protection has been attributed to defective parasite growth or to enhanced removal of the parasitized RBCs. We suggested enhanced phagocytosis of rings, the early intraerythrocytic form of the parasite, as an alternative explanation for protection in G6PD deficiency. We show here that P falciparum developed similarly in normal RBCs and in sickle trait, beta- and alpha-thalassemia trait, and HbH RBCs. We also show that membrane-bound hemichromes, autologous immunoglobulin G (IgG) and complement C3c fragments, aggregated band 3, and phagocytosis by human monocytes were remarkably higher in rings developing in all mutant RBCs considered except alpha-thalassemia trait. Phagocytosis of ring-parasitized mutant RBCs was predominantly complement mediated and very similar to phagocytosis of senescent or damaged normal RBCs. Trophozoite-parasitized normal and mutant RBCs were phagocytosed similarly in all conditions examined. Enhanced phagocytosis of ring-parasitized mutant RBCs may represent the common mechanism for malaria protection in nonimmune individuals affected by widespread RBC mutations, while individuals with alpha-thalassemia trait are likely protected by a different mechanism. (Blood. 2004;104:3364-3371)
Hematopoietic cell-derived microparticle tissue factor contributes to fibrin formation during thrombus propagation
Authors: Chou Janet , Mackman Nigel , Merrill-Skoloff Glenn , Pedersen Brian , Furie Barbara C. , Furie Bruce 
Published: July 2004

AbstractTissue factor (TF) is expressed on nonvascular cells and cells within the vessel wall and circulates in blood associated with microparticles. Although blood-borne TF accumulates into the developing thrombus during thrombus formation, the contribution of blood-borne TF and vessel wall TF to thrombin generation in vivo following vessel injury is unknown. To determine the source and role of blood-borne microparticle TF, we studied arterial thrombus formation in a living mouse using intravital microscopy. Platelet, TF, and fibrin accumulation in the developing thrombus was compared in wild-type and low TF mice. Compared to wild-type mice, low TF mice formed very small platelet thrombi lacking TF or fibrin. Wild-type and low TF mice received transplants of bone marrow from wild-type and low TF mice. Arterial thrombi in low TF bone marrow/wild-type chimeric mice had decreased size and decreased TF and fibrin levels. Arterial thrombi in wild-type bone marrow/low TF chimeric mice showed decreased platelet thrombus size but normal TF and fibrin levels. This demonstrates that blood-borne TF associated with hematopoietic cell-derived microparticles contributes to thrombus propagation.
Hairy cell leukemia: at the crossroad of somatic mutation and isotype switch
Authors: Forconi Francesco , Sahota Surinder S. , Raspadori Donatella , Ippoliti Micaela , Babbage Gavin , Lauria Francesco , Stevenson Freda K. 
Published: July 2004

AbstractHairy cell leukemia (HCL) commonly expresses multiple immunoglobulin isotypes, a feature rare in other B-cell malignancies or in normal B cells. In HCL, there is no phenotypic evidence for subpopulations, and single cells from one previous case contained transcripts for several isotypes. This raises the questions of the differentiation status of the cell of origin and of posttransformation events. We have investigated 9 cases, all expressing multiple immunoglobulin isotypes. Multiple tumor-derived variable-(diversity)-joining-constant μ δ, γ, α (V(D)J-Cμ, δ, γ, α) transcripts were confirmed in single cells of a further case. All cases were negative for germinal center (GC)-associated markers CD27 and CD38. Seven of 9 cases had mutated VH genes, with low levels of intraclonal heterogeneity, but 2 of 9 were unmutated, indicative of pre-GC origin. Eight of 9 cases expressed activation-induced cytidine deaminase (AID), a molecule essential for somatic mutation and isotype switch. All cases expressed germ line heavy-chain I exon (IH)-CH transcripts which paralleled surface immunoglobulin (sIg) isotype. Significantly, no circle transcripts indicative of deletional recombination of switched isotypes were detectable in 9 of 9 cases. These data indicate heterogeneity in the cell of origin in terms of mutational status, but reveal common features of AID expression and isotype-switching events occurring prior to deletional recombination. Both mutational and switching events may be influenced by environmental factors at extrafollicular sites. (Blood. 2004;104:3312-3317)
Comparative analysis of T-cell costimulation and CD43 activation reveals novel signaling pathways and target genes
Authors: Mattioli Ivan , Dittrich-Breiholz Oliver , Livingstone Mark , Kracht Michael , Schmitz M. Lienhard 
Published: July 2004

Abstract
The CD43 lymphocyte surface receptor is involved in the regulation of lymphocyte adhesion and activation. Many CD43 functions remain controversial or unclear, and it is not known to which extent CD43 signaling pathways are shared with or distinct from those used by the T-cell receptor (TCR). Here, we systematically compared signaling events and target gene expression induced by CD43 or T-cell costimulation in primary human peripheral T cells. These studies identify nuclear factor-κB (NF-κB) p65 serine 468 as a novel inducible phosphorylation site strongly induced by T-cell costimulation and only weakly triggered by CD43 ligation. We also identified CD43 as a novel Jun N-terminal kinase (JNK) activator and a comprehensive analysis of further signaling events suggests that both stimuli use overlapping but also distinct signaling pathways. Microarray analysis of inflammatory genes shows 1 group of genes coregulated by both stimuli and 2 further groups of target genes affected solely by costimulation or primarily by CD43. (Blood. 2004;104:3302-3304)
Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation
Authors: Erba P. , Anastasi S. , Senn O. , Maggiorini M. , Bloch K.E. 
Published: July 2004

The purpose of the study was to investigate determinants of acute mountain sickness after rapid ascent to high altitude.A total of 21 climbers were studied ascending from <1,200 m to Capanna Regina Margherita, a hut in the Alps at 4,559 m, within <24 h. During their overnight stay at 4,559 m, breathing patterns and ventilation were recorded by calibrated respiratory inductive plethysmography along with pulse oximetry. In the following morning, acute mountain sickness was assessed.Altogether, 11 mountaineers developed pronounced symptoms of acute mountain sickness (Lake Louise score ≥5) and 10 did not (controls). Compared to controls, subjects with acute mountain sickness had lower nocturnal oxygen saturation (mean±sd 59±13%versus73±6%), higher minute ventilation (7.94±2.35versus6.06±1.34 L·min−1), and greater mean inspiratory flow, a measure of respiratory centre drive (0.29±0.09versus0.22±0.05 L·s−1). Periodic respiration was prevalent but not significantly different among the two groups (apnoea/hypopnea index 60.1±34.6versus47.1±42.6 events per h).The data suggest that pronounced nocturnal hypoxemia, which was not related to hypoventilation, may have promoted acute mountain sickness. Periodic breathing seems not to play a predominant role in the pathogenesis of acute mountain sickness.
Patient-physician communication about end-of-life care for patients with severe COPD
Authors: Curtis J.R. , Engelberg R.A. , Nielsen E.L. , Au D.H. , Patrick D.L. 
Published: July 2004

Since patients with chronic obstructive pulmonary disease (COPD) infrequently discuss treatment preferences about end-of-life care with physicians, the goal of the present study was to identify which specific areas of communication about end-of-life care occur between patients with severe COPD and their physicians, and how patients rate the quality of this communication.A total of 115 patients with oxygen-dependent COPD, identified in pulmonary clinics in three hospitals and through an oxygen delivery company, were enrolled in this study. A 17‐item quality of communication questionnaire (QOC) was administered to patients, along with other measures, including satisfaction with care.The patients reported that most physicians do not discuss how long the patients have to live, what dying might be like or patients' spirituality. Patients rated physicians highly at listening and answering questions. Areas patients rated relatively low included discussing prognosis, what dying might be like and spirituality/religion. Patients' assessments of physicians' overall communication and communication about treatment correlated well with the QOC. Patients' overall satisfaction with care also correlated significantly with the QOC.In conclusion, this study identifies areas of communication that physicians do not address and areas that patients rate poorly, including talking about prognosis, dying and spirituality. These areas may provide targets for interventions to improve communication about end-of-life care for patients with chronic obstructive pulmonary disease. Future studies should determine the responsiveness of these items to interventions, and the effect such interventions have on patient satisfaction and quality of care.