bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laryngopharyngeal Reflux Symptoms Improve Before Changes in Physical Findings
Authors: Belafsky Peter C. , Postma Gregory N. , Koufman James A. 
Published: September 2004

AbstractBackground Patients with laryngopharyngeal reflux (LPR) undergoing treatment appear to have improvement in symptoms before the complete resolution of the laryngeal findings.Objective To determine whether patients with LPR experience an improvement in symptoms before the complete resolution of the laryngeal findings.Methodology Forty consecutive patients with LPR documented by double‐probe pH monitoring were evaluated prospectively. Symptom response to therapy with proton pump inhibitors was assessed at 2, 4, and 6 months of treatment with a self‐administered reflux symptom index (RSI). In addition, transnasal fiberoptic laryngoscopy (TFL) was performed and a reflux finding score (RFS) was determined for each patient at each visit.Results The mean RSI at entry was 19.3 (± 8.9 standard deviation) and it improved to 13.9 (± 8.8) at 2 months of treatment (P <.05). No further significant improvement was noted at 4 months (13.1 ± 9.8) or 6 months (12.2 ± 8.1) of treatment. The RFS at entry was 11.5 (± 5.2), and it improved to 9.4 (± 4.7) at 2 months, 7.3 (± 5.5) at 4 months, and 6.1 (± 5.2) after 6 months of treatment (P <.05 with trend).Conclusions Symptoms of LPR improve over 2 months of therapy. No significant improvement in symptoms occurs after 2 months. This preliminary report demonstrates that the physical findings of LPR resolve more slowly than the symptoms and this continues throughout at least 6 months of treatment. These data imply that the physical findings of LPR are not always associated with patient symptoms, and that treatment should continue for a minimum of 6 months or until complete resolution of the physical findings.
Benign Positional Vertigo Without Detectable Nystagmus
Authors: Tirelli Giancarlo , D'Orlando Elena , Giacomarra Vittorio , Russolo Mario 
Published: September 2004

AbstractObjectives To demonstrate that for treatment of benign positional vertigo it is not necessary to identify a positional nystagmus.Study Design Prospective trial of 43 patients with positional vertigo without clinical evidence of positional nystagmus who were treated with a modified canal‐repositioning maneuver.Methods Results were compared with the results obtained in the treatment of posterior semicircular cupolo‐canalithiasis with typical positional nystagmus with the same repositioning maneuver.Results Treatment of 43 patients with positional vertigo without positional nystagmus resulted in a 60.46% (26/43) complete recovery rate and a 6% (3/43) persistence of disorder rate compared with a 90% complete recovery rate obtained in 90 patients with typical benign positional paroxysmal vertigo (with positional nystagmus).Conclusions What is attempted by this work is to confirm that through clinical evaluation based on history and positioning tests alone, one can obtain acceptable results in treatment of supposed canalithiasis without having detected the pathognomonic nystagmus.
Selective Vestibular Ablation by KTP Laser in Endolymphatic Hydrops
Authors: Adamczyk Melanie , Antonelli Patrick J. 
Published: September 2004

AbstractObjectives and Hypothesis Vertigo, the cause of disability in many patients with Ménière's disease, may be the result of the effects of endolymphatic hydrops on the semicircular canals. We hypothesize that intractable vertigo may be controlled by destruction of the semicircular canal neuroepithelium using visible light lasers without the need for extensive fenestration of the bony labyrinth. This study was designed to assess the cochlear effects of potassium titanyl phosphate (KTP) laser‐assisted triple semicircular canal ablation (TSCA) in endolymphatic hydrops.Study Design Randomized, prospective, and controlled.Methods Forty‐one adult guinea pigs underwent either a unilateral endolymphatic duct occlusion to induce hydrops or a sham procedure. Ten weeks after induction of the hydrops, a KTP laser‐assisted TSCA or a sham surgery was performed.Results Electrocochleographic thresholds to clicks and tone‐bursts (2–20 kHz) did not change significantly up to 4 weeks after TSCA in hydropic ears. Cross‐sectional histology confirmed the presence of hydrops and the ablation of the semicircular canals. Cochlear whole‐mounts for hair cell counts showed no significant loss of outer or inner hair cells in hydropic ears treated with TSCA.Conclusion KTP laser‐assisted TSCA can be performed in the guinea pig model of endolymphatic hydrops without significant loss of hearing. Evaluation of this technique may be warranted in patients with intractable Ménière's disease.
DiHA (Dextranomers in Hyaluronan) Injections for Treatment of Insufficient Closure of the Vocal Folds: Early Clinical Experiences
Authors: Hallén Lars , Testad Per , Sederholm Elisabeth , Dahlqvist Åke , Laurent Claude 
Published: September 2004

AbstractObjective To determine the clinical effects of injecting DiHA (a mixture of dextranomer molecules and 1% hyaluronan solution in equal proportions) as a “space filler” into the vocal folds of patients experiencing insufficient closure of the vocal folds resulting from either unilateral vocal fold paralysis or bowed vocal folds.Study Design A consecutive series of patients with insufficient closure of the vocal folds treated with DiHA injections and prospectively followed up with videostroboscopy and voice recordings that were evaluated by expert panels.Methods During a 21/2‐year period, 14 patients with insufficient closure of the vocal folds were included. Six had a unilateral vocal fold palsy and 8 patients had “bowed” vocal folds. DiHA was injected into one vocal fold. Laryngoscopic examination and voice recordings were performed pre‐ and postoperatively. Expert panels did the evaluation of the stroboscopy examination and the perceptual voice analysis.Results Three patients were operated on with local and 11 under general anesthesia. All patients with unilateral palsy improved their stroboscopic status regarding both the wave and the closure after injection. Also, their voice parameters were significantly improved. Among the patients with bowed vocal folds, all except 2 showed an improvement in the glottic wave, 5 of 8 improved in glottic closure, and 3 improved their voice parameters significantly.Conclusion This early clinical experience indicates that DiHA fulfills most of the requirements of an ideal “space‐filling” substance for voice restoration in patients experiencing insufficient vocal fold closure.
Soleus Neurotomy for Treatment of the Spastic Equinus Foot
Authors: Decq Philippe , Filipetti Paul , Cubillos Alexandro , Slavov Velislav , Lefaucheur Jean-Pascal , Nguyen Jean-Paul ,   Groupe d'Evaluation et de Traitement de la Spasticité et de la Dystonie
Published: September 2004

AbstractOBJECTIVEThis prospective, nonrandomized, noncontrolled study was performed to evaluate the results of a new type of neurotomy, namely the soleus neurotomy, for treatment of the spastic equinus foot.METHODSBetween May 1996 and March 1998, 46 patients were treated for a spastic equinus foot. Clinical status, spasticity (Ashworth Scale score), and kinematic parameters of the gait were determined before and after surgery. The neurotomy was performed on the upper nerve of the soleus in all cases and was associated with other neurotomies (lower nerve of the soleus, 21 patients; gastrocnemius, 9 patients, tibialis posterior, 18 patients; flexor hallucis longus, 16 patients; and flexor digitorum longus, 17 patients).RESULTSThe mean follow-up period was 15 months (range, 8–28 mo). The equinus deformity disappeared clinically in all patients. Before the operation, all patients had an Ashworth Scale score of 2, with an inexhaustible clonus present on knee extension and persisting with knee flexion (Tardieu Scale score, 4), which was abolished in 95% of the patients after surgery. Two patients still had some clonus on knee extension; this did not interfere with their clinical improvement. Knee recurvatum disappeared in eight patients. Analysis of kinematic parameters demonstrated a statistically significant increase in joint motion of the second rocker (P = 0.0026) of the ankle during stance. The duration of the stance or swing phase, length of the walking cycle, and velocity or rate of spontaneous walking were not significantly modified.CONCLUSIONThe study demonstrated that soleus neurotomy is effective for the treatment of spastic equinus foot, leading to abolition of spasticity and improvement in the range of ankle motion during the stance phase of gait.
Population-Based Assessment of Burn Injury in Southern Iowa: Identification of Children and Young-Adult At-Risk Groups and Behaviors
Authors: Wibbenmeyer Lucy Ann , Amelon Margery Josephine , Torner James Corydon , Kealey Gerald Patrick , de Mola Rebecca Marie Loret , Lundell John , Lynch Charles F. , Aspelund Thor , Zwerling Craig 
Published: September 2004

Abstract
Although nonfatal burn injuries vastly outnumber fatal injuries, their epidemiology is not well defined. We sought to determine the epidemiology of nonfatal burn injuries in a largely rural region of a midwestern state to target intervention efforts at populations and injury mechanisms at risk. Data were retrospectively collected on a population-based sample of medically treated burn injuries in 10 counties in southern Iowa from 1997 to 1999 using International Classification of Diseases, 9th Revision, Clinical Modification codes (ICD-9-CM, Ncode 940–949) to identify burn-related emergency room visits from computerized lists. A total of 1430 emergency room visits were identified, with 1382 records available for review. Injuries were grouped into etiology subcategories to better delineate common mechanisms and determine methods of prevention. Scald and hot-object contact and flame-related injuries were the leading causes of burn injury. Scald and contact injuries were subdivided into three major sets of scenarios, scald and contact injuries related to household food preparation and consumption, work-related scald and contact injuries. and injuries resulting from contact with nonfood and nonbeverage-related household objects. Children ages 0 to 4 had the highest population-based scald and hot-object contact injury rate of all age groups, with an average annual incidence rate of 35.9 per 10,000. Injuries in this age group were most commonly related to household objects (34.7%) followed by food preparation (25.3%). Children and young adults ages 5 to 24 were also the most likely to be injured by flame and fire-related causes secondary to open fires. Nonfatal burn injuries typically afflict children and young adults in definable patterns, suggesting intervention strategies. Future studies need to better delineate the contributing factors associated with these injuries to refine the intervention strategies.
Frequency of Anxiety in Myasthenia Gravis
Authors: Lundeen Jessica , Fisher Justin , Kothari Milind J 
Published: September 2004

Abstract

Symptoms of anxiety are common in many chronic medical conditions. Myasthenia gravis (MG) is a chronic neuromuscular condition characterized by fatigable weakness; few studies to date have examined the occurrence of anxiety in patients with MG and related it to anxiety in other chronic conditions. Sixty-nine patients were given a set of self-administered questionnaires, which included the Beck Anxiety Inventory (BAI). The BAI was scored and showed that 55% of the patients had scores suggestive of anxiety. Forty percent was mildly anxious, 12% were moderately anxious, and 3% were severely anxious. This study suggests that anxiety is at least as common in patients with MG as in patients with other chronic medical conditions. It also suggests that the BAI is a clinically useful tool for assessing anxiety in such a population.
Phosphoproteomics of the Arabidopsis Plasma Membrane and a New Phosphorylation Site Database[W]
Authors: Nühse Thomas S. , Stensballe Allan , Jensen Ole N. , Peck Scott C. 
Published: September 2004

AbstractFunctional genomic technologies are generating vast amounts of data describing the presence of transcripts or proteins in plant cells. Together with classical genetics, these approaches broaden our understanding of the gene products required for specific responses. Looking to the future, the focus of research must shift to the dynamic aspects of biology: molecular mechanisms of function and regulation. Phosphorylation is a key regulatory factor in all aspects of plant biology; but it is difficult, if not impossible, for most researchers to identify in vivo phosphorylation sites within their proteins of interest. We have developed a large-scale strategy for the isolation of phosphopeptides and identification by mass spectrometry (Nühse et al., 2003b). Here, we describe the identification of more than 300 phosphorylation sites from Arabidopsis thaliana plasma membrane proteins. These data will be a valuable resource for many fields of plant biology and overcome a major impediment to the elucidation of signal transduction pathways. We present an analysis of the characteristics of phosphorylation sites, their conservation among orthologs and paralogs, and the existence of putative motifs surrounding the sites. These analyses yield general principles for predicting other phosphorylation sites in plants and provide indications of specificity determinants for responsible kinases. In addition, more than 50 sites were mapped on receptor-like kinases and revealed an unexpected complexity of regulation. Finally, the data also provide empirical evidence on the topology of transmembrane proteins. This information indicates that prediction programs incorrectly identified the cytosolic portion of the protein in 25% of the transmembrane proteins found in this study. All data are deposited in a new searchable database for plant phosphorylation sites maintained by PlantsP (http://plantsp.sdsc.edu) that will be updated as the project expands to encompass additional tissues and organelles.
Transcript Profiling in thechl1-5Mutant of Arabidopsis Reveals a Role of the Nitrate Transporter NRT1.1 in the Regulation of Another Nitrate Transporter, NRT2.1[W]
Authors: Muños Steéphane , Cazettes Ceéline , Fizames Ceécile , Gaymard Freédeéric , Tillard Pascal , Lepetit Marc , Lejay Laurence , Gojon Alain 
Published: September 2004

AbstractArabidopsis thaliana mutants deficient for the NRT1.1 NO3 − transporter display complex phenotypes, including lowered NO3 − uptake, altered development of nascent organs, and reduced stomatal opening. To obtain further insight at the molecular level on the multiple physiological functions of NRT1.1, we performed large-scale transcript profiling by serial analysis of gene expression in the roots of the chl1-5 deletion mutant of NRT1.1 and of the Columbia wild type. Several hundred genes were differentially expressed between the two genotypes, when plants were grown on NH4NO3 as N source. Among these genes, the N satiety-repressed NRT2.1 gene, encoding a major component of the root high-affinity NO3 − transport system (HATS), was found to be strongly derepressed in the chl1-5 mutant (as well as in other NRT1.1 mutants). This was associated with a marked stimulation of the NO3 − HATS activity in the mutant, suggesting adaptive response to a possible N limitation resulting from NRT1.1 mutation. However, derepression of NRT2.1 in NH4NO3-fed chl1-5 plants could not be attributed to lowered production of N metabolites. Rather, the results show that normal regulation of NRT2.1 expression is strongly altered in the chl1-5 mutant, where this gene is no more repressible by high N provision to the plant. This indicates that NRT1.1 plays an unexpected but important role in the regulation of both NRT2.1 expression and NO3 − HATS activity. Overexpression of NRT2.1 was also found in wild-type plants supplied with 1 mM NH4 + plus 0.1 mM NO3 −, a situation where NRT1.1 is likely to mediate very low NO3 − transport. Thus, we suggest that it is the lack of NRT1.1 activity, rather than the absence of this transporter, that derepresses NRT2.1 expression in the presence of NH4 +. Two hypotheses are discussed to explain these results: (1) NRT2.1 is upregulated by a NO3 − demand signaling, indirectly triggered by lack of NRT1.1-mediated uptake, which overrides feedback repression by N metabolites, and (2) NRT1.1 plays a more direct signaling role, and its transport activity generates an unknown signal required for NRT2.1 repression by N metabolites. Both mechanisms would warrant that either NRT1.1 or NRT2.1 ensure significant NO3 − uptake in the presence of NH4 + in the external medium, which is crucial to prevent the detrimental effects of pure NH4 + nutrition.
Thinking Ahead about Reproductive Health: Contingency Planning and Emergency Preparedness in Crisis Situations (Iraq and West Africa)
Authors: DeLargy Pamela , Alakbarov Ramiz 
Published: September 2004

The United Nations Population Fund (UNFPA) coordinated efforts to integrate RH into contingency planning for the 2003 Iraq crisis and the 2003 regional response for displaced populations in West Africa. Using UNFPA's network of country offices in the Middle East, staff developed logistics plans, conducted workshops and pre‐positioned RH supplies. Though refugee movements did not occur, the contingency planning enhanced the response capacity of UNFPA offices and made it possible to rapidly provide assistance inside Iraq. In West Africa, multi‐country workshops and follow‐up resulted in country‐level and regional action plans useful during the renewed crises of 2003; scarce funding, however, limited their full implementation.UNFPA's experiences show that contingency planning requires committing resources for crises, some of which will not occur; new staff skills; and follow‐up. Moreover, RH is considered by some to be additional to the core elements of contingency planning. RH's political sensitivity, particularly with certain donors, further complicated integrated planning.
Community nursing: health professional and public perceptions
Authors: McKenna Hugh , Keeney Sinead 
Published: September 2004

Background.  Almost 10 years ago senior United Kingdom nurses met at Heathrow Airport to discuss the challenges and opportunities facing nursing. One aspect of this ‘Heathrow Debate’ was to encourage nurses to work closer with members of the public. The resulting report stated that nurses have not been effective in working outside their professional area and, in particular, they have not been adept at working in partnership with the public.Aim.  The aim of this paper is to report a study to obtain the views of general practitioners (GPs), community nurses and members of the public on how the public perceive community nursing. A further aim was to explore the perceptions of senior health care managers and policymakers about public involvement in primary care.Methods.  A two‐stage Delphi investigation was undertaken with community nurses (n = 38), GPs (n = 14) and members of the public (n = 8). In addition, one‐to‐one interviews were carried out with 34 senior health service managers and policymakers.Findings.  There was agreement on the following issues: community nurses must work more closely with members of the public; there is a lack of public understanding on the roles of community nurses and specialist nurses; there is public support for nurse prescribing; there is a preference for seeing the community nurse as opposed to the GP; and people prefer one nurse to care for them rather than a variety of nurses. Comments from managers and senior policymakers showed agreement on the public being involved in primary care, but an acknowledgement that this was problematic. A number of recommendations are outlined.
Changing nurses’ dis‐empowering relationship patterns
Authors: Daiski Isolde 
Published: September 2004

Background. Nurses’ inter‐ and intra‐disciplinary relationships are frequently interpreted as oppressed group behaviours, contributing to their relatively dis‐empowered status. In the context of restructuring in health care, this study examined the views of hospital staff nurses about their relationships with nursing colleagues and other health care professionals and their ideas for change.Aim. The aim of this paper is to report a study to add the views of staff nurses to the discourse on restructuring and to make visible the processes that contribute to their marginalization.Design. The study was descriptive and exploratory. Staff nurses from various hospitals in a large Canadian city were selected by theoretical sampling.Method. Twenty volunteer staff nurses were interviewed between 1998 and 1999, using broad, open‐ended questions and prompts to explore nurses’ various relationships in the health care system. This approach allowed for multiple responses and expansions of ideas, without losing focus. The interviews were audio‐taped and later transcribed. Thematic analysis was carried out.Findings. Many participants were aware of inter‐disciplinary hierarchies, particularly between nurses and physicians. Many also showed insights into their own intra‐disciplinary hierarchies and mutual non‐supportiveness. Both types of relationships were found to be inextricably linked, sustaining nurses’ oppression through dis‐empowering discourses. Nurses expressed many ideas about how to promote mutually supportive relationships.Conclusion. Change for the better needs to come from within the nursing profession. To develop effective strategies, bedside nurses have to be included in decision‐making processes affecting them and their practice, about which they are the experts. Mutual respect, awareness‐raising through education, development of caring nursing communities, mentorship and non‐hierarchical leadership are key to stopping dis‐empowering discourses and practices amongst nurses.
Diabetes care: practice nurse roles, attitudes and concerns
Authors: Kenealy Tim , Arroll Bruce , Kenealy Helen , Docherty Barbara , Scott David , Scragg Robert , Simmons David 
Published: September 2004

Background.  Practice nurses (PNs) are the largest group of nurses providing primary care for patients with diabetes in New Zealand, and changes in the health system are likely to have a substantial effect on their roles. To inform the development of a new primary health care nursing structure and evaluate the new role associated with this, it will be important to have data on current practice nurse roles.Aims.  The aim of this paper is to report a study to compare the diabetes‐related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care.Methods.  Questionnaires were mailed to all 146 PNs in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organization, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life.Results.  More nurses surveyed in 1999 had postregistration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999.Conclusions.  Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.