bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐related quality of life in persons with long‐term pain after a stroke
Authors: Widar Marita , Ahlström Gerd , Ek Anna‐Christina 
Published: December 2004

Background.  No study has, to our knowledge, previously been published on health‐related quality of life (HRQoL) in a group suffering from long‐term pain after a stroke.Aim.  The aim of the present study was to describe HRQoL in persons with long‐term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status.Design.  This study has a design combining qualitative and quantitative methods.Methods.  Forty three participants suffering from long‐term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self‐report questionnaires, SF‐36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used.Results.  The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF‐36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF‐36. The men had more decreased vitality than the women.Conclusion.  The results show, that the participants in this study have a lower HRQoL due to their long‐term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care.Relevance to clinical practice.  Awareness and understanding of the patients’ perceptions and transitions with regard to their life situation and suffering from long‐term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.
Chronic illness self‐management: taking action to create order
Authors: Kralik Debbie , Koch Tina , Price Kay , Howard Natalie 
Published: December 2004

Background.  This paper presents research that was framed by our early understandings about the ways that people incorporate the consequences of illness into their lives. The word ‘transition’ has been used to describe this process. We believed self‐management to be central to the transition process but this assertion required further research, hence this paper.Aim.  The research aimed at understanding the way in which people who lived with chronic illness constructed the notion of self‐management. While the participants of this study were living with arthritis, the focus was on understanding the meaning of self‐management rather than the experience of living with the symptoms of arthritis.Approach.  Data were generated when nine people living with arthritis were invited to write an autobiography about their life and experiences of living with illness. Two telephone interviews were recorded with each participant and then the research group (researchers and participants) convened for a discussion meeting.Findings.  In contrast to health professionals who identify self‐management as structured education, participants identified self‐management as a process initiated to bring about order in their lives. Creating a sense of order, or self‐management, had four key themes (i) Recognizing and monitoring the boundaries, (ii) Mobilizing the resources, (iii) Managing the shift in self‐identity, (iv) Balancing, pacing, planning and prioritizingConclusions.  People learned about their responses to illness through daily life experiences and as a result of trial and error. They reconfigured their daily lives and reconstructed their self‐identity by exploring their personal limitations or boundaries. Self‐management of chronic illness has been considered as both structure and process, however it is the process of self‐management that we contend is central to the experience of transition.Relevance to clinical practice.  Clinical nursing intervention for people with a long term illness may be enhanced when self‐management is approached from a broad, contextual perspective and self‐management processes are integrated into clinical practice. The challenge is for nurses to embrace processes in nursing practice that will facilitate interactions with clients without obstructing the diversity of perspectives, create an environment conducive to learning and engage individuals in identifying self‐management strategies that have meaning in their lives.
The challenge of spiritual care in a multi‐faith society experienced as a Christian nurse
Authors: Fawcett Tonks N. , Noble Amy 
Published: December 2004

Background.  Understanding the spiritual dimension of holistic nursing care is arguably regaining its centrality in the assessment of patient well being in whatever area of care. However it is argued that we are still far from having a universal agreement as to what is meant by the concept of spirituality.Aims and objectives.  This paper aims to explore some of the definitions and models of spirituality and determine what is meant by spiritual needs. Taking the perspective of a Christian nurse, the potential tension between the nature of spiritual care and evidence‐based professionalism is explored.Conclusion.  The exploration reveals the challenges faced by a nurse who wishes to administer this spiritual care and holds a personal commitment to the Christian faith.Relevance to clinical practice.  Acknowledging and debating the challenge of spiritual care is arguably the first step towards meeting optimally this need in our patients. The dilemma that may need to be further explored within the context of nursing care is how a nurse, holding and operating within one particular belief (e.g. Christianity) can offer the ideal of spiritual care to patients who hold other, quite different beliefs.
Professionalism in medicine
Authors: Miettinen MD MPH MSc PhD MD‐PhD(hc) D(hc) FAHA FACE FIEA Olli S. , Flegel MD MSc FRCP(C) FACP Kenneth M. 
Published: December 2004

AbstractA Charter on Medical Professionalism (CMA) has just recently been developed internationally, and the Canadian Medical Association is calling for public dialogue on medical professionalism now that reforms in the Canadian system of health care are imminent. We posit that good practices are at issue; we outline the essence of these in general and also specifically in the knowing, teaching and intervening components of practice. We also see challenges not to, but in, medical professionalism – first and foremost in the profession's definition of good practices and the payer's confinement of insurance coverage to these.
Improving ACE inhibitor use in patients hospitalized with systolic heart failure: a cluster randomized controlled trial of clinical practice guideline development and use
Authors: Thilly Nathalie , Briançon Serge , Juillière Yves , Dufay Edith , Zannad Faiez 
Published: December 2004

AbstractRationale, aims and objectives   The efficacy of angiotensin‐converting enzyme (ACE) inhibitors in treating heart failure is well established, but there is concern that these agents are underutilized. This study aimed to evaluate the effect of developing and implementing Clinical Practice Guidelines (CPGs) on the quality of care given to patients receiving ACE inhibitors for systolic heart failure.Methods  Twenty cardiology units in Lorraine (France) were randomized to an experimental (n = 10) or a control group (n = 10). In each experimental unit, doctors were involved in drafting and implementing CPGs; those at control units were not. Practice surveys were conducted in all units before and after the intervention; 723 patients with heart failure and less than 75 years old were included. The main outcome was compliance with the CPGs.Results  Before intervention, clinicians in both groups were already compliant with CPGs relating to indications and contra‐indications, adverse effects management, concomitant therapy and monitoring of biologic factors. After intervention, adherence to others CPGs was generally better in the experimental group. Compliance with the CPG relating to ACE inhibitor dose on discharge was higher in the experimental group (P = 0.003). Compliance with CPGs relating to increasing ACE inhibitors doses (P < 0.0001) and the contents of the discharge letter (P = 0.02) improved in all units between the two periods.Conclusions  These results suggest that doctors involved in drafting and implementing CPGs are more likely to comply with them.
Case reports and a review of the literature on ulcers mimicking pyoderma gangrenosum
Authors: Nguyen Kari H. , Miller Jeffrey J. , Helm Klaus F. 
Published: December 2004

AbstractPyoderma gangrenosum (PG) is a rare, ulcerative skin disease. Diseases with cutaneous manifestations resembling PG may lead to the misdiagnosis of PG. We discuss two patients presenting with cutaneous ulcers originally thought to be PG, and review the literature on the clinical and pathologic characteristics of PG ulcers compared to PG‐like ulcers in order to determine possible distinguishing features.
Polymerase chain reaction based detection ofMycobacterium tuberculosisin tissues showing granulomatous inflammation without demonstrable acid‐fast bacilli
Authors: Hsiao Pa‐Fan , Tzen Chin‐Yuan , Chen Hsiu‐Chin , Su Hsin‐Yi 
Published: December 2004

AbstractBackgroundCutaneous tuberculosis is especially difficult to distinguish from other granulomatous dermatoses. We used polymerase chain reaction (PCR) to evaluate the incidence of cutaneous tuberculosis and atypical mycobacterial infection in formalin‐fixed, paraffin‐embedded tissues with unspecified granulomatous inflammation and negative results for acid‐fast bacilli (AFB), and analyzed the pattern of cutaneous tuberculosis in this group of patients.MethodsA total of 38 specimens which had been collected from 36 patients and fulfillled the criteria for tissues described above were used in this study. Two different primer pairs targeting the gene encoding for 16S ribosomal RNA (common to all mycobacteria) and the insertion sequence IS6110 (specific forM. tuberculosiscomplex) were used in the PCR assays. The clinical characteristics, histopathologic findings, and culture results of the patients were also analyzed.ResultsFour specimens were excluded from the analysis due to the lack of internal control testing. Of the remaining 34 specimens, 22 were PCR positive for the 16S rRNA gene. Among them, 18 specimens were PCR positive for both the 16S rRNA gene and IS6110. Cutaneous tuberculosis could be diagnosed in these 18 cases (56.2%). Out of the 18 cases, there were 8 women and 10 men. The age range was 15–77 years (mean: 44.2 years). After reviewing their clinical presentation, 11 cases were considered as tuberculosis verrucosa cutis, 6 cases as lupus vulgaris, and 1 case as erythema induratum. The remaining 4 cases (12.5%) positive only for 16S rRNA gene were considered as possible atypical mycobacteria infection.ConclusionsThese results show that in paucibacillary form of cutaneous tuberculosis with unclassical clinical and histological presentation, this PCR system provides rapid and sensitive detection ofM. tuberculosisDNA in formalin‐fixed, paraffin‐embedded specimens. Cutaneous tuberculosis represents a significant proportion in specimens showing granulomatous inflammation. In areas like Taiwan, where prevalence of pulmonary tuberculosis is still high, tuberculosis verrucosa cutis and lupus vulgaris are common forms of cutaneous tuberculosis and are seen more frequently than atypical mycobacterial infection.
IgG class antibodies to heat shock‐induced streptococcal antigens in psoriatic patients
Authors: Pérez‐Lorenzo Rolando , Zambrano‐Zaragoza José Francisco , Moo‐Castillo Karina , Luna‐Vázquez Dora L. , Ruiz‐Guillermo Leopoldo , García‐Latorre Ethel 
Published: December 2004

AbstractBackground Psoriasis is a chronic inflammatory skin disease. Probably autoimmune in nature, and associated with streptococcal throat infections as a triggering factor. Although many groups have associated the disease with other pathogens, Streptococcus pyogenes seems to be the most important microorganism related to this disease. Therefore, it is necessary to identify the streptococcal antigens involved in the process.Methods In this work IgG class antibodies to soluble antigens obtained from Staphylococcus aureus, Candica albicans or S. pyogenes before and after heat shock induction, were analyzed by ELISA in 28 psoriatic patients and 30 healthy donors.Results In all cases, the patients and the controls had IgG class antibodies to the four antigens. Nevertheless, the IgG levels to the heat shock‐induced S. pyogenes were statistically different between the patients and the controls (P < 0.001). There was no difference between the groups when the IgG antibodies to the other antigens, including the noninduced streptococcal extract, were analyzed. Additionally, anti‐streptolysin O titers and throat cultures were carried out in all patients and controls. No differences between ASO titers were found but the patients were more frequently colonized by S. pyogenes.Conclusion Results obtained in this study suggest that heat shock‐induced proteins from S. pyogenes are associated with psoriasis.
Incidence of cutaneous tuberculosis in patients with organ tuberculosis
Authors: Kivanç‐Altunay Ilknur , Baysal Zerrin , Ekmekçi Tugba Rezan , Köslü Adem 
Published: December 2004

AbstractBackground Tuberculosis continues to be a health problem in some countries. The development of resistance to antituberculitic drugs and the increase in diseases and conditions associated with immunodeficiency such as AIDS and chemotherapy have caused tuberculosis to increase recently. As a result, the incidence of cutaneous tuberculosis has been increasing as well.Aim To detect cutaneous tuberculosis in patients with organ tuberculosis and to establish some characteristics of the relation between organ and cutaneous TB.Material and methods A total of 370 patients (145 females and 225 males), aged 2–76 years (mean age 27.5), enrolled for this screening study. These patients were hospitalized patients who already had pulmonary or extrapulmonary tuberculosis diagnosed before admission. All patients underwent a general skin examination, and, if needed, cutaneous biopsies were taken from involved skin areas.Results Three hundred and forty‐seven (93.78%) out of 370 patients had pulmonary tuberculosis only or in association with one of other organ tuberculoses. Twenty‐three patients had extrapulmonary TB: nine were TB adenitis, six were TB peritonitis, three were bone tuberculosis, and five were TB meningitides. Of 370 patients, only 13 (3.51%) had cutaneous TB: seven scrofuloderma (SCD; 2.16%), four lupus vulgaris (LV; 1.35%), one LV and SCD, and one Bacille Calmette‐Guerin (BCG) adenitis (0.027%). Cutaneous tuberculosis was observed in seven out of 260 patients with parenchymal tuberculosis (2.96%). Four out of nine patients with TB adenitis (44.4%), one out of 12 pulmopleuretic (8.3%), and one out of 67 pleuresic patients (1.40%) had cutaneous TB as well. Mean age of the 13 patients was 32.46 years: mean age of SCD and LV was 24.8 and 48 years, respectively. The one patient with BCG adenitis was 7 months old. Five (62.5%) out of eight patients with SCD, and only one (20%) out of five patients with LV were new cases. Four patients with SCD had a positive family history, while LV patients did not.Conclusions Organ tuberculosis is rarely associated with cutaneous tuberculosis. Scrofuloderma and LV are the most frequent forms of skin TB associated with organ TB in this population. Tuberculosis adenitis is the organ TB that causes cutaneous TB most often among other organ tuberculoses. More than one form of cutaneous TB affected only one patient with pulmonary TB; therefore, it is very rare. Tuberculids were not observed in any of the patients.
Familial atrophia maculosa varioliformis cutis
Authors: Kalayciyan Aylin , Kotogyan Agop , Demirkesen Cuyan , Tüzün Yalçin 
Published: December 2004

Atrophia maculosa varioliformis cutis (AVMC) was first described by Heidingsfeld in 1918, as a rarely reported form of idiopathic macular atrophy on the cheek.1 It is characterized, clinically, by shallow, sharply demarcated depressions in various shapes. Extrahepatic biliary atresia2 and pachydermodactyly3 have been the only conditions associated with AMVC reported in the past 80 years. Although keratosis pilaris is a common skin disorder, it is related to other idiopathic atrophic conditions considered in the differential diagnosis of AMVC, namely keratosis pilaris atrophicans.4 However, the two associations may be coincidental. We observed a patient with keratosis pilaris, and her brother and an unrelated young man, whose findings led to a diagnosis of AMVC.
Detection of new endemic areas of cutaneous leishmaniasis in Pakistan: a 6‐year study
Authors: Bhutto Abdul Manan , Soomro Rashid A. , Nonaka Shigeo , Hashiguchi Yoshihisa 
Published: December 2004

AbstractBackground Cutaneous leishmaniasis (CL) is endemic in Pakistan and is widely spreading. Recently, an outbreak of the disease was observed in the region. We report some new endemic areas of CL in the country.Methods A total of 1210 cases of CL who visited our department from 1996 to 2001 are reported. Among them, 760 were residents of the Jacobabad, Larkana, and Dadu districts of Sindh province and had never previously traveled to endemic areas. These districts have never been reported/recognized as endemic for CL. Others were residents of endemic areas of Balochistan province. Diagnosis was made on clinical presentation; a giemsa‐stained smear test and histopathological results. All the cases were treated with the meglumine antimoniate 600 mg/day (adults) and 15 mg/kg/day (children) intramuscularly for 20 consecutive days.Results All the patients were aged between 2.5 months and 65 years. Three hundred and ninety‐two patients were females and 368 were males. Duration of the disease ranged from 2 to 18 months. Most of the patients had a single lesion on the face and/or extremities. Clinically, the disease was classified as: dry papular type, 407 cases; dry ulcerative type, 335 cases; and wet ulcerative type, 18 cases. No cases of muco‐cutaneous or visceral leishmaniasis were found during this period. Smear testing was positive in 845 cases, while 365 cases were histopathologically positive. An ultrastructural study was performed using specimens of a few of the cases. Leishmania parasites were detected in the dermal tissues as well as in the macrophages.Conclusions We propose that the Jacobabad, Larkana and Dadu districts could be considered endemic for CL. Wet‐ and dry‐type lesions indicate the presence of both Leishmania tropica and L. major in this tropical region.
Practical and experimental consideration of sun protection in dermatology
Authors: Ting William W. , Vest Cortney D. , Sontheimer Richard 
Published: December 2004

AbstractMuch is known regarding the deleterious effects of ultraviolet radiation (UV) on the skin. As more epidemiologic and basic research continues to characterize the impact of sun exposure and other sources of UV radiation upon the development of cutaneous neoplasm and a variety of photosensitive dermatoses, it is crucial for the dermatologist to promote sun protection among his/her patients as well as the primary care physician who has a greater reach of the community than the skin specialist. Practical steps to achieve optimal sun protection include avoidance of UV radiation, avoidance of photosensitizing drugs, use of photo‐protective clothing, and diligent application of broad‐spectrum sunscreens. In recent years, novel agents and experimental modalities with the potential to offer enhanced protective effects against deleterious sequelae of sun exposure have been elucidated, e.g. antioxidants, alpha‐MSH, polyphenol in green teas, genistein, NF‐kB decoy oligodeoxynucleotides, pTpT vaccination, and IL‐12. As these new photo‐protective tools are being developed by scientists around the world, greater concerted effort is needed to engage public health officials and the media to promote sun protection awareness throughout the general public.
Courtship behavior and sexual isolation between Drosophila auraria and D. triauraria in darkness and light
Authors: Oguma Y. , Jallon J.‐M. , Tomaru M. , Matsubayashi H. 
Published: December 2004

AbstractSexual isolation between two species of the Drosophila auraria complex, D. auraria and D. triauraria is different in darkness and light. In darkness there is complete isolation while in light it is only partial. The sensory bases of these differences were investigated by behavioral studies in darkness and light. In darkness there was no normal courtship sequence but males of both species displayed attempted copulation to homospecific and heterospecific females, as well as homospecific males. After a few hours together, homospecific copulations were observed after females displayed a characteristic posture: spreading the wings. Such an acceptance posture, also observed in other Drosophila species, was probably released by the wing vibration of a homospecific male. In light, visual signals alone are able to elicit male's orientation and following, whether flies are housed together or physically separated. Intense homosexual courtships were observed. All these data suggest that males have a low discrimination ability and females play the main role in sexual isolation.
1H‐NMR Method Enables Early Identification of Degeneration in the Quality of Sweet Potato Tubers
Authors: Iwaya‐Inoue M. , Matsui R. , Sultana N. , Saitou K. , Sakaguchi K. , Fukuyama M. 
Published: December 2004

AbstractIn sweet potato tuber, which is a tropical plant, long‐term storage leads to loss of water and carbohydrate, thus water mobility was investigated using1H‐NMR spectroscopy. Electrolyte leakage indicated that tubers stored at 15 °C for 1 year were partly injured and that frozen‐thawed tissues were dead. Nuclear magnetic resonance (NMR) spin–lattice relaxation time (T1) and spin–spin relaxation time (T2) clearly increased with the duration of storage, whereas these values decreased in the dead tissues. Furthermore, Arrhenius plots forT1andT2were determined at temperatures ranging from 20 to 0 °C in 2.5 °C steps. In the fresh tubers, a strong converse temperature dependency was shown in theT2measurement. On the contrary, there was no temperature dependency in theT2of the dead tissues. Thus, the existence of inverse temperature dependency reflected tissue viability. Additionally, any change in theT2of the fresh tubers occurred at about 14 °C, which virtually coincided with the storage temperature of 15 °C. The slope change inT2might have responded to a physiological change as a primary event. In conclusion, monitoring water status by NMR could provide early identification of changes in the quality of post‐harvest crops; this method shows great promise for use in environmental‐stressed crop yield research.