bluuebunny/crossref_metadata_2025_split huggingface dataset:
Additive Effect of Pronase on the Efficacy of Eradication Therapy Against Helicobacter pylori
Authors: Gotoh Akira , Akamatsu Taiji , Shimizu Toshiki , Shimodaira Kazuhisa , Kaneko Taimei , Kiyosawa Kendo , Ishida Kimitaka , Ikeno Tatsuo , Sugiyama Atsushi , Kawakami Yoshiyuki , Ota Hiroyoshi , Katsuyama Tsutomu 
Published: March 2003

AbstractBackground. Helicobacter pylori (H. pylori) colonizes not only the surface of the surface mucous cells but also the surface mucous gel layer (SMGL). Thus, we examined the possible value of pronase, a mucolytic agent, as a potential eradication therapy.Materials and Methods. One hundred and thirty‐five patients were randomly assigned to two treatment groups. Sixty‐eight patients received 30 mg of lansoprazole once daily, 500 mg of amoxicillin and 250 mg of metronidazole thrice daily for 2 weeks (LAM group), while the other 67 patients received the same dosage of those agents plus 18,000 tyrosine units of pronase thrice daily for 2 weeks (LAMP group). Eradication was assessed 4–6 weeks after treatment by immunohistochemical tests and cultures. We also determined the in vitro activity of pronase against H. pylori, and evaluated the synergistic effects between pronase and the other three drugs. To investigate the effect of pronase on the structure of the SMGL, surgically removed stomachs obtained from patients who had taken pronase were examined histopathologically.Results. The cure rates for H. pylori infection in the LAMP group were significantly higher than those in the LAM group (intention to treat analysis: 94.0 vs. 76.5%, p = .0041). Pronase exhibited no antibacterial activity against H. pylori., and no in vitro synergistic effects were observed. In the patients who took pronase before surgery, the SMGL was thinner than in the patients who did not take pronase, and the structure of the SMGL was markedly disrupted.Conclusions. Pronase has an additive effect in curing H. pylori infection. Pronase has no apparent in vitro activity against H. pylori, but may improve the local delivery of antibiotics by virtue of its removal and disruption of the SMGL.
The Role of the Ferric Uptake Regulator (Fur) in Regulation of Helicobacter pylori Iron Uptake
Authors: Van Vliet Arnoud H. M. , Stoof Jeroen , Vlasblom Ronald , Wainwright Stuart A. , Hughes Nicola J. , Kelly David J. , Bereswill Stefan , Bijlsma Jetta J. E. , Hoogenboezem Theo , Vandenbroucke‐Grauls Christina M. J. E. , Kist Manfred , Kuipers Ernst J. , Kusters Johannes G. 
Published: March 2003

AbstractBackground. Availability of the essential nutrient iron is thought to vary greatly in the gastric mucosa, and thus the human gastric pathogen Helicobacter pylori requires regulatory responses to these environmental changes. Bacterial iron‐responsive regulation is often mediated by Ferric Uptake Regulator (Fur) homologs, and in this study we have determined the role of H. pylori Fur in regulation of H. pylori iron uptake.Methods. Wild‐type H. pylori and fur mutant derivatives were compared after growth in iron‐restricted and iron‐replete conditions. Iron‐uptake was measured using 55Fe‐labeled iron, whereas gene expression was monitored at the transcriptional level using Northern hybridization and lacZ reporter gene fusions.Results. Iron‐uptake and total cellular iron content were approximately five‐fold increased in the fur mutant compared with the wild‐type strain, which indicated that in the fur mutant iron‐uptake is not repressed by excess iron. A comprehensive screening of all H. pylori genes encoding putative iron‐uptake proteins indicated that some of these H. pylori genes are constitutively expressed, while others are iron‐ and Fur‐regulated.Conclusions. Iron uptake in H. pylori is in part differently regulated compared with other bacteria, since in H. pylori some iron‐uptake systems are constitutively expressed. However, other iron uptake systems of H. pylori display the iron‐ and Fur‐mediated repression that is common in bacteria. Taken together, this Fur‐mediated modulation of iron‐uptake capacity may be a specific adaptation to the conditions in the human stomach, where iron starvation and iron overload can be encountered in relatively short time intervals.
Helicobacter pylori Strain and the Pattern of Gastritis Among First‐Degree Relatives of Patients with Gastric Carcinoma
Authors: Li Li , Genta Robert M. , Go Mae F. , Gutierrez Oscar , Kim Jong G. , Graham David Y. 
Published: March 2003

AbstractBackground. Relatives of gastric cancer patients have an increased risk of gastric cancer, possibly related to genetically‐related strains of Helicobacter pylori or a common environment.Methods. The pattern of gastritis and H. pylori from gastric cancer patients and their first‐degree relatives were compared using detailed DNA fingerprints and vacA, cagA, and iceA genotyping.Results. Sixteen index cases from Korea, the US, or Colombia and their 38 first‐degree relatives (brothers, sisters, sons and daughters) were studied. No definite, or consistent, relationship between the pattern of gastritis and the relatedness of the H. pylori strain was observed (i.e. relatives could have an identical or a totally different pattern of gastritis regardless if they were infected with identical or highly similar organisms). For example, three elderly siblings of an index case with atrophic pangastritis had identical H. pylori isolates and environments in childhood and yet two had antral predominant nonatrophic gastritis, which is typically associated with duodenal ulcer instead of gastric cancer.Conclusions. The results of this study are not consistent with the hypothesis that specific virulence factors or similar H. pylori strains correlate with a specific histologic pattern or outcome even among those sharing the same environment in childhood.
Current Surgical Options in the Control of Cancer Pain
Authors: Cullinane Carey A. , Chu David Z.J. , Mamelak Adam N. 
Published: March 2003

purpose: Pain syndromes resulting from recurrent or metastatic cancer require careful evaluation to determine the cause of the pain and the appropriate and judicious use of antitumor treatment. The choice of therapy must integrate the type of pain, its function, the overall disease burden of the patient, and psychological aspects of the cancer. As a general rule, opioid analgesics are the mainstay of treatment in patients with cancer‐related pain. When pharmacologic pain control is insufficient or is associated with intolerable side effects, the surgical management of pain can be considered.overview: In this article, we review the options, indications, and side effects of the interventional and surgical methods available for the treatment of cancer‐related pain.clinical implications: Planning surgical treatment for cancer‐related pain after a patient's lack of response to therapy with opioid analgesics requires an understanding of sensory innervation as well as a realistic expectation of survival, anesthetic risk, or possibility of incomplete pain relief. As such, surgical interventions must be tailored to the individual patient. Clinicians should keep in mind the surgical alternatives for the effective control of pain when it becomes apparent that medical therapy is ineffective.
Telephone Prescreening Enhancing a Model for Proactive Healthcare Practice
Authors: Korcz Irene R. , Moreland Sharron 
Published: March 2003

PURPOSE: This article explicates the process of developing and implementing a contemporary, innovative program using the telephone as a tool for prescreening newly diagnosed cancer patients before their arrival at the cancer center. As another element of existing models of psychosocial care, this service lays the foundation for the efficient delivery of clinical social work services. DESCRIPTION OF PROGRAM: In the Surgical Oncology Clinic of the M.D. Anderson Cancer Center in Houston, Tex, 28 patients were contacted as part of a telephone prescreening model of a practice program from February 1, 1995 through March 31, 1995. Using a structured telephone interview format, two clinic social workers contacted patients and provided information on social work services. Patients needing resource assistance were provided with community referrals. Using the information from the telephone call, a brief outpatient assessment was completed for each patient before his or her arrival at the clinic. During the initial clinic visit, each new patient was met by the social worker to conduct a qualitative interview and address specific treatment‐related concerns. OUTCOME OF PROGRAM: The patients expressed their appreciation of the interest of the social work staff and their satisfaction with the information provided. In addition, obtaining patient information and identifying patient needs before the initial visit allowed social workers to use clinic time more efficiently. Because of restructuring, the Surgical Oncology Clinic was eliminated and use of the intervention suspended. Based on the encouraging results of the telephone prescreening model of care program, reinstating the program in the future would include expanding its hours of operation to reach individuals who are not at home during the hours of 8:00
am 25:00
pm and including language assistance to address the needs of the increasingly multicultural population. CLINICAL IMPLICATIONS: Telephone prescreening is one strategy for personalizing psychosocial assessment. In this era of outpatient day surgery and cost‐controlled managed healthcare, the benefits of prescreening are empowerment for both patients and multidisciplinary team members. The future holds promise for telephone prescreening to become part of the collaborative clinical pathways model of the disease‐site centers concept.
Missed Cancer Screening Opportunities Among Older Women
Authors: Gulitz Elizabeth , Hernandez Marta Bustillo , Kent Ellen B. 
Published: March 2003

PURPOSE
: The authors present an analysis of the literature and findings from a qualitative research study as a framework for discussion of potential strategies to increase utilization of breast and cervical cancer screening among older women. The qualitative findings are one component of a comprehensive two‐part study investigating why providers miss the opportunity to screen older women for cancer.
OVERVIEW
: Qualitative analysis of in‐depth interviews with experts in cancer control (academicians, clinicians, and cancer center administrators) and a survey of primary care providers revealed four emergent themes of patient, provider, office, and access barriers that contribute to underutilization of screening. Patient and provider barriers represent human factors or reasons why both groups may be reluctant to participate in screening. Office and access barriers exemplify systems factors that impede the screening process for both groups. Primary care providers may miss the opportunity to perform or recommend screening for underserved groups of older women because of their perceptions of these human and systems factors.
CLINICAL IMPLICATIONS
: In light of the critical importance of primary care providers' recommendations, health professionals and community leaders should collaborate in developing multifaceted programs to help providers feel more comfortable about promoting screening to their patients. Such comprehensive, coordinated initiatives, which adapt successfully proven strategies to community needs and resources, may be essential to increase utilization of screening among underserved groups of older American women.
Reintegration After Bone Marrow Transplantation
Authors: Baker Frank , Zabora James , Polland Adrienne , Wingard John 
Published: March 2003

objectives: This study examines the problems of bone marrow transplantation (BMT) survivors in returning to “normal” life in the community after BMT.materials and methods: Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post‐BMT, producing considerable qualitative data regarding their problems in living. Eighty‐four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post‐BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material.results: Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity: 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties.conclusions: Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.
A Qualitative Study of Patient Perspectives on Colorectal Cancer
Authors: Sahay Tina B. , Gray Ross E. , Fitch Margaret 
Published: March 2003

Objectives: The purpose of this study was to use qualitative methods to contribute to a complete patient perspective on the psychosocial impact of colorectal cancer.Materials and methods: A qualitative descriptive study was conducted in 20 patients attending a gastrointestinal follow‐up clinic at the Toronto‐Sunnybrook Regional Cancer Centre. The data documented included patient satisfaction and perceptions regarding to quality of care, information received, involvement in decision making, and long‐term management of the illness.Results: Overall, patients were satisfied with their treatment, including the quality and timeliness of the information they received, the quality of their healthcare, and the level of involvement in decision making. However, some patients were dissatisfied with information concerning long‐term management of their illness. Patient care, including information and social support, was provided by cancer specialists, family physicians, family, and friends. Patients looked to cancer specialists as their primary source of information, but relied on family physicians to fill in gaps in understanding, to provide support, to manage overall care, and to act as a sounding board for ideas and treatment options. Social support was also provided by family and friends. All patients had a relatively positive outlook on their illness experience, although those with colostomies had some added difficulty. Despite the focus on positive change, many patients acknowledged difficulty coping with the side effects of treatment.Conclusions: These data indicate that patient information needs to be provided in the most common terms and the most straightforward language. Information also may need to be repeated and should include attention to long‐term management of the illness. Health professionals should assume that patients may have difficulty in illness management and should encourage a discussion of patients' concerns.
Attitudes Toward Genetic Testing in Patients with Colorectal Cancer
Authors: Kinney Anita Yeomans , Choi Yeon‐Ah , DeVellis Brenda , Millikan Robert , Kobetz Erin , Sandler Robert S. 
Published: March 2003

Purpose: The purpose of this study was to examine risk perceptions and interest in genetic testing among African American and White patients with colorectal cancer.Description of study: In this cross‐sectional study, 98 patients with colorectal cancer participated in a brief structured telephone interview. Information was collected on knowledge and risk perceptions regarding colorectal cancer genetics, health behaviors, knowledge about the availability of genetic testing, and interest in genetic testing for colorectal cancer susceptibility.Results: Sixty‐one percent of the participants were worried about their relatives' risk of colorectal cancer, and 64% were concerned about being a colorectal cancer susceptibility gene carrier. Although 81% of the participants reported that they had never heard about a genetic test for colorectal cancer susceptibility, 72% stated that they would want to take the test if it were available. Predictors of intention to have a genetic test were younger age, less advanced stage of disease, and more frequent thoughts about colorectal cancer being hereditary.Clinical implications: These results suggest that the demand for genetic testing may be great, despite a general lack of knowledge about colorectal cancer genetics and the potential risks and limitations of testing. Education and counseling about cancer genetics and genetic testing may clarify misconceptions about hereditary colorectal cancer and help patients with colorectal cancer and their family members make informed decisions about whether to undergo testing.
Developing a Community Program on Cancer Pain and Fatigue
Authors: Grant Marcia , Golant Mitch , Rivera Lynne , Dean Grace , Benjamin Harold 
Published: March 2003

Purpose: The overall purpose of this project was to establish a community‐based educational model on pain and fatigue management for individuals with cancer. The specific aims were: 1) to develop an appropriate educational program; 2) to pilot test this program in a community setting that supported a self‐care approach; and 3) to evaluate the program process and outcomes.Description of program: The I Feel Better program was implemented through a two‐session educational workshop taught by masters‐prepared oncology nurses and was held at four Southern California sites of The Wellness Community. The focus of the sessions was to provide participants with general information about each symptom, assessment and management of those symptoms, and strategies for effectively communicating with their healthcare providers. Sessions of 2.5‐hour duration were held on Saturday mornings and required preregistration.Results: The participants were primarily female and White, with an average age of 58 years. Participants reported considerable pain and fatigue. They also lacked accurate information about pain management. Program evaluation revealed that the content and format were well received by the participants. They rated the program as extremely useful and reported positive outcomes after the first session.Clinical implications: This pilot educational intervention program has strong implications for multidisciplinary educational approaches for patients with cancer. Limitations resulted from the setting selected and the possibility that participants were already active in their fight against cancer. Generalization to other community settings may not be as successful. Programs could be cosponsored by several collaborating institutions to share resources. Referral to community programs by physicians, nurses, and social workers can occur as needed when identified during patient interventions. The voluntary participation of health professionals in community education programs could provide a valuable service for patients and a rewarding experience for educators.
Breast and Cervical Cancer Screening among Chinese American Women
Authors: Yu Elena S. H. , Kim Katherine K. , Chen Edwin H. , Brintnall Ruth Ann 
Published: March 2003

Purpose: The purpose of this study was to describe breast and cervical cancer screening knowledge and practices of a representative sample of Chinese American women and to examine the factors associated with screening practices.Description of study: A random sample of 332 Chinese American women, 40 to 69 years of age, from the Chinatown area of Chicago, Illinois, were interviewed face to face, using both Chinese Mandarin (or Putunghua) and Cantonese versions of the National Health Interview Survey (NHIS) Cancer Control Supplement Questionnaire. Knowledge and use of mammogram, clinical breast examination (CBE), breast self‐examination (BSE), and Pap smear test were assessed.Results: The results showed a low level of knowledge of cancer screening tests and low use rates. Multiple logistics regression analysis showed that women with spoken English fluency were more likely to have knowledge and use of CBE, BSE, Pap test, and mammograms. Women with better than an elementary education were more likely to have knowledge and use of CBE, BSE, and Pap test. The source of medical care was statistically significant for having had a mammogram. Knowledge of cancer warning signs and symptoms was significant for knowledge of mammogram and BSE and for the use of BSE.Clinical implications: Multiple strategies are needed. These might include the following: 1) integration of research with population‐based care by physicians and scientists; 2) coordinated public health education on cancer screening and postscreening support in Chinese languages; and 3) replication of the NHIS survey methodology and adaptive application of these instruments across several states and regions, combined with the assessment of screening performance in Chinese American populations.
A Weekend Camp for Bereaved Siblings
Authors: Creed Joan , Ruffin Julian E. , Ward Marsha 
Published: March 2003

Purpose: The purpose of this article is to describe a weekend bereavement camp for children age 6 to 18 years who have lost a brother or sister to cancer. A description of the planning for the camp and the weekend program is included.Overview: Camp New Horizons is a weekend camp for children age 6 to 18 years who have lost a sibling to cancer. At the camp, the children are divided into age‐appropriate groups and spend time, through various activities, learning about the grief process to reduce their feelings of isolation, to express grief appropriately, and to move forward in the grief process. Similar programs, as well as the uniqueness of this program, are discussed.Clinical implications: Camp New Horizons has met many of the educational and support needs of bereaved siblings. Networks of support and friendship have formed that allow the children to reach out to one another when needed. Parents and children have increased their communication about the death in their family, thus accepting their feelings and increasing support in the family system. Continued collaboration between centers will create ongoing support for the healthcare professionals and the programs they provide.