bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audit of nutritional guidelines for head and neck cancer patients undergoing radiotherapy
Authors: Wood K. 
Published: September 2005

AbstractBackground  Head and neck cancer patients being treated with radiotherapy are at an increased risk of malnutrition due to the severe side‐effects, e.g. mucositis, odynophagia and xerostomia, impacting on the ability to eat and drink (Lees, Eur. J. Cancer Care 1997;6:45). Effective dietetic management involves identifying those patients malnourished or at risk of becoming so and incorporating nutritional intervention into their treatment plan (Lees, 1997). The use of gastrostomy tubes in this patient group has been shown to be acceptable (Lees, 1997; Magne et al., Eur. Arch. Otorhinololaryngol. 2001;258:89). By placing them prophylactically, the aim is to prevent a disruption to treatment and avoid an unnecessary admission for feeding. This audit was carried out to determine whether the implementation of locally produced nutritional guidelines improved the dietetic management of this patient group.Method  A prospective audit tool was used to collect data on 32 head and neck cancer patients undergoing radiotherapy. Data was collected weekly during the course of treatment and compared with data from previous audits. Weight change was the nutritional outcome measured.Results  More patients underwent combined treatment (radiotherapy postoperatively or with concurrent weekly chemotherapy) when compared with previous audits. However, implementation of the guidelines appeared to contribute to an improvement in dietetic management, as fewer patients lost weight over the course of radiotherapy and there were no admissions for feeding. The presence of a dietitian at the multidisciplinary head and neck clinic improved access and communication and this is also likely to have contributed to the improved management.Conclusions  Implementation of the guidelines led to an improvement in the nutritional management of this patient group. Implementation may be more likely if a dietitian is present at the combined head and neck clinic.
Body mass index and waist circumference in non‐alcoholic fatty liver disease
Authors: Rocha R. , Cotrim H. P. , Carvalho F. M. , Siqueira A. C. , Braga H. , Freitas L. A. 
Published: September 2005

AbstractObjective  To evaluate the association of anthropometric indexes (body mass index and waist circumference) in patients with non‐alcoholic fatty liver disease (NAFLD), and its association with insulin resistance (IR), metabolic syndrome (MS) and histological findings.Methods  From August 2003 to July 2004 a case series of 81 outpatients with clinic and/or histological diagnosis of NAFLD were selected at the Bahia University Gastro‐Hepatology Clinic, Brazil. Liver function tests, lipid profile, glucose and insulin were performed in all patients. Body mass index (BMI) and waist circumference (WC) were determined according to WHO criteria. IR was measured by means of the homeostasis model assessment (HOMA) and IR was considered with HOMA ≥3. MS was defined according to the Adult Treatment Panel III (ATP III). Liver biopsy was performed in 37 cases.Results  Body mass index ≥ 30 kg m−2 (obesity) was found in 39% of the cases and BMI ≥ 25–29.9 kg m−2 (overweight) in 53%. BMI was correlated with IR (r = 0.29; P = 0.02) and WC with ALT (r = 0.02; P = 0.03). Increased WC also was related to IR and to MS. The presence of steatohepatitis with fibrosis on liver biopsy was associated with overweight (68%) and increase of WC (41%).Conclusions  Body mass index and WC are frequent associated with MS, IR and histological findings (steatohepatitis and fibrosis) in patients with NAFLD.
Confirmation of nasogastric tube position by pH testing
Authors: Taylor S. J. , Clemente R. 
Published: September 2005

AbstractIntroduction  In 2004, the Medicines and Healthcare products Regulatory Agency (MHRA) advised that nasogastric (NG) tube position should be confirmed using pH strips or paper. However, gastric pH is raised by the use of H2‐blockers and proton‐pump inhibitors (PPIs) potentially producing false negative pH tests resulting in delayed feeding. In addition, colorimetric differentiation using pH strips may be more prone to bias and inaccuracy than direct pH measurements largely used to establish the threshold.Method  To quantify this problem a 1 day survey of all the patients requiring NG and nasointestinal (NI) feeding was undertaken, to establish the numbers of patients receiving H2‐Blockers or PPIs, with or without a safe swallow and the methods currently being used to confirm tube positioning. A second observational study was performed to establish the accuracy of six pH strips available to NHS trusts against four unlabelled pH solutions.Results  Forty‐two per cent of patients receiving NG feeding were on H2‐blockers or PPIs, including 13% who had a safe swallow for acidic drinks that could be subsequently aspirated to confirm position. In the second study ‘testers’ correctly identified pH's 3, 4, 5 and 6 with Mackery–Nagel 0–6, BDH 0–6 and 0–14 strips but overestimated pH 4 as pH 5 with Johnson 0–11 paper, underestimated pH 6 as pH 5 with Pehanon 0–12 paper and with Litmus classified pH 3–5 as acid (all), but half also classified pH 6 as acid.Conclusion  Theoretically 29% of NG tube positions could not be confirmed by pH testing because of the usage of PPIs or H2‐blockers and lack of swallow. Some pH strips are either inaccurate or their result misinterpreted by staff. Large surveys and trials of the actual efficacy and accuracy of pH testing are required.
Contribution of foods to trans unsaturated fatty acid intake in a group of Irish adults
Authors: Cantwell M. M. , Flynn M. A. T. , Cronin D. , O'Neill J. P. , Gibney M. J. 
Published: September 2005

AbstractObjective  To assess fat intake with particular focus on trans unsaturated fatty acid (TUFA) intake and the major sources of TUFA among Irish individuals using a Fat Intake Questionnaire (FIQ), designed specifically for an Irish context.Subjects and methods  A total of 105 healthy volunteers (43 females, 62 males; aged 23–63 years) were recruited from Dublin Airport Medical centre, Republic of Ireland. Dietary intake was assessed using an 88 food item/food group semi‐quantitative FIQ, which was developed and validated for the Irish population.Results  Mean energy intake was 10.6 MJ day−1, and 34% was provided by fat. Saturated, monounsaturated, polyunsaturated, trans unsaturated fatty acids and linoleic acid contributed 13%, 10%, 6%, 2% and 5% of energy respectively. Mean TUFA intake was 5.4 g day−1 (range 0.3–26). Margarine spreads provided the majority of TUFAs (1.93 g day−1), but the contribution was significantly greater for men compared with women (2.35 g day−1 versus 1.33 g day−1; P = 0.024). Milk and meat also contributed more to TUFA intake for men compared with women, but confectionery was a significantly greater contributor for women (8.6% versus 3.1% respectively, P = 0.01).Conclusions  Although the mean TUFA intake of the total group was 5.4 g day−1 and was within current dietary recommendations (2% energy intake), some individuals had intakes as high as 26 g day−1. Public health efforts are therefore required to reduce TUFA intake in those individuals with high intakes.
Cytokine responses in immunized and non‐immunized calves after Ostertagia ostertagi infection
Authors: CLAEREBOUT E. , VERCAUTEREN I. , GELDHOF P. , OLBRECHTS A. , ZARLENGA D. S. , GODDEERIS B. M. , VERCRUYSSE J. 
Published: September 2005

SUMMARY The objective of this study was to evaluate abomasal cytokine responses in helminth‐naive calves and calves vaccinated with protective antigen fractions from Ostertagia ostertagi after an experimental challenge infection with infective third stage (L3) larvae. Abomasal lymph nodes and/or abomasal mucosa were collected and messenger RNA for the Th1 cytokines (IFN‐γ, IL‐2, IL‐12 p40 subunit), the Th2 cytokines (IL‐4, IL‐5, IL‐6, IL‐10, IL‐13, IL‐15) and the Th3/Tr cytokine TGF‐β was quantified by real‐time RT‐PCR. Vaccination had no effect on cytokine profiles in either the abomasal lymph nodes or the abomasal mucosa. However, following infection all calves showed a significant decrease in the Th1 cytokines, IFN‐γ and IL‐12 p40, and a significant increase in the Th2 cytokines, IL‐4, IL‐5, IL‐10 and IL‐13 in the lymph nodes, compared to non‐infected calves. No correlation between the Th2 response and protection induced by vaccination could be demonstrated. In contrast, a Th2 pattern was not observed in the mucosa of the infected calves, which exhibited an increase in IFN‐γ as well as in the Th2 cytokines IL‐4, IL‐5 and IL‐10 mRNA. No significant association was observed in the abomasal mucosa between any examined cytokine mRNA level and immune effector responses such as parasite‐specific antibodies or the number of mucosal mast cells or eosinophils.
Leishmania (Viannia) braziliensis: Interaction of mannose‐binding lectin with surface glycoconjugates and complement activation. An antibody‐independent defence mechanism
Authors: AMBROSIO A. R. , DE MESSIAS‐REASON I. J. T. 
Published: September 2005

SUMMARY The activation of complement on the surface of Leishmania promastigotes appears to be an important factor for parasite infectivity in the mammalian host, allowing their attachment and the invasion of macrophages via complement receptors. Mannose‐binding lectin (MBL) is a well‐known complement activator and an efficient opsonine. We have investigated here whether serum and purified MBL bind to and promote lysis of live promastigotes of L. braziliensis; and evaluated the deposition of MBL, C1q, C4 and C3 on the parasite surface after interaction with non‐immune normal human serum (NHS). We observed that both serum MBL and the purified MBL–MASP complex bind to the surface of L. braziliensis and that this binding occurred via the carbohydrate recognition domains of MBL. The binding of MBL, however, did not affect the lytic effect of complement on the parasites. The deposition of C1q, C4, C3 and parasite lysis was observed after incubation with NHS. EDTA but not EGTA abolished C3 deposition on the parasite surface, indicating the involvement of the alternative pathway in this process. Our results indicate that MBL binds to L. braziliensis and that this is mediated by a specific carbohydrate on the surface of parasites and provides evidence for antibody‐independent mechanisms that complement activation on the parasite surface.
Repigmentation of vitiligo with punch grafting and narrow‐band UV‐B (311 nm) – a prospective study
Authors: Lahiri Koushik , Malakar Subrata , Sarma Nilendu , Banerjee Uttam 
Published: September 2005

AbstractBackground  Phototherapy is already established as an effective mode of therapy in vitiligo. An evidence‐based study was carried out of the effect of narrow‐band (311 nm) ultraviolet‐B (NB‐UV‐B) radiation in 66 surgically treated patients with recalcitrant vitiligo in whom autologous mini‐punch grafting was deployed.Methods  A total of 2613 grafts were placed over 108 lesions on 17 regions in 66 individuals (39 females and 27 males) with stable, refractory vitiligo. The age range was 21–48 years. Postsurgically, they were exposed to a suberythemal dose of NB‐UV‐B (311 nm). Different parameters of surgical repigmentation were documented.Results  Successful repigmentation was achieved in 57 (86.36%) cases. The appearance of repigmentation (AOR) time in different regions varied between 14 and 32 days, with an overall average of approximately 20.6 days. Maximum pigment spread (MPS) reached 12 mm with an average of 6.5 mm. The relationship between the donor graft area and area of surgical repigmentation was also calculated. Cobblestoning was the most common (31.8%) complication, but improved with time and/or interference.Conclusions  Punch grafting in combination with phototherapy (NB‐UV‐B, 311 nm) was found to be an easy, safe, inexpensive, and effective method of repigmenting static and stubborn vitiligo. Different facets of punch grafting‐induced and phototherapy‐aided surgical repigmentation were taken into consideration. The area of repigmentation, MPS, and relationship between the donor graft area and area of surgical repigmentation were documented.
Occult hepatitis B in renal transplant patients
Authors: Peres A.A. , Dias E.A. , Chesky M. , Alvares‐da‐Silva M.R. , Jobim L.F. , Gonçalves L.F. , Manfro R.C. 
Published: September 2005

Abstract: Background. Occult hepatitis B (HB) is characterized by the presence of HBV‐DNA in patients who do not have HB surface antigen (HBsAg) detectable in sera, and is frequently described in patients with hepatitis C virus (HCV) infection. These viral liver diseases are common and may have a negative impact on the survival of renal transplant patients, especially if they are both present. In this study we aimed to evaluate the prevalence of occult HB in renal transplant patients either with or without HCV infection.Patients and methods. In a cross‐sectional survey 101 HbsAg‐negative renal transplant patients were evaluated; 51 were anti‐HCV positive. Sera were analyzed for the presence of the S and core genes of the HBV‐DNA by a nested polymerase chain reaction technique. Markers of HBV infection and liver function tests were also analyzed.Results. The core gene was identified in 1 HCV‐infected patient and 1 anti‐HCV‐negative patient who also presented the S gene (prevalence: 2% and 1% for each gene, respectively). HCV‐infected patients had longer pre‐transplant dialysis time (50.8±34.6 vs. 32.0±20.9; P<0.001). Liver function tests were also increased in the HCV‐infected group: alanine aminotransferase (P<0.001), aspartate aminotransferase (P<0.05), γ‐glutamyl transpeptidase (P<0.02), and alkaline phosphatase (P<0.04). Multivariate analysis revealed that HCV infection was the only determinant of the altered results of the liver function tests.Conclusion. We found that occult HB is a condition present in our population of renal transplant patients and that HCV infection does not seem to be associated with occult HB infection in this setting.
Impact of targeted oral ganciclovir prophylaxis for transplant recipients of livers from cytomegalovirus‐seropositive donors
Authors: Shah T. , Lai W.K. , Mutimer D. 
Published: September 2005

Abstract: Objectives. Symptomatic cytomegalovirus (CMV) infection can cause significant morbidity and occasional mortality after liver transplantation. In a previous audit, we showed that donor CMV seropositivity (D+) was a risk factor for symptomatic infection, and we estimated the likely clinical and financial impact of 14 weeks of oral ganciclovir prophylaxis given to recipients of CMV‐seropositive organs. In August 2001, we adopted this policy of targeted oral ganciclovir prophylaxis for recipients of CMV‐seropositive livers.Method. The additional costs of adopting targeted prophylaxis policy for 1 year, patient and doctor compliance with the new strategy, and its clinical impact were analysed.Results. Targeted prophylaxis reduced the incidence of symptomatic CMV infection from 9.5% (in the earlier cohort that did not receive prophylaxis) to 5.8% (P=NS). Symptomatic infection was not observed in CMV‐seropositive recipients of CMV‐seropositive donor livers (P=0.06 for comparison of the 2 cohorts), but the incidence of symptomatic infection in the CMV‐seronegative recipients of CMV‐seropositive organs did not change. However, symptomatic infection appeared to be less severe and was delayed by ganciclovir prophylaxis (median time from transplantation to symptom onset 96 vs. 39 days without prophylaxis). Death attributable to CMV infection was not observed in the cohort that received prophylaxis. The additional cost associated with implementation of the prophylaxis strategy was £108,068.Conclusion. Targeted CMV prophylaxis with oral ganciclovir reduces the incidence and severity of symptomatic infection and appears to be a cost‐effective means of improving outcome following liver transplantation.
Comparing cytomegalovirus prophylaxis in renal transplantation: single center experience
Authors: Varga M. , Remport Á. , Hídvégi M. , Péter A. , Kóbori L. , Telkes G. , Fazakas J. , Gerlei Z. , Sárváry E. , Sulyok B. , Járay J. 
Published: September 2005

Abstract: Background: Cytomegalovirus (CMV) presents a serious threat to CMV‐seronegative recipients (R−), who have received an organ from a seropositive donor (D+).Objectives: We compared the effectiveness of three different prophylactic protocols in CMV D+/R− patients and reviewed data on patients who received no prophylaxis.Patients and methods: We reviewed 1137 kidney transplantations from 1995 to 2004. Of these, 147 recipients were CMV negative (D+/R−); 125 patients received CMV prophylaxis. Group I received CMV hyperimmune gammaglobulin only, group II received CMV hyperimmune gammaglobulin plus oral ganciclovir, and group III received prophylaxis with oral ganciclovir only.Results: In group I, CMV infection was observed in 31 of 53 patients (59%), and CMV disease was diagnosed in 9 (17%) during the prophylaxis. In the first year post transplant, a total of 41 of 53 patients (77.5%) had primary CMV infection. In group II, CMV infection occurred in 7 of 30 patients (23%), and CMV disease was diagnosed in only 2 (7%) during prophylaxis. In the first year post transplant, a total of 9 of 30 patients (30%) had primary CMV infection. In group III, 9 of 42 patients (21%) developed CMV infection during prophylaxis, and CMV disease was not observed. In the first year post transplant, a total of 13 of 42 patients (30%) had primary CMV infection. In contrast, all 22 CMV D+/R− patients without prophylaxis developed CMV infection (100%); CMV disease was diagnosed in 10 (45%), and 1 patient died.Conclusions: Prophylaxis with hyperimmune gammaglobulin and/or oral ganciclovir significantly reduces CMV infection and disease. Prophylaxis with ganciclovir was significantly more effective than hyperimmune gammaglobulin monoprophylaxis, and more cost effective than combined prophylaxis.
Obstructive jaundice increases sensitivity to lipopolysaccharide via TLR4 upregulation: Possible involvement in gut‐derived hepatocyte growth factor‐protection of hepatocytes
Authors: MIYASO HIDEAKI , MORIMOTO YOSHINORI , OZAKI MICHITAKA , HAGA SANAE , SHINOURA SUSUMU , CHODA YASUHIRO , IWAGAKI HIROMI , TANAKA NORIAKI 
Published: September 2005

AbstractBackground:  Patients with obstructive jaundice are prone to sepsis after biliary tract surgery. The present study was designed to determine the effect of biliary obstruction on cytokine responses to lipopolysaccharide (LPS).Methods:  Wister rats were allocated into two groups; the BDL group underwent bile duct ligation, followed 2 weeks later by administration of LPS into the duodenum. The control group underwent sham operation, and similarly received enteral LPS. Specimens were collected serially, and applied for the assays.Results:  Serum aspartate aminotransferase and alanine aminotransferase levels were significantly increased in BDL rats. High tumor necrosis factor alpha (TNF‐α) and interleukin (IL)‐6 levels in peripheral blood were observed 2 h after LPS administration in BDL rats. In contrast, no increases in both cytokines were noted in peripheral and portal blood in control rats. Baseline HGF levels in portal and peripheral blood in BDL rats were significantly higher than in control rats. LPS significantly increased hepatocyte growth factor (HGF) levels in portal blood and decreased in peripheral blood in BDL rats, but not in control rats. Immunohistochemical analysis revealed that BDL increased expressions of Toll‐like receptor (TLR)4, CD14 and CD68 both in the small intestine and liver. Both TLR4 and CD14 mRNAs were upregulated in the small intestine and liver after LPS administration in BDL rats.Conclusion:  Obstructive jaundice and LPS stimulation induced TLR4 upregulation both in the liver and small intestine, which led to increased TNF‐α and IL‐6 production in liver and HGF production in the small intestine. The upregulation of TLR4 may lead to pathological and host defense reactions in obstructive jaundice complicated with Gram‐negative bacterial infection.
Spontaneous bacterial peritonitis in cirrhotic patients: Is prophylactic propranolol therapy beneficial?
Authors: CHOLONGITAS EVANGELOS , PAPATHEODORIDIS GEORGE V , MANESIS EMANUEL K , BURROUGHS ANDREW K , ARCHIMANDRITIS ATHANASIOS J 
Published: September 2005

AbstractBackground and Aim:  It has been suggested that propranolol may have a protective effect on the development of spontaneous bacterial peritonitis by increasing the motility of the bowel and lowering the pressure of the portal vein. The aim of this study is to evaluate the association between the use of propranolol and development of spontaneous bacterial peritonitis in patients with cirrhosis and ascites.Methods:  We retrospectively evaluated 134 patients with cirrhosis and ascites admitted consecutively for a period of 2 years. Diagnosis of spontaneous bacterial peritonitis was based on an ascitic fluid neutrophilic count of >250/mm3 and/or a positive culture without evidence of secondary peritonitis.Results:  Spontaneous bacterial peritonitis was diagnosed in 39 of 134 (29%) patients and 12 of 39 (31%) patients died in hospital compared to only 4% (four of 95) of those without spontaneous bacterial peritonitis (P < 0.001). At admission, patients with spontaneous bacterial peritonitis, as compared to those without, had significantly more encephalopathy (28 vs 11%, P = 0.02) or fever (18 vs 4%, P = 0.01) and less frequently tense ascites (33 vs 57%, P = 0.02). Spontaneous bacterial peritonitis was diagnosed in six of 33 (18%) patients who did and in 33 of 101 (33%) who did not receive propranolol therapy (OR = 0.46, 95% CI: 0.17–1.22, P = 0.17).Conclusion:  Our data indicate that spontaneous bacterial peritonitis significantly increases mortality in patients with cirrhosis. Propranolol therapy was not found to be associated with a significantly lower risk for spontaneous bacterial peritonitis, but a Type II statistical error cannot be definitely excluded. The potential protective effect of propranolol on the incidence of spontaneous bacterial peritonitis might deserve evaluation in properly designed prospective studies.
Curcumin ameliorates acute thioacetamide‐induced hepatotoxicity
Authors: SHAPIRO HAIM , ASHKENAZI MICHAL , WEIZMAN NIR , SHAHMUROV MARK , AEED HUSSEIN , BRUCK RAFAEL 
Published: September 2005

AbstractBackground and Aim: Increased production of reactive oxygen species and nitric oxide and activation of nuclear factor κ B are implicated in the pathogenesis of various liver diseases, including fulminant hepatic failure. Curcumin is a naturally occurring anti‐oxidant that reduces oxidative stress and inhibits nuclear factor κ B and nitric oxide formation. The aim of the present study is to assess curcumin's therapeutic potential in acute thioacetamide hepatotoxicity, a rat model of fulminant hepatic failure.Methods: Fulminant hepatic failure was induced by two intraperitoneal (i.p.) injections of 300 mg/kg thioacetamide (TAA) at 24‐h intervals. The experimental groups received a low‐dose (200 mg/kg per day, i.p.) or a high‐dose (400 mg/kg per day) of curcumin, initiated 48 h prior to the first TAA injection. A fourth group was administered neither TAA nor curcumin and served as a control.Results: The survival rate was higher in both curcumin‐treated groups compared to the TAA only treated group. Biochemical parameters of liver injury, blood ammonia and hepatic necroinflammation were lower in the low‐dose curcumin group compared to TAA controls, and were further reduced in the high‐dose group (P < 0.05 andP < 0.01, respectively). Curcumin treatment also reduced the TAA‐induced elevated hepatic levels of thiobarbituric acid‐reactive substances (TBARS), and inhibited the nuclear binding of nuclear factor κ B (NFκB) and inducible nitric oxide (iNOS) protein expression.Conclusions: Curcumin improved survival and minimized oxidative stress, hepatocellular injury and hepatic necroinflammation, NFκB binding and iNOS expression in a rat model of FHF. These findings support the role of ROS, NFκB and iNOS in mediating liver insult due to TAA, and that of curcumin as a hepato‐protectant.