bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extinction of a Species of Land Snail Due to Infection with a Microsporidian Parasite
Authors: Cunningham Andrew A. , Daszak Peter 
Published: March 2003

Snails of the genus Partula are highly endangered, with many species occurring solely in captivity. Captive populations experience periodic crashes, some of which have resulted in extinction. Pathologic investigations of the last individuals of a species that had undergone such a crash (Partula turgida) showed infection with a protozoan parasite as the cause of death. The parasite was identified as a member of the microsporidian genus Steinhausia, other members of which are known to cause mortality in aquatic pulmonate snails. We believe this is the first definitive report of an infectious disease causing the extinction of a species. Extinción de una especie de Caracol Terrestre Debido a una Infección por un Parásito Microsporidio Los caracoles del género Partula estan altamente amenazados junto con muchas especies existiendo únicamente en cautividad. Las poblaciones cautivas experimentan colapsos periódicos, algunos de los cuales han resultado en extinciones. Investigaciones patológicas de los últimos individuos de una especie que ha pasado por este tipo de colapso (Partula turgida) muestran infecciones de un protozoario parásito como la causa de su muerte. El parásito ha sido identificado como un miembro del género Steinhausia, otros miembros de este género han sido identificados como los causantes de mortalidades en caracoles pulmonados acuáticos. Creemos que este es un reporte definitivo de una enfermedad infecciosa causante de la extinción de una especie.
Are Breastfeeding Problems Related to Incorrect Breastfeeding Technique and the Use of Pacifiers and Bottles?
Authors: Righard Lennart 
Published: March 2003

Background:In Western countries during the 1960s and 1970s, sore nipples and insufficient milk were common problems that made it hard for mothers to maintain breastfeeding for long. This study investigated the relationship of breastfeeding problems to nursing behavior and pacifier use.Methods:Fifty‐two healthy mother‐infant pairs with breastfeeding problems were referred for observation of nursing behavior to a breastfeeding clinic at the Department of Pediatrics of Malmö General Hospital, Malmö, Sweden, from August 1987 to July 1989. The infants ranged in age from 1 to 17 weeks. A faulty nursing pattern was corrected as necessary. Forty mother‐infant pairs with no breastfeeding problems provided a control group.Results:In most cases the nursing problems were related to incorrect sucking technique. The difference in technique of the study group compared with the control group was significant (p= 0.0001). The continuation of breastfeeding was poorer if the infant already had become used to bottle‐feeding. Pacifier use was more common in conjunction with breastfeeding problems and in cases with a faulty superficial nipple‐sucking technique.Conclusion:Breastfeeding problems may be prevented by the adoption of hospital routines that do not interfere with the start of breastfeeding and by the avoidance of extensive use of pacifiers. (BIRTH 25:1, March, 1998)
U.S. Trends in Obstetric Procedures, 1990–2000
Authors: Jean Kozak Lola , Dawson Weeks Julie 
Published: March 2003

ABSTRACT: Background: During the 1980s the rate of obstetric procedures performed during delivery rose precipitously. This study follows the use of obstetric procedures through the 1990s to explore whether the patterns witnessed in the previous decade continued through the next.Methods: Data on total obstetric procedures and eight specific procedures (cesarean section, medical and surgical induction of labor, other artificial rupture of membranes, episiotomy, repair of current obstetric laceration, vacuum extraction, forceps delivery) were obtained from the National Hospital Discharge Survey, a nationally representative survey of discharges from short‐stay non‐Federal hospitals. Approximately 32,000 records for women with deliveries were included in the survey each year.Results: The total rate of all obstetric procedures did not change significantly from 1990 through 2000. However, as during the 1980s, rates increased for induction of labor, vacuum extraction, and repair of current obstetric laceration. Rates decreased for forceps delivery and episiotomy, also continuing 1980s trends. After a long period of increase, the rate of cesarean section declined from 1988 to 1995 but increased again from 1995 to 2000.Conclusions: Unlike the 1980s, the overall rate of obstetric procedures did not increase from 1990 to 2000, but the mix of obstetric procedures performed continued to change during this period. (BIRTH 29:3 September2002)
Parent Visiting and Participation in Infant Caregiving Activities in a Neonatal Unit
Authors: Franck Linda S. , Spencer Caroline 
Published: March 2003

ABSTRACT: Background: Active parent involvement in caring for their infants in the neonatal care unit is thought to improve parent‐infant attachment and to moderate the psychological stress for parents, but few recent studies have examined parent visiting patterns and participation in infant caregiving. The study purposes were to describe the frequency and duration of parent visiting and participation in infant caregiving activities, and to identify parent and infant factors associated with parental participation.Methods: Parental visiting frequency, duration, and participation in social, cleaning, and feeding activities with their infant (n=110) were recorded on 12 days during a 3‐month period in a tertiary neonatal unit.Results: Mothers visited more frequently (85% vs 45% of possible days) and for longer than fathers, and visited less frequently if the infant had other siblings, if the infant was over age 1 month, or if fathers made fewer visits. Fathers visited less frequently if the infant was over age 7 days and more frequently if the mothers visited more frequently. All mothers and most (96%) fathers carried out social activities, such as talking, stroking or holding, during their visits. Over 75 percent of mothers engaged in infant cleaning and feeding activities during visits in contrast with less than 20 percent of fathers. Mothers’ participation in infant feeding was best predicted by the duration of their visit and their participation in infant cleaning. Fathers’ participation in infant feeding was only related to their participation in infant cleaning.Conclusions: Significant differences were found in this neonatal unit between mothers’ and fathers’ visiting patterns and infant caregiving activities. Neonatal unit staff should consider factors that may influence parental visiting and explore strategies to improve parental involvement in caregiving. (BIRTH 30:1 March 2003)
Performance of a Rapid Whole Blood Test for Helicobacter pylori in Primary Care: A German Multicenter Study
Authors: Hackelsberger Andreas , Schultze Viola , Peitz Ulrich , Günther Thomas , Nilius Manfred , Diete Ulf , Schumacher Michael , Roessner Albert , Malfertheiner Peter 
Published: March 2003

Background.Serological rapid whole‐blood tests for the detection of H. pylori are presently being promoted for use in primary care. We conducted a multi‐center study to investigate the diagnostic accuracy of the Boehringer Mannheim Helicobacter pylori® test (BM test), which is identical with the Cortecs Helisal® test.Patients and Methods.A previous diagnosis of H. pylori, a history of peptic ulcer diseases, or proton‐pump inhibitor, bismuth or antibiotic use during the preceding month were exclusion criteria. The BM test was performed prior to endoscopy by 7 primary care physicians, 5 practicing gastroenterologists, or a single physician in the university hospital outpatient service. During endoscopy, antral and corpus biopsies were obtained for histology and rapid urease testing (RUT). H. pylori positivity was defined by histology and/or RUT as reference methods. H. pylori IgG‐ELISA was performed additionally.Results.Of the 203 patients included, 151 were H. pylori‐positive by reference methods (74.4%). The overall accuracy of the BM test was 77.3%. Eight BM tests were indeterminate, and in the other 195 patients the test performed as follows: sensitivity 80.3%, specificity 81.3%, positive predictive value 92.9%, negative predictive value 57.4%. Using IgG‐ELISA as reference, the BM test performance was similar. It also did not differ substantially among the three groups of physicians involved.Conclusions.We found the performance of the BM test to be insufficiently accurate, as both over‐ and underdiagnosis of H. pylori infection were not infrequent. This test needs to be improved before its use in primary care can be recommended.
High Dose Omeprazole Plus Amoxicillin and Azithromycin in Eradication of Helicobacter pylori in Duodenal Ulcers
Authors: Vc˘ev~ Aleksandar , Štimac Davor , Vc˘eva Andrijana , Takac˘ Boris , Pezerovíc Davorin , Ivandíc Ante 
Published: March 2003

Background.The aim of our study was to establish whether one‐week triple therapy regimen (omeprazole, amoxicillin, azithromycin) with low dose (2 × 20 mg/day) or high dose omeprazole (2 × 40 mg/day) is more effective in curing H. pylori infection in patients with active duodenal ulcer disease.Methods.One hundred and twenty patients with duodenal ulcer and H. pylori infection were treated with amoxicillin 2 × 1000 mg/day for the first 7 days plus azithromycin 500 mg/day for the first 6 days. Patients were randomly assigned to receive either omeprazole 2 × 20 mg/day for the first 7 days (group A; n = 60) or omeprazole 2 × 40 mg/day for the first 7 days (group B; n = 60). After 7 days all patients in both groups continued treatment with omeprazole (40 mg/day (days 8–14) and 20 mg/day (days 15–28)). H. pylori status was determined by urease test and histology before the treatment and 4 weeks after cessation of any medication.Results.One hundred and thirteen patients completed the study. H. pylori infection was eradicated in 73.2%[41/56] of patients in group A (intention‐to‐treat [ITT] analysis: 68.3%; 95% CI: 58.6–80.4%) vs. 82.5%[47/57] of patients in group B (ITT analysis: 78.3%; 95% CI: 67.8–87.9%; NS). All ulcers had healed after 4 weeks of omeprazole treatment. Side effects, usually minor, were recorded in 12.5% (group A) and in 14% (group B) of patients (NS), but therapy was discontinued for only one patient in group B (NS).Conclusion.There was no statistically significant difference between one‐week triple therapy regimen (omeprazole, amoxicillin, azithromycin) with high dose omeprazole (2 × 40 mg/day) and regimen with low dose omeprazole (2 × 20 mg/day) in curing H. pylori infection in patients with active duodenal ulcer disease.
Discrepancy Between Polymerase Chain Reaction Assay and Western Blot Analysis in the Assessment of CagA Status in Dyspeptic Patients
Authors: Paoluzi Omero Alessandro , Rossi Pina , Montesano Carla , Bernardi Sabrina , Carnieri Emanuela , Marchione Orazio Paolo , Nardi Francesco , Iacopini Federico , Pica Roberta , Paoluzi Paolo 
Published: March 2003

AbstractBackground.Infection with CagA‐positive Helicobacter pylori may be diagnosed by detecting cagA gene by polymerase chain reaction assay (PCR) or serum antibodies against CagA by Western blot analysis. The aim of this study is to evaluate whether results of PCR and Western blot analysis are in agreement in CagA status assessment.Patients and methods.Thirty‐six dyspeptic patients with unknown H. pylori status underwent upper gastrointestinal endoscopy to assess the presence of mucosal lesions and to collect six gastric biopsies (three from the antrum and three from the body) for evaluation of H. pylori infection (rapid urease test, histology and PCR for ureA gene) and gastritis. CagA status was assessed by PCR (cagA gene) on two biopsy specimens and by Western blot analysis of serum (CagA‐antibodies) in each patient.Results.At endoscopy, nine patients showed normal mucosa, 15 a duodenal ulcer and 12 antral erosions. Twenty‐eight patients were found to be H. pylori‐positive and eight H. pylori‐negative. Of the 28 H. pylori‐positive patients, 17 were CagA‐positive and five were CagA‐negative by both methods, five were CagA‐positive by Western blot analysis but not by PCR and one was CagA‐positive by PCR but not by Western blot analysis. Of the eight H. pylori‐negative patients, none was CagA‐positive by PCR, while six were CagA‐positive by Western blot analysis. Therefore, the two tests agreed in only 24 patients (67%). In those patients in whom the PCR and Western blot analysis were not in agreement, the histological features appear to suggest that the results of the Western blot analysis should be considered false positives or false negatives.Conclusions.PCR and Western blot analysis failed to provide comparable data in many cases. Western blot analysis seems to be more likely to give misleading results than PCR. Thus, PCR seems to be the method of choice to assess CagA status.
cag Pathogenicity Island of Helicobacter pylori in Korean Children
Authors: Ko Jae Sung , Seo Jeong Kee 
Published: March 2003

AbstractBackground. cag pathogenicity island is reported to be a major virulence factor of Helicobacter pylori. The aim of this study was to investigate the status of cag pathogenicity island genes and gastric histology in Korean children with H. pylori gastritis.Methods. Helicobacter pylori DNA was extracted from antral biopsy specimens from 25 children with H. pylori gastritis. Specific polymerase chain reaction assays were used for four genes of cag pathogenicity island. The features of gastritis were scored in accordance with the updated Sydney System.Results. cagA was present in 23 (92%) of 25 children, and cagE in 24 (96%). Twenty‐two (88%) children were cagT positive and 19 (76%) virD4 positive. All of the selected genes of the cag pathogenicity island were present in 17 (68%) children and completely deleted in one child. There were no differences in neutrophil activity and chronic inflammation between children infected with intact cag pathogenicity island strains and those with partially or totally deleted‐cag pathogenicity island strains.Conclusion. cag pathogenicity island is not a uniform, conserved entity in Korea. Completeness of cag pathogenicity island may not be the major factor to determine the severity of H. pylori gastritis in children.
Impact of Helicobacter pylori on the Development of Vitamin B12 Deficiency in the Absence of Gastric Atrophy
Authors: Serin Ender , Gümürdülü Yüksel , Özer Birol , Kayaselçuk Fazilet , Yilmaz Ugur , Koçak Rikkat 
Published: March 2003

AbstractBackground. Cobalamin (vitamin B12) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B12.Materials and Methods. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pylori‐infected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed.Results. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B12 level (p < .01) on univariate analysis. Only H. pylori density was significantly associated with B12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status (p < .001).Conclusion. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with nonulcer dyspepsia and minimal or no gastric atrophy.
Helicobacter pylori and nonmalignant disease
Authors: Moayyedi Paul , Malfertheiner Peter 
Published: March 2003

Abstract Helicobacter pylori eradication has become the recognized standard and widely adopted therapy to cure peptic ulcer disease. Other H. pylori associated conditions with potential benefit from eradication therapy are still subject to clinical investigations. The current state of evidence for these indications is summarized in this article.For NSAID associated peptic ulcer disease the current evidence needs to be grouped in three subsets of clinical conditions: a) H. pylori eradication for prevention of ulcers before starting NSAIDs therapy is advisable; b) eradication during PPI treatment for NSAID associated active ulcer shows no advantage on healing; and c) eradication alone is not sufficient for secondary prevention of ulcer complications induced by NSAID, however it appears to protect from further episodes of aspirin induced bleeding.In nonulcer dyspepsia the latest Cochrane collaboration review supports a small benefit in favour of H. pylori eradication.New insight in the relationship of H. pylori with GERD is provided from clinical trials which show that H. pylori eradication does not influence the clinical course of patients with reflux esophagitis.Finally important new data are presented regarding the management of dyspepsia at the primary care level with the confirmation that the H. pylori‘test and treat’ strategy in the appropriate setting is more cost‐effective than endoscopy.
Influence of Culture on Cancer Pain Management in Hispanic Patients
Authors: Juarez Gloria , Ferrell Betty , Borneman Tami 
Published: March 2003

PURPOSE: The purpose of this pilot study was to describe the influence of culture on cancer pain management in Hispanic (Mexican and Central American) patients. DESCRIPTION OF STUDY: This qualitative study is guided by the conceptual framework of the Pain and Quality of Life model and the Biocultural Model of Pain. It was developed as a companion study to a National Cancer Institute (NCI)‐funded project to disseminate a pain education program for adult patients with cancer and their family care givers in community home‐care agencies. After completing the NCI study, Hispanic subjects were invited to participate in the qualitative companion study. A total of 17 subjects, the majority of whom were women, were interviewed. The Hispanic Pain Experience Questionnaire (HPEQ) was used to elicit answers to open‐ended questions regarding the perception and management of cancer pain. RESULTS: Themes that emerged from the questionnaire were Influence of Culture, Expressions of Pain, Managing Pain/Medications, and Use of Nondrug Interventions. Responses suggest that culture, family beliefs, and religion contribute significantly to management and expression of pain by the patient and care giver. In addition, this group showed that pain may be approached with stoicism; therefore, lack of verbal or behavioral expression of pain does not indicate a lack of pain itself. These patients also demonstrated a reliance on folk beliefs and nondrug interventions. The most common reason cited for noncompliance with pharmacologic treatment was an inability to understand instructions. CLINICAL IMPLICATIONS: When providing care to Hispanic patients, it is imperative to be nonjudgmental, sensitive, and respectful. To improve compliance, the multidisciplinary cancer team should 1) incorporate the patients' folk healthcare practices and beliefs into the plan of care when possible; 2) involve family members and friends in the patient's care, identifying one key family contact; and 3) ensure that instructions for medications are available in Spanish and understood by the patient and care giver. When patients' overall beliefs and values are respected, compliance with pharmacological and other interventions may increase accordingly.
A Multidimensional Measure of Fatigue for Use with Cancer Patients
Authors: Stein Kevin D. , Martin Staci C. , Hann Danette M. , Jacobsen Paul B. 
Published: March 2003

purpose
: The purpose of this study was to develop and validate a multidimensional measure of fatigue for use with cancer patients.
description of study
: Items for the Multidimensional Fatigue Symptom Inventory (MFSI) were generated through literature review, discussion with healthcare providers,and a survey of currently available measures of fatigue. The 83‐item MFSI was designed to assess global, somatic, affective, cognitive, and behavioral symptoms of fatigue. The instrument was administered on three occasions to 275 women who had received or were undergoing treatment for breast cancer and 70 women with no history of cancer. Reliability, validity, and factorialstructure of the MFSI were analyzed.
results
: The factor analysis produced five empirically derived scales that correspond generally to the five rationally derived scales. Reliability of the rationally and empirically derived scales was excellent (alpha coefficients .87 to .96). Estimates of test‐retest reliability were also favorable. Other results support the validity of both the rationally and empirically derived scales. The MFSI appears to be sensitive to fatigue, accurately discriminating cancer patients from control subjects and between patients with varying levels of performance status.
clinical implications
: The MFSI may be useful in identifying patterns of fatigue within individual patients and across treatment modalities. Such specificity may allow the clinician to develop, implement, and evaluate interventions that are targeted for differing patterns of fatigue. Because the measure is keyed to a 1‐week time frame, it may be useful during the course of cancer treatment. The MFSI appears to be a valid and reliable tool to assess the full spectrum of symptoms that characterize the construct of fatigue.
Cross‐Cultural Issues in the Disclosure of Cancer
Authors: Mitchell Jill L. 
Published: March 2003

purpose
: To increase awareness of cultural differences in the disclosure of a cancer diagnosis or prognosis, the author reviews several surveys of patients and physicians from around the world.
overview
: The Western medical community is increasingly emphasizing full truthful dislosure of cancer diagnoses or prognoses and respect for autonomy as necessary prerequisites to ethical practice. However, surveys of European, Japanese, Native American, and various ethnic American (including Korean, Chinese, Mexican, Hispanic, African, and European American) cancer patients and physicians reveal that many cultures consider complete and accurate disclosure of cancer undesirable. Cultural differences in the rates of disclosure of a cancer diagnosis or prognosis; the physician's use of euphemisms to give a true or false diagnosis; as well as considerations of how to disclose a cancer diagnosis are described.
clinical implications
: Developing an awareness about cross‐cultural practices regarding cancer disclosure issues allows the clinician to become more sensitive to the expectations of culturally and individually diverse cancer patients. To this end, all healthcare professionals should be informed about how the patient would like to be informed of a diagnosis and how involved he or she would like family members to be. In addition, an awareness of the use of nonverbal communication in some cultures and the psychosocial impact of certain terms, such as “cancer,” is essential. Often, phrases such as “ malignant tumor” or “growth” are less inflammatory and are more readily accepted. In ascertaining a knowledge of various cultural preferences and developing a sensitivity to these preferences, clinicians are better able to provide effective care to individuals from a variety of cultural and individual backgrounds.