bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of intravenous immunoglobulin in severe steroid‐dependent asthma
Authors: Haque S. , Boyce N. , Thien F. C. K. , O'Hehir R. E. , Douglass J. 
Published: December 2004

Abstract Background:  Subgroups of asthma patients have extremely severe respiratory symptoms that require chronic use of steroids for disease control. These patients are at risk of significant side‐effects from chronic exposure to high doses of oral steroids. Intra­venous immunoglobulin (IVIG) has immunomodulatory properties as shown by its use in some immune disorders. A few trials have suggested a possible benefit in individuals with severe asthma.Aims:  To evaluate the role of IVIG as an adjunctive therapy in steroid‐dependent asthma, monitoring the outcomes of lung function and measured reduction in oral steroid requirementMethod:  Seven patients with severe steroid‐dependent asthma were given IVIG at a dose of 1 g/kg each month for 6 months. Baseline pulmonary function tests and immunoglobulin levels were obtained. At the end of 6 months, the end‐points observed were lung function and the degree of reduction in the dose of oral steroids. The number of hospital admissions during the 12 months following commencement of IVIG was compared with the preceding 12 months.Results:  There was a significant reduction in daily prednisolone dose from 56 ± 31 mg to 39 ± 35 mg (P = 0.04, Wilcoxon rank sum test) and a decrease in the number of hospital admissions from 5.9 ± 2.9 to 3.6 ± 3.5 (P = 0.04). No significant improvement occurred in lung function.Conclusion:  IVIG provides a potentially important adjunctive therapy in severe steroid‐dependent asthma, reducing steroid requirement and decreasing hospital admissions, but not improving lung function. (Intern Med J 2003; 33: 341−344)
Expectations of the child health nurse in Sweden: two perspectives
Authors: Fägerskiöld A. , Ek A. ‐C. 
Published: December 2004

AbstractBackground: the child health service exists to support and stimulate parents in order to reduce stress and to encourage an advantageous development of the preschool child. Aim: To explore and describe similarities and differences in expectations of the child health nurse, from the perspective of the recently delivered first‐time mother, as compared to an expression of what the child health nurse believed mothers of infants expected of them. The data consisted of 15 interviews with child health nurses and 20 interviews with first‐time mothers. Thematic content analysis resulted in seven categories of expectations. The child health nurse was expected to be someone to approach, who could assess the child's development and give immunizations and to be a supporter, counsellor, safety provider and a parent group organizer with knowledge. Similarities between the mothers’ and the nurses’ statements occurred more frequently than differences, which is suggested to depend on the Swedish tradition among new mothers of visiting the child health clinic. The mothers expected participation in parent groups to a higher degree than the nurses thought they did. Child health nurses who fulfil the mothers’ expectations appear to require a good relationship with the mother in order to find out what she desires, which the allocation of sufficient time for regular meetings, will facilitate. Moreover, the nurse requires knowledge about children's requirements and the transition to motherhood as well as the father's important role.
Cross‐cultural adaptation of the Nordic musculoskeletal questionnaire
Authors: De Barros E. N. C. , Alexandre N. M. C. 
Published: December 2004

AbstractBackground: Reports in the literature have identified a need for internationally standardized and reliable measurements to analyse musculoskeletal symptoms. Screening of musculoskeletal disorders may serve as a diagnostic tool to evaluate the work environment. The Nordic general questionnaire is a standardized instrument used to analyse musculoskeletal symptoms in an ergonomic or occupational health context. Purpose: To translate and adapt a version of the Nordic general questionnaire into Brazilian Portuguese and evaluate its reliability. Method: The cross‐cultural adaptation was performed according to internationally recommended methodology, using the following guidelines: translation; back‐translation; committee review; and pretesting. First, the questionnaire was independently translated into Portuguese by two teachers and one doctor, and a consensus version was generated. Second, two other translators performed a back‐translation independently from one another. This version was then submitted to a committee, consisting of six specialists in the area of knowledge of the instrument, to evaluate its equivalence to the original instrument. The final version was pretested on 20 subjects randomly selected in an outpatient clinic. Reliability was assessed by a test–retest procedure at 1‐day intervals using the Kappa coefficient in a group of 40 subjects. The Kappa agreement values were calculated for each one of the four questions of the questionnaire. The agreement among the same observers was substantial, varying from 0.88 to 1, according to the Kappa values. Results: these demonstrated strong agreement of the instrument, suggesting that the Brazilian version of the ‘Standardized Nordic Questionnaire’ offers substantial reliability.
A1. Evaluation of antioxidant activity of lycopene
Authors: Andreassi M , Stanghellini E , Ettorre A , Di Stefano A , Andreassi L 
Published: December 2004

Cutaneous antioxidant capacity can be strengthened by application of suitable substances to the skin. This has been demonstrated for vitamin E, vitamin C, and melatonin, especially when applied in combination. An evaluation was made of the protective capacity of three emulsions containing: (a) lycopene 0.03% (Lycopersicon esculentum extract); (b) alpha‐tocopherol acetate (0.5%) and ascorbic acid (1%); (c) a mixture of these three substances at the above concentrations.Twenty healthy volunteers of phototype II or III were irradiated with a solar simulator (Multiport solar UV simulator, model 601) on the flexural surface of the forearm, with doses ranging from 20 to 80 mJ/cm2. The products containing antioxidants were applied on areas with similar characteristics which were irradiated after 30 min with the same UV doses. Skin damage was evaluated measuring erythema and transepidermal water loss before UV exposure and after 24 and 48 h. Erythema was measured by tristimulus colourimeter (Chroma meter CR‐200, Minolta) according to our previous experience. The barrier function was evaluated by evaporimeter (Tewameter TM 210, Courage‐Khazaka).The product containing lycopene alone had a protective capacity against UV exposure similar to that of the product containing both alpha‐tocopherol acetate and ascorbic acid. When the three antioxidants were applied in combination the protective capacity was greater, as demonstrated by statistical evaluation.Lycopene exhibits an antioxidant activity which is enhanced when applied in combination with other substances.
Postresuscitation Stunning: Postfibrillatory Myocardial Dysfunction Caused by Reduced Myofilament Ca2+ Responsiveness After Ventricular Fibrillation‐Induced Myocyte Ca2+ Overload
Authors: ZAUGG CHRISTIAN E. , ZIEGLER ANDRÉ , LEE RANDALL J. , BARBOSA VÂNIA , BUSER PETER T. 
Published: December 2004

Postresuscitation Myocardial Stunning.
Introduction: Resuscitation from ventricular fibrillation (VF), particularly from prolonged VF, frequently is complicated by postfibrillatory myocardial dysfunction (postresuscitation stunning). We tested whether this dysfunction can be caused by reduced myofilament Ca2+ responsiveness after VF‐induced myocyte Ca2+ overload. We also tested whether electrical defibrillation shocks contribute to this dysfunction. Methods and Results: Myofilament Ca2+ responsiveness was estimated as ratio of left ventricular developed pressure over myocyte Ca2+ transient amplitudes (assessed as indo‐1 fluorescence) in isolated perfused rat hearts before, during, and after VF (1.5 or 10 min) comparing three modes of defibrillation (biphasic electrical shocks, lidocaine, or spontaneous). We found that, independent of these defibrillation modes, myofilament Ca2+ responsiveness was significantly reduced, particularly after prolonged VF, although hearts were not ischemic or acidotic during and after VF (unchanged coronary flow, myocardial oxygen consumption, and pH of the coronary effluent). This reduction was associated with VF‐induced myocyte Ca2+ overload and increasing or decreasing Ca2+ overload during VF (using 1 μM diltiazem or 6 mM extracellular calcium) led to parallel changes of myofilament Ca2+ responsiveness. However, myofilament Ca2+ responsiveness was not associated with the defibrillation shock energy (range 0.1–15.0 J/g wet heart weight). Conclusion: Postfibrillatory myocardial dysfunction can be caused by reduced myofilament Ca2+ responsiveness after VF‐induced myocyte Ca2+ overload. Electrical defibrillation shocks (up to 15 J/g wet heart weight), however, do not significantly contribute to this dysfunction. Our findings suggest that early additional therapy targeting intracellular Ca2+ overload may normalize myocyte Ca2+ and partially prevent postresuscitation stunning.
Interaction of Implantable Defibrillator Therapy with Angiotensin‐Converting Enzyme Deletion/Insertion Polymorphism
Authors: BEDI MANINDER S. , POSTAVA LISA A. , MURALI SRINIVAS , MACGOWAN GUY A. , MATHIER MICHAEL , MCNAMARA DENNIS M. , LONDON BARRY 
Published: December 2004

Introduction: The angiotensin‐converting enzyme deletion allele (ACE D) decreases survival in patients with advanced heart failure. Whether the adverse impact on survival reflects an increased risk of pump failure or arrhythmic sudden death remains uncertain. If the ACE D genotype increases the risk of sudden death, implantable cardioverter defibrillator (ICD) therapy should diminish its negative impact. We sought to evaluate the effect of ICD therapy on ACE D genetic risk. Methods and Results: The Genetic Risk Assessment of Cardiac Events (GRACE) study enrolled 479 patients at the University of Pittsburgh between 1996 and 2001. Blood was genotyped for the ACE D/I (deletion/insertion) polymorphism. Of the 479 patients, 82 (77% male, 84% Caucasian, age 56 ± 11 years, 60% ischemic, left ventricular ejection fraction 0.23 ± 0.08) received an ICD and were selected for outcomes analysis (mean follow‐up 871 ± 538 days). Transplant‐free survival and survival alone were compared in ACE DD patients (n = 24, 29%) versus ACE DI/II patients (n = 58, 71%). Survival was significantly improved in ACE DI/II patients compared to those without an ICD (1 year: 93% vs 87%; 2 year: 89% vs 77%; P = 0.02) but not in ACE DD patients. Transplant‐free survival among patients with an ICD was significantly worse in ACE DD versus ACE DI/II (1 year: 67% vs 88%, 2 year: 55% vs 80%, P = 0.03). Analysis of survival as a single endpoint revealed a similar result (1 year = 78% vs 94%; 2 year: 72% vs 88%; P = 0.05). ICD telemetry data showed a nonsignificant trend toward fewer individuals with arrhythmias in the ACE‐DD group (46% vs 65%, P = 0.22) Conclusion: ICDs do not diminish the adverse influence of the ACE DD genotype on survival. This finding suggests that mortality in this high‐risk genetic subset of patients is due to progression of heart failure rather than arrhythmic sudden death.
Magnetic Resonance Imaging Findings in Patients with Brugada Syndrome
Authors: PAPAVASSILIU THEANO , WOLPERT CHRISTIAN , FLÜCHTER STEPHAN , SCHIMPF RAINER , NEFF WOLFGANG , HAASE KARL KONSTANTIN , DÜBER CHRISTOPH , BORGGREFE MARTIN 
Published: December 2004

Introduction: Cardiac magnetic resonance imaging (CMR) is a powerful diagnostic tool for evaluating cardiac structure and function. Recently, right ventricular wall‐motion abnormalities were described using electron beam tomography in patients with Brugada syndrome. In the present study, we prospectively evaluated CMR findings in patients with Brugada syndrome compared to matched controls. Methods and Results: CMR was performed on 20 consecutive patients with proven Brugada syndrome. The imaging protocol included breath‐hold dark blood prepared T1‐weighted multislice turbo spin‐echo and gradient‐echo images. Ventricular volumes and dimensions were compared to age‐ and sex‐matched normal volunteers. The right ventricular outflow tract area was significantly enlarged in patients with Brugada syndrome compared to controls (11 vs 9 cm2, P = 0.018). There was a trend to larger right ventricular end‐diastolic and end‐systolic volumes and lower right ventricular ejection fraction in patients with Brugada syndrome compared to controls. However, none of the differences reached significance (P = 0.3, P = 0.08, and P = 0.06, respectively). There was no statistically significant difference in the left ventricular parameters between patients and controls. High intramyocardial T1 signal similar to fat signal was observed in 4 (20%) of the 20 patients compared to none of the controls. Conclusion: The findings support the view that subtle structural changes, such as right ventricular outflow tract dilation may point to a localized arrhythmogenic substrate in patients with Brugada syndrome.
Clinical Assessment of Antiarrhythmic Agents for Paroxysmal Atrial Fibrillation Guided by Modification of Electrophysiologic Arrhythmogenicity
Authors: SASANO TETSUO , OKISHIGE KAORU , AZEGAMI KOUJI , ISOBE MITSUAKI 
Published: December 2004

Introduction: Rapid atrial pacing alters atrial electrophysiology, promoting initiation and maintenance of atrial fibrillation (AF). The aim of this study was to assess differences in the electrophysiologic properties of atrial tissue between patients with and without AF episodes and to determine whether electrophysiologic properties can predict the clinical efficacy of antiarrhythmic agents. Methods and Results: Sixty patients were studied, 33 with documented episodes of paroxysmal atrial fibrillation (PAF) and 27 control patients. Atrial effective refractory period (AERP), atrial vulnerability, and intra‐atrial conduction time were measured at baseline and after rapid constant atrial pacing for 5 minutes at rates of 130, 150, 170, and 190 beats/min. The clinical efficacy of antiarrhythmic agents for PAF prophylaxis was assessed over 14 months with an antiarrhythmic agent identical to that administered intravenously, and the antiarrhythmic agent effects on AERP, atrial vulnerability, and intra‐atrial conduction time were assessed. AERP shortening and atrial vulnerability increase were significantly larger in the PAF group. Antiarrhythmic agents that were clinically effective in suppressing PAF significantly attenuated AERP shortening, but antiarrhythmic agents that were clinically ineffective did not. Conclusion: Changes in AERP and atrial vulnerability observed after rapid atrial pacing are considered indicative of the electrophysiologic substrate of PAF. Attenuation of AERP and atrial vulnerability by antiarrhythmic agents might be useful in predicting their clinical efficacy.
Effects of Ablation, Digitalis, and Beta‐Blocker on Dual Atrioventricular Nodal Pathways and Conduction During Atrial Fibrillation
Authors: HEGBOM FINN , ORNING OTTO M. , HELDAL MAGNUS , GJESDAL KNUT 
Published: December 2004

Introduction: Modification of AV nodal conduction by radiofrequency ablation (RFA) results in a variable reduction in heart rate during atrial fibrillation (AF). Using AF induced in patients with dual AV nodal pathways as a model, we tested the effect of additional treatment with digitalis (ouabain) and beta‐blocker (esmolol). Methods and Results: Ten patients were randomized to control (group I) and studied only before ablation. AF was induced in 30 patients before and after slow pathway ablation (group II). Mean ventricular cycle lengths (AF CLmean) were recorded. Slow pathway conduction was eliminated after ablation in 10 patients (group IIA), whereas slow pathway conduction was still present in 20 patients (group IIB). Compared to pre‐RFA there was a 10% increase in AF CLmean post‐RFA (P < 0.01). During isoproterenol infusion the increase was 8% (P = NS). Adding digitalis and beta‐blocker during isoproterenol infusion increased AF CLmean by 75% (95% in group IIA) compared to 36% in group I (P < 0.001 II vs I). Conclusion: Slow pathway ablation reduces ventricular rate during AF. Addition of digitalis and beta‐blocker during isoproterenol infusion significantly decreases ventricular rate after ablation compared to the control group. The finding suggests that beta‐blocker has significant effects on fast AV nodal pathway conduction during induced AF with isoproterenol infusion.
Early Morphologic Changes Following Microwave Endocardial Ablation for Treatment of Chronic Atrial Fibrillation During Mitral Valve Surgery
Authors: CLIMENT VICENTE , HURLÉ AQUILINO , HO SIEW YEN , SÁENZ‐SANTAMARÍA JAVIER , NOGALES AGUSTÍN G. , SÁNCHEZ‐QUINTANA DAMIÁN 
Published: December 2004

Introduction: The aim of this study was to investigate the early qualitative and quantitative structural changes in the left atrial wall after endocardial microwave ablation in patients with chronic atrial fibrillation (AF) undergoing mitral surgery. Methods and Results: Seven patients with chronic AF of for at least 6 months underwent surgical microwave energy ablation. Linear isolation of pulmonary veins was performed in all patients by microwave energy applications to the endocardial surface delivered by catheter at 65‐W constant power for 45 seconds. Biopsies were obtained from a selected site (below the right lower pulmonary vein) of the left atrial posterior wall before and after the ablation procedure in all patients. Control tissues from the same sites were obtained at autopsy from patients with noncardiac causes of death. Light and electron microscopy was used to examine qualitative and quantitative changes in tissue morphology. Tissues after endocardial ablation procedure showed significantly increased loss of contractile material. Electron microscopy of atrial tissue demonstrated loss of profile of perinuclear and plasma membranes of myocytes, disruption of the endothelial cells of capillary vessels, and presence of macrophages. Conclusion: Lesions created by endocardial microwave energy ablation revealed a transmural effect on the left atrial wall without a significant reduction in thickness but a significant increase in the myolytic areas involving the entire cytosol and occlusion of the small intramyocardial vessels within the ablative lesion.
The Future of the Stability and Growth Pact
Authors: Bishop Graham 
Published: December 2004

Books reviewed in this article:Anne Brunila, Marco Buti and Daniele Franco (eds), The Stability and Growth Pact: The Architecture of Fiscal Policy in EMUMarco Buti, Jurgen von Hagen and Carlos Martinez‐Mongay (eds), The Behaviour of Fiscal Authorities: Stabilization, Growth and InstitutionsMarco Buti and Andre Sapir (eds), EMU and Economic Policy in Europe: The Challenge of the Early YearsSylvester C. Eijffinger and Jakob de Haan, European Monetary and Fiscal Policy
The onward sweep of social capital: causes and consequences for understanding cities, communities and urban movements
Authors: Mayer Margit 
Published: December 2004

This article examines the way ‘social capital’ has been deployed by researchers and practitioners in the field of urban movements and community development. It reveals the powerful and in many ways effective role the concept is playing in framing the contemporary reconfigurations of local state‐society relations which impact especially on the trajectory of third or voluntary sector development. The article identifies the gaps and weaknesses the ‘social capital’ perspective responds to, thereby explaining why it looms so large within the urban development discourse. Its own blind spots and ambiguities, however, limit our understanding of contemporary urban change. By prioritizing specific forms of civic engagement (and neglecting others), the concept filters the contemporary reconfigurations in the relationship of civil society, state and market in a peculiar way, which is conducive to supporting the spread of market forces to areas so far beyond the reach of capital. By directing attention to the self‐activation potential of different communities, whether in the form of civic engagement of well‐to‐do volunteers or in the form of activation/reinsertion (into the low‐wage labour market) of the marginalized, this new discourse plays a crucial role not only in current efforts to unburden the local (welfare) state, but also in the expansion of market forces into new areas.L'article examine comment les chercheurs et spécialistes ont fait usage du ‘capital social’ dans le domaine des mouvements urbains et de l'évolution des communautés. Il dévoile le rô le dynamique et, par bien des aspects, efficace que ce concept joue en structurant les reconfigurations contemporaines des relations société‐gouvernement local, lesquelles influent notamment sur les tendances du secteur associatif ou du bénévolat. L'article identifie les lacunes et faiblesses que comble la perspective du ‘capital social’, expliquant ainsi les raisons de son omniprésence dans la rhétorique de l'urbanisme. Ses propres faiblesses et ambiguïtés limitent toutefois notre compréhension du changement urbain contemporain. En mettant en avant des formes spécifiques d'engagement civique (et en en négligeant d'autres), le concept dégage les reconfigurations modernes qui interviennent sur la relation entre société civile, É tat et marché, et ce d'une manière particulière qui contribue à la propagation des forces du marché dans des zones jusqu'alors inaccessibles au capital. En s'intéressant au potentiel d'auto‐activation de diverses communautés, que ce soit sous la forme d'un engagement civique de nantis volontaires ou de l'activation ou la réinsertion (sur le marché du travail des bas salaires) des marginaux, ce nouveau discours est essentiel, non seulement dans le cadre des efforts actuels visant à soulager l'É tat (providence) local, mais aussi dans l'expansion des forces du marché vers des zones nouvelles.
From ‘Talking Shop’ to ‘Working Parliament’? The European Parliament and Agricultural Change
Authors: Roederer‐Rynning Christilla 
Published: December 2004

AbstractStudies of agricultural change in the EU have disregarded the European Parliament on the grounds that it enjoys limited formal policy‐making prerogatives in this domain. Contrary to perceptions of parliamentary powerlessness, it is argued here that European Parliament committees can steer change by manipulating the formal institutional parameters defining their actions. The analysis shows how shifting patterns of farm politics in the last 15 years have enabled the European Parliament to promote key public concerns on the EU farm agenda. It fits one more piece into the puzzle of agricultural change by shedding light on the work of parliamentary committees.