bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced progression of atherosclerosis in apolipoprotein E‐deficient mice treated with lacidipine is associated with a decreased susceptibility of low‐density lipoprotein to oxidation
Authors: Cristofori Patrizia , Crivellente Federica , Campagnola Mario , Pasini Anna Fratta , Garbin Ulisse , Rigoni Anna , Tosetti Maria , Turton John , Faustinelli Ivo , Cominacini Luciano 
Published: May 2004

SummaryA study has been carried out in the apolipoprotein (apo) E‐deficient mouse to investigate the activity of lacidipine (a calcium antagonist with antioxidant properties) in inhibiting the development of atherosclerotic lesions; of particular interest were changes in the susceptibility of low‐density lipoproteins (LDL) to oxidation. Mice receiving a Western‐type diet to accelerate the development of atherosclerosis were treated orally with vehicle or lacidipine at 3 or 10 mg/kg/day for 8 weeks. Lacidipine treatment (at 3 or 10 mg/kg) had no effect on the plasma lipid profile. However, a significant (P < 0.01) dose‐related reduction of 43 and 50% of the aortic lesion area in respect to vehicle‐treated mice was observed. Moreover, the resistance of mouse plasma LDL to undergo lipid peroxidation was significantly (P < 0.01) increased in apo E‐deficient mice treated with lacidipine. The native LDL‐like particle, derived from apo E‐deficient mice treated with lacidipine, contained significantly lower concentrations of malonyldialdehyde than the vehicle‐treated control group (P < 0.01). After exposure to human umbilical vein endothelial cells, LDL‐like particle vitamin E levels (expressed as area under the curve; AUC), were significantly higher (P < 0.01) in both the 3 and 10 mg/kg lacidipine‐treated groups, in comparison with the vehicle‐treated control animals. We conclude that lacidipine reduced the extent of the atherosclerotic area in hypercholesterolaemic apo E‐deficient mice, and that this reduction may be associated with the capacity of the drug to decrease the susceptibility of LDL to oxidation.
A novel option for dosing of proton pump inhibitors: dispersion of lansoprazole orally disintegrating tablet in water via oral syringe
Authors: Gremse D. A. , Donnelly J. R. , Kukulka M. J. , Lloyd E. , Lee C. 
Published: May 2004

SummaryBackground : A new formulation of lansoprazole, the lansoprazole orally disintegrating tablet, rapidly disintegrates in water eliminating the need for swallowing whole pills.Aim : To assess the effect that dispersing the lansoprazole orally disintegrating tablet in water would have on lansoprazole pharmacokinetics.Methods : Forty healthy adult men and women (18–43 years) received two single 15 mg lansoprazole orally disintegrating tablet doses separated by 3 days (one administered directly onto the tongue without water and one dispersed in water and administered orally via syringe) in a randomized, crossover fashion. Serial plasma samples were determined from 0 to 12 h for each dose. Ratios of central values for peak plasma exposure (Cmax) and mean overall extent of exposure (area under the plasma concentration) were used to compare the bioavailability.Results : The two dosing regimens were bioequivalent, with the point estimate for area under the plasma concentration equalling 1.080 (confidence interval 1.012–1.152) and the point estimate for Cmax equalling 1.082 (confidence interval 0.961–1.218).Conclusions : Dispersing the 15 mg lansoprazole orally disintegrating tablet in water and administering the dose orally via syringe is bioequivalent to the 15 mg intact lansoprazole orally disintegrating tablet with respect to lansoprazole area under the plasma concentration and Cmax. This dosing route provides an additional, convenient dosing option for lansoprazole.
Randomized controlled azathioprine withdrawal after more than two years treatment in Crohn's disease: increased relapse rate the following year
Authors: Vilien M. , Dahlerup J. F. , Munck L. K. , Nørregaard P. , Grønbæk K. , Fallingborg J. 
Published: May 2004

SummaryIntroduction : Azathioprine is effective for maintenance of remission in Crohn's disease, however, duration of efficacy and the dose response relationship has not been fully evaluated.Aims : To investigate whether patients kept in remission by azathioprine treatment for >2 years benefit from further treatment, and to explore dose–response relationship.Patients and methods : In an open 12‐month trial, patients with inactive Crohn's disease after >2 years (median 37 months) of azathioprine treatment were randomized to azathioprine withdrawal or continued treatment. Primary end point was relapse defined as: (i) Crohn's disease activity index rise ≥ 75, and Crohn's disease activity index >150 or (ii) disease activity requiring intervention.Results : Of 29 patients, 28 completed the observation period or relapsed. Eleven of 13 patients (85%) continuing azathioprine remained in remission compared with seven of 15 (47%) observed without azathioprine (P = 0.043). In patients who had been treated with azathioprine >1.60 mg/kg/day the difference was even more pronounced, eight of nine (89%) vs. four of 12 (33%) respectively (P = 0.017).Conclusions : Patients with Crohn's disease in remission after >2 years of continuous azathioprine treatment will benefit from further continued treatment. Further controlled studies with azathioprine doses <2.0 mg/kg/day are needed.
Long‐term effect of Helicobacter pylori eradication on the reversibility of acid secretion in profound hypochlorhydria
Authors: Iijima K. , Sekine H. , Koike T. , Imatani A. , Ohara S. , Shimosegawa T. 
Published: May 2004

SummaryBackground : Although profound hypochlorhydria is considered to be an important risk factor for development of gastric cancer, long‐term effect of Helicobacter pylori eradication on its reversibility remains uncertain.Aim : To clarify the change in acid secretion after eradication in a long‐term follow‐up over 5 years in patients with profound hypochlorhydria.Methods : Twenty‐three H. pylori‐positive patients with hypochlorhydria (<0.6 mmol/10 min) were enrolled prospectively. Assessment of gastrin‐stimulated acid output and histologic evaluation of biopsy specimens were performed prior to, and 1, 7 months after eradication. Subsequently, gastric acid secretion was assessed for long‐term period over 5 years after eradication in 12 patients.Results : Gastric acid secretion was reversed to normal range in nine of 23 patients (39%) at 7 months after eradication. In the long‐term follow‐up, gradual and significant recovery in gastric acid secretion was observed up to 2 years post‐therapy. However, there was no additional increase during the last 3 years of 5‐year follow‐up period, leaving the acid secretory levels subnormal in the majority of the patients.Conclusions : This long‐term follow‐up study suggests that the pathologic process has already progressed to an irreversible stage in the majority of H. pylori‐positive patients with marked body atrophy and profound hypochlorhydria.
Outcome of emergency ERCP for acute cholangitis in patients 90 years of age and older
Authors: Hui C.‐K. , Liu C.‐L. , Lai K.‐C. , Chan S.‐C. , Hu W. H. C. , Wong W.‐M. , Cheung W. W. , Ng M. , Yuen M.‐F. , Chan A. O. , Lo C. M. , Fan S.‐T. , Wong B. C. Y. 
Published: May 2004

SummaryBackground : An increasing proportion of the general population across the Western World now survives to an advanced age. However, there is limited data on the outcome of therapeutic endoscopic retrograde cholangiopancreatography in patients above 90 years of age with severe acute cholangitis.Aim : To determine the relative frequency of postendoscopic retrograde cholangiopancreatography complication in this group of patients.Methods : The postendoscopic retrograde cholangiopancreatography complications related outcome of 64 patients aged 90 years and above (Group 1) with severe acute cholangitis were retrospectively compared with 165 patients under the age of 90 years (Group 2).Results : The postendoscopic retrograde cholangiopancreatography complication rate was 4.7% (three patients) in Group 1 and 7.3% (12 patients) in Group 2. There was no significant difference in the postendoscopic retrograde cholangiopancreatography complication rate between the two groups (P = 0.567). The relative frequency of 30‐day mortality was 7.8% (five patients) in Group 1 and 4.2% (seven patients) in Group 2 (P = 0.227).Conclusion : Urgent biliary decompression with endoscopic retrograde cholangiopancreatography in patients 90 years of age and older with severe acute cholangitis is a safe and effective procedure in the hands of highly skilled endoscopists and is not associated with increased morbidity or mortality even in this group of high risk patients.
Reflection in preregistration nursing curricula
Authors: Nicholl Honor , Higgins Agnes 
Published: May 2004

Background.  The concepts of reflection and reflective practice are increasingly popular themes in the nursing literature. Reflective practice has been advocated as a method for overcoming the divergence between nursing theory and practice, and as a means of articulating and developing knowledge embedded in practice. However, these claims are based more on theoretical debate than research evidence. In common with other regulatory bodies, the Irish regulatory nursing body advocates the need for reflective nurses, and curricula are being adapted to reflect this. These changes are taking place when there is still little guidance on the teaching or assessment of reflective practice. Given the lack of research on the topic and the need for evidence on which to base the teaching of reflective practice, a descriptive exploratory study was undertaken.Aim.  The aim of this paper is to report how a group of nurse teachers perceived and interpreted reflective practice in preregistration nursing curricula in schools of nursing in The Republic of Ireland.Methods.  Data were collected using a postal questionnaire distributed to all schools of nursing involved in the preregistration diploma in nursing (n = 40).Results.  The results indicate variation between institutions in the number of hours allocated to the subject and where reflective practice was included in the curriculum. Emphasis was placed on theoretical models of reflection as opposed to the process or the skills required to become a reflective practitioner. Lecture and group discussion were the dominant teaching methods. Additionally, a number of teachers expressed dissatisfaction with the preparation they had received to teach the subject, and identified some of the challenges they experience when teaching reflective practice.Conclusions.  The results provide a focus for further debate amongst nurse educators involved in implementing reflective practice in the curriculum. The results are limited by a response rate of 50% and by the geographic setting. Further research is needed to substantiate the findings of the study. However, there results do suggest that there is a need to clarify curricular content in relation to reflective practice and prepare nurse tutors for their role in teaching this subject more effectively.
Smoking habits and predictors of continued smoking in patients with acute coronary syndromes
Authors: Attebring Mona From , Hartford Marianne , Hjalmarson Agneta , Caidahl Kenneth , Karlsson Thomas , Herlitz Johan 
Published: May 2004

Background.  Most patients with acute coronary syndrome quit smoking when hospitalized, although several have been found to relapse and resume smoking within 3 months.Aim.  This paper reports a study to identify factors that can predict who will resume smoking after hospitalization for an acute coronary syndrome.Methods.  Patients (n = 1320) below the age of 75 years, admitted to a Swedish university hospital coronary care unit with acute coronary syndromes, between September 1995 and September 1999, were consecutively included. Data were collected from hospital medical records and included information on previous clinical history, former illnesses and smoking. During their hospitalization, an experienced nurse interviewed the patients by using a structured questionnaire to obtain additional information. Patients were followed up 3 months after the discharge. Those who continued to smoke (non‐quitters) were compared with those who had stopped (quitters) with regard to age, sex, medical history, clinical course, and intention to quit. To identify factors independently related to continued smoking, a logistical regression in a formal forward stepwise mode was used.Results.  Of the patients admitted, 33% were current smokers. Three months after discharge, 51% of these patients were still smoking. There were no significant differences in age, gender or marital status between non‐quitters and quitters. In a multivariate analysis, independent predictors of continued smoking were: non‐participation in the heart rehabilitation programme (P = 0·0008); use of sedatives/antidepressants at time of admission (P = 0·001); history of cerebral vascular disease (P = 0·002), history of previous cardiac event (P = 0·01); history of smoking‐related pulmonary disease (P = 0·03) and cigarette consumption at index (P = 0·03).Conclusions.  Smoking patients who do not participate in a heart rehabilitation programme may need extra help with smoking cessation. The findings may provide means of identifying patients in need of special intervention.
Spiritual perspectives, needs and nursing interventions of Christian African–Americans
Authors: Conner Norma E. , Eller Lucille Sanzero 
Published: May 2004

Background. Although the amount of literature on spiritual needs and care has increased, in practice there has been little change in how nurses assess spiritual need. This suggests that not all spiritual needs of patients are being addressed. Based on the assumption that spiritual needs vary by culture, this study focused on one subgroup, namely Christian African–Americans.Aims. The aim of this paper is to report a study examining spiritual perspectives, spiritual needs and desired nursing interventions during hospitalization identified by Christian African–Americans.Methods. A descriptive correlational design was employed. A convenience sample (n = 44) was recruited from three African–American churches. Descriptive statistics were calculated, and one‐wayanovas used to examine spiritual perspectives and spiritual values. Content analysis was used to analyse and summarize qualitative data. Instruments included the Spiritual Perspective Scale (SPS) and two open‐ended questions.Results. The mean age of participants was 56 years (range 19–84). The majority was female (86%); 71% of respondents strongly agreed that they had spiritual needs to be met during hospitalization. Mean score for the SPS was 5·7 (sd = 0·36). Respondents used a total of 103 phrases to describe spiritual needs, based on three dimensions of connectedness: connectedness to God (50 phrases), connectedness to others (37 phrases) and connectedness to self (16 phrases). Desired nursing interventions included: participating in spiritual activities (n = 41); demonstrating caring qualities (n = 27); providing comforting measures (n = 13); providing reassurance (n = 9); recognizing the spiritual caregiver role (n = 7); and incorporating diversity in care (n = 3).Conclusions. The findings provide information for nurses to facilitate development of culturally appropriate spiritual nursing interventions.
Towards a Chinese definition of nursing
Authors: Pang Samantha M.C. , Wong Thomas K.S. , Wang Chun Sheng , Zhang Zhi Jun , Chan Helen Y.L. , Lam Cynthia W.Y. , Chan Kay Lok 
Published: May 2004

Background.  A theory of nursing derived from nurses’ experience can reflect indigenous practice values, which in turn can act as a fertile source of ideas and inventiveness in developing a relevant knowledge base to inform practice. However, systematic study of how Chinese nurses articulate nursing in their everyday practice is lacking.Aim.  The aim of this paper is to describe how Chinese nurses conceptualize the practice of nursing; and to arrive at a definition of nursing based on this common understanding.Method.  A systematic inquiry using a modified version of Van Kaam's controlled explication was designed. In the prescientific phase, 254 written accounts of nurses’ views on nursing as lived in their everyday practice were collected in eight Chinese cities. In the scientific phase, concept analysis based on Aristotle's notion of four causes was adopted to capture the richness of the phrases that explain the multi‐dimensionality of Chinese nurses’ concepts of nursing. This was followed by a survey of 1782 nurses to verify the findings. The most commonly held views were summarized and a Chinese definition of nursing was drafted.Findings.  Nursing in the Chinese sense means to understand the dynamic health status of a person, to verify health concerns dialectically, and to consider interventions with the goal of assisting the person to master the appropriate health knowledge and skills for the attainment of optimal well‐being. The survey findings show that nursing has developed into a professional caring practice in China today. The definition has some similarities with those of Western nurses, but the underpinning epistemic concerns are grounded in the philosophy of traditional Chinese medicine and Eastern ideologies.Conclusion.  The findings provide Chinese nurses with a definition of nursing articulated in their own language. The identification of qing, li, zhi, and xin as its epistemic concerns, and the articulation of the process of nursing as ‘dialectical verification’, provides a perspective for understanding nursing based on Eastern philosophies. The findings can enhance nurses’ engagement in a cross‐cultural dialogue to promote better understanding of nursing as it is practised in different parts of the world.
Glycosphingolipids in Plasmodium falciparum
Authors: Couto Alicia S. , Caffaro Carolina , Uhrig M. Laura , Kimura Emilia , Peres Valnice J. , Merino Emilio F. , Katzin Alejandro M. , Nishioka Masae , Nonami Hiroshi , Erra‐Balsells Rosa 
Published: May 2004

Malaria remains a major health problem especially in tropical and subtropical regions of the world, and therefore developing new antimalarial drugs constitutes an urgent challenge. Lipid metabolism has been attracting a lot of attention as an application for malarial chemotherapeutic purposes in recent years. However, little is known about glycosphingolipid biosynthesis in Plasmodium falciparum. In this report we describe for the first time the presence of an active glucosylceramide synthase in the intraerythrocytic stages of the parasite. Two different experiments, using UDP‐[14C]glucose as donor with ceramides as acceptors, or UDP‐glucose as donor and fluorescent ceramides as acceptors, were performed. In both cases, we found that the parasitic enzyme was able to glycosylate only dihydroceramide. The enzyme activity could be inhibited in vitro with low concentrations of d,l‐threo‐phenyl‐2‐palmitoylamino‐3‐morpholino‐1‐propanol (PPMP). In addition, de novo biosynthesis of glycosphingolipids was shown by metabolic incorporation of [14C]palmitic acid and [14C]glucose in the three intraerythrocytic stages of the parasite. The structure of the ceramide, monohexosylceramide, trihexosylceramide and tetrahexosylceramide fractions was analysed by UV‐MALDI‐TOF mass spectrometry.When PPMP was added to parasite cultures, a correlation between arrest of parasite growth and inhibition of glycosphingolipid biosynthesis was observed. The particular substrate specificity of the malarial glucosylceramide synthase must be added to the already known unique and amazing features of P. falciparum lipid metabolism; therefore this enzyme might represent a new attractive target for malarial chemotherapy.
Effects of white and red wine on endothelial function in subjects with coronary artery disease
Authors: Whelan A. P. , Sutherland W. H. F. , McCormick M. P. , Yeoman D. J. , De Jong S. A. , Williams M. J. A. 
Published: May 2004

Abstract Background : Levels of anti‐oxidant polyphenols are higher in red than in white wine and are thought to contribute to the reduced cardiovascular risk associated with moderate consumption of wine observed in epidemiological studies.Aim : To compare the acute effects of acute ingestion of white and red wine on endothelial function in subjects with coronary artery disease (CAD).Methods : Fourteen subjects with proven CAD were randomised to consume white and red wine with a light meal in a single blind cross‐over study. Flow‐mediated dilatation (FMD) of the brachial artery was measured using high‐resolution ultrasonography. Endothelial function, lipid profile, plasma alcohol and polyphenols were measured at baseline, 60 and 360 min after wine consumption.Results : At baseline, FMD was similar (white wine 1.6 ± 1.9%, red wine 1.8 ± 1.7%). At 360 min after ingestion of wine there was no difference in FMD, which improved nearly threefold after both wines (white wine 4.7 ± 2.2%, red wine 3.4 ± 2.9%; P = 0.002). There was no detectable change in plasma polyphenol levels after either wine.Conclusions : These data suggest that wine acutely improves endothelial function in patients with CAD. This improved endothelial function might contribute to a reduced risk of cardiovascular events. (Intern Med J 2004; 34: 224−228)
Tackling Australia's future health problems: developing strategies to combat sarcopenia − age‐related muscle wasting and weakness
Authors: Lynch G. S. 
Published: May 2004

Abstract Some of the most serious consequences of ageing are its effects on skeletal muscle structure and function. Ageing is associated with a progressive loss of muscle mass (sarcopenia), a slowing of movement, and a decline in strength; factors that increase the risk of injury from sudden falls and a reliance on the frail elderly for assistance in accomplishing even the most basic tasks required for independent living. From a public health perspective, sarcopenia has widespread clinical implications. As the proportion of older persons in the popu­lation continues to grow, sarcopenia will have a dramatic impact on the lives of Australians and place increasing demands on health care. Although it is generally agreed that the deleterious effects of ageing on skeletal muscle are inevitable, debate exists as to whether these intrinsic changes are immutable or reversible. There is clearly a profound need for therapeutic strategies that can slow the effects of ageing on muscle function, and restore muscle size and strength in the frail elderly so that their quality of life can be maintained or improved. Physical activity plays an important role in slowing the effects of ageing, but exercise alone will not prevent the gradual decline in skeletal muscle function. Other factors, such as age‐related changes in circulating levels of muscle anabolic hormones and growth factors, must also be considered when developing strategies to combat sarcopenia. Much research is needed to test the safety and efficacy of these exciting experimental strategies before they can be recommended for clinical application. (Intern Med J 2004; 34: 294−296)
Management of brain metastases
Authors: Lim L. C. , Rosenthal M. A. , Maartens N. , Ryan G. 
Published: May 2004

Abstract Solid tumour brain metastases are a frequent clinical dilemma for oncologists and general physicians. The sound management of brain metastases requires a multidisciplinary approach. In this review we discuss the diagnosis and management of brain metastases including the role of surgery, radiotherapy, and chemotherapy. The standard approaches of surgical excision and primary radiotherapy have evolved from randomised studies. However, controversies remain regarding post‐surgery irradiation in the setting of a solitary metastasis and the role of palliative chemotherapy. (Intern Med J 2004; 34: 270−278)