bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanisms and management of diuretic resistance in congestive heart failure
Authors: De Bruyne L K M 
Published: June 2003

Abstract
Diuretic drugs are used almost universally in patients with congestive heart failure, most frequently the potent loop diuretics. Despite their unproven effect on survival, their indisputable efficacy in relieving congestive symptoms makes them first line therapy for most patients. In the treatment of more advanced stages of heart failure diuretics may fail to control salt and water retention despite the use of appropriate doses. Diuretic resistance may be caused by decreased renal function and reduced and delayed peak concentrations of loop diuretics in the tubular fluid, but it can also be observed in the absence of these pharmacokinetic abnormalities. When the effect of a short acting diuretic has worn off, postdiuretic salt retention will occur during the rest of the day. Chronic treatment with a loop diuretic results in compensatory hypertrophy of epithelial cells downstream from the thick ascending limb and consequently its diuretic effect will be blunted. Strategies to overcome diuretic resistance include restriction of sodium intake, changes in dose, changes in timing, and combination diuretic therapy.
Paediatric tuberculosis
Authors: Hoskyns W 
Published: June 2003

Abstract
Children are important in the epidemiology of tuberculosis as a marker of recent disease transmission and a reservoir for the future. Once infected they have a higher risk of progressing to tuberculous disease. Chest radiography and tuberculin testing with or without tissue for culture are still the standard tools for confirming the diagnosis once this is considered. Well researched treatment protocols are available but multidrug resistant tuberculosis and coexistent HIV are a challenge. Ensuring compliance with treatment is a major concern. Controversy still surrounds the place of BCG. Advances in the molecular genetics of tuberculosis hold out the possibility of better vaccines.
Feasibility and safety of day care laparoscopic cholecystectomy in a developing country
Authors: Bal S , Reddy L G S , Parshad R , Guleria R , Kashyap L 
Published: June 2003

Abstract

Background
Although day care laparoscopic cholecystectomy (DCLC) has been shown to be safe in centres with adequate infrastructure for day care surgery, its feasibility and safety in developing countries has never been studied. Because of differences in the quality of health care delivery, western guidelines for day care surgery cannot be universally applied to developing countries.

Patients and methods
Patients less than 65 years who were graded I and II on the American Society of Anesthesiologists physical status score, irrespective of their educational status, living within 20 km, and willing to make their own arrangements for a return to hospital in case of problems were selected for DCLC. Follow up was done by patients calling the hospital the morning after surgery.

Results
50% of the eligibility criteria were new; 313/383 patients were suitable for DCLC. The commonest cause for rejection was that the patient lived out of the defined area (50%). Altogether 92% were discharged within eight hours of surgery. The reasons for failure to discharge were the presence of abdominal drains in four (2%), nausea and vomiting in nine (3%), and conversion to open surgery in five (2%). Ten patients (3%) were readmitted; of these only two (&lt;1%) had complications needing re-exploration. Analysis of results showed that the inclusion and discharge criteria were valid and that the readmission and complication rates as well as the ease and accuracy of follow up were comparable to published data. DCLC reduced waiting times and increased patient turnover and may have a positive impact on resident training.

Conclusions
DCLC is safe, feasible, and has potential benefits for health care delivery in developing countries. Each surgical service needs to develop their own guidelines based on local patient demography.
Assessment of basic surgical trainees: can we do more?
Authors: Somaseker K , Shankar J , Conway K P , Foster M E , Lewis M H 
Published: June 2003

Abstract

Introduction
Changes to surgical training and reduction of junior doctors’ working hours has resulted in trainees spending less time in surgical specialties before becoming eligible to apply for specialist registrar posts. A high quality basic surgical training programme is needed to improve the competence of trainees during their shortened period, an essential part of which is to conduct a formal assessment at the end of each training post and regular appraisals during their period of training.

Aims
To analyse the existing practice with regard to conducting assessment and appraisals for basic surgical trainees in the South East Wales region.

Methods
A questionnaire was sent to all the basic surgical trainees in the South East Wales region.

Results
A total of 52 questionnaires were sent out and 44 (84%) were returned. Four candidates were in the first post of their rotation, and were therefore excluded from the study. Nine of the 40 trainees (23%) did not have an assessment in one or more of their posts. There are 17 senior house officer posts available in general surgery in the rotation. Of the 31 “six month” episodes spent in these 17 posts, 27 (87%) underwent an assessment, 12 of the 17 (70%) episodes in trauma and orthopaedics (12 available posts) were assessed, and 31 of the 35 (88%) episodes in accident and emergency (eight available posts) underwent an assessment. Twenty eight of the 40 trainees (70%) did not undergo regular appraisals during the majority of their posts. Only 30%–50% of episodes spent in general surgery, orthopaedics, and accident and emergency underwent appraisals. The majority of the episodes spent in the other surgical specialties (12 posts available in total) had formal assessment and regular appraisals except for urology in which two of seven episodes underwent assessment and one underwent an appraisal. Twelve candidates (30%) expressed the view that operative experience and technical skills must form part of their assessment. Eight trainees (20%) felt that they needed more help from tutors with regard to career advice, preparation of curriculum vitae, and interview techniques for specialist registrar posts. Eight trainees mentioned that they had discussed unsatisfactory posts with their tutors but were not aware of any changes made to these posts.

Conclusions
This study has shown that the formal assessment of basic surgical trainees at the end of each training post has to improve further. The existing practice of conducting regular appraisals for the trainees is grossly inadequate. There appears to be a need for formulating guidelines for conducting such appraisals, which would help to improve practice in the future.
How valuable is ascitic cytology in the detection and management of malignancy?
Authors: Karoo R O S , Lloyd T D R , Garcea G , Redway H D , Robertson G S R 
Published: June 2003

Abstract

Introduction
Ascitic cytology is often requested in the early stages of ascitic assessment. A review of this practice in a major English teaching hospital is presented.

Method
Patients were retrospectively identified using the histopathology and patient administration system between January 1999 and May 2001.

Results
Of 276 samples sent for assessment 35 cases were found to be negative when on further review an intra-abdominal malignancy was present. The malignancy was diagnosed using a radiological modality. The sensitivity of ascitic cytology was found to be 60% with 100% specificity. A delay of up to five days could be incurred awaiting the cytology results before further radiological examinations were undertaken.

Conclusion
Too much hope is placed on ascitic cytology to provide the diagnosis at the expense of other investigations. It is recommended that the initial assessment should concentrate on history, examination, and basic tests on ascitic fluid to assess the serum-ascites albumin gradient. Ovarian malignancy is the only tumour type yielding a significant rate of detection from cytology with some prognostic impact. Results should not be awaited before abdominal ultrasound is undertaken. This more directed practice would help reduce unnecessary workload for the pathologist and has resource implications.
Ventricular fibrillation during electrical cardioversion of pre-excited atrial fibrillation
Authors: Adlam D , Azeem T 
Published: June 2003

Abstract
The Wolff-Parkinson-White syndrome can rarely present with pre-excited atrial fibrillation. In this condition the short refractory period of the accessory pathway can lead to rapid atrioventricular conduction. There is then a danger that at high heart rates the irregular broad complex tachycardia that results can deteriorate into ventricular fibrillation. The initial management of patients presenting in pre-excited atrial fibrillation requires cardioversion to sinus rhythm. This can be performed by DC cardioversion or pharmacological means. This paper describes the case of a patient presenting in pre-excited atrial fibrillation where electrical DC cardioversion lead to transient iatrogenic ventricular fibrillation.
ADVANCES IN ADAPTIVE PROTOTYPE WEIGHTING AND SELECTION
Authors: NOCK R. , SEBBAN M. 
Published: June 2003

The noise intolerance and the storage requirements of Nearest-Neighbor-based algorithms are the two main obstacles to their use for solving complex classification tasks. From the beginning of the 70's (with Hart and Gates), many methods have been proposed for dealing with these problems, by eliminating mislabeled instances, and selecting relevant prototypes. These models often have the distinctive feature of optimizing during the process the accuracy. In this paper, we present a new original approach which adapts the properties of boosting (which optimizes an other criterion) to the prototype selection field. While in a standard boosting algorithm the final classifier combines a set of weak hypotheses, where each one is a classifier built according to a given distribution over the training data, we defined in our approach each weak hypothesis as a single weighted prototype. The distribution update (a key step of boosting) and the criterion optimized during the process are slightly modified to allow an efficient adaptation of boosting to the prototype selection field. In order to show the interest of our new algorithm, called PSBOOST, we achieved a wide experimental study, comparing our procedure with the state-of-the-art prototype selection algorithms. Taking into account many performance measures, such as storage reduction, noise tolerance, generalization accuracy and learning speed, we can claim that PSBOOST seems to be very efficient by providing a good balance between all these performance measures. A statistical analysis is presented to validate all the results.
Specific Phospholipid Oxidation Products Inhibit Ligand Activation of Toll-Like Receptors 4 and 2
Authors: Walton Kimberly A. , Cole Amy L. , Yeh Michael , Subbanagounder Ganesamoorthy , Krutzik Stephan R. , Modlin Robert L. , Lucas Robert M. , Nakai Junko , Smart Eric J. , Vora Deven K. , Berliner Judith A. 
Published: June 2003

Objective—We have previously shown that phospholipid oxidation products of 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (ox-PAPC) inhibit lipopolysaccharide (LPS)-induced E-selectin expression and neutrophil binding in human aortic endothelial cells (HAECs). The current studies identify specific phospholipids that inhibit chemokine induction by Toll-like receptor-4 (TLR4) and -2 (TLR2) ligands inECs and macrophages.Methods and Results—Measurements of interleukin (IL)-8 and monocyte chemotactic protein-1 levels secreted from ox-PAPC- and LPS-cotreated ECs indicate that ox-PAPC inhibits activation of TLR4 by LPS. The effects of IL-1β and tumor necrosis factor-α, which utilize the same intracellular signaling molecules, were not inhibited. Cell fractionation and immunofluorescence analyses demonstrate that LPS induces membrane translocation of the LPS receptor complex to a lipid raft/caveolar fraction in ECs. Ox-PAPC inhibits this translocation and alters caveolin-1 distribution. Supporting an important role for caveolae in LPS action, overexpression of caveolin-1 enhanced LPS-induced IL-8 synthesis. Ox-PAPC also inhibits the effect of TLR2 and TLR4 ligands in human macrophages.Conclusions—These studies report a novel mechanism that involves alterations to lipid raft/caveolar processing, by which specific phospholipid oxidation products inhibit activation by TLR4 and TLR2 ligands. These studies have broader implications for the role of ox-PAPC as a regulator of specific lipid raft/caveolar function.
C-Reactive Protein, Interleukin-6, and Fibrinogen as Predictors of Coronary Heart Disease
Authors: Luc Gérald , Bard Jean-Marie , Juhan-Vague Irène , Ferrieres Jean , Evans Alun , Amouyel Philippe , Arveiler Dominique , Fruchart Jean-Charles , Ducimetiere Pierre 
Published: June 2003

Objective—This study was undertaken to examine the association of plasma inflammatory markers such as C-reactive protein (CRP), interleukin-6, and fibrinogen with the incidence of coronary heart disease within the prospective cohort study on myocardial infarction (PRIME study).Methods and Results—Multiple risk factors were recorded at baseline in 9758 men aged 50 to 59 years who were free of coronary heart disease (CHD) on entry. Nested case-control comparisons were carried out on 317 participants who suffered myocardial infarction (MI)-coronary death (n=163) or angina (n=158) as an initial CHD event during a follow-up for 5 years. After adjustment for traditional risk factors, incident MI-coronary death, but not angina, was significantly associated with CRP, interleukin-6, and fibrinogen, but only interleukin-6 remained significantly associated with MI-coronary death when the 3 inflammatory markers were included in the model. The different interleukin-6 levels in Northern Ireland and France partly explained the difference in risk between these countries. Interleukin-6 appeared as a risk marker of MI-coronary death, and it improved the definition of CHD risk beyond LDL cholesterol.Conclusions—This association may reflect the underlying inflammatory reaction located in the atherosclerotic plaque or a genetic susceptibility on the part of CHD subjects to answer a proinflammatory stimulus and subsequent increase in hepatic CRP gene expression.
'The Roman Family' in Recent Research: State of the Question
Authors: Rawson Beryl 
Published: June 2003

AbstractIn the past two decades of rapid expansion,the study of ‘the Roman family’ has developed from its early focus on the city of Rome and on legal, literary and epigraphical sources to a wider geographical canvas and to more extensive use of archaeological material. The whole range of sources is now being applied to particular problems, providing different perspectives and a better chance of contextualising specific details. Of the new methodologies available, demography and the archaeology of domestic space are proving most productive. Questions most frequently debated are the Romans’ concept of ‘the family’ and the nature of family relationships. There is a growing recognition that regional and cultural differentiation must be taken into account: generalisations about ‘the Mediterranean world’ or even ‘Greco-Roman culture’ are seldom useful. Similarly, regional differentiations in early Christianity are being recognised: Christian communities were likely to share many of the characteristics of the city or area in which they were developing. This makes the growing dialogue between Romanists and Early Christian scholars profitable and stimulating, and topics of particular fertilisation are those of family relationships and domestic space.
Ευσεβεια: Roman Imperial Family Values and the Sexual Politics of 4 Maccabees and the Pastorals
Authors: D'Angelo Mary 
Published: June 2003

AbstractEarly Christian and Jewish texts responded to the “family values” campaigns mounted by successive emperors from Augustus and Hadrian with varying combinations of accommodation and resistance. This dialectic of resistance and accommodation appears in central aspects of 4 Maccabees and the Pastorals, texts that have frequently been assigned to the earlier part of the second century, that is, to the reigns of Trajan and Hadrian, and that foreground martyrs as the exemplars of their teaching. Both the Jewish and the Christian text give the virtue ευσεβεια a central role, constructing that virtue along the lines of the Roman virtue pietas, that is, as duty and devotion not only to the divine, but also to those of one’s household and family. The specifically post-Augustan character of this virtue is manifest in their displays of an a ideal of chastity for women that responds to the Julian laws—not only the avoidance of adultery and stuprum, but also a commitment to marriage and remarriage as long as the woman can bear children. Both likewise espouse the long term Roman idealization of the univira and both are insistent that the husband must be the teacher of the wife. Among the most significant aspects of this comparison are the close correspondences between the exegeses of Genesis 2-3 in 4 Macc.18:7-10 and 1 Tim. 2:13-15.
The Jesus Movement Was Not Egalitarian but Family-oriented
Authors: Elliott John 
Published: June 2003

AbstractThe theory that Jesus founded a "discipleship of equals" that after his death assumed the shape of egalitarian structured house churches, which by the end of the first century abandoned their egalitarian ethos and organization and assimilated to the conventional patriarchal household pattern of their Greco-Roman environment, fails to stand up under close scrutiny. The theory lacks probative textual and historical support, is sociologically implausible, conceptually anachronistic, and appears ideologically driven.
Fathers and Householders in the Jesus Movement: The Perspective of the Gospel of Luke
Authors: Pesce Mauro , Destro Adriana 
Published: June 2003

AbstractThe Jesus' movement has in Luke a structural relation with the households. The relation between household and discipleship is dialectical, because it assigns external and internal roles to those that belong to both social forms. The itinerant followers of Jesus seem to belong to an emerging middle generation in their households, and have some experience in choosing to adhere to voluntary associations. Most (both married and unmarried, both men and women) belong to the households of their fathers. Some are themselves householders, who can freely dispose of their property, and who have an important function in their own household. This creates strong conflicts between the followers and the other members of the household because of the function they fulfilled before their becoming part of the movement. On the other hand, Jesus and his movement depend on the household structure. The householders offer Jesus' movement the required support through hospitality. Furthermore, Luke's Jesus denounces the mechanism of exchange between householders that excludes all social classes that have no chance whatsoever of entering into it and cannot benefit from the mechanisms of patronage. Jesus asks the householders to open their homes and offer a different kind of hospitality without reciprocity and social compensation. The double challenge to the itinerant followers and to the householders differentiates the kind of participation of individuals to Jesus movement, and put all of them into a close interrelation within which the model of discipleship tends to transform the model of the household.
Gender, Judaism, and Literature: Unwelcome Guests in Household Configurations
Authors: Levine Amy-Jill 
Published: June 2003

AbstractInvestigation of the early Christian household, frequently based on social-science models, can benefit by attending more formally to gender constructs, Jewish sources, and literary-critical observations. The category of 'householder' should be expanded to include independent women; the role of women and slaves in Jewish environs should be examined in light not only of Greek and Roman political and philosophical ideals but also of early Rabbinic thought; social models applied to and/or gleaned from the Gospels should be checked against the evangelists' narrative art.
BOULDERS, NATIVE PRAIRIE AND A THEISTIC STEWARDSHIP ETHIC
Authors: Reichenbach Bruce 
Published: June 2003

AbstractThe recent fad of removing glacial boulders from native Midwest prairie to create walls for urban wildflower gardens provides the context for thinking about how a theistic stewardship ethic addresses the environment. The three commands of Genesis 1 and 2 provide the basis for a theistic stewardship ethic, where God as the Creator/Landowner establishes humans as stewards to administer his kingdom. Contrary to the oft-repeated view that the injunction to rule over justifies a mere instrumental use and hence abuse of the environment, the command gives value to the biotic environment because the created has interests and thereby moral standing. Consequently, the environment must be considered in the for-whom of moral calculation. However, a theistic environmental ethic adds that the value of nature is neither merely intrinsic nor instrumental, but derives from the value accorded it by its Creator, who in seeing it function declares it good. The command to care for allows for sustainable conservation and human use rather than mere preservation. And the command to fill connects with the need to preserve and foster genetic and ecological diversity. Throughout we apply these commands to the case study about boulders and native prairie.
ENVIRONMENTAL UNDERSTANDING: SACRED COWS NEED CULLING
Authors:   Berry
Published: June 2003

AbstractAttitudes towards the natural world are complicated by all sorts of preconceptions and out-dated ideas. Some of these arise from different interpretations of the same data, but others are hangovers from past debates in science, philosophy or religion. The result is a herd of 'sacred cows' which need drastic culling. I suggest that Francis Bacon's insistence that we should read both Books of God—of words (the Bible) and of works (scientific understanding)—is a key part of this process; it could provide a positive way of testing scientific and theological interpretations, and hopefully undergird progress towards a sensible basis for a robust environmental ethic.
HGF receptor up-regulation contributes to the angiogenic phenotype of human endothelial cells and promotes angiogenesis in vitro
Authors: Ding Shunli , Merkulova-Rainon Tatyana , Han Zhong Chao , Tobelem Gérard 
Published: June 2003

AbstractHepatocyte growth factor (HGF) is a mesenchyme-derived pleiotropic growth factor and a powerful stimulator of angiogenesis, which acts on cells by binding to the c-met receptor. The exact role of the endogenous HGF/c-met system in one or more steps of the angiogenic process is not completely understood. To contribute to this question we used immunocytochemical analysis, Western blotting, and reverse transcription–polymerase chain reaction to study the expression of c-met in endothelial cells cultured in different growth conditions. We found that c-met is not colocalized with vascular endothelial (VE)–cadherin in cell-cell junctions. c-met and VE-cadherin were shown to be inversely regulated by cell density, at both the protein and the mRNA levels. We established that c-met is up-regulated during the in vitro recapitulation of several steps of angiogenesis. The c-met expression was increased shortly after switching to angiogenic growth conditions and remained high during the very first steps of angiogenesis, including cell migration, and cell proliferation. The endothelial cells in which the expression of c-met was up-regulated were more responsive to HGF and exhibited a higher rate of morphogenesis. Moreover, the antibody directed against the extracellular domain of the c-met inhibited angiogenesis in vitro. Our results suggest that c-met is a marker of angiogenic phenotype for endothelial cells and represents an attractive target for the development of new antiangiogenic therapies.