bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of postmenopausal bone loss at lumbar spine and upper femur with tibolone: a two‐year randomised controlled trial
Authors: Beardsworth S. A. , Kearney C. E. , Purdie D. W. 
Published: August 2005

Objective
To examine the effects of tibolone on bone mineral density and its concurrent safety and subject acceptability.Design
Prospective randomised controlled study.Setting
Centre for Metabolic Bone Disease, Hull.Population
Forty‐seven healthy post‐menopausal women aged 50–57 years with normal bone mineral density at lumbar spine.Methods
Bone mineral density was assessed every 24 weeks at lumbar spine and proximal femur using dual energy X‐ray absorptiometry.Results
The bone mineral density of the tibolone treated subjects tended to increase while those of the controls tended to fall. The higher densities in the tibolone group were significant at lumbar spine from week 24 (P= 0.002) and at the trochanter from week 72 (P= 0.014). The lower bone densities in the controls were significant at Ward's Triangle and femoral neck at week 96 (P < 0.0001), and at lumbar spine from week 24 onwards (P < 0.05). Between‐treatment analysis indicated that, by the 96th week, the bone densities at all sites in the tibolone group were significantly different from those in the control group. At the lumbar spine the differences were highly significant throughout the study (P < 0.0004). Four women receiving tibolone withdrew from the study due to unacceptable adverse events. Two women withdrew from the control group. There was no significant difference between the groups in the number of subjects suffering adverse experiences. Vaginal bleeding occurred in seven women, all from the tibolone treated group, resulting in one withdrawal from the study.Conclusion
Tibolone is thus an effective and well‐tolerated alternative to oestrogen in the prevention of osteoporosis with its beneficial effects being most apparent at the lumbar spine.
Microwave endometrial ablation: development, clinical trials and outcomes at three years
Authors: Hodgson David A. , Feldberg Ian B. , Sharp Nicholas , Cronin Nigel , Evans Martyn , Hirschowitz Lynn 
Published: August 2005

Objective
To describe the introduction of microwave endometrial ablation to clinical practice, and to report the outcomes three years after endometrial ablation.Design
A clinical trial using prototype microwave endometrial ablation equipment.Setting
District general hospital.Population
Forty‐three women with completed families and with failed medical management for men‐orrhagia were treated with microwave endometrial ablation between October 1994 and April 1995.Main outcome measures
A statement of perceived menstrual loss and satisfaction supported by a menstrual symptom questionnaire score. Dysmenorrhoea was graded as a measure of described severity. Treatment time.Results
Forty‐three women had a total of 46 treatments. Mean treatment time: n= 43, was 141 seconds (50–310). Amenorrhoea: n= 16; 37.2%. Very light periods/discharge: n= 11; 25.6%. Improved periods and woman satisfied: n= 9; 20.9%. Improved periods and woman not satisfied: n= 1; 2.3%. Overall satisfaction at three years is 83.7%. Moderate (55.8%) or severe (27.9%) dysmenorrhoea pre‐operatively had improved to 11.6% and 6.8% respectively at three years. Three re‐treatments and four hysterectomies will be discussed.Conclusions
Microwave endometrial ablation is a new treatment for dysfunctional uterine bleeding using the application of microwave energy to the endometrium. This results in a rapid but restricted depth of intrauterine heating avoiding hysteroscopic fluid, operative haemorrhage and earthing risks. The technique is simple to learn and perform. Women report a high level of satisfaction three years after microwave endometrial ablation.
Expression of macrophage inflammatory protein‐1α (MIP‐1α) in human endometrium throughout the menstrual cycle
Authors: Akiyama Minoru , Okabe Hidetoshi , Takakura Kenji , Fujiyama Yoshihide , Noda Yoichi 
Published: August 2005

Objective
To investigate the distribution and the role of macrophage inflammatory protein‐la (MIP‐ 1α) in human endometrium during cyclic changes.Setting
Department of Obstetrics and Gynaecology, Shiga University of Medical Science and University Hospital.Materials
Eighteen endometrial tissue specimens surgically resected or biopsied from women with normal menstrual cycles, without hormonal disorder or endometrial diseases.Methods
By immunohistochemistry, using monoclonalantibodies (lambda delta 78 for MIP‐la and CR3/43 for human leukocyte antigen‐DR (HLA‐DR)).Results
Immunoreactivity for anti‐MIP‐lα was distributed diffusely in epithelial cells throughout the proliferative and secretory phases but was absent during menstruation due to degenerative or necrotic changes. HLA‐DR was expressed in epithelial cells only in the late secretory phase and was not expressed in stromal cells.Conclusion
Immunohistochemicalanalysis showed the presence of MIP‐ lα in the endometrial epithelium. Expression of HLA‐DR in epithelial cells was observed only in the late secretory phase, suggesting that accumulation of MIP‐lα in epithelium occurred by self production and not via a receptor mediated pathway. MIP‐lα was released from the denuded epithelium during menstruation and appeared to contribute to the accumulation of monocytes/macrophages into the endometrial cavity. MIP‐la has a number of biological effects other than monocytic chemotaxis, and some of these effects may be exerted in the endometrial tissue.
Women's attitudes to urodynamics: a questionnaire survey
Authors: Gorton Emma , Stanton Stuart 
Published: August 2005

Objective
To obtain a measure of how well women tolerate urodynamic investigations and to determineDesign
Prospective questionnaire surveySetting
A teaching hospital tertiary referral centre urodynamic laboratory.Participants
Three hundred and twenty‐four women attending for urodynamic investigations on 33 1 occasions. Questionnaires were returned from 297 women (9 1.7%) with six women returning two questionnaires.Results
Urodynamic investigations were well tolerated by most women, with 45% feeling that the procedure was not as bad as they expected. Moderate or severe anxiety about the test was experienced by 42% and 40% felt moderately or severely embarrassed. Pain was noted by 27% of women during investigation, and by 13% after investigation. Overall distress from the procedure was less in older women and in those who had been referred from a specialist urogynaecology clinic. Distress was higher when difficulties were encountered during the investigation and in women who had investigations other than a standard cystometrogram. Women were likely to find the test less distressing when they felt they had been given adequate information about the test.Conclusions
Although urodynamic investigations are generally well tolerated, there is a significant minority of women who find the test embarrassing, painful and distressing. how well they thought the test was explained.
A randomised comparison of the effects of oral versus transdermal 17β‐oestradiol, each combined with sequential oral norethisterone acetate, on serum lipoprotein levels
Authors: Spencer Chris , Crook David , Ross David , Cooper Alison , Whitehead Malcolm , Stevenson John 
Published: August 2005

Objective
To investigate the effects of oral versus, transdermal 17β‐oestradiol, given in both cases with sequential addition of oral norethisterone acetate, on serum lipid and lipoprotein levels in postmenopausal women.Design
Open, randomised, parallel groups study.Setting
University Clinical Research Group.Population
Sixty‐four postmenopausal women with climacteric complaints who were otherwise healthy were screened. Of these, 58 fulfilled the entry criteria.Methods
Fifty‐eight postmenopausal women were randomised to receive either oral 17β‐oestradiol/oestriol (Trisequens) or transdermal 17β‐oestradiol (Estrapak) together with cyclical addition of norethisterone acetate for 48 weeks.Main outcome measures
Serum levels of total cholesterol, triglycerides, high density lipoproteins (HDL), low density lipoproteins (LDL), very low density lipoproteins (VLDL), apolipoproteins, and lipoprotein(a) at baseline, and after 46 weeks (oestrogen‐alone phase), and 48 weeks (oestrogen‐progestogen phase) of treatment.Results
Oral oestradiol therapy did not affect serum total cholesterol levels during the oestrogen‐alone phase, but during the combined phase there was a 5% fall (P < 0.05) due to a 7% decrease in LDL cholesterol levels (P < 0.01). Oral therapy also increased serum triglyceride levels by 9.4% during the oestrogen‐alone phase (P < 0.05). During the combined phase of transdermal therapy, there was a 19% fall in serum triglyceride levels (P < 0.05) and a 6%, fall in HDL levels (P < 0.05). Oral oestradiol reduced lipoprotein(a) levels by 31% during the oestrogen‐alone phase and by 37% with norethisterone acetate addition (P < 0.05). Transdermal therapy had no significant effect on lipoprotein(a).Conclusions
Other than a minor fall in HDL, in women receiving transdermal 17β‐oestradiol, co‐administration of oral progestogen in general improved, rather than worsened, this serum lipoprotein profile.
Long term effects of tibolone on the genital tract in postmenopausal women
Authors: Morris E. P. , Wilson P. O. G. , Robinson J. , Rymer J. M. 
Published: August 2005

Objectives
To assess the effects of six years tibolone therapy on the genital tract in postmenopausal women against matched voluntary controls.Design
Prospective, non‐randomised, open label study of the efficacy of tibolone.Methods
Symptoms were assessed by questionnaires every six months. Assessment of genital tract cellular activity comprised annual vaginal smear and endometrial biopsy/smear in the tibolone group (n= 58) and vaginal smear alone in the control group (n= 55). As a recent protocol addition, transvaginal ultrasound assessment of endometrial thickness was performed in all women who gave consent. endometrial biopsy was performed in control women if the endometrial thickness was > 5 mm. Karyopyknotic index and maturation index were calculated from the vaginal smears.Results
The rate of amenorrhoea between six months and six years treatment was 90% in the tibolone group compared with 91% in the controls (P was not significant). There was improvement in reported vaginal symptomatology in the treatment group but not in the controls. Median endometrial thickness increased slightly in the tibolone treated group (3.2 mm tibolone vs 2.5 mm control; P < 0.05). There were no cases of cytologically proven endometrial stimulation in asymptomatic women in either group. Both vaginal karyopyknotic index and maturation index increased significantly in the tibolone treated group over six years, but not in the control group.Conclusions
Tibolone is effective at maintaining an inactive endometrium while providing oestrogenisation of the lower genital tract over a six year period.
Human papillomavirus type 16 and 18 detection in the management of mild dyskaryosis
Authors: Cruickshank Margaret E. , Buchan Suzanne , Melvin William T. , Kitchener Henry C. 
Published: August 2005

Objective
To determine if semi‐quantitative human papillomavirus (HPV) types 16 and 18 detection by polymerase chain reaction can increase the sensitivity and specificity of repeat cytology alone for underlying high grade cervical intraepithelial neoplasia (CIN).Design
Prospective randomised study of immediate treatment and surveillance.Setting
A dedicated colposcopy clinic serving a regional population.Sample
Three hundred and four women with smears reported as mild dyskaryosis.Methods
Repeat cytology, HPV 16 and 18 tests, and colposcopy were performed at study entry. Women were randomised to either immediate treatment or surveillance with repeated tests at 6 and 12 months. Unless all study smears were negative, women were treated at study exit by large loop excision of the transformation zone.Main outcome measures
Sensitivity and specificity of HPV testing for types 16 and 18 in conjunction with cytology for high grade CIN.Results
Combining repeat cytology with HPV 16 and 18 testing had a sensitivity of 94% and a specificity of 26%., a positive predictive value of 71%, and a negative predictive value of 71%, for underlying high grade CIN. If used to secondary screen in conjunction with repeat cytology for mild dyskaryosis, 88% of women would have been referred for colposcopy on the basis of either test being positive.Conclusion
Combining repeat cytology and HPV 16 and 18 detection would result in the majority of women being referred for immediate colposcopy. Taken with an overall default rate of 17%, immediate referral of all women with mild dyskaryosis for colposcopic assessment still appears to be a more effective clinical strategy.
Guided Health Imagery for Smoking Cessation and Long‐Term Abstinence
Authors: Wynd Christine A. 
Published: August 2005

Purpose:

To examine the effectiveness of guided imagery for immediate smoking cessation and long‐term abstinence in adult smokers.
Design:

A repeated measures design was used with 71 smokers recruited from a hospital outpatient clinic, 38 in the intervention group, and 33 in the control group.
Methods:

Both study groups received educational and counseling sessions in their homes. The intervention group was provided with additional instruction in the use of guided imagery and was encouraged to practice this imagery at least once per day with a 20‐minute audiotaped exercise for reinforcement. The repeated measures included smoking rates (cigarettes per day) that were measured and confirmed through corroborating friends and family.
Findings:

At 24‐months after the intervention, smoking abstinence rates were significantly higher for the guided health imagery intervention group (26% abstinence rate versus 12% abstinence rate for the placebo‐control group).
Conclusions:

Guided imagery was an effective intervention for long‐term smoking cessation and abstinence in adult smokers.
Utility of a Standardized Nursing Terminology to Evaluate Dosage and Tailoring of an HIV/AIDS Adherence Intervention
Authors: Bakken Suzanne , Holzemer William L. , Portillo Carmen J. , Grimes Richard , Welch Jennifer , Wantland Dean 
Published: August 2005

Purpose:

To illustrate the utility of a standardized nursing terminology to calculate the dosage of the Client Adherence Profiling‐Intervention Tailoring (CAP‐IT) and to determine the extent to which a tailored intervention was delivered to 117 persons with HIV/AIDS who participated in the experimental arm of a randomized controlled trial (RCT).
Methods:

The intervention nurse assigned nursing diagnoses from the Home Health Care Classification (HHCC) based upon CAP scores. During the IT phase of CAP‐IT, the nurse delivered and documented a tailored set of nursing interventions associated with the CAP and assigned nursing diagnoses. Hierarchical linear regression was used to evaluate the extent to which the number of interventions and intervention times were tailored to client needs.
Results:

Linear regression models that included CAP scores and nursing diagnoses as predictor variables explained 53.2% of the variance in total number of interventions and 58.9% of the variance in intervention time.
Conclusions:

The use of the standardized nursing terminology enabled calculation of the intervention dose and documentation that a tailored intervention was delivered.
Ultraviolette Strahlung – Immunantwort
Authors: Schwarz Thomas 
Published: August 2005

ZusammenfassungUltraviolette (UV) Strahlung übt eine Vielzahl biologischer Effekte aus, darunter Induktion von Hautkrebs, vorzeitige Hautalterung und Unterdrückung des Immunsystems. Die immunsuppressiven Effekte von UV‐Strahlung sind von großer biologischer und klinischer Relevanz, da sie zur Photokarzinogenese beitragen. Daher ist die Kenntnis der der Immunsuppression zugrunde liegenden Mechanismen von großer Wichtigkeit. UV‐Strahlung unterdrückt das Immunsystem in mehrfacher Weise. Sie inhibiert die Präsentation von Antigenen, stimuliert die Freisetzung immunsuppressiver Zytokine und induziert T‐Lymphozyten vom regulatorischen Typ. Eine wesentliche molekulare Zielstruktur bei der UV‐induzierten Immunsuppression ist der UV‐induzierte DNA‐Schaden. Die weitere Aufklärung der Mechanismen der UV‐induzierten Immunsuppression wird nicht nur zu einem besseren Verständnis der physiologischen und pathologischen Effekte von UV‐Strahlung führen, sondern auch einen Beitrag zur Entwicklung neuer protektiver Strategien beitragen.
Down Regulation of Virulence Factors of
Pseudomonas aeruginosa
by Salicylic Acid Attenuates Its Virulence on
Arabidopsis thaliana
and
Caenorhabditis elegans
Authors: Prithiviraj B. , Bais H. P. , Weir T. , Suresh B. , Najarro E. H. , Dayakar B. V. , Schweizer H. P. , Vivanco J. M. 
Published: August 2005

ABSTRACT

Salicylic acid (SA) is a phenolic metabolite produced by plants and is known to play an important role in several physiological processes, such as the induction of plant defense responses against pathogen attack. Here, using the
Arabidopsis thaliana
-
Pseudomonas aeruginosa
pathosystem, we provide evidence that SA acts directly on the pathogen, down regulating fitness and virulence factor production of the bacteria.
Pseudomonas aeruginosa
PA14 showed reduced attachment and biofilm formation on the roots of the
Arabidopsis
mutants
lox2
and
cpr5
-
2
, which produce elevated amounts of SA, as well as on wild-type
Arabidopsis
plants primed with exogenous SA, a treatment known to enhance endogenous SA concentration. Salicylic acid at a concentration that did not inhibit PA14 growth was sufficient to significantly affect the ability of the bacteria to attach and form biofilm communities on abiotic surfaces. Furthermore, SA down regulated three known virulence factors of PA14: pyocyanin, protease, and elastase. Interestingly,
P. aeruginosa
produced more pyocyanin when infiltrated into leaves of the
Arabidopsis
transgenic line
NahG
, which accumulates less SA than wild-type plants. This finding suggests that endogenous SA plays a role in down regulating the synthesis and secretion of pyocyanin in vivo. To further test if SA directly affects the virulence of
P. aeruginosa
, we used the
Caenorhabiditis elegans
-
P. aeruginosa
infection model. The addition of SA to
P. aeruginosa
lawns significantly diminished the bacterium's ability to kill the worms, without affecting the accumulation of bacteria inside the nematodes' guts, suggesting that SA negatively affects factors that influence the virulence of
P. aeruginosa
. We employed microarray technology to identify SA target genes. These analyses showed that SA treatment affected expression of 331 genes. It selectively repressed transcription of exoproteins and other virulence factors, while it had no effect on expression of housekeeping genes. Our results indicate that in addition to its role as a signal molecule in plant defense responses, SA works as an anti-infective compound by affecting the physiology of
P. aeruginosa
and ultimately attenuating its virulence.
Examination of the Coordinate Effects ofPseudomonas aeruginosaExoS on Rac1
Authors: Rocha Claudia L. , Rucks Elizabeth A. , Vincent Deanne M. , Olson Joan C. 
Published: August 2005

ABSTRACTExoenzyme S (ExoS) is a bifunctional toxin directly translocated into eukaryotic cells by thePseudomonas aeruginosatype III secretory (TTS) process. The amino-terminal GTPase-activating (GAP) activity and the carboxy-terminal ADP-ribosyltransferase (ADPRT) activity of ExoS have been found to target but exert opposite effects on the same low-molecular-weight G protein, Rac1. ExoS ADP-ribosylation of Rac1 is cell line dependent. In HT-29 human epithelial cells, where Rac1 is ADP-ribosylated by TTS-ExoS, Rac1 was activated and relocalized to the membrane fraction. Arg66 and Arg68 within the GTPase-binding region of Rac1 were identified as preferred sites of ExoS ADP-ribosylation. The modification of these residues by ExoS would be predicted to interfere with Rac1 inactivation and explain the increase in active Rac1 caused by ExoS ADPRT activity. Using ExoS-GAP and ADPRT mutants to examine the coordinate effects of the two domains on Rac1 function, limited effects of ExoS-GAP on Rac1 inactivation were evident in HT-29 cells. In J774A.1 macrophages, where Rac1 was not ADP-ribosylated, ExoS caused a decrease in the levels of active Rac1, and this decrease was linked to ExoS-GAP. Using immunofluorescence staining of Rac1 to understand the cellular basis for the targeting of ExoS ADPRT activity to Rac1, an inverse relationship was observed between Rac1 plasma membrane localization and Rac1 ADP-ribosylation. The results obtained from these studies have allowed the development of a model to explain the differential targeting and coordinate effects of ExoS GAP and ADPRT activity on Rac1 within the host cell.
Unusual Genetic Organization of a Functional Type I Protein Secretion System in
Neisseria meningitidis
Authors: Wooldridge Karl G. , Kizil Murat , Wells Damien B. , Ala'Aldeen Dlawer A. A. 
Published: August 2005

ABSTRACT

Proteins secreted by
Neisseria meningitidis
are thought to play important roles in the pathogenesis of meningococcal disease. These proteins include the iron-repressible repeat-in-toxin (RTX) exoprotein FrpC. Related proteins in other pathogens are secreted via a type I secretion system (TOSS), but such a system has not been demonstrated in
N. meningitidis
. An in silico search of the group B meningococcal genome suggested the presence of a uniquely organized TOSS. Genes encoding homologs of the
Escherichia coli
HlyB (ATP-binding), HlyD (membrane fusion), and TolC (outer membrane channel) proteins were identified. In contrast to the cistronic organization of the secretion genes in most other
rtx
operons, the
hlyD
and
tolC
genes were adjacent but unlinked to
hlyB
; neither locus was part of an operon containing genes encoding putative TOSS substrates. Both loci were flanked by genes normally associated with mobile genetic elements. The three genes were shown to be expressed independently. Mutation at either locus resulted in an inability to secrete FrpC and a related protein, here called FrpC2. Successful complementation of these mutations at an ectopic site confirmed the observed phenotypes were caused by loss of function of the putative TOSS genes. We show that genes scattered in the meningococcal genome encode a functional TOSS required for secretion of the meningococcal RTX proteins.