bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undertaking the Role of Patient Advocate: a longitudinal study of nursing students
Authors: Altun Insaf , Ersoy Nermin 
Published: November 2003

Patient advocacy has been claimed as a new role for professional nurses and many codes of ethics for nurses state that they act as patient advocates. Nursing education is faced with the challenge of preparing nurses for this role. In this article we describe the results of a study that considered the tendencies of a cohort of nursing students at the Kocaeli University School of Nursing to act as advocates and to respect patients’ rights, and how their capacities to do so changed (or not) as a result of their nursing education. This longitudinal study used a questionnaire consisting of 10 statements relating to patient care. It was performed both at the start (1998) and at the end (2002) of the nursing training. At the beginning of their course 77 students participated; in the study. After four years, only 55 students participated, the reason for this drop in number being unknown. The questions asked nurses if patients should have: the right to receive health care; the right to participate in the decision-making process about their treatment; the right always to be told the truth; and the right to have access to their own medical records. They were also asked: if quality of life should be a criterion for discontinuing treatment; if patients have the right to die and the right to refuse treatment; if patients should be assisted to die or helped to undergo active euthanasia; and if severely disabled newborn babies should be allowed to die. The student nurses demonstrated considerable insight into contemporary nursing issues and were ready to act as patient advocates. Professional responsibility demands that good nurses advocate strongly for patients’ choices.
The Practice Setting: site of ethical conflict for some mothers and midwives
Authors: Thompson Faye E 
Published: November 2003

Practitioners’ ethical orientation and responses vary between practice settings. Yet, currently, the ethics for midwifery practice that is explicit in the literature and which provides the ideals of socialization into practice, is that of bio(medical)ethics. Traditional bioethics, developed because of World War II atrocities and increased scientific research, is based on moral philosophy, normative theory, abstract universal principles and objective problem solving, all of which focus on right and wrong ‘action’ for resolving dilemmas. They exclude context and relationship. Personal narratives of mothers and midwives contest the appropriateness of these accepted values and systems for childbirth because they induce conflict between work-place/service provider ethics and personal/professional midwifery ethics. In contrast to the disembedded and disembodied approach of biomedical ethics, an ethically adequate response in midwifery practice resonates more with the ethics of intimates, such as feminist virtue ethics.
The impact of workload changes and staff availability on IV chemotherapy services
Authors: Summerhayes Maxwell 
Published: November 2003

Objectives. To determine the extent of change in intravenous (IV) chemotherapy workload in recent years, the availability of specialist pharmacy and nursing staff to carry out this work and the service implications of any mismatch between these two parameters. To determine the volume of chemotherapy currently administered for metastatic colorectal cancer (MCRC) to allow assessment of the possible workload implication of a switch to oral fluoropyrimidine therapy. Design. An anonymous postal survey of pharmacist members of the British Oncology Pharmacy Association (BOPA) and their nursing colleagues. Response. 0f 104 questionnaires distributed, 54 were returned (response rate 51.9%). Data summary. Ninety-three per cent of pharmacists reported an increase averaging 178% (range 15]/500%) in the volume of IV chemotherapy being prepared by their units over the last five years, with the average unit currently producing 896 (range 110]/5000) doses each month. Pharmacist and nurse recruitment difficulties were also reported almost universally. The combination of these two factors led to reported problems for both staff and patients, with a majority of nursing and pharmacy staff noting increased staff stress and prolonged patient waiting times. A significant minority of departments have already taken, generally undesirable, steps to address a significant imbalance between chemotherapy workload and service capacity, including restricting clinical trial activity and other aseptic dispensing work. Conclusions. Rapid expansion in the use of IV cytototoxic chemotherapy has resulted in pharmacy and nursing services facing severe pressure. Imaginative solutions are necessary if safe and efficient services are to be maintained. These may include increased use of oral fluorpyrimidines for the first-line treatment of MCRC, which this survey indicates accounts for about 10% of IV chemotherapy administered in the UK.
Clinical pharmacokinetics and metabolism of paclitaxel after a three-hour infusion: comparison of two preparations
Authors: Czejka Martin , Schueller Johannes , Schnait Heinz , Springer Beate , Eder Isabella 
Published: November 2003

The clinical pharmacokinetics (PHK) of paclitaxel (PACLI) and its hydroxylated metabolites after three hours IV infusion (200 mg/m2) of two preparations were investigated in 13 patients receiving chemotherapy against breast cancer. Standard TaxolÒ was purchased from Bristol Myers Squibb and a test preparation ebetaxel (containing additional 2 mg/mL citric acid) was provided by Ebewe Pharma Austria. In the first cycle, either standard or test preparation was administered, then its alternative preparation in the second cycle (latin square, paired crossover design). In both treatment schedules the peak concentrations of PACLI occurred at the end of infusion after three hours. Mean peak concentration of PACLI was cmax5 505191131 ng/mL for the test preparation and cmax5 526991109 ng/mL for the standard preparation. No statistically significant differences in these plasma concentrations could be calculated. Mean tmax of metabolites was between 3.00 and 3.25 hours, their plasma concentrations were very similar: 6-OH-PACLI: cmax 4689266 ng/mL versus 4529212 ng/mL, 3Í-OH-PACLI: cmax 85938 ng/mL versus 90944 ng/mL, 3Í,6-DiOH-PACLI: cmax 87927 ng/mL versus 76931 ng/mL. The PHK parameters of PACLI (AUC, Cltot, Vd) and its metabolites (AUC, t1/2 dis, t1/2 el) did not differ significantly between both preparations. Biotransformation of PACLI into its three hydro-xylated metabolites (expressed as their appearance in blood) was not affected by the content of citric acid in the test preparation.
Pyridoxine treatment and prevention of hand-and-foot syndrome in patients receiving capecitabine
Authors: Mortimer Joanne E , Lauman Mary Kay , Tan Benjamin , Dempsey Cindy L , Shillington Alicia C , Hutchins Kellie S 
Published: November 2003

Background. Capecitabine is a novel fluoropyrimidine administered orally for treatment of gastrointestinal and breast malignancies. Toxicity described with capecitabine includes hand-and-foot syndrome (HFS), a potentially painful inflammation of the hands and feet. Pyridoxine has been reported to produce improvement in HFS symptoms. We conducted our study to determine the incidence and severity of HFS symptoms in capecitabine patients and to assess the effects of pyridoxine administered as prophylaxis or treatment. Patients and methods. We retrospectively reviewed 99 charts of capecitabine patients receiving pyridoxine and 99 charts of those who had not. Results. Of the 99 pyridoxine patients, 73 (74%) received it as prophylaxis, with the remainder receiving pyridoxine as acute HFS treatment. The median number of capecitabine cycles administered was five, with first-reported HFS onset at cycle 2 in those receiving pyridoxine prophylaxis versus 1.5 in those not (P 5 0.06). Incidence was significantly associated with capecitabine dose, with 76% of patients experiencing HFS in the highest dose ranges compared with 40% in the lowest (P B 0.01). The data did not support that pyridoxine prophylaxis prevented overall HFS incidence in a greater proportion of patients compared with those who did not receive prophylaxis (60% versus 53%, respectively, P 5 NS). However, when used as treatment, a greater proportion of patients receiving pyridoxine reported symptom improvement compared with those not receiving the agent (65% versus 12%, P B0.001). No differences in 12-week tumor response were seen. Conclusion. The data do not support the use of pyridoxine as prophylaxis as neither the incidence nor the severity of HFS was affected. Once HFS develops, however, pyridoxine may provide some relief of HFS symptoms. A controlled trial of capecitabine with and without pyridoxine seems warranted.
Blood-brain barrier disruption in multiple sclerosis
Authors: Minagar Alireza , Alexander J Steven 
Published: November 2003

The blood-brain barrier (BBB) is a complex organization of cerebral endothelial cells (C EC), pericytes and their basal lamina, which are surrounded and supported by astrocytes and perivascular macrophages. C ollectively these cells separate and form the compartments of the cerebral vascular space and the cerebral interstitium under normal conditions. Without the BBB, the ‘interior milieu’ of the central nervous system (CNS) would be flooded by humoral neurotransmitters and formed blood elements that upset normal C NS functions and lead to vascular/neural injury. Dysregulation of the BBB and transendo thelial migration of activated leukocytes are among the earliest cerebrovascular abnormalities seen in multiple sclerosis (MS) brains and parallel the release of inflammatory cytokines/chemokines. Mechanisms for breakdown of the BBB in MS are incompletely understood, but appear to involve direct effects of these cytokines/chemokines on endothelial regulation of BBB components, as well as indirect cytokine/chemokine-dependent leukocyte mediated injury. Unique endothelial structural features of the BBB include highly organized endothelial tight junctions, the absence of class II major histocompatibility complex, abundant mitochondria and a highly developed transport system in C EC. Exposure of endothelium to proinflammatory cytokines (IFN-g, TNF-a and IL-1b) interrupts the BBB by disorganizing cell-cell junctions, decreases the brain solute barrier, enhances leukocyte endothelial adhesion and migration as well as increases expression of class II MHC and promotes shedding of endothelial ‘microparticles’ (EMP). In this review we examine interactions between cytokines/chemokines, activated leukocytes, adhesion molecules and activated C EC in the pathogenesis of BBB failure in MS.
Shrapnell’s membrane in a mammal exposed to extreme pressure variations: morphological and radiological observations in the hooded seal
Authors: Stenfors Lars-Eric , Bye Helga-Marie , Tikkakoski Tapani 
Published: November 2003

The function of Shrapnell’s membrane (pars flaccida; PF) in middle-ear mechanics is still an enigma, though numerous proposals have been put forward, e.g. protection of pars tensa, equalizing of middle-ear pressure, sound transmission, and the site of origin of otitis media. In this study the PF was studied in a mammal (the hooded seal) which exposes itself to extreme pressure differences (from 1 to 100 atmospheres) when diving.Formaldehyde-fixed temporal bones obtained from newborn, one-year-old, and adult seals (three of each) were cleansed and decalcified in 10 per cent EDTA. The lateral wall of the middle-ear cavity, including the whole tympanic membrane with its bony surroundings, was then excised and photodocumented. Thin sections were cut parallel with, and perpendicular to, the handle of the malleus, stained with haematoxylin-eosin, toluidine blue or Giemsa stain and examined under a light microscope. One seal head was subjected to high resolution computerized tomography (HRCT) before sectioning. The PF was observed to be a narrow fissure measuring a maximum of 0.8 mm between processus brevis of the malleus and the notch of Rivinus in pars squamosa (pars tensa diameter 10–12 mm). It seems unlikely that the PF of the hooded seal participates in pressure equalization in the middle ear. The main function of the lateral wall of the attic, including the minimal PF, appears to be to protect the middle-ear ossicles and allow movement of the malleus.
Primary leiomyoma of the thyroid gland
Authors: Erkiliç Suna , Erkiliç Ahmet , Bayazit Yildirim A. 
Published: November 2003

Primary thyroid leiomyomas are rare, and only four cases have been reported to date. This is a report of an additional case of primary thyroid leiomyoma in a 40-year-old male who was admitted with a painless swelling in the right thyroid lobe and underwent subtotal thyroidectomy. The surgical specimen showed a well-circumscribed, greyish-white solid nodule. Histologically, the tumour was composed of spindle cells with blunt-ended nuclei that were arranged with short intersecting bundles.Immunohistochemical staining revealed reactivity with smooth muscle actin, vimentin and desmin. Histopathologic and immunohistochemical assessments produced the diagnosis of thyroid leiomyoma.Although primary thyroid leiomyoma is rare, it should be considered in the differential diagnosis of a cold thyroid nodule.
Benzoyl Piperidine
Authors: Marvel C. S. , Lazier W. A. 
Published: November 2003

Abstract

Benzoyl piperidine

product: Benzoyl piperidine thus obtained is a straw‐colored viscous liquid. Upon long standing or seeding with crystalline benzoyl piperidine

reactant: 170 g. of piperidine (2.0 moles)
Azlactone of α‐Benzoylamino‐β‐(3,4‐dimethoxyphenyl)‐acrylic Acid
Authors: Buck Johannes S. , Ide Walter S. 
Published: November 2003

Abstract

Azlactone of α‐benzoylamino‐β‐(3,4‐dimethoxyphenyl)‐acrylic acid

product: azlactones of α‐benzoylaminocinnamic acids
Pelargonic Acid
Authors: Reid E. Emmet , Ruhoff John R. 
Published: November 2003

AbstractPelargonic acidreactant: 2.5 l. of anhydrous butyl alcoholreactant: 800 g. (5 moles) of redistilled ethyl malonatereactant: 913 g. (5.1 moles) of pure heptyl bromideproduct: pelargonic acid
β‐Di‐
n
‐Butylaminoethylamine
Authors: Amundsen Lawrence H. , Krantz Karl W. , Sanderson James J. 
Published: November 2003

Abstract

β‐Di‐
n
‐butylaminoethylamine

reactant: 49 g. (0.16 mole) of di‐
n
‐butylaminoethyl bromide hydrobromide

product: Di‐
n
‐butylaminoethylamine
Phenylpropargyl Aldehyde
Authors: Allen C. F. H. , Edens C. O. 
Published: November 2003

Abstract

Phenylpropargyl aldehyde

intermediate: α‐Bromocinnamic aldehyde

intermediate: α‐
Bromocinnamic aldehyde acetal

intermediate: phenylpropargyl aldehyde acetal

product: phenylpropargyl aldehyde
β‐Aminopropionitrile and
bis
‐(β‐Cyanoethyl)‐amine
Authors: Buc Saul R. 
Published: November 2003

Abstract

β‐Aminopropionitrile and
bis
‐(β‐cyanoethyl)‐amine

byproduct:
tris
‐(β‐cyanoethyl) amine

product: β‐Aminopropionitrile

product:
bis
‐(β‐cyanoethyl) amine
trans‐1‐Phenyl‐1,3‐Butadiene
Authors: Grummitt Oliver , Becker Ernest I. 
Published: November 2003

Abstracttrans‐1‐phenyl‐1,3‐butadienereactant: 66.1 g. (0.50 mole) of cinnamaldehydeproduct:trans‐1‐phenyl‐1,3‐butadienebyproduct:trans‐methylstyrylcarbinolsolvent: petroleum ether
o
‐Tolualdehyde
Authors: Hass H. B. , Bender Myron L. 
Published: November 2003

Abstract

o
‐Tolualdehyde

product:
o
‐tolualdehyde

:
p
‐Bromobenzaldehyde

: Benzaldehyde

:
p
‐Carbomethoxybenzaldehyde

:
p
‐Cyanobenzaldehyde

:
p
‐Trifluoromethylbenzaldehyde
1,2‐Cyclohexanedione Dioxime
Authors: Hach Clifford C. , Banks Charles V. , Diehl Harvey 
Published: November 2003

Abstract

1,2‐Cyclohexanedione dioxime

intermediate: 1,2‐cyclohexanedione

product: 0.5 g. of nioxime (1,2‐cyclohexanedione dioxime)
Benzeneboronic Anhydride
Authors: Washburn Robert M. , Levens Ernest , Albright Charles F. , Billig Franklin A. 
Published: November 2003

Abstract

Benzeneboronic anhydride

reactant: Three hundred thirty‐six milliliters (312 g., 3 moles) of methyl borate

intermediate: benzeneboronic acid

product: benzeneboronic anhydride

reactant: methanol
Benzenediazonium‐2‐Carboxylate and Biphenylene
Authors: Logullo Francis M. , Seitz Arnold H. , Friedman Lester 
Published: November 2003

Abstract

Benzenediazonium‐2‐carboxylate and biphenylene

solvent: 50‐ml. portions of 1,2‐dichloroethane

product: benzenediazonium‐2‐carboxylate

product: biphenylene
Bicyclo[2.1.0]Pentane
Authors: Gassman P. G. , Mansfield K. T. 
Published: November 2003

Abstract

Bicyclo[2.1.0]pentane

intermediate: diethyl 2,3‐diazabicyclo[2.2.1]hept‐5‐ene‐2,3‐dicarboxylate

intermediate: diethyl 2,3‐diazabicyclo[2.2.1]heptane‐2,3‐dicarboxylate

intermediate: 2,3‐diazabicyclo [2.2.1]hept‐2‐ene

product: bicyclo[2.1.0]pentane
Oxidation with Bis(salicylidene)ethylenediiminocobalt(II) (Salcomine): 2,6‐Di‐
tert
‐butyl‐
p
‐benzoquinone
Authors: De Jonge C. R. H. I. , Hageman H. J. , Hoentjen G. , Mijs W. J. 
Published: November 2003

Abstract

Oxidation with Bis(salicylidene)ethylenediiminocobalt(II) (salcomine): 2,6‐Di‐
tert
‐butyl‐
p
‐benzoquinone

product: 2,6‐di‐
tert
‐butyl
p
‐benzoquinone

product: 2,6‐diphenyl‐
p
‐benzoquinone

product: 2,6‐dimethoxy‐
p
‐benzoquinone
Tropolone
Authors: Minns Richard A. 
Published: November 2003

AbstractTropolonereactant: 100 g. (0.678 mole) of dichloroacetyl chlorideintermediate: dicyclopentadieneintermediate: 7,7‐dichlorobicyclo[3.2.0]hept‐2‐en‐6‐oneproduct: tropolone
Oxidation of Alcohols by Methyl Sulfide‐
N
‐Chlorosuccinimide‐ Triethylamine: 4‐
tert
‐Butylcyclohexanone
Authors: Corey E. J. , Kim C. U. , Misco P. F. 
Published: November 2003

Abstract

Oxidation of alcohols by methyl sulfide‐
N
‐chlorosuccinimide‐ triethylamine: 4‐
tert
‐butylcyclohexanone

catalyst: 8.0 g. (0.060 mole) of
N
‐chlorosuccinimide

product: 4‐
tert
‐butylcyclohexanone

byproduct: 4‐
tert
‐butylcyclohexylmethyl methylthiomethyl ether

product: C6H5CHO
β‐Alkyl‐α,β‐Unsaturated Esters from Enol Phosphates of β‐Keto Esters: Methyl 2‐Methyl‐1‐Cyclohexene‐1‐Carboxylate
Authors: Alderdice Margot , Sum F. W. , Weiler Larry 
Published: November 2003

Abstractβ‐Alkyl‐α,β‐unsaturated esters from enol phosphates of β‐keto esters: methyl 2‐methyl‐1‐cyclohexene‐1‐carboxylateintermediate: methyl 2‐oxocyclohexanecarboxylateintermediate: Methyl 2‐(diethylphosphoryloxy)‐1‐cyclohexene‐1‐carboxylateproduct: methyl 2‐methyl‐1‐cyclohexene‐1‐carboxylatebyproduct: 1‐acetyl‐2‐methylcyclohexenesolvent: petroleum ether
Ozonolytic Cleavage of Cyclohexene to Terminally Differentiated Products: Methyl 6‐Oxohexanoate, 6,6‐Dimethoxyhexanal, Methyl 6,6‐Dimethoxyhexanoate
Authors: Claus Ronald E. , Schreiber Stuart L. 
Published: November 2003

Abstract

Ozonolytic cleavage of cyclohexene to terminally differentiated products: Methyl 6‐oxohexanoate, 6,6‐dimethoxyhexanal, methyl 6,6‐dimethoxyhexanoate

product: 6,6‐dimethoxyhexanal

product: methyl 6‐oxohexanoate

product: methyl (6,6‐dimethoxy)hexanoate
Oxidative Cleavage of an Aromatic Ring:
cis,cis
‐Monomethyl Muconate from 1,2‐Dihydroxybenzene
Authors: Bankston Donald 
Published: November 2003

Abstract

Oxidative cleavage of an aromatic ring:
cis,cis
‐monomethyl muconate from 1,2‐dihydroxybenzene

solvent: 400 mL of pyridine

product: cis,cis‐monomethyl muconate
Synthesis of Cyclobutanones via 1‐Bromo‐1‐Ethoxycyclopropane: (
E
)‐2‐(1‐Propenyl)Cyclobutanone
Authors: Miller Scott A. , Gadwood Robert C. 
Published: November 2003

Abstract

Synthesis of cyclobutanones via 1‐bromo‐1‐ethoxycyclopropane: (
E
)‐2‐(1‐propenyl)cyclobutanone

intermediate: 1‐bromo‐1‐ethoxycyclopropane

product: (E)‐2‐(1‐Propenyl)cyclobutanone.

intermediate: 15.3 g (0.098 mol) of (E)‐1‐ethoxy‐1‐(1‐hydroxy‐2‐butenyl)cyclopropane
Benzoannelation of Ketones: 3,4‐Cyclododeceno‐1‐Methylbenzene
Authors: Tius Marcus A. , Kannangara G. S. Kamali 
Published: November 2003

Abstract

Benzoannelation of ketones: 3,4‐cyclododeceno‐1‐methylbenzene

reactant: Methallyl chloride, 64.6 mL (0.65 mol,)

reactant: 12.6 g (60.0 mmol) of 2‐(hydroxymethylene)cyclododecanone

product: 3,4‐Cyclododeceno‐1‐methylbenzene.
Levels of paraoxonase and arylesterase activities and malondialdehyde in workers exposed to ionizing radiation
Authors: Serhatlioglu Selami , Gursu M. Ferit , Gulcu Funda , Canatan Halit , Godekmerdan Ahmet 
Published: November 2003

AbstractWe examined levels of malondialdehyde (MDA) (an end‐product of lipid peroxidation) and paraoxonase (PON1) (an antioxidant enzyme) activity and PON1 phenotypes in people who were exposed to ionizing radiation for different time periods and doses. A total of 78 individuals (mean age 34 ± 7 years) were included in the study. Fifty‐one of them were radiology workers whereas the control group was composed of 27 healthy volunteers who had never worked in a radiology‐related job. Paraoxon was used as substrate for measurement of PON1 activity levels (basal and NaCl‐stimulated). Phenylacetate was used as substrate for measurement of arylesterase activity levels. Cumulative levels of serum NaCl‐stimulated PON1/arylesterase activities were utilized for phenotypic differentiation. In radiology workers, three different phenotypes were determined based on paraoxonase/arylesterase ratio. The ratios were 1.09 ± 0.30 for AA (homozygote low activity); 2.91 ± 1.07 for AB (heterozygote activity) and 4.97 ± 1.21 for BB (homozygote high activity). There was a statistically meaningful negative correlation between serum MDA levels and PON1 activity levels in all phenotypes (p < 0.05). PON1 activity levels were found to be 25–35% lower in people who were exposed to long‐term ( > 5 years) radiation compared to controls. There was no statistically significant correlation between serum arylesterase activity and MDA levels in these subjects (r = −0.185, p > 0.05). PON1 activity levels were decreased whereas serum MDA levels were increased in individuals exposed to radiation for a long period. PON phenotypes of people employed in jobs which expose them to radiation should be determined and based on these findings they should be advised to avoid risk factors inducing oxidative stress, such as smoking, and to consume foods rich in vitamins and trace elements to increase their antioxidant capacity. Copyright © 2003 John Wiley & Sons, Ltd.
Nonionic low‐osmolar contrast media have no impact on major adverse cardiac events in patients undergoing coronary stenting with appropriate antiplatelet therapy
Authors: Danzi Gian B. , Capuano Cinzia , Sesana Marco , Predolini Simonetta , Baglini Roberto 
Published: November 2003

AbstractThe aim of this study was to assess the impact of two nonionic low‐osmolar monomers (iopamidol and iopromide) and one ionic low‐osmolar dimeric contrast medium (ioxaglate) on 30‐day major adverse cardiac events in patients undergoing coronary interventions involving the use of new‐generation stents and appropriate antiplatelet agents. Thirteen hundred and eight patients treated with stent implantation were randomized to receive ioxaglate (438 patients), iopamidol (442 patients), or iopromide (428 patients). Most of them (55%) had an acute coronary syndrome. Glycoprotein IIb/IIIa inhibitors were used in 37% of cases. All of the patients were on aspirin and ticlopidine for 1 month after the procedure. There was no significant between‐group difference in the incidence of the primary composite endpoint of major adverse cardiac events 30 days after stenting (ioxaglate 3.6%; iopamidol 2.3%; iopromide 4.2%; P = 0.27). Adverse drug reactions were more frequent in the ioxaglate group (4.6% vs. 1.1% vs. 0.5%; P = 0.001). Multivariate analysis showed that intracoronary thrombus (P = 0.002), diabetes mellitus (P = 0.01), and postprocedure minimum lumen diameter (P = 0.04) independently correlated with an adverse outcome after 1 month. In conclusion, no significant differences in 30‐day major ischemic complications were observed in this unselected population of patients undergoing coronary stenting who received ioxaglate, iopamidol, or iopromide. These data seem to suggest that the use of nonionic low‐osmolar contrast media does not adversely affect stent patency. Catheter Cardiovasc Interv 2003;60:477–482. © 2003 Wiley‐Liss, Inc.