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Terms modified by Increasing Body Selected AbstractsEpidemiology of slow and fast colonic transit using a scale of stool form in a communityALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2007R. S. CHOUNG Summary Background, Measurement of gastrointestinal transit is commonly performed in the clinic, but data on transit in the community are lacking. Aim, To estimate the prevalence of slow and fast colonic transit using stool form, and potential risk factors. Methods, A validated self-reported gastrointestinal symptom questionnaire was mailed to 4196 randomly selected members of the community (response rate 54%). One question asked the subject to self-report their stool form using the Bristol Stool Scale. Results, Overall, 18%, 9% and 73% met stool form criteria for slow, fast or normal colonic transit, respectively. Increased odds for slow transit were observed with a higher Somatic Symptom Checklist score (OR = 1.6; 1.3,2.0), while a decreased odds for slow transit was observed in males relative to females (OR = 0.6; 0.5,0.8). An increased odds for fast transit was observed with higher Somatic Symptom Checklist score (OR = 2.3; 1.7,2.9) and a history of cholecystectomy (OR = 1.8; 1.2,2.8). Increasing body mass index (per 5 units) was associated with decreased odds for slow (OR = 0.85; 0.78,0.93), and an increased odds for fast (OR = 1.1; 1.04,1.24) colonic transit. Conclusion, Based on stool form assessment, nearly one in five community members may have slow colonic transit and one in 12 have accelerated colonic transit. [source] Novel non-invasive approach for visualizing inflamed atherosclerotic plaques using fluorodeoxyglucose-positron emission tomographyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2010Hisashi Kai There is an increasing body of evidence that a dynamic inflammatory process plays a role in the initiation, progression and destabilization of atherosclerotic plaques. The biological composition and inflammatory state of an atherosclerotic plaque, rather than the degree of stenosis or its size, are the major determinants of life-threatening events, such as ischemic cerebrovascular accident and acute coronary syndrome. To date, there is no non-invasive method clinically available for visualizing inflammation of individual plaques. Recently, we and others have shown that 18(F)-fluorodeoxyglucose (FDG) uptake, namely inflammation, can be evaluated quantitatively in the aortic, carotid, iliac and femoral plaques by using FDG positron emission tomography (PET) co-registered with computed tomography (FDG-PET/CT). Therefore, FDG-PET/CT, a combined functional and structural wholebody imaging modalities, holds great promise for non-invasive evaluation of inflammation , namely, activity , of atherosclerotic plaques of large arteries. [source] The role of the information specialist in the systematic review process: a health information case studyHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2003C. A. Beverley There is an increasing body of literature on the information specialist's role in supporting evidence-based health care. In particular, the information component in systematic reviews has received considerable attention in recent years. Information professionals have evolved from simply acting as ,evidence locators' and ,resource providers' to being quality literature filterers, critical appraisers, educators, disseminators, and even change managers. This paper describes ten possible roles for information professionals in the systematic review process, using a case study of a review of the health information needs of visually impaired people carried out by the Centre for Health Information Management Research (CHIMR) at the University of Sheffield. This health information review was undertaken entirely by a team of information professionals. The ten roles identified are: project leader, project manager, literature searcher, reference manager, document supplier, critical appraiser, data extractor, data synthesiser, report writer and disseminator. This review has also identified an eleventh possible role for information professionals; that of primary researcher. Finally, the implications for evidence-based health care and evidence-based health informatics are discussed. [source] Mutations of the CEP290 gene encoding a centrosomal protein cause Meckel-Gruber syndrome,HUMAN MUTATION, Issue 1 2008Valeska Frank Abstract Meckel-Gruber syndrome (MKS) is an autosomal recessive, lethal multisystemic disorder characterized by meningooccipital encephalocele, cystic kidney dysplasia, hepatobiliary ductal plate malformation, and postaxial polydactyly. Recently, genes for MKS1 and MKS3 were identified, putting MKS on the list of ciliary disorders (ciliopathies). By positional cloning in a distantly related multiplex family, we mapped a novel locus for MKS to a 3-Mb interval on 12q21. Sequencing of the CEP290 gene located in the minimal critical region showed a homozygous 1-bp deletion supposed to lead to loss of function of the encoded centrosomal protein CEP290/nephrocystin-6. CEP290 is thought to be involved in chromosome segregation and localizes to cilia, centrosomes, and the nucleus. Subsequent analysis of another consanguineous multiplex family revealed homozygous haplotypes and the same frameshift mutation. Our findings add to the increasing body of evidence that ciliopathies can cause a broad spectrum of disease phenotypes, and pleiotropic effects of CEP290 mutations range from single organ involvement with isolated Leber congenital amaurosis to Joubert syndrome and lethal early embryonic multisystemic malformations in Meckel-Gruber syndrome. We compiled clinical and genetic data of all patients with CEP290 mutations described so far. No clear-cut genotype,phenotype correlations were apparent as almost all mutations are nonsense, frameshift, or splice-site changes and scattered throughout the gene irrespective of the patients' phenotypes. Conclusively, other factors than the type and location of CEP290 mutations may underlie phenotypic variability. Hum Mutat 29(1), 45,52, 2008. © 2007 Wiley-Liss, Inc. [source] Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 5 2010Lucy Goulding goulding l., furze g. & birks y. (2010) Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review. Journal of Advanced Nursing,66(5), 946,961. Abstract Title.,Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review. Aim., This paper is a report of a systematic review of randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease, and was conducted to determine whether such interventions were effective in changing maladaptive beliefs, and to assess any consequent change in coping and outcome. Background., An increasing body of evidence suggests that faulty beliefs can lead to maladaptive behaviours and, in turn, to poor outcomes. However, the effectiveness of interventions to change such faulty illness beliefs in people with coronary heart disease is unknown. Data sources., Multiple data bases were searched using a systematic search strategy. In addition, reference lists of included papers were checked and key authors in the field contacted. Review methods., The systematic review included randomized controlled trials with adults of any age with a diagnosis of coronary heart disease and an intervention aimed at changing cardiac beliefs. The primary outcome measured was change in beliefs about coronary heart disease. Results., Thirteen trials met the inclusion criteria. Owing to the heterogeneity of these studies, quantitative synthesis was not practicable. Descriptive synthesis of the results suggested that cognitive behavioural and counselling/education interventions can be effective in changing beliefs. The effects of changing beliefs on behavioural, functional and psychological outcomes remain unclear. Conclusion., While some interventions may be effective in changing beliefs in people with coronary heart disease, the effect of these changes on outcome is not clear. Further high quality research is required before firmer guidance can be given to clinicians on the most effective method to dispel cardiac misconceptions. [source] A literature review comparing the experiences and emergent needs of adult patients with permanent pacemakers (PPMs) and implantable cardioverter defibrillators (ICDs)JOURNAL OF CLINICAL NURSING, Issue 15-16 2010Jenny Tagney Aims and objectives., This literature review aims to critically appraise any published studies that compare the experiences of patients with permanent pacemakers and those with implantable cardioverter defibrillators. It seeks to identify issues that are similar or unique to one or other group; whether identified needs are being met by current nursing practice and considers how any gaps might be addressed. Background., Increasing numbers of patients are receiving pacemakers and implantable cardioverter defibrillators (ICDs) as indications for devices continue to expand worldwide. Technical follow-up of such patients is well structured. There is an increasing body of knowledge regarding ICD patients' experiences with promising work testing recovery interventions but less seems to be known about pacemaker patients. Design., Systematic review. Methods., Using an integrative approach, electronic searches using comprehensive search terms were supplemented by following reference lists and key journals from 1975,2008. Conclusion., From the direct comparison studies identified, ICD patients who experience shocks are more likely to report lifestyle limitations than pacemaker patients. However, ICD and pacemaker patients share similar outcomes, with both groups reporting increased anxiety and depression. Whilst experiences of ICD patients have been well reported, experiences of patients receiving pacemakers for any reason and pacemakers or ICDs for heart failure (bi-ventricular devices or cardiac resynchronisation therapy , CRT) remain largely unknown. Although psychosocial interventions are suggested for both groups, these have apparently only been tested and reported for ICD patients. Relevance to clinical practice., Nurses internationally encounter increasing numbers of patients with pacemakers and ICDs from primary to tertiary clinical care settings, therefore knowledge of patient experiences relating to such devices and their impact is important to inform care planning. Whilst interventions to assist ICD patients are being tested, further research is required regarding the experiences of patients with contemporary pacemakers to inform care planning and potential nursing support interventions. [source] Effect of an essential oil-containing antiseptic mouthrinse on induction of platelet aggregation by oral bacteria in vitroJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2000E. J. Whitaker Abstract Background: With an increasing body of data suggesting an association between periodontitis and cardiovascular disease, studies have been conducted to elucidate potential mechanisms by which oral bacteria might exert systemic effects. 2 oral bacteria, Streptococcus sanguis and Porphyromonas gingivalis, have been shown to induce platelet aggregation in vitro. This study was conducted to determine the effect of treatment with an essential oil mouthrinse (Listerine® Antiseptic) on the platelet-aggregating activity of these organisms. Method: Bacteria were grown under standard culture conditions. S. sanguis ATCC strain 10556 was exposed for 3 min to the essential oil mouthrinse at either full strength or a 1:1 dilution, while P. gingivalis FDC strain 381 was exposed to the essential oil mouthrinse at a 1:10 dilution. Positive control cells were treated with Hanks balanced salt solution (HBSS). Aggregation was measured using a recording platelet aggregometer. The assay of each organism in its respective mouthrinse dilution(s) or HBSS was repeated 5 times. Results: In all cases, the HBSS-treated organisms induced platelet aggregation, with mean(±S.E.) lag times of 12.30 (±1.36) min and 11.36 (±0.58) min for P. gingivalis and S. sanguis, respectively. In contrast, treatment with the essential oil mouthrinse completely inhibited the platelet aggregating activity of P. gingivalis and of S. sanguis exposed to the 1:1 mouthrinse dilution in all assays; the aggregating activity of S. sanguis treated with full-strength mouthrinse was completely inhibited in 4 of 5 assays, and inhibited by 75% in the 5th, for a mean inhibition of 95±1.5%. Conclusion: This study provides additional evidence that the essential oil mouthrinse can interfere with bacterial cell surface-associated activities which may have clinical relevance. [source] A systematic review on communicating with patients about evidenceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2006Lyndal J Trevena MBBS (Hons) MPhilPH Abstract Objective, To conduct a systematic search for (1) the effectiveness of evidence-based communication tools to increase patient understanding of evidence, (2) effective formats for representing probabilistic information and (3) effective strategies for eliciting patient preferences about evidence. A case scenario is used to illustrate some of the difficulties of putting these results into practice., ,Data sources, Systematic search of The Cochrane Library, Medline, Psychinfo, Embase and Cancerlit. Review methods, Systematic reviews of randomized controlled trials (RCTs) and high quality RCTs were included. Studies were excluded if they did not address the question, were focused on behavioural outcomes without attempting to increase understanding, were concerned with counselling as a therapeutic intervention, or were specific to communication regarding clinical trial participation., ,Results, We found 10 systematic reviews of RCTs and 30 additional RCTs addressing our questions. Communication tools in most formats (verbal, written, video, provider-delivered, computer-based) will increase patients' understanding but are more likely to do so if structured, tailored and/or interactive. Probabilistic information is best represented as event rates (natural frequencies) in relevant groups of people, rather than words, probabilities or summarized as effect measures such as relative risk reduction. Illustrations such as cartoons, or graphs (vertical bar charts) appear to aid understanding. Values clarification exercises may be better than standard utility techniques for eliciting preferences in individual decision making. Looking for effective evidence-based communication tools for prostatic specific antigen testing highlighted the challenges for clinicians and consumers in accessing tools that are evidence-based in design as well as content. Conclusion, There is an increasing body of evidence supporting the design of effective evidence-based communication tools but variable access to such tools in practice. [source] Epilepsy and intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 5 2000C. Bowley Abstract A Medline and Psychline literature review of epilepsy in people with intellectual disability was performed. The review has highlighted the importance of the impact of epilepsy on the lives of individuals and their families, affecting physical morbidity, leading to an increased mortality and increasing the care-giving burden. Interventions with a strong evidence base are mainly pharmacological with an increasing body of work on the novel antiepileptic drugs. Surprisingly little research exists into the quality of service provision for this population. The authors suggest three areas for future work: (1) an increasing application of research methodologies such as direct observation and qualitative studies into this field; (2) an exploration of the broad impact of treatment and (3) the possibility that epilepsy is a barrier to care provision. [source] Acute liver failure induced by green tea extracts: Case report and review of the literatureLIVER TRANSPLANTATION, Issue 12 2006Michele Molinari In industrialized countries, over-the-counter dietary supplements have become popular in preventing and treating an expanding list of medical conditions. Although most commercially available supplements have not been rigorously tested for safety and efficacy, they have found an enlarging market because they are considered natural. Oral supplements containing green tea extract have been marketed as effective for weight loss and to prevent and cure some solid tumors. Although there is little scientific evidence of the effectiveness of green tea extracts to improve the quality of health of regular consumers, there is an increasing body of medical literature supporting the hypothesis that they can cause serious side effects. Our experience adds to previous reports of acute liver toxicity observed in individuals consuming supplements containing green tea extract. We highlight the importance of obtaining a detailed history of dietary supplement consumption when evaluating a patient presenting with acute liver dysfunction. Liver Transpl 12:1892,1895, 2006. © 2006 AASLD. [source] Finnish Allergy Programme 2008,2018 , time to act and change the courseALLERGY, Issue 6 2008T. Haahtela Background:, The prevalence of allergic diseases has grown in Finland, similarly to many other western countries. Although the origin of allergy remains unresolved, increasing body of evidence indicates that the modern man living in urban built environment is deprived from environmental protective factors (e.g. soil microorganisms) that are fundamental for normal tolerance development. The current dogma of allergen avoidance has not proved effective in halting the ,epidemic', and it is the Finnish consensus that restoring and strengthening tolerance should more be in focus. Aim:, The national 10-year programme is aimed to reduce burden of allergies. The main goals are to (i) prevent the development of allergic symptoms; (ii) increase tolerance against allergens; (iii) improve the diagnostics; (iv) decrease work-related allergies; (v) allocate resources to manage and prevent exacerbations of severe allergies and (vi) decrease costs caused by allergic diseases. Methods:, For each goal, specific tasks, tools and evaluation methods are defined. Nationwide implementation acts through the network of local co-ordinators (primary care physicians, nurses, pharmacists). In addition, three nongovernmental organizations (NGOs) take care of the programme implementation. The 21 central hospital districts carry out a three step educational process: (i) healthcare personnel; (ii) representatives and educators of NGOs and (iii) patients and the general population. For outcome evaluation, repeated surveys are performed and healthcare registers employed at the beginning, at 5 years, and at the end of the programme. The process will be evaluated by an independent external body. Conclusion:, The Finnish initiative is a comprehensive plan to reduce burden of allergies. The aim is to increase immunological tolerance and change attitudes to support health instead of medicalizing common and mild allergy symptoms. It is time to act, when allergic individuals are becoming a majority of western populations and their numbers are in rapid increase worldwide. The Programme is associated with the Global Alliance of Chronic Respiratory Diseases (GARD), WHO. [source] Recent advances in the role and biosynthesis of ascorbic acid in plantsPLANT CELL & ENVIRONMENT, Issue 4 2001P. L. Conklin ABSTRACT The past few years have provided many advances in the role and biosynthesis of L -ascorbic acid (AsA) in plants. There is an increasing body of evidence confirming that AsA plays an important role in the detoxification of reactive oxygen species. The role of AsA in photoprotection has been confirmed in vivo with the use of Arabidopsis mutants. A player in the defence against reactive oxygen species, AsA peroxidase, has been extensively studied at the molecular level, and regulation of this key enzymatic activity appears to occur at several levels. As a cofactor in the hydroxylation of prolyl and lysl-residues by peptidyl-prolyl and -lysyl hydroxylases, AsA plays a part in cell wall synthesis, defence, and possibly cell division. The maintenance of reduced levels of AsA appears to be highly regulated, involving the interplay of both monodehydroascorbate and dehydroascorbate reductases and possibly auxin. A major breakthrough in plant AsA biosynthesis has been made recently, and strong biochemical and genetic evidence suggest that GDP-mannose and L -galactose are key substrates. In addition, evidence for an alternative AsA biosynthetic pathway(s) exists and awaits additional scrutiny. Finally, newly described Arabidopsis mutants deficient in AsA will further increase our understanding of AsA biosynthesis [source] Multiple diverse ligands binding at a single protein site: A matter of pre-existing populationsPROTEIN SCIENCE, Issue 2 2002Buyong Ma Abstract Here, we comment on the steadily increasing body of data showing that proteins with specificity actually bind ligands of diverse shapes, sizes, and composition. Such a phenomenon is not surprising when one considers that binding is a dynamic process with populations in equilibrium and that the shape of the binding site is strongly influenced by the molecular partner. It derives implicitly from the concept of populations. All proteins, specific and nonspecific, exist in ensembles of substates. If the library of ligands in solution is large enough, favorably matching ligands with altered shapes and sizes can be expected to bind, with a redistribution of the protein populations. Point mutations at spatially distant sites may exert large conformational rearrangements and hinge effects, consistent with mutations away from the binding site leading to population shifts and (cross-)drug resistance. A similar effect is observed in protein superfamilies, in which different sequences with similar topologies display similar large-scale dynamic motions. The hinges are frequently at analogous sites, yet with different substrate specificity. Similar topologies yield similar conformational isomers, although with different distributions of population times, owing to the change in the conditions, that is, the change in the sequences. In turn, different distributions relate to binding of different sizes and shapes. Hence, the binding site shape and size are defined by the ligand. They are not independent entities of fixed proportions and cannot be analyzed independently of the binding partner. Such a proposition derives from viewing proteins as dynamic distributions, presenting to the incoming ligands a range of binding site shapes. It illustrates how presumably specific binding molecules can bind multiple ligands. In terms of drug design, the ability of a single receptor to recognize many dissimilar ligands shows the need to consider more diverse molecules. It provides a rationale for higher affinity inhibitors that are not derived from substrates at their transition states and indicates flexible docking schemes. [source] Complex interactions among mammalian carnivores in Australia, and their implications for wildlife managementBIOLOGICAL REVIEWS, Issue 3 2005Alistair S. Glen ABSTRACT Mammalian carnivore populations are often intensively managed, either because the carnivore in question is endangered, or because it is viewed as a pest and is subjected to control measures, or both. Most management programmes treat carnivore species in isolation. However, there is a large and emerging body of evidence to demonstrate that populations of different carnivores interact with each other in a variety of complex ways. Thus, the removal or introduction of predators to or from a system can often affect other species in ways that are difficult to predict. Wildlife managers must consider such interactions when planning predator control programmes. Integrated predator control will require a greater understanding of the complex relationships between species. In many parts of the world, sympatric species of carnivores have coexisted over an evolutionary time scale so that niche differentiation has occurred, and competition is difficult to observe. Australia has experienced numerous introductions during the past 200 years, including those of the red fox (Vulpes vulpes) and the feral cat (Felis catus). These species now exist in sympatry with native mammalian predators, providing ecologists with the opportunity to study their interactions without the confounding effects of coevolution. Despite an increasing body of observational evidence for complex interactions among native and introduced predators in Australia, few studies have attempted to clarify these relationships experimentally, and the interactions remain largely unacknowledged. A greater understanding of these interactions would provide ecologists and wildlife managers world-wide with the ability to construct robust predictive models of carnivore communities, and to identify their broader effects on ecosystem functioning. We suggest that future research should focus on controlled and replicated predator removal or addition experiments. The dingo (Canis lupus dingo), as a likely keystone species, should be a particular focus of attention. [source] Retinal neurodegeneration: early pathology in diabetesCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2000Erich Lieth ABSTRACT Normal vision depends on the normal function of retinal neurons, so vision loss in diabetes must ultimately be explained in terms of altered neuronal function. However, to date relatively little attention has been paid to the impact of diabetes on the neural retina. Instead, the focus of most research has been primarily on retinal vascular changes, with the assumption that they cause altered neuronal function and consequently vision loss. An increasing body of evidence suggests that alterations in neuronal function and viability may contribute to the pathogenic mechanisms of diabetic retinopathy beginning shortly after the onset of diabetes. This view arises from neurophysiological, psychometric, histopathological and biochemical observations in humans and experimental animals. The collective evidence from past and recent studies supports the hypothesis that neurodegeneration, together with functional changes in the vasculature, is an important component of diabetic retinopathy. The authors invite other investigators to include the neural retina as a component of their studies so that the pathogenesis of diabetic retinopathy can be understood more clearly. [source] | ||||||||||||||||||||||