bluuebunny/crossref_metadata_2025 huggingface dataset:
T‐cell interleukin‐6 receptor binding in interferon‐β‐1b‐treated multiple sclerosis patients
Authors: Bongioanni P. , Lombardo F. , Moscato G. , Mosti S. , Meucci G.
Published: February 2003

Multiple sclerosis (MS) is a T‐cell‐mediated autoimmune demyelinating disease of the central nervous system, associated with an altered cytokine network. We previously assayed peripheral blood T‐lymphocyte binding for two prototypic cytokines, tumour necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), and found that T cells from MS patients had significantly more TNF‐α and IL‐6 receptors than those from healthy controls. In the present work, paralleling a previous one on T‐cell TNF‐α binding, we studied the effect of interferon (IFN)‐β‐1b treatment on T‐lymphocyte IL‐6 binding in patients with relapsing–remitting MS. T cells from MS patients had significantly (P < 0.001) higher amounts of IL‐6 receptors than those from controls [292 ± 6 vs. 228 ± 8 (mean ± SEM) receptors per cell, respectively], whereas the ligand‐receptor affinity values were similar in the two groups [26.2 ± 0.7 and 25.7 ± 0.4 (mean ± SEM) pmoles/l, respectively]. After a 3‐month IFN‐β‐1b treatment, they showed a significant decrease in IL‐6 binding [266 ± 7 (mean ± SEM) receptors per cell]. After 6 and 9 months, T‐cell IL‐6 Bmax values were even lower [258 ± 8 and 251 ± 8 (mean ± SEM) receptors per cell]. Since an increased IL‐6 binding might be linked to a lymphocyte activation, our data give further support for an enhanced immune response in patients with MS. Our data seem to demonstrate that the major effects of IFN‐β‐1b treatment result in a decrease of T‐cell activation.
Transcranial colour‐coded sonography for the bedside evaluation of mass effect after stroke
Authors: Bertram M. , Khoja W. , Ringleb P. , Schwab S.
Published: February 2003

Repeated cranial computerized tomography scan examination in patients with elevated intracranial pressure is time consuming and requires patient transportation. We prospectively evaluated the diagnostic value of transcranial duplex sonography as a bedside tool for detection of the mass effect after space‐occupying ischemic stroke and brain haemorrhage and for evaluating the width and dislocation of the ventricular system and the dislocation of brain mid‐line structures.

We used transcranial duplex sonography in 21 consecutive patients with space‐occupying ischemic middle cerebral artery infarction and brain haemorrhage. The transcranial duplex sonography examinations were performed within 2 h before or after corresponding follow‐up cranial computerized tomography scans. We measured the third ventricular width as a parameter for infratentorial and the mid‐line shift for supratentorial space‐occupying effect.

In all patients, mid‐line structures could be identified by transcranial duplex sonography. Significant third ventricular dilation was found subsequently in most patients with infratentorial mass effect, and mid‐line shift occurred in all patients with supratentorial space‐occupying lesions, respectively. The mean difference (absolute values) between transcranial duplex sonography and cranial computerized tomography measurements was 0.8 mm for the ventricular width (standard deviation 1 mm) and 1.1 mm for the mid‐line shift (standard deviation: 1.46 mm), with a tendency for these parameters to be underestimated at higher values using transcranial duplex sonography. The linear correlation coefficients were R = 0.97 and R = 0.94, respectively.

Transcranial duplex sonography appears to be a sufficiently reliable bedside method for evaluating the width and the lateral displacement of the third ventricle, as validated by cranial computerized tomography scan. Thus, it may be suitable for monitoring the space‐occupying effect of both supra‐ and infratentorial strokes during treatment on critical care and stroke units.
The effect of magnesium oral therapy on spasticity in a patient with multiple sclerosis
Authors: Rossier P. , van Erven S. , Wade D. T.
Published: February 2003

The effects of magnesium glycerophosphate oral therapy on spasticity was studied in a 35‐year‐old woman with severe spastic paraplegia resulting from multiple sclerosis (MS). We found a significant improvement in the spasticity after only 1 week from the onset of the treatment on the modified Ashworth scale, an improvement in the range of motion and in the measures of angles at resting position in lower limbs. No side‐effects were reported and there was no weakness in the arms during the treatment.
Ictal generalized rhythmic alpha activity during non‐convulsive status epilepticus
Authors: Bauer J. , Neumann M. , Kölmel H. W. , Elger C. E.
Published: February 2003

We investigated the repetitive manifestation of non‐convulsive status epilepticus with an uncommon ictal electroencephalographic pattern observed in two patients suffering from epilepsy (aged 29 and 55 years). The patients had suffered from epilepsy since the age of 1 and 40 years, respectively. Interictal and ictal neurological, neuropsychological and electroencephalographic investigations were carried out. Non‐convulsive status started and ended abruptly, clinically as well as electroencephalographically. The ictal electroencephalographic pattern was a monomorphic alpha activity with a generalized bilateral distribution. Altered responsiveness, sometimes eyelid myoclonia (in one patient) and amnesia were the most characteristic clinical findings during non‐convulsive status. Intellectual development was delayed in the patient with early onset of epilepsy. However, this was not the case in the other patient, who developed memory impairment during the course of the disease. In both patients, lamotrigine added to valproate reduced the frequency of status epileptici significantly. Obviously, these patients suffer(ed) from a type of generalized non‐convulsive status epilepticus with an uncommon electroencephalographic pattern.
Hyperreflexia in a patient with motor axonal Guillain–Barré syndrome
Authors: Podnar S. , Vodušek D. B.
Published: February 2003

We report a patient who presented after an episode of diarrhoea with ascending, symmetrical weakness without sensory loss, and without sphincter or other autonomic dysfunction. On clinical examination there were no cranial nerve deficits. Hyperreflexia of tendon jerks without other upper motor neurone signs was found. Electrophysiological examination demonstrated acute distal symmetrical motor axonal polyneuropathy. No electrophysiological signs of peripheral nerve demyelination or central nervous system involvement were found. Albuminocytologic dissociation was present in the cerebrospinal fluid. Stool culture and serological tests were inconclusive.

Our patient's clinical picture was, apart from hyperreflexia of tendon jerks throughout the disease, characteristic of Guillain–Barré syndrome. This is the first such patient reported in Europe. The aetiology remained unclear. We suggest that selective axonal motor fibre affection, with possible mild pyramidal involvement, caused tendon jerk hyperreflexia.
Myelopathy following influenza vaccination in inflammatory CNS disorder treated with chronic immunosuppression
Authors: Larner A. J. , Farmer S. F.
Published: February 2003

We report a patient who developed a transverse myelitis with Brown–Séquard syndrome following a prophylactic influenza vaccination, despite being chronically immunosuppressed for a steroid‐responsive optic neuropathy. Although influenza vaccination is recommended in patients receiving chronic immunosuppression, its use may on occasion be associated with neurological complications previously reported in immunocompetent individuals.
Vogt–Koyanagi–Harada disease presenting initially as aseptic meningoencephalitis
Authors: Kamondi A. , Szegedi A. , Papp A. , Seres A. , Szirmai I.
Published: February 2003

Vogt–Koyanagi–Harada (VKH) disease in a Gypsy woman was diagnosed 4 months after her initial complaints. The delay is explained by the facts that: (1) the characteristic ophthalmological symptoms, which usually herald the disease and ensure early diagnosis, developed only late during the course; and (2) only retrospective analysis of the cerebrospinal fluid (CSF) cell preparation proved the presence of melanin‐laden macrophages (MLMs), specific for the syndrome.

We emphasize that VKH syndrome may initially present as aseptic meningitis, without specific ophthalmological symptoms. In suspected cases a very detailed CSF cell analysis is needed, because the presence of MLMs could confirm the diagnosis. However, VKH syndrome has a much higher incidence in Asia; cases in other races, including white people in Europe, also occur.
EFNS Task Force Report: a questionnaire‐based survey on the service provision and quality assurance for determination of diagnostic autoantibody tests in European neuroimmunology centres
Authors: Willison H. J. , Ang W. , Gilhus N. E. , Graus F. , Liblau R. , Vedeler C. , Vincent A.
Published: February 2003

Autoantibodies to a wide variety of neural components are frequently sought in the sera of patients with neurological diseases suspected to have an antibody‐associated autoimmune basis. Variations in assay methodology and availability are likely to exist throughout European diagnostic immunology centres, and interlaboratory discrepancies in performance for some assays have been reported. The availability of quality assurance is largely unknown. In this questionnaire‐based EFNS task force, all 18 national representatives of the Neuroimmunology Panel within the EFNS were invited to estimate the service provision within their country; 12 panel members responded. From these responses, it emerged that a range of assays are being performed throughout European centres, involving over 20 separate antigens, using a broad array of immunodetection techniques. With the exception of the estimation of anti‐AChR antibodies for the diagnosis of myasthenia gravis, no systematic quality assurance schemes are available, this being conducted on an ad hoc basis, or not at all. Since quality is a central component of assay sensitivity and specificity, we conclude that there is an urgent need to introduce pan‐European quality assurance schemes, based on provision of positive and negative test sera from a central source, and in which all neuroimmunology laboratories should participate.
Facial nerve palsy secondary to internal carotid artery dissection
Authors: McCarron M. O. , Metcalfe R. A. , Muir K. W.
Published: February 2003

We report facial palsy as the sole cranial neuropathy complicating an ipsilateral internal carotid artery dissection. A previously healthy 44‐year‐old man developed retro‐orbital and temporal headache with associated nausea while engaged in modest physical exercise. On the following morning he noticed a left ptosis and miotic pupil. One week later he woke with a left facial weakness. On the same day he had a 90‐minute episode of expressive dysphasia. Magnetic resonance imaging and angiography demonstrated left internal carotid artery dissection. The temporal association between our patient's facial nerve palsy and typical features of spontaneous internal carotid artery dissection suggests a common aetiology. We suggest that involvement of the VII cranial nerve in isolation followed disruption of an anomalous nutrient artery. The delay in clinical manifestation may imply extension of the dissection.
Prevention of allergy and asthma
Authors: Baena‐Cagnani C. E. , Serra H. , Teijeiro A. , Croce J. S.
Published: February 2003

In the last few decades much insight has been gained on the pathogenesis and risk factors associated with atopic diseases (asthma, rhinitis and atopic dermatitis). In addition, there are very effective drugs to manage exaceabations and to control the appearance of symptoms. The prevalence of allergic diseases, particularly in western countries (mainly English‐speaking ones), and also in Latin America and Western Europe, is very high. Even in those countries with lower prevalence (such as in Africa or Asia), this has been higher than expected. In countries where surveys have been made using the same protocol in different time periods, an upward trend in the prevalence of atopic diseases has been shown. The socio‐economic impact of atopic diseases has become a public health problem and a rise in costs can be expected in correlation with the increased prevalence. The inception of atopic diseases is the consequence of genetic and environmental interactions and some changes in environment in the last few decades could partly explain this trend. The roles of infections, allergen exposure, dietary factors, among others, are being intensively studied. Nevertheless, the reason for the increasing prevalence of atopic diseases is still unknown. The primary prevention of atopic disorders emerges as an ideal way to stop the upward trend in the prevalence of allergy and asthma and different environmental factors can be targeted to ameliorate the ‘atopic epidemic’.
Allergy: discovery of immunoglobulin E to today
Authors: Johansson S. G. O.
Published: February 2003

Knowledge about the immunological, IgE‐mediated mechanisms of allergic rhinitis has improved our understanding of the disease and its diagnosis and treatment. Due to the very high prevalence of allergic rhinitis and allergy in general, allergy specialists must take responsibility for teaching GPs, family practitioners and other nonallergists to care for patients with allergy. For these nonallergy specialists the diagnosis is best restricted to in vitro quantitation of IgE antibodies performed by an accredited laboratory. Treatment should be limited to anti‐inflammatory drugs, allergen‐avoidance advice and patient care.
Allergic rhinitis and asthma: epidemiological evidence for the link
Authors: Katelaris C. H.
Published: February 2003

For years, a clinical relationship between allergic rhinoconjunctivitis (AR/C) and asthma has been observed. Recently, evidence supporting this link has been published. An important body of evidence for a real link between the two conditions has come from epidemiological studies. An increasing prevalence of both conditions is noted in the developed and developing countries. A number of studies have documented the co‐existence of AR/C and asthma, with one group reporting up to 80% of patients with asthma having AR/C. Increased bronchial hyperresponsiveness, one of the characteristic findings in asthma, is also demonstrated in those with AR/C even in the absence of clinical asthma. There are a number of common factors linking the two conditions. Atopy is a risk factor for the development of both asthma and AR/C, as is the finding of positive skin tests to common aeroallergens. There is also a well documented temporal relationship between the two conditions, with AR/C beginning soon before or simultaneously with asthma – an association noted in a number of studies examining large groups of subjects . Finally, there are a few studies that demonstrate treatment of one condition leading to an effect on the other – this has been particularly noted with the improvement in asthma control once AR/C has been adequately managed. Given the growing evidence of common factors between the two conditions and the frequent finding that they co‐exist in the same patient, management strategies must include treatment of both the upper and the lower airway rather than focusing only on the predominant complaint.
What's in a name? The allergic rhinitis–asthma connection
Authors: Simons F. E. R.
Published: February 2003

In studies conducted since the epidemic of allergic disorders began, at least 40% of young patients with allergic rhinitis have been found to have concurrent asthma, and up to 100% of young patients with allergic asthma have been found to have concurrent allergic rhinitis. Many patients with occupational or nonsteroidal anti‐inflammatory drug‐induced asthma also have concurrent allergic rhinitis. In addition to being associated epidemiologically (occurring in patients with similar genetic background and triggered by similar provoking factors), allergic rhinitis and asthma are associated anatomically, physiologically, immunopathologically, and by their response to therapeutic interventions. Anatomically, both the upper and the lower airways are lined with ciliated columnar epithelium containing mucus‐secreting goblet cells. Physiologically, they are connected not only by the nasobronchial reflex, but also by the adverse effects on the lower airways produced when nasal congestion results in mouth breathing and loss of nasal air‐conditioning (warming, humidification, and filtration of inspired air). The underlying immunopathological process is similar in allergic rhinitis and asthma. It involves not only the immediate hypersensitivity (Type I) allergic response, but also persistent allergic inflammation (the Type IVa2 response in the revised Gell and Coombs classification). In addition, the systemic immunologic response to intranasal or orally‐inhaled allergens is similar in allergic rhinitis and asthma. Down‐regulation of allergic inflammation by allergen avoidance, allergen‐specific immunotherapy, and medications such as H1‐antihistamines, leukotriene modifiers, intranasal/inhaled glucocorticoids or novel immunomodulators such as anti‐IgE is the key to managing both disorders. ‘Combined allergic rhinitis/asthma syndrome’, ‘allergic rhinobronchitis’, ‘the united airways’, ‘one airway, one disease’, and other phrases in current usage lead to increased awareness that persistent allergic inflammation occurs throughout the upper and lower airways of patients with concurrent allergic rhinitis and asthma. Terms involving the words ‘allergic’ or ‘asthma’ are preferable to nonspecific terms such as ‘united airways’ or ‘one airway, one disease’. Additional studies of the immunopathophysiological processes that link the upper and lower airways are needed.
Prevention of relapsing rhino‐sinusal polyposis: efficacy of intranasal furosemide in 104 patients
Authors: Bellussi L. , Passàli F. M. , Damiani V. , Passàli G. C
Published: February 2003

The relapse of nasal polyps after surgical treatment remains a yet unsolved medical problem and, at the same time, a challenge for researchers. Starting from the observation that oedema, vessel dilatation and inflammatory cell infiltration are the histopathological characteristics of nasal polyps, our aim is to demonstrate the long‐term efficacy of furosemide, administered by nasal inhalation, in preventing relapses of rhino‐sinusal polyps after surgical treatment. In the study discussed in this paper, two groups of patients affected by rhino‐sinusal polyposis were enrolled: 64 patients were included in the study group and 40 in the control group. After surgical treatment, the study group started the therapy with topic intranasal furosemide; the control group received no treatment. Six years after the operation only four cases of relapse were noticed in the study group (10%), while in the control group there were 12 relapses, four slight (6.4%) and eight severe (20%). Our paper concludes that local intranasal furosemide represents a valid therapeutic aid in the prevention of naso‐sinusal polyps.
Natural history of allergic rhinitis: our experience in Italy
Authors: Passà D. , Damiani V. , Passà F. M. , Mora R. , Passà G. C. , Bellussi L.
Published: February 2003

To date, several aspects of allergic rhinitis remain controversial. In particular, data concerning its epidemiological evolution are extremely contradictory and vary between negation and assertion of an increased prevalence within the last decade. In the study discussed in this paper, our aim was to follow the evolution of allergic rhinitis in three different territorial areas of Central Italy in the last 20 years and to analyse the long‐term efficacy of treatment. Between 1980 and 1981, 1620 children, attending seven state schools (four elementary and three lower secondary), were screened for allergic rhinitis. All children underwent a skin test on the inner forearm. Positive‐skin‐test children were examined to specify the exact nasal allergy. Between 1998 and 1999, positive‐skin‐test patients were contacted and re‐examined. The results revealed that elementary school children showed lower degrees of skin positivity, a better nasal patency, a more efficient nasal clearance and less frequent anomalous radiological findings. Seventy‐three children were positive to skin tests (4.5%). Forty‐six positive‐skin‐test subjects were re‐examined: 21 recovered, 12 were unchanged, 10 developed complications, three become asthmatics. Twenty‐one subjects had not received any treatment, 15 were treated with symptomatic drugs, and 10 with immunotherapy. Our study showed an increased prevalence of allergic rhinitis in the last 20 years of the 20th century, with a jump from 4.5 to 10–20%; moreover, it showed that immunotherapy guarantees remission of local symptoms and valid protection against localized and bronchial complications. Symptomatic treatment with antihistamines and/or corticosteroids, although not always resolutive, represents a valid alternative.
The bone marrow and airway inflammation: evidence for allergy as a systemic disease
Authors: Denburg J. A.
Published: February 2003

Rhinitis and asthma are linked closely epidemiologically, as has been known for quite some time and emphasized in recent surveys (ISAAC study). Patients with seasonal allergic rhinitis without asthma symptoms can, as a group, be shown to have increased bronchial hyperresponsiveness. During the course of seasonal allergen exposure, patients with allergic rhinitis can be shown to have increased numbers of inflammatory cells (eosinophils and mast cells) in the lower airways, even without symptoms of lower airway disease. Long‐standing observations from our laboratory have indicated fluctuations of eosinophil/basophil (Eo‐B) progenitors in the peripheral blood in patients with seasonal allergic rhinitis, paralleling changes that are recognized in mature eosinophils and basophils in circulation. The finding of Eo‐B progenitor decreases during the height of seasonal allergen exposure led us to hypothesize the concept of ‘in situ haemopoiesis’ to explain a process of systemic activation of haemopoietic mechanisms, in which communication among bone marrow peripheral blood and airway tissue compartments contributed to the allergic inflammatory process at a systemic level. Indeed, allergen challenge to the lower airways in atopic asthmatics elicits an immediate rise in Eo‐B progenitors, especially in subjects with late phase responses. These original observations have been buttressed by a series of investigations demonstrating conclusively that exacerbations of asthma are attended by increases in peripheral blood Eo‐B progenitors; that allergen challenge to dogs or mice with allergic airways inflammation elicits bone marrow progenitor responses, with trafficking of bone marrow cells to the airway either in pure upper or lower airway disease; and that allergen challenge to atopic asthmatics up‐regulates the high affinity receptor for IL‐5 on bone marrow progenitors (IL‐5Rα), beginning a process of eosinophil differentiation that is probably driven by the release of a serum haemopoietic factor – as we have found in the canine model – which acts on the bone marrow and initiates a series of systemic events.
Nose and lung cross‐talk in allergic airways disease
Authors: Braunstahl G. J. , Prins J. B. , KleinJan A. , Overbeek S. E. , Hoogsteden H. C. , Fokkens W. J.
Published: February 2003

Allergic rhinitis and asthma are two manifestations of the atopic syndrome. Allergic rhinitis often coexists with, and may even precede, allergic asthma. Both diseases are characterized by a similar inflammatory process in which mast cells and eosinophils are major effector cells. To date, however, interaction between the upper and lower airways' inflammatory processes has not been demonstrated. Allergen provocation studies provide a good model to analyse the aspects of naso‐bronchial cross‐talk. We performed segmental bronchial provocation (SBP) and nasal provocation (NP) in seasonal allergic rhinitis patients without asthma. In allergic rhinitis patients, SBP as well as NP induced allergic inflammation in both nasal and bronchial mucosa. Furthermore, allergen provocation resulted in an increase in circulating inflammatory cells and mediators. Although the clinical response was more severe after SBP, allergic rhinitis patients developed pulmonary symptoms and decreased airway function after NP as well. These studies demonstrate that allergic rhinitis is not a local disease, but that the entire respiratory tract is involved even in the absence of clinical asthma. The systemic pathway, involving bloodstream and bone marrow, contributes to the cross‐talk between upper and lower airways.
Global Resources in Allergy (GLORIA): allergic rhinitis and allergic conjunctivitis
Authors: Van Cauwenberge P. , De Belder T. , Vermeiren J. , Kaplan A.
Published: February 2003

Allergic rhinitis is a common disease, affecting 25–35% of the population. Allergic rhinitis is still increasing in prevalence. It is characterized by rhinorrhoea, itching, sneezing and nasal obstruction. Allergic rhinitis is classically classified into three groups: seasonal (intermittent), perennial (persistent) and occupational allergic rhinitis. In the ARIA document allergic rhinitis is classified into intermittent and persistent. There is a known relationship between allergic rhinitis and asthma, sinusitis, otitis media with effusion, nasal polyposis and upper respiratory tract infections. Allergic rhinitis results from IgE‐mediated allergy, associated with cellular inflammation of the nasal mucosa. The diagnosis of allergic rhinitis is confirmed by a clinical history of typical allergic symptoms and in vivo or in vitro tests for detection of free or cell‐bound IgE. Treatment of allergic rhinitis comprises avoidance of the allergens, oral/nasal antihistamines, decongestants, chromones, ipratropium bromide and intranasal/oral corticosteroids. It is advised to follow the international guidelines, ‘a stepwise approach’. Allergic conjunctivitis is the most common ocular allergic disorder, affecting 5–22% of the population. Ocular allergy involves typical symptoms (itching, watery, stringy or ropey discharge and redness), recurrent/intermittent/persistent episodes, a strong personal and/or family history of atopy and an early age of onset. Treatment of allergic conjunctivitis includes oral/intraocular antihistamines, cromones or topical corticosteroids.
Allergic Rhinitis and its Impact on Asthma (ARIA)
Authors: Bousquet J.
Published: February 2003

Allergic rhinitis is a worldwide health problem and prevalence of the disease is increasing, with economic and social consequences. An initiative from ARIA (Allergic Rhinitis and its Impact on Asthma), an NGO working with the World Health Organization, has forwarded three main developments in the management of allergic rhinitis. Firstly, ARIA has provided new evidence‐based guidelines for the treatment of rhinitis that can be used worldwide, including in developing countries. The guidelines were designed to be used by the specialist as well as by the primary caregiver. Secondly, ARIA proposes a new subdivision of allergic rhinitis and suggests evidence‐based management of the disease using a stepwise approach. Thirdly, ARIA notes that asthma and rhinitis are common comorbidities and proposes that allergic patients are treated globally to combine treatment of upper and lower airway disease.
Functional relationships between allergic rhinitis and asthma
Authors: Togias A.
Published: February 2003

Allergic rhinitis and asthma should be considered manifestations of one syndrome in two parts of the respiratory tract. In addition, the notion that these entities affect each other should be strongly entertained. The pathophysiology of allergic rhinitis is very similar to that of allergic asthma and their responses to pharmacological and immunological interventions are very comparable, as well. Epidemiological data attest to the strong link; 85% or more of allergic asthmatics have rhinitis and, in cross‐sectional population studies, rhinitis is a major risk factor for asthma. Adults with allergic rhinitis have a threefold higher probability of developing asthma, compared with those without rhinitis. A model has been developed to describe the relationships between allergic rhinitis and asthma. According to the model, the two conditions are linked in a horizontal and a vertical fashion. When both conditions are present, their clinical activity tracks in parallel; however, rhinitis appears as a lone condition in the mildest forms of the syndrome. The vertical relationship reflects the fact that experimentally‐induced allergic reactions in the nose can induce changes in the lower airways and the fact that local treatment of rhinitis can have beneficial effects in patients with asthma. Various mechanisms have been proposed to explain the vertical relationship. Investigation into these mechanisms can offer major insights into the physiological and immunological basis of all allergic conditions.
Women's Views of Pregnancy Ultrasound: A Systematic Review
Authors: Garcia Jo , Bricker Leanne , Henderson Jane , Martin Marie‐Anne , Mugford Miranda , Nielson Jim , Roberts Tracy
Published: February 2003

ABSTRACT: Background: Ultrasound has become a routine part of care for pregnant women in most countries with developed health services. It is one of a range of techniques used in screening and diagnosis, but it differs from most others because of the direct access that it gives parents to images of the fetus. A review of women's views of ultrasound was commissioned as part of a larger study of the clinical and economic aspects of routine antenatal ultrasound use.

Methods: Studies of women's views about antenatal screening and diagnosis were searched for on electronic databases. Studies about pregnancy ultrasound were then identified from this material. Further studies were found by contacting researchers, hand searches, and following up references. The searches were not intentionally limited by date or language. Studies that reported direct data from women about pregnancy ultrasound were then included in a structured review. Studies were not excluded on the basis of methodological quality unless they were impossible to understand. They were read by one author and tabulated. The review then addressed a series of questions in a nonquantitative way.

Results: The structured review included 74 primary studies represented by 98 reports. Studies from 18 countries were included, and they employed methods ranging from qualitative interviewing to psychometric testing. The review included studies from the very early period of ultrasound use up to reports of research on contemporary practice. Ultrasound is very attractive to women and families. Women's early concerns about the safety of ultrasound were rarely reported in more recent research. Women often lack information about the purposes for which an ultrasound scan is being done and the technical limitations of the procedure. The strong appeal of diagnostic ultrasound use may contribute to the fact that pregnant women are often unprepared for adverse findings.

Conclusions: Despite the highly varied study designs and contexts for the research included, this review provided useful information about women's views of pregnancy ultrasound. One key finding for clinicians was the need for all staff, women, and partners to be well informed about the specific purposes of ultrasound scans and what they can and cannot achieve. (BIRTH 29:4 December 2002)
Racial and Ethnic Disparities in Breastfeeding among United States Infants: Third National Health and Nutrition Examination Survey, 1988–1994
Authors: Li Ruowei , Grummer‐Strawn Laurence
Published: February 2003

ABSTRACT: Background: The studies suggesting that blacks are less likely to initiate and maintain breastfeeding than whites in the United States are limited either by the representativeness of the sample or by the ambiguousness of attribution of racial and ethnic disparities to generally poor socioeconomic status among blacks. The purpose of this study was to examine racial and ethnic disparities in breastfeeding rates among U.S. infants using national representative data.

Methods: We analyzed breastfeeding data reported by parents of children ages 12 to 71 months at the time of interview from the Third National Health and Nutrition Examination Survey (1988–1994). Breastfeeding data were stratified by both race and ethnicity, and by a series of sociodemographic and health‐related characteristics.

Results: The proportion of children ever breastfed was 60 percent among non‐Hispanic whites, 26 percent among non‐Hispanic blacks, and 54 percent among Mexican Americans. By 6 months postpartum, the proportion still breastfed decreased to 27, 9, and 23 percent, correspondently. Blacks also had a significantly lower rate of exclusive breastfeeding at 4 months than whites (14%). In addition, the differentials in breastfeeding rates between high and low socioeconomic classes were most substantial among blacks.

Conclusions: Blacks had consistent lower breastfeeding rates than whites regardless of their sociodemographic status. The large differentials between high and low socioeconomic classes among blacks suggest that socioeconomic status has a bigger impact on breastfeeding practices among blacks. Therefore, blacks, particularly those who are poor or less educated, need to be targeted for promotion, protection, and support of breastfeeding. (BIRTH 29:4 December 2002)
Home versus Hospital Breastfeeding Support for Newborns: A Randomized Controlled Trial
Authors: McKeever Patricia , Stevens Bonnie , Miller Karen‐Lee , MacDonell Jo Watson , Gibbins Sharyn , Guerriere Denise , Dunn Michael S. , Coyte Peter C.
Published: February 2003

ABSTRACT: Background: The advantages of breastfeeding have been well established for both mothers and their infants. Existing research reports equivocal effects of early discharge and postpartum home care on breastfeeding success. The purpose of this study was to compare the effects of breastfeeding support offered in hospital and home settings on breastfeeding outcomes and maternal satisfaction for mothers of term and near‐term newborns who experienced standard or early discharge.

Methods: In a randomized controlled trial with prognostic stratification for gestational age, 101 term and 37 near‐term (35–37 weeks’ gestational age) mother‐newborn pairs were randomized to either a standard care group (standard care and standard length of hospitalization) or an experimental group (standard hospital care with early discharge and home support from nurses who were certified lactation consultants). Data collection occurred before randomization, at discharge from hospital, and from 5 to12 days postpartum. Primary outcomes included breastfeeding rates and maternal satisfaction.

Results: More mothers of term newborns in the experimental group were breastfeeding exclusively at follow‐up (p=0.02) compared with the control group. No significant breastfeeding differences occurred among mothers with near‐term newborns in the experimental and standard care groups.

Conclusions: In‐home lactation support appears to facilitate positive breastfeeding outcomes for mothers of term newborns. This may also be a beneficial model of postpartum care for mothers of near‐term newborns; however, further research is required. The findings suggest implications for health caregivers and policy makers with respect to postpartum lactation and health care services. (BIRTH 29:4 December 2002)
Immigrant Women's Views About Care During Labor and Birth: An Australian Study of Vietnamese, Turkish, and Filipino Women
Authors: Small Rhonda , Yelland Jane , Lumley Judith , Brown Stephanie , Liamputtong Pranee
Published: February 2003

ABSTRACT: Background: Few studies of immigrant women's views of maternity care in their new homelands have been conducted. In Victoria, Australia, approximately 1 woman in 7 giving birth was born overseas in a non‐English speaking country. This paper examines the views of three groups of immigrant women about the care they received in hospital for the birth of their babies and compares the findings with a population‐based statewide survey.

Methods: Mothers in a New Country was a study of 318 Vietnamese, Turkish, and Filipino women interviewed about their maternity care experiences by bicultural interviewers 6 months after giving birth in Melbourne, Australia. The interview schedule was adapted from the 1994 Victorian Survey of Recent Mothers, a population‐based postal survey of 1336 women.

Results: Of the 3 groups, 27 percent of Vietnamese, 48 percent of Turkish, and 39 percent of Filipino women reported their care during labor and birth as “very good,” figures significantly lower than for the statewide survey, in which 61 percent of women experiencing similar models of care described their care as “very good.” This significant differential in views about care was also present for many individual aspects of care. In the current study of mothers in a new country, comments about aspects of care with which women were particularly happy and unhappy highlighted their appreciation of care that was safe, kind, supportive, and respectful, and conversely, illustrated how distressed women were when care failed to meet these basic standards.

Conclusions: What immigrant women wanted from their maternity care proved to be extremely similar to what Australian‐born women—and women the world over—want. Unfortunately, immigrant women were much less likely to experience care that gave them what they wanted. (BIRTH 29:4 December 2002)
Effect of Maternal Confidence on Breastfeeding Duration: An Application of Breastfeeding Self‐Efficacy Theory
Authors: Blyth Rosemary , Creedy Debra K. , Dennis Cindy‐Lee , Moyle Wendy , Pratt Jan , De Vries Susan M.
Published: February 2003

ABSTRACT: Background: Although much research has focused on identifying factors that influence breastfeeding initiation and duration, many high‐risk factors are nonmodifiable demographic variables. Predisposing factors for low breastfeeding duration rates that are amenable to supportive interventions should be identified. The purpose of this study was to assess the effect of maternal confidence (breastfeeding self‐efficacy) on breastfeeding duration.

Method: A prospective survey was conducted with 300 women in the last trimester of pregnancy recruited from the antenatal clinic of a large metropolitan hospital in Brisbane, Australia. Telephone interviews were conducted at 1week and 4 months postpartum to assess infant feeding methods and breastfeeding confidence using the Breastfeeding Self‐Efficacy Scale.

Results: Although 92 percent of participants initiated breastfeeding, by 4 months postpartum almost 40 percent of mothers discontinued and only 28.6 percent were breastfeeding exclusively; the most common reason for discontinuation was insufficient milk supply. Antenatal and 1‐week Breastfeeding Self‐Efficacy Scale scores were significantly related to breastfeeding outcomes at 1 week and 4 months. Mothers with high breastfeeding self‐efficacy were significantly more likely to be breastfeeding, and doing so exclusively, at 1 week and 4 months postpartum than mothers with low breastfeeding self‐efficacy.

Conclusions: Maternal breastfeeding self‐efficacy is a significant predictor of breastfeeding duration and level. Integrating self‐efficacy enhancing strategies may improve the quality of care that health care professionals deliver and may increase a new mother's confidence in her ability to breastfeed, and to persevere if she does encounter difficulties. (BIRTH 29:4 December 2002)
Barriers to Implementing the Group B Streptococcal Prevention Guidelines
Authors: Cárdenas Vicky , Davis Robert L. , Hasselquist Mary Beth , Zavitkovsky Ann , Schuchat Anne
Published: February 2003

ABSTRACT: Background: Group B streptococcal disease is the leading cause of neonatal sepsis in the United States. We assessed predictors of compliance with the consensus guidelines for perinatal group B streptococcus disease prevention at two Group Health Cooperative hospitals.

Methods: A descriptive and cohort analysis was conducted of failure to comply with the screening‐based approach to group B streptococcus prevention among singleton birth pregnancies in two Group Health Cooperative hospitals, September 1, 1996 to December 31, 1997. We studied determinants of failure to screen pregnant women for group B streptococcus at 35 to 37 weeks’ gestation and failure to deliver intrapartum antibiotic prophylaxis to Group B streptococcus‐positive women.

Results: Nearly 28 percent of 1969 women delivering at two Group Health Cooperative hospitals were not screened appropriately for group B streptococcus. Women who were not screened properly were more likely to be in their teens. A short length of hospital stay before delivery was the strongest predictor of the lack of administration of intrapartum antibiotic prophylaxis to infected multiparas at delivery. Group B streptococcus‐positive women without pregnancy complications were less likely to receive intrapartum antibiotic prophylaxis than infected women with complications.

Conclusions: The findings of this study suggest that to improve group B streptococcus disease prevention, screening efforts should focus on teenage women, and intrapartum antibiotic prophylaxis delivery efforts should be aimed at low‐risk women with precipitous labor. (BIRTH 29:4 December 2002)
Selected Cochrane Systematic Reviews
Authors: Brown S. , Small R. , Faber B. , Krastev A. , Davis P.
Published: February 2003

A substantive amendment to this systematic review was last made on 23 May 2002. Cochrane reviews are regularly checked and updated if necessary.
Noise-induced synchronization and coherence resonance of a Hodgkin–Huxley model of thermally sensitive neurons
Authors: Zhou Changsong , Kurths Jürgen
Published: February 2003

We study nontrivial effects of noise on synchronization and coherence of a chaotic Hodgkin–Huxley model of thermally sensitive neurons. We demonstrate that identical neurons which are not coupled but subjected to a common fluctuating input (Gaussian noise) can achieve complete synchronization when the noise amplitude is larger than a threshold. For nonidentical neurons, noise can induce phase synchronization. Noise enhances synchronization of weakly coupled neurons. We also find that noise enhances the coherence of the spike trains. A saddle point embedded in the chaotic attractor is responsible for these nontrivial noise-induced effects. Relevance of our results to biological information processing is discussed.
Unstable attractors induce perpetual synchronization and desynchronization
Authors: Timme Marc , Wolf Fred , Geisel Theo
Published: February 2003

Common experience suggests that attracting invariant sets in nonlinear dynamical systems are generally stable. Contrary to this intuition, we present a dynamical system, a network of pulse-coupled oscillators, in which unstable attractors arise naturally. From random initial conditions, groups of synchronized oscillators (clusters) are formed that send pulses alternately, resulting in a periodic dynamics of the network. Under the influence of arbitrarily weak noise, this synchronization is followed by a desynchronization of clusters, a phenomenon induced by attractors that are unstable. Perpetual synchronization and desynchronization lead to a switching among attractors. This is explained by the geometrical fact, that these unstable attractors are surrounded by basins of attraction of other attractors, whereas the full measure of their own basin is located remote from the attractor. Unstable attractors do not only exist in these systems, but moreover dominate the dynamics for large networks and a wide range of parameters.
Control and manipulation of solitary structures in a nonlinear optical single feedback experiment
Authors: Gütlich B. , Neubecker R. , Kreuzer M. , Tschudi T.
Published: February 2003

We report on the addressing and control of the lateral positions of optical spatial solitary structures in a single feedback experiment with a saturable Kerr nonlinearity. Solitary structures allow a locally self-confined switching between a dark background and a bright state. This binary character can be of use to all-optically route information in optical networks. In general the lateral positions of solitary structures are strongly influenced by mutual interactions and system inhomogeneities. For potential photonic applications these interactions must be controllable. Therefore a noninvasive interferometric control method based on spatial Fourier filtering is studied in order to position solitary structures. Numerical and experimental results show that solitary structures can be aligned to periodic grids of different scale with hexagonal or square geometries.
Pseudo-Hermiticity and generalized PT- and CPT-symmetries
Authors: Mostafazadeh Ali
Published: February 2003

We study certain linear and antilinear symmetry generators and involution operators associated with pseudo-Hermitian Hamiltonians and show that the theory of pseudo-Hermitian operators provides a simple explanation for the recent results of Bender, Brody and Jones (quant-ph/0208076) on the CPT-symmetry of a class of PT-symmetric non-Hermitian Hamiltonians. We present a natural extension of these results to the class of diagonalizable pseudo-Hermitian Hamiltonians H with a discrete spectrum. In particular, we introduce generalized parity (𝒫), time-reversal (𝒯), and charge-conjugation (𝒞) operators and establish the 𝒫𝒯- and 𝒞𝒫𝒯-invariance of H.
Three-dimensional modes of unsteady solid-flame combustion
Authors: Ivleva Tatyana P. , Merzhanov Alexander G.
Published: February 2003

Mathematical simulation is being widely used in modeling wave propagation in various physical, chemical, and biological processes, such as gasless combustion, frontal polymerization, etc. Numerical simulation is especially important in three-dimensional (3D) modeling of the spinning and chaotic waves propagating in nontransparent solids. In this paper, we analyze the system of equations that describes the propagation of a self-sustained wave through a cylindrical sample of combustible mixture. In this case, sample composition, sample radius, and heat loss from the sample surface will be used as variable parameters. We will describe (i) the combustion modes that give rise to periodic screw motion of one or several hot spots, (ii) inner wave structure, (iii) effect of parameters on the wave structure, (iv) some modes that have not yet been observed experimentally, (v) a loss of periodicity that leads to chaotic propagation of a 3D self-sustained wave.
A quantum Monte Carlo and density functional theory study of the electronic structure of peroxynitrite anion
Authors: Harkless J. A. W. , Rodriguez J. H. , Mitas L. , Lester W. A.
Published: February 2003

Single point calculations of the ground state electronic structure of peroxynitrite anion have been performed at the optimized cis geometry using the restricted Hartree–Fock (RHF), Møller Plesset second order perturbation theory (MP2), generalized gradient approximation density functional theory (GGA DFT) in the B3LYP form and two quantum Monte Carlo (QMC) methods, variational Monte Carlo (VMC) and diffusion Monte Carlo (DMC). These calculations reveal differences in atomization energies estimated by B3LYP (287.03 kcal/mol), MP2 (290.84 kcal/mol), and DMC, 307.4(1.9) kcal/mol, as compared to experiment, 313(1) kcal/mol. The error associated with MP2 and B3LYP methods is attributed largely to differential recovery of correlation energies for neutral nitrogen and oxygen atoms relative to the oxygen and peroxynitrite anions. In addition, basis set studies were carried out to determine potential sources of error in MP2 and B3LYP valence energy values. Our studies indicate that MP2 and B3LYP valence energies are strongly dependent on the presence of diffuse functions for the negative ions O− and ONOO−.