bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of care for the preterm infant: review of literature on follow‐up of preterm and low birthweight infants
Authors: Ens‐Dokkum Martina H. , Schreuder Anneke M. , Veen Sylvia , Verloove‐Vanhorick S. Pauline , Brand Ronald , Ruys Jan H.
Published: April 2008

Summary. Since the introduction of neonatal intensive care in the 1960s, mortality in very preterm and very low birthweight infants has been decreasing steadily. Consequently, interest in the outcome of surviving infants is growing. Restriction of health care resources has stressed the need for information concerning the effect of individual treatment components on mortality and morbidity. Concern about the quality in apparently normal survivors has been increasing as well. The current flood of papers on these subjects illustrates the interest in these issues. The first part of this paper reviews the methodology used in follow‐up studies in the past decades. It aims at methodological problems that hamper comparison between studies and preclude unequivocal conclusions. New treatment techniques seldom were but should be evaluated by randomised trials. To monitor the combined effects of changing obstetric and neonatal techniques on perinatal outcome, studies in geographically defined populations are recommended using data from early pregnancy until at least preschool age. Comparability of outcomes could be enhanced by international agreement on standardisation of assessment methods and outcome measures. In the second part the results concerning gestational age‐ and birth‐weight‐specific mortality, impairments and disabilities and the risk factors for such disorders are discussed. Increased survival of even the tiniest infants is clearly established. This increase in survival has not yet been accompanied by an apparent increase in major morbidity. However, many minor impairments are reported, occurring often in combination and predisposing these children to deviations of normal development. Important changes in the manifestation of brain damage appear to occur during development. These findings stress the importance of long‐term follow‐up studies.
Small‐for‐gestational‐age term birth: the contribution of socio‐economic, behavioural and biological factors to recurrence
Authors: Read Anne W. , Stanley Fiona J.
Published: April 2008

Summary. This paper follows a previous study comparing women who had repeatedly given birth to small‐for‐gestational‐age (SGA) term infants (‘repeater’ mothers) with multiparous women who had had only one such infant (‘non‐repeater’ mothers). The present investigation involves the individual matching of each woman in the above groups with a control mother whose offspring were all term non‐SGA infants. The study was based on all Western Australian Caucasian women giving birth to singletons and the study population comprised 594 repeater cases with 594 matched controls and 935 non‐repeater cases with 935 matched controls. Conditional logistic regression analyses indicated that demographic and paternal factors were significant predictors for recurrent SGA term birth wheYeas obstetric conditions, particularly preeclampsia, were important for the prediction of isolated SGA term birth. Maternal smoking, low maternal birthweight and lack of higher educational qualifications were associated with both types of SGA birth. After multivariable analyses, a strong and significant association remained between having a first infant as a teenager and recurrent SGA term birth. The tendency to repeat SGA term birth appears to be associated with social, economic and behavioural disadvantage and is unlikely to be ameliorated without fundamental changes in society.
Risk factors associated with low Apgar scores in a low‐income population
Authors: Rogers J. Felix , Graves William L.
Published: April 2008

Summary. The purpose of this study was to identify risk factors associated with Apgar scores of less than 7 in newborns scored at 5 minutes after birth. All newborns were delivered at Grady Memorial Hospital, Atlanta, Georgia, which primarily serves a low‐income population. The data were obtained from the obstetric discharge records for 1985–89. In this case‐control study, 939 newborns with Apgar scores of less than 7 were compared with 2817 new‐borns with Apgar scores of 7 or higher. Low birthweight (< 2500 g) and short gestational age (< 37 weeks) were each significantly associated with low Apgar scores. Race was not a significant risk factor for low Apgar scores in this low socio‐economic population. It is also demonstrated that maternal risk factors (pregnancy‐induced hypertension, prolonged rupture of membranes), method of delivery (caesarean, repeat caesarean, vaginal birth after caesarean section) and male sex were significantly associated with Apgar scores of less than 7. As a result of the risks that were found to be associated with method of delivery, further study of the risks associated with caesarean delivery and of the relative advantage of a caesarean delivery versus vaginal delivery after a previous caesarean section is advocated.
Recurrent pregnancy loss as an indicator for increased risk of birth defects: a population‐based case‐control study
Authors: Khoury Muin J. , Erickson J. David
Published: April 2008

Summary. Stillbirths and spontaneous abortuses have higher rates of birth defects than liveborn infants. The relationship between a woman's previous pregnancy loss and the risk of birth defects in the offspring has not been adequately examined, however. Using data from a population‐based case‐control study, we assessed whether one or more previous pregnancy loss was associated with increased birth defect risks. Case subjects were 4918 infants with serious births defects diagnosed in the first year of life and ascertained by the Metropolitan Atlanta Congenital Defects Program from 1968 to 1980. Control subjects were 3028 normal liveborn infants frequency‐matched to case infants by race, hospital and period of birth. Among case and control infants whose mothers had already had at least one previous pregnancy, reported pregnancy losses (stillbirths and miscarriages) were associated with elevated risks of birth defects (odds ratios for one pregnancy loss of 1.24, two pregnancy losses of 1.49, and three or more pregnancy losses of 1.62, P < 0.0001 for trend). This association held after considering several potential confounders using logistic regression analysis. When specific defects were examined, many exhibited this association, notably hydrocephalus, and some cardiovascular, genital and limb defects. We estimate that the risk of serious birth defects increases from 2.5% for infants of women with no prior pregnancy loss to 4.2% for infants of women with three or more pregnancy losses. This finding has both clinical implications for pregnancy counselling and pathogenetic implications related to birth defect aetiology.
An epidemiological study of the factors influencing poisoning in children aged 0–5 years
Authors: Paritsis N. , Pallis D. , Deligeorgis D. , Doxiadis S. , Phylactou C. , Vlachonicolist I.
Published: April 2008

Summary. The aim of this cross disciplinary study was to identify the most significant variables related to childhood accidental poisoning. The study was carried out on a representative sample of families living in the Greater Athens Area comprising 1245 children aged up to 5 years. Data were collected by a team of researchers (paediatricians, psychologists and social workers) and involved a structured interview and a paediatric examination. The findings show that childhood poisoning is correlated with: (1) biological variables, such as skeletal anomalies, language disorders, number of recent infections and complications of pregnancy; and (2) social factors, such as father's educational level, monthly family income, and overcrowding. Sex of the child was not found to influence poisoning.
Developmental outcome of infants treated with extracorporeal membrane oxygenation (ECMO) in the neonatal period: is the evidence all in?
Authors: Page Jacqueline , Frisk Virginia , Whyte Hilary
Published: April 2008

Summary. The North American literature was reviewed regarding the developmental outcome of infants treated with ECMO therapy versus those infants who received conventional medical therapy for treatment of persistent pulmonary hypertension of the newborn. The literature reviewed included all ECMO follow‐up investigations published in medical journals cited in CD‐ROM between January 1980 and July 1992, as well as abstracts presented at the Society for Pediatric Research 1990 — 1992. The literature was examined with respect to the incidence, prevalence and nature of morbidity, with particular attention paid to the neurodevelopmental domains assessed, test measures used, age at assessment and criteria for normal and abnormal outcome.

Rough comparison of the published outcome statistics for the cohorts of infants who received neonatal ECMO therapy or conventional medical therapy (CMT) suggest equivalent amounts of morbidity within the first few years of life. Without appropriate systematic comparison at the same ages on the same measures and in infants with equivalent severity of illness, the current observations remain tentative at best. Longitudinal investigations are needed in order to identify specific medical and developmental markers in infancy of good and poor long‐term outcome in this population, together with comparisons of outcome in the group treated with ECMO versus the group treated with CMT. Fine‐grained, sensitive measures must be employed that record transient or permanent delays and/or qualitative deficits in specific skills.
Past obstetric history of the mother and its association with low birthweight of a subsequent child: a population based study
Authors: Lekea‐Karanika V. , Tzoumaka‐Bakoula C.
Published: April 2008

Summary. A total population sample of 7286 multigravidae from the Greek National Perinatal Survey (April 1983) was used to determine the association between maternal obstetric history and low birthweight of the subsequent singleton delivery. Significant associations were found with previous early and late fetal losses (miscarriages, induced abortions, stillbirths) and history of haemorrhage during a prior pregnancy. It was found that mothers who had experienced miscarriage(s), induced abortion(s) or stillbirth(s) had relative risks (RRs) of 1.65, 1.81 and 3.59 respectively compared with mothers without any fetal loss. The risk increased substantially with the increasing number of losses and reached 8.83 for the small group of mothers who had experienced all three kinds of fetal loss. For mothers with a history of bleeding in a previous pregnancy the risk was double that of mothers without such a history. The results above were changed only slightly when the significant socio‐economic characteristics of the family were taken into account.
Impact of induced abortions and statistical definitions on perinatal mortality figures
Authors: Gissler Mika , Ollila Eeva , Teperi Juha , Hemminki Elina
Published: April 2008

Summary. Two problems originating from the advanced use of medical technology in screening for malformations and in the care of preterm and low birthweight infants are presented: the impact of the increasing number of induced medical abortions and the differences in statistical definitions on perinatal mortality (PNM) figures. Data on 186562 births registered in the Finnish Medical Birth Registry between 1987 and 1989 were studied, and 65554 medical abortions (of which 1647 were performed after the sixteenth week of gestation) registered in the Abortion Registry between 1985 and 1990. A 115% increase in abortions for medical reasons in the period 1985–1990 was found. It was estimated that the trend accounted for up to one‐third of the decline in PNM rate during that time. The perinatal mortality rate was strongly influenced by very small infants. The application of the Finnish version of the International Classification of Diseases, Ninth Revision (ICD‐9) (including all livebirths and using both birthweight of 500g and gestational age of 22 weeks as the criteria) resulted in PNM rates which were about 5% higher than according to ICD‐9. We suggest that the impact of medical abortions on perinatal statistics has reduced the value of the perinatal mortality rate as an indicator of the standard of care.
Perinatal mortality survey in Jamaica: aims and methodology
Authors: Ashley Deanna , McCaw‐Binns Affette , Golding Jean , Keeling Jean , Escoffery Carlos , Coard Kathleen , Foster‐Williams Karen
Published: April 2008

Summary. The Jamaican Perinatal Mortality Survey was designed to identify the true perinatal mortality rate, and assess the factors which could contribute towards a reduction in perinatal mortality on the island.

All births in a 2‐month period (n= 10527) were compared with all perinatal deaths occurring over a 12‐month period (n= 2069). Over half the deaths (n= 1058) received a detailed post‐mortem examination.

Use of the Wigglesworth classification identifies the major component of perinatal death in this country to be associated with intrapartum asphyxia (44% of deaths). Deaths due to congenital malformations and miscellaneous causes contribute relatively little (< 10%) to the overall mortality rate. Over a quarter of deaths apparently occur before the onset of labour, and a fifth are prematurely liveborn but die of causes related to immaturity.
Associations between social and environmental factors and perinatal mortality in Jamaica
Authors: Golding Jean , Greenwood Rosemary , McCaw‐Binns Affette , Thomas Peter
Published: April 2008

Summary. Social and environmental factors in Jamaica were compared between 9919 mothers delivering in a 2‐month period a singleton who survived the early neonatal period and 1847 mothers who were delivered of a singleton perinatal death in a contiguous 12‐month period.

Logistic regression showed independent positive statistically significant increased odds of having a perinatal death among mothers who lived in rural parishes, older mothers (aged 30+), single parents, no other children in the household, large number of adults in the household, mother unemployed, the major wage earner of the household not being in a managerial, professional or skilled non‐manual occupation, the household not having sole use of toilet facilities, smaller mothers and those classified as obese or undernourished.

Variations were found for different categories of death. Intrapartum asphyxia deaths were not related to union (marital) status, occupation of major wage earner, number of adults nor to the use of the toilet. Antepartum fetal deaths did not vary significantly with occupation of major wage earner or maternal height, but did show a relationship with maternal education, mothers with lowest levels having reduced risk. Deaths from immaturity were significantly related only to occupation of major wage earner, number of children in the household, number of social amenities available (negative relationships) and maternal age (<17 at highest risk).

In conclusion there was little to indicate that social deprivation per se was related to perinatal death, although specific features of the environment showed strong relationships.
Mother‐to‐infant HIV transmission: timing, risk factors and prevention
Authors: Kuhn Louise , Stein Zena A.
Published: April 2008

Summary. Identifying when ‐ during pregnancy, delivery or the postnatal period ‐ transmission of human immunodeficiency virus (HIV) from mother to infant usually takes place is critical to the development of methods to prevent maternal‐infant transmission. Evidence is reviewed in this paper as to whether transmission occurs prepartum (early or late in gestation), intrapartum, or postpartum with breast feeding. Evidence in support of the notion of prepartum transmission has come from isolation of HIV from aborted fetal organs, comparison of maternal‐child viral genotypes and study of neonatal cell‐mediated immune responses. Evidence against prepartum transmission is that fewer than half of the children later known to be HIV‐infected can be identified by virological tests carried out close to birth. A reduced rate of transmission in infants delivered by Caesarean section, and a reduced risk of transmission to second‐born twins delivered vaginally, offers support to the view that intrapartum factors influence the risk of HIV transmission. Transmission through breast feeding can occur if a mother is infected postpartum and seems to pose some additional risk if she is already infected at parturition. The risk of infection increases with the stage of maternal HIV disease, but specific immunological, clinical and viral characteristics need to be investigated further. A clinical trial of zidovudine, used during late pregnancy and delivery and given to the infant at birth, has reported a significant reduction in transmission. Primary prevention of HIV infection in women remains a principal priority.
Similarities and disparities in maternal risk and birth outcomes of white and Japanese‐American mothers
Authors: Mor Joanne M. , Alexander Greg R. , Kogan Michael D. , Kieffer Edith C. , Ichiho Henry M.
Published: April 2008

Summary. This study compares the maternal sociodemographic and prenatal care characteristics and birth outcomes of US resident white and Japanese‐American mothers, using data from the state of Hawaii. The specific focus is to determine to what extent these factors can explain variations in newborn maturity and mortality indicators. Single livebirths to resident, non‐military dependent white and Japanese‐American mothers were selected for analysis from the 1979–1990 linked livebirth‐infant death files from Hawaii. Compared with white mothers, Japanese‐American mothers were significantly more likely to be married, age 18 years and older, have higher educational attainment, and have adequate prenatal care utilisation. The majority of Japanese‐American mothers were born in Hawaii, while the majority of white mothers were born on the US mainland. The mean birthweight of Japanese‐American infants was 200 g lighter than that of white infants. Infant mortality rates (IMRs) for both groups were below the US Year 2000 Health Objective. After controlling for maternal sociodemographic and prenatal care factors with logistic regression, Japanese‐American infants had significantly higher risks of low birthweight, preterm and very preterm birth and of being small‐for‐gestational age. These findings indicate that populations with preferential maternal sociodemographic and prenatal care risk indicators may still exhibit higher low birthweight percentages, but achieve comparatively low IMRs.
High incidence of congenital dislocation of the hip in Northern Ireland
Authors: Patterson Christopher C. , Kernohan W. George , Mollan RAB , Haugh Pauline E. , Trainor Bernadette P.
Published: April 2008

Summary. To determine the incidence of congenital hip dislocation (CDH) a retrospective study was carried out of cases occurring in a defined population using multiple information sources. Of 138600 children born in the period 1983–1987, a total of 243 were diagnosed with CDH, defined as those requiring splintage or surgery whose treatment extended beyond 6 months of age. Incidence and estimates of relative risks for pre‐disposing factors were determined. The rate was 1.75 cases per 1000 livebirths. Major risk factors were female gender and breech presentation. The proportions of cases identified before 1,3 and 6 months of age were 8,14 and 35%, respectively. Despite using a restrictive definition, we have obtained an incidence rate among the highest reported in any United Kingdom population. Early detection is widely accepted as desirable, but neonatal screening has proved ineffective.
Enrolment into Birth to Ten (BTT): population and sample characteristics
Authors: Richter L. M. , Yach D. , Cameron N. , Griesel R. D. , de Wet T.
Published: April 2008

Summary. The population under study in the South African longitudinal study of urban children and their families, ‘Birth to Ten’ (BTT), comprised all births during a 7‐week period from April to June 1990 in Soweto‐Johannesburg. Specification of the population base for the cohort was hampered by a number of flaws in the notification and recordkeeping systems of the local authorities. As far as could be ascertained, 5460 singleton births occurred during this time to women who gave a permanent address within the defined region. Enrolment into BTT took place over the first 15 months of the study and covered the antenatal, delivery, 6‐month and 1‐year periods. By the end of this time, and despite a major health service strike during the delivery phase, 74% of all births (4029 cases) had been enrolled into the study. There were marked variations in levels of enrolment, however, by population group membership, residential area and place of delivery. In general, there was substantial under‐enrolment of largely middle‐class white women and their babies. Initial non‐enrolment of specific segments of the population and attrition of the enrolled sample up to the end of the first year are discussed in the context of racial and social differentiation in South Africa.
Smoking in pregnancy as a risk factor for long‐term mortality in the offspring
Authors: Hofvendahl Erik A.
Published: April 2008

Summary. This study addresses the question of whether maternal smoking is related to postneonatal mortality and which are the contributing causes of death. Mortality of births in Sweden between 1 January 1983 and 31 December 1989 (n= 714389) registered in the Medical Birth Registry was followed until 31 December 1990. The registry carries information on maternal smoking habits in early pregnancy. The Mantel‐Haenszel procedure was used to control for confounding effects of maternal age, parity and year of birth: relative risks (95% confidence interval) associated with smoking were: 1.24 (1.17‐1.31) for fetal death, 1.08 (1.01‐1.16) for early neonatal death, 1.22 (1.08‐1.39) for late neonatal death, 1.31 (1.23‐1.41) for postneonatal mortality during the first year, and for the period between 1 and 8 years of age it was 1.19 (1.06‐1.32). When birth‐weight was controlled for, the increased relative risk for postneonatal mortality during the first year disappeared. Mortality between 1 and 8 years still showed an elevated risk of 1.43 (1.00–2.06). In order to control for confounding by social factors, 1986 births were linked to data from the 1985 Swedish census. The measure used was the socio‐economic index (SEI), which reflects the parental education level. When maternal, paternal or family SEI was controlled for, late neonatal death was not significantly related to maternal smoking, but postneonatal death still showed a significantly increased relative risk of about 1.35. Four causes of death based on International Classification of Diseases (ICD) 8 and 9 were significantly related to maternal smoking: sudden infant death syndrome, injuries and poisoning, perinatal causes and infections.
Which birthweight groups contributed most to the overall reduction in the neonatal mortality rate in the United States from 1960 to 1986?
Authors: Lee Kwang‐sun , Khoshnood Babak , Hsieh Hui‐lung , Kim Beyong II , Schreiber Michael D. , Mittendorf Robert
Published: April 2008

Summary. We determined the relative contributions of individual birthweight groups to the reduction in neonatal mortality rate (NMR) of US singleton livebirths from 1960 to 1986, the period during which neonatal intensive care was introduced and became established. Changes in the NMR for each race (non‐white/white) and birthweight group were assessed in terms of three components of NMR (1) birthweight‐specific neonatal mortality rate (BWS‐NMR), (2) birthweight distribution, and (3) the interaction resulting from simultaneous changes in BWS‐NMR and birthweight distribution. Overall, NMR decreased from 16.7 per 1000 livebirths in 1960 to 5.5 per 1000 livebirths in 1986. This reduction was achieved mainly by improvements in the BWS‐NMRs of all birthweight groups. Neonates who weighed > 1.5 kg at birth were the major contributors to the overall reduction in the NMR; approximately two‐thirds of total reduction in NMR between 1960 and 1980 and 52.6% of the total reduction between 1980 and 1986 occurred in the > 1.5 kg birthweight groups. Our study demonstrates that with the introduction of neonatal intensive care, survival of infants with birth weights > 1.5 kg improved markedly and that this improvement accounted for most of the decline in the neonatal mortality rate in the United States from 1960 to 1986. Therefore, in measuring the effectiveness of neonatal intensive care, the assessment should include not only very low birthweight (< 1.5 kg) but all birthweight groups.
Preterm birth and low birthweight among children of Swedish and immigrant women between 1978 and 1990
Authors: Rasmussen Finn , Oldenburg Claes Erik Michael , Ericson Anders , Gunnarskog Jan
Published: April 2008

Summary. The aim of the study was to estimate the occurrence of low birthweight (LBW) and preterm birth among immigrant and Swedish women in Sweden. Eligible for analysis were all 1270407 singleton births in Sweden between 1978 and 1990 to mothers aged between 15 and 44 years, whose own country of birth was known. The mothers of the children were born in Sweden (88.2%), or had immigrated from Finland (4.4%), other Scandinavian countries (1.2%), Western Europe or North America (1.3%), Eastern Europe (1.8%), the Middle East and North Africa (1.7%), Central and South America (0.6%), Asia and the Pacific Islands (0.6%), or Sub‐Saharan Africa (0.2%). Multiple logistic regression was used to model LBW and preterm birth categorical outcomes. Each immigrant group was compared with the Swedish group. Odds ratios (ORs) for LBW were 1.13 (95% CI 1.04,1.22) for Asia and the Pacific Islands, 1.21 (1.05,1.38) for Sub‐Saharan Africa and 0.89 (0.86‐0.93) for Finland. Odds ratios for preterm birth were 1.15 (1.08‐1.23) for immigrants from Asia and the Pacific Islands and 1.08 (1.04,1.13) for immigrants from Eastern Europe. Remarkably small differences were found between immigrant women and native Swedish women.
Promotion of children's early psychosocial development through primary health care services
Authors: Tsiantis J. , Dragonas Th , Cox A. , Smith M. , Ispanovic V. , Sampaio‐Faria J.
Published: April 2008

Summary. The paper presents the study design of the development and organisation of an EU/WHO multicentre study on the promotion of children's early psychosocial development through primary health care services. The aim of the programme is to develop training for primary health care workers (PHCWs) that improves their ability to assess factors relevant to children's psychosocial development and gives them preventive approaches to foster that development, building on the families' strengths. The focus is on the period from conception to the end of the second year of the child's life. Two main components are the training of die PHCWs and the semi‐structured interviews that guide the workers in practice. The training has content and structure that is feasible within primary health care resources working in collaboration with mental health services. The programme is evaluated in terms of (a) the impact of training on both the PHCWs' knowledge and attitudes with regard to infant behaviour and development, and on practice as assessed by the delivery of the semi‐structured interview; and (b) the effect of the intervention on maternal well‐being, infant language development and behaviour, home environment and mother‐infant interaction. The programme is taking place in Cyprus, Greece, the Federal Republic of Yugoslavia, Portugal, Slovenia and Turkey.
Isolation, car ownership, and small area variation in incidence of acute lymphoblastic leukaemia in children
Authors: Alexander Freda E. , Leon David A. , Cartwright Raymond A.
Published: April 2008

Summary. .To determine whether increased rates of childhood acute lymphoblastic leukaemia (ALL) which had been reported in isolated areas could be attributed to higher proportions of households owning cars, ecological analysis was performed with electoral wards as area units. Previous data were re‐analysed using the proportion of households having no car, taken from the 1981 census of England and Wales, as an additional explanatory factor. A specialist registry of haematopoietic malignancies covering one‐third of England and Wales (3270 electoral wards) recorded 438 cases of ALL in children diagnosed 1984‐89, including 304 in the childhood peak (at ages 1–7 years). Relative risks were derived by Poisson regression of total childhood ALL and at ages 1–7 years for groups of electoral wards classified by isolation and car ownership. Multivariable analyses included adjustment for socio‐economic status. No evidence of increased risk of childhood ALL in areas where more households own cars was found. ALL at ages 1–7 years was inversely associated with car ownership (risk in wards with least cars relative to those with most cars = 2.28,95% CI: 1.12‐4.64). The associations with geographic isolation persisted after allowing for car ownership (risks for ALL in young children in isolated relative to built‐up areas = 2.19,95% CI: 1.44‐3.33). Levels of car ownership cannot explain the increased rates of childhood ALL which have been observed in isolated areas. No support has been found for a hypothesis relating these excesses to benzene exposure of children transported in cars. The previous explanation for the small area variation of childhood ALL in terms of geographical isolation and interpretation in terms of exposure to common infections continues to be justified.
Functional characterization of two cold shock domain proteins from Oryza sativa
Authors: CHAIKAM VIJAY , KARLSON DALE
Published: April 2008

Two novel rice cold shock domain (CSD) proteins were cloned and characterized under different stress treatments and during various stages of development. OsCSP1 and OsCSP2 (Oryza sativa CSD protein) encode putative proteins consisting of an N‐terminal CSD and glycine‐rich regions that are interspersed by 4 and 2 CX2CX4HX4C (CCHC) retroviral‐like zinc fingers, respectively. In vivo functional analysis confirmed that OsCSPs can complement a cold‐sensitive bacterial strain which lacks four endogenous cold shock proteins. In vitro ssDNA binding assays determined that recombinant OsCSPs are capable of functioning as nucleic acid‐binding proteins. Both OsCSP transcripts are transiently up‐regulated in response to low‐temperature stress and rapidly return to a basal level of gene expression. Protein blot analysis determined that OsCSPs are maintained at a constant level subsequent to a cold treatment lasting over a period of several days. Both the transcript and protein data are in sharp contrast to those previously obtained for winter wheat WCSP1. A time‐coursed study through various stages of rice development confirmed that both OsCSP proteins and transcripts are highly accumulated in reproductive tissues and tissues which exhibit meristematic activity.
The influence of age and gender on sensitization to aero‐allergens
Authors: Govaere Elke , Gysel Dirk Van , Massa Guy , Verhamme Katia MC , Doli Erenik , Baets Frans De
Published: April 2008

Boys run a higher risk for atopy than girls but this gender difference is less pronounced in adulthood. The underlying mechanisms and the exact timing of this decrease in male/female ratio remain unclear. The aim of this study was to evaluate the effect of age and gender on sensitization in schoolchildren. A cross‐sectional study was performed in an unbiased community population of 2021 Belgian schoolchildren, aged 3.4–14.8 yr. The overall sensitization and the sensitization for mites, mixed grass pollens and tree pollens increased significantly with increasing age. Male sex was strongly associated with sensitization (ORadj 2.0, 98% CI 1.6–2.4). Male predominance was more obvious in children under the age of 8 yr. After the age of 8 male predominance persisted, but a significant increase in sensitized females occurred. Our data demonstrate a significant increase in prevalence of sensitization with age and a significant decrease in male/female ratio of sensitization after the age of 8 yr, although a male predominance persists. These data are the first published data ever that document this change in male/female ratio in sensitization at this age.
Immune response to rabies vaccination in pediatric transplant patients
Authors: Cramer II Carl H. , Shieck Victoria , Thomas Susan E. , Kershaw David B. , Magee John C. , Lopez M. James
Published: April 2008

Abstract:  Children have become engaged in a wider variety of activities as the success of solid organ transplantation has improved. These activities can result in exposure to infectious agents for which there are no data documenting the efficacy of standard treatment in children on immunosuppressive therapy. This is a retrospective review of five OLT patients and three RT patients who were potentially exposed to rabies during camp. They completed the immunoprophylaxis treatment for rabies exposure outlined by the CDC in the 2003 Red Book. Rabies titers were followed for six to 12 months post‐immunization. All five OLT patients were on tacrolimus. All three RT patients were on tacrolimus, mycophenolate mofetil, and prednisone. At the time of exposure median age was 10.0 yr (8.4–17.3). None of the subjects developed rabies. A positive rabies titer, indicative of successful immunization, was present by one month in seven subjects and all subjects by six months. Rabies vaccination in pediatric transplant patients is safe and associated with the successful production of antirabies titers.
Analysis of nodulation kinetics in Frankia–Discaria trinervis symbiosis reveals different factors involved in the nodulation process
Authors: Gabbarini Luciano Andrés , Wall Luis Gabriel
Published: April 2008

The induction of root nodule development in actinorhizal symbiosis would depend on the concentration of factors produced by the bacteria and the plant. A detailed analysis of nodulation description parameters revealed different factors related to the nodulation process. The initial time for nodulation (t0), the initial nodulation rate (v0) and the total time of nodule development (tNOD) were defined and consequently quantified in different experimental conditions: co‐inoculation of Discaria trinervis with increasing concentrations of different non‐infective bacteria together with the full compatible infective Frankia strain (the indicator strain) used at a limiting concentration or by changing plant factor(s) concentration. All the above nodulation parameters were modified by changing doses of full compatibility infective strain Frankia BCU110501; v0 appears to be an expression of symbiotic recognition between partners as only fully symbiotic indicator Frankia BCU110501 was able to change it; t0 seems not to reflect symbiotic recognition because it can also be modified by non‐infective Frankia but suggest the existence of a basic level of plant microbe recognition. The initial time for nodulation t0, reflecting the time required for the early interactions toward nodulation, is an inverse measure of the ability to establish early interactions toward nodulation. The increase in plant factors concentration also reduces t0 values, suggesting that a plant factor is involved and favors very early interactions. Increases in plant factors concentration also modify the final number of nodules per plant and the nodule cluster profile along the taproot as an expression of the autoregulation phenomenon. Meanwhile, Frankia inoculums’ concentration, either infective or not, modified tNOD in an opposite way plant factors did. In conclusion, the analysis of nodulation kinetics appears to be an appropriate tool to investigate factors involved in the symbiotic interaction leading to the formation of nitrogen‐fixing nodules.
Constitutive expression of Arabidopsis NPR1 confers enhanced resistance to the early instars of Spodoptera litura in transgenic tobacco
Authors: Meur Gargi , Budatha Madhusudhan , Srinivasan Tantravahi , Rajesh Kumar Koppolu Raja , Dutta Gupta Aparna , Kirti Pulugurtha Bharadwaja
Published: April 2008

In Arabidopsis, NPR1 (AtNPR1) regulates salicylic acid (SA)‐mediated activation of PR genes at the onset of systemic acquired resistance. AtNPR1 also modulates SA‐induced suppression of jasmonic acid‐responsive gene expression, and npr1 mutants manifest enhanced herbivore resistance. We have raised stable transgenic tobacco lines, expressing AtNPR1 constitutively, which showed elevated expression of PR1 and PR2 genes upon SA treatment. Herbivore bioassays with a generalist polyphagous pest, Spodoptera litura, revealed that the transgenic lines exhibited enhanced resistance compared to the wild‐type plants, particularly with respect to younger larval populations. Insect‐mediated injury induced several protease inhibitors (PIs), more significantly a 40‐kDa serine PI in all the tobacco lines, but the induction was higher in the transgenic plants. We show in this communication that heterologous expression of AtNPR1 provides enhanced resistance to early larval populations of the herbivore, Spodoptera in transgenic tobacco plants.
Direct fluconazole susceptibility testing of positive Candida blood cultures by flow cytometry
Authors: Rudensky Bernard , Broide Ellen , Berko Nathanel , Wiener‐Well Yonit , Yinnon Amos M. , Raveh David
Published: April 2008

The standard methods for yeast susceptibility testing require 24–48 h of incubation. As there has been an increase in incidence of non‐albicans Candida species, the clinician is very often wary of initiating therapy with fluconazole until a final susceptibility report is generated, especially when treating very sick patients. A rapid reliable susceptibility testing method would enable the clinician to prescribe fluconazole, thus avoiding more toxic or expensive therapy. To determine the feasibility of direct susceptibility testing of Candida species to fluconazole by a rapid flow cytometric method, 50 Candida strains were seeded into blood culture bottles and were tested for susceptibility to fluconazole directly from the bottles after their being flagged as positive by the blood culture instrument. Minimal inhibitory concentration (MIC) determined by fluorescent flow cytometry (FACS) showed excellent agreement to that determined by macrodilution. Following the seeding experiments, 30 true patient specimens were tested directly from positive blood cultures, and MIC determined by both methods showed excellent agreement. Antifungal susceptibility testing by FACS directly from positive blood culture bottles is a reliable, rapid method for susceptibility testing of Candida to fluconazole. The method allows same‐day results, does not require subculture to agar media, and can greatly assist in the selection of appropriate antifungal therapy.
Innate and adaptive immunity in patients with autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy
Authors: Perniola R. , Congedo M. , Rizzo A. , Damiani A. Sticchi , Faneschi M. L. , Pizzolante M. , Lobreglio G.
Published: April 2008

Autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED) is an autosomal recessive syndrome characterised by chronic mucocutaneous candidiasis (CMC) and multiple endocrine failures. While the spectrum and modalities of autoimmunity are the main objects of current research into APECED, unequivocal data on the efficiency of immune responses to infectious agents are still elusive. The in vitro ability of monocytes and polymorphonuclear leucocytes to phagocytise and kill bacteria and fungi, and the degree of activation of lymphocytes cultured with mitogens and Candida albicans were investigated by flow cytometry in 11 APECED patients and healthy subjects. In addition, a comparison of γ‐globulin and immunoglobulin (Ig) concentrations was performed, and a correlation was sought between oral fungal load and the anti‐Candida antibody titre. No difference between APECED patients and healthy subjects was observed in the phagocyte function, although the patients had a larger number of monocytes. Similarly, cultured lymphocytes were equally activated in the two groups. The concentration of γ‐globulins was higher among APECED patients, and anti‐Candida IgM and IgG correlated with current and past oral candidiasis respectively. APECED patients have efficient innate and adaptive immune responses against exogenous stimuli, and currently, the mechanisms of mucocutaneous anergy leading to the high prevalence of CMC in this syndrome remain to be elucidated.
Current scenario of cryptococcosis and antifungal susceptibility pattern in India: a cause for reappraisal
Authors: Capoor Malini Rajinder , Mandal Piyali , Deb Monorama , Aggarwal Pushpa , Banerjee Uma
Published: April 2008

This study analysed the spectrum, antifungal susceptibility pattern, clinical course and molecular epidemiology of cryptococcosis. Four hundred and thirty‐nine samples obtained from 378 meningitis patients were processed by standard procedures. Minimum inhibitory concentration (MIC) of fluconazole and amphotericin B for the isolates was tested by broth micro dilution and by E‐strip method. Molecular analysis by random amplified polymorphic DNA‐PCR of eight isolates was performed using M13 primer. Cryptococcosis was diagnosed in 35 patients [HIV‐1 seropositive (19) and apparently immunocompetent (16)]. Cryptococcus neoformans var. neoformans (serotype A and D) was the predominant isolate on phenotypic identification. Three C. neoformans var. gattii were isolated from HIV‐1 seropositive (2) and apparently immunocompetent (1) patients. MIC 90 for amphotericin B and fluconazole were 1 and 8 μg ml−1 respectively. On RAPD‐PCR, less diversity was seen among Indian isolates. AIDS remains the single most important risk factor for cryptococcosis. Rising MIC of the available induction and maintenance drugs is of grave concern. The DNA typing technique showed less diversity among Indian strains. Routine surveillance and application of molecular typing methods are crucial to know the baseline and existing pattern of cryptococcosis.
Carcinoid tumours of the testis
Authors: Stroosma Otto B. , Delaere Karl P.J.
Published: April 2008

OBJECTIVE

To review previous reports of carcinoid (an endocrine tumour mostly of the gastrointestinal tract) tumours of the testis.

METHODS

Carcinoid tumours of the testis are rare and can be divided into primary carcinoid (group 1), testicular metastasis from another location (group 2) and carcinoid within a testicular teratoma (group 3). A case of testicular carcinoid within our clinic prompted us to review previous reports; all the cases found were assessed for patient and tumour characteristics, diagnostic tools used, treatment and prognosis.

RESULTS

In all, 62 cases were assessed and divided into groups 1 (44 patients), 2 (six) and 3 (12), respectively. Seven patients in group 1 developed metastases. A wide variety of diagnostic tools was used to search for other tumour sites. All patients were treated with orchidectomy. Three patients with a primary carcinoid were treated with adjuvant chemotherapy (two) or radiotherapy (one), with unknown results. All but one of the nine patients who died were known to have metastasis, either from a primary testicular carcinoid or testicular metastases from an intestinal carcinoid.

CONCLUSION

When a testicular carcinoid tumour is discovered, other tumour sites should be excluded. The most useful diagnostic tools for this purpose seem to be urinary 5‐hydroxyindoleacetic acid measurement, somatostatin receptor scintigraphy, computed tomography and video‐capsule endoscopy. Localized testicular carcinoid tumours have an excellent prognosis after orchidectomy.
Re‐operation rates after permanent sacral nerve stimulation for refractory voiding dysfunction in women
Authors: Blandon Roberta E. , Gebhart John B. , Lightner Deborah J. , Klingele Christopher J.
Published: April 2008

OBJECTIVES

To describe the development of screening tests and to identify re‐operation rates after the permanent implant phase, and its characteristics, of the Interstim® (Medtronic, Inc., Minneapolis, MI, USA) device for sacral nerve stimulation (SNS).

PATIENTS AND METHODS

We retrospectively reviewed the charts of women who had SNS between January 1998 and December 2005; their demographic, clinical and surgical information was abstracted. Descriptive statistics, chi‐square and analysis of variance were used to compare the results.

RESULTS

In all, 95 patients had 105 test procedures; 30 peripheral nerve evaluation (PNE) and 75 staged tined leads. Response rates were lower in the PNE than in the tined lead (40% vs 67%, P = 0.01). The indication for SNS was associated with the response rate, with urinary retention having the highest response (71%, P = 0.01). For the 55 implanted devices, there were 18 revisions (33%) and eight explants (15%). The main reasons for revision or explants were loss of efficacy (16/26) and pain at the implant site (six of 26). The median (range) time to intervention after implantation was 17 (1.2–75.0) months, and this was significantly associated with the indication. Revisions due to pain at the implant site were within the first year, and re‐operations due to loss of efficacy after 1–2 years, whereas battery replacement was required on average 4 years after initial implantation.

CONCLUSIONS

This study confirms the higher response rates of the tined‐lead staged technique over PNE. Unobstructive urinary retention had the highest response rates. The reason for revision appeared to be largely predicted by the length of time since implantation.
Outcomes related to placing an artificial urinary sphincter using a single‐incision, transverse‐scrotal technique in high‐risk patients
Authors: Sotelo Tiffany M. , Westney O. Lenaine
Published: April 2008

OBJECTIVE

To determine, in a retrospective review, whether the single‐incision technique for placing an artificial urinary sphincter (AUS) is as effective and as safe as the traditional two‐incision approach in high‐risk patients, as there have been questions about the efficacy and safety of a single incision, transverse‐scrotal technique for placing the AUS.

PATIENTS AND METHODS

From January 2000 to May 2006, 83 patients had an AUS placed using a single‐incision, transverse‐scrotal approach. Emphasis was put on placing the cuff around the proximal aspect of the bulbar urethra. The charts of the patients were reviewed retrospectively and the patients completed standardized questionnaires during the follow‐up.

RESULTS

Of the 83 patients, 24 (29%) had a history of radiation therapy and four had cryotherapy of the prostate. The mean follow‐up was 18.8 months and 14 (17%) patients required revision or explantation (for any reason), nine of whom had had previous radiation therapy. The mean (sd) number of pads used per day before and after surgery was 6.7 (4.0) and 1.1 (1.6), respectively. Overall, 83% of the patients (79% of the irradiated and 85% of the unirradiated) used one or fewer pads per day after surgery.

CONCLUSIONS

Even in high‐risk patients there is no greater risk associated with using the single‐incision, transverse‐scrotal technique than in related series. Outcomes for pad use after surgery, rate of erosion, infections and mechanical malfunctions were similar to those in other series using the traditional technique.