bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibiotic resistance and genetic diversity of Shigella sonnei isolated from patients with diarrhoea between 1999 and 2003 in Bangladesh
Authors: Talukder Kaisar A. , Islam Zhahirul , Dutta Dilip K. , Islam M. Aminul , Khajanchi Bijay K. , Azmi Ishrat J. , Iqbal Mohd S. , Hossain M. A. , Faruque A. S. G. , Nair G. Balakrish , Sack David A.
Published: August 2006

Shigella sonneiis a significant cause of diarrhoeal infection in both developing and industrialized countries. From 1999 to 2003, 445 strains ofShigella sonneiwere isolated from patients admitted to the diarrhoea treatment centre of the International Center for Diarrhoeal Disease Research, Bangladesh. More than 60 % of the isolates were resistant to nalidixic acid, 89 % to sulfamethoxazole-trimethoprim and 9.5 % to ampicillin. In addition, 4 % of strains were resistant to multiple antibiotics (AmpRTetRSxtRStrR) and 4.2 % of strains were sensitive to all antibiotics tested. None of the strains were positive for theset1 gene, whereas 46 % were positive for thesengene. Forty-six per cent of the strains (stored at −70 °C) harboured the 120 MDa invasive plasmid and representative strains produced keratoconjunctivitis in the guinea pig eye. In addition, three plasmids of approximately 5, 1.8 and 1.4 MDa were found to be present in more than 90 % of the strains. A self-transmissible, middle-ranged plasmid (35–80 MDa) carrying the multiple antibiotic resistance gene was found in some strains. PFGE analysis of the strains identified five unique types with many subtypes, which were characterized into four unique types by ribotyping analysis. It can be concluded that endemic strains ofShigella sonneiisolated from patients in Bangladesh are diverse in their genetic pattern.
High mortality of embryos of a distinct autochthonous Austrian coregonid population during Zuger jar incubation
Authors: Lahnsteiner F. , Kletzl M.
Published: August 2006

For a distinct autochthonous Austrian coregonid population called Reinanke Coregonus sp., embryo viability was very low in Zuger jars (mean ±s.d. 36·1 ± 16·1% eyed stage embryos in experiment 1, 15·1 ± 17·0% in experiment 2) but high in vertical flow incubators (63·3 ± 29·0% eyed stage embryos in experiment 1, 57·8 ± 18·9% in experiment 2). Mechanical shock sensitivity is a possible explanation for high embryo mortality.
Rapid changes in renal morphometrics in silver sea bream Sparus sarba on exposure to different salinities
Authors: Wong M. K. S. , Woo N. Y. S.
Published: August 2006

The kidney histology of silver sea bream Sparus sarba adapted to different salinities was studied. Renal glomeruli in silver sea bream were grouped into clusters and two distinct types of glomeruli could be discerned. Expanded glomeruli were highly vascular, probably related to an active filtering role, while collapsed glomeruli had a shrunken appearance, probably related to an abated filtering role. Collecting tubules were lined by tall columnar cells and were more prominent and muscular in hypo‐osmotic media. Chronic adaptation across a broad spectrum of salinities (0, 6, 12, 33 and 50) caused significant modifications in renal morphology. In hypo‐osmotic media, a significant increase in glomerular number, size and percentage expanded glomeruli were found, which could facilitate water excretion. Collecting tubules exhibited an increase in thickness, diameter and muscularity that tended to favour a faster glomerular filtrate flow upon hypo‐osmotic adaptation. Abrupt hypo‐osmotic exposure induced rapid changes in the morphology of renal tubules. There was an increase in diameter and thickness of collecting tubules, suggesting increased glomerular filtrate flow was stimulated by hypo‐osmotic exposure. The data suggested that the rapid change in kidney morphology is one of the osmoregulatory strategies of silver sea bream that may contribute to its ability to withstand abrupt hypo‐osmotic challenge. A fast‐acting mechanism that could be triggered within several hours could reorganize silver sea bream kidney so that the renal machinery is highly responsive to changes in environmental salinities.
Effects of angling on feeding by largemouth bass
Authors: Siepker M. J. , Ostrand K. G. , Wahl D. H.
Published: August 2006

Angling practice significantly effected the time required for largemouth bass Micropterus salmoides to begin feeding. Mean ±s.e. time until feeding resumed was longest for fish that experienced a simulated tournament (15·6 ± 2·2 h) followed by fish that were caught and released (8·4 ± 2·2 h) and controls (0·3 ± 1·6 h). Effects on feeding related to angling practices were maintained throughout the 48 h observation period. Using multiple logistic regression and bioenergetics simulations, decreased growth in fish subjected to competitive or catch‐and‐release angling events was predicted. Fish subjected to multiple captures in a pond experiment had greater mass loss than those not captured, supporting model predictions.
The effect of temperature and somatic growth on otolith growth: the discrepancy between two clupeid species from a similar environment
Authors: Fey D. P.
Published: August 2006

Otolith growth rates of the early life stages of herring Clupea harengus (n= 472) and smelt Osmerus eperlanus (n= 348) collected in the Vistula Lagoon (Baltic Sea) during 1997–1999 were analysed. The larvae and early juveniles were not only collected in the same geographical area they were also of the same size (range 15–43 mm standard length, LS), similar ages and were collected during the same seasons (May to July). Although the two clupeid species experienced very similar environmental conditions, there were significant discrepancies in the analysed relationships. The otolith growth of larval and juvenile smelt was very strongly related to somatic growth while temperature had a minor effect. In herring, the effect of somatic growth, although clearly visible and statistically highly significant, was of less importance than temperature. Furthermore, variation in the otolith size and LS relationship was affected by temperature and somatic growth in both species, but the variance of otolith size at LS was higher for herring than for smelt. Although growth backcalculation from otoliths can presently be recommended as an appropriate method for use with both smelt and herring (despite possibly lower precision and accuracy with the latter), other methods referring directly to short‐term increment width changes (e.g. marginal increment analysis) are recommended for smelt but not for herring.
Cyclic feeding and subsequent compensatory growth do not significantly impact standard metabolic rate or critical swimming speed in rainbow trout
Authors: Blake R. W. , Chan K. H. S.
Published: August 2006

Standard metabolic rate (Rs) and critical swimming speed (Ucrit) were used to assess the aspects of physiological status (stamina) of rainbow trout Oncorhynchus mykiss. Fish were fed either 1·5% body mass daily, 1·5% body mass cyclically (3 weeks of food deprivation followed by 3 weeks of refeeding), a ration based on Stauffer’s formula (a maximum temperature‐specific ration level) daily or on Stauffer’s ration cyclically for 18 weeks. It was hypothesized that if cyclic feeding had no impact on the status of the fish, Rs and Ucrit would not cycle with the feeding regime. This hypothesis was supported. No significant difference was found between the mean mass and the fork length of the four groups at the end of the experiment (P > 0·05). Feeding had no effect on changes in Rs among the four groups, which were significantly different throughout the experiment (P≤ 0·05). No significant difference in Ucrit was found (P > 0·05) until at week 12 between groups fed 1·5% body mass ration cyclically and Stauffer’s ration daily (P≤ 0·05). For groups fed a 1·5% body mass ration cyclically and daily, significant differences occurred at week 15 (P≤ 0·05) but no significant difference was found by week 18 (P > 0·05), suggesting that cyclic feeding does not affect the aspects of physiological status (stamina) of the fish.
Life‐history effects of migratory costs in anadromous brown trout
Authors: Jonsson B. , Jonsson N.
Published: August 2006

Mean size of sexually mature anadromous brown trout (sea trout) Salmo trutta in south‐east Norway increased significantly with migratory distance (D) between the feeding area at sea and the spawning area in fresh water, from 32 cm for those spawning close to the river mouth to 43 cm at the spawning grounds 40 km inland. This was largely due to an increased size of the smallest anadromous spawners with increasing D. The raised mean size of the long‐distance migrants is paralleled by an increased age at sexual maturity. Body mass at the same length of sea trout decreased with D in fresh water, meaning that the fish moving far inland was slimmer than those spawning near the coast. Gonadal mass of first‐time spawning anadromous males declined significantly with D, and the fecundity and the ratio of fecundity over mean mass of the individual eggs adjusted for variation in fish mass, increased with D. There was no clear relationship between the ratio of anadromous to resident fish and D, probably because more variables than D, influence this relationship in the study streams.
Systematic review: are antibiotics detrimental or beneficial for the treatment of patients with Escherichia coli O157:H7 infection?
Authors: PANOS G. Z. , BETSI G. I. , FALAGAS M. E.
Published: August 2006

Background

Escherichia coli O157:H7 is a foodborne pathogen causing haemorrhagic colitis, which is sometimes complicated by haemolytic uraemic syndrome or thrombotic thrombocytopenic purpura.

Aim

To review the available evidence regarding the question of whether antibiotics are effective or harmful for the treatment of patients infected with E. coli O157:H7 infection.

Methods

We searched in the PubMed for relevant laboratory and clinical studies published between 1982 and 2005.

Results

In vitro studies have shown that most E. coli O157:H7 isolates are susceptible to various antibiotics, although certain antibiotics, especially at sublethal concentrations, have been found to increase the release of Shiga‐like toxins, which have been associated with the development of haemolytic uraemic syndrome/thrombotic thrombocytopenic purpura in humans. No clinical studies have indicated that antibiotics are effective in reducing the duration of E. coli O157:H7 infection or the duration of diarrhoea or bloody diarrhoea specifically, while a few studies have supported that some antibiotics, especially quinolones and fosfomycin, may prevent the development of haemolytic uraemic syndrome or thrombotic thrombocytopenic purpura. On the other hand, there are some clinical studies that associate antibiotics with a higher risk for haemolytic uraemic syndrome and/or longer duration of diarrhoea, even with high mortality.

Conclusions

More randomized controlled trials are necessary in order to elucidate whether antibiotics are effective in reducing the morbidity and mortality of E. coli O157:H7 infection, rather than having a detrimental effect.
Meta‐analysis: anti‐viral therapy of hepatitis B virus‐associated glomerulonephritis
Authors: FABRIZI F. , DIXIT V. , MARTIN P.
Published: August 2006

Background

Hepatitis B virus‐associated glomerulonephritis is an infrequent complication of chronic hepatitis B virus (HBV) with significant morbidity. A causal association between hepatitis B virus infection and the development of glomerulonephritis remains controversial. Also, the optimal therapy is undefined although several approaches have been made.

Aim

To evaluate the efficacy and safety of anti‐viral therapy (interferon or lamivudine) in HBV‐associated glomerulonephritis by a systematic review and meta‐analysis of clinical trials.

Methods

The primary outcome was clinical response (as a measure of efficacy); the secondary outcomes were drop‐out rate (as a measure of tolerability), and virological response. We used the random effects model of DerSimonian and Laird, with heterogeneity, sensitivity and meta‐regression analyses.

Results

We identified six clinical trials (84 unique patients); three had controlled design. The overall estimate for proteinuria remission was 65.2% (95% confidence intervals: 52.7–75.9%), Q‐test for heterogeneity = 7.731, P = 0.172, I2 = 35.327. The overall estimate for hepatitis B e antigen clearance was 62.0% (95% confidence intervals: 50.5–72.2%). The overall estimate for drop‐out rate was 12.7% (95% confidence intervals: 6.4–23.6%). Meta‐regression analysis showed a significant link between hepatitis B e antigen clearance and logit rate of proteinuria remission after interferon therapy [coefficient –2.585 (S.E. 1.089), P = 0.017].

Conclusion

Remission of the nephrotic syndrome is accompanied by clearance of HBV replication, supporting the role of the virus in the pathogenesis of the disease.
Review article: prebiotics in the gastrointestinal tract
Authors: MACFARLANE S. , MACFARLANE G. T. , CUMMINGS J. H.
Published: August 2006

Background

Prebiotics are short‐chain carbohydrates that alter the composition, or metabolism, of the gut microbiota in a beneficial manner. It is therefore expected that prebiotics will improve health in a way similar to probiotics, whilst at the same time being cheaper, and carrying less risk and being easier to incorporate into the diet than probiotics.

Aim

To review published evidence for prebiotic effects on gut function and human health.

Methods

We searched the Science Citation Index with the terms prebiotic, microbiota, gut bacteria, large intestine, mucosa, bowel habit, constipation, diarrhoea, inflammatory bowel disease, Crohn's disease, ulcerative colitis, pouchitis, calcium and cancer, focussing principally on studies in humans and reports in the English language. Search of the Cochrane Library did not identify any clinical study or meta‐analysis on this topic.

Results

Three prebiotics, oligofructose, galacto‐oligosaccharides and lactulose, clearly alter the balance of the large bowel microbiota by increasing bifidobacteria and Lactobacillus numbers. These carbohydrates are fermented and give rise to short‐chain fatty acid and intestinal gas; however, effects on bowel habit are relatively small. Randomized‐controlled trials of their effect in a clinical context are few, although animal studies show anti‐inflammatory effects in inflammatory bowel disease, while calcium absorption is increased.

Conclusions

It is still early days for prebiotics, but they offer the potential to modify the gut microbial balance in such a way as to bring direct health benefits cheaply and safely.
Systematic review: the lower gastrointestinal adverse effects of non‐steroidal anti‐inflammatory drugs
Authors: LAINE L. , SMITH R. , MIN K. , CHEN C. , DUBOIS R. W.
Published: August 2006

Background

Lower gastrointestinal effects of non‐steroidal anti‐inflammatory drugs (NSAIDs) are much more poorly characterized than upper gastrointestinal effects.

Aim

To determine if NSAIDs increase lower gastrointestinal adverse effects and if the risk with non‐selective NSAIDs is greater than with cyclooxygenase‐2‐selective inhibitors (coxibs).

Methods

Computerized databases were searched to identify studies of NSAID use reporting on lower gastrointestinal integrity (e.g. permeability), visualization (e.g. erosions, ulcers) and clinical events.

Results

Designs in 47 studies were randomized (18), case–control (14), cohort (eight) and before‐after (seven). Non‐selective‐NSAIDs had significantly more adverse effects vs. no NSAIDs in 20 of 22 lower gastrointestinal integrity studies, five of seven visualization studies, seven of 11 bleeding studies (OR: 1.9–18.4 in case–control studies), two of two perforation studies (OR: 2.5–8.1) and five of seven diverticular disease studies (OR: 1.5–11.2). Coxibs had significantly less effect vs. non‐selective‐NSAIDs in three of four integrity studies, one endoscopic study (RR mucosal breaks: 0.3), and two randomized studies (RR lower gastrointestinal clinical events: 0.5; haematochezia: 0.4).

Conclusions

An increase in lower gastrointestinal injury and clinical events with non‐selective‐NSAIDs appears relatively consistent across the heterogeneous collection of trials. Coxibs are associated with lower rates of lower gastrointestinal injury than non‐selective‐NSAIDs. More high‐quality trials are warranted to more precisely estimate the effects of non‐selective‐NSAIDs and coxibs on the lower gastrointestinal tract.
Liver injury in long‐term methotrexate treatment in psoriasis is relatively infrequent
Authors: BERENDS M. A. M. , SNOEK J. , DE JONG E. M. G. J. , VAN DE KERKHOF P. C. M. , VAN OIJEN M. G. H. , VAN KRIEKEN J. H. , DRENTH J. P. H.
Published: August 2006

Background

Methotrexate‐induced liver damage in psoriasis has led to dermatologic guidelines that stipulate monitoring of liver injury by means of serial liver biopsies. Recent literature data suggest that methotrexate may be considerably less hepatotoxic than previously assumed.

Aim

To evaluate prevalence and development of liver injury in methotrexate treated psoriasis.

Methods

Retrospective chart review (1976–2005).

Results

Hundred and twenty‐five patients (F58/M67; mean age 45.0, SD 12.7 years) received a median cumulative methotrexate dose of 2113 mg (range 180–20 235) over a median period of 228 weeks (range 16–1763). Two hundred and seventy eight liver biopsies were analysed and 71% were classified as Roenigk grade I, 14% as Roenigk II, 14% grade IIIa, 2% grade IIIB and 2% grade IV. Liver injury was not associated with cumulative dose, weekly prescribed dose, age or duration of treatment. Obesity and diabetes were significant risk factors for liver injury. A total of 68 patients had multiple biopsies, 3% improved, 72% did not change and in 25% liver histology deteriorated. The majority of cases (84%) that progressed to Roenigk 2 had a cumulative dose of 1500–6000 mg.

Conclusions

Methotrexate‐related liver injury is less frequent than previously thought and mostly occurred at cumulative dose of <6000 mg. Diabetes and being overweight are significantly correlated with liver injury.
Sequential therapy using high‐dose esomeprazole‐amoxicillin followed by gatifloxacin for Helicobacter pylori infection
Authors: GRAHAM D. Y. , ABUDAYYEH S. , EL‐ZIMAITY H. M. T. , HOFFMAN J. , REDDY R. , OPEKUN A. R.
Published: August 2006

Background

The success rate of current anti‐Helicobacter pylori triple therapies in now generally 80% or less. Sequential therapy has proved superior.

Aim

To test a new sequential therapy for H. pylori eradication.

Methods

This was a pilot study of a sequential therapy consisting of 40 mg of esomeprazole and 1 g amoxicillin t.d.s., for 12 days. On days 6 through 12 gatifloxacin (400 mg in the morning) was added. Outcome was accessed 4 or more weeks after ending antibiotic therapy. Both naive and treatment failures were eligible.

Results

Thirty patients were entered in the study. One was lost to follow‐up and one stopped early because of side effects. The success rate intention‐to‐treat was 80% (95% CI: 61–92%). The per‐protocol eradication rate was 85.7% (95% CI: 67–95%); two of the four failures had pre‐treatment gatifloxacin‐resistant H. pylori. Side effects were reported by 13 patients (46%) and were generally mild with diarrhoea being most common (n = 6). Only one patient stopped medicine because of side effects of dizziness (severe) and diarrhoea (mild).

Conclusions

Sequential therapy using the combination of a high dose of proton‐pump inhibitor and amoxicillin followed gatifloxacin was effective, but pre‐treatment susceptibility testing may become necessary as fluoroquinolone resistance increases.
A cross‐sectional study evaluating the relationship between cortisol suppression and asthma control in patients with difficult asthma
Authors: AbuRuz S. , Heaney L. G. , Millership J. , Gamble J. , McElnay J.
Published: August 2006

Aim

To examine the relationship between cortisol suppression and asthma symptoms in patients with difficult asthma.

Methods

Patients, referred to a specialist difficult asthma service and who fulfilled the criteria for difficult asthma, were recruited to the study in a sequential, unselected manner. At each clinic visit, all patients completed a validated asthma control questionnaire. For measuring cortisol suppression, early morning urinary cortisol [corrected for creatinine to give urinary cortisol creatinine ratio (UCC ratio)] was used. The urine samples were collected and stored at − 70 °C until ready for analysis. Urinary cortisol was extracted (solid‐phase extraction) and analysed using high‐performance liquid chromatography. The Pearson correlation coefficient was used for correlation analysis while t‐tests were used for between‐group differences for normally distributed data. If the data were not normally distributed, nonparametric statistics were used. A P‐value < 0.05 was considered statistically significant.

Results

During the study period all the patients who attended the difficult asthma clinic and fulfilled the criteria for difficult asthma (n = 66) agreed to take part in the study. There were moderate to strong and significant associations between several measures of asthma control and UCC ratio. The correlation coefficient with five indicators of asthma control ranged between 0.3 and 0.5 (P < 0.05).

Conclusions

We have demonstrated a relationship between cortisol suppression and asthma control in difficult asthmatics on high‐dose steroid therapy. We have proposed a model based on the relationship between symptom control and cortisol suppression, whereby both adherence and therapeutic adjustments could potentially be made. A properly controlled prospective clinical trial should examine the utility of this approach in clinical practice.
Patterns of re‐referral to social services: a study of 400 closed cases
Authors: Forrester Donald
Published: August 2006

The last 10 years have seen considerable government focus on effective initial assessment processes in the UK. This has been given added impetus by research that found that more than 97% of referrals are closed without allocation for long‐term work. Yet there is little research on referrals that are closed and no British study of patterns of re‐referral for such children. The current study looks at 400 consecutive referrals to three local authority Social Services Departments in London that were closed rather than being allocated for long‐term work. It investigates how many children were re‐referred in the 27 months after closure and identifies factors statistically associated with re‐referrals. The study found that a third of closed cases were re‐referred (36.5%), with most re‐referrals happening relatively rapidly. A small proportion of families accounted for most re‐referrals: 8.5% of families had 52% of subsequent referrals. There was very wide variation between local authorities in the number of referrals and re‐referrals received. Other factors associated with increased likelihood of a re‐referral were: previous referrals, neglect, parental capacity issues (particularly drug misuse) and parent/child relationship problems. The implications of the findings for practitioners, policy‐makers and researchers are discussed.
ChronicChlamydia pneumoniaeinfection may promote coronary artery disease in humans through enhancing secretion of interleukin-4
Authors: Clancy R , Ren Z , Pang G , Fletcher P , D'Este C
Published: August 2006

Atherosclerosis is an inflammatory response, probably to a range of initiating causes. Chronic infection with Chlamydia pneumoniae (C.pn) has been suggested as one cause, but the nature of the association is controversial, in large part due to lack of an identified mechanism to link infection with the atherosclerotic process in man. This study examined 139 consecutive subjects with stable chest pain, with the aim of correlating the serological status of C.pn infection with the pattern of secretion of cytokines from CD4+ T lymphocytes. C.pn seropositive subjects secreted significantly more interleukin (IL)-4 than did those who were C.pn seronegative (P = 0·02). No significant difference was noted for secreted interferon (IFN)-γ. The amount of secreted IL-4, but not of secreted IFN-γ, correlated positively with the extent of coronary artery disease (P = 0·006). A similar correlation with secreted IL-4 was not identified with Helicobacter pylori infection. These results support the hypothesis that C.pn infection contributes to the inflammatory process responsible for coronary artery atherosclerosis. The method used to detect cytokine secretion involves ligation of CD40L on blood CD4+ T cells, which may have relevance to tissue events.
R1 Effect of brushing on dental erosion
Authors: ABDULLAH A. Z. , STRAFFORD S. M. , BROOKES S. J. , TOUMBA K. J. , BARLOW A. P. , SMITH S. R. , DUGGAL M. S.
Published: August 2006

Objectives:  To compare the effect of brushing versus dipping using three different concentrations of fluoridated toothpastes on enamel erosion in vitro using surface profilometry.

Methods:  In a randomised, blinded experiment six groups of seven enamel slabs each were cut and mounted into resin blocks, ground and checked for surface flatness using a scanning profilometer (Scantron Proscan 2000). Each slabs’ surface was covered with nail varnish except for a small window (1 x 2 mm). Each group was immersed under static conditions for 2 minutes, five times daily in fresh 200 ml aliquots of citric acid 0.3% (pH = 3.6). In addition, three groups were immersed in three different fluoridated toothpastes (0 ppm F, 1100 ppm F, or 1450 ppm F) twice daily morning and evening for 2 minutes each time. The other three groups were brushed using the same toothpastes twice daily for 2 minutes each time. The total cycling period lasted 16 days during which the slabs were incubated overnight and between erosive challenges in artificial saliva at 37oC. A 60‐minute gap was left between daytime immersions. Before and after dipping in the erosive solutions the slabs were rinsed with de‐ionised water. After the cycling period, the slabs were analysed with the scanning profilometer to measure the amount of surface loss at day 4, 8, 12, and 16.

Results:  Surface loss ± SD of enamel at day 16 caused by citric acid combined with dipping using non‐fluoridated toothpaste was 61.19 ± 8.50 μm, 1100 ppm F was 43.44 ± 10.94 μm or 1450 ppm F was 34.98 ± 4.29 μm. Surface Loss ± SD of enamel at day 16 caused by citric acid combined with brushing using 0 ppm F, 1100 ppm F, or 1450 ppm F toothpastes was 75.62 ±10.64, 63.51 ± 5.27 and 48.94 ± 13.67 μm, respectively.

Conclusion:  Enamel erosion was increased significantly (CI 95%) using brushing with toothpastes compared to dipping. In addition, enamel erosion showed a dose‐response to fluoridated toothpastes.

Acknowledgment:  This project was supported by GlaxoSmithKline.
R2 The pattern of extraction of first permanent molars: results from three dental hospitals
Authors: ALBADRI S. S. , MCDONNELL S. , ZAITOUN H. , NORTH S. , DAVIDSON L. E. , LLEWELYN R. , BLINKHORN A. S. , MACKIE I. C.
Published: August 2006

Objective:  To determine and compare the reasons and pattern of extraction of first permanent molars (FPM) in 3 UK dental hospitals.

Design:  Data were collected prospectively from 300 children attending Manchester Dental Hospital (MDH), Liverpool Dental Hospital (LDH) and Charles Clifford Dental Hospital, Sheffield (CCDH) who required extractions of at least one FPM. Information recorded included age, FPM extracted, reason for extractions, previous treatment, method of extraction, and whether patients had previous extractions.

Result:  The mean age in months was 129 (Std 22.7), 139 (Std 29.4), and 133 (Std 26.8) for MDH, LDH, CCDH respectively. 45% and 48% of children had four FPM extracted at MDH & CCDH, respectively, compared to 25% in LDH. The main reason for extraction (70%) was caries with poor prognosis, followed by caries and compensating extraction (14%). Molar Incisal Hypoplasia was the reason for extraction in 11% of cases. General anaesthesia was the main anaesthetic method used with 77%, 55%, and 47% in MDH, LDH and CCDH, respectively. Local anaesthesia was used in 43% of cases in LDH in comparison to 12% and 22% in MDH and CCDH, respectively. 68% of children had received no previous treatment to the FPM and only 5% had fissure sealants placed. 40% of children had previous extractions.

Conclusion:  The children who are attending our hospitals for extractions of FPM tend to be older than the recommended age for achieving maximum space closure. This study highlights the need for extensive prevention programs targeted at those children with high caries risk.
R4 Dental age assessment in 15–17 year old young people
Authors: MITCHELL* J. C. , ROBERTS G. J. , LUCAS V. S.
Published: August 2006

Objectives:  To determine reference intervals for Dental Age Assessment (DAA) for the 16 year threshold.

Design:  Descriptive study from a convenience sample of radiographic archives.

Sample and methods:  Dental Panoramic Tomographs of 15–17 year patients treated at King's College Dental Hospital. Tooth Development Stages (TDS) for the 12 stage (Haavikko 1970), and the 8 stage (Demirjian 1971), will be recorded on specially prepared forms. The computer database is designed to return the age of attainment for each of the TDS's. Each TDS provides a set of statistical information viz. the mean, standard deviation, standard error and confidence intervals. In addition a probability distribution function is produced for each TDS. Only teeth that are still developing are included in the assessment. The ages for still developing teeth are ‘averaged’ using meta‐analysis to provide an estimate of age for an individual. This will be tested by taking a separate sample of 50 children with the gold standard of Chronological Age and comparing this with the Dental Age Assessment for these subjects.

Results:  To date, a small number of assessments show that the individual Dental Age Assessments are within 6 months of the chronological age.

Conclusion:  Dental Age assessment derived by age calculation of tooth development stages and meta‐analysis provides, improved estimates of age.
R7 Theatre time trials: an efficiency study of paediatric dentistry lists
Authors: MOONEY* G. , NORTH S. , DAVIDSON L. E. , BENSON R. , RODD H. D.
Published: August 2006

Objective:  To determine usage of theatre time during Paediatric Dentistry operating lists.

Design:  Prospective cross‐sectional study.

Setting:  Operating theatres, Sheffield Children's Hospital.

Sample and methods:  A standard data collection sheet was employed to record the following information: session (am/pm); type and time of anaesthetic induction; medical status of patient; dental procedures undertaken and total operating time; start and finish time of list and reason for any delays. Each session allocation was 210 minutes.

Results:  Data were collected for 36 consecutive Paediatric Dentistry lists over a 4‐month period, involving 95 patients. A further eight patients were cancelled on admission. Only one list started on time, the remaining lists had a mean delay of 16 minutes (SD = 12.9; range = 1–51). Delays were mainly attributed to porter shortages, ward delays and late arrival of the anaesthetist. The mean time taken to anaesthetise a patient was 18 minutes (SD = 7.7; range = 5–42) with no significant differences according to type of intubation or patient's medical status (P > 0.05, ANOVA). Mean operating time was 32 minutes (SD = 19.6; range = 5–128) with significant time differences according to procedures undertaken and the patient's medical condition (P < 0.05, ANOVA). Six lists ran overtime by a mean 28.7 minutes (SD = 30.2; range = 3–85) and 25 lists finished early by a mean 56.4 minutes (SD = 41.2; range = 1–170). Overall, a mean 60 minutes (SD = 42.0; range = 1–184) are ‘wasted’ during every theatre list, with total anaesthetic and operating time accounting for only 71% of the actual session allocation.

Conclusions:  This study has revealed significant inefficiencies within hospital systems, which may adversely affect productivity.
C2 Management of a patient exhibiting concomitant supernumerary teeth and hypodontia
Authors: PATCHETT* C. L. , SARGISON A. E. , COLE B. O. I.
Published: August 2006

Presenting problem:  A 9‐year‐old boy was referred by his General Dental Practitioner for the management of supernumerary teeth in the anterior maxilla. The child had little experience of dental treatment but was concerned with the aesthetics of his teeth. He was medically fit and well. Clinical and radiographic examination revealed the presence of a supplemental megadont tooth in the position of 11, an erupted palatal tuberculate supernumerary tooth causing displacement on closure and hypodontia of 35 and 45 with infraocclusion of 75. Orthodontically, the patient had a Class II division 1 incisal relationship on a mild Class II skeletal base. He was severely crowded in the upper arch but the lower arch was well aligned. Oral hygiene was noted to be poor.

Clinical management:  All treatment was provided under the close supervision of an Associate Specialist in Orthodontics and initially involved extraction of 53 and the palatal supernumerary tooth and thorough oral hygiene instruction and preventive advice. Following further dental development, the megadont tooth and 24 were extracted to facilitate orthodontic alignment with an upper fixed appliance. A heat‐treated gold onlay has been provided for 75 and 85 is currently monitored for signs of infraocclusion.

Discussion:  There are few reported cases in the literature of concomitant supernumerary teeth and hypodontia. This case describes the multi‐disciplinary management of a child with a complex dental problem.
C4 Staphylococcus aureus infection associated with orofacial granulomatosis
Authors: GILCHRIST* F. , GIBSON J.
Published: August 2006

Presenting problem:  A 6‐year‐old girl attended the Department of Paediatric Dentistry at Edinburgh Dental Institute complaining of swelling and blistering of her upper lips and adjacent gingivae, which had been present for approximately 1 month. The patient had an unremarkable medical history.

Clinical management:  Examination revealed submandibular lymphadenopathy with vesiculation and erythema in the upper incisor region. There was swelling and crusting of the upper lip with slight swelling of the lower lip. Foetor oris was evident. An initial diagnosis of primary herpetic gingivostomatitis was made. Despite treatment the lesions did not resolve. At review, the patient's mother stated that the patient was now suffering abdominal pain and diarrhoea. Haematological investigations revealed no abnormalities. Punch biopsies of the lips carried out under general anaesthesia showed lymphoedema but no granulomata. It was felt by the pathologist that the appearance was of a secondarily infected lesion with an underlying allergic component, most likely to be orofacial granulomatosis (OFG). Swabs sent for bacterial and fungal culture identified no fungal species but Staphlycoccous aureus was present in large numbers. The patient was prescribed Nystaform® cream and oral flucloxacillin which has improved the appearance of the upper lips. The patient has been referred for patch testing, and also to gastroenterology for investigation.

Discussion:  Staphylococcal mucositis has been reported previously in a series of patients with OFG. This case demonstrates an unusual presentation of Staphylococcus aureus infection, previously unreported, in a child with OFG.
C5 Oral submucous fibrosis in paediatric patients
Authors: HAYES M. L. , RICHARDS A. M.
Published: August 2006

Presenting complaint:  This case report relates to two paediatric patients, aged 11 and 13 years, referred to the Birmingham Dental Hospital with limited oral opening. In both instances, this limitation of opening was of unknown duration but thought to be progressive in nature by the referring agent.

Clinical management:  On examination, the inter‐incisal opening was found to be approximately 15–20 mm. On questioning, a betel chewing habit was identified in both patients. The mucosa was found to be pale and taut in nature. Both patients and parents were counselled on the adverse effects of betel chewing and the possibility of tissue changes as a result. Symptomatic relief was provided with benzydamine hydrochloride and biopsies of the affected sites were carried out. A histological diagnosis of oral submucous fibrosis was made in both instances.

Discussion:  Oral submucous fibrosis is recognized as a pre‐malignant condition. It is thought to be associated with an epithelial inflammatory reaction and subsequent fibro‐epithelial change. This can lead to epithelial atrophy and later mucosal stiffening. The occurrence of oral submucous fibrosis in younger patients is extremely uncommon. This case report highlights the importance of investigating the social history of presenting patients and the need to improve patient and parent education in relation to the habit of betel nut chewing.
C6 A case of facial cellulitis associated with a supplemental tooth
Authors: MITCHELL J. C. , AHLUWALIA* M.
Published: August 2006

Presenting problem:  An 8‐year‐old boy presented with a facial cellulitis. This appeared to be associated with the right maxillary lateral incisor.

Clinical management:  There was no history of dental trauma. It was reported that a primary supplemental tooth had been present in the right premaxilla. On examination the right maxillary lateral incisor had a deep palatal pit and was grade 3 mobile. There was evidence of a tooth erupting palatal to this tooth. The radiographic examination suggested the right lateral incisor tooth was supplemental, invaginated and had an apical radiolucent area. The acute infection was managed by extirpating the pulp and dressing the supplemental tooth with non‐setting calcium hydroxide. It was later removed under inhalation sedation and local anaesthetic. The ectopic tooth was monitored and subsequently erupted palatally. This may require orthodontic interception in the future for the correction of a crossbite.

Discussion:  The prevalence of supernumerary teeth in the permanent dentition has been reported as 0.1–3.8%. They are less frequently seen in the primary dentition. However, it is not uncommon for a child to present with dental anomalies in both dentitions. In this case study, the subject had a supplemental lateral incisor in both the primary and permanent dentition. The permanent supplemental tooth was invaginated, confirmed by histological examination. The cellulitis was therefore caused by the invaginated odontome.
Radiographic Evolution of the Forelimb Digit in Ardenner Horses from Weaning to 28 months of Age and its Clinical Significance
Authors: Lejeune J. P. , Schneider N. , Caudron I. , Duvivier D. H. , Serteyn D.
Published: August 2006

Ossification of collateral cartilages is a common radiographic finding in draught horses and indication of a high frequency of interphalangeal osteo‐arthropathy have been found in Ardenner horses. This study first aimed at following the evolution of the digits of the forelimbs on radiographic images in a group of 32 Ardenner horses from weaning to 852 ± 19 days and, secondly, at evaluating the clinical significance of the observed radiographic changes. At 250 ± 21 days, only 23% of the horses presented a small separate ossification centre of collateral cartilages above the level of the distal sesamoid bone or at the level of the proximal half of the middle phalanx. At 852 ± 19 days, 100% of the horses presented an ossification of collateral cartilages but at different stages and grades. The presence and the extent of the ossification of the lateral cartilages were not significantly associated with lameness. Phalanges changes appeared at the average age of 1 year and they were represented by entheseophytes on the dorsal surface of the middle and distal phalanges. The frequency of affected horses increased with age as well as the size of the entheseophytes. This may reflect mechanical stresses applied to the interphalangeal joints. A significant association with the presence of lameness was pointed out. The presence and the severity of phalanges changes could be of importance, in combination with a clinical examination, in improving the selection of horses able to assume work and/or leisure activities.
Effects of Flunixin Meglumine on Selected Clinicopathologic Variables, and Serum Testosterone Concentration in Stallions after Endotoxin Administration
Authors: Danek J.
Published: August 2006

Four clinically normal stallions were infused intravenously with endotoxin (LPS) fromEscherichia coli055:B5 at a dose of 0.3 μg/kg b.w. and four stallions were treated with flunixin meglumine (FM) as a single intravenous injection at a dose of 1.1 mg/kg b.w., 5 min after the infusion of LPS. In response to endotoxin infusion, stallions’ reaction was fever (increased rectal and scrotal skin temperature), increased heart rate (HR) and leucopenia. Administration of endotoxin also influenced the level of testosterone (decrease at 3–24 h and increase at 48–72 h after LPS administration) in the blood serum. FM treatment prevented an endotoxin‐induced increase in rectal and scrotal skin temperature, HR, with no influence on the decrease of leucocytes. Administration of FM only had a significant effect on the latter changes (at 24–72 h) of serum testosterone concentration after addition of endotoxin.
Increased Number of Neurons Expressing Androgen Receptor in the Basolateral Amygdala of Pathologically Aggressive Dogs
Authors: Jacobs C. , Van Den Broeck W. , Simoens P.
Published: August 2006

The present study aimed to determine the extent to which the androgen receptor (AR) is directly involved in the hormonal modulation of pathological canine aggressive behaviour in the basolateral nuclear group (BNG) of the amygdaloid body. A stereological quantification of AR‐positive neurons was performed in the BNGs of normally behaving and aggressive male dogs. The BNG was selected because it is involved in sexual and behavioural activities that are influenced by androgens. In the aggressive dogs the BNG contained a significantly higher number of AR‐positive neurons compared with normally behaving dogs suggesting differences in androgen activity within the BNGs of both the groups. However, additional mechanisms are likely to be involved because the AR‐negative fraction of BNG neurons was also increased in the aggressive dogs. It was concluded that most of the AR was unliganded because a cytoplasmic staining pattern of AR positivity was observed in the canine BNG neurons. This indicates that genomic androgen actions, which are mediated through the AR are of minor importance in the testosterone modulation of canine aggression within the BNG. Other non‐genomic mechanisms through which androgens may exert their action in the BNG are discussed. The aromatase pathway is suggested to be the main mechanism through which testosterone exerts its action within the BNG.
Effect of Vitamin E Supplementation on Lymphocyte Distribution in Gut‐Associated Lymphoid Tissues Obtained from Weaned Piglets
Authors: Fragou S. , Balaskas C. , Fegeros K. , Politis I.
Published: August 2006

Fifteen piglets were used to determine the effect of vitamin E supplementation on the number of CD4‐immunoreactive (CD4+) T‐lymphocytes, CD8‐immunoreactive (CD8+) T‐lymphocytes and IgA‐immunoreactive (IgA+) B‐lymphocytes per follicle in the Peyer's patch of distal ileum and the mesenteric lymph nodes of weaned piglets. Piglets, following a 3‐day adaptation period after weaning, were assigned to one of three experimental groups: control (no vitamin E supplementation), vitamin E supplementation of 100 mg/kg of diet and vitamin E supplementation of 300 mg/kg of diet. Supplementation of vitamin E lasted for a period of 36 days. The basal diet contained 80 mg α‐tocopherol/kg of diet. All piglets were killed at day 39 after weaning and samples of the distal ileum and adjacent mesenteric lymph nodes were collected. The number of cells for each lymphocyte subset was counted in the Peyer's patch and the mesenteric lymph nodes follicles, in cryostat sections processed for immunohistochemistry. Results showed that vitamin E supplementation (300 mg/kg diet) of piglets caused an increase (P < 0.05) in the number of IgA+ B‐lymphocytes in the Peyer's patch, but not in the mesenteric lymph nodes, compared with the corresponding values in control animals. Vitamin E supplementation had no effect (P > 0.05) on the number of CD4+ and CD8+ T‐lymphocytes in the follicles of the Peyer's patch and the adjacent mesenteric lymph nodes. Thus, vitamin E had relatively minor effects on distribution of the major immunocompetent cells in the gut. The numbers of CD4+ and CD8+ T‐lymphocytes as well as IgA+ B‐lymphocytes per follicle were higher by 26–77% (P < 0.05) in the mesenteric lymph nodes than the corresponding values in the Peyer's patch.
A New Method for Detecting the Abomasal Position and Characteristics of Movement at the Onset of the Left Displacement of the Abomasum in Cows
Authors: Itoh N. , Egawa M. , Kitazawa T. , Ueda M. , Koiwa M.
Published: August 2006

A new method has been developed by us to observe the movements of the abomasum by using a magnet and digital magnetometer. Four cows with left displacement of the abomasum underwent conventional correction by rolling without tacking. A doughnut‐type magnet was sutured to the pyloric region in a routine operation. The same was done in three control cows. The position of the pyloric region was observed with a digital magnetometer from outside the cow's body. The magnets in the pyloric region of the control cows were located at the right side of the abdominal cavity at 10–30 cm anterior to the udder base, and moved slightly in various directions within the span of a day. On the other hand, the magnets in the pyloric region of cows with abomasal displacement moved widely in the abdominal cavity from the normal right side to the abnormal left front side. A large movement of the magnet from the normal right side to the abnormal left side of the abdominal cavity was observed within 12 h of the onset of abomasal displacement.
COMPARISON OF MAJOR BILE DUCT INJURIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY AND OPEN CHOLECYSTECTOMY
Authors: Kaman Lileswar , Sanyal Sudip , Behera Arunanshu , Singh Rajinder , Katariya Rabindra N.
Published: August 2006

Background:  The mechanism and extent of major bile duct injuries following laparoscopic cholecystectomy differ from those of open cholecystectomy.

Methods:  To identify differences in the demographic profile, timing of injury detection, management strategies and outcome, we undertook a retrospective review and analysis of our experience with 55 major bile duct injuries following both laparoscopic and open cholecystectomies over a period of 9 years.

Results:  Thirty‐one major bile duct injuries resulted from laparoscopic cholecystectomy (56%) and 24 of them were sustained after open cholecystectomy (44%). The median time of presentation was 7 days after laparoscopic cholecystectomy and 14 days following open cholecystectomy (P < 0.001). Twenty‐eight (51%) patients had injuries recognized intraoperatively in both groups, of whom 18 patients underwent an attempt at primary repair before referral. All patients required subsequent surgical intervention. There were no differences in the clinical presentations between the two groups. However, serum alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase levels were significantly higher following open cholecystectomy (P < 0.05). There was no significant difference in the level of injury between the two groups. All patients underwent surgical repair in the form of a Roux‐en‐Y hepaticojejunostomy (including two revision hepaticojejunostomies in each group). Surgical outcome did not differ between the groups; however, better results were seen with Bismuth grades 1 and 2 strictures compared with Bismuth grades 3 and 4 strictures for both groups (P < 0.002).

Conclusion:  Major bile duct injuries following laparoscopic cholecystectomy present earlier and with lower levels of serum alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. There does not appear to be a significant difference between the Bismuth–Strasberg grading of the strictures and the type of surgery carried out.