bluuebunny/crossref_metadata_2025 huggingface dataset:
Findings from the British HIV Association's national clinical audit of first‐line antiretroviral therapy and survey of treatment practice and maternity care, 2002
Authors: Brook M G , Curtis H , Johnson M A ,   on behalf of the British HIV Association Clinical Audit Committee
Published: November 2004

Objectives

To assess the impact of and adherence to the British HIV Association (BHIVA) guidelines in routine clinical practice in the UK and Ireland.

Methods

A self‐completed postal survey of practice with regard to HIV management and maternity care of HIV‐positive women was carried out. A case‐note review of all patients starting their first antiretroviral (ART) therapy (up to a maximum of 25 patients) between April and September 2002 was also performed.

Results

A total of 113 treatment centres participated. Ninety‐nine units (88%) use the BHIVA ART guidelines as part of their treatment policy. Problems revealed by the survey include limited access to some ARTs in a small number of units and a wait longer than 4 weeks before the first assessment of patients started on ART in some units. Thirty‐one centres (33%) felt that their maternity services had reached the government target of >90% antenatal HIV testing by October 2002. A total of 942 case‐notes audited showed shortfalls in reported pretreatment testing of blood glucose, lipids and hepatitis C virus. Three patients had not strictly met the BHIVA guidelines for starting ART, but all had a high viral load (>100 000 HIV‐1 RNA copies/mL). The majority (844 patients; 90%) had started on recommended therapies, most commonly two nucleoside reverse transcriptase inhibitors and a nonnucleoside reverse transcriptase inhibitor. The other 98 patients (10%) were given a variety of nonstandard triple or quadruple ART.

Conclusions

This audit again shows a high rate of consistency and quality of care of patients with HIV across the UK and Ireland. Problems with pretreatment assessment and early follow up of patients starting ART have been found.
Ethical Responsibility and the Historian: On the Possible End of a History “of a Certain Kind”
Authors: JENKINS KEITH
Published: November 2004

In this article I try to answer the question posed by History and Theory's“call for papers”; namely, “do historians as historians have an ethical responsibility, and if so to whom and to what?” To do this I draw mainly (but not exclusively and somewhat unevenly) on three texts: Alain Badiou's Ethics: An Essay on the Understanding of Evil, J. F. Lyotard's The Differend, and Edward Said's Representations of the Intellectual; Jacques Derrida and Richard Rorty have a presence too, albeit a largely absent one. Together, I argue that these theorists (intellectuals) enable me to draw a portrait of an ethically responsible intellectual. I then consider whether historians qua historians have some kind of ethical responsibility—to somebody or to something—over and above that of the intellectual qua intellectual; I reply negatively. And this negative reply has implications for historians. For if historians are to be intellectuals of the type I outline here, then they must end their present practices insofar as they do not fulfill the criteria for the type of ethical responsibility I have argued for. Consequently, to be “ethical” in the way suggested perhaps signals—as the subtitle of my paper suggests—the possible end of a history “of a certain kind” and, as the inevitable corollary, the end of a historian “of a certain kind” too.
A Declaration of the Responsibilities of Present Generations Toward Past Generations
Authors: DE BAETS ANTOON
Published: November 2004

Historians study the living and the dead. If we can identify the rights of the living and their responsibilities to the dead, we may be able to formulate a solid ethical infrastructure for historians. A short and generally accepted answer to the question of what the rights of the living are can be found in the Universal Declaration of Human Rights. The central idea of human rights is that the living possess dignity and therefore deserve respect. In addition, the living believe that the dead also have dignity and thus deserve respect too. When human beings die, I argue, some human traces survive and mark the dead with symbolic value. The dead are less than human beings, but still reminiscent of them, and they are more than bodies or objects. This invites us to speak about the dead in a language of posthumous dignity and respect, and about the living, therefore, as having some definable core responsibilities to the dead. I argue further that these responsibilities are universal. In a Declaration of the Responsibilities of Present Generations toward Past Generations, then, I attempt to cover the whole area. I identify and comment on four body‐ and property‐related responsibilities (body, funeral, burial, and will), three personality‐related responsibilities (identity, image, and speech), one general responsibility (heritage), and two consequential rights (memory and history). I then discuss modalities of non‐compliance, identifying more than forty types of failures to fulfill responsibilities toward past generations. I conclude that the cardinal principle of any code of ethics for historians should be to respect the dignity of the living and the dead whom they study.
Voicing the Silent Fear: South Asian Women's Experiences of Domestic Violence
Authors: Gill Aisha
Published: November 2004

Abstract: This article examines the subjective experiences of South Asian women in the United Kingdom who have suffered domestic violence, and identifies some of the risk factors for domestic violence within this community. The study, based on in‐depth interviews with 18 Asian women, describes and analyses several aspects of domestic violence in relation to South Asian women. The guiding research questions are: how do Asian women interpret their experiences of domestic violence, and to whom do they report it? This article presents data that suggest that abusive acts against Asian women arise out of a multiplicity of cultural circumstances influenced by power relations. Abusive acts are not therefore limited to a single characteristic, such as physical abuse, or to a particular relationship. Recurrent themes emerge from the women's accounts, revealing their definitions of domestic violence and showing how some continue to play down the levels of violence they experience.

The article voices the concerns of and hardships experienced by victims and survivors of domestic violence, in their own words. Finally, the article offers an analysis of the ways in which notions of honour and shame are used both as tools to constrain women's self‐determination and independence, and as catalysts for domestic violence when these notions of family and community are challenged by women.
Corporate governance, industrial relations and trends in company‐level restructuring in Europe: convergence towards the Anglo‐American model?
Authors: Edwards Tony
Published: November 2004

This article addresses the issue of how patterns of corporate restructuring are shaped by national systems of corporate governance and industrial relations. Using case studies of three multinationals, it sheds light on the question of whether the way in which restructuring takes place is converging towards the norms characteristic of the Anglo‐American model. It is argued that considerable changes are evident among national systems, but that these changes are not all occurring at the same pace, nor are all countries moving in the same direction. Consequently, the way that multinational companies restructure their activities varies markedly according to both the business system in their country of origin and the various host systems in which they are located.
Re‐evaluating the concept of working time: an analysis of recent case law
Authors: Kenner Jeff
Published: November 2004

Controversy abounds the Working Time Directive seven years since its implementation as the European Commission seeks to unpick the compromise that led to the notorious individual opt‐out from maximum weekly working time. This article explores the roots of that controversy in the context of the Court of Justice’s expansive interpretation of the concept of ‘working time’. To what extent is it possible to maintain a health and safety guarantee but allow for more flexibility in the organisation of working time for individual workers in an increasingly heterogeneous working environment?
Consolidating segmentation: post‐Socialist employment relations in Central and Eastern Europe
Authors: Martin Roderick , Cristescu‐Martin Anamaria M.
Published: November 2004

The article argues that, of the four major potential mechanisms for integration—the state, tripartite social partnerships, employer and employee organisations and shared values—in Central and Eastern Europe only the trade unions are contributing significantly towards national employment relations convergence. Against a background of imminent European Union accession, incorporation into global production systems, economic growth and gradual improvement in real incomes, four divergent employment relations systems are thus emerging: the state budget, privatised or about to be privatised, private and multinational.
Bookshelf 2004
Authors: Hoque Kim
Published: November 2004

Books reviewed:

Ola Bergstrom and Donald Storrie (eds). Contingent Employment in Europe and the United States. Reviewed by Ian Kirkpatrick

Tonia Novitz. International and European Protection of the Right to Strike. Reviewed by Lord McCarthy

Deborah Foster and Peter Scott (eds). Trade Unions in Europe—Meeting the Challenge. Reviewed by Michael Gold

Jeff Kenner. EU Employment Law. From Rome to Amsterdam and Beyond. Reviewed by Simon Deakin

Vladimir Gimpelson and Douglas Lippoldt. The Russian Labour Market: Between Transition and Turmoil. Reviewed by Gregory Schwartz
How can studies of memory and language enhance the authenticity, validity and reliability of interviews?
Authors: Dockrell Julie E.
Published: November 2004

Gathering reliable and valid information is the cornerstone of applicable research. Interviews provide a basis for collecting information about an individual's experiences, attitudes and beliefs. Yet interviews place significant demands on an individual's cognitive and linguistic skills. Such demands have implications for interviews with children and people with specific and general learning disabilities. In order to provide a range of views in research and practice specific attention must be paid to the mechanisms that limit participation or result in unreliable reports. This paper examines the ways in which studies of memory and language can provide relevant data to help interpret interviews and support the development of techniques to enhance the reliability and validity of the information provided.
Carbon sequestration in temperate grassland ecosystems and the influence of management, climate and elevated CO2
Authors: Jones M. B. , Donnelly Alison
Published: November 2004

The substantial stocks of carbon sequestered in temperate grassland ecosystems are located largely below ground in roots and soil. Organic C in the soil is located in discrete pools, but the characteristics of these pools are still uncertain. Carbon sequestration can be determined directly by measuring changes in C pools, indirectly by using13C as a tracer, or by simulation modelling. All these methods have their limitations, but long‐term estimates rely almost exclusively on modelling. Measured and modelled rates of C sequestration range from 0 to > 8 Mg C ha−1 yr−1. Management practices, climate and elevated CO2strongly influence C sequestration rates and their influence on future C stocks in grassland soils is considered. Currently there is significant potential to increase C sequestration in temperate grassland systems by changes in management, but climate change and increasing CO2concentrations in future will also have significant impacts. Global warming may negate any storage stimulated by changed management and elevated CO2, although there is increasing evidence that the reverse could be the case.

ContentsI.Introduction2II.Carbon in temperate grasslands2III.The process of carbon sequestration in soils4IV.Tracking carbon movement9V.Models of soil carbon dynamics10VI.Management effects on carbon sequestration11VII.Climate‐change effects on carbon sequestration12VIII.Response to elevated CO213IX.Conclusions14References14
The use of video information in obtaining consent for female sterilisation: a randomised study
Authors: Mason Victoria , McEwan Alec , Walker David , Barrett Steve , James David
Published: November 2004

Hypothesis
Providing additional information by video in addition to the standard consultation in women requesting sterilisation increases patients' knowledge about the procedure with no change in anxiety levels.

Design
Randomised control trial in 6 weeks.

Population
Women requesting sterilisation (n= 31).

Setting
Gynaecology clinics in two teaching hospitals.

Methods
Comparison of providing additional information by video in addition to the standard consultation with the standard consultation.

Main outcome measures
Patients' knowledge of sterilisation, anxiety levels and acceptance of the video approach.

Results
Women receiving video information as well as the standard consultation had significantly higher knowledge scores compared with women only receiving the conventional consultation. Women undergoing a conventional consultation (no video) in a nurse‐led dedicated sterilisation clinic had significantly higher knowledge scores than women having their consultation in a general gynaecological clinic. There were no differences in anxiety levels between the groups. Information giving by video was acceptable to the majority of women.

Conclusion
Videos are a reliable and consistent method of delivering information to women requesting female sterilisation.
Microsatellite DNA markers for the ground beetle Pterostichus oblongopunctatus F.
Authors: Lagisz M. , Wolff K.
Published: November 2004

Six microsatellite DNA loci were isolated from the ground beetle Pterostichus oblongopunctatus F. (Coleoptera, Carabidae) to study population structure. Each locus was polymorphic, with the number of alleles ranging from three to six. Observed heterozygosity varied between 0.20 and 0.67. All six loci were tested for amplification in the closely related P. quadrifoveolatus and they were shown to be polymorphic. The primers developed were used in multiplex polymerase chain reactions.
Microsatellite markers for the cosmopolitan marine diatom Pseudo‐nitzschia pungens
Authors: Evans Katharine M. , Hayes Paul K.
Published: November 2004

Very little information is available on the genetic structure of populations of phytoplankton species. Here we report the characterization of six polymorphic microsatellite loci in the marine diatom, Pseudo‐nitzschia pungens, using clones (between 87 and 213 per locus) isolated from spring blooms in the North Sea. The number of alleles per locus ranged from five to 19 and observed heterozygosities ranged from 0.55 to 0.86.
Isolation and characterization of microsatellite loci in Bencomia exstipulata and B. caudata (Rosaceae)
Authors: González‐Pérez M. A. , Lledó M. D. , Fay M. F. , Lexer C. , Sosa P. A.
Published: November 2004

Five novel polymorphic microsatellite markers were isolated from enriched libraries in order to examine population structure in the Canary Island endemic Bencomia exstipulata and the related Bencomia caudata. All markers were successfully amplified from both Bencomia species. They possessed an average of 6.8 and 7.0 alleles per locus in B. exstipulata and B. caudata, respectively. Our data are consistent with the tetraploid condition of both Bencomia species. In addition, this set of microsatellite loci offers an efficient tool to clarify the genetic relationships within the Bencomia alliance.
Rationale, design and methods of the CASHMERE study†
Authors: Simon Tabassome , Boutouyrie Pierre , Gompel Anne , Christin‐Maitre Sophie , Laurent Stéphane , Thuillez Christian , Zannad Faiez , Bernaud Corine , Jaillon Patrice ,   on behalf of the CASHMERE investigators
Published: November 2004

Carotid intima‐media thickness (IMT) measurement is a noninvasive method used for quantification of early stage of atherosclerosis. Data suggest that the combination of statin and hormone replacement therapy (HRT) might be useful in reducing the early progression of atherosclerosis in postmenopausal women. The main aim of the study is to compare the effects of 12‐month therapy with atorvastatin (80 mg/day), HRT (oral 17β‐estradiol 1 or 2 mg/day, plus cyclic dydrogesterone 10 mg) alone and their combination vs. placebo on the progression of carotid IMT by using a high‐definition echotracking device. The secondary objectives are to assess the effects of the treatments vs. placebo on arterial stiffness, lipid profile and C‐reactive protein. The CASHMERE trial is an European randomized study with a 2 × 2‐factorial design, double blinded for atorvastatin and prospective randomized, open blinded endpoint evaluation (PROBE) method applied to HRT. The investigators can adjust the dose of estradiol at any time during follow‐up if necessary. A total of 800 postmenopausal women with mild hypercholesterolemia and with no previous history of cardiovascular disease will be included and followed up by their physicians [general practitioners (GPs) or gynecologists] for 1 year. The CASHMERE trial is the first randomized clinical trial to examine the effects of a statin alone or combined with HRT on the structure and the function of carotid artery as early markers of atherosclerosis in postmenopausal women with mild hypercholesterolemia. The results are expected for 2007.
Geographical variation in the breeding biology of the Purple SandpiperCalidris maritima
Authors: Summers Ron W. , Nicoll Mike
Published: November 2004

Studies in Iceland (66°N) and Svalbard (78°N), combined with the results of previous work, allowed geographical comparisons of different aspects of the breeding biology of the Purple SandpiperCalidris maritima, testing predictions that they may be related to latitude and altitude (here taken as surrogates for climatic severity). The breeding density was lowest in the polar deserts of Franz Josef Land (82°N) and highest in coastal Arctic TernSterna paradisaeacolonies in Iceland where the terns perhaps afforded protection from predators. There was no difference in the percentages of 1‐year‐old (first‐year) birds in the breeding populations in Svalbard and Iceland. Time of breeding was related to both latitude and altitude, being later at higher latitudes and altitudes. In Iceland, larger males and males over 1 year old nested earlier than small males and 1‐year‐old males, respectively. Relaying occurred in Iceland but it was not observed in Svalbard. There were no geographical differences in clutch size. Egg size was related to female size in Svalbard. There were also geographical differences in egg size associated with female size (wing length), with the largest eggs in Iceland and smallest in south Norway. Males usually attended broods and the rates at which females deserted their broods were similar in Iceland and Svalbard. Chick growth rates were similar for Iceland and Franz Josef Land. Thus, in breeding biology, Purple Sandpipers varied geographically only in breeding density, time of nesting and egg size, which was associated with female size.
Measurement of the Relative Motion Between an Implant and Bone under Cyclic Loading
Authors: Britton J. R. , Lyons C. G. , Prendergast P. J.
Published: November 2004

Abstract:  The measurement of the relative motion between a prosthesis and the surrounding bone is important for the pre‐clinical testing of prostheses and implants. A technique that allows measurements to be made over several million loading cycles was developed by Maher et al. (Clin. Biomech. 2001; 16: 307–314). However, the measurement of implant/bone motion is fraught with difficulties because: (i) testing over millions of cycles can take several days and errors because of diurnal temperature variations can occur, (ii) elastic deformations of the stem could have a dominant effect on ‘inducible displacements’, the rate of change of which is hypothesised to be a measure of loosening, and (iii) the use of this method for the analysis of cementless prostheses has yet to be demonstrated. This paper addresses these methodological issues with respect to testing hip prostheses, and concludes with a comparative evaluation of pre‐clinical testing methods.
Experimental Device for Simulating Traumatic Brain Injury Resulting from Linear Accelerations
Authors: Gilchrist Michael D.
Published: November 2004

Abstract:  Various methods are used to model and analyse traumatic brain injuries (TBI) in human beings. These include volunteer and cadaver experiments, anthropomorphic dummies, physical models, computational models and mathematical models. The pathophysiological response to mechanical impact of the human central nervous system and of in vivo neural tissue, is most realistically analysed using animal models, which provide the best surrogate for the human brain. During non‐fatal impacts, a mechanical insult may trigger a cascade of physiological processes, many mediated by neurochemicals within the neural tissue which will, in turn, control the depth and extent of the brain injury. This paper reports the development of a novel experimental device which can apply different linear acceleration impacts directly to in vivo neural tissue in a manner which permits the experimental analysis of non‐fatal TBI of varying severity.
Managing tendupatta leaf logistics: an integrated approach
Authors: Singh N. , Shah J.
Published: November 2004

The collection of tendupatta leaf is a massive operation involving around 2.5 million families, who depend on this activity for their livelihood. Key decisions, which affect the livelihood of these poor families, are not only based on local political considerations but are managed in an inefficient manner, as a result of which, only 30% of the potential produce is collected. These types of geographically dispersed logistic activities which involve huge resources and affect large numbers of people are ideal candidates for OR applications. We have modelled the above problem using facility location and vehicle‐routing models. This OR‐based methodology can help the decision maker to raise leaf output substantially under existing budget limitations.
Understanding Employee Awareness of Health Care Quality Information: How Can Employers Benefit?
Authors: Abraham Jean , Feldman Roger , Carlin Caroline
Published: November 2004

Objective. To analyze the factors associated with employee awareness of employer‐disseminated quality information on providers.

Data Sources. Primary data were collected in 2002 on a stratified, random sample of 1,365 employees in 16 firms that are members of the Buyers Health Care Action Group (BHCAG) located in the Minneapolis–St. Paul region. An employer survey was also conducted to assess how employers communicated the quality information to employees.

Study Design. In 2001, BHCAG sponsored two programs for reporting provider quality. We specify employee awareness of the quality information to depend on factors that influence the benefits and costs of search. Factors influencing the benefits include age, sex, provider satisfaction, health status, job tenure, and Twin Cities tenure. Factors influencing search costs include employee income, education, and employer communication strategies. We estimate the model using bivariate probit analysis.

Data Collection. Employee data were collected by phone survey.

Principal Findings. Overall, the level of quality information awareness is low. However, employer communication strategies such as distributing booklets to all employees or making them available on request have a large effect on the probability of quality information awareness. Employee education and utilization of providers' services are also positively related to awareness.

Conclusions. This study is one of the first to investigate employee awareness of provider quality information. Given the direct implications for medical outcomes, one might anticipate higher rates of awareness regarding provider quality, relative to plan quality. However, we do not find empirical evidence to support this assertion.
Can Japan Become “A Society Attractive for Immigrants?” Identity, Gender and Nation‐States under Globalization in East Asia
Authors: Jung Yeong‐Hae
Published: November 2004

Abstract:  In 2003, the total fertility rate in Japan was 1.29. According to many predictions, if the current rate continues, the labor shortage will become critical. The Economic and Fiscal Policy White Paper, edited by the Cabinet Office (Naikakuhu, 2003a), stated “If we attempt to fill the lack by accepting immigrants in order to maintain the population of productive workers, we will need to accept 640 000 immigrants every year until 2050. It is necessary to make our country more attractive for foreign workers”. However, it is unlikely that more than 30 million immigrants will choose to live in Japan unless efforts are made to abolish xenophobia and to make qualitative changes that will change Japanese society so that it is more open to co‐existence. Moreover, Japan is not the only country that must worry about future declines in the work force and other countries will most likely start to attract foreign workers earlier than Japan (Naikakuhu, 2003b).
Epidemiology of Skin Diseases in School Children: A Study from Northern India
Authors: Dogra Sunil , Kumar Bhushan
Published: November 2004

Abstract:  Little information is available about the prevalence of skin conditions among children in the general population of northern India. Low socioeconomic status, malnutrition, overcrowding, and poor standards of hygiene are important factors accounting for the distribution of skin diseases in developing countries such as India. In order to estimate the burden and relative frequency of dermatologic diseases among children in the community, we measured the point prevalence of skin conditions in 12,586 Indian school children ages 6–14 years. The overall point prevalence of one or more identifiable/apparent skin conditions was 38.8%. Of those studied, 3786 children (30%) had only one skin disease, 765 (6%) had two, and 336 (2.7%) had three skin pathologies. The most common skin conditions and their respective point prevalences were skin infections (11.4%), pityriasis alba (8.4%), dermatitis/nonspecific eczemas (5.2%), infestations (5.0%), disorders of pigmentation (2.6%), keratinization disorders (mostly keratosis pilaris) (1.3%), and nevi/hamartomas (1.1%). This study shows that skin conditions are common in children and about one‐third of them are affected at any given time. The finding that more than 85% of the disorders can be grouped into fewer than eight categories is important in designing training programs for medical teams involved in the delivery of primary health care services in developing countries such as India, where about one‐third of the population is less than 15 years of age.
Congenital Erythropoietic Porphyria Complicated by Squamous Cell Carcinoma
Authors: Pandhi Deepika , Suman Mansi , Khurana Neeta , Reddy B. S. N.
Published: November 2004

Abstract:  We report two sisters, ages 12 and 8 years, with the characteristic clinical and biochemical profile of congenital erythropoietic porphyria (CEP). The disease is inherited as an autosomal recessive. The elder sibling had squamous cell carcinoma arising from the stump of the amputated left arm with metastases to lymph nodes, adrenals, and bone. To our knowledge, this feature has not been described in the English language literature, making our patient the first documented report of CEP with squamous cell carcinoma.
Childhood Pustular Psoriasis Elicited by the Streptococcal Antigen: A Case Report and Review of the Literature
Authors: Cassandra Marya , Conte Eugene , Cortez Barbara
Published: November 2004

Abstract:  The Zumbusch pattern of generalized pustular psoriasis (GPP) classically presents as waves of widespread sheets of sterile pustules on brightly erythematous skin. The occurrence of this disease in childhood is rare, and fewer than 200 cases have been reported in the literature. We describe a 10‐year‐old boy with GPP who had an elevated serum antistreptolysin titer. Several antigenic factors shown to elicit GPP have been reported, including withdrawal of steroids, emotional stress, and infection. However, we further propose that the group A β‐hemolytic streptococcus can trigger a flare of GPP. We suggest that if pustular psoriasis is suspected clinically, an elevated serum antistreptolysin antibody titer may help identify the causative antigen.
Long‐Term Tolerability of Sumatriptan Nasal Spray in Adolescent Patients With Migraine
Authors: Natarajan Shankar , Jabbour J. T. , Webster Christopher J. , Richardson Mary S.
Published: November 2004

Objective.—This 1‐year, open‐label, multicenter study was designed to assess the long‐term tolerability and efficacy of sumatriptan nasal spray 20 mg in adolescent patients with migraine.

Methods.—A prospective, multicenter, open‐label study was conducted in patients aged 12 to 17 years who were allowed to treat an unlimited number of migraines at severe, moderate, or mild pain intensity with sumatriptan nasal spray for up to 1 year. All patients started the study at the 20‐mg dose of sumatriptan nasal spray. Dose could be adjusted downward to 5 mg at the discretion of the investigator to optimize therapy.

Results.—A total of 484 adolescent migraineurs treated 4676 migraines with sumatriptan nasal spray 20 mg (3593 during the first 6 months and 1083 during the second 6 months). A total of 3940 migraines and 699 migraines were treated with one and two 20‐mg doses of sumatriptan nasal spray, respectively. Only 10 patients (treating 42 migraines) took the 5‐mg dose of sumatriptan nasal spray. The overall percentage of migraines treated with either one 20‐mg dose or one, two, or three 20‐mg doses with at least 1 drug‐related adverse event was 19%. The most common specific drug‐related adverse event was unpleasant taste, reported in 17% of migraines. No other single drug‐related adverse event was reported in more than 1% of migraines over the 1‐year treatment period. When unpleasant taste was excluded from the adverse‐event tabulations, the percentages of migraines with at least 1 drug‐related adverse event after one or one, two, or three 20‐mg doses declined to 4% and 3%, respectively. No patient experienced any drug‐related changes in 12‐lead ECGs, vital signs, or nasal assessments; and no clinically meaningful changes in clinical laboratory values were observed. Across all migraines with evaluable efficacy data (n = 4334), headache relief was reported in 43% of migraines at 1 hour and in 59% at 2 hours after dosing with sumatriptan nasal spray 20 mg. Of the 2561 migraines with headache relief 2 hours postdose, headache recurrence was reported within 24 hours of initial dosing in 7% of migraines. None of the efficacy or tolerability results varied as a function of time in the study (ie, first 6 months vs. second 6 months).

Conclusion.—Sumatriptan nasal spray 20 mg is generally well tolerated and may be beneficial during long‐term use by adolescent migraineurs ages 12 to 17 years.
Assessment of Adverse Events Associated With Triptans—Methods of Assessment Influence the Results
Authors: Sheftell Fred D. , Feleppa Michele , Tepper Stewart J. , Rapoport Alan M. , Ciannella Luciana , Bigal Marcelo E.
Published: November 2004

Background.—A recent study conducted in triptan‐naïve migraine patients showed that tolerability was the second most important attribute of an acute treatment. However, the proportion of patients reporting side effects after any acute treatment may vary with regard to the method of assessment.

Objectives.—To contrast two methods of assessing adverse events (prompted and unprompted) in those with headache using triptans.

Methods.—This study was conducted in two sites, a headache center in the United States, and a neurology office focusing on headache in Italy. We prospectively surveyed 415 adults with headache, who had been using the same triptan for at least 3 months. Participants were asked about their headache and treatment history. Subjects then completed a standardized questionnaire, assessing adverse events in two different ways. First, subjects were asked if they had any adverse events when using the triptan. After returning the first part of the questionnaire, subjects received a second form, where 49 possible adverse events were listed. We contrasted and correlated both sets of answers.

Results.—Most patients (U.S. = 74.9%, Italy = 65.5%) reported no side effects in the unprompted questionnaire. However, most of them (U.S. = 62.9%, Italy = 54.1%) reported at least one side effect in the prompted questionnaire. Most patients that reported side effects in the unprompted questionnaire said they had just one adverse event, while most reported two or more side effects in the prompted questionnaire. Both in the unprompted and in the prompted questionnaires, most side effects were rated as mild or moderate. Interestingly, 31 (7.5%) subjects (pooling data from both sites together) graded their adverse events as severe in the prompted questionnaire, but had not self‐reported them.

Conclusions.—(1) When assessing adverse events, the method of data collection may dramatically influence the results. (2) From those subjects who did not self‐report adverse events after using a triptan, most of them will report positively if presented with a list of side effects.
Serotonin Transporter Polymorphism and Harm Avoidance Personality in Chronic Tension‐Type Headache
Authors: Park Jeong Wook , Kim Joong Seok , Lee Hae Kook , Kim Yeong In , Lee Kwang Soo
Published: November 2004

Objective.—To investigate the 5‐HTT‐gene‐linked polymorphic region (5‐HTTLPR) genotypes and harm avoidance (HA) dimension in chronic tension‐type headache (CTH).

Background.—Serotonin transporter protein (5‐HTT) is a key modulating protein in synaptic serotonergic neurotransmission. Among serotonin gene‐linked polymorphism, promoter located in the regulatory region of the 5‐HTTLPR has two alleles (short and long) with different transcriptional efficiencies. The HA personality trait may be heritable and associated with serotonergic neurotransmitter activity.

Design.—We amplified the 5‐HTTLPR by means of polymerase chain reaction and performed genotype polymorphism analyses and we investigated the serotonin‐related personality trait by evaluating the HA dimension in tridimensional personality questionnaire (TPQ) in 107 patients with CTH and in 100 healthy controls.

Results.—We found an excess frequency of the short allele and a different genotype distribution in patients with CTH. S/S genotype frequency was significantly higher in patients with CTH (76%) than in those with controls (59%; P= .02). Patients with CTH had significantly higher HA scores (21.4 ± 6.3) than controls (16.3 ± 6.1).

Conclusions.—This suggests a serotonergic activity might be involved in the development of CTH and 5‐HTTLPR might be one of the genetically contributing factors.
Focal Hypertrophic Pachymeningitis in Association with Temporal Arteritis
Authors: Kuhn Jens , Harzheim Andreas , Brockmann Michael , Mahkorn Déirdre , Bewermeyer Heiko
Published: November 2004

We present an extremely rare case of a patient with focal hypertrophic pachymeningitis in association with histologically proven temporal arteritis (giant cell arteritis). It is proposed that focal hypertrophic pachymeningitis in itself is the contributing factor to severe headache rather than temporal arteritis alone.
Patient Evaluation of Treatment with Fixed Prostheses Supported by Implants or a Combination of Teeth and Implants
Authors: Kronström Mats , Trulsson Mats , Söderfeldt Björn
Published: November 2004

Purpose: The objective of this study was to compare treatment outcomes among subjects with complete arch fixed prostheses in the maxilla, supported by implants or a combination of natural teeth and dental implants.

Materials and Methods: Twenty‐one subjects with maxillary tooth‐ and implant‐supported fixed prostheses and 21 subjects with maxillary implant‐supported fixed prostheses were identified and included in the study. All abutment teeth in the group with tooth‐ and implant‐supported prostheses were provided with cemented copings that incorporated threads for vertical locking screws. Frameworks were fabricated with a gold alloy that was veneered with acrylic resin or ceramic materials. All frameworks were screw‐retained to implants and copings. Frameworks in the group with implant‐supported prostheses were fabricated with milled titanium or gold alloy to which denture teeth and resin base material were applied. All prostheses had a minimum of 8 units, at least 4 of which were in one quadrant. Subjects in both groups were mailed a questionnaire consisting of 15 questions focused on various factors related to treatment outcome, such as oral function and patient satisfaction.

Results: The response rate was 86%. Both groups reported a high satisfaction rate for most items with few regretting their choice of treatment. Most individuals in both groups reported great improvement in chewing ability and few reported phonetic disturbances. No statistically significant differences were found between the groups.

Conclusion: The results of the present study showed similarity in questionnaire responses between the 2 groups of participants. High satisfaction was reported both among subjects who received a complete arch fixed prosthesis in the maxilla supported by dental implants only, as well as among those whose prostheses were supported by a combination of natural teeth and dental implants.
Effect of Denture Cleansers on the Surface Roughness and Hardness of a Microwave‐Cured Acrylic Resin and Dental Alloys
Authors: Garcia Renata Cunha Matheus Rodrigues , Júnior Joane Augusto de Souza , Rached Rodrigo Nunes , Del Bel Cury Altair Antoninha
Published: November 2004

Purpose: This study evaluated the effect of denture cleansers on the surface hardness of a denture base resin, and on the surface roughness of the resin and Co‐Cr and Ti‐6Al‐4V alloys.

Materials and Methods: Forty‐eight disc‐shaped specimens were fabricated of a microwave‐cured acrylic resin, each having one of the alloys attached to its surface. The specimens were randomly divided into 6 groups, each consisting of 8 samples. Specimens were exposed to one of the three cleansing treatments (polident, manipulation pharmacy cleanser, and water) as follows. Group I: Co‐Cr + polident; Group II: Co‐Cr + manipulation; Group III: Co‐Cr + water; Group IV: Ti‐6Al‐4V + polident; Group V: Ti‐6Al‐4V + manipulation; and Group VI: Ti‐6Al‐4V + water. Three exposures lasting 5 minutes each were conducted daily, and repeated after storage periods of 1, 14, and 29 days in artificial saliva at 37°C. Hardness and roughness measurements were undertaken immediately after specimen preparation (T0) and on the 1st (T1), 15th (T15), and 30th (T30) day following the beginning of storage. Three roughness and hardness evaluations were carried out for each sample and testing time, and mean values were calculated. Results were analyzed using ANOVA and linear regression.

Results:
The Knoop hardness test demonstrated differences (p < 0.05) between Groups I and IV at T1 and T30 (14.30 ± 2.78; 14.06 ± 1.76) and between Groups II and V at T15 (16.99 ± 2.24). Significant differences (p < 0.05) in resin roughness (in μm) were observed between Groups I and IV at T15 and T30 (0.14 ± 0.06; 0.21 ± 0.38). With regard to Co‐Cr, roughness data showed differences (p < 0.05) for all groups at T30 (Group I: 0.15 ± 0.07; Group II: 2.43 ± 0.66; Group III: 4.05 ± 1.03), for Group II at T1 (0.10 ± 0.03), and for Group I at T15 (0.15 ± 0.02). There were significant differences (p < 0.05) in titanium roughness for Group IV at T15 (0.12 ± 0.01) and T30 (0.11 ± 0.04).

Conclusions: Manipulated cleanser containing sodium perborate increased surface roughness and hardness, probably due to its incapacity to remove the pellicle formed on the acrylic resin and dental alloys.
Comparison of Laparoscopic Ovariohysterectomy and Ovariohysterectomy in Dogs
Authors: Davidson Ellen B. , David moll H. , Payton Mark E.
Published: November 2004

Objectives—To evaluate technique, complication rates, postoperative pain scores, and clinical outcomes in dogs after laparoscopic ovariohysterectomy (LOVH) or traditional ovariohysterectomy (OVH).

Study Design—Prospective clinical trial.

Animals or Sample Population—Thirty‐four intact female dogs, weighing 2.4–31 kg.

Methods—LOVH (16 dogs) was performed by ligation of the uterus and ovaries with surgical wire, and then removal by an assisted laparoscopic technique. OVH was performed in 18 dogs. Subjective and objective pain scores were assigned at 0, 2, 8, and 24 hours. Surgical time, complications, and pain and incision scores were evaluated. Dogs were followed for up to 6 months.

Results—The mean surgical time for LOVH (120 minutes; range, 47–175 minutes) was significantly longer than for OVH (69 minutes; range, 25–140 minutes). Significantly lower pain scores (subjective, in 2 of 10 categories; objective, in 8 of 10 categories) were identified with LOVH at 1 or more time periods. Surgical complications with LOVH were postoperative fever and anorexia (1 dog), minor splenic (3) or pedicle hemorrhage (4), intermittent vaginal hemorrhagic discharge (1), and suture reaction (3). Surgical complications with OVH were hemorrhage from an ovarian pedicle requiring reoperation (1 dog), dehiscence of the abdominal wall (1), and seroma (1). Anesthetic complications included hypotension in 8 OVH dogs and 1 LOVH dog, and hypothermia in 4 OVH and 9 LOVH dogs. The mean incision scores were lower for LOVH at all time periods.

Conclusion—LOVH was performed successfully in young nonparous dogs >10 kg. Surgical time and complication rates were greater; however, LOVH postoperative pain scores were ≤OVH scores.

Clinical Relevance—LOVH is a potentially safe surgical alternative to traditional OVH in dogs. Equipment cost and necessity for more than 1 surgeon may limit its usefulness in small animal practice.
Spatial and Temporal Expression of Types I and II Receptors for Transforming Growth Factor β in Normal Equine Skin and Dermal Wounds
Authors: De martin Isabelle , Theoret Christine L.
Published: November 2004

Objective— To describe immunolocalization of TGF‐β receptors (RI and RII) in normal equine skin and in thoracic or limb wounds, healing normally or with exuberant granulation tissue (EGT).

Study Design— Group A: six wounds on one metacarpus and one midthoracic area. Group B: six wounds on both metacarpi, one of which was bandaged to stimulate EGT. Immunohistochemistry was used to detect RI and RII expression in wound margins.

Animals— Eight horses, randomly assigned to one of two study groups.

Methods— Neutralizing polyclonal anti‐rabbit RI and RII antibodies were used to detect spatial expression of RI and RII in biopsies obtained before wounding, at 12 and 24 hours, and 5, 10 and 14 days after wounding.

Results— RI and RII were co‐localized in both unwounded and wounded skin. There were no differences in cell types staining positively between tissues obtained from the limb and the thorax, or from normally healing limb wounds and limb wounds with EGT, at any time. Because of increased cellularity within EGT, staining intensity of limb wounds with ‘proud flesh’ was greater than limb wounds healing normally, and thoracic wounds, during the proliferative phase of repair.

Conclusions— Strong expression of RI and RII, particularly in limb wounds with EGT, suggested that signalling for stimulation of matrix proteins is in place to contribute to scarring.

Clinical Relevance— This information may help determine the appropriate time for using receptor antagonists to prevent scarring of limb wounds of horses.
Effects of Extracorporeal Shock Wave Therapy on Bone
Authors: Mcclure Scott R. , Van sickle David , White M. Randy
Published: November 2004

Extracorporeal shock waves have been used for 30 years to fragment uroliths for nonsurgical treatment for urolithiasis in humans. Applied to bone, shock waves delivered at the appropriate energy and pulse number, can stimulate osteogenesis. In Europe, shock waves are routinely used to treat nonunions in humans despite poor understanding of the mechanism of action. Shock wave therapy has also been used clinically in horses. Preliminary experimental studies indicate that shock wave therapy does not damage soft tissue in the distal aspect of the equine limb and can stimulate osteogenesis throughout the depth of the near cortex of the metacarpus and metatarsus.
Endocardial Pacemaker Implantation in Infants Weighing ≤ 10 Kilograms
Authors: KAMMERAAD JANNEKE A.E. , ROSENTHAL ERIC , BOSTOCK JULIAN , ROGERS JON , SREERAM NARAYANSWAMI
Published: November 2004

Epicardial pacemaker implantation is the most common approach for small children requiring pacemaker implantation, though it is not free from complications. This article reviews the experience with endocardial pacemaker implantation, as an alternative approach, in children ≤10 kg at two centers. Thirty‐nine children, median age 3.8 months (2 days–35 months), weight 4.6 kg (2.3–10 kg) underwent endocardial permanent pacing (VVI/R in 38, DDDR in 1). Indications for pacing were complete heart block (CHB) in 34 (congenital in 21, postsurgical in 12, congenitally corrected transposition of the great arteries 1), long QT syndrome in 3, and sinus bradycardia in 2 children. Two children with postsurgical CHB died 7 days and 3 weeks after implantation, respectively, due to heart failure and septicemia, despite appropriate pacemaker therapy. Over a median follow‐up of 4.3 years (9 months–15.3 years), 12 patients underwent 18 generator replacements. Five patients were upgraded to physiological pacing. Ten patients underwent 12 ventricular lead advancements. Ventricular lead extraction was attempted 11 times in nine patients and succeeded 10 times. Two patients were converted to epicardial dual chamber systems. Two prepectorally placed generators required resiting due to threatened skin necrosis. Infective endocarditis on the lead, 9 months postimplant required removal of the system in one patient. The subclavian vein was found to be asymptomatically thrombosed in four patients. Endocardial permanent pacing is feasible and effective in children ≤ 10 kg and an acceptable alternative to epicardial pacing.