bluuebunny/crossref_metadata_2025 huggingface dataset:
Different effects of polymorphisms of tumor necrosis factor‐alpha and interleukin‐1 beta on development of peptic ulcer and gastric cancer
Authors: Sugimoto Mitsushige , Furuta Takahisa , Shirai Naohito , Nakamura Akiko , Xiao Fang , Kajimura Masayoshi , Sugimura Haruhiko , Hishida Akira
Published: May 2006

Background and Aim:  In Western countries, polymorphism of pro‐inflammatory cytokine genes is associated with the development of gastric cancer and duodenal ulcer. The aim of this study was to clarify the association of polymorphisms of interleukin (IL)‐1β and tumor necrosis factor (TNF)‐α with susceptibility to peptic ulcer diseases and gastric cancer in Japan.

Methods:  The IL‐1β‐511/‐31 and TNF‐α‐308/‐857/‐863/‐1031 genotypes were determined in Helicobacter pylori‐positive patients with gastritis only (n = 164), gastric ulcers (n = 110), duodenal ulcers (n = 94), or gastric cancers (n = 105), and in H. pylori‐negative controls (n = 172).

Results:  Carriage of the alleles TNF‐α‐857 T (odd ratio [OR], 1.826; 95% confidence interval [CI], 1.097–3.039), TNF‐α‐863 A (OR, 1.788; 95% CI, 1.079–2.905) and TNF‐α‐1031 C (OR, 1.912; 95% CI, 1.152–3.171) was associated with increased risk for gastric ulcer development. Carriage of the alleles TNF‐α‐857 T (OR, 1.686; 95% CI, 1.003–2.832), TNF‐α‐863 A (OR, 1.863; 95% CI, 1.118–3.107) and TNF‐α‐1031 C (OR 2.074; 95% CI, 1.244–3.457) was also associated with increased risk of gastric cancer development. There was no relationship between the development of H. pylori‐related diseases and polymorphisms of IL‐1β‐511/‐31 and TNF‐α‐308. The simultaneous carriage of three different high‐producer alleles of TNF‐α‐857/‐863/‐1031 significantly increased the risk of gastric ulcer (OR, 6.57; 95% CI, 2.34–18.40) and gastric cancer (OR, 5.20; 95% CI, 1.83–14.78).

Conclusions:  Polymorphisms in TNF‐α rather than IL‐1β are associated with increased risk for gastric ulcers and gastric cancer in Japan. The simultaneous carriage of more than one high‐producer allele of TNF‐α further increased the risks for gastric ulcer and cancer.
Hepatocellular carcinoma in an Australian tertiary referral hospital 1975–2002: Change in epidemiology and clinical presentation
Authors: Roberts Stuart K , Kemp William
Published: May 2006

Aim:  We compared the epidemiology and clinical features of hepatocellular carcinoma (HCC) cases diagnosed between 1975 and 2002.

Methods:  Retrospective and prospective analysis was performed of HCC cases diagnosed at The Alfred during the time periods 1975–1983 and 1995–2002. Demographic, epidemiological, clinical and laboratory data were recorded and compared between the two periods.

Results:  Comparing the 1995–2002 cohort to the 1975–1983 cohort, patients were older (64 years vs 60 years; P = 0.02), and were more likely to be non‐Caucasian (25%vs 9%; P = 0.003) and born overseas (57%vs 40%; P = 0.03) particularly from Asia. In addition, hepatitis C virus (HCV) (35%), hepatitis B virus (HBV) (22%), and alcoholic liver disease (29%) were the major etiological factors for HCC with alcohol less likely the cause of underlying liver disease (33%vs 55%; P < 0.01). Among the 1995–2002 cohort, overseas‐born patients were more likely to be infected with HBV (P < 0.001) and HCV (P = 0.01), while alcohol was more likely to be the etiological factor in Australian‐born cases (P = 0.02), particularly among males. Detection of HCC by screening was the initial presentation in 38% of patients, and diagnosis of HCC was often by non‐invasive means.

Conclusions:  The epidemiology of HCC has changed in Australia over the past 20 years with hepatitis C and hepatitis B now major etiological factors, and an increase in cases born overseas particularly from areas where HCV and HBV are endemic. This suggests the recent increase in incidence and death rates due to HCC in Australia relate to HCV and HBV infection.
Prevention of intraventricular haemorrhage: A role for recombinant activated factor VII?
Authors: Robertson Jeremy D
Published: May 2006

Abstract:  As the survival from extreme prematurity continues to improve, focus on the quality of this survival becomes increasingly important. Prevention of intraventricular haemorrhage (IVH) and its potential long‐term sequelae remains one of the major challenges in the early management of these infants. Recombinant activated factor VII (rVIIa), a novel haemostatic agent with an ever‐expanding list of potential applications, warrants consideration for use in this setting. This review examines the pathogenesis and prevention of IVH, current concepts of haemostasis both in adults and neonates, and the postulated mechanism of action and various uses of rVIIa. Published data specifically relating to use of rVIIa in neonates is summarised. The hypothesis that early (prophylactic) administration of rVIIa to extremely preterm infants (<28 weeks) would reduce the incidence of severe IVH is explored.
Incidence of Retinopathy of Prematurity requiring treatment in infants born greater than 30 weeks’ gestation and with a birthweight greater than 1250 g from 1998 to 2002: A regional study
Authors: Ahmed Mohamed AT , Duncan Martin , Kent Alison ,   NICUS Group
Published: May 2006

Aim:  To ascertain the prevalence of significant Retinopathy of Prematurity (ROP) and ROP requiring treatment in infants born greater than 30 weeks gestation and with a birthweight greater than 1250 g, utilising the Neonatal Intensive Care Units’ (NICUS) data collection from 1998 to 2002. Second, to determine whether infants delivered at more than 30 weeks gestation or with a birthweight greater than 1250 g require ROP screening.

Methods:  A review of the New South Wales and Australian Capital Territory NICUS data collection from 1998 to 2002 was performed. Infants of gestational age 31–33 weeks and with a birthweight greater than 1250 g were included. A review was performed of these infants to ascertain stage of ROP, threshold disease and treatment for ROP.

Results:  2292 infants were greater than 30 weeks and had a birthweight greater than 1250 g. Of these 1386 (60%) were not examined or died prior to eye examination. No ROP was noted in 888 of the 904 infants examined (98%), 13 infants had stage 1 (1.4%), five infants stage 2 (0.6%) and no infant had stage 3 ROP. No infant developed stage 3 ROP, required treatment for ROP or had threshold disease.

Conclusion:  In this regional study of infants greater than 30 weeks gestation and with a birthweight greater than 1250 g, the prevalence of any ROP was low (2.0%). This study supports evidence from other studies that screening for ROP could be restricted, at least within our referral network, to infants less than 30 completed weeks and a birthweight less than 1250 g.
Musculoskeletal findings in obese children
Authors: De Sá Pinto Ana L , De Barros Holanda Patricia M , Radu Ari S , Villares Sandra MF , Lima Fernanda R
Published: May 2006

Aim:  A cross‐sectional study was conducted to explore osteoarticular alterations in obese children.

Methods:  Twenty‐five boys and 24 girls (mean age: 10.8 ± 2.07 years) with a body mass index (BMI) above the 95th percentile were compared with 28 boys and 19 girls (controls, mean age: 10.4 ± 2.3 years) with a BMI below the 80th percentile.

Results:  A higher frequency of at least one osteoarticular manifestation was observed in obese patients (55%) compared with the control group (23%) (P = 0.001). A statistically significant association was also found between obesity and lower back pain, genu valgum, genu recurvatum and tight quadriceps. Fibromyalgia tender points (=11) were present at similar frequency in both groups (obese: 3/38 (9%) vs. control: 1/48 (2%)).

Conclusion:  The present data suggest that obesity has a negative impact on osteoarticular health by promoting biomechanical changes in the lumbar spine and lower extremities.
Serious injury is associated with suboptimal restraint use in child motor vehicle occupants
Authors: Brown Julie , McCaskill Mary E , Henderson Michael , Bilston Lynne E
Published: May 2006

Aim:  To investigate the relationship between restraint usage and injury outcome in child motor vehicle occupants aged 2–8 years.

Methods:  Retrospective case review of all child occupants presenting at the Children’s Hospital at Westmead between July 2002 and January 2005 subsequent to a motor vehicle crash. Injury severity was assessed in terms of the Abbreviated Injury Scale (AIS), by age and type of restraint.

Results:  Data were collected for 152 child occupants aged 2 and 8 years. While nearly all children (94%) used some restraint, most (82%) used a suboptimal form of restraint. Injury severity between optimally restrained children and suboptimally restrained children differed significantly (Fisher’s exact test, P < 0.001), with suboptimally restrained children receiving a greater proportion of moderate to severe (AIS 2+) injuries. No optimally restrained child sustained an AIS 2+ injury.

Conclusion:  A total of 82% of child occupants aged 2–8 years involved in crashes were suboptimally restrained. All children who sustained serious injuries were suboptimally restrained. There is a need to encourage correct use of the most appropriate restraint for child motor vehicle occupants in order to reduce the number and severity of injuries in these road users.
Lignocaine and chlorhexidine toxicity in children resulting from mouth paint ingestion: A bottling problem
Authors: Balit Corrine R , Lynch Anne‐Maree , Gilmore Simon P , Murray Lindsay , Isbister Geoffrey K
Published: May 2006

Background:  A pharmaceutical product was marketed in Australia for ‘teething’ in an almost identical container to a popular paediatric paracetamol preparation. The product contained lignocaine and chlorhexidine. The similarity of the packaging resulted in large number of therapeutic errors in which the ‘teething’ preparation was given in error for paracetamol. As the exact dose of the erroneously administered mouth paint was known this provided an opportunity for outcome assessment of lignocaine ingestion.

Methods:  Calls to two state poison information centres regarding this product were prospectively followed up. Information collected included: demographics, type of exposure, details of the exposure and adverse effects. A systematic review of the literature was used to identify all previous reported cases of lignocaine and chlorhexidine ingestion.

Results:  There were 28 cases with complete follow up where the product was given in therapeutic errors (10 girls and 18 boys; median age 11 months; range 2 months−4 years). The mean ingested dose of lignocaine was 2.7 mg/kg (standard deviation 1.3 mg) and chlorhexidine was 0.06 mg/kg (standard deviation 0.03 mg). The largest ingested lignocaine dose was 5.9 mg/kg. Two children developed minor symptoms: one vomited twice and the other was reported to have increased salivation and difficulty with solid food for 20 min. No other adverse effects were reported. The literature review suggested that severe effects occurred with doses more than 15 mg/kg.

Conclusion:  No major adverse effects occurred with lignocaine ingestions of less than 6 mg/kg and it would be appropriate to observe these patients at home. Chlorhexidine did not appear to cause clinical effects in this low concentration.
Cellulitis in childhood invasive pneumococcal disease: A population‐based study
Authors: Gubbay Jonathan B , Mcintyre Peter B , Gilmour Robin E
Published: May 2006

Aim:  There are few detailed data on the age‐specific incidence and clinical pattern of pneumococcal cellulitis in children. We conducted a retrospective review of cellulitis as a subset of prospectively collected laboratory‐identified invasive pneumococcal disease (IPD) and performed a systematic review of published literature.

Methods:  Prospective laboratory surveillance in urban regions of New South Wales, Australia, 1 June 1997–31 December 2001. Medical notes reviewed for each identified case and defined literature search strategy applied.

Results:  There were 1067 cases of IPD in children aged 0–17 years; 38 (3.3%) were cellulitis (32 periorbital, 6 buccal). Compared with other types of IPD, a greater proportion of cellulitis cases occur in children <2 years (30/38, 79% vs. 617/1029, 60.0%; P = 0.004) in whom underlying illness was less common (0/30, 0% vs. 53/590, 9%; P = 0.06). Initially, another diagnosis was made in 13 (34%) of cases; only five had a lumbar puncture, all normal. Of the 239 cases of pneumococcal cellulitis documented in the literature, 28 (11.7%) had the diagnosis made by means other than positive blood culture and 95% were facial or orbital with underlying illness (6%) and associated meningitis (1.9%) uncommon.

Conclusion:  Cellulitis is an uncommon focus in IPD in children, and is almost always facial. Most cases occur under 2 years of age, are seldom associated with meningitis or other complications, and are frequently not recognised on admission.
Foetal and neonatal autopsy rates and use of tissue for research: The influence of ‘organ retention’ controversy and new consent process
Authors: Khong TY , Tanner Alison R
Published: May 2006

Aim:  To examine whether the ‘organ retention’ controversy and new autopsy consent process had any effect on foetal and neonatal autopsy rates and on permitting the use of tissue for scientific research and education.

Methods:  An audit of perinatal autopsy rates in a tertiary hospital prior to (1999–2001) and subsequent to the ‘organ retention’ controversy (2001–2002), and the introduction of a new consenting process (2002–2004). Rates were compared also with those a decade earlier (1990–1993).

Results:  Overall autopsy rates have been falling significantly between the three study periods (1999–2001 71.7%; 2001–2002 61.5%; 2003–2004 50.5%). Autopsy rates have fallen significantly between 1990–1993 and 1999–2001 (P < 0.00005) and between 1990–1993 and 1999–2004 (P < 0.0000001). The autopsy rates for stillbirths and neonatal deaths have fallen significantly further since the ‘organ retention’ controversy but not significantly so following the new consenting process. Significantly fewer autopsies are performed on foetuses less than 20 weeks gestation in recent years than a decade ago (P < 0.0000001). There were more external or limited autopsies in later years (P = 0.015). Permission for the use of tissue for education and research is less frequent following the ‘organ retention’ controversy and particularly following the introduction of the new consenting process.

Conclusion:  Perinatal autopsy rates have fallen over the past 10 years. Fewer autopsies are being performed following the ‘organ retention’ controversy and use of tissue for research and education is permitted even less frequently following the introduction of the new consenting process.
Polioviruses and other enteroviruses isolated from faecal samples of patients with acute flaccid paralysis in Australia, 1996–2004
Authors: Kelly Heath , Brussen Kerri A , Lawrence Andrew , Elliot Elizabeth , Pearn John , Thorley Bruce
Published: May 2006

Background:  Acute flaccid paralysis (AFP) is the most common clinical presentation of acute poliovirus infection, occurring in 0.1–1% of infected cases. AFP surveillance has been used world‐wide to monitor the control and eradication of circulating wild poliovirus. This study aims to review the significance of all enteroviruses, including polioviruses, isolated from patients with AFP in Australia between 1996 and 2004.

Methods:  We undertook a retrospective review of all notified cases of AFP, aged 0–15 years and resident in Australia at the time of notification. We reviewed all available clinical and virological data for these cases and all records of the Polio Expert Committee, which determined the final classification for all cases.

Results:  There were 335 notified cases that satisfied the case definition for AFP, 162 (48%) of whom had at least one faecal sample tested. Enteroviruses isolated from the faeces of 26 (16%) of the 162 cases were Coxsackie A24, Coxsackie B5, enterovirus 71, enterovirus 75, echovirus 9, echovirus 11 and echovirus 18. In addition, one or more polioviruses were isolated from the faeces of seven patients. Six of seven polioviruses were characterised as Sabin‐like, one was not characterised, but all were considered to be incidental isolates. Five of these cases were classified as infant botulism, one case as transverse myelitis and one as a focal mononeuropathy.

Conclusion:  With the eradication of circulating wild polioviruses, other enteroviruses are being more commonly identified as the cause of polio‐like illnesses. In the polio end game, when there is increased testing for polioviruses, it is important to consider infant botulism as a differential diagnosis in cases presenting with AFP.
Health service utilisation of a regional cohort of very preterm infants over the first 2 years of life
Authors: Gray Diane , Woodward Lianne J , Spencer Carole , Inder Terrie E , Austin Nicola C
Published: May 2006

Aim:  Very preterm infants represent major consumers of health services following neonatal discharge. We examined the health service utilisation of a regional cohort of very preterm infants over the first 2 years of life, including the association with neurodevelopmental outcome.

Methods:  A regionally based 2‐year cohort of 100 very preterm infants along with a comparison sample of 104 full term control infants matched for sex, time and place of birth were recruited. Perinatal and social background factors that predispose very preterm infants to increased risk of subsequent general practitioner (GP) and hospital service use were identified. At 2 years, all children underwent a neurodevelopmental assessment, Bayley Scales of Infant Development (BSID‐II). Details of children’s medical contacts obtained by parent interview were cross‐checked against GP and hospital records/databases.

Results:  Very preterm infants had a similar number of GP visits to term infants but more outpatient hospital visits. Fifty‐three (55%) very preterm infants were admitted to hospital on 131 occasions compared with 26 (26%) term infants on 37 occasions (p < 0.001). The main reason for hospitalisation in the preterm cohort was respiratory disorder. The frequency of hospital admissions was significantly related to birthweight (P = 0.01), gestational age (P < 0.001) and the number of people living in the family household (P = 0.02). No associations were found between hospital admission and neurodevelopment at 2 years.

Conclusion:  Very preterm infants had higher rates of hospital admissions and visits than term infants unrelated to neurodevelopmental outcome at 2 years of age. These findings highlight that very preterm birth is associated with ongoing health morbidity.
Neonatal urinary ascites in renal candidal infection
Authors: Sie Adrian HI , Patel Neil , Spenceley Neil
Published: May 2006

Abstract:  A preterm neonate developed anuria and abdominal distension. Peritoneal fluid contained high levels of potassium, urea and creatinine with a low level of bicarbonate compared with plasma. Renal ultrasound showed dilatation of the left collecting system with echogenic material in the calyces bilaterally, which together with positive cultures of candida from blood, urine and peritoneal fluid suggested renal candidiasis with obstruction. Computed tomography (CT) showed extravasation around the right kidney on delayed post contrast films, confirming that the peritoneal fluid was urine. The patient improved rapidly after insertion of the peritoneal drain and made a full recovery with antifungal agents and a left nephrostomy. Causes of urinary ascites are discussed and characteristic biochemical features described. Ultrasound and contrast CT may be diagnostic and help to monitor progress.
Attendance of paediatricians at elective Caesarean sections performed under regional anaesthesia: Is it warranted?
Authors: Atherton Neil , Parsons Simon J , Mansfield Peter
Published: May 2006

Aim:  Whether or not a paediatric registrar or consultant paediatrician trained in advanced neonatal resuscitation is needed at elective Caesarean section (CS) deliveries remains controversial. The objective of this study was to provide recent population‐based data comparing the need for resuscitation of babies born at ≥37 weeks gestation by elective CS under regional anaesthesia with those born by spontaneous, unassisted vertex vaginal delivery.

Methods:  We performed a population‐based cohort study in Tasmania using data collected between January 1998 and December 2003 inclusive. Data on all singleton births ≥37 weeks gestation was analysed from the Tasmanian Obstetric and Neonatal Audit database to determine the number and type of resuscitations, and the number of low 1‐min Apgar scores for each mode of delivery.

Results:  There were 31 820 singleton deliveries born at ≥37 weeks gestation over the 6‐year period. Of these 21 733 (68.3%) were spontaneous unassisted vertex vaginal deliveries and 2918 (9.2%) were elective CSs performed under regional anaesthesia (2620 spinal and 298 epidural). The incidence of a 1‐min Apgar score of <4 and a 1‐min Apgar score of ≥4 and <7 for elective sections under spinal was significantly lower when compared with unassisted, spontaneous, vertex vaginal delivery at 0.57% and 11.8% respectively. The relative risks when compared with unassisted, spontaneous, vertex vaginal delivery were 0.36 (95% confidence interval (CI) 0.21–0.60, P < 0.05) and 0.73 (95% CI 0.65–0.81, P < 0.05), respectively. There was a small but statistically significant difference between unassisted, spontaneous, vertex vaginal delivery and elective CSs performed under regional anaesthesia in the requirement for resuscitation in the form of bag and mask ventilation. The relative risk for the need for bag and mask ventilation was 1.33 (95% CI 1.11–1.58, P < 0.05) for spinal anaesthesia and 1.99 (95% CI 1.33–2.96, P < 0.05) for epidural anaesthesia. There was no difference in the need for bag and mask ventilation or low 1‐min Apgar scores between non‐cephalic and cephalic presentation at elective CS under regional anaesthesia.

Conclusion:  Elective CSs performed under regional anaesthesia are low‐risk deliveries. The slight increased requirement for bag and mask ventilation is not practically significant. Such deliveries do not require the routine attendance of experienced paediatric medical staff.
Seasonal variations in phytoplankton populations in Ogelube Lake, a small natural West African Lake
Authors: Nweze Nkechinyere O.
Published: May 2006

Water samples were collected on a monthly basis at three locations along the north–south axis of the lake at 1 m depth intervals for 1 year. A sedimentation technique was used for microscopic examination of the samples. The monthly mean and seasonal phytoplankton densities were calculated. The original data were square‐root transformed, and analysis of variance performed with SPSS version 10.0. The significant treatment effects were determined using Fisher's least significance difference at the 5% probability level. The mean phytoplankton population per millilitre was very high for the entire sampling period. There was a phytoplankton bloom formation in the early rainy season, with the mean total phytoplankton population density for the rainy season (April–October) being significantly higher than that of for the dry season (November–March). A population increase was observed during the late part of the dry season to the early part of the rainy season. During the rainy season, Chlorophyceae (mostly desmids) were most abundant, followed by Cyanobacteria, Bacillariophyceae, Euglenophyceae, Dinophyceae, Cryptophyceae, Chrysophyceae and Xanthophyceae, in decreasing order of abundance. This order changed slightly in the dry season, when there was relative abundance of Bacillariophyceae over Cyanophyceae, and Dinophyceae over Euglenophyceae. The low population of Euglenophyceae indicates that the organic pollution is still low, with the predominance of desmids, indicating an oligotrophic lake condition.
Modelling natural conditions and impacts of consumptive water use and sedimentation of Lake Abaya and Lake Chamo, Ethiopia
Authors: Awulachew Seleshi Bekele
Published: May 2006

There is few available information regarding the water resource systems of Abaya Lake and Chamo Lake, which are found in the Southern Rift Valley Region of Ethiopia. This paper describes modelling of the water balance components of these lakes, as well as the impacts of water uses, and sediment transport and deposition in the lakes. The various parameters and data needed for the water balance model are derived on the basis of various surveys, analysis of data and modelling efforts. The watershed characteristics are derived using geographical information system, whereas the morphometry of the lakes is investigated by undertaking bathymetry surveys. The hydrometeorological components of this lake system also were investigated through the development of relevant database and information systems, by identifying regional relationships, and by a rainfall‐run‐off model. These information systems have subsequently been integrated to model the water balance of the two lakes, and simulating the in‐lake water levels. Several scenarios reflecting the natural conditions, water consumptive development possibilities, and sedimentation impacts have been investigated in this study. Based on the model simulation results, and on the computation of the life expectancies of the two lakes, it was found that sediment inflow and deposition significantly threaten their existence.
Toxic cyanobacterial blooms in a shallow, artificially mixed urban lake in Colorado, USA
Authors: Oberholster P. J. , Botha A.‐M. , Cloete T. E.
Published: May 2006

One of the most severe problems associated with eutrophication of urban freshwater ecosystems is the occurrence of increasingly frequent blooms of toxic cyanobacteria. Cyanotoxins might accumulate in the trophic web, producing diverse intoxication symptoms and chronic effects that are difficult to diagnose and prevent. High mortality of domestic animals and fish has been reported previously under these prevailing conditions. This study investigates the taxonomic composition of phytoplankton assemblages in Sheldon Lake during the summer of 2004, a year after the completion of a restoration project on the lake. The study analysed the physical and chemical changes caused by urban run‐off and artificial mixing, as well as the usefulness of microcystin molecular markers derived from the mcy gene cluster for the detection of toxic cyanobacterial strains in environmental samples from Sheldon Lake. This study clearly demonstrates that the artificial mixing rate alone was insufficient to cause a transition to a well‐mixed aquatic system, and that cyanobacteria remained dominant throughout the summer months. The presence of toxic cyanobacterial strains was confirmed with the use of molecular markers that detected the presence of the mcy gene cluster responsible for the production of toxin by Microcystis spp. This approach might have a great potential use in the routine analyses of urban aquatic ecosystems. It also might make toxicity monitoring more feasible, allowing for the early application of corrective actions, especially for cases such as Sheldon Lake, which is a public recreational focal point.
Determinants of disability in everyday activities differ in primary and cervicogenic headaches and in low back pain
Authors: GESZTELYI GYÖNGYI , BERECZKI DÁNIEL
Published: May 2006

Abstract  The aim of this study was to test whether the association between disability and depressive symptoms in patients with cervicogenic headache is similar to that found in primary headaches or to the pattern found in low back pain. During a 2‐year period, 716 consecutive patients with the clinical diagnosis of cervicogenic headache (n = 182), low back pain (n = 116), migraine (n = 231), tension‐type headache (n = 176), and cluster headache (n = 11) filled in the Beck Depression Inventory (BDI). Disability was scored by the migraine disability score questionnaire reflecting the number of days with lost or decreased work, household and social activities. Non‐parametric tests and multiple general regression were used for statistical analysis. In multivariate testing, significant independent determinants of disability were pain frequency, pain intensity and the severity of depressive symptoms in migraine and tension‐type headache; pain frequency and the BDI score in cervicogenic headache, and pain frequency alone in low back pain. Disability is related to pain frequency in all pain syndromes evaluated in the present study. The level of disability is associated with the severity of pain only in primary headaches, but not in pain syndromes of vertebral origin (cervicogenic headache and low back pain). Disability is associated with the severity of depressive symptoms in all headache types but not in low back pain. Both the location and the etiology of pain have importance in determining the interrelationship between pain characteristics, depression and disability.
An evaluation strategy for the early detection of postoperative delirium
Authors: OHKI TOMOMI , MATSUSHIMA EISUKE , SHIBUYA MASAKO , SUNAMORI MAKOTO
Published: May 2006

Abstract  The aim of the present study was to identify clinical signs detective of the postoperative delirium at the early stage for nursing management. A total of 66 inpatients undergoing cardiac surgery were interviewed using the Delirium Rating Scale (DRS) and NEECHAM Confusion Scale (NCS) preoperatively and on days 1 and 3 postoperatively. The mean onset of delirium occurred on postoperative day 1.3. Development of delirium was detected early by cognitive impairments in the DRS subscales of perceptual disturbance, hallucination, and cognitive status, and the NCS subscales of attention, command, orientation, and verbal skill. These results suggest that assessment of cognitive status on postoperative day is an important strategy in the early detection of postoperative delirium.
Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia
Authors: ALTINDAG ABDURRAHMAN , YANIK MEDAIM , UCOK ALP , ALPTEKIN KOKSAL , OZKAN MUSTAFA
Published: May 2006

Abstract  People with schizophrenia are amongst the most stigmatized of those with mental illnesses. The purpose of this study was to examine whether an antistigma program which consists of education, contact, and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia. The antistigma program was carried out with first‐year medical students (n = 25). Students’ attitudes towards people with schizophrenia were assessed before and after the program. In parallel, a control group of first‐year medical students were questioned (n = 35). Assessment was repeated after 1 month. Favorable attitudinal changes were observed in terms of ‘belief about the etiology of schizophrenia’, ‘social distance to people with schizophrenia’, and ‘care and management of people with schizophrenia’. In contrast, no significant change was observed in the control group. Attitude changes tended to decrease at the 1‐month follow up. These results suggest that attitudes towards schizophrenia could be changed favorably with this program. To sustain changed attitudes towards people with schizophrenia, antistigma programs should be offered on a regular basis.
Neuropsychological correlates of error negativity and positivity in schizophrenia patients
Authors: KIM MYUNG‐SUN , KANG SEUNG SUK , SHIN KYUNG SOON , YOO SO YOUNG , KIM YOUNG YOUN , KWON JUN SOO
Published: May 2006

Abstract  The purpose of the present paper was to determine error‐monitoring ability and its relationship with executive function in patients with schizophrenia. In order to evaluate error‐monitoring ability, the error negativity (Ne) and error positivity (Pe) were measured using the Stroop task. The correct‐related negativity (CRN) and positivity (Pc) were also measured. In addition, neuropsychological tests were administered in order to evaluate executive function. The patients with schizophrenia had significantly reduced Ne and augmented CRN amplitudes, but the Pe and Pc amplitudes of the patients were comparable to those of the controls. In addition, the Ne amplitude, measured at Fcz was positively correlated with the Trail Making Test (TMT), part B response time, and the categories achieved on the Wisconsin Card Sorting Test (WCST) in patients with schizophrenia. No significant correlations were found between Ne amplitude and performance on the neuropsychological tests in the controls. And no associations were detected between CRN, Pe, Pc amplitudes and neuropsychological performance, in either the patients with schizophrenia or the controls. Reduced Ne amplitudes and augmented CRN amplitudes in patients with schizophrenia suggest the dysfunctional behavior‐monitoring system in these patients. The functional significances of Ne and Pe are discussed.
Discrepancy of performance among working memory‐related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution
Authors: NAKAHACHI TAKAYUKI , IWASE MASAO , TAKAHASHI HIDETOSHI , HONAGA EIKO , SEKIYAMA RYUJI , UKAI SATOSHI , ISHII RYOUHEI , ISHIGAMI WATARU , KAJIMOTO OSAMI , YAMASHITA KO , HASHIMOTO RYOTA , TANII HISASHI , SHIMIZU AKIRA , TAKEDA MASATOSHI
Published: May 2006

Abstract  Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number–symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ‐, age‐ and sex‐matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory‐related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.
Factors disturbing treatment for cancer in patients with schizophrenia
Authors: INAGAKI TAKUJI , YASUKAWA REI , OKAZAKI SHIHOH , YASUDA HIDEAKI , KAWAMUKAI TETSUYA , UTANI ETSUKO , HAYASHIDA MAIKO , MIZUNO SOICHI , MIYAOKA TSUYOSHI , SHINNO HIDETO , HORIGUCHI JUN
Published: May 2006

Abstract  Patients with schizophrenia who develop cancer often have a variety of complicated medical and psychiatric problems. Problems associated with receiving a diagnosis of cancer and with understanding or cooperating with medical treatment may develop. Research in managing and treating schizophrenia patients with cancer is scarce. Presented herein is the experience of the authors’ consultation–liaison psychiatry service in treating patients with schizophrenia who have cancer, and discussion of the medical management of such cases. Fourteen patients were treated between April 1999 and March 2003 and included patients receiving consultation psychiatric services at Shimane University Hospital as well as patients referred from other psychiatric hospitals. These patients were divided into two groups based on whether they were amenable to cancer treatment or not. The treated group consisted of patients who accepted cancer treatment, and the untreated group consisted of patients who refused or interrupted the cancer treatment. The clinical course, clinical psychiatric symptoms, problems in understanding cancer, cancer treatment course and convalescence were retrospectively assessed. Psychiatric symptoms and state were measured using the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). The mean of the duration of schizophrenia in these two groups was not significantly different. The mean scores on measures of psychiatric symptoms in each group (treated and untreated) were as follows: BPRS, 45.3 ± 15.4 and 64.9 ± 9.2 (P < 0.05); positive symptoms scores on PANSS, 14.4 ± 8.8 and 20.6 ± 6.0 (NS); negative symptoms scores on PANSS, 20.6 ± 4.7 and 33.6 ± 4.4 (P < 0.01); and total scores on PANSS, 31.7 ± 7.0 and 48.6 ± 7.4 (P < 0.01). Patients with severe negative symptoms had greater difficulty understanding and cooperating with the cancer treatment. Regarding cancer stage, when cancer was discovered, the disease had already advanced and was no longer amenable to first‐line treatment. Regarding notification of the diagnosis, it was rarely possible to give sufficiently early notice to patients in the untreated group. The important role of consultation–liaison psychiatrist in treating cancer patients is suggested. Some steps are proposed for managing schizophrenia patients with cancer who are not able to give informed consent.
Estimation of premorbid IQ in individuals with Alzheimer’s disease using Japanese ideographic script (Kanji) compound words: Japanese version of National Adult Reading Test
Authors: MATSUOKA KEIKO , UNO MASATAKE , KASAI KIYOTO , KOYAMA KEIKO , KIM YOSHIHARU
Published: May 2006

Abstract  The National Adult Reading Test (NART) is widely used as a measure of premorbid IQ of the English‐speaking patients with dementia. The purpose of the present study was to develop a Japanese version of the NART (JART), using 50 Japanese irregular words, all of which are Kanji (ideographic script) compound words. Reading performance based on JART and IQ as measured by the Wechsler Adult Intelligence Scale–Revised (WAIS‐R) was examined in a sample of 100 normal elderly (NE) persons and in 70 age‐, sex‐, and education‐matched patients with Alzheimer’s disease (AD). The NE group was randomly divided into the NE calculation group (n = 50) and the NE validation group (n = 50). Using the NE calculation group, a linear regression equation was obtained in which the observed full‐scale IQ (FSIQ) was regressed on the reading errors of the JART. When the regressed equation computed from the NE calculation group was applied to the NE validation group, the predicted FSIQ adequately fit the observed FSIQ (R2 = 0.78). Further, independent t‐tests showed that the JART‐predicted IQs were not significantly different between the NE and AD groups, whereas the AD group performed worse in the observed IQs. The reading ability of Kanji compound words is well‐preserved in Japanese patients with AD. The JART is a valid scale for evaluating premorbid IQ in patients with AD.
Brief posturographic test as an indicator of fatigue
Authors: AVNI NOA , AVNI ISAAC , BARENBOIM EREZ , AZARIA BELLA , ZADOK DAVID , KOHEN‐RAZ REUVEN , MORAD YAIR
Published: May 2006

Abstract  The purpose of the present paper was to analyze the efficiency of an abbreviated, albeit objective posturographic test as an indicator of fatigue. Posturography was measured in 10 healthy adults (age 18–33 years, male/female 7/3). Baseline posturographic measurements were taken for each subject. Later, a shorter (3‐min) posturographic test was administered 12 times during 25 h of sleep deprivation. This was correlated with subjective assessment of fatigue using a questionnaire and cognitive performance assessed with a reaction time test (Psychomotor Vigilance Test). Although showing significant individual differences, the score of the abbreviated posturographic examination, normalized to each subject’s baseline performance (‘fatigue index’) had a pronounced circadian pattern with a peak of instability in the early morning hours. Fatigue index was highly correlated with the cognitive test (r = 0.80–0.90). A substantial, albeit weaker correlation was found between the fatigue index and the subjective fatigue scores (r = 0.59–0.75). Fourier spectral analysis showed that low median sway (0.10–0.50 Hz), considered to be an expression of vestibular control, was most affected by fatigue. The study demonstrates that cognitive deterioration caused by fatigue can be objectively predicted by an abbreviated postural test of ≤3 min. This test is promising to be valid, reliable, and practicable, while being significantly correlated with physiological markers and validated cognitive measures of fatigue obtained by substantially more time‐consuming and less convenient methods.
Comparison of venlafaxine extended release versus paroxetine for treatment of patients with generalized anxiety disorder
Authors: KIM TAE‐SUK , PAE CHI‐UN , YOON SU‐JUNG , BAHK WON‐MYONG , JUN TAE‐YOUN , RHEE WON‐IHL , CHAE JEONG‐HO
Published: May 2006

Abstract  This trial was to evaluate the efficacy and tolerability of venlafaxine extended release (XR) and paroxetine for treatment of patients with generalized anxiety disorder (GAD). Sixty patients who met DSM‐IV criteria for GAD were randomly assigned to either venlafaxine XR or paroxetine for 8 weeks. Efficacy was assessed with the Hamilton Rating Scale for Anxiety (HAM‐A) and Clinical Global Impression‐Severity of Illness (CGI‐S) scale at the baseline, week 1, week 4, and week 8. The side‐effects were collected with reported adverse events and laboratory tests throughout the study period. Repeated measures analysis of variance (anova) on the HAM‐A and CGI‐S scores showed a significant decrease over time in both treatment groups without significant group difference or time × group interaction effect. There were no serious adverse events in both groups. This open trial demonstrated that either venlafaxine XR or paroxetine would be effective and tolerable for the treatment of patients with GAD. Double blind, placebo‐controlled head‐to‐head comparison studies are needed to draw a definite conclusion.
Cognitive patterns and depression: Study of a Japanese university student population
Authors: TANAKA NAO , UJI MASAYO , HIRAMURA HIDETOSHI , CHEN ZI , SHIKAI NORIKO , KITAMURA TOSHINORI
Published: May 2006

Abstract  According to Beck’s cognitive theory, individuals who endure negative self‐schemas (dysfunctional attitudes) are more likely to present automatic thoughts consisting of negative schemata of oneself and one’s world while experiencing depression. In order to examine the relationships between depression, automatic thought, and dysfunctional attitude, 329 Japanese university students were given a set of questionnaires, including the Center for Epidemiologic Studies Depression Scale (CES‐D), Automatic Thought Questionnaire‐revised (ATQ‐R), and Dysfunctional Attitude Scale (DAS). A structural equation model revealed that depression was predicted predominantly by automatic thought, which was in turn predicted by dysfunctional attitude. The male gender had a tendency to predict dysfunctional attitude. The link between a student’s depression and dysfunctional attitude was mediated by automatic thought.
Autism‐Spectrum Quotient Japanese version measures mental health problems other than autistic traits
Authors: KURITA HIROSHI , KOYAMA TOMONORI
Published: May 2006

Abstract  The purpose of the present paper was to examine the extent to which the Autism Spectrum Quotient Japanese version (AQ‐J) measures mental health problems other than autistic traits, with the 12‐item General Health Questionnaire Japanese version (GHQ‐12) as a criterion. A questionnaire involving AQ‐J and GHQ‐12 was sent to 2000 adults aged 20–39 randomly selected from the general population, and intact data were obtained from 215 (mean age, 30.4 years; 86 male). The AQ‐J score was significantly associated with the GHQ‐12 score (r = 0.518) and was significantly higher in 111 scoring ≥4 on the GHQ‐12 (mean = 24.8 ± 6.5) than in 104 scoring <4 (mean = 19.4 ± 5.5). At a cut‐off 22, the AQ‐J had modest sensitivity (0.64) and specificity (0.66) for predicting mental health problems. The 21‐item mental health AQ‐J (AQJ‐21MH; range, 0–21; cut‐off, 9; sensitivity, 0.69; specificity, 0.76), items of which had a significant odds ratio (OR) for GHQ‐12 ≥4, and the AQ‐J‐4MH (range, 0–4; cut‐off, 2; sensitivity, 0.68; specificity, 0.74) consisting of four items with a significant OR adjusted for collinearity selected from the 21 items by multiple logistic regression, were more efficient than the AQ‐J. Because the AQ‐J and its short forms measure mental health problems other than autistic traits, it is important to consider such problems in interpreting AQ‐J scores to identify persons who may need professional help when screening normally intelligent adolescents and adults with pervasive developmental disorders.
Sensitivity to seasonal changes in panic disorder patients
Authors: OHTANI TOSHIYUKI , KAIYA HISANOBU , UTSUMI TAKESHI , INOUE KEN , KATO NOBUMASA , SASAKI TSUKASA
Published: May 2006

Abstract  It has been suggested that symptoms of panic disorder may be significantly affected by seasonal factors including weather changes, although few studies have explored the issue. The purpose of the present paper was to investigate clinical data to examine sensitivity of panic disorder patients to seasonal changes and seasonal fluctuation of panic disorder symptoms. A self‐rating questionnaire consisting of the Seasonal Pattern Assessment Questionnaire (SPAQ) and additional self‐rating questions were analyzed in 146 Japanese patients (50 male, 96 female) with panic disorder (DSM‐IV) at an outpatient clinic for anxiety disorder. The average of the Global Seasonality Scores (GSS) was 12.5 ± 4.7 and 25.3% of the patients were suggested to suffer from seasonal affective disorder, according to the GSS. Frequency of the panic attack was found to fluctuate seasonally, with peaks in August and December (P = 0.005 and 0.01, χ2 test). The present results indicate that panic disorder patients may be more sensitive to seasonal and meteorological factors than the general population and become more fragile in a specific season or months. This might assist in the development of preventive measures for the frequent recurrence of symptoms in panic disorder.
Characteristics of facial nerve palsy during childhood in Japan: frequency of varicella–zoster virus association
Authors: OGITA SATOKO , TERADA KIHEI , NIIZUMA TAKAHIRO , KOSAKA YASUKO , KATAOKA NAOKI
Published: May 2006

Background: The aim of this study was to clarify the clinical characteristics of facial nerve palsy and the frequency of varicella–zoster virus association in Japanese children, retrospectively.

Methods: The subjects were 30 facial nerve palsy patients less than 15 years old, treated in the Department of Pediatrics, Kawasaki Medical School Hospital, Okayama, Japan, during the last 10 years.

Results: The male/female and right/left ratios were 16/14 and 16/13, respectively. The patients included 21 cases (70%) of Bell’s palsy, four cases (13%) due to otitis media, three cases (10%) of Ramsay Hunt syndrome and two cases (7%) due to birth trauma. There were six cases of zoster sine herpete among the Bell’s palsy cases.

Conclusion: Varicella–zoster virus‐associated facial palsy was found in nine (36%) of the 25 patients examined. Zoster sine herpete was more frequently encountered in children than adults. Ramsay Hunt syndrome was found in school‐age children and zoster sine herpete was often found in preschool children. The period of recovery was fast for facial nerve palsy due to acute otitis media, which occurred within 23 months of age, after myringotomy and administration of antibiotics.