bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder
Authors: Emmanuel A V , Mason H J , Kamm M A 
Published: July 2002

BACKGROUNDAnxiety and depression are known to be associated with alterations in central autonomic activity, and this may manifest as a functional gut disturbance. However, the final expression of motility disturbance is non-specific and non-quantifiable. This study examines the relationship between psychological state and psychosocial functioning with a new direct measure of the level of activity of extrinsic autonomic gut innervation, rectal mucosal Doppler blood flow.MATERIALS AND METHODSThirty four female patients (mean age 36 years, range 19–45) with constipation for greater than five years and 19 healthy women (mean age 38 years, range 21–60) were studied. They completed the general health questionnaire—28 point scale (GHQ-28; psychosocial functioning) and the Bem sex role inventory (BSRI; an index of women's psychological feelings about their own femininity). On the same day they underwent measurement of rectal mucosal Doppler blood flow, a new validated measure of the activity of gut extrinsic nerve innervation. Measurements were made during the follicular phase and in the fasted state.RESULTSWomen with constipation scored higher on the total GHQ-28 score and the somatisation (p=0.05) and anxiety (p=0.05) subscales of the GHQ-28. There was a negative correlation between mucosal blood flow and GHQ somatisation subscale (r=−0.45, p<0.005), anxiety (r=−0.38, p<0.05), and depression (r=−0.40, p<0.01) scores in women with constipation. Although constipated women scored no higher than controls on the BSRI, there was a significant negative correlation between blood flow and BSRI score (r=−0.49, p<0.005) for constipated women.CONCLUSIONSGeneral psychosocial function, somatisation, anxiety, depression, and feelings about female role are impaired in women with constipation and associated with altered rectal mucosal blood flow, a measure of extrinsic gut innervation. These findings suggest that psychological factors are likely to influence gut function via autonomic efferent neural pathways.
Osteoporosis in primary biliary cirrhosis revisited
Authors: Newton J , Francis R , Prince M , James O , Bassendine M , Rawlings D , Jones D 
Published: July 2002

BACKGROUNDPrimary biliary cirrhosis (PBC) is increasingly being diagnosed in the earlier non-cholestatic stages of disease. Accepted wisdom has been that PBC is frequently complicated by osteoporosis. Whether this association holds true for the broader spectrum of PBC patients now recognised has not as yet been studied.AIMSTo examine the extent to which osteoporosis occurs more commonly in PBC patients than in normal individuals of the same age and sex.DESIGNRetrospective review of a large cohort of well characterised PBC patients.PATIENTSA total of 272 PBC patients with definite or probable PBC followed up for a mean of 10.1 years (total follow up 2726 patient years) who had at least one bone mineral density measurement (BMD).RESULTSIn this unselected group of PBC patients, mean Z scores (number of SDs from age and sex matched normal mean values) at the neck of femur (NOF) and lumbar spine (LS) at first BMD measurement (7 (6) years after PBC diagnosis) were −0.1 (1.4) and 0.1 (1.4), respectively. At first BMD measurement, 18 PBC patients had Z scores less than −2.0 and 85 had T scores less than −2.5. No factors predictive of osteoporosis were found in affected patients. A total of 957 BMD measurements were performed (0.35 per patient year of follow up); 220 patients had two or more measurements. No patient went on to develop de novo osteoporosis during follow up. In the 51 patients (who were clinically representative of the whole group) who received no PBC or bone related treatment during follow up, %BMD changes per year at the NOF and LS were −1.6 (3.2) and 0.1 (2.2), respectively. No variance in this “natural” rate of BMD measurement was seen in patients receiving PBC modulating agents (including prednisolone and UDCA) or osteoporosis prophylaxis/therapy. Significant improvement at the LS was seen in patients undergoing liver transplantation.CONCLUSIONSOsteoporosis is not a specific complication of PBC.
Justified deception? The single blind placebo in drug research
Authors: Evans Martyn 
Published: July 2002

“Run-in” and “washout” periods involving the withholding of medication are widely used in drug research trials in pursuit of both patient safety and scientific reliability. Such no-medication periods can be justified ethically provided that they are apparent to patients, who can thereby properly consent to undergoing them. Less widespread, but still common, is the practice of “single blinding” no-medication periods, concealing them from patients by means of placebo. Whilst all placebos involve a measure of concealment, their use is typically justified in drug research trials (i) by their preserving the uncertainty generated by the random allocation of different treatments within a drug trial; and (ii) by the researchers openly declaring both the randomisation process and the chances of receiving placebo. In the single blind placebo “run-in” or “washout”, neither of these conditions is met.This paper considers three possible defences of the practice of using single blind placebo “run-ins” or “washouts” and finds them all to fail; the practice appears ethically unjustified.
Evaluation of environmental bacterial contamination and procedures to control cross infection in a sample of Italian dental surgeries
Authors: Monarca Silvano , Grottolo Mario , Renzi Daniela , Paganelli Corrado , Sapelli Pierluigi , Zerbini Ilaria , Nardi Giuseppe 
Published: July 2002

OBJECTIVESTo perform a pilot study on bacterial contamination in some dental surgeries (n=51) in a local health unit in Brescia (Lombardy Region, Italy) and to evaluate the procedures to control cross infection used by the personnel to reduce the risk of infection in dental practice.METHODSA survey was carried out by interviewing 133 dental personnel with a questionnaire on the procedures used to control infection. The autoclaves, chemical baths (chemiclaves), and ovens present in the surgeries were tested for sterilisation efficiency with a spore test, and already packed and sterilised instruments were randomly sampled and tested for sterility. Microbial contamination of air, surface, and dental unit water samples were also studied.RESULTSThe dental personnel did not generally follow the principal procedures for infection control: 30% of personnel were not vaccinated against hepatitis B virus, infected instruments were often not decontaminated, periodic checks of autoclave efficiency were lacking, and the knowledge of disinfection mechanisms and procedures was incomplete. High bacteriological contamination of water at dental surgeries was often found and total bacteriological counts in air samples were high. Surface studies showed widespread bacterial contamination.CONCLUSIONSOn the basis of these results, an educational programme for the prevention of infective hazards has been prepared and carried out. The results of this pilot study will be used for planning a national survey.
Risk of mortality, cancer incidence, and stroke in a population potentially exposed to cadmium
Authors: Elliott Paul , Arnold Richard , Cockings Samantha , Eaton Naomi , Järup Lars , Jones Jennifer , Quinn Mike , Rosato Michael , Thornton Iain , Toledano Mireille , Tristan Emma , Wakefield Jon 
Published: July 2002

OBJECTIVESTo follow up mortality and cancer incidence in a cohort potentially exposed to cadmium and to perform a geographical (ecological) analysis to further assess the health effects of potential exposure to cadmium.METHODSThe English village of Shipham has very high concentrations of cadmium in the soil. A previous cohort study of residents of Shipham in 1939 showed overall mortality below that expected, but a 40% excess of mortality from stroke. This study extends the follow up of the cohort for mortality to 1997, and includes an analysis of cancer incidence from 1971 to 1992, and a geographical study of mortality and cancer incidence. Standardised mortality and incidence ratios (SMRs and SIRs) were estimated with regional reference rates. Comparisons were made with the nearby village of Hutton.RESULTSAll cause cohort mortality was lower than expected in both villages, although there was excess cancer incidence in both Shipham (SIR 167, 95% confidence interval (95% CI) 106 to 250) and Hutton (SIR 167, 95% CI 105 to 253). There was an excess of mortality from hypertension, cerebrovascular disease, and nephritis and nephrosis, of borderline significance, in Shipham (SMR 128, 95% CI 99 to 162). In the geographical study, all cause mortality in Shipham was also lower than expected (SMR 84, 95% CI 71 to 100). There was an excess in genitourinary cancers in both Shipham (SIR 160, 95% CI 107 to 239) and Hutton (SIR 153, 95% CI 122 to 192).CONCLUSIONNo clear evidence of health effects from possible exposure to cadmium in Shipham was found despite the extremely high concentrations of cadmium in the soil.
Job experience, work load, and risk of musculoskeletal disorders
Authors: Häkkänen M , Viikari-Juntura E , Martikainen R 
Published: July 2002

OBJECTIVESTo investigate the effects of physical work load and job experience on morbidity from musculoskeletal disorders among trailer assembly workers.METHODSA longitudinal study was carried out in a trailer assembly factory with many new workers employed during the follow up. The sickness absence of 532 workers (160 experienced and 372 new (separately for the first year of employment and from the second year on)) was followed up. Exposure was assessed by job titles, visits, task descriptions, and some direct measurements. The associations between the explanatory variables and sick leave were assessed by log linear models.RESULTSA higher rate of sick leave due to disorders of the upper limbs was found for new workers compared with experienced ones, especially in the high work load group. Women had a higher rate than men. New male workers in physically strenuous tasks had a high rate of sick leave due to neck and shoulder disorders.CONCLUSIONSAs being unaccustomed to work seems to increase the risk of musculoskeletal disorders, special attention should be paid to newly employed workers.
Prospective study of hepatic, renal, and haematological surveillance in hazardous materials firefighters
Authors: Kales S N , Polyhronopoulos G N , Aldrich J M , Mendoza P J , Suh J H , Christiani D C 
Published: July 2002

OBJECTIVESTo evaluate possible health effects related to work with hazardous materials as measured by end organ effect markers in a large cohort over about 2 years, and in a subcohort over 5 years.METHODSHepatic, renal, and haematological variables were analysed from 1996–98 in hazardous materials firefighters including 288 hazardous materials technicians (81%) and 68 support workers (19%). The same end organ effect markers in a subcohort of the technicians were also analysed (n=35) from 1993–98. Support workers were considered as controls because they are also firefighters, but had a low potential exposure to hazardous materials.RESULTSDuring the study period, no serious injuries or exposures were reported. For the end organ effect markers studied, no significant differences were found between technicians and support workers at either year 1 or year 3. After adjustment for a change in laboratory, no significant longitudinal changes were found within groups for any of the markers except for creatinine which decreased for both technicians (p<0.001) and controls (p<0.01).CONCLUSIONSHealth effects related to work are infrequent among hazardous materials technicians. Haematological, hepatic, and renal testing is not required on an annual basis and has limited use in detecting health effects in hazardous materials technicians.
Smoking and mortality in 81 344 drivers in Guangzhou, China
Authors: Lam T H , Jiang C Q , Ho S Y , Zhang W S , Liu W W , He J M 
Published: July 2002

Objectives: Previous studies on drivers focused on the effect of their exposure to vehicle exhaust and there is little evidence of the effect of smoking. This cohort analytical study aimed to examine the mortality of drivers relative to smoking and professional driving in Guangzhou, China.Methods: Information on demographic characteristics, type of driver (professional and non-professional), smoking, and drinking were retrieved from medical records of drivers who applied for driving licences from March to December 1992. Vital status and causes of death of 81 344 men aged 30 or above were ascertained to the end of September 1999 (follow up, mean=7.14 years, median=7.17 years).Results: At baseline, the mean (SD) age was 40.8 (5.6) years. One third were professional drivers; 49.0% were daily smokers. 858 Deaths were identified. The relative risk of overall mortality for ever smoking was 1.24 (95% confidence interval (95% CI) 1.07 to 1.44) after adjusting for age, alcohol drinking, education, and type of drivers. Compared with non-professional drivers, professional drivers had similar risks of death, and their relative risk of overall mortality for ever smoking was 1.35 (1.06 to 1.71).Conclusions: Smoking is a more important cause of death than professional driving itself. The results show serious public health problems in the early stage of the tobacco epidemic and support urgent measures to help drivers stop smoking.
A cohort mortality and nested case-control study of French and Austrian talc workers
Authors: Wild P , Leodolter K , Réfrégier M , Schmidt H , Zidek T , Haidinger G 
Published: July 2002

Objectives: To study whether the mortality from non-malignant and malignant respiratory diseases of workers employed in French and Austrian talc mines and mills is related to their long term occupational exposure.Methods: Two historical cohorts were set up comprising all male subjects who had been working continuously for at least 1 year in a series of talc producing companies in France and Austria. The French cohort consisted of those employed at a site in the French Pyrenees and working between 1 January 1945 and 31 December 1994. The Austrian cohort consisted of the workers employed between 1 January 1972 and 31 December 1995 in one of four industrial sites in the Austrian Alps. The mortality within the cohorts was compared with local death rates. Two nested case-control studies focusing on non-malignant and malignant respiratory diseases were set up to estimate possible dose-response relations with cumulative exposure to talc dust based on an industry specific job exposure matrix.Results: Mortality from lung cancer was in small excess in both cohorts (France, standardised mortality ratio (SMR) 1.23, 21 cases observed, 95% confidence interval (95% CI) 0.76 to 1.89; Austria, SMR 1.06, seven observed, 95% CI 0.43 to 2.19). A non-significant excess mortality was found for all non-malignant respiratory diseases in the French cohort due to a significant excess for pneumoconiosis (SMR 5.56, three observed, 95% CI 1.12 to 16.2). The case-control study of non-malignant respiratory disease showed an increased mortality in the highest exposure groups (odds ratio (OR) 2.5 for a cumulative exposure ≥800 y.mg/m3) with a significant trend (OR/100 y.mg/m31.08) with cumulative exposure to talc. On the contrary, no increasing trend could be found in the case-control study of lung cancer. This result must be interpreted considering the small cohort size. Adjustment on smoking and exposure to quartz did not influence these results to any extent.Conclusions: The mortality from non-malignant respiratory disease was found to be related to high cumulative exposure to talc dust. The small excess in lung cancer does not seem to be attributable to talc.
Health and neuropsychological functioning of dentists exposed to mercury
Authors: Ritchie K A , Gilmour W H , Macdonald E B , Burke F J T , McGowan D A , Dale I M , Hammersley R , Hamilton R M , Binnie V , Collington D 
Published: July 2002

Objectives: A cross sectional survey of dentists in the west of Scotland and unmatched controls was conducted to find the effect of chronic exposure to mercury on health and cognitive functioning.Methods: 180 dentists were asked to complete a questionnaire that included items on handling of amalgam, symptoms experienced, possible influences on psychomotor function, and the 12 item general health questionnaire. Dentists were asked to complete a dental chart of their own mouths and to give samples of urine, hair, and nails for mercury analysis. Environmental measurements of mercury in dentists' surgeries were made and participants undertook a package of computerised psychomotor tests. 180 control subjects underwent a similar procedure, completing a questionnaire, having their amalgam surfaces counted, giving urine, hair, and nail samples and undergoing the psychomotor test package.Results: Dentists had, on average, urinary mercury concentrations over four times that of control subjects, but all but one dentist had urinary mercury below the Health and Safety Executive health guidance value. Dentists were significantly more likely than control subjects to have had disorders of the kidney and memory disturbance. These symptoms were not significantly associated with urinary mercury concentration. Differences were found between the psychomotor performance of dentists and controls after adjusting for age and sex, but there was no significant association between changes in psychomotor response and mercury concentrations in urine, hair, or nails.Conclusions: Several differences in health and cognitive functioning between dentists and controls were found. These differences could not be directly attributed to their exposure to mercury. However, as similar health effects are known to be associated with mercury exposure, it would be appropriate to consider a system of health surveillance of dental staff with particular emphasis on symptoms associated with mercury toxicity where there is evidence of high levels of exposure to environmental mercury.
Oral care of elderly patients: nurses' knowledge and views
Authors: Preston A J , Punekar S , Gosney M A 
Published: July 2002

Summary
It is important that healthcare professionals caring for the elderly in hospitals have a core knowledge of the orodental care requirements of their patients. The aim of this study was to determine the knowledge and views of nurses working on acute and rehabilitation care of the elderly wards about orodental care. One hundred nurses and healthcare assistants took part in this questionnaire study of which 58 were qualified nurses and 70 had been employed on care of the elderly wards for two or more years. Although the majority of the respondents were registered with a dentist and attended regularly, 40 did have ‘some anxiety’ about visiting their dentist. Approximately half of the study population regularly gave advice to their patients about dental care but their knowledge of and reasons for providing oral care and advice was often incorrect. The group's understanding of the availability of dental treatment provided by the National Health Service was also often inaccurate. It was concluded that a better core knowledge of the orodental care of older patients is required by all healthcare professionals who care for this group. It is also important that individuals in whom anxiety is associated with their own dental experience do not neglect to give orodental health advice to their patients.
Histoplasmosis of the small bowel in patients with AIDS
Authors: Gumbs Milton A , Girishkumar Hanasoge , Yousuf Arshad , Levy Leo , Patel Mayank , Narasimha Vijay 
Published: July 2002

Abstract
Two cases of jejunal strictures caused by Histoplasma capsulatum in AIDS patients are presented. Both patients were intravenous drug abusers. One patient, who was being treated for Pneumocystis carnii pneumonia, presented with jejunal perforation and the other presented with lower gastrointestinal bleeding and intestinal obstruction. On exploration, both patients were found to have jejunal strictures; one had intestinal perforation, and the other had intestinal obstruction with ulcers and strictures resulting in gastrointestinal bleeding. In areas where it is endemic, histoplasmosis is rarely disseminated. Dissemination is most commonly seen in immunosuppressed patients. Dissemination and extrapulmonary histoplasmosis is now included in the case definition of AIDS.
Role of the human papilloma virus in the development of cervical intraepithelial neoplasia and malignancy
Authors: Jastreboff A M , Cymet T 
Published: July 2002

AbstractHuman papilloma virus (HPV) is a public health problem as a sexually transmitted disease and as a critical factor in the pathogenesis of various cancers. The clinical manifestations, epidemiology, and virology that are critical to understanding the process of cervical dysplasia and neoplasia are reviewed. A discussion of the cervical transformation zone and the classification of cervical dysplasia and neoplasia leads into the importance of the Papanicolaou smear in prevention of potentially devastating sequelae of this virus. The role of the immune system in the progression of the disease and how it relates to vaccines, as well as treatment and prevention of HPV, are reviewed.
Transient ischaemic attacks mimicking focal motor seizures
Authors: Schulz U G R , Rothwell P M 
Published: July 2002

Abstract
Limb shaking is an under-recognised form of transient ischaemic attack (TIA), which can easily be confused with focal motor seizures. However, it is important to distinguish limb shaking TIAs and focal seizures, as patients with this form of TIA almost invariably have severe carotid occlusive disease and are at high risk of stroke. A patient with limb shaking TIAs is presented in whom the diagnosis was missed.
ON THE CLIQUE-WIDTH OF SOME PERFECT GRAPH CLASSES
Authors: GOLUMBIC MARTIN CHARLES , ROTICS UDI 
Published: July 2002

Graphs of clique–width at most k were introduced by Courcelle, Engelfriet and Rozenberg (1993) as graphs which can be defined by k-expressions based on graph operations which use k vertex labels. In this paper we study the clique–width of perfect graph classes. On one hand, we show that every distance–hereditary graph, has clique–width at most 3, and a 3–expression defining it can be obtained in linear time. On the other hand, we show that the classes of unit interval and permutation graphs are not of bounded clique–width. More precisely, we show that for every [Formula: see text] there is a unit interval graph In and a permutation graph Hn having n2 vertices, each of whose clique–width is at least n. These results allow us to see the border within the hierarchy of perfect graphs between classes whose clique–width is bounded and classes whose clique–width is unbounded. Finally we show that every n×n square grid, [Formula: see text], n ≥ 3, has clique–width exactly n+1.