bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of Perinatal Hepatitis B Virus Transmission in an Obstetric/Infant Population
Authors: Parker Paul J , Gyorkos Theresa W , Dylewski Joseph S , Joshi Arvind K , Franco Elaine D 
Published: March 2016

Study Design: This retrospective study reviewed the screening practice and seroprevalence of hepatitis B surface antigen (HBsAg) among all mothers with live births at a teaching hospital in Montreal between November 1, 1990 and April 30, 1991.Results: Most women (94%) were screened prenatally and 5.2% postnatally. Screening status could not be determined for 0.8% of women. One‐quarter of all postnatal screening results were available only at 48 h or more postdelivery. No infants born to women with postnatal screening or to women with unknown screening status were immunized expectantly. The maternal seroprevalence was 1.08% (95% confidence interval from 0.6, 1.4). All 22 infants born to HBsAg‐positive mothers had received hepatitis B immune globulin within 12 h of birth and the first dose of hepatitis B vaccine within 24 h. Follow‐up of infants revealed that only 50% had received the second and third doses according to the recommended protocol, with 83% completing the immunization series.Conclusion: These results indicate that a program of prenatal HBsAg screening and neonatal prophylaxis against hepatitis B can be successfully instituted in a high volume obstetric hospital, and that better monitoring of infants is required to ensure completion of vaccination.
A Nonselective Cation Channel in Adult Alveolar Epithelial Cells
Authors: Orser Beverley A , Edelson Jeffrey D 
Published: March 2016

OBJECTIVE: Efficient gas exchange across the alveolar
membrane requires a dry air space. At birth, active Na+
transport provides the major driving force for absorption of
fetal lung liquid, and during adult life, similar transport
mechanisms balance fluid exchange across the alveolarcapillary
membrane. A cation channel, previously identified
in fetal alveolar epithe lium, may represent one of several
pathways which regulate apical‐basal transepithelial Na+
flux. The purpose of this study was to determine if cation
channels are also present in adult alveolar epithelial cells.DESIGN: Standard inside‐out patch‐clamp recording techniques
were used to study channels present in patches of
membrane from adult rat alveolar epithelium.POPULATION: Alveolar epithelial cells were obtained from
adult male Sprague‐Dawley rats and studied in primary cell
culture.MAIN RESULTS: A 23 pS nonselective cation channel was
identified in 68% of patches voltage clamped to ‐60 mV.
The probability of channel opening was not influenced by
changes in membrane potential. Amiloride ( I05 M) applied
to the extracellular membrane induced channel flickering
and reduced the apparent mean channel open time
without affecting channel conductance.CONCLUSIONS: These results provide direct evidence for a
cation channel in the apical membrane of adult alveolar
epithelial cells. The channel is similar to a nonselective
cation channel in fetal alveolar epithelial cells and may play
an important role in Na+‐coupled fluid absorption and/or K+
secretion.
Persistent Cough in Nonsmokers
Authors: Hoffstein Victor 
Published: March 2016

OBJECTIVE: The purpose of this study was to test the
hypothesis that, using Irwin′s protocol, the majority of
nonsmokers with persistent cough can be diagnosed and
treated successfully.DESIGN: Retrospective review of patients referred for the
investigation of chronic cough.SETTING: Referral out‐patient practice of a hospital‐based
pulmonary physician.PATIBNTS: There were 228 patients who satisfied the following
entry criteria for inclusion in the data analysis:
cough longer than four weeks; nonsmoker; normal chest
radiograph; and completion of the required investigations.
A total of 198 patients completed the required investigations
and returned for the final follow‐up visit.INTERVENTIONS: Diagnostic tests included chest radiographs,
pulmonary function tests, radiographs of the sinuses,
barium swallow and fibreoptic bronchoscopy.MAIN OUTCOME MEASURES: Status of cough at the time
of final follow‐up visit, classified according to four levels:
resolved, improved, unchanged or worse.RESULTS: The diagnosis was established in 91 % of patients.
The most common diagnoses (alone or in combination)
were postnasal drip (26% ), asthma (25% ), gastroesophageal
reflux (24%), postinfectious cough (21 %), and
cough due to angiotensin‐converting enzyme inhibitors
(6%); none had an occult malignancy and one patient had
endobronchial tuberculosis. The initial diagnostic impression
was best in patients with postinfectious cough (100%)
and worst in patients with asthma (25%). The outcome of
specific therapy was successful in 91 % of patients.CONCLUSIONS: In the majority of nonsmoking adults
cough can be diagnosed and treated successfully. most
causes are relatively ′benign′ and the initial clinical impression
may be quite misleading, particularly in cough‐variant
asthma.
Diaphragm Structure and Function in Emphysematous Hamsters
Authors: Reid WD , Wilton RK 
Published: March 2016

OBJECTIVE: To determine if muscle fibre injury, reduced
force output and fatigue of the diaphragm accompanied
hyperinflation induced by experimental emphysema.DESIGN: Controlled and randomized.ANIMALS: Adult male golden Syrian hamsters: seven control
and seven experimental emphysema hamsters were
studied.INTERVENTIONS: Following anesthesia, experimental emphysema
hamsters received a transtracheal injection of elastase.
They also received injections of β‐aminopropionitrile
every other day for five weeks. After five weeks, all hamsters we re anesthetized , and their diaphragm and lungs were
excised.MAIN RESULTS: Measurements of the excised lungs
showed an increased residual volume. functional residual
capacity and total lung capacity in experimental emphysema hamsters. In vitro physiological study of diaphragm
strips showed no difference in force output but a greater
fatiguability during repetitive stimulation for 5 mins in
experimental emphysema hamsters than in control hamsters. Histological examination did not show significant
muscle injury in the diaphragm of experimental emphysema
hamsters.CONCLUSION: The greater fatiguability and absence of
muscle injury in the diaphragm of emphysematous hamsters
may result from hyperinflation decreasing diaphragmatic
load. Alternatively, muscle damage not detectable at the
light microscopic level may have contributed to increased
fatiguability of the diaphragm of experimental emphysematous
hamsters.
Effect of Cigarette Smoke on Bronchial Reactivity
Authors: Wright JL , Sun J-P , Vedal S , Churg A 
Published: March 2016

OBJECTIVE: To compare the effects of a brief low level exposure to cigarette smoke in rats with known low (Sprague‐Dawley) and high (Fisher) airway responsiveness, to test the hypothesis that airways reactivity influences the severity or duration of pulmonary function alterations after cigarette smoke exposure.METHODS: Baseline pulmonary function tests and methacholine dose response tests were conducted in 10 Sprague‐Dawley and 10 Fisher rats. On the following day, the animals were reanaesthetized, and breathed for 1 min from a 2 L chamber into which 25 mL of fresh cigarette smoke had been injected, followed by a second set of pulmonary function and methacholine response tests; a final set was performed two weeks later.RESULTS: Sprague‐Dawley rats were larger, with larger lung volumes, compliance and flow rates, but Fisher rats showed a fourfold higher airway reactivity. Although neither resistance nor response to methacholine changed in either strain of animal, Sprague‐Dawley rats showed an increase in residual volume post smoke, which was not sustained over two weeks, and sustained small increases in vital capacity, total lung capacity and static lung compliance, with a sustained decrease in forced expiratory volume in 0.1 s, while Fisher rats showed only a small sustained increase in functional residual capacity.CONCLUSIONS: Although there are marked differences in pulmonary function between the two different strains of rats, increased airways responsiveness per se does not make the animal more sensitive to the acute effects of cigarette smoke, and the effects of cigarette smoke on pulmonary function are not necessarily related to increased airway resistance. Pulmonary function alterations seen after brief cigarette smoke exposure may be sustained for a relatively long period of time.
Overreliance on Bronchodilators as a Risk Factor for Life‐Threatening Asthma
Authors: Ernst Pierre , Hemmelgarn Brenda , Cockcroft Donald W , Suissa Samy 
Published: March 2016

OBJECTIVE: To assess the potential impact on the risk of life‐threatening asthma of current recommendations in pharmacotherapy, which emphasize the early use of steroids and the avoidance of beta‐agonist overuse.DESIGN: Nested case‐control study.SETTING: Province of Saskatchewan.POPULATION STUDIED: From a cohort of 12,301 subjects dispensed 10 or more asthma medications from 1980 to 1987, 129 case patients were identified who had experienced an episode of fatal or near fatal asthma and 129 control patients matched to the cases on age, time period at risk and severity of asthma (as judged by the need for hospitalization for asthma in the preceding two years).METHODS: Two clinicians reviewed the therapy these 258 subjects had been dispensed over the prior two‐year period and classified their treatment as ‘incompatible’ or ‘compatible’ (at least partially compatible) with current pharmacotherapeutic guide lines. In addition to this classification a treatment evaluation score was also applied to each study subject. This score was based on the use of anti‐inflammatory therapy (oral and inhaled) in conjunction with the regular use of bronchodilators, as well as the use of oral corticosteroids for patients recently discharged from hospital foll owing an attack or asthma.RESULTS: At least one of the two clinician reviewers judged therapy to be incompatible with current standards in 49% of the case patients compared with 20% of the subjects who had not experienced a life‐threatening episode. The mean ± SD treatment score was 3.5±1.7 in cases compared with 0.8±1.4 in controls, suggesting quality or pharmacological treatment was worse in cases (P<0.001).CONCLUSIONS: Pharmacological therapy incompatible with current recommendations was more common among cases of fatal and near fata l asthma in Saskatchewan from 1980 to 1987.
Effects of High Frequency Chest Compression on Respiratory System Mechanics in Normal Subjects and Cystic Fibrosis Patients
Authors: Jones Richard L , Lester Richard T , Brown Neil E 
Published: March 2016

OBJECTIVE: To investigate the short term effects of high frequency chest compression (HFCC) on several indices of respiratory system mechanics in normal subjects and patients with cystic fibrosis (CF).DESIGN: Comparative physiological approach. Subjects were blinded to 10 randomized HFCC settings (5, 10, 15, 20 and 25 Hz) with each applied at the lowest and at the highest background vest pressure.SETTING: Pulmonary function and lung mechanics laboratory, University of Alberta.PARTICIPANTS: Ten normal male volunteers (24.2±3.8 years) and 11 clinically stable CF patients (23.4±6.7 years). Normal subjects were nonsmokers who had normal lung function. The CF patients had a wide range of airway obstruction.INTERVENTIONS: HFCC was supplied by oscillating a pneumatic vest that covered the entire torso. Balloon tipped catheters were used to measure esophageal (Pes) and external chest wall (Pew) pressures. Changes in end‐expiratory lung volume (EELV) during HFCC were measured from a spirogram and were compared with baseline functional residual capacity (FRC). The HFCC induced air movement al the mouth, oscillated tidal volume (Vosc), was measured by reverse plethysmography.RESULTS: Both normals and CF patients had similar changes in Pes and EELV. At the highest background vest pressure and at the higher oscillation frequencies, EELV decreased approximately 30% from the no‐HFCC baseline FRC. Vosc decreased with increasing oscillation frequency but normals had higher Vosc than CF patients at each frequency. Conversion of Vose to flow () revealed that the highest occurred between 10 and 15 Hz for both normals and CF patients. Also, was dependent on the overall airway function. Low forced expired volume in 1 s resulted in low , especially when was measured during spontaneous expiration.CONCLUSIONS: CF patients with moderate or severe airway obstruction may gain maximal benefit from HFCC therapy when low vest pressure is used at an oscillation frequency of 10 to 15 Hz. The low vest pressure minimizes the decrease in EELV and 10 to 15 Hz maximizes .
Activity of Vancomycin, Teicoplanin and Cephalosporins against Penicillin‐Susceptible and Penicillin‐Intermediate Streptococcus Pneumoniae
Authors: Loo Vivian G , Lavallée Jocelyne , McAlear Diane , Robson Hugh G 
Published: March 2016

Objective: To report in vitro susceptibilities of penicillin‐susceptible and penicillin‐intermediate Streptococcus pneumoniae isolates to cephalosporins, vancomycin and teicoplanin.Design: Minimal inhibitory concentrations (mic) were determined according to National Committee for Clinical Laboratory Standards guidelines for 17 penicillin‐susceptible isolates (mic 0.06 mg/L or less) and 16 isolates showing intermediate susceptibility to penicillin (mic 0.12 to 1.0 mg/L).Setting: Tertiary care university centre.Main Results: Comparison of the mic90 values with those of other antibiotics tested demonstrated that ceftriaxone, cefotaxime and teicoplanin were the most active agents against penicillin‐susceptible strains. However, teicoplanin had the lowest mic and was superior to other agents against strains with intermediate penicillin susceptibility. The mics of all cephalosporins increased in concordance with the mic of penicillin.Conclusion: Isolates demonstrating intermediate susceptibility or resistance to penicillin should be routinely evaluated for susceptibility to clinically important cephalosporins.
Adjunctive Corticosteroid Therapy Decreases Lung Permeability in Patients with AIDS‐Related Pneumocystis carinii Pneumonia
Authors: Guillemi Silvia , Belzberg Allan , Lawson Lindsay M , Schechter Martin T , Montaner Julio SG 
Published: March 2016

OBJECTIVE: To assess the effect of adjunctive corticosteroid therapy on lung permeability as measured by Tc‐DTPA lung clearance scan in patients with AIDS‐related Pneumocystis carinii pneumonia (PCP).METHODS: Sixteen patients with microbiologically proven AIDS‐related PCP were prospectively studied using sequential Tc‐DTPA lung clearance scan. All patients received slant.lard antimicrobial treatment. Six patients received adjunctive oral corticosteroids in addition to the usual antimicrobial therapy. Tc‐DTPA lung clearance scan was performed al baseline and during the second week of therapy. All scans were read by a blinded single observer using a standardized protocol.RESULTS: Baseline Tc‐DTPA lung clearance halftime (T1/2) was 12±2 and 9±1 mins in the noncorticosteroid and corticosteroid treated groups, respectively. During the second week of therapy, Tc‐DTPA T1/2 lung clearance was 17±8 and 24±9 mins for the noncorticosteroid and corticosteroid treated groups, respectively. The change in Tc‐DTPA lung clearance between baseline and week 2 was significantly greater (P<0.02) in the corticosteroid treated patients.CONCLUSION: Data suggest that the use of adjunctive corticosteroid therapy decreases lung permeability, as measured by Tc‐DTPA lung clearance scan, in patients with AIDS‐related PCP.
Immune Response to Verotoxin 1 and 2 in Children with Escherichia Coli O157:H7 Hemorrhagic Colitis and Classic Hemolytic Uremic Syndrome
Authors: Proulx François , Turgeon Jean P , Delage Gilles , Lior Hermy , Lafleur Lucette , Chicoine Luc 
Published: March 2016

Objectives: To compare neutralizing antibody titres against verotoxin (vt)‐1 and vt-2 between children with uncomplicated hemorrhagic colitis (hc) and those with classic hemolytic uremic syndrome (hus). vt antibody titres were also compared in children with hc who received trimethoprim‐sulfamethoxazole with those who did not.Design: Prospective study.Setting: Tertiary pediatric hospital.Population Studied: Children with hc (n=41) or classic hus (n=12).Interventions: Serum antibodies against vt-1 and vt-2 were determined by quantitative neutralization.Main Results: Antibodies were detected in 40% (21 of 53) of serum samples for vt-1 and in 100% (53 of 53) of samples for vt-2. A positive immune response, defined as a fourfold increase in vt antibody titres or as a single titre of 1/64 or greater, was found in 0% (0 of 12) of patients with hus compared with 7% (three of 41) of those with hc for vt-1 (P=0.4); and in 17% (two of 12) of patients with hus compared with 22% (nine of 41) of those with hc for vt-2 (P=0.3). The rate of seroconversion against either vt-1 or vt-2 was comparable in treated and untreated patients with uncomplicated hc.Conclusions: There was no evidence that neutralizing antibody levels against vt-1 or vt-2 in classic hus or after antibiotic therapy are substantially different from those in patients with uncomplicated hc.
Health Effects of Air Pollution in Canada: Expert Panel Findings for The Canadian Smog Advisory Program
Authors: Stieb David M , Pengelly L David , Arron Nina , Taylor S Martin , Raizenne Mark E 
Published: March 2016

OBJECTIVE: To review the evidence on health effects of air pollution for the Canadian Smog Advisory Program.METHODS: Evidence was reviewed by two expert panels, who were asked to define the health effects expected at levels of exposure given by the National Ambient Air Quality Objectives, to examine a variety of issues related to communicating with the public about environmental health risks, and to draft health messages for the advisory program.RESULTS: The panels concluded that health effects of ground‐level ozone at levels that occur in Canada include pulmonary inflammation, pulmonary function decrements, airway hyperreactivity, respiratory symptoms, possible increased medication use and physician/emergency room visits among individuals with heart or lung disease, reduced exercise capacity, increased hospital admissions and possible
increased mortality. Similar effects were felt to occur in association with airborne particles, with the exception of inflammatory changes, and with the addition of increased school absenteeism. Poor data on individual exposure were identified as a limitation of studies on hospital admissions and mortality.RECOMMENDATIONS: The panels identified the need to reflect the evidence accurately without unduly raising public concern and recommended that advisory health messages identify expected health effects, while health care providers could more appropriately recommend protective actions to individuals. Supplementary educational strategies and evaluation of the advisory program were also recommended.
Variability in Urine Culture Reporting by Canadian Microbiology Laboratories
Authors: Noble Michael A , Nikiforuk Shirley 
Published: March 2016

OBJECTIVE: To determine the ability of microbiology laboratories to perform and to report urine colony counts.DESIGN: Clinical Microbiology Proficiency Testing program participants received stabilized simulated urine samples. Laboratories were asked to perform the appropriate test and report results.PARTICIPANTS: One hundred and nine clinical microbiology laboratories in British Columbia, Alberta and Nova Scotia.OUTCOME MEASURES: Consistency of reporting was compared with standards for reporting results as described in the SI Manual in Health Care, 2nd edition.RESULTS: The study demonstrated a wide variation in units used for the reporting of results. Ninety‐five (87.2%) laboratories reported quantitative urine results in a variety of unit styles. Of those laboratories providing results with units, 80 (84.2%) used one of 10 variations of SI reporting styles. Fifteen (16.8%) laboratories reported metric units in three different styles. Eleven (10.0%) laboratories reported semiquantitative values without stating units. The remaining three (2.8%) did not respond to the survey.CONCLUSIONS: Many clinical microbiology laboratories have not adopted a consistent form of SI units for reporting quantitative urine culture results. This lack of consistency could potentially lead to interpretation confusion.
A Simple and Effective Method to Evaluate Peak Flowmeters
Authors: Wang Liman , Proudlock Melva , Liu Mingyao 
Published: March 2016

OBJECTIVE: Peak flowmeters have been widely used to monitor the course of asthma. The objective of this study was to develop a simple, convenient and effective method to evaluate these devices routinely.METHODS: A rubber band‐driven 3 L syringe was used to generate airflows, and a pneumotachometer was connected in series with the peak flowmeter as a standard. Waveforms were recorded and compared with maximal expiratory curves. The accuracy of peak flowmeters was analyzed by linear regression and by calculating the percentage of the difference measured by the flowmeter (F) and the pneumotachometer (P), expressed as (F‐‐P)/P (%).RESULTS: This set‐up generated waveforms similar to the initial phase of maximal expiratory curves, with linear increment of peak flow rates up to 790 L/min (R=0.999, PÃ0.001). Both waveforms and peak flow rates were highly reproducible with coefficients of variation less than 5% throughout the full range tested. Fourteen peak flowmeters from seven different models were evaluated. Most of these devices revealed a satisfactory linear relationship with the pneumotachometer. The interdevice variation of different models and variations of each device at different flow rates were clearly demonstrated by (F‐‐P)/P (%).CONCLUSION: The system developed in the present study can be easily set up and used to evaluate the performance of peak flowmeters.
Influenza and Pneumococcal Vaccination in Long Term Care Facilities in Two Regions of Quebec
Authors: De Wals Philippe , Carbonneau Michel , Payette Hélène , Niyonsenga Théophile 
Published: March 2016

OBJECTIVES: To evaluate the use of influenza and pneumococcal vaccines in long term care facilities.DESIGN: Cross‐sectional survey in a random sample of 30 facilities in two regions of Quebec. Information was collected from the general manager or the chief of nursing, all consultant physicians and a random sample of 20 residents in each facility.RESULTS: Twenty‐nine centres agreed to participate. The mean influenza vaccination rate was 70%, and was not influenced by differences in the types of facilities or the organization of the programs for immunization. The main obstacle to influenza vaccination reported by physicians was nonacceptance by a significant proportion of residents. Of the residents who did not initially request influenza vaccine, only 64% accepted vaccination when it was offered. The vast majority of residents were satisfied with the information they had received and the respect shown for their freedom of choice. Forty per cent of residents were unfit to provide a valid consent and the vaccination rate was 76% in this group. Only one‐third of the physicians regularly obtained authorization from a relative or the legal guardian before prescribing vaccination for incompetent residents. None of the facilities studied had an effective program for pneumococcal vaccination, only 43% of the physicians reported any use of pneumococcal vaccine and 98% of residents had never heard of the vaccine.CONCLUSIONS: The national objective of 95% coverage with influenza vaccine will be difficult to achieve in long term care facilities, mainly because a minority of residents are not likely to be convinced of the benefit of immunization. Much remains to be done to promote and administer pneumococcal vaccine in this setting.