bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methamphetamine Users in Northern Thailand: Changing Demographics and Risks for HIV and STD among Treatment-Seeking Substance Abusers
Authors: Beyrer C , Razak M H , Jittiwutikarn J , Suriyanon V , Vongchak T , Srirak N , Kawichai S , Tovanabutra S , Rungruengthanakit K , Sawanpanyalert P , Sripaipan T , Celentano D D 
Published: January 2017

Our objective was to determine sociodemographic, sexual and drug-use-related risk factors among methamphetamine (MA) users presenting for drug treatment in northern Thailand. Patients admitted for drug detoxification for MA and other drugs were studied cross-sectionally for risk factors associated with substance abuse and blood-borne and sexually transmitted pathogens. In all, 1865 (200 women) patients treated for MA, opiate, and mixed substance abuse between 1 February 1999 and 31 January 2000 completed all study procedures. Among 1865 participants, 750 (40.2%) were admitted for MA detoxification and 1115 (59.8%) for opiate (heroin, opium, or both). treatment. MA users were significantly younger, better educated, more likely to be Thai than highland ethnic minorities, and had significantly different sexual risks and sexually transmitted disease rates, including lower syphilis seropositivity and higher chlamydial prevalence, than persons admitted for opiate or mixed drug treatment. For those who reported MA use only, use by injection was rare and HIV infections significantly less common than among all other drug users. Thailand is undergoing an epidemic of MA use. These young users are a strikingly different population from opiate/heroin. users In northern Thailand. MA users had higher rates of chlamydia infection than opiate users, reflecting their young age, and HIV rates in this population were lower than injecting drug users, but still elevated. MA use is a serious public health problem in Thailand and both Improved prevention and treatment methodologies are urgently needed.
Management of Genital Herpes Simplex Infection
Authors: Thin R N 
Published: January 2017

Herpes simplex infection of the genitals is a common condition, more often due to herpes simplex virus (HSV) type 2 than to type 1 virus. There is a severe first attack followed by mild recurrences which are more common and more frequent after HSV-2 than after HSV-1 genital infection. Clinical features with prodrome, vesicles and erosions may be characteristic allowing rapid clinical diagnosis. When possible laboratory confirmation should be attempted. General management includes simple hygiene, avoidance of sexual transmission, use of condoms, and notifying partners. Oral acyclovir (Zovirax, Wellcome) is the drug of choice for initial attacks and should be considered for all women with this diagnosis. Intravenous acyclovir may be used for very severe attacks. Men with initial attacks may be treated with oral acyclovir but mild disease affecting only skin may be treated with 5% acyclovir cream. Recurrences are short so acyclovir has less effect. Frequent recurrences can be troublesome and may be suppressed by continuous oral acyclovir, or individual attacks may be aborted with intermittent therapy. Various systemic complications may occur; an important but rare problem is primary herpes in late pregnancy. Acyclovir is effective in the treatment of the troublesome herpes simplex disease associated with human immunodeficiency infection. Acyclovir is one of the more expensive treatments for sexually transmitted diseases. At present in many countries costs are being examined, and application of the principles outlined here should help to minimize cost and maximize care.
Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome) – An update
Authors: Watad A , Quaresma M , Brown S , Cohen Tervaert J W , Rodríguez-Pint I , Cervera R , Perricone C , Shoenfeld Y 
Published: January 2017

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants. In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
Implementation of an Antenatal Serum Screening Programme for Down's Syndrome in Two Districts (Brighton and Eastbourne)
Authors: Piggott M , Wilkinson P , Bennett J ,   For the Brighton Eastbourne Down's Syndrome Screening Group
Published: January 2017

To evaluate the introduction to two health districts of an antenatal serum screening programme for Down's syndrome using the triple test-measurement of a fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin concentrations in second trimester serum samples. All women delivering at the main maternity units in both districts were eligible for the screening programme. A serum sample was taken between 15 and 22 weeks' gestation, confirmed by ultrasound scan. An estimated risk of 1 in 250 or greater was considered to be a screen positive result and further diagnostic tests were offered. As far as possible the outcome of all screened pregnancies was recorded, and babies with Down's syndrome born to women who declined serum screening were also identified. 6990 singleton pregnancies were screened over a two year period, representing an estimated uptake of 67% (6990/10 443). After a screen positive result 80% of women (168/211; 95% confidence interval 74–2 to 85–1%) opted for amniocentesis. The false positive rate was 2–9% (203/6979; 95% confidence interval 2–5 to 3–3%). The detection rate in the screened population was 73% (8/11). The estimated cost of identifying one Down's syndrome affected pregnancy was about £31 000. Successful introduction of the triple test to health districts where there is no established serum screening programme for neural tube defects is possible. The programme seems to be acceptable to most of those screened. Uptake of the programme is sufficient to make it more effective than a policy for Down's syndrome screening dependent on age only.
Cascade Testing for the Identification of Carriers of Cystic Fibrosis
Authors: Holloway Susan , Brock David J H 
Published: January 2017

It has been suggested that cascade testing, in which relatives of a person affected with cystic fibrosis (CF) are tested for carrier status, is preferable to screening individuals in the general population. This idea was examined by calculating the number of relatives requiring testing, assuming that it is necessary to identify all those of reproductive age no more distantly related to the proband than second cousins. Two hypothetical programmes were used, in each of which only blood relatives of an affected proband were tested and subsequent analysis applied to relatives of those with a positive result. If started in the grandparental generation, cascade testing of about 28 relatives for each proband would detect 86.4% of carriers in the family. If only carried out for the parental generation and their descendants, testing of about 35 relatives for each proband would detect 92.1% of carriers in the family. If cascade testing were restricted to the second cousin level, however, these programmes would only detect between 8 and 24% of all carrier couples. This contrasts with the 50% detection rate that has already been demonstrated for antenatal CF screening.
Adverse Effects of Screening for Gestational Diabetes: A Prospective Cohort Study in Toronto, Canada
Authors: Kerbel Diane , Glazier Richard , Holzapfel Stephen , Yeung Maria , Lofsky Stanley 
Published: January 2017

Objective— To investigate the adverse effects associated with a false positive SO g glucose challenge test for gestational diabetes mellitus (GDM). Setting— Consecutive women attending a prenatal registration clinic at a large community hospital in suburban Toronto, Canada. Methods— Prospective cohort study of women between 12 and 24 weeks' gestation with no previous history of diabetes mellitus or GDM. Main outcome measures included anxiety (Spielberger's State-Trait Anxiety Inventory), depression (Centers for Epidemiologic Studies Depression Scale), perceived maternal health, and concern about health of the newborn. Results— Among 2564 eligible subjects, there were 897 subjects with complete data at enrolment and at 32 weeks' gestation, including 88 who had false positive glucose challenge test results. At 32 weeks, only 20% (95% confidence limits 11%, 28%) of women with false positive glucose challenge test results rated their health as excellent, compared with 38% (35%, 42%) of those having negative results and those not tested (P = 0.001). These results were sustained at 36 weeks. There was no association between glucose challenge test result and the change in anxiety (P = 0.57), depression (P = 0.09) or concern about health of the newborn (P = 0.91) between baseline and 32 weeks' gestation, nor were these associations found at 36 weeks. Conclusions— False positive glucose challenge test results are about six times more likely than true positive results in the general population. Pregnant women with false positive GDM screening results experience a significant decline in their perception of their own health. These adverse effects should be taken into account when deciding about a policy of screening all pregnant women for gestational diabetes.
Evaluation of Surveillance Programmes for Colorectal Cancer in Ulcerative Colitis Patients by Case-Control Studies: Methodological Considerations
Authors: Zack M M , Ekbom A , Adami H O , Persson P G 
Published: January 2017

Objectives— The evaluation of the efficacy of colonoscopy screening in patients with ulcerative colitis for colorectal cancer is associated with methodological difficulties. Case-control studies can, however, be used to determine the efficacy of such a programme and the outline of the methodology in such a programme is presented. Methods— The randomised controlled trial provides perspective for case-control studies of screening efficacy. Cases are selected from persons who have ulcerative colitis with manifestations of colorectal cancer: for example, those who have died of colorectal cancer or have symptomatic metastases. Controls are selected from persons who have ulcerative colitis, who had been alive when the case died of colorectal cancer, and who had been subject to the risk of dying from, but had not had, colorectal cancer diagnosed when the case was diagnosed with colorectal cancer. The relevant screening history for cases begins with the case's diagnosis of ulcerative colitis and ends with the case's diagnosis of colorectal cancer; that for controls should be comparable to that for cases to avoid bias. Cases and controls are compared with respect to their “exposure” to colonoscopy during their screening histories: the occurrence of any screening, which took place during the period of time that an occult tumour (or an identifiable lesion) may plausibly have been present. Conclusion— The proposed methodology can evaluate the efficacy of a screening programme rapidly, practically, and ethically.
Globalization, Growth and Employment in India
Authors: Ghose Ajit K. 
Published: January 2017

The opening-up of India’s economy to trade and capital flows in the early 1990s did lead to growth acceleration. But it also led to developments that had not been anticipated. Far from promoting specialisation in unskilled-labour-intensive products, openness to trade increased the capital-and-skill-intensity of exports. Inflow of foreign finance stimulated growth not by boosting investment but by boosting consumption. Not surprisingly, the growth stimulus generated by increased openness was short-lived. The stimulating effect of trade disappeared after 2004. And the stimulating effect of capital inflow was visible only during 2004–08. Employment conditions showed substantial improvement only after 2000. During 2000–10, growth of the organised sector was both rapid and employment-intensive. So the sector was pulling labour out of the unorganised sector. The consequent deceleration in labour force growth combined with accelerated output growth to produce rapid improvement in employment conditions in the unorganised sector. The increased employment intensity of growth in the organised sector is explained by (a) the rapid growth of construction and services, and (b) the declining unit cost of labour that resulted from the rapid expansion of informal employment of relatively low-skilled labour.
Topical Treatment with Minoxidil 2% and Smoking Intolerance
Authors: Trattner Akiva , Ingber Aryeh 
Published: January 2017

OBJECTIVE: To report smoking intolerance that occurred in two patients while they were treated with minoxidil. DATA SYNTHESIS: Minoxidil is a potent vasodilator useful in treating severe hypertension. Topical minoxidil was approved as a treatment for androgenital alopecia. Only few side effects have been reported during treatment with topical minoxidil, most of them localized skin reactions. Two of our patients developed smoking intolerance during treatment with topical minoxidil for androgenital alopecia. The relation between treatment with minoxidil and smoking intolerance was emphasized by stopping treatment and the disappearance of the smoking intolerance, and then by rechallenge in both patients. CONCLUSIONS: Topical minoxidil may cause smoking intolerance; further studies are needed to evaluation this side effect.
Controversies over the Use of Magnesium Sulfate in Delirium Tremens
Authors: Jermain Donna M. , Crismon M. Lynn , Nisbet Robert B. 
Published: January 2017

OBJECTIVE: To critically address the controversy of using parenteral magnesium sulfate in delirium tremens (DT). DATA SOURCES: English-language journal articles published between 1954 and 1987. STUDY SELECTION: All literature available, mostly case reports, that either support or discourage magnesium sulfate administration to patients with DT. DATA EXTRACTION: Pertinent information (as judged by the authors) was summarized and interpreted. DATA SYNTHESIS: DT has long been associated with magnesium deficiency because many alcoholic patients with DT have low serum magnesium concentrations. Recent literature, however, suggests that hypomagnesemia is not noted universally in this patient population and that patients' serum magnesium concentrations may return to normal without exogenous magnesium administration. Thus, there is most likely not a specific causal relationship of hypomagnesemia in DT. CONCLUSIONS: Routine administration of parenteral magnesium sulfate in patients with DT is not recommended.
Drug-Use Patterns among Black and Nonblack Community-Dwelling Elderly
Authors: Hanlon Joseph T. , Fillenbaum Gerda G. , Burchett Bruce , Wall William E. , Service Connie , Blazer Dan G. , George Linda K. 
Published: January 2017

OBJECTIVE: To describe and compare drug-use patterns among black and nonblack community-dwelling elderly. DESIGN: Survey. SETTING: Five-county urban and rural region in Piedmont, NC. PARTICIPANTS: Stratified probability household sample of 4164 community residents aged 65 or older from the Piedmont Health Survey of the Elderly (65 percent women, 54 percent black, mean age 73.56 ± 6.74 y). MAIN OUTCOME MEASURES: Prevalence of medication use and mean drug use; therapeutic medication category use. RESULTS: Data were weighted to represent the population in this geographic area. Fewer blacks reported the use of over-the-counter (OTC) medications and total medications than did nonblacks (66 vs. 76 percent and 88 vs. 92 percent, respectively; p<0.001). Compared with nonblacks, blacks reported using a lower mean number of prescription (2.02 vs. 2.35; p<0.001), OTC (1.12 vs. 1.42; p<0.001), and total (3.14 vs. 3.77; p<0.001) drugs. The therapeutic medication categories varied by race for prescription cardiovascular, analgesic, and central nervous system (CNS) drugs and OTC nutritional supplements. More nonblacks than blacks reported the use of analgesics (62.5 vs. 55.6 percent, respectively; p<0.001), CNS drugs (26.1 vs. 14.2 percent, respectively; p<0.001), nutritional supplements (27.5 vs. 16.9 percent, respectively; p<0.001), and gastrointestinal agents (29.0 vs. 23.5 percent, respectively; p<0.001). Blacks were more likely to report problems in managing their medications than were nonblacks (9.0 vs. 6.1 percent, respectively; p=0.001). CONCLUSIONS: Our data suggest that there are distinct racial differences in medication-use patterns among the elderly.
Suspected Cross-Reactivity of Enalapril- and Captopril-Induced Hepatotoxicity
Authors: Hagley Michael T. , Benak Robert L. , Hulisz Darrell T. 
Published: January 2017

OBJECTIVE: To present evidence that enalapril and captopril may produce hepatotoxicity by a common mechanism. DATA SOURCES: A case report and review of pertinent literature. DATA SYNTHESIS: A patient developed hepatotoxicity once while taking enalapril and again while taking captopril. Hepatotoxicity resolved with cessation of therapy. Hepatotoxicity has been reported with use of captopril, enalapril, and lisinopril. Apparent cross-reactivity has been reported on just one other occasion. CONCLUSIONS: Because hepatotoxicity is uncommon with angiotensin-converting enzyme (ACE) inhibitors, our observations suggest the possibility that these agents produce hepatotoxicity by a common mechanism. In patients who develop hepatotoxicity while taking one ACE inhibitor, other agents in this class probably should be avoided.
Variability in Plasma Lipoprotein Profiles When Comparing Diltiazem and Propranolol
Authors: Labreche Dustan G. , Kondos George T. , Bartels David W. , Bauman Jerry L. 
Published: January 2017

OBJECTIVE: To examine the effects of diltiazem and propranolol on plasma lipoproteins in a double-blind, comparative trial. PATIENTS: Twenty-one mild-to-moderate hypertensive patients. METHODS: Following discontinuation of previous antihypertensive treatments, and a 4-week, single-blind, placebo run-in, subjects were randomized to receive sustained-release diltiazem or propranolol. Total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very-low-density lipoproteins (VLDL) were measured during placebo administration and after 12–16 weeks of treatment. RESULTS: No significant changes in plasma lipoprotein concentrations were noted in either the diltiazem or propranolol group compared with baseline values or each other. Marked variation in HDL, LDL, and VLDL were noted following drug treatment and in eight subjects whose lipoprotein concentrations were remeasured prior to drug treatment during the placebo period. The alterations were bidirectional, and similar in magnitude to those found following drug treatment. CONCLUSIONS: In many cases, changes in plasma lipoproteins reported to be a consequence of antihypertensive treatment may merely reflect normal intrapatient variability.
Granulocyte-Colony Stimulating Factor for Sulfasalazine-Induced Agranulocytosis
Authors: Gales Barry J. , Gales Mark A. 
Published: January 2017

OBJECTIVE: To report a case of sulfasalazine-induced agranulocytosis that was successfully treated with granulocyte-colony stimulating factor (G-CSF). CASE SUMMARY: An 82-year-old woman developed agranulocytosis within two months of initiating sulfasalazine therapy. She was hospitalized, empiric antibiotics and antifungal agents were prescribed, and sulfasalazine therapy was stopped. The patient received G-CSF 600 μg/d subcutaneously for six consecutive days, starting on hospital day 5. Agranulocytosis resolved on day 5 and leukopenia on day 6 of G-CSF therapy. No adverse reactions were attributed to administration of this agent and the patient was discharged on hospital day 13. DISCUSSION: Numerous agents, including sulfasalazine, have been associated with agranulocytosis. Agranulocytic patients frequently experience life-threatening bacterial and fungal infections. Administration of colony stimulating factors may reduce the duration of agranulocytosis and incidence of life-threatening infections. CONCLUSIONS: G-CSF administration appears to have decreased the duration of this elderly patient's agranulocytosis and hospitalization.
Metronidazole Hypersensitivity
Authors: Knowles Sandra , Choudhury Taffik , Shear Neil H. 
Published: January 2017

OBJECTIVE: To report a case of a possible hypersensitivity reaction induced by metronidazole. CASE SUMMARY: An Asian woman with a history of recurrent vaginitis had previously developed localized erythema while on intravaginal metronidazole and nystatin. While receiving oral metronidazole for treatment of a current bacterial vaginosis, she developed chills, fever, generalized erythema, and a rash within 60 minutes of the first dose. Treatment with diphenhydramine was instituted. The following day while in the hospital, the patient's condition worsened; she experienced shortness of breath and increased edema of the extremities. Methylprednisolone was administered with diphenhydramine and her condition improved over the next 5 days. The patient's vaginitis was treated with gentian violet and she was discharged on a tapering dosage of prednisone. DISCUSSION: Metronidazole-induced cutaneous reactions and systemic hypersensitivity reactions are reviewed. Alternatives to metronidazole and other potential cross-reactive drugs are suggested for the treatment of recurrent vaginitis. CONCLUSIONS: Although the patient's initial reaction to metronidazole represented a rare event, written documentation and communication in the patient's native language may have prevented the subsequent severe hypersensitivity reaction.
Ondansetron for Treating Nausea and Vomiting in the Poisoned Patient
Authors: Reed Michael D. , Marx Celeste M. 
Published: January 2017

OBJECTIVE: To describe the efficacy of ondansetron for the treatment of poisoning-associated vomiting in two patients following drug intoxication. PATIENTS: Two self-poisoned adolescent patients. INTERVENTION: Intravenous ondansetron. RESULTS: Resolution of nausea and vomiting in both patients. CONCLUSIONS: Ondansetron appears to be a very effective antiemetic drug for use in selected intoxicated patients.