bluuebunny/crossref_metadata_2025_split huggingface dataset:
Père alcoolique, consommation de psychotropes à l'adolescence et facteurs de protection
Authors: Vitaro Frank , Tremblay Richard E , Zoccolillo Mark 
Published: January 2017

Objectifs: La présente études 'intéresse aux caractéristiques personnelles et familiales des enfants de pères alcooliques qui ne développent pas de problème d'alcool et/ou de drogue à l'adolescence (c 'est à dire, les enfants résilients) en comparaison avec ceux qui en développent. Divers traits comportementaux sont examinés comme facteurs de résilience ainsi que certaines pratiques éducatives des parents. Méthode: Les facteurs de résilience sont évalués tout au cours de l'enfance, soit entre l'âge de 6 et 12 ans. La présence ou l'absence de problème d'alcool et/ou de drogue chez le jeune est établie à l'âge de 15 ou 16 ans. Résultats: Près de 1000jeunes des 2 sexes ont participé à l'étude. Comme prévu, l'alcoolisme du père constitue un facteur de risque important en regard des problèmes de consommation des substances psychotropes à l'adolescence. Des traits de personnalité comme une faible recherche de sensations ainsi qu'une propension à l'inhibition constituent, au contraire, des facteurs qui diminuent le risque d'éprouver des problèmes de consommation. Ces facteurs ne peuvent cependant être considérés comme des facteurs de resilience car leur effet s'exerce autant chez les enfants de pères non alcooliques que chez ceux de pères alcooliques. Par contre, la supervision parentale s'est avérée protectrice car elle a diminué le risque de problème de consommation seulement chez les enfants de pères alcooliques. Conclusion: Ces résultats indiquent qu 'au-delà des variables de personnalité, l'alcoolisme du père constitue un facteur de risque élevé en regard d'un problème de toxicomanie chez les jeunes. Toutefois, la supervision parentale permet d'atténuer ce risque, ce qui constitue un élément d'intervention important à considérer.
Evaluation on biological compatibility of carboxymethyl chitosan as biomaterials for antitumor drug delivery
Authors: Jiang Zhiwen , Han Baoqin , Liu Wanshun , Peng Yanfei 
Published: January 2017

Carboxymethyl-chitosan, a water-soluble derivative of chitosan, has emerged as a promising candidate for biomedical applications due to its excellent water solubility, biodegradation, biocompatibility, hydrating, antimicrobial, and nontoxicity. In this paper, the antitumor proliferation and metastasis was studied in vitro and in vivo to evaluate biocompatibility of carboxymethyl-chitosan as biomaterials for antitumor drug delivery. The results showed that carboxymethyl-chitosan could significantly reduce the clone formation and tumor migration of human cancer cells including kidney cancer cell line OS-RC-2, gastric cancer cell line SGC-7901, colon cancer cell line HT-29, and nonsmall cell lung cancer cell line NCI-H1650 in vitro. Through Lewis tumor-bearing C57BL/6 mouse model, carboxymethyl-chitosan was proved to be able to inhibit solid tumor growth and tumor metastasis to the liver and lung, meanwhile increase the level of tissue inhibitor of metalloproteinase 1 and E-cadherin, and decrease the level of mice blood serum matrix metalloproteinase 9. This study suggested that carboxymethyl-chitosan had certain antimetastasis effect and good biocompatibility and may have a potential application as a synergic antitumor reagent.
Analysis of Hospitalization Rates by Electoral Ward: Relationship to Accessibility and Deprivation Data
Authors: Slack R. , Ferguson B. , Ryder S. 
Published: January 2017

The objective of this paper is to investigate the relevance of access to hospital services in explaining utilization rates at a District Health Authority level in the UK. In order to test the hypothesis that access is important, it is necessary to develop a means of scoring access factors and then combining these scores with other more recognized influences on hospitalization rates e.g. deprivation measures. Acknowledging that hospitalization rates are not merely products of a population's socio-economic characteristics, the effect of accessibility to hospital services for the resident population is investigated through the derivation of an access score using both private and public transport from electoral ward of residence. Deprivation and accessibility to services were both found to be significant factors in determining hospitalization rates at electoral ward level. The chosen supply variable — number of GPs — was not found to be significant in any of the models developed using linear regression techniques. To conclude, it appears that access plays an important role in determining hospitalization rates within a given population. If high hospitalization rates are accepted as an indicator of effectively met demand then policy makers may have to consider increasing the accessibility of hospital services.
Comparative Study of Cefuroxime Axetil and Procaine Penicillin in the Treatment of Uncomplicated Gonorrhoea
Authors: Kinghorn G R , Spencer R C , Smith T K , Woolley P D , Patel R , Robinson A J 
Published: January 2017

A total of 311 patients presenting with uncomplicated gonorrhoea were entered into a comparative randomized open-label study and given single-dose treatment with either oral cefuroxime axetil (CAE) or intramuscular procaine penicillin (PP). Neisseria gonorrhoeae was eliminated from 129 (98%) of 131 evaluable patients treated with CAE and 127 (98%) of 129 evaluable patients treated with PP. None of the 4 treatment failures (3 male and 1 female) were caused by β-lactamase-producing isolates. Both treatments were well tolerated with minor adverse events reported in 3 (2%) of CAE treated patients. We conclude that CAE is an effective, well tolerated treatment for uncomplicated gonorrhoea which has the convenience and acceptability of single-dose oral therapy.
A Case-Control Study to Evaluate Efficacy-Of Screening for Faecal Occult Blood
Authors: Lazovich DeAnn , Weiss Noel S , Stevens Nancy G , White Emily , McKnight Barbara , Wagner Edward H 
Published: January 2017

Objectives — Faecal occult blood testing is routinely used for early detection of colorectal cancer, but evidence of its efficacy in preventing death from colorectal cancer is limited. A case-control study was carried out to evaluate whether screening for faecal occult blood is associated with a reduced risk of fatal colorectal cancer. Setting — A health maintenance organisation in western Washington State, which has offered its members faecal occult blood testing every two years since 1983. Methods — Cases (n = 248) were members of the health maintenance organisation who died from colorectal cancer between 1986 and 1991. For each case,. two control subjects, who did not die from colorectal cancer and who were similar to each case in age, gender, and year of enrolment at the health maintenance organisation, were randomly selected from the membership list of the year in which the case was diagnosed (n = 496). Information about episodes of faecal occult blood testing (including the location and reason for the test, and the evaluation of positive tests) and potential confounders was obtained from medical records. Results — Cases were less likely than controls to have ever been screened (odds ratio (OR) =0·7, 95% confidence interval (CI) 0·5 to 1·0), consistent with a beneficial impact of screening. There was little difference, however, for screening that had taken place within a three year period before diagnosis (OR = 0·9, 95% CI 0·6 to 1·2), the maximum interval during which most tumours ought to have been detectable by faecal occult blood testing. A reduction in risk was seen for home testing but not for office testing, and in individuals aged less than 75 but not in those aged 75 or older. Although most of the 21 controls with a positive faecal occult blood test underwent some additional testing, only five (24%) were evaluated with colonosocopy or air contrast barium enema. Conclusions — While there can be uncertainty as to whether specific faecal occult blood tests were performed as screening or diagnostic tests, those performed at home and in younger persons may be relatively less likely to be diagnostic tests that were misclassified as screening. Thus the modest reduced risk associated with faecal occult blood testing in these settings/persons may reflect genuine benefit. However, the presence of a reduced risk associated with a screening faecal occult blood test received in the past, well before a tumour or polyp might bleed enough to allow detection, is compatible with uncontrolled confounding. Interpretation is further complicated by the fact that a number of individuals in the study group who had positive test results underwent limited or no diagnostic testing. Thus our results should be interpreted with considerable caution.
Independent Double Reading of Screening Mammograms
Authors: Ciatto Stefano , Del Turco Marco Rosselli , Morrone Doralba , Catarzi Sandra , Ambrogetti Daniela , Cariddi Angelo , Zappa Marco 
Published: January 2017

Objective — To evaluate the cost effectiveness of independent double reading of screening mammograms. Setting — Prospective study of 18817 women undergoing first or repeat screening in a population based programme in the Florence district. Methods — Mammograms were independently double read by experienced radiologists. Subjects with mammographic abnormalities reported by at least one reader were recalled for diagnostic assessment. The mean increase in recall rate, cancer detection rate, and screening costs attributable to double reading was calculated. Results — Eleven of 125 cancers were detected by only one reader. The mean increase in cancer detection rate attributable to double reading compared with single reading was 4·6% (95% confidence interval (CI) 1·1 to 8·9). From a total of 748 cases referred for diagnostic assessment, 196 subjects were referred by one reader only. The mean increase in referral rate attributable to double reading compared with single reading was 15·1% (CI 12·3 to 17·8). Double reading caused a marked increase in the cost for each woman screened −8·5% at the first screening and 6·2% at repeat screening and a more limited increase in the cost for each cancer detected −3·5% at the first screening and 2·7% at repeat screening. Cancers detected by only one screener were at an earlier stage than those detected by both screeners (P = 0·6, not significant). Conclusions — Independent double reading results in only a modest increase in the detection of cancers and therefore may not be cost effective.
Cost Effectiveness of Screening for Primary Open Angle Glaucoma
Authors: Boivin J F , McGregor M , Archer C 
Published: January 2017

Objectives and Setting –To determine the cost effectiveness of screening for glaucoma. Methods –Information on treatment efficacy, diagnostic methods, epidemiological characteristics of glaucoma, and costs were determined from the literature, from administrative databases, and from experts. Scenarios with different screening frequency, age, participation in screening, compliance with treatment, treatment efficacy, and diagnostic tests were examined. Results –The initial scenario comprised three-yearly screening of subjects aged 40–79 by funduscopy and tonometry, followed by perimetry when abnormalities were discovered. The assumption of levels of participation in screening and of compliance with treatment of 75%, and treatment efficacy of 50% resulted in a cost of $C100 000 per year of blindness prevented. A scenario in which screening was restricted to subjects aged 65–79, with the same input variables, would prevent 81% of the cases of blindness prevented with scenario 1, at a cost of $C42 000 per year of blindness prevented. Screening with tonometry only as the initial diagnostic test in subjects aged 65–79 would result in a cost of $C36 000 per year of blindness prevented, but would only prevent 59% of the cases prevented with scenario 1. Conclusions –There is as yet no proof that treatment of glaucoma or of high intraocular pressure will arrest the progression of glaucoma to blindness. Even when treatment efficacy is assumed to be as high as 50%, however, the cost effectiveness of most glaucoma screening programmes considered would not be competitive.
Cervical Screening of Arabic-Speaking Women in Australian General Practice
Authors: Lesjak Margaret , Ward Jeanette , Rissel Chris 
Published: January 2017

Abstract Objective— To determine recency and predictors of cervical screening among Arabic-speaking women in Sydney, Australia. Method— A consecutive sample of Arabic-speaking women, attending 20 Arabic-speaking general practitioners, was asked to complete a self administered health risk questionnaire available in Arabic or English which included three questions about cervical screening knowledge and behaviour. Results— Of 756 eligible women, 526 (70%) returned completed questionnaires. Of these, 69 (13%) did not know what a cervical smear was. Sixteen per cent of overseas-born compared with 2% of Australian-born women at risk had not heard of a cervical smear. Women were defined as being at risk of cervical cancer if they had both been married and not had a hysterectomy. Of 318 women at risk for cervical cancer who knew what a cervical smear was, 66% had had a smear in the last two years, a further 7% were attending for one that day while 11% had not had a smear for at least two years, 9% had never had one and 7% did not answer/could not remember. Religion, age, and residence in Australia for more than 10 years were significant and independent predictors of screening after adjustment for other variables in a simultaneous logistic regression model (P = 0.002, P = 0.002, and P = 0.040 respectively). Muslim women and older women were more likely to be under-screened, and women with more than 10 years' residence in Australia were more likely to have been screened in the last two years. Acculturation, smoking status, health status, duration of relationship with participating doctor, and chronic disease were not significant predictors of a recent smear. Conclusion— As only 73% of women at risk had been screened in the last two years, including women attending on the day, and 9% had never been screened, Arabic-speaking women should be a priority for public campaigns, particularly Muslim and older women. Studies to evaluate the effectiveness and acceptability of reminders by ethnic general pratitioners are recommended.
Toxic Epidermal Necrolysis Possibly Linked to Aztreonam in Bone Marrow Transplant Patients
Authors: McDonald Brendan J. , Singer Jack W. , Bianco James A. 
Published: January 2017

OBJECTIVE AND SETTING: After instituting aztreonam as part of antibiotic prophylaxis in bone marrow transplant (BMT) patients at the Seattle Department of Veterans Affairs Medical Center, the first two cases of toxic epidermal necrolysis (TEN) occurred in more than 250 BMT patients at this center. We have examined the possible cause-and-effect relationship between aztreonam and TEN. PATIENTS: The first patient was a 23-year-old man with acute lymphocytic leukemia receiving a BMT from a related mismatched donor. He experienced profound conjunctivitis and superficial bulla covering 60 percent of his body surface area (BSA). The second patient, a 32-year-old man with lymphoma, received a BMT from a matched unrelated donor. He exhibited lymphocytosis, acute conjunctivitis, and bullous lesions covering 60 percent of his BSA. INTERVENTIONS: Aztreonam was discontinued in both patients. The first patient was treated with pigskin grafting and the second was treated with topical silver sulfadiazine. RESULTS: Despite stabilization of symptoms, both patients eventually died of infectious complications. CONCLUSIONS: Histological data in both patients were more consistent with TEN than graft-versus-host disease (GVHD) in that dermal infiltrates were sparse or absent. The onset of cutaneous symptoms was of more acute onset than acute GVHD, and ocular complaints are uncommon in acute GVHD. Furthermore, the onset of TEN bore a closer temporal relationship to aztreonam than to other drugs administered.
Nonthrombocytopenic Purpura Associated Sequentially with Nifedipine and Diltiazem
Authors: Kuo Margaret , Winiarski Nancy , Garella Serafino 
Published: January 2017

OBJECTIVE: To report the case of a patient who developed nonthrombocytopenic purpura sequentially following the administration of nifedipine and diltiazem. DATA SOURCES: Case reports, MEDLINE review of pertinent literature, and review of relevant studies. DATA EXTRACTION: Data were extracted from direct patient observation and review of laboratory studies and published reports. DATA SYNTHESIS: Nonthrombocytopenic purpura secondary to cutaneous vasculitis is a known, although rare, adverse effect of nifedipine. It has not been reported in association with diltiazem. We report the case of a 75-year-old woman in whom a purpuric rash demonstrated by biopsy to be attributable to cutaneous vasculitis developed in the course of nifedipine therapy. The rash disappeared after discontinuation of the drug; however, it recurred when diltiazem therapy was initiated. CONCLUSIONS: Nonthrombocytopenic purpura may be associated with diltiazem as well as with nifedipine. When this adverse effect occurs following administration of a calcium-channel blocker, caution is advised in using other agents of the same class.
Home Total Parenteral Nutrition in a “No-Bowel” Patient in Spain
Authors: Ibáñez Emilio , Ruiz M. Carmen , Corell Ricardo , Guasch Javier , Ferrándiz Amparo , Ferriols Rafael , García Juan 
Published: January 2017

OBJECTIVE: To report a case of a patient with no functional bowel who was receiving home total parenteral nutrition in a country that has had few professional experiences in this area of therapy. CASE SUMMARY: A woman with a history of scattered colonic polyposis developed a mesenteric tumor that caused intestinal obstruction. Tumor withdrawal required the excision of 1.5 m of jejunum—ileum. Postoperative complications required further surgical intervention and subtotal intestinal resection. Duodenocolic anastomosis was not possible and a high output and permanent fistula remained. DISCUSSION: The complications of home parenteral nutrition addressed in the literature are reviewed. The problems encountered in our patient have been resolved. CONCLUSIONS: After three years of postoperative survival, we believe the quality of life of our patient has increased and the parenteral nutrition team members are much better prepared to manage patients with similar problems.
Didanosine-Associated Eosinophilia with Acute Thrombocytopenia
Authors: Lor Edward , Liu Yong Qing 
Published: January 2017

OBJECTIVE: To report a case of didanosine (ddI)-induced acute thrombocytopenia and to discuss the incidence of this occurrence. CASE SUMMARY: A 42-year-old man was admitted to the hospital on November 21, 1991, with acute thrombocytopenia. The patient had an AIDS index diagnosis of Kaposi's sarcoma (KS) in 1988 and had been taking zidovudine (ZDV) for three years without any adverse effects. On July 26, 1991, he complained of increasing fatigue and weight loss. At that time, the therapy was changed from ZDV to ddI. Over the next four months the drug therapy was altered from ddI to ZDV and ZDV to ddI because of increasing fatigue and gastrointestinal symptomatology; all of the other chronic medications were maintained at the same dosages and frequency. All laboratory work remained stable and no new active processes were found during this period. The patient developed acute thrombocytopenia upon his last change to ddI and all of the chronic drug therapy was stopped. His platelet count returned to his baseline value three weeks after the discontinuation of ddI and reinstitution of his chronic medications. DISCUSSION: A review of the literature showed two documented cases of thrombocytopenia with ddI on a dosage escalation study. CONCLUSIONS: Close patient monitoring is essential while administering ddI.
Impact of Vancomycin Therapeutic Drug Monitoring on Patient Care
Authors: Welty Timothy E. , Copa Alan K. 
Published: January 2017

OBJECTIVE: To document differences in the outcome of vancomycin therapy in patients managed through a therapeutic drug monitoring (TDM) service and patients managed empirically, without the participation of a TDM service. DESIGN: Prospective, cohort study. SETTING: An 1100-bed, tertiary-care, teaching hospital. PATIENTS: Those who received vancomycin for more than four days, were at least 18 years old, had an estimated creatinine clearance of more than 0.33 mL/s (20 mL/min), were not neutropenic at the start of vancomycin therapy, and were not treated in a critical care unit were enrolled in the study. A total of 116 patients (61 TDM; 55 non-TDM) were monitored prospectively from June 1990 through March 1991. INTERVENTIONS: Patients in the TDM group had vancomycin drug therapy monitored daily by a pharmacist and vancomycin dosages adjusted following a pharmacokinetic analysis of vancomycin serum concentrations. For patients in the non-TDM group, the pharmacist only completed a data collection form. The patients and physicians were unaware of the monitoring. MAIN OUTCOME MEASURES: Duration of therapy, total vancomycin dosage, infection site, concomitant antibiotics, body temperature, and white blood cell counts were compared between the two groups. Length of stay data were also compared. Nephrotoxicity was evaluated by comparing serum creatinine concentration and estimated creatinine clearance. RESULTS: TDM of vancomycin appeared to reduce the incidence of vancomycin-related renal insufficiency (TDM 7 percent; non-TDM 24 percent). Patients managed through the TDM service received an average of 5 g less of vancomycin than did the patients in the non-TDM group. The duration of vancomycin therapy was an average of 2 days less for patients in the TDM group. Mean length of stay was 38.0 days for the TDM group and 44.5 days for the non-TDM group. Other measures of efficacy, infection site, and concomitant antibiotics were the same for both groups. CONCLUSIONS: TDM of vancomycin was associated with fewer cases of vancomycin-related renal insufficiency. Vancomycin efficacy was not compromised by TDM. Provision of TDM for vancomycin therapy aided in patient management.
Delayed Neutropenia with Ticlopidine
Authors: Farver Debra K. , Hansen Lori A. 
Published: January 2017

OBJECTIVE: To report a case of ticlopidine-induced neutropenia occurring 18 days after discontinuation of the drug. CASE SUMMARY: A 68-year-old woman was placed on ticlopidine after a transient ischemic attack. Ten days later the drug was discontinued because the patient developed a rash. Eighteen days later she developed pneumonia and neutropenia, which were believed to be induced by ticlopidine. DISCUSSION: Drug-induced neutropenia is serious and at times life-threatening. Ticlopidine-induced neutropenia has been described in patients receiving the medication. We report neutropenia occurring 18 days after discontinuation of ticlopidine. CONCLUSIONS: Indications for prescribing ticlopidine must be closely followed. Complete blood cell count monitoring is imperative while the patient is receiving the medication. This case suggests that the duration of monitoring after the discontinuation of ticlopidine may need to be longer than the 14 days recommended by the manufacturer.