bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of hepatitis C virus infection in patients with end‐stage renal disease
Authors: Liu Chen‐Hua , Kao Jia‐Horng 
Published: August 2010

AbstractHepatitis C virus (HCV) infection is a major health problem in patients with end‐stage renal disease (ESRD). The incidence of acute HCV infection during maintenance dialysis is much higher than that in the general population because of the risk of nosocomial transmission. Following acute HCV infection, most patients develop chronic HCV infection, and a significant proportion develop chronic hepatitis, cirrhosis, and even hepatocellular carcinoma. Overall, chronic hepatitis C patients on hemodialysis bear an increased risk of liver‐related morbidity and mortality, either during dialysis or after renal transplantation. Interferon (IFN) therapy is modestly effective for the treatment of HCV infection in ESRD patients. Conventional or pegylated IFN monotherapy has been used to treat acute hepatitis C in ESRD patients with excellent safety and efficacy. Regarding chronic hepatitis C, approximately one‐third of patients can achieve a sustained virological response (SVR) after conventional or pegylated IFN monotherapy. The combination of low‐dose ribavirin and conventional or pegylated IFN has further improved the SVR rate in treatment‐naïve or retreated ESRD patients in clinical trials. Similar to the treatment of patients with normal renal function, baseline and on‐treatment HCV virokinetics are useful to guide optimized therapy in ESRD patients. Of particular note, IFN‐based therapy is not recommended at the post‐renal transplantation stage because of the low SVR rate and risk of acute graft rejection. In conclusion, ESRD patients with HCV infection should be encouraged to receive antiviral therapy, and those who achieve an SVR usually have long‐term, durable, virological, biochemical, and histological responses.
Allopurinol might improve response to azathioprine and 6‐mercaptopurine by correcting an unfavorable metabolite ratio
Authors: Gardiner Sharon J , Gearry Richard B , Burt Michael J , Chalmers‐Watson Teresa , Chapman Bruce A , Ross Alison G , Stedman Catherine A M , Huelsen Alexander , Barclay Murray L 
Published: August 2010

AbstractBackground and Aim:  Allopurinol potentiates azathioprine and 6‐mercaptopurine (6‐MP) by increasing 6‐thioguanine nucleotide (6‐TGN) metabolite concentrations. The outcome might also be improved by adding allopurinol in individuals who preferentially produce 6‐methylmercaptopurine nucleotides (6‐MMPN), rather than 6‐TGN. The aim of the present study was to investigate the effect of allopurinol on concentrations of 6‐MMPN and 6‐TGN in individuals with a high ratio of these metabolites (>20), which is indicative of a poor thiopurine response.Methods:  Sixteen individuals were identified who were taking azathioprine or 6‐MP, and were commenced on allopurinol to improve a high 6‐MMPN : TGN ratio. Metabolite concentrations were compared before and after commencing allopurinol, and markers of disease control were compared.Results:  The addition of 100–300 mg allopurinol daily and thiopurine dose reduction (17–50% of the original dose) resulted in a reduction of the median (and range) 6‐MMPN concentration, from 11 643 (3 365–27 832) to 221 (55–844) pmol/8 × 108 red blood cells (RBC; P = 0.0005), increased 6‐TGN from 162 (125–300) to 332 (135–923) pmol/8 × 108 RBC (P = 0.0005), and reduced the 6‐MMPN : 6‐TGN ratio from 63 (12–199) to 1 (0.1–4.5) (P = 0.0005). There was a significant reduction in steroid dose requirements at 12 months (P = 0.04) and trends for improvement in other markers of disease control. One patient developed red cell aplasia that resolved upon stopping azathioprine and allopurinol.Conclusions:  In those with a high 6‐MMPN : 6‐TGN ratio (>20), response to thiopurine treatment might be improved by the addition of allopurinol, together with a reduced thiopurine dose and close hematological monitoring.
PROBLEMS IN THE MANAGEMENT OF NEONATAL MENINGITIS
Authors: ROBINSON M. J. 
Published: August 2010

SYNOPSISUndoubtedly much of the morbidity and mortality associated with neonatal meningitis is related to delay in diagnosis. Undoubtedly also, organisms such as proteus and pyocyaneus are more lethal. Despite this, there is adequate evidence that electrolyte imbalance from inappropriate A.D.H. secretion can compound the problems of the meningitis and thus disturb cerebral function. Careful monitoring of the serum sodium and also appropriate fluid restriction will prevent this. In addition, there should be an awareness of the frequency of ventriculitis in this age group. Ventriculitis can only be effectively managed by the local instillation of chemotherapeutic agents and a Rickham reservoir is a most satisfactory means of accomplishing this end.
THE INFANT BORN OF A SINGLE MOTHER PREGNANCY A STUDY OF THE RISK
Authors: JOHNS NAN 
Published: August 2010

SYNOPSISThe pregnancy and delivery histories of two groups of single mothers confined in a Melbourne public maternity hospital in 1968 were compared with those of a control group of married women. No significant incidence of factors liable to influence adversely the well‐being of the infants born to the single mothers was found.
HYPERCALCIURIA IN POTASSIUM‐LOSING NEPHROPATHY:
Authors: McCREDIE D. A. , ROTENBERG E. , WILLIAMS A. L. 
Published: August 2010

SYNOPSISThe case histories of 4 children with Bartter's syndrome are presented. All were born prematurely and pregnancy was associated with hydramnios. All failed to thrive and had a vasopressin‐insensitive urinary concentrating defect, but were of normal intelligence. Hypo‐kalaemia was not necessarily present when first seen, but serum sodium was low compared with other patients with diabetes insipidus. Salt loading caused a sharp fall in serum potassium, often associated with a paradoxical rise in plasma renin levels. Urine calcium was high in all patients and rose to very high levels with salt loading. Nephrocalcinosis was a constant finding. The basic defect is thought to be one of ion absorption in the proximal tubule, though membrane transport may also be affected in other areas.
HYPERTENSION IN CHILDHOOD OBESITY
Authors: COURT J. M. , HILL G. J. , DUNLOP MARJORIE , BOULTON T. J. C. 
Published: August 2010

SYNOPSISBlood pressure has been measured in 209 children on first consultation when referred to the Obesity Research Clinic. Blood pressure correlated with estimates of obesity made by subscapular‐skinfold thickness, and calculations of per cent body weight as fat. Neither age nor duration of the obesity showed significant correlation with the blood pressure.
Is prescribing paracetamol ‘pro re nata’ acceptable?
Authors: PENNA A. C. , DAWSON K. P. , PENNA C. M. 
Published: August 2010

Abstract The aim of this study was to assess the prescribing pattern of paracetamol in a children's department of a general hospital. A retrospective audit of the case record prescriptions revealed that 190 of a sample of 299 children had received paracetamol during their inpatient stay.The major indications for paracetamol use were fever associated with infection in medical patients and pain following minor surgical procedures. The most common regimen was 4 hourly p.r.n. and this had the greatest potential to lead to a dose in excess of 90 mg/kg per 24h, other than the actual prescribing of high doses on a fixed basis. This dose was actually administered to 13.6% of the children, and was prescribed for 74% of the group. We conclude that a p.r.n. regimen can lead to overdose and this may be potentially hazardous for children.
Childhood injury mortality in New South Wales: Geographical and socio‐economic variations
Authors: CAREY V. , VIMPANI G. , TAYLOR R. 
Published: August 2010

Abstract This paper reports a retrospective study of deaths due to unintentional injury in children aged between 0 and 14 years of age in New South Wales between 1985 and 1987. The aims were to determine whether the pattern of child injury mortality differed between rural and metropolitan New South Wales and to establish the relationship between socio‐economic status, based on a geographical indicator of socio‐economic status and child injury mortality.The child injury mortality rate for New South Wales in 1985–87 was 12.3 deaths per 100000 population per year. The rate in the country area of 15.3 deaths per 100000 was significantly higher than that for the metropolitan area of 11.3 per 100000 (P<0.05). Deaths of passengers in motor vehicle traffic accidents (P<0.01) and deaths due to fires (P<0.01) were greater in the country area. A negative linear association between socio‐economic status and child injury mortality was found in the Sydney metropolitan area (P<0.01). This trend was most apparent for deaths of child pedestrians (P<0.01).
Surfactant replacement therapy in neonates less than 32 weeks gestation: Effect on neonatal intensive care resource utilization
Authors: DIWAKER K. , ROBERTS S. , JOHN E. 
Published: August 2010

Abstract  The effect of synthetic surfactant (Exosurf) replacement on complications from hyaline membrane disease (HMD) in infants <32 weeks gestation and their resource utilization within a neonatal intensive care unit was studied in 1991‐92. A control group was selected from infants admitted to the same unit during the preceding 3 years when Exosurf was not available. The infants were controlled for gestation, weight and severity of HMD.Infants given Exosurf had a significant reduction in the incidence of pulmonary interstitial emphysema (PIE), and a marginal decrease in the incidence of pneumothorax. They required fewer days on the ventilator and consumed less of the scarce financial resources. There was no difference in the mortality rate among the two groups. The changes seen were more evident among those infants between 30 and 31 weeks gestation, compared to those <28 weeks.
Primary course immunogenicity and reactogenicity of a new diphtheria‐tetanus‐whole cell pertussis vaccine (DTPw)
Authors: NOLAN T , HOGG G , DARCY M‐A , VARIGOS J , McEWEN J 
Published: August 2010

Objective: To establish safety, immunogenicity, and batch stability of a reformulated whole cell pertussis based diphtheria‐tetanus‐whole cell pertussis (DTP) vaccine (nDTPw) compared to the currently marketed Australian DTPw vaccine (Triple Antigen™) in a three dose 2, 4 and 6 month primary immunization course. Reformulation was necessary to make the DTPw vaccine suitable for combination with hepatitis B and Haemophilus influenzae b vaccines. Methods: Double blind randomized controlled trial in suburban Melbourne in 812 healthy infants recruited through maternal and child health centres, of whom 208 received Triple Antigen and 604 received nDTPw. Results: Results for both reactogenicity and immunogenicity were similar and were not significantly different for the three batches of nDTPw. No new, serious, or unexpected adverse effect was recorded. Nearly twice as many nDTPw infants experienced no general reaction to the third dose (18%) compared to Triple Antigen™ (11%, P=0.06). An elevated temperature (≥38°C axillary) occurred in about three out of 10 babies overall, with rates being slightly higher for both vaccines after the second vaccination. Local reaction rates were significantly less common for nDTPw on days 2 and 3 following each of the three vaccinations. After dose three, 30% of nDTPw subjects experienced no local reaction compared to 20% of Triple Antigen™ subjects (P= 0.015, 95% Cl on difference 2%, 19%). Swelling after doses one and three occurred in 30% and 24% of Triple Antigen™ subjects, compared to 23% (P=0.07, 95% Cl diff 0%, 13%) and 14% (P=0.017, 95% Cl diff 2%, 17%) of nDTPw subjects. Tenderness after doses two and three occurred in 80%, and 78% of Triple Antigen™ subjects, compared to 71% (P= 0.04, 95% Cl diff 1%, 17%) and 68% (P=0.025, 95% Cl diff 2%, 19%) of nDTPw subjects. There was a significantly higher post immunization diphtheria antitoxin GMT (2.73 IU/mL) for Triple Antigen™ compared to nDTPw (1.89 IU/mL; P= 0.02), although no subject in either vaccine group had a tetanus or diphtheria antibody titre less than six times the protective level of 0.01 IU/mL following immunization. The nDTPw post immunization GMTs were significantly higher for Agg2, Fha, and pertactin compared to Triple Antigen™ geometric mean titres (GMTs). Conclusion: nDTPw is a safe and immunogenic vaccine when compared to Triple Antigen™. The reformulated vaccine is an acceptable replacement for the currently marketed formulation, and for evaluation as a component of future combination vaccines.
Incidence of apnoea and bradycardia in preterm infants following DTPw and Hib immunization: A prospective study
Authors: BOTHAM SJ , ISAACS D , HENDERSON‐SMART DJ 
Published: August 2010

Objective: To evaluate the incidence and severity of apnoea and bradycardia in hospitalized preterm infants following immunization at 2 months of age, and identify risk factors. Methodology: A prospective study of 98 preterm infants, of gestational age 24–31 weeks, immunized at approximately 2 months post natal age with diphtheria‐tetanus‐whole cell pertussis vaccine (DTPw) in the neonatal intensive care unit (NICU) at King George V Hospital Sydney. Half the infants also received Haemophilus influenzae type b conjugate vaccine (Hib) simultaneously. All infants were monitored for apnoea and bradycardia in the 24 h periods pre‐ and post immunization. Results: Only one infant had apnoea and/or bradycardia pre‐immunization compared with 17 post immunization. For 12 infants these events were brief, self‐limiting and not associated with desaturations (oxygen saturation <90%). However, for five infants (30%) these events were associated with oxygen desaturation and two of these infants required supplemental oxygen. The group that had apnoea and/or bradycardia and the group that did not were not significantly different in terms of gestational age, birth weight and other variables. Infants who received Hib together with DTPw were less likely to have apnoea and/or bradycardia than those given DTPw alone. Conclusion: When considering immunization for preterm infants, the benefits of early immunization must be balanced against the risk of apnoea and bradycardia. We recommend that the cardio‐respiratory function of hospitalized infants born at less than 31 weeks gestation be monitored for 48 h post immunization.
Young Malaysian children with lower respiratory tract infections show low incidence of chlamydial infection
Authors: NGEOW YF , WEIL AF , KHAIRULLAH NS , YUSOF MY MOHD , LUAM L , GAYDOS C , QUINN TC 
Published: August 2010

Objective: The incidence of Chlamydia pneumoniae and Chlamydia trachomatis infection was studied among infants and young children admitted to hospital for the management of lower respiratory tract infections, over a 12 month period. Methodology: Respiratory secretions were examined for chlamydiae by cell culture, enzyme‐linked immunosorbent assay and polymerase chain reaction‐enzyme immunoassay. Sera were tested by micro‐immunofluorescence for chlamydial IgG, IgM and IgA. Other bacterial and viral pathogens were also looked for by standard cultural and serological methods. Results: Of 87 patients aged 2 months‐3 years, an aetiologic diagnosis was made in 41 (47.1%). C. pneumoniae and C. trachomatis were each detected in 1 (1.2%) of the patients. Among common bacterial pathogens, Haemophilus influenzae (13.8%) and Streptococcus pneumoniae (8.1%) were the most frequently identified. Respiratory viruses and elevated Mycoplasma pneumoniae antibodies were found in 10.3% and 9.1% of patients, respectively. Conclusion: Chlamydiae are infrequent causes of community‐acquired acute lower respiratory tract infections in infants and very young children in Malaysia.
The health of a group of young Australians in a New South Wales juvenile justice detention centre: A pilot study
Authors: FASHER AM , DUNBAR N , ROTHENBURY BA , BEBB DK , YOUNG SJW 
Published: August 2010

Objective: To consider the health profile of a sample of young, largely male Australians as assessed on their admission to a New South Wales Juvenile Justice Detention Centre. Method: A retrospective analysis of primary care nurse health records for 100 sequential admissions. Results: Of the 97 males and three females (mean age = 15.9 years), 30 were Aboriginal and 39 did not live with either parent at the time of admission. Respiratory illness, such as bronchitis and asthma were common. These diagnoses were overshadowed by histories of significant physical injury. The sample was at high risk of sexually transmitted disease. Forty‐six per cent had prior contact with a mental health professional, 26% reported they had thought of suicide and 9% reported having attempted suicide. There was a high prevalence of substance abuse. Conclusion: The health of these young Australians is at risk from every perspective. Improving the quality of their health assessments is an important issue for the clinicians who attend them as individuals and for policy makers who aim to reduce the considerable social and economic cost of juvenile crime. The discussion of these results from one centre has revealed opportunities to make such improvements. There is a need for a gathering of expertise to address the issue, preferably on a national basis.
Acne in Victorian adolescents: Associations with age, gender, puberty and psychiatric symptoms
Authors: KILKENNY M , STATHAKIS V , HIBBERT ME , PATTON G , CAUST J , BOWES G 
Published: August 2010

Objectives: This study aimed to examine the associations between the frequency and severity of self‐reported acne and age, gender, puberty and psychiatric symptoms in Victorian adolescents. Methodology: A sample of secondary schoolchildren in Victoria, Australia were surveyed using a computerized questionnaire. Developmental and psycho‐social factors associated with acne were recorded and analysed using logistic regression. Results: The Victorian Adolescent Health Survey (1992) recorded the frequency and severity of self‐reported acne in 2491 students. Frequency of acne increased with age and pubertal development. For females commencement of menstruation was associated with increased frequency of acne. Asian born male students were less likely to report acne than Australian born males. Acne severity was coded into mild (students reporting acne sometimes on back or face) and moderate (students reporting acne often on face or back). Students reporting moderate acne were more likely to report a high level of psychiatric symptoms and were in the later stages of puberty. Conclusions: This study confirms an association between the frequency and severity of self‐reported acne and stage of pubertal development. It showed also that students reporting moderate acne were more likely to report psychiatric symptoms of depression and anxiety.
Severe iron‐deficiency anaemia in adolescents: Consider Helicobacter pylori infection
Authors: Cardamone Michael , Alex George , Harari Michael D , Moss William P , Oliver Mark R 
Published: August 2010

Aim:  This article describes the association of severe iron‐deficiency anaemia with Helicobacter pylori gastritis.Results:  We report three children who had symptomatic iron‐deficiency anaemia with no obvious clinical cause and refractory to iron replacement therapy. All three underwent a diagnostic endoscopy and were found to have H. pylori gastritis. Histopathology confirmed inflammatory changes consisting of dense bands of clusters of plasma cells within the lamina propria and two of the three adolescents were noted to have numerous H. pylori in gastric crypts and glands. Two of the three cases had a urease positive test. Iron deficiency was successfully corrected following antibiotic eradication of H. pylori infection.Conclusions:  This case series highlights the importance of considering H. pylori infection as a cause of refractory iron‐deficiency anaemia in adolescents, even in the absence of gastrointestinal symptoms.
Hepatic derangement following N‐Acetylcysteine enemas in an infant with cystic fibrosis
Authors: Cooke Andrew , Deshpande Aniruddh V , Wong Chris KF , Cohen Ralph 
Published: August 2010

AbstractWe discuss an infant with MI secondary to cystic fibrosis, who was managed surgically by a double barrel ileostomy for mid – small bowel atresia and developed severe faecal impaction in the post – operative period. The faecal impaction was treated successfully with oral NAC and 0.2% NAC contrast enemas. The patient's liver function tests revealed a dramatic increase in transaminases and bilirubin contemporaneous with the administration of the enemas. The levels showed a spontaneous improvement after discontinuation. This is only the second reported case of hepatotoxicity secondary to NAC enemas in the literature. While our experience offers modest support for the use of NAC, its efficacy is not yet proven and paediatric surgeons using NAC in the enema form need to closely monitor liver function contemporaneous with this agent's administration and adjust their treatment accordingly.
‘Halving the heel pricks’: Evaluation of a neonatal jaundice protocol incorporating the use of a transcutaneous bilirubinometer
Authors: Hartshorn David , Buckmaster Adam 
Published: August 2010

Aim:  This study aimed to assess the impact of implementing a new jaundice protocol incorporating the use of the Konica Minolta/Air Shields JM 103 Jaundice Meter (JM103) (Konica Minolta Sensing Inc., Osaka, Japan) in the setting of an Australian post‐natal ward.Methods:  A before‐and‐after study was completed following the introduction of a protocol integrating the use of the JM103 monitor on to the post‐natal ward. Eligible infants were ≥36 weeks gestation, >24 h and <8 days of age. The number of Total Serum Bilirubin tests (TSBRs) were compared for the 12 months prior (T1) with a 6‐month period and 6 months after protocol introduction (T2). Transcutaneous bilirubin (TcBR) results were also collected in T2. Rates of phototherapy and peak TSBRs at commencement were also compared as measures of safety.Results:  Four hundred and twenty‐six of the 2197 live births in T1 required one or more TSBRs compared with 119 of the 1169 live births in T2. This represents an odds ratio of 0.47 (95% confidence interval 0.38–0.58) for infants in T2 having ≥1 TSBR compared with T1. There was no difference between the groups for rates of phototherapy (3.8% vs. 3.0%; P= 0.2) nor any difference between the groups for peak SBR during phototherapy (301.9 µmol/L (standard deviation, SD 58) for T1 vs. 303.2 µmol/L (SD 54) for T2; P= 0.45). The estimated cost saving per year is $6966.00.Conclusion:  TcBR measurement in conjunction with our protocol significantly reduces painful procedures and costs without increasing the risk of delaying treatment with phototherapy.
Molecular phylogeny ofIsodon(Lamiaceae) in Japan using chloroplast DNA sequences: recent rapid radiations or ancient introgressive hybridization?
Authors: MAKI MASAYUKI , YAMASHIRO TADASHI , DOHZONO IKUMI , SUZUKI KAZUO 
Published: August 2010

AbstractPhylogenetic relationships between 14 taxa ofIsodon(Lamiaceae) occurring in Japan and South Korea were examined using sequence variations in 11 chloroplast DNA regions. The phylogenetic tree based on the sequence of 6478 bp did not reflect a previous taxonomic treatment of the genus at the section level: the three main clades contained species in different sections. Furthermore, individuals from different populations in the same species were rarely monophyletic in the tree. In addition, individuals forming monophyletic groups did not show geographical proximity. Lineage sorting of chloroplast DNA variations following rapid divergence of the taxa is likely to have caused complex phylogeny of the taxa, which was reconstructed in the present study. Another possible explanation could be ancient introgressions and resultant chloroplast capture.