bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing adherence to referral advice following pre‐referral treatment with artesunate suppositories in children in rural Tanzania
Authors: Simba Daudi O. , Warsame Marian , Kimbute Omari , Kakoko Deodatus , Petzold Max , Tomson Goran , Premji Zul , Gomes Melba 
Published: May 2009

SummaryObjective WHO recommends artemisinin suppository formulations as pre‐referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers’ adherence to referral advice following pre‐referral treatment of their children with rectal artesunate suppositories.Methods The study was nested within an intervention study that involved pre‐referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post‐referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio‐economic status (SES), knowledge about malaria, referral advice given and actions they took following pre‐referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post–pre‐referral treatment.Results The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32–5.17,P < 0.001]. When questioned, caretakers who rememberedwhen(OR 2.19, 95% CI 1.48–3.23,P < 0.001) andwhy(OR 1.77, 95% CI 1.07–2.95,P = 0.026) they were advised to proceed to health facility – were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by four to five times for those who had previously paid for laboratory services (OR = 0.25, 95% CI: 0.09–0.67,P = 0.006) or consultation (OR 0.20, 95% CI: 0.06–0.61,P = 0.005) compared with those who had not.Conclusion When given referral advice, caretakers of patients with life‐threatening symptoms adhere to referral advice more readily than other caretakers. Health service charges deter adherence.
Healthcare‐associated hepatitis C virus transmission among patients in an abdominal organ transplant center
Authors: Thompson N.D. , Hellinger W.C. , Kay R.S. , Cohen L. , Ragan P. , Voss R.A. , Bacalis L.P. , Xia G. , Keating M.R. , Dickson R.C. , Hughes C.B. , Williams I.T. , Perz J.F. 
Published: May 2009

Background. De novo hepatitis C virus (HCV) infection among transplant patients is rarely recognized but can have severe consequences. We investigated the scope, source, and mode of HCV transmission within a transplant center after incident HCV infection was identified in 2 patients who had liver transplantation in late 2006.Methods. Patients were interviewed, and transplant logs, medical records, and staff practices were reviewed to identify opportunities for HCV transmission. Infection via receipt of blood or organs was evaluated. Molecular epidemiology was used to determine the relatedness between persons with incident and chronic HCV infection.Results. HCV from infected blood or organ donors was ruled out. Among the 308 patients who underwent transplant in 2006, no additional incident HCV infections were identified. Eighty‐five (28%) had pre‐transplant chronic HCV infection; 13 were considered possible HCV source patients based upon shared days on the inpatient unit, nursing assignment, or invasive procedures in common with incident HCV case‐patients. Viral isolates from 1 HCV source patient and 1 incident case‐patient were found to be highly related by quasispecies analysis, confirming patient‐to‐patient HCV transmission. Possible modes of transmission identified were the improper use of multidose vials, sharing of blood‐contaminated glucometers, and touch contamination.Conclusion. Sporadic transmission or endemic levels of HCV transmission might be overlooked in a setting with high HCV prevalence, such as liver transplant units, where multiple, repeated opportunities for patient‐to‐patient HCV transmission can occur. Surveillance through pre‐ and post‐transplant screening is necessary to identify incident HCV infection in this setting. Constant, meticulous attention must be paid to maintaining aseptic technique and good infection control practices to eliminate HCV transmission opportunities.
A randomized, controlled trial of banding ligation plus drug therapy versus drug therapy alone in the prevention of esophageal variceal rebleeding
Authors: Lo Gin‐Ho , Chen Wen‐Chi , Chan Hoi‐Hung , Tsai Wei‐Lun , Hsu Ping‐I , Lin Chiun‐Ku , Chen Tai‐An , Lai Kwok‐Hung 
Published: May 2009

AbstractBackground & Aims:  Both medications with beta‐blockers and isosorbide‐5‐mononitrate and endoscopic variceal ligation have been proven plausible in the prevention of variceal rebleeding. However, the relative efficacy and safety of the combined treatment for preventing rebleeding remains unresolved.Methods:  Patients with history of esophageal variceal bleeding were enrolled. Emergency ligation was performed in patients with acute variceal bleeding. After hemodynamic stability, eligible patients were randomized to either the Medication group, using nadolol plus isorsorbide‐5‐mononitrate, or the Combined group, receiving banding ligation in addition to medications. Patients in the two groups with rebleeding from esophageal varices were treated with band ligation. The end points were rebleeding from varices or death.Results:  After a median follow up of 23 months, recurrent upper gastrointestinal bleeding developed in 51% in the Medication group and 38% in the Combined group (P = 0.21). Recurrent bleeding from esophageal varices occurred in 26 patients (43%) in the Medication group and in 16 patients (26%) in the Combined group (P = 0.07). Recurrent bleeding from gastroesophageal varices occurred in 48% of Medication group and 28% of Combined group (P = 0.05). The frequency of adverse effects and mortality rates were similar between both groups (P = 0.28).Conclusions:  Combined ligation with medications was marginally more effective than medication alone in the prevention of gastroesophageal variceal rebleeding with similar adverse effects and mortality.
Efficacy of prepackaged, low residual test meals with 4L polyethylene glycol versus a clear liquid diet with 4L polyethylene glycol bowel preparation: A randomized trial
Authors: Park Dong Il , Park Seung Ha , Lee Sang Kil , Baek Yoo Hum , Han Dong Soo , Eun Chang Soo , Kim Won Ho , Byeon Jeong‐Sik , Yang Suk‐Kyun 
Published: May 2009

AbstractBackground and study aims:  A prepackaged low residue one‐day diet (breakfast, lunch and dinner) has been recently developed to improve patient tolerance for bowel preparation prior to colonoscopy. The aims of this study were to evaluate the efficacy and tolerability of bowel preparation protocols based on a low residue diet and 4L polyethylene glycol (PEG) solution, and to compare these new options with the traditional liquid diet and the PEG 4L lavage.Methods:  A total of 214 patients (mean age: 54.1 years; 120 male, 94 female) from four university hospitals were included in the analysis. Patients were randomized to receive a clear liquid diet and the PEG 4L regimen (106 patients) or the low residue test meals and the PEG 4L regimen (TM‐PEG 4L, 108 patients). The colon cleansing efficacy of the different preparations was rated using the Ottawa bowel preparation scale.Results:  No significant differences were observed between the treatment groups according to the Ottawa cleansing scale findings (PEG 4L: 2.97 vs TM‐PEG 4L: 2.46, P = 0.063). The overall tolerability was higher in the TM‐PEG 4L group than in the PEG 4L group (P = 0.036). No difference was found when the two groups were compared with regard to adverse events (P = 0.599).Conclusions:  A prepackaged low residue one‐day diet provided cleansing efficacy similar to that of a clear liquid diet and offered the benefit of improved tolerability compared to the conventional PEG 4L regimen.
Reflux profile of Chinese gastroesophageal reflux disease patients with combined multichannel intraluminal impedance‐pH monitoring
Authors: Xiao Ying L , Lin Jin K , Cheung Ting K , Wong Nina Y H , Hung Ivan F N , Wong Benjamin C Y , Peng Sui , Wang An J , Chen Min H 
Published: May 2009

AbstractBackground and Aims:  To investigate the reflux profile of Chinese gastroesophageal reflux disease (GERD) patients with the aid of combined multichannel intraluminal impedance‐pH (MII‐pH) monitoring technique.Methods:  Consecutive patients presented with GERD symptoms were enrolled to erosive esophagitis (EE) group, non‐erosive reflux disease (NERD) group and functional heartburn (FH) group after upper endoscopy, combined MII‐pH monitoring and rabeprazole test. Another 20 healthy controls (HC) were recruited.Results:  Sixty‐four GERD patients (EE:20, NERD:22, FH:22, HC:20) were enrolled. There were more episodes of liquid reflux and proximal reflux in EE and NERD groups than that in FH and HC groups (P < 0.05). Patients in FH and HC groups had higher proportion of mixed reflux (P = 0.000). The percentage of acid reflux in EE and NERD was much higher, while there was a higher percentage of weakly acidic reflux in FH and HC (P = 0.000). No significant difference was found in MII‐pH parameters between groups with and without response to rabeprazole test except recumbent percentage time of esophageal pH value below 4 and episodes of proximal reflux.Conclusion:  Erosive esophagitis and NERD patients had more liquid and proximal reflux episodes than FH patients and healthy controls. Acid and liquid reflux was predominant in the former two groups, while weakly acidic and mixed reflux was predominant in the latter two groups.
Open‐labeled pilot study of cysteine‐rich whey protein isolate supplementation for nonalcoholic steatohepatitis patients
Authors: Chitapanarux Taned , Tienboon Prasong , Pojchamarnwiputh Suwalee , Leelarungrayub Donrawee 
Published: May 2009

AbstractBackground and Aims:  Glutathione (GSH) depletion contributes to liver injury and development of steatohepatitis. Undenatured cysteine‐rich whey protein isolate has been clinically proven to raise GSH in several patient groups. The aim of this study was to evaluate the effect of oral supplementation with whey protein on patients with nonalcoholic steatohepatitis (NASH).Methods:  In an open‐labeled clinical trial, 38 patients (18 male, 20 female; mean age 48 ± 14 years) with NASH confirmed by computed tomography measurements and liver biochemistries were given with a daily dose of 20 g whey protein isolate for 12 weeks.Results:  A significant reduction in alanine aminotransferase (ALT) (64 ± 72 vs 46 ± 36, P = 0.016) and aspartate aminotransferase (AST) (45 ± 49 vs 33 ± 18, P = 0.047) were observed. Plasma glutathione and total antioxidant capacity increased significantly at the end of study (53 ± 11 vs 68 ± 11, P < 0.05 and 1.26 ± 0.10 vs 2.03 ± 0.10, P < 0.05). Liver attenuation index improved from −13.4 ± 11.1 to −9.7 ± 13.1 (P = 0.048). Hepatic macrovesicular steatosis decreased significantly after 12 weeks of supplementation (33.82 ± 12.82 vs 30.66 ± 15.96, P = 0.046). Whey protein isolate was well tolerated. No serious adverse events were observed.Conclusions:  The results indicate that oral supplementation of cysteine‐rich whey protein isolate leads to improvements in liver biochemistries, increased plasma GSH, total antioxidant capacity and reduced hepatic macrovesicular steatosis in NASH patients. The results support the role of oxidative stress in the pathogenesis of this disease.
Disease pattern and seasonal variation among Japanese expatriate children in Thailand
Authors: Sakai Rie , Marui Eiji , Wongkhomthong Som‐Arch , Laobhripatr Suchart 
Published: May 2009

AbstractBackground:  Due to recent globalization, the number of Japanese expatriates including children has increased. The aim of the present study was to clarify the disease patterns and seasonal variation among Japanese children living in Thailand.Methods:  Records of Japanese children seen at the outpatient clinic at Bangkok Hospital in 2005 (n = 1668) were analyzed and records of Thai children (n = 23 339) were also analyzed for comparison.Results:  ‘Diseases of the respiratory system’ was the most frequent category in both groups (Japanese, 42.1%; Thai, 45.0 %,) followed by ‘factors influencing health status and contact with health services’ (Japanese, 12.7%; Thai, 14.9%), and ‘certain infectious and parasitic diseases’ (Japanese, 10.3%; Thai, 8.5%). The number of hospital visits by Japanese patients decreased in January, April, August and December and those by Thai patients in April and September. Identical drops in the number of visits for diseases of the respiratory system were also seen. A large number of patients visited the hospital for viral infections characterized by skin and mucous membrane lesions during the rainy season. The number of hospital visits for intestinal infection fluctuated during the rainy season.Conclusion:  There were no marked differences between disease patterns of Japanese patients and Thai patients. Temporary visits back to Japan could account for sharp drops in total hospital visits and hospital visits for diseases of the respiratory system in January, April, August and December because these times of the year corresponded to extended school vacations. Preventive measures for viral infections characterized by skin and mucous membrane lesions should be promoted during the rainy season.
Pentaschistis (Poaceae) diversity in the Cape mediterranean region: habitat heterogeneity and climate stability
Authors: Galley C. , Linder H. P. , Zimmermann N. E. 
Published: May 2009

ABSTRACTAim  To evaluate the role of habitat heterogeneity on species richness and turnover in the mega species‐rich Cape Floristic Region (Cape), the mediterranean region of southern Africa.Location  The Cape and Drakensberg regions of southern Africa.Methods  Bioclimatic data were used to estimate habitat amount and habitat heterogeneity in the Cape and Drakensberg regions; these data were then used to explain the patterns of species diversity in the Pentaschistis clade (Poaceae) in these two regions. Habitat variables were used to create ‘bioclimatic units’ to characterize 1′× 1′ cells in southern Africa and to describe the niches of species. Using these bioclimatic units, the niche and range sizes of species in the two regions were compared. A phylogram was used to test for age and lineage effects.Results  Pentaschistis species diversity and turnover are higher in the Cape than the Drakensberg. There is no significant difference in the habitat amount and heterogeneity between the two regions. Species occupy the same range of estimated niche sizes, yet there are significantly more range‐restricted Pentaschistis species in the Cape.Main conclusions  The roles of age‐ and lineage‐related effects are rejected; biodiversity differences lie in the regions. Current macrohabitat does not explain the differences in biodiversity between the two regions. The larger number of range‐restricted species in the Cape cannot be explained by dispersal mechanism or the occupation of range‐restricted habitats. Species of Pentaschistis and other Cape clades share characteristics associated with species from historically climatically stable areas, and palaeoclimatic and palaeontological evidence indicates the Cape climate has been more stable than the Drakensberg climate throughout the Pleistocene. We conclude that the corresponding lack of extinction might have allowed an accumulation of species in the Cape. Similar climatic and biological evidence for the south‐west Australian Floristic and Mediterranean regions indicate that the same mechanism might explain the high species richness of these mediterranean regions.
Short‐ and long‐term effects of endurance training in patients with mitochondrial myopathy
Authors: Jeppesen T. D. , Dunø M. , Schwartz M. , Krag T. , Rafiq J. , Wibrand F. , Vissing J. 
Published: May 2009

Background and purpose:  It is unknown whether prolonged training is a safe treatment to alleviate exercise intolerance in patients with mitochondrial DNA (mtDNA) mutations.Methods:  The effect of 3 and 12 months training and 3–12 months deconditioning was studied in four patients carrying different mtDNA mutations.Results:  Three‐month moderate‐intensity training increased oxidative capacity by 23%, which was sustained after 6–12 months of low‐intensity training. Training and deconditioning did not induce adverse effects on clinical symptoms, muscle morphology and mtDNA mutation load in muscle.Conclusion:  Long‐term training effectively improves exercise capacity in patients with mitochondrial myopathy, and appears to be safe.
Arithmetic difficulties in children with cerebral palsy are related to executive function and working memory
Authors: Jenks Kathleen M. , De Moor Jan , Van Lieshout Ernest C.D.M. 
Published: May 2009

Background:  Although it is believed that children with cerebral palsy are at high risk for learning difficulties and arithmetic difficulties in particular, few studies have investigated this issue.Methods:  Arithmetic ability was longitudinally assessed in children with cerebral palsy in special (n = 41) and mainstream education (n = 16) and controls in mainstream education (n = 16). Second grade executive function and working memory scores were used to predict third grade arithmetic accuracy and response time.Results:  Children with cerebral palsy in special education were less accurate and slower than their peers on all arithmetic tests, even after controlling for IQ, whereas children with cerebral palsy in mainstream education performed as well as controls. Although the performance gap became smaller over time, it did not disappear. Children with cerebral palsy in special education showed evidence of executive function and working memory deficits in shifting, updating, visuospatial sketchpad and phonological loop (for digits, not words) whereas children with cerebral palsy in mainstream education only had a deficit in visuospatial sketchpad. Hierarchical regression revealed that, after controlling for intelligence, components of executive function and working memory explained large proportions of unique variance in arithmetic accuracy and response time and these variables were sufficient to explain group differences in simple, but not complex, arithmetic.Conclusions:  Children with cerebral palsy are at risk for specific executive function and working memory deficits that, when present, increase the risk for arithmetic difficulties in these children.
A typology of reviews: an analysis of 14 review types and associated methodologies
Authors: Grant Maria J. , Booth Andrew 
Published: May 2009

AbstractBackground and objectives:  The expansion of evidence‐based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains.Methods:  Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework—Search, AppraisaL, Synthesis and Analysis (SALSA)—was used to examine the main review types.Results:  Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain.Conclusions:  Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.
Potential of Fortified Fibrin/Hyaluronic Acid Composite Gel as a Cell Delivery Vehicle for Chondrocytes
Authors: Park Sang‐Hyug , Cui Ji Hao , Park So Ra , Min Byoung‐Hyun 
Published: May 2009

AbstractNumerous treatment methods have been applied for use in cartilage repair, including abrasion, drilling, and microfracture. Although chondrocyte transplantation is the preferred treatment, it has some shortcomings, such as difficulty of application (large and posterior condylar regions), poor chondrocyte distribution, and potential cell leakage from the defect region. The cell delivery system of the tissue engineering technique can be used to overcome these shortcomings. We chose fibrin/hyaluronan (HA) composite gel as an effective cell delivery system to resolve these issues. Both components are derived from natural extracellular matrix. In the first trial, fortified fibrin/HA composite gels with rabbit chondrocytes were tested by implantation in nude mice. At 4 weeks, glycosaminoglycan contents in the fibrin/HA composite (0.186 ±  0.006 mg/mg) were significantly higher than those in the presence of fibrin alone (0.153 ± 0.017 mg/mg). As a next step, we applied the fibrin/HA composite gel to animal cartilage defects using full thickness cartilage defect rabbit models. The fibrin/HA composite gel with rabbit chondrocytes (allogenic) was implanted into the experimental group, and the control group was implanted with the fibrin/HA composite gel alone. Implanted chondrocytes with the fibrin/HA composite showed improved cartilage formation. In conclusion, the key to successful regeneration of cartilage is to provide the repair site with a sufficient supply of chondrogenic cells with a suitable delivery vehicle to ensure maximal differentiation and deposition of the proper extracellular matrix. This study suggests the feasibility of tissue‐engineered cartilage formation using fibrin/HA composite gel.