bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Placental Barrier in Allogenic Immune Conflict in Spontaneous Early Abortions: Immunohistochemical and Morphological Study
Authors: Gurevich Pavel , Elhayany Asher , Milovanov Andrey P. , Halperin Reuvit , Kaganovsky Ella , Zusman Itzhak , Ben‐Hur Herzel 
Published: September 2007

ProblemMorphologic changes in the placental barrier in spontaneous early abortions under the maternal‐embryonic immune conflict, and the role of maternal immunoglobulins (Igs) in these changes.Materials and methodsWe examined chorionic villi and other tissues obtained from 54 aborts between weeks 3.5 and 8 of pregnancy. Material was divided into two groups. Group 1 (control) contained 15 medically recommended and spontaneous early aborts with no signs of inflammations or pathologic immune processes. Group 2 contained 39 spontaneous early aborts with acute chorionic villitis. Immunohistochemical and morphometric methods were used to study the Igs, different types of immunocompetent cells, and apoptosis‐related components of the placental barrier.ResultsAcute villitis was found to be characterized by the destruction of all components of the chorionic villi, thrombovasculitis with apoptosis of the endothelium of capillaries and erythroblasts, mucous swelling of the basal membrane, and coagulation of the blood proteins. Due to destruction of the capillaries, the number of avasculate villi increased, and the average number of capillaries per villus decreased. The extremely high number of phagolysosomes with IgG and IgA in the villous monocytes in the group 2 indicates an increase in the phagocytic activity of monocytes against maternal Igs and may reflect the presence of mother‐embryo immune conflict. Apoptosis of monocytes and a high number of promonocytes were seen accompanied by a high concentration of p53 protein. A large disturbance in the trophoblast occurred with disappearance of bcl‐2 and the appearance of Fas ligand.ConclusionMassive destruction of maternal Igs in embryonic monocytes and acute villitis in the placental barrier are manifested during the mother‐embryo immune conflict, and this may be one of the reasons of spontaneous early abortions.
The perception of emotional facial expressions in stroke patients with and without depression
Authors: Montagne Barbara , Nys Gudrun M. S. , van Zandvoort Martine J. E , Kappelle L. Jaap , de Haan Edward H. F , Kessels Roy P. C. 
Published: September 2007

Background:Emotion perception may be impaired after stroke. No study on emotion perception after stroke has taken the influence of post-stroke depressive symptoms into account, although depressive symptoms themselves may hamper emotion perception.Objective:To compare the perception of emotional facial expressions in stroke patients with and without depressive symptoms.Methods:Twenty-two stroke patients participated whose depressive symptoms were classified using the Montgomery-Åsberg Depression Rating Scale (cutoff = 10) and who were compared with healthy controls. Emotion recognition was measured using morphed images of facial expressions.Results:Patients with depressive symptoms performed worse than controls on all emotions; patients without depressive symptoms performed at control level. Patients with depressive symptoms were less sensitive to the emotions anger, happiness and sadness compared with patients without depressive symptoms.Conclusions:Post-stroke depressive symptoms impair emotion perception. This extends findings in bipolar disorder indicating that emotion perception deficits are strongly related to the level of depression.
Four cases of congenital airway obstruction: optimising perinatal management
Authors: McDevitt Helen , Kubba Haytham , Macara Lena , Reynolds Ben , Simpson Judith 
Published: September 2007

AbstractCongenital anomalies causing airway obstruction in the newborn are potentially fatal. However if an effective airway can be maintained the long‐term prognosis is often excellent. We present four cases of airway obstruction, three of which were diagnosed antenatally. We discuss the role of antenatal imaging and review delivery options including the need for a multidisciplinary team approach. In conclusion, we recommend antenatal imaging with both ultrasound scan and magnetic resonance to inform perinatal management. Polyhydramnios, in association with suspected neonatal airway obstruction, should alert clinicians to a high‐risk situation. We recognize that even in skilled hands, securing an airway can be very difficult and alternatives such as maintenance of the fetomaternal circulation or extra‐corporeal life support should be considered.
Transpyloric feeding in gastroesophageal‐reflux–associated apnea in premature infants
Authors: Misra Sudipta , Macwan Kamlesh , Albert Viola 
Published: September 2007

AbstractObjective: The aetiological role of gastroesophageal reflux in apnea of prematurity is controversial. We hypothesized that transpyloric feeds, which decreases reflux and aspiration, will not be associated with decrease in reflux‐related apnea.Study design: The shows retrospective chart review of 41 premature babies on transpyloric feeds. Fifteen infants meeting the inclusion criteria of apnea of prematurity and clinical evidence of gastroesophageal reflux were included. Primary data points were number of apneas before and after transpyloric feeds. t‐statistics was used for analysis.Results: Twelve of the 15 babies showed significant improvement on transpyloric feeds (p <. 005). The nonresponders were identified within 48 h. After discontinuation of transpyloric feeds, 2 responders underwent antireflux surgery and 9 were discharged without further intervention. No transpyloric‐tube–related complication was documented.Conclusion: Transpyloric feeds may be useful for diagnosis and management of suspected gastroesophageal‐reflux–associated apnea in a selected group of infants.
Individualized developmental care in a Dutch NICU: short‐term clinical outcome
Authors: Wielenga JM , Smit BJ , Merkus MP , Kok JH 
Published: September 2007

AbstractAim: To compare the short‐term clinical outcomes of Newborn Individualized Developmental Care and Assessment Program (NIDCAP®) and conventional care.Methods: A prospective phase‐lag cohort study was performed in a Dutch tertiary level neonatal intensive care unit (NICU). Infants born before 30 weeks of gestational age (GA) were included, 26 in the conventional and 25 in the NIDCAP group. Outcomes were respiratory status, cerebral ultrasound findings, growth and length of NICU stay.Results: At study entry, NIDCAP infants had a lower birth weight (mean [SD]: 1043 [191] vs. 1154 [174] g, p = 0.044), were more often small for GA (8 vs. 2, p = 0.038), had smaller head circumferences (mean [SD]: 25.1 [1.3] vs. 26.1 [1.8] cm, p = 0.041) and were less often multiples (6 vs. 14, p = 0.029) than conventional care infants. During NICU stay, more infants in the NIDCAP group developed pneumonia (9 vs. 3, p = 0.040) due to nosocomial infections. After adjustment for these differences, a decreased risk for more severe cerebral damage in favour of NIDCAP was seen (Odds ratio: 0.12, 95% CI: 0.03–0.46, p = 0.002). No differences were observed for the other outcomes.Conclusions: We conclude with precaution that in this phase‐lag cohort study NIDCAP may have resulted in less severe cerebral damage, but was not associated with other clinical outcomes. In light of these findings, NIDCAP deserves further exploration.
Acute decrease of coronary flow after indomethacin delivery in newborn lambs
Authors: Harling Solweig , Oskarsson Gylfi , Gudmundsson Saemundur , Pesonen Erkki 
Published: September 2007

AbstractAim: To document the effects of indomethacin (IND) on coronary flow.Methods: We studied nine premature lambs during the first day of life. The gestational age varied between 132 and 134 days (term 145 days) and weight 3.1–4.7 kg. Coronary flow velocities were recorded with an intracoronary Doppler guide wire in the proximal left anterior descending coronary artery (LAD). Average peak flow velocity was measured before, during and after an intravenous IND injection of 0.2 mg per kilogram of body weight.Results: IND increased systemic blood pressure (p < 0.05) and rate pressure product (RPP; p < 0.05) indicating that IND increased cardiac workload. IND decreased coronary average peak flow velocity in all lambs (p < 0.05). The maximal fall in coronary velocity appeared after 3 min (range 1–7 min) and was regained 10 min (range 4–53 min) after the drug delivery. The maximal reduction of coronary average peak flow velocity was 52% (median 26). The recovery time was directly related to the maximal reduction of the coronary average peak flow velocity (R = 0.91, R2 0.84, p < 0.002).Conclusion: Coronary flow velocity decreased markedly in premature born lambs given a bolus dose of IND.
Persisting high hospital and community childhood mortality in an urban setting in Guinea‐Bissau
Authors: Veirum Jens Erik , Biai Sidu , Jakobsen Marianne , Sandström Anita , Hedegaard Kathryn , Kofoed Poul Erik , Aaby Peter , Sodemann Morten 
Published: September 2007

AbstractAim: To describe paediatric hospitalization in a West African capital in relation to overall childhood mortality in the community and to evaluate the potential impact of improved management at the hospital.Methods: Hospital data on child admissions in a 6‐year period were linked to information in a community‐based longitudinal surveillance system. Paediatric hospitalization rates, risk factors for hospitalizations, community mortality, in‐hospital mortality and the proportion of deaths occurring at hospital were examined.Results: Almost 15% of infants and 45% of children less than 5 years of age had been hospitalized, and 24% of all deaths in the community occurred in‐hospital. Community infant and under‐three mortality rates were 110 and 207 per 1 000 person‐years, respectively. In‐hospital mortality remained persistently high from 1991 to 1996 and the overall in‐hospital mortality was 12%. It was found that wet season, lack of maternal schooling and living in a specific district were significant risk factors for both community and in‐hospital death, whereas higher hospitalization rates were associated with better‐off families.Conclusion: In populations with high hospitalization rates, even minor improvements in acute case management of sick children attending the hospital would be expected to result in substantial reduction in overall childhood mortality. Persistently high acute in‐hospital mortality reflects the need of immediate and appropriate care at the hospital. Treatment should be free of charge, in order to minimize the impact of social inequality.
Coeliac disease and cornelia de Lange Syndrome: lack of association
Authors: Macchini Francesco , Selicorni Angelo , Luzzani Sergio , Milani Donatella , Roggero Paola , Valadè Alberto 
Published: September 2007

AbstractObjectives: Cornelia de Lange syndrome (CdLS) is a dominantly inherited disorder characterized by growth and mental retardation, abnormalities of the upper limbs, gastroesophageal dysfunction, cardiac, ophthalmologic and genitourinary anomalies, hirsutism and characteristic facial features. Growth retardation, behavioural disturbances and gastro‐intestinal manifestations can mimic coeliac disease (CD). Genetic conditions like Down, Williams and Turner syndromes can be associated to CD.Aim: To establish if gastro‐intestinal signs and symptoms in CdLS patients are due to CD.Methods: Multiple duodenal biopsies were performed in 24 CdLS patients (mean age 12 years) during the endoscopic follow‐up for gastro‐esophageal reflux disease (GERD). Histological assessment was performed. Anthropometric parameters were recorded and plotted on the growth charts specific for CdLS patients. Antiendomysium and antitransglutaminase antibodies and HLA‐DQ2/DQ8 were tested in all patients.Results: All CdLS patients were growth retarded, although weight and height were within the normal limits using the specific growth charts for CdLS. No histological abnormalities were noted in the intestinal biopsy specimens. Serum levels of antiendomysium and antitransglutaminase antibodies were always normal. The HLA‐DQ2/DQ8 was absent in all patients.Conclusions: While a high prevalence of gastro‐intestinal disorders has been described in CdLS children, no association with CdLS has been found.
Differences in the length of initial hospital stay in very preterm infants
Authors: Korvenranta Emmi , Linna Miika , Häkkinen Unto , Peltola Mikko , Andersson Sture , Gissler Mika , Hallman Mikko , Korvenranta Heikki , Leipälä Jaana , Rautava Liisi , Tammela Outi , Lehtonen Liisa ,   PERFECT Preterm Infant Study Group
Published: September 2007

AbstractAim: To investigate the effect of maternal, infant and birth hospital district related factors on the length of initial hospital stay in very preterm infants. In addition, rehospitalization rate within the first year from the initial discharge was studied.Methods: A register study covering all very preterm infants (gestational age < 32 weeks or birthweight < 1501 g) born alive in Finland between years 2000 and 2003 (N = 2148). Factors affecting length of stay (LOS) were studied using generalized linear model (GLM).Results: The proportion of very preterm infants born in a level III unit varied in the hospital districts from 53% to 94%. Median LOS was 53 days (interquartile range: 38–76). There were large regional differences in the LOS, the difference being up to 10.5 days among the hospital districts (p < 0.0001). Rehospitalization rate was 47.2% within the first year from the initial discharge, and the absence of rehospitalization was associated with a 4.1 days shorter initial LOS (p < 0.0001).Conclusion: Our study showed large regional variation in LOS of very preterm infants despite similar case mix. We speculate that the variation depends on differences in treatment practices and discharge criteria.
Risk factors related to intention to breastfeed, early weaning and suboptimal duration of breastfeeding
Authors: Ladomenou Fani , Kafatos Anthony , Galanakis Emmanouil 
Published: September 2007

AbstractAim: To identify maternal and infantile factors affecting intention to breastfeed, early weaning and duration of breastfeeding.Design/subjects: In a prospective cohort study, 1049 mothers were interviewed after delivery and at 1, 3, 6, 9 and 12 months post‐partum.Results: Of 1049 mothers, 942 (89.7%) intended to breastfeed. Negative attitude was associated with lack of breastfeeding previous offspring, multiparity, admission to neonatal ward, tobacco use, prematurity and male gender (OR: 10.1, 2.67, 3.02, 2.63, 2.40 and 1.54, respectively). Six hundred and twenty‐three mothers (60.7%) were breastfeeding at month 1. Early weaning was associated with lack of breastfeeding previous offspring, tobacco use, prematurity, admission to neonatal ward, caesarean section (OR: 12.3, 3.39, 2.33, 2.22, 1.34), low education (p < 0.0001) and young age (p = 0.034). Factors negatively affecting total duration of breastfeeding included lack of breastfeeding previous offspring (3.91 vs. 16.2 weeks, p < 0.001), tobacco use (6.78 vs. 15.9 weeks, p < 0.001), low education (p < 0.001), early re‐employment (12.5 vs. 15.1 weeks, p < 0.01) and prematurity (p < 0.005).Conclusion: Maternal negative attitude, tobacco use and early re‐employment are factors negatively affecting breastfeeding that can be liable to intervention. All health professionals involved in perinatal medicine share a part of responsibility in sustaining breastfeeding, particularly in high‐risk groups of mothers.
Safety and efficacy of subcutaneous human immunoglobulin in children with primary immunodeficiency
Authors: Fasth Anders , Nyström Jeanette 
Published: September 2007

AbstractThe primary objective of this prospective, open‐label study was to evaluate the safety and tolerability of home treatment with a 16%, ready‐to‐use, human normal immunoglobulin solution for subcutaneous administration (SCIg 16%, Subcuvia®, Baxter Medical AB, Kista, Sweden) in children with primary immunodeficiency (PI) previously receiving intravenous immunoglobulins (IVIg) treatment. Secondary objectives were to evaluate the efficacy of SCIg 16% through documented bacterial infections, IgG trough levels, quality of life (Child Health Questionnaire [CHQ]), healthcare resource utilization and patient preference.Twelve patients with PI were included in the study. There were no significant changes from baseline in vital signs or laboratory parameters. Most adverse events (311 of 328) were mild injection site reactions that, in most cases, resolved after 1–2 months. SCIg 16% maintained consistently high IgG trough levels, and the rate of bacterial infections was not different from that seen with previous IVIg treatment. SCIg treatment was also associated with significantly fewer lost work and school days and lower direct healthcare‐related expenses and time consumed due to hospital or physician visits.Conclusion: Home‐based SCIg treatment was well tolerated, at least as effective as IVIg for preventing infections, and preferred by children with PI previously receiving IVIg treatment.
Managerial Leadership for Nurses' Use of Research Evidence: An Integrative Review of the Literature
Authors: Gifford Wendy , Davies Barbara , Edwards Nancy , Griffin Pat , Lybanon Vanessa 
Published: September 2007

ABSTRACT Background: Integration of research evidence into clinical nursing practice is essential for the delivery of high‐quality nursing care. Leadership behaviours of nurse managers and administrators have been identified as important to support research use and evidence‐based practice. Yet minimal evidence exists indicating what constitutes effective nursing leadership for this purpose, or what kinds of interventions help leaders to successfully influence research‐based care. Aims: (1) To describe leadership activities of nurse managers that influence nurses' use of research evidence; and (2) to identify interventions aimed at supporting nurse managers to influence research use in clinical nursing practice. Methods: A search of electronic databases was conducted for studies on behaviours or activities of nurse managers/administrators and the use of research evidence by nurses. Sifting, screening, and quality assessments were done by two reviewers. Results were synthesized by study type (quantitative and qualitative) and reported. Results: Twelve studies met inclusion criteria (eight quantitative, four qualitative). Three activities were found in quantitative studies that influenced nurses' use of research: managerial support, policy revisions, and auditing. Qualitative studies showed organizational issues as barriers to managers' abilities to affect research use, while role modeling and valuing research facilitated research use. Four studies, one of which was experimental, included an intervention to support managers, but all had insufficient information about leadership development. Conclusions: To date, important descriptive work highlights the strategic role managers have in research transfer. Both facilitative and regulatory activities appear to be necessary for mangers to influence research use. These findings have important implications for evolving theoretical models describing factors that affect the process of research utilization. It is time to move the science forward and test a hypothesis linking leadership to outcomes. Qualitative methods are essential for understanding the process of leadership for research transfer.
Route of administration of redback spider bite antivenom: Determining clinician beliefs to facilitate Bayesian analysis of a clinical trial
Authors: Brown Simon G A , Isbister Geoffrey K , Stokes Barrie 
Published: September 2007

AbstractObjective:  To determine current beliefs of Australasian emergency physicians, to form the basis of ‘stopping rules’ for a clinical trial of intravenous (i.v.) versus intramuscular (i.m.) redback spider antivenom.Methods:  An email survey of fellows and trainees of the Australasian College for Emergency Medicine.Results:  There were 218 responses; 30% used the i.v. route exclusively, 16% used the i.m route exclusively, 17% used i.m. followed by i.v. if there was a poor initial clinical response, and 38% stated that they had no particular preference. The probability given by respondents that the i.v. route is superior allowed us to differentiate ‘i.v. enthusiasts’ from ‘i.v. sceptics’. Median predicted response rates were 90% versus 80% for the i.v. route and 60% versus 75% for the i.m. route in the enthusiastic and sceptical groups, respectively. The median expected absolute advantage of i.v. compared with i.m. antivenom was 20% versus 5%, respectively. The median number‐needed‐to‐treat threshold that would lead respondents to choose the i.v. route in preference to the i.m. was 5.Conclusion:  Australasian emergency physicians have polarized views on the optimal route for administering redback spider antivenom. We were therefore able to define both sceptical and enthusiastic priors for a fully Bayesian trial analysis. Our findings support using a number needed to treat of 5 (20% absolute advantage) for powering a clinical study and for determining the point at which it should be stopped.
Two new highly polymorphic markers in the 3′ UTR region of the PLA2G7 gene
Authors: Lira M. Gomez , Provezza L. , Terranova C. , Martinelli N. , Bozzini C. , Pignatti P. F. 
Published: September 2007

SummaryWe described two new highly polymorphic markers located 31 bp downstream of the last nucleotide of exon 12 in the 3′ UTR region of the gene PLA2G7: 1344 +31TGn AGm. Eight and 14 alleles were observed for the AG and TG repeats, respectively. These two markers have the highest heterozygosity until now reported for PLA2G7 gene.
Vegetation of the Stipa loess steppe in Ningxia (northern China) in relation to grazing intensity
Authors: Xie Yingzhong , Becker Ute , Wittig Rüdiger 
Published: September 2007

AbstractLarge areas of northern and western China are covered with steppe vegetation which is grazed with different intensities. Areas which are not or only slightly grazed are rare and mostly exist in nature reserves. We investigated floristic composition and species diversity of the steppe vegetation of the autonomous region Ningxia Hui with emphasis on the Yunwushan dry steppe nature reserve in relation to grazing intensity; all 77 plots were analyzed using ordination techniques, and the relationship between the variation in species composition and environmental conditions was analyzed. In Ningxia, two types of loess grass steppes prevail: in areas with lower altitudes from approximately 1650–1950 m a.s.l., the Stipa bungeana steppe occurs whereas the Stipa grandis steppe is typical for higher altitudes between 1900 and 2100 m a.s.l. For both vegetation types, three subtypes can be distinguished according to different levels of grazing intensity. With increasing grazing intensity, the number of plant species per plot strongly declines and the typical steppe vegetation types are dominated by Artemisia species (A. frigida in the Stipa grandis community and A. sacrorum in the Stipa bungeana community). In contrast to studies carried out in neighboring areas, in our study area the Artemisia steppes do not represent the final state of degradation. Instead, Convolvulus ammanii dominates in heavily grazed areas of both Stipa steppe types. Detrended correspondence analysis confirms the classification and shows that the heavily grazed subtypes of the Stipa grandis and the Stipa bungeana steppe with Convolvulus ammanii are more similar to each other than the other vegetation types. The first axis of the detrended correspondence analysis is strongly related to the grazing intensity (r = 0.93). Our results show that grazing intensity is an important factor for the differentiation of the steppe grasslands and a severe threat to species diversity.