bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are general practitioners equipped to detect child overweight/obesity? Survey and audit
Authors: Gerner Bibi , McCallum Zoe , Sheehan Jane , Harris Claire , Wake Melissa 
Published: March 2006

Aim:  To ascertain the extent to which general practitioners (GPs) routinely weigh, measure and calculate body mass index (BMI) in children, and to assess the accuracy and accessibility of their anthropometric equipment.Methods:  A convenience sample of 34 GPs from 29 primary care family medical practices in Melbourne, Australia, completed a questionnaire regarding their routine anthropometric practice for 5–10‐year‐old children and perceived role in managing childhood overweight and obesity. Practice audits (April–June 2002) assessed the accuracy and accessibility of anthropometric equipment.Results:  Forty‐four per cent of GPs reported regularly weighing children; 38% regularly measured children's height. Only one regularly calculated children's BMI. Formal training in child anthropometry and servicing of anthropometric equipment was rare. The majority of equipment was accessible. Stadiometers on average measured the height of a ‘short’ pole (true height 92.68 cm) as 92.52 cm (SD = 0.8), and measured the height of a ‘tall’ pole (true height 157.64 cm) as 157.55 cm (SD = 0.9). On average, calibration weights of 20 kg and 80 kg were recorded as 19.7 kg (SD = 0.6) and 79.2 kg (SD = 1.5) respectively. Despite these shortcomings, these GPs generally felt they played a key role in managing overweight in children.Conclusions:  Self‐reported practice by these GPs falls well short of 2003 National Health and Medical Research Council guidelines recommending bi‐annual measuring of all children in the primary care setting. The variability of anthropometric equipment audited could result in widely discrepant BMI values, leading to serious misclassification of many children's weight status.
Anesthesia for sickle cell disease and congenital myopathy in combination
Authors: FANNING REBECCA , O'DONNELL BRIAN , LYNCH BRIAN , STEPHENS MICHAEL , O'DONOVAN FRANCES 
Published: March 2006

SummaryWe report on the perioperative management of anesthesia and analgesia in a child with sickle cell disease and a congenital myopathy, presenting for corrective orthopedic surgery. The case illustrates two valuable points of interest: the many benefits of regional anesthesia in complex medical cases and the successful use of tourniquets in children with sickle cell disease.
Perioperative cardiac arrest and its mortality in children. A 9‐year survey in a Brazilian tertiary teaching hospital
Authors: GOBBO BRAZ LEANDRO , BRAZ JOSÉ REINALDO CERQUEIRA , MÓDOLO NORMA SUELI PINHEIRO , NASCIMENTO PAULO DO , BRUSHI BRUNO AUGUSTO MOURA , RAQUEL DE CARVALHO LÍDIA 
Published: March 2006

SummaryBackground:  The incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods:  The incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia‐related, partially anesthesia‐related, totally surgery‐related, or totally child disease or condition‐related.Results:  There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) – four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication‐related events (28.5%).Conclusions:  Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.
Epidural analgesia in a patient with an intrathecal catheter and subcutaneous pump to deliver baclofen
Authors: PIPER NATALIA A. , FLACK SEAN H. , LOESER JOHN D. , LYNN ANNE M. 
Published: March 2006

SummaryBaclofen is used for the treatment of spasticity. Small doses administered intrathecally achieve high cerebrospinal fluid concentrations with reduced side‐effects. Pediatric anesthesiologists are often reluctant to consider epidural analgesia in children receiving baclofen via an intrathecal catheter and subcutaneous pump. This reluctance is based on concerns for damaging the intrathecal catheter and introducing infection. In addition, the acute cessation of intrathecal baclofen can precipitate a life‐threatening withdrawal state. We report a case of successful epidural analgesia in a patient receiving intrathecal baclofen and discuss the steps we took to minimize the chance of harm with this technique. We conclude that an intrathecal catheter and subcutaneous pump to deliver baclofen should not preclude the use of an epidural catheter for perioperative analgesia.
Evaluation of in vitro antimicrobial activity of Thai basil oils and their micro‐emulsion formulas against Propionibacterium acnes
Authors: Viyoch J. , Pisutthanan N. , Faikreua A. , Nupangta K. , Wangtorpol K. , Ngokkuen J. 
Published: March 2006

SynopsisThe aim of this study was to evaluate the efficacy of Thai basil oils and their micro‐emulsions, on in vitro activity against Propionibacterium acnes. An agar disc diffusion method was employed for screening antimicrobial activity of the essential oils of Ocimum basilicum L. (sweet basil), Ocimum sanctum L. (holy basil) and Ocimum americanum L. (hoary basil) against P. acnes. Minimum inhibitory concentration (MIC) values of the basil oils were determined using an agar dilution assay. The obtained results indicated that the MIC values of sweet basil and holy basil oils were 2.0% and 3.0% v/v, respectively, whereas hoary basil oil did not show activity against P. acnes at the highest concentration tested (5.0% v/v). Gas chromatography‐mass spectrometry analysis revealed that methyl chavicol (93.0%) was the major compound in sweet basil oil, and eugenol (41.5%), γ‐caryophyllene (23.7%) and methyl eugenol (11.8%) were major compounds in holy basil oil. Hoary basil oil contained high amounts of geraniol (32.0%) and neral (27.2%) and small amounts of methyl chavicol (0.8%). The Oil‐in‐water (o/w) micro‐emulsions of individual basil oils with concentrations corresponding to their MIC values were formulated. The stable o/w micro‐emulsion system for basil oil consisted of 55.0% v/v water phase, 10.0% v/v oil phase (2.0 or 3.0% v/v sweet basil or 3.0% v/v holy basil oil plus 7.0% v/v isopropyl myristate), 29.2% v/v polysorbate 80 and 5.8% v/v 1,2‐propylene glycol. Hydroxyethylcellulose at a concentration of 0.5% w/v was used as thickening agent. According to the disc diffusion assay, the formulations containing sweet basil oil exhibited higher activity against P. acnes than those containing holy basil oil, and the thickened formulations tended to give a lower activity against P. acnes than the non‐thickened formulations. The prepared micro‐emulsions were stable after being tested by a heat–cool cycling method for five cycles. These findings indicate the possibility to use Thai sweet and holy basil oil in suitable formulations for acne skin care.
Increased health care utilization and increased antiretroviral use in HIV‐infected individuals with mental health disorders
Authors: Mijch A , Burgess P , Judd F , Grech P , Komiti A , Hoy J , Lloyd JH , Gibbie T , Street A 
Published: March 2006

ObjectivesThe aims of the study were to describe the prevalence and associations of mental health disorder (MHD) among a cohort of HIV‐infected patients attending the Victorian HIV/AIDS Service between 1984 and 2000, and to examine whether antiretroviral therapy use or mortality was influenced by MHD (defined as a record of service provision by psychiatric services on the Victorian Psychiatric Case Register). It was hypothesized that HIV‐positive individuals with MHD would have poorer treatment outcomes, reduced responses to highly active antiretroviral therapy (HAART) and increased mortality compared with those without MHD.MethodsThis is a retrospective cohort of 2981 individuals (73% of the Victorian population diagnosed with HIV infection) captured on an HIV database which was electronically matched with the public Victorian Psychiatric Case Register (VPCR) (accounting for 95% of public system psychiatry service provision). The prevalence, dates and recorded specifics of mental health disorders at the time of the electronic match on 1 June 2000 are described. The association with recorded MHD, gender, age, AIDS illness, HIV exposure category, duration and type of antiviral therapy, treatment era (prior to 1986, post‐1987 and pre‐HAART, and post‐HAART) on hospitalization and mortality at 1 September 2001 was assessed.ResultsFive hundred and twenty‐five individuals (17.6% of the Victorian HIV‐positive population) were recorded with MHD, most frequently coded as attributable to substance dependence/abuse or affective disorder. MHD was diagnosed prior to HIV in 33% and, of those diagnosed after HIV, 93.8% were recorded more than 1 year after the HIV diagnosis. Schizophrenia was recorded in 6% of the population with MHD. Hospitalizations for both psychiatric and nonpsychiatric illness were more frequent in those with MHD (relative risk 5.4; 95% confidence interval 3.7, 8.2). The total number of antiretrovirals used (median 6.4 agents vs 5.5 agents) was greater in those with MHD. When adjusted for antiretroviral treatment era, HIV exposure category, CD4 cell count and antiretroviral therapy, survival was not affected by MHD.ConclusionsMHD is frequent in this population with HIV infection and is associated with increased healthcare utilization but not with reduced survival.
Intrathoracic fat in HIV‐infected patients
Authors: Blanco JL , Biglia A , Martinez E , Sánchez M , De Lazzari E , Leon A , Milinkovic A , Larrousse M , Lonca M , Laguno M , Mallolas J , Gatell JM 
Published: March 2006

BackgroundThe impact of HIV infection or antiretroviral therapy on the intrathoracic fat compartment is unknown.MethodsConsecutive clinically stable HIV‐infected adult patients, irrespective of exposure to antiretroviral therapy, and non‐HIV‐infected healthy volunteers, both without clinical evidence of body fat changes consistent with lipodystrophy and adjusted for age, gender and body mass index, were recruited for this study. Thoracic and abdominal fat was assessed by computed tomography and compared between patients and controls.ResultsThere were nine women (33%) and 18 men (67%) in each group. Nineteen patients (70%) had been taking antiretrovirals for a median of 8 months (interquartile range: 6–11). Among the HIV‐infected patients, intrathoracic fat (median; interquartile range) did not differ significantly between treated (6.7 cm2; 4.5–8.3 cm2) and untreated (6.9 cm2; 5.7–10.9 cm2) individuals (P=0.288). However, intrathoracic fat content (median; interquartile range) was higher in HIV‐infected patients (6.8 cm2; 5.6–10.5 cm2) than in controls (5.6 cm2; 3.9–6.7 cm2) (P=0.025). Intrathoracic fat was positively correlated with intra‐abdominal fat both in patients (rho=0.6, P=0.002) and in controls (rho=0.7, P=0.004).ConclusionIn HIV‐infected adults without clinical evidence of lipodystrophy, intrathoracic fat content was higher than in healthy persons and positively correlated with intra‐abdominal fat content.
Maternal hepatotoxicity with nevirapine as part of combination antiretroviral therapy in pregnancy
Authors: Lyons F , Hopkins S , Kelleher B , McGeary A , Sheehan G , Geoghegan J , Bergin C , Mulcahy FM , McCormick PA 
Published: March 2006

ObjectivesTo describe the maternal tolerability of nevirapine as part of combination antiretroviral therapy in pregnancy at three HIV centres in Dublin, Ireland and to determine risk factors for development of significant hepatotoxicity.MethodsA retrospective study was carried out of all women prescribed nevirapine as part of combination antiretroviral therapy in pregnancy at three HIV centres in Dublin, Ireland (October 2000 to February 2003). Toxicities experienced were graded according to the Division of AIDS toxicity guidelines for adults. Statistical analysis was performed to determine whether there were differences between those that did and those that did not experience significant hepatotoxicity.ResultsA total of 123 women initiated nevirapine as part of combination antiretroviral therapy in the study period. Eight women developed significant hepatotoxicity, including two women who died from fulminant hepatitis. Women who experienced more severe hepatotoxicity had higher pretreatment CD4 counts (P=0.01).ConclusionsIn this cohort, women who experienced more severe hepatotoxicity had higher pretreatment CD4 counts, lending additional weight to the need for caution in using nevirapine as part of combination antiretroviral therapy in women not requiring antiretroviral therapy for their own health.
Regulation of adiponectin in adipocytes upon exposure to HIV‐1
Authors: Sankalé J‐LG , Tong Q , Hadigan CM , Tan G , Grinspoon SK , Kanki PJ , Hotamisligil GS 
Published: March 2006

ObjectivesAdipose dysregulation, dyslipidemia, and insulin resistance are hallmarks of HIV‐related lipodystrophy. The precise mechanisms behind these disturbances are unknown. In HIV‐infected patients, we previously demonstrated a strong relationship between lipodystrophy and levels of adiponectin, an adipose peptide implicated in regulation of glucose and lipid metabolisms. In this study we investigated the effect of HIV on adipocytes, to determine whether HIV can directly infect adipocytes and/or alter the regulation and secretion of the adipocyte‐derived hormone adiponectin.MethodsHuman subcutaneous preadipocytes and adipocytes were exposed to HIV‐1 under various conditions. Adiponectin was measured in supernatants and cell lysates.ResultsAlthough adipocytes expressed CD4, the major HIV receptor, they could not be infected in vitro. However, exposure to HIV dramatically increased the secretion of adiponectin from human adipocytes, in the absence of infection. This was exacerbated with sustained exposure to HIV in a transwell assay. Further, human peripheral mononuclear cells also produced adiponectin, but this was largely dependent upon T‐cell activation.ConclusionsWe propose that the stimulation of adiponectin production by HIV can perturb adiponectin regulation, leading to substantially decreased levels upon viral suppression by antiretroviral therapy. These data suggest a potential molecular mechanism of adiponectin regulation in HIV‐infected patients.
Facial assessments: identifying the suitable pathway to facial rejuvenation
Authors: Weinkle S 
Published: March 2006

AbstractObjectives  There are now numerous ways in which a patient can rejuvenate their facial appearance, including various types of expensive, invasive, surgical procedures, and an ever increasing gamut of products that can be inserted or injected beneath the skin to restore a youthful look to the face. The importance of facial assessments in identifying the most suitable treatment option is discussed here.Results  Before a patient commits to any one of these corrective options, it is the responsibility of the physician to conduct a thorough assessment of the patient's face. All of the facial characteristics should be examined closely: underlying bone and musculature, shape, proportion, and features including folds, wrinkles, fine lines, volume deficits and changes in pigmentation. The degree of ptosis in the facial tissues should be assessed by light palpation. Following assessment of the face, digital photographs should be taken of the patient's full face and profile, allowing the physician to indicate areas, on a visual display, that need correction and there are now computer programs which can ‘morph’ the features of a facial photograph, providing an approximation of the post‐treatment result. Shape and proportion are neglected facets in the assessment of the face prior to corrective treatment. A treatment or technique which rejuvenates a ‘thin’ face may not work so successfully on a ‘round’ face and vice versa. Most importantly, the physician should aim to understand the patient's objective and subjective perceptions of their face and ascertain the results that are desired by the patient before evaluating what can be achieved. Appropriate corrective options can then be discussed in detail, highlighting the risks, side effects, costs, invasiveness, logistics and anticipated outcomes of each.Conclusion  A comprehensive assessment of the patient's face allows the physician to formulate a regimen of treatments that will reach or exceed the expectations of the patient.
Br/Cl signature of hydrothermal fluids: liquid–vapour fractionation of bromine revisited
Authors: LIEBSCHER A. , LÜDERS V. , HEINRICH W. , SCHETTLER G. 
Published: March 2006

AbstractBr/Cl ratios of hydrothermal fluids are widely used as geochemical tracers in marine hydrothermal systems to prove fluid phase separation processes. However, previous results of the liquid–vapour fractionation of bromine are ambiguous. Here we report new experimental results of the liquid–vapour fractionation of bromine in the system H2O–NaCl–NaBr at 380–450°C and 22.9–41.7 MPa. Our data indicate that bromine is generally more enriched than chlorine in the liquid phase. Calculated exchange coefficients KD(Br‐Cl)liquid‐vapour for the reaction Brvapour + Clliquid = Brliquid + Clvapour are between 0.94 ± 0.08 and 1.66 ± 0.14 within the investigated P–T range. They correlate positively with DClliquid‐vapour and suggest increasing bromine–chlorine fractionation with increasing opening of the liquid–vapour solvus, i.e. increasing distance to the critical curve in the H2O–NaCl system. An empirical fit of the form KD(Br‐Cl)liquid‐vapour = a*ln[b*(DClliquid‐vapour−1) + e1/a] yields a = 0.349 and b = 1.697. Based on this empirical fit and the well‐constrained phase relations in the H2O–NaCl system we calculated the effect of fluid phase separation on the Br/Cl signature of a hydrothermal fluid with initial seawater composition for closed and open adiabatic ascents along the 4.5 and 4.8 J g−1 K−1 isentropes. The calculations indicate that fluid phase separation can significantly alter the Br/Cl ratio in hydrothermal fluids. The predicted Br/Cl evolutions are in accord with the Br/Cl signatures in low‐salinity vent fluids from the 9 to 10°N East Pacific Rise.
Diving to extremes: are New Zealand sea lions (Phocarctos hookeri) pushing their limits in a marginal habitat?
Authors: Chilvers B. L. , Wilkinson I. S. , Duignan P. J. , Gemmell N. J. 
Published: March 2006

AbstractWhen studying diving behaviour, it is important to know whether a species is operating at or close to its maximum physiological capacity, because if it is, it will be less capable of compensating for normal environmental or human‐induced fluctuations in its environment. New Zealand (NZ) sea lionsPhocarctos hookeriare among the world's rarest pinnipeds with a restricted distribution and abundance to the most southerly limit of their known range, NZ's sub‐Antarctic. Female NZ sea lions are the deepest and longest diving of the otariids, foraging further from their breeding rookeries than any other sea lion. In this study, the diving behaviours of 18 female NZ sea lions from Enderby Island, Auckland Islands, were recorded during early lactation over two austral summers, 2003 and 2004. While at sea, sea lions dived almost continuously, spending on average 52.7% of their time submerged (>6 m). The mean dive depth (±se) for all dives was 129.5±5.3 m (range 94.6±1.1 to 178.9±1.6 m). The mean duration of dives was 4.0±0.1 min with an average of 40±2.9% of all dive times spent in the deepest 85% of the dive. Although there was high variation in diving behaviour among individuals, overall, animals were found to be diving beyond their estimated aerobic dive limits on 68% of all dives. Given that female NZ sea lions have a high percentage of dives that are beyond their theoretical aerobic limits, we ask whether this represents a miscalculation in aerobic limits, is it a species highly adapted to carry an anaerobic load or a species that is physically stretched to their limits? A species that is presumably under physiological stress just to maintain its current low static population numbers is also likely to be more susceptible to external impacts and this needs consideration for their management.
Planktonic microbial community composition across steep physical/chemical gradients in permanently ice‐covered Lake Bonney, Antarctica
Authors: GLATZ R. E. , LEPP P. W. , WARD B. B. , FRANCIS C. A. 
Published: March 2006

ABSTRACTLake Bonney is a chemically stratified, permanently ice‐covered Antarctic lake that is unusual because anomalous nutrient concentrations in the east lobe suggest that denitrification occurs in the deep suboxic waters of the west lobe but not the east lobe, resulting in high concentrations of nitrate and nitrite below the east lobe chemocline. Environmental factors that usually control denitrification rates (e.g. organic carbon, nitrate, oxygen) do not appear to explain the nitrate distribution in the east lobe, suggesting that other factors (e.g. trace metals, salts, microbial community structure, etc.) may be involved. In order to explore the potential importance of microbial community composition, samples collected from multiple depths in both lobes were compared on the basis of 16S rRNA gene diversity. 16S rRNA polymerase chain reaction (PCR) clone libraries generated from five depths were subjected to restriction fragment length polymorphism (RFLP), rarefaction, statistical and phylogenetic analyses. Bacterial and archaeal 16S rRNA gene sequences were determined for clones corresponding to unique RFLP patterns. The bacterial community below the chemocline (at 25 m) in the east lobe was the least diverse of the five depths analysed and was compositionally distinct from the communities of the overlying waters. The greatest compositional overlap was observed between 16 and 19 m in the east lobe, while the east lobe at 25 m and the west lobe at 13 and 16 m had relatively distinct communities. Despite very little compositional overlap between the suboxic, hypersaline depths of the east and west lobes (25 m and 16 m, respectively), sequences closely related to the denitrifying Marinobacter strain ELB17 previously isolated from the east lobe were found in both libraries. Most of the Lake Bonney sequences are fairly distinct from those reported from other Antarctic environments. Archaeal 16S rRNA genes were only successfully amplified from the two hypersaline depths analysed, with only one identical halophilic sequence type occurring in both libraries, indicating extremely low archaeal diversity. Overall, microbial community composition varies both between lobes and across depths within lobes in Lake Bonney, reflecting the steep gradients in physical/chemical parameters across the chemocline, as well as the anomalous nutrient chemistry of the system.