bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine Immunization Practices: Use of Topical Anesthetics and Oral Analgesics
Authors: Taddio Anna , Manley Jennifer , Potash Leah , Ipp Moshe , Sgro Michael , Shah Vibhuti 
Published: August 2007

BACKGROUND. Immunization pain is a global public health issue. Despite an abundance of data that demonstrate the efficacy of local anesthetics for decreasing immunization pain, their adoption in practice has not been determined. Our objective was to evaluate analgesic use during childhood immunization.PATIENTS AND METHODS. We used a cluster-sampling survey of pediatricians in the greater Toronto area (who administer immunizations) and multiparous women. By using a self-administered survey, pediatricians reported frequency of analgesic use in their practice for 2 phases of immunization: injection (needle puncture and vaccine administration) and postinjection (hours to days postvaccination). By using an interviewer-administered face-to-face survey, mothers reported analgesic practices for their children.RESULTS. Of 195 eligible pediatricians, 140 (72%) responded. During the injection phase, 58% rarely or never used analgesics compared with 11% for the postinjection phase. During injection, the local anesthetics lidocaine-prilocaine and tetracaine were used at least sometimes in 12% and 2% of the practices, respectively, whereas acetaminophen and ibuprofen were used in 81% and 46%, respectively. Postinjection, acetaminophen and ibuprofen were used in 89% and 56% of practices. Of 257 eligible mothers, 200 (78%) participated. During injection, analgesics were used in 25% of immunizations (acetaminophen [87%], ibuprofen [7%], and lidocaine-prilocaine [6%]). Postinjection, analgesics were used in 33% of immunizations (acetaminophen [86%] and ibuprofen [14%]).CONCLUSIONS. A minority of pediatricians and mothers use topical local anesthetics during childhood immunization despite evidence to support their use. Oral analgesics are used more commonly, but this practice is not consistent with scientific evidence. Knowledge-translation strategies are needed to increase the use of local anesthesia.
Childhood Influenza: Number Needed to Vaccinate to Prevent 1 Hospitalization or Outpatient Visit
Authors: Lewis Elizabeth N. , Griffin Marie R. , Szilagyi Peter G. , Zhu Yuwei , Edwards Kathryn M. , Poehling Katherine A. 
Published: August 2007

OBJECTIVE. The goal was to assess the potential benefits of the influenza vaccine recommendations for children 6 to 59 months of age by estimating the number of children needed to be vaccinated to prevent 1 hospitalization or 1 outpatient visit attributable to influenza.
METHODS. The influenza burden was obtained from published studies in which rates for children 6 to 23 months and 24 to 59 months of age could be ascertained. We assumed a range of influenza vaccine efficacies of 25% to 75%, consistent with the literature. We estimated the number of children who needed to be vaccinated to prevent 1 influenza-attributable hospitalization or 1 outpatient visit for each age group.
RESULTS. As both vaccine efficacy and severity of the influenza season increased, the number of children who needed to be vaccinated to prevent 1 hospitalization or 1 outpatient visit decreased. The numbers of children who needed to be vaccinated to prevent 1 hospitalization in a year with 50% vaccine efficacy ranged from 1031 to 3050 for children 6 to 23 months of age and from 4255 to 6897 for children 24 to 59 months of age. For every 12 to 42 children 6 to 59 months of age vaccinated in a year with 50% vaccine efficacy, we estimated that 1 influenza-attributable outpatient visit would be prevented.
CONCLUSIONS. With 1 outpatient visit being prevented through vaccination of &lt;50 children, influenza vaccination can reduce influenza-attributable medical visits in children significantly, even in years with modest vaccine efficacy.
Does Childhood Television Viewing Lead to Attention Problems in Adolescence? Results From a Prospective Longitudinal Study
Authors: Landhuis Carl Erik , Poulton Richie , Welch David , Hancox Robert John 
Published: August 2007

CONTEXT. There is controversy over whether childhood television viewing causes attention problems. The findings from cross-sectional and longitudinal studies have been mixed. To our knowledge, no longitudinal studies have assessed the impact of children's television viewing on attention problems in adolescence. The objective of this study was to assess this association.
DESIGN, PARTICIPANTS, AND SETTING. Study members were a general population birth cohort of 1037 participants (502 female) born in Dunedin, New Zealand, between April 1972 and March 1973. Parental estimates of children's television-viewing time were obtained at ages 5, 7, 9, and 11 years. Self-, parent-, and teacher-reported attention problems in adolescence were obtained at ages 13 and 15 years.
RESULTS. The mean of hours of television viewing during childhood was associated with symptoms of attention problems in adolescence. These associations remained significant after controlling for gender, attention problems in early childhood, cognitive ability at 5 years of age, and childhood socioeconomic status. This association was also independent of adolescent television viewing.
CONCLUSIONS. Childhood television viewing was associated with attention problems in adolescence, independent of early attention problems and other confounders. These results support the hypothesis that childhood television viewing may contribute to the development of attention problems and suggest that the effects may be long-lasting.
Does Cerebellar Injury in Premature Infants Contribute to the High Prevalence of Long-term Cognitive, Learning, and Behavioral Disability in Survivors?
Authors: Limperopoulos Catherine , Bassan Haim , Gauvreau Kimberlee , Robertson Richard L. , Sullivan Nancy R. , Benson Carol B. , Avery Lauren , Stewart Jane , MD Janet S. Soul , Ringer Steven A. , Volpe Joseph J. , duPlessis Adré J. 
Published: August 2007

OBJECTIVE. Although cerebellar hemorrhagic injury is increasingly diagnosed in infants who survive premature birth, its long-term neurodevelopmental impact is poorly defined. We sought to delineate the potential role of cerebellar hemorrhagic injury in the long-term disabilities of survivors of prematurity.
DESIGN. We compared neurodevelopmental outcome in 3 groups of premature infants (N = 86; 35 isolated cerebellar hemorrhagic injury, 35 age-matched controls, 16 cerebellar hemorrhagic injury plus supratentorial parenchymal injury). Subjects underwent formal neurologic examinations and a battery of standardized developmental, functional, and behavioral evaluations (mean age: 32.1 ± 11.1 months). Autism-screening questionnaires were completed.
RESULTS. Neurologic abnormalities were present in 66% of the isolated cerebellar hemorrhagic injury cases compared with 5% of the infants in the control group. Infants with isolated cerebellar hemorrhagic injury versus controls had significantly lower mean scores on all tested measures, including severe motor disabilities (48% vs 0%), expressive language (42% vs 0%), delayed receptive language (37% vs 0%), and cognitive deficits (40% vs 0%). Isolated cerebellar hemorrhagic injury was significantly associated with severe functional limitations in day-to-day activities. Significant differences were noted between cases of cerebellar hemorrhagic injury versus controls on autism screeners (37% vs 0%) and internalizing behavioral problems (34% vs 9%). Global developmental, functional, and social-behavioral deficits were more common and profound in preterm infants with injury to the vermis. Preterm infants with cerebellar hemorrhagic injury and supratentorial parenchymal injury were not at overall greater risk for neurodevelopmental disabilities, although neuromotor impairment was more severe.
CONCLUSIONS. Cerebellar hemorrhagic injury in preterm infants is associated with a high prevalence of long-term pervasive neurodevelopment disabilities and may play an important and underrecognized role in the cognitive, learning, and behavioral dysfunction known to affect survivors.
Validity of the Nasometer Measuring the Temporal Characteristics of Nasalization
Authors: Bae Youkyung , Kuehn David P. , Ha Seunghee 
Published: August 2007

Objective: To examine the validity of the Nasometer (KayPENTAX, Lincoln Park, NJ) in measuring the temporal characteristics of nasalization by comparing the Nasometer measures to the measures from an external criterion procedure. Design: Speech samples consisted of three rate-controlled nonsense syllables, which varied in their vowel compositions: /izinizi/, /azanaza/, and /uzunuzu/. Acoustic data were recorded simultaneously through the Nasometer and an external criterion procedure (a specialized microphone set that collected acoustic signals separately for the nasal and oral channels). Speech segment durations measured from the two instrumental conditions were compared on the Nasometer display and the Computerized Speech Lab (KayPENTAX, Lincoln Park, NJ) display. Five durational variables were measured: total utterance duration, nasal onset interval, nasal consonant duration, nasal offset interval, and total nasalization duration. Participants: Fourteen normal adults who speak American English as their first language participated in the study. Results: No significant differences were found between the measures from the Nasometer and those from an external criterion procedure in all the durational variables pertinent to nasalization. Different vowels, however, yielded significantly different patterns in these durational variables, in which the low vowel /a/ context revealed significantly longer total nasalization duration than did the high vowel /i/ and /u/ contexts. Conclusions: The results suggest that the Nasometer can be used as a valid tool to measure the temporal characteristics underlying nasalization and confirm significant vowel effects on the temporal patterns of nasalization.
A Simple and Precise Classification for Cleft Lip and Palate: A Five-Digit Numerical Recording System
Authors: Liu Qiang , Yang Ming-Liang , Li Zeng-Jian , Bai Xiao-Feng , Wang Xu-Kai , Lu Li , Wang Yu-Xin 
Published: August 2007

Objective: Numerous methods have been developed for recording cleft lip and palate deformities, but none has been universally accepted due to limitations, inadequate description of the cleft deformities, and varying complexity. Design: The classification system introduced in this article is designed to describe detailed information of the cleft deformities with five-digit codes. The anatomic description of the cleft components is denoted with five Arabic numerals in order of right lip, right alveolus and primary palate, secondary palate, left alveolus and primary palate, and left lip. The extent of the cleft deformities is recorded using the numerals 0 to 4 (i.e., from intact to complete). Setting: Department of Oral-Maxillofacial Surgery, The Affiliated Hospital of Stomatology, China Medical University. Results: This new classification system allows a numerical description of any kind of complete cleft, incomplete cleft, asymmetry, and complex clefts with an intervening intact segment (all simulated cases). Conclusions: The simplicity and precision of this five-digit classification system make it easy to understand, and it can be used for computerized data analysis.
Superiorly Based Facial Artery Musculomucosal Flap for Large Anterior Palatal Fistulae in Clefts
Authors: Lahiri Anindya , Richard Bruce 
Published: August 2007

Objective: An anterior hard palate fistula for which more than one attempt at repair using local tissue has failed is a difficult complication in cleft surgery. Prior to alveolar bone grafting, cleft patients have an open anterior maxillary arch that allows passage of a pedicled flap from cheek to hard palate. The superiorly based facial artery musculomucosal flap passed through the clefted alveolus is one of the newer techniques to solve this difficult problem. The aim of this study was to assess the validity of using a facial artery musculomucosal flap with an anterosuperiorly based pedicle with retrograde blood flow to repair a large anterior hard palate fistula when a lack of adequate local soft tissue precludes a local flap closure and the patient otherwise would need a tongue flap. Results: Of 16 facial artery musculomucosal flaps in 14 children, 12 were successful, 2 suffered partial flap loss secondary to venous congestion, and 2 had complete flap failure. One had a small wound dehiscence that resulted in a small posterior fistula. Conclusion: An anterosuperiorly based facial artery musculomucosal flap is a viable option to close large anterior hard palate defects. Care needs to be taken to ensure adequate venous drainage. This flap obviates the need for a staged tongue flap repair for those patients with an open maxillary arch.
Comparison of Codeine Phosphate and Morphine Sulphate in Infants Undergoing Cleft Palate Repair
Authors: Fenlon S. , Somerville N. 
Published: August 2007

Objective: To ascertain the quality of analgesia provided by morphine in comparison to codeine. Design: The study is a prospective, randomized, double-blind trial of analgesic effect employing validated pain scores. Patients: Infants having primary cleft palate repair with informed parental consent to enter the study. Interventions: Infants received one of two analgesics intraoperatively for immediate postoperative pain relief. Morphine was given by intravenous injection and codeine by the intramuscular route. Main Outcome Measure: Pain scores in the immediate postoperative period for 2 hours following surgery; this outcome measure was decided prior to data collection. Results: The pain score and other outcome measures were all blinded. Measurements are all evident from the nature of the results. Conclusions: There was no clinically significant difference observed in the analgesic effect of either drug on the two groups studied.
Enhanced Oxygenation Promotes β-Cell Differentiation In Vitro
Authors: Fraker Christopher A. , Álvarez Silvia , Papadopoulos Panagiotis , Giraldo Jaime , Gu Weiyong , Ricordi Camillo , Inverardi Luca , Domínguez-Bendala Juan 
Published: August 2007

Abstract
Despite progress in our knowledge about pancreatic islet specification, most attempts at differentiating stem/progenitor cells into functional, transplantable β cells have met only with moderate success thus far. A major challenge is the intrinsic simplicity of in vitro culture systems, which cannot approximate the physiological complexity of in vivo microenvironments. Oxygenation is a critical limitation of standard culture methods, and one of special relevance for the development of β cells, known for their high O2 requirements. Based on our understanding of islet physiology, we have tested the hypothesis that enhanced O2 delivery (as provided by novel perfluorocarbon-based culture devices) may result in higher levels of β-cell differentiation from progenitor cells in vitro. Using a mouse model of pancreatic development, we demonstrate that a physiological-like mode of O2 delivery results in a very significant upregulation of endocrine differentiation markers (up to 30-fold for insulin one and 2), comparable to relevant in vivo controls. This effect was not observed by merely increasing environmental O2 concentrations in conventional settings. Our findings indicate that O2 plays an important role in the differentiation of β cells from their progenitors and may open the door to more efficient islet differentiation protocols from embryonic and/or adult stem cells.
Disclosure of potential conflicts of interest is found at the end of this article.
Isolation and Characterization of Mesoangioblasts from Facioscapulohumeral Muscular Dystrophy Muscle Biopsies
Authors: Morosetti Roberta , Mirabella Massimiliano , Gliubizzi Carla , Broccolini Aldobrando , Sancricca Cristina , Pescatori Mario , Gidaro Teresa , Tasca Giorgio , Frusciante Roberto , Tonali Pietro Attilio , Cossu Giulio , Ricci Enzo 
Published: August 2007

Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is the third most frequent inherited muscle disease. Because in FSHD patients the coexistence of affected and unaffected muscles is common, myoblasts expanded from unaffected FSHD muscles have been proposed as suitable tools for autologous cell transplantation. Mesoangioblasts are a new class of adult stem cells of mesodermal origin, potentially useful for the treatment of primitive myopathies of different etiology. Here, we report the isolation and characterization of mesoangioblasts from FSHD muscle biopsies and describe morphology, proliferation, and differentiation abilities of both mesoangioblasts and myoblasts derived from various affected and unaffected muscles of nine representative FSHD patients. We demonstrate that mesoangioblasts can be efficiently isolated from FSHD muscle biopsies and expanded to an amount of cells necessary to transplant into an adult patient. Proliferating mesoangioblasts from all muscles examined did not differ from controls in terms of morphology, phenotype, proliferation rate, or clonogenicity. However, their differentiation ability into skeletal muscle was variably impaired, and this defect correlated with the overall disease severity and the degree of histopathologic abnormalities of the muscle of origin. A remarkable differentiation defect was observed in mesoangioblasts from all mildly to severely affected FSHD muscles, whereas mesoangioblasts from morphologically normal muscles showed no myogenic differentiation block. Our study could open the way to cell therapy for FSHD patients to limit muscle damage in vivo through the use of autologous mesoangioblasts capable of reaching damaged muscles and engrafting into them, without requiring immune suppression or genetic correction in vitro.
Disclosure of potential conflicts of interest is found at the end of this article.
Trends for Inflammatory Breast Cancer: Is Survival Improving?
Authors: Gonzalez-Angulo Ana M. , Hennessy Bryan T. , Broglio Kristine , Meric-Bernstam Funda , Cristofanilli Massimo , Giordano Sharon H. , Buchholz Thomas A. , Sahin Aysegul , Singletary S. Eva , Buzdar Aman U. , Hortobágyi Gabriel N. 
Published: August 2007

Abstract
The purpose of this study was to evaluate whether the survival of women with inflammatory breast cancer (IBC) treated at our institution has improved over the past 30 years. Three-hundred ninety-eight patients with IBC were treated between 1974 and 2005. Patient characteristics and outcomes were tabulated and compared among decades of diagnosis. Survival outcomes were estimated with the Kaplan-Meier product limit method and compared among groups with the log-rank statistic. Cox proportional hazards models were fit to determine the association between year of diagnosis and survival outcomes after adjustment for patient and disease characteristics and treatments received. The median follow-up was 5.8 years (range, 0.3–23.8 years). There were 238 recurrences and 236 deaths. The median recurrence-free survival (RFS) duration was 2.3 years and the median overall survival (OS) time was 4.2 years. In the models for RFS and OS, after adjustment for patient and disease characteristics, increasing year of diagnosis was not associated with a decrease in the risk for recurrence (hazard ratio, [HR], 1.00; 95% confidence interval [CI], 0.97–1.04) or death (HR, 0.97; 95% CI, 0.94–1.01). Our data show that there has not been an important change in the prognosis of patients with IBC in the last 30 years. Clinical trials focusing on the management of this aggressive disease are warranted.
Concise Review: Clinical Relevance of Drug–Drug and Herb–Drug Interactions Mediated by the ABC Transporter ABCB1 (MDR1, P-glycoprotein)
Authors: Marchetti Serena , Mazzanti Roberto , Beijnen Jos H. , Schellens Jan H. M. 
Published: August 2007

Learning ObjectivesAfter completing this course, the reader will be able to: Identify important sources of variability in drug exposure caused by drug interactions mediated by P-glycoprotein.Describe how unwanted drug–drug interactions may lead to unexpected serious toxicity or undertreatment.Prevent these interactions by individualizing pharmacotherapy; this means selecting noninteracting drugs or adapting the dose of (the) interacting drug(s).CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
New Criteria for Selecting Elderly Patients for Breast Cancer Adjuvant Treatment Studies
Authors: Dellapasqua Silvia , Colleoni Marco , Castiglione Monica , Goldhirsch Aron 
Published: August 2007

Learning Objectives
After completing this course, the reader will be able to: List the factors that should be considered when choosing the appropriate adjuvant treatment for an elderly women with operable breast cancer.Discuss the possible explanations that account for the underrepresentation of elderly patients in breast cancer clinical trials.Describe the clinical trials that are being specifically conducted in elderly patients with early breast cancer to evaluate different forms of adjuvant treatments.
CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Gingival Blood Flow in Periodontitis Patients Before and After Periodontal Surgery Assessed in Smokers and Non‐Smokers
Authors: Mavropoulos Antonios , Brodin Pål , Rösing Cassiano Kuchenbecker , Aass Anne Merete , Aars Harald 
Published: August 2007

Background: The aim of this study was to evaluate the gingival blood flow of smokers and non‐smokers with periodontal disease before and after surgical periodontal treatment.Methods: Nine smokers and six non‐smokers with at least two periodontal lesions were included in the study. Laser Doppler flowmetry was used to measure blood flow in two gingival sites and two skin sites. Two intrabony defects were treated surgically at the same time; enamel matrix derivative was applied at random to one of the sites, whereas the other site received a placebo gel. We measured resting gingival blood flow (GBF) and responses to cold pressor test (CPT) and to smoking and made continuous measurements of blood pressure (BP). Resting GBF levels of 26 young healthy subjects were used as a reference value.Results: Resting GBF was significantly lower for the periodontitis patients compared to the reference subjects, regardless of smoking habits. GBF and gingival vascular conductance (VC) decreased significantly pre‐ and postoperatively in response to smoking. CPT evoked significant decreases in VC in smokers and non‐smokers. Skin blood flow decreased significantly in response to CPT, more so in the non‐smokers. BP was significantly higher in the non‐smokers.Conclusions: Resting GBF of periodontitis patients was not lower in smokers than in non‐smokers, but it was significantly lower than in the younger reference subjects. In contrast to our earlier findings in healthy subjects, smoking one cigarette may cause a decrease in GBF and VC in periodontitis patients. These observations suggested the existence of a dysfunction in the gingival vasculature in smokers and non‐smokers with periodontitis.