bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of 45 degree head up tilt on the lumbar puncture success rate in children undergoing spinal anesthesia
Authors: APILIOGULLARI SEZA , DUMAN ATES , GOK FUNDA , OGUN CEMILE OZTIN , AKILLIOGLU ISHAK 
Published: October 2008

SummaryBackground:  There are few studies for procedural techniques of lumbar puncture (LP) for spinal anesthesia in children. There are no controlled studies on the effect of patient positioning. We designed this prospective, randomized study to compare the success rates of LP of the lateral decubitus and lateral decubitus position with a 45 degree head up tilt in children undergoing spinal anesthesia.Methods:  Study was conducted in 180 children aged between one month to twelve years. The LP was performed under general anesthesia using sevoflurane with a 26‐gauge, atraumatic needle either in the standard lateral decubitus, knee‐chest position (group I, n = 90) or lateral decubitus, knee‐chest position with a 45 degree head up tilt (group II, n = 90). The free flow of clear cerebrospinal fluid (CSF) at first attempt was considered to evidence a successful LP.Results:  The two groups were similar in age and weight. Total LP success rate was higher in group II than in group I (P < 0.05). When the significance between the groups was evaluated according to age, the increase in LP success rate was significant in children aged <12 months of age but not significant in children older than 12 months of age.Conclusions:  Because of higher success rate, lateral decubitus, knee‐chest position with 45 degree head up tilt may be the preferred position for spinal anesthesia in infants.
Clostridium difficile PCR ribotype 078 toxinotype V found in diarrhoeal pigs identical to isolates from affected humans
Authors: Debast Sylvia B. , Van Leengoed Leo A. M. G. , Goorhuis Abraham , Harmanus Celine , Kuijper Ed J. , Bergwerff Aldert A. 
Published: October 2008

SummaryIn diseased piglets from two Dutch pig‐breeding farms with neonatal diarrhoea for more than a year, culture and PCR analyses identified the involved microorganism as Clostridium difficile PCR ribotype 078 harbouring toxin A (tcdA) and B (tcdB), and binary toxin genes. Isolated strains showed a 39 bp deletion in the tcdC gene and they were ermB gene‐negative. A number of 11 porcine and 21 human isolated C. difficile PCR ribotype 078 toxinotype V strains were found genetically related by multiple‐locus variable‐number tandem‐repeat analysis (MLVA). Moreover, a clonal complex was identified, containing both porcine and human isolates. The porcine isolates showed an antimicrobial susceptibility profile overlapping that of isolates from Dutch human patients. On the basis of these pheno‐ and genotypical analyses results, it was concluded that the strains from affected piglets were indistinguishable from increasingly encountered C. difficile PCR ribotype 078 strains of human C. difficile infections in the Dutch population and that a common origin of animal and humans strains should be considered.
Insulin‐induced weight gain and cardiovascular events in patients with type 2 diabetes. A report from the DIGAMI 2 study
Authors: Aas A.‐M. , Öhrvik J. , Malmberg K. , Rydén L. , Birkeland K. I. ,   the DIGAMI 2 Investigators
Published: October 2008

Aim:  We investigated whether insulin treatment‐induced weight gain was accompanied by increased cardiovascular (CV) mortality and morbidity in the second Diabetes Insulin Glucose in Acute Myocardial Infarction (DIGAMI 2) study.Methods:  We studied the 865 patients who survived during 12 months without any change in their glucose‐lowering (GL) therapy. They were divided into four subgroups according to GL treatment: group I, no pharmacological GL treatment (n = 99); group II, oral hypoglycaemic agents (n = 250); group III, new insulin treatment (n = 245) and group IV, insulin before inclusion continued during the first year of follow up (n = 271).Results:  Patients who started on insulin (group III) experienced an average body weight increase of 2.3 (1.5–3.2) kg during the first year of treatment, whereas weight remained unchanged in groups I, II and IV. The incidence of non‐fatal reinfarction was higher in group III compared with the other groups (hazard ratio (HR) = 2.5, p = 0.011) and CV mortality was higher in group IV (HR = 2.4, p = 0.003). When the subjects were grouped in quartiles according to maximal body weight increase, those in the lowest quartile experienced the highest CV mortality. Each kilogram increase in weight reduced the risk for CV death with 6%. The incidence of reinfarction did not differ between quartiles.Conclusions:  Initiation of insulin treatment after myocardial infarction was associated with a significant increase in weight and incidence of reinfarction. The increase in weight did, however, not explain the increased rate of reinfarction.
Long‐acting insulin analogues vs. NPH human insulin in type 1 diabetes. A meta‐analysis
Authors: Monami M. , Marchionni N. , Mannucci E. 
Published: October 2008

Aim:  Basal insulin in type 1 diabetes can be provided using either NPH (Neutral Protamine Hagedorn) human insulin or long‐acting insulin analogues, which are supposed to warrant a better metabolic control with reduced hypoglycaemic risk. Aim of this meta‐analysis is the assessment of differences with respect to HbA1c (Glycated hemoglobin), incidence of hypoglycaemia, and weight gain, between NPH human insulin and each long‐acting analogue.Methods:  Of 285 randomized controlled trials with a duration > 12 weeks comparing long‐acting insulin analogues (detemir or glargine) with NPH insulin in type 1 diabetic patients identified through Medline search and searches on www.clinicaltrials.gov, 20 met eligibility criteria (enrolling 3693 and 2485 in the long‐acting analogues and NPH group respectively). Data on HbA1c and body mass index at endpoint, and incidence of any, nocturnal and severe hypoglycaemia, were extracted and meta‐analysed.Results:  Long‐acting analogues had a small, but significant effect on HbA1c [‐0.07 (−0.13; −0.01)%; p = 0.026], in comparison with NPH human insulin. When analysing the effect of long‐acting analogues on body weight, detemir was associated with a significantly smaller weight gain than human insulin [by 0.26 (0.06;0.47) kg/m2; p = 0.012]. Long‐acting analogues were associated with a reduced risk for nocturnal and severe hypoglycaemia [OR (Odd Ratio, 95% Confidence Intervals) 0.69 (0.55; 0.86), and OR 0.73 (0.60; 0.89) respectively; all p < 0.01].Conclusions:  The switch from NPH to long‐acting analogues as basal insulin replacement in type 1 diabetic patients had a small effect on HbA1c, and also reduced the risk of nocturnal and severe hypoglycaemia.
Improved glycaemic control decreases inner mitochondrial membrane leak in type 2 diabetes
Authors: Rabøl R. , Højberg P. M. V. , Almdal T. , Boushel R. , Haugaard S. B. , Madsbad S. , Dela F. 
Published: October 2008

Aim:  Several mechanisms have been targeted as culprits of weight gain during antihyperglycaemic treatment in type 2 diabetes (T2DM). These include reductions in glucosuria, increased food intake from fear of hypoglycaemia, the anabolic effect of insulin, decreased metabolic rate and increased efficiency in fuel usage. The purpose of the study was to test the hypothesis that mitochondrial efficiency increases as a result of insulin treatment in patients with type 2 diabetes.Methods:  We included ten patients with T2DM (eight males) on oral antidiabetic treatment, median age: 51.5 years (range: 39–67) and body mass index (BMI): 30.1 ± 1.2 kg/m2 (mean ± s.e.). Muscle biopsies from m. vastus lateralis and m. deltoideus were obtained before and after seven weeks of intensive insulin treatment, and mitochondrial respiration was measured using high‐resolution respirometry. State 3 respiration was measured with the substrates malate, pyruvate, glutamate, succinate and ADP. State 4o was measured with addition of oligomycine. An age, sex and BMI‐matched control group was also included.Results:  HbA1c improved significantly and the patients gained on average 3.4 ± 0.9 kg. Before treatment, respiratory control ratios (RCRs) of the T2DM were lower than the obese controls [2.6 vs. 3.2 (p < 0.05)], but RCR returned to the levels of the control subjects during treatment. Average state 4o of arm and leg declined by 14% (p < 0.05) during insulin treatment.Conclusions:  Tight glycaemic control leads to reductions in inner mitochondrial membrane leak and increased efficiency of mitochondria. This change in mitochondrial physiology could contribute to the weight gain seen with antihyperglycaemic treatment.
Effects of a controlled hypoglycaemia test on QTc in adolescents with Type 1 diabetes
Authors: Rothenbuhler A. , Petit Bibal C. , Le Fur S. , Bougneres P. 
Published: October 2008

AbstractOur objective was to test the ventricular repolarization response to a controlled hypoglycaemia test in Type 1 diabetic adolescents, an age group at risk for ‘dead in bed syndrome’. We measured QTc, blood glucose level, potassium, heart rate, blood pressure and urinary metanephrine levels in 16 Type 1 diabetic adolescents during an insulin clamp mimicking the transition from mild hyperglycaemia to hypoglycaemia. QTc increased in all patients by 146 ± 44 ms (mean ±sd) ranging from 70 to 230 ms. The longest QTc (630 ms) was recorded in the sibling of a diabetic patient found ‘dead in bed’. Heart rate and urinary metanephrine levels correlated with QTc (r = 0.60 and 0.79, respectively; P = 0.02 and 0.003). QTc in euglycaemia showed no correlation with hypoglycaemia associated QTc prolongation. The prognostic value of the hypoglycaemia test for the risk of recurrent episodes of QTc prolongation should be evaluated in real‐life conditions in large‐scale studies of diabetic adolescents.
Training and transfer effects of executive functions in preschool children
Authors: Thorell Lisa B. , Lindqvist Sofia , Bergman Nutley Sissela , Bohlin Gunilla , Klingberg Torkel 
Published: October 2008

Abstract Executive functions, including working memory and inhibition, are of central importance to much of human behavior. Interventions intended to improve executive functions might therefore serve an important purpose. Previous studies show that working memory can be improved by training, but it is unknown if this also holds for inhibition, and whether it is possible to train executive functions in preschoolers. In the present study, preschool children received computerized training of either visuo‐spatial working memory or inhibition for 5 weeks. An active control group played commercially available computer games, and a passive control group took part in only pre‐ and posttesting. Children trained on working memory improved significantly on trained tasks; they showed training effects on non‐trained tests of spatial and verbal working memory, as well as transfer effects to attention. Children trained on inhibition showed a significant improvement over time on two out of three trained task paradigms, but no significant improvements relative to the control groups on tasks measuring working memory or attention. In neither of the two interventions were there effects on non‐trained inhibitory tasks. The results suggest that working memory training can have significant effects also among preschool children. The finding that inhibition could not be improved by either one of the two training programs might be due to the particular training program used in the present study or possibly indicate that executive functions differ in how easily they can be improved by training, which in turn might relate to differences in their underlying psychological and neural processes.
Logic and belief across the lifespan: the rise and fall of belief inhibition during syllogistic reasoning
Authors: De Neys Wim , Van Gelder Elke 
Published: October 2008

AbstractPopular reasoning theories postulate that the ability to inhibit inappropriate beliefs lies at the heart of the human reasoning engine. Given that people's inhibitory capacities are known to rise and fall across the lifespan, we predicted that people's deductive reasoning performance would show similar curvilinear age trends. A group of children (12‐year‐olds), young adults (20‐year‐olds), and older adults (65+‐year‐olds) were presented with a classic syllogistic reasoning task and a decision‐making questionnaire. Results indicated that on syllogisms where beliefs and logic conflicted, reasoning performance showed the expected curvilinear age trend: Reasoning performance initially increased from childhood to early adulthood but declined again in later life. On syllogisms where beliefs and logic were consistent and sound reasoning did not require belief inhibition, however, age did not affect performance. Furthermore, across the lifespan we observed that the better people were at resisting intuitive temptations in the decision‐making task, the less they were biased by their beliefs on the conflict syllogisms. As with the effect of age, one's ability to override intuitions in the decision‐making task did not mediate reasoning performance on the no‐conflict syllogisms. Results lend credence to the postulated central role of inhibitory processing in those situations where beliefs and logic conflict.
To generalize or not to generalize: spatial categories are influenced by physical attributes and language
Authors: Hespos Susan J. , Piccin Thomas B. 
Published: October 2008

AbstractThe current work explored the conditions under which infants generalize spatial relationships from one event to another. English‐learning 5‐month‐olds habituated to a tight‐ or loose‐fitcoveringevent dishabituated to a change in fit during acontainmenttest event, but infants habituated to a visually similarocclusionevent did not. Thus, infants’ responses appeared to be driven by the physical nature of the fit rather than visual similarity. This response pattern was replicated with Korean‐speaking adults, but English‐speaking adults showed no sensitivity to change in fit for either event. These findings suggest that language development links linguistic forms to universal, pre‐existing representations of meaning, and that linguistic experience can shape sensitivity to distinctions that are marked in one's native language.
Motor and cognitive control in a normative sample of 7‐year‐olds
Authors: Roebers Claudia M. , Kauer Marianne 
Published: October 2008

Abstract The aim of the present study was to explore the relationship between cognitive and motor control by correlating individual performance on a variety of complex tasks in a normative sample of over 100 7‐year‐olds. While there are a few studies including children with specific developmental disorders (i.e. ADHD and DCD) showing that they share similar comorbid deficits, it is still unclear whether control processes share variance in normative samples. Results presented here reveal on the one hand that some aspects of cognitive and motor control are significantly interrelated, even when controlling for age. On the other hand, individuals’ ability to efficiently respond to the speed and accuracy demands of any of the included tasks appeared to constitute an important aspect of executive functioning.
Primary care physicians' knowledge, attitudes, beliefs and practices regarding childhood obesity: a systematic review
Authors: Van Gerwen M. , Franc C. , Rosman S. , Le Vaillant M. , Pelletier‐Fleury N. 
Published: October 2008

SummaryObesity is an important public health issue with an epidemic spread in adolescents and children, which needs to be tackled. This systematic review of primary care physicians' knowledge, attitudes, beliefs and practices (KABP) regarding childhood obesity will help to implement or adjust the actions necessary to counteract obesity. Eligible studies were identified through a systematic database search for all available years to 2007. Articles were selected if they included data on primary care physicians' KABP regarding childhood obesity: 130 articles were assessed and eventually 11 articles covering the period 1987–2007 and responding to the inclusion criteria were analyzed. The included studies showed that almost all physicians agreed on the necessity to treat childhood obesity but they believed to have a low self‐efficacy in the treatment and experienced a negative feeling regarding obesity management. There was a large heterogeneity in the assessment of childhood obesity between the different studies but the awareness of the importance of using body mass index increased over the years among physicians. Almost all studies noted that physicians recommended dietary advice, exercise or referral to a dietician. From this review, it is obvious that there is a need for education of primary care physicians to increase the uniformity of the assessment and to improve physicians' self‐efficacy in managing childhood obesity. Multidisciplinary treatment including general practitioners, paediatricians and specialized dieticians appears to be the way to counteract the growing obesity epidemic and thus, primary care physicians have to initiate, coordinate and obviously participate in obesity prevention initiatives.
From Lydia Pinkham to Queen Levitra: direct‐to‐consumer advertising and medicalisation
Authors: Conrad Peter , Leiter Valerie 
Published: October 2008

AbstractThe medicalisation of life problems has been occurring for well over a century and has increased over the past 30 years, with the engines of medicalisation shifting to biotechnology, managed care, and consumers. This paper examines one strand of medicalisation during the last century: direct‐to‐consumer advertising (DTCA) of pharmaceuticals. In particular, it examines the roles that physicians and the Food and Drug Administration (FDA) have played in regulating DTCA in the US. Two advertising exemplars, the late 19thcentury Lydia E. Pinkham's Vegetable Compound (for ‘women's complaints’) and contemporary Levitra (for erectile dysfunction) are used to examine the parallels between the patent medicine era and the DTCA era. DTCA re‐establishes the direct and independent relationship between drug companies and consumers that existed in the late 19thcentury, encouraging self‐diagnosis and requests for specific drugs. The extravagant claims of Lydia Pinkham's day are constrained by laws, but modern‐day advertising is more subtle and sophisticated. DTCA has facilitated the impact of the pharmaceutical industry and consumers in becoming more important forces in medicalisation.
Sociology of pharmaceuticals development and regulation: a realist empirical research programme
Authors: Abraham John 
Published: October 2008

AbstractA realist conceptualisation of interests is proposed in opposition to the fashionable view that interests, objectivity and reality are merely social constructs, and that sociological analyses should be confined to discourse, actor‐networks and micro‐contextual practices. The objective interests of pharmaceutical companies in profit‐maximisation, and of patients/public health in the optimisation of drugs’ benefit‐risk ratios, can be empirically validated. The relationship between those interests and pharmaceutical regulation is best characterised by ‘neo‐liberal corporate bias’ at the macro‐ and meso‐levels. How such bias manifests itself at the micro‐social level of science‐based pharmaceutical testing and regulatory decision making is examined using a realist sociology of scientific knowledge, which appreciates that assessment of the validity of techno‐scientific knowledge claims is essential for their sociological explanation. Commercial interests are shown to have biased science away from the interests of public health, in favour of industry. International comparisons of drug regulation demonstrate that drug injuries are not necessarily an inevitable by‐product of pharmaceutical progress because some countries have fewer drug safety problems than others. Similarly, the lowering of techno‐scientific standards for drug safety testing is not an inevitable cost of faster development of therapeutically valuable medicines, but a consequence of the internationalisation of neo‐liberal corporate bias.
Over‐the‐counter medicines: professional expertise and consumer discourses
Authors: Stevenson Fiona A. , Leontowitsch Miranda , Duggan Catherine 
Published: October 2008

AbstractIdeas of participation and partnership in health care consultations have attracted increasing attention in recent years; however the consequences in terms of the necessary shifts in existing relationships are often overlooked. We examine how pharmacists work to maintain their professional expertise against the rise of health‐care consumerism. We draw on the following data from a UK study of consultations for over‐the‐counter (OTC) medicines in two pharmacies: (i) an outline of the pharmacy owners’ views of their practice model, (ii) data from observations and tape recorded consultations (iii) interviews with customers and pharmacists and (iv) views expressed in two feedback sessions discussing vignettes developed from observational and interview‐based fieldwork. There was no suggestion that attempts to engage customers in discussions about their treatment necessitated a diminution of the importance of pharmaceutical expertise. Indeed, both pharmacists and customers acknowledged the importance of the asymmetry of knowledge between pharmacists and customers. Pharmaceutical expertise was however not always perceived to be necessary and transactions in pharmacies may be treated like those in any other retail environment. Further research using a larger dataset to investigate problems in interactions resulting from tensions between pharmaceutical expertise and consumerism is indicated.
In whose interest? Relationships between health consumer groups and the pharmaceutical industry in the UK
Authors: Jones Kathryn 
Published: October 2008

AbstractThis paper explores how health consumer groups in the UK disclose and manage links with pharmaceutical companies in the context of their growing involvement in the policy process. In particular, it examines claims that industry engages with groups in an attempt to capture the groups’ policy agenda, thereby increasing industry's political influence. Drawing on theories of disclosure, analysis of group and industry websites revealed a varying level of detail on the nature and extent of relationships. Only 26 per cent of consumer groups known to be in receipt of industry financial or in‐kind support openly acknowledged this. Interviews undertaken with representatives from consumer groups, industry and other health‐care stakeholders, highlighted a coincidence of aims between the two sectors, an acknowledgement that collaboration was inevitable, and tacit support for policy guidelines to manage conflicts of interest. The paper concludes by arguing that while claims of organisational capture are over‐stated, the shallow approach to transparency adopted by the majority of companies and groups strengthens critiques of undue influence. This may ultimately reduce policy makers’ willingness to see consumer groups as the legitimate voice of patients, users and carers in the policy process.