bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol‐attributable mortality and potential years of life lost in Canada 2001: implications for prevention and policy
Authors: Rehm Jürgen , Patra Jayadeep , Popova Svetlana 
Published: February 2006

ABSTRACTBackground Alcohol is one of the most important risk factors for burden of disease.Objective To estimate the number of deaths and the years of life lost attributable to alcohol for Canada 2001 using different ways to measure alcohol exposure.Methods Distribution of exposure was taken from a major national survey of Canada, the Canadian Addiction Survey, and corrected for per capita consumption from production and sales. For chronic disease, risk relations were taken from the published literature and combined with exposure to calculate age‐ and sex‐specific alcohol‐attributable fractions (AAFs). For injury, AAFs were taken directly from available statistics. Information on mortality, with cause of death coded according to the International Classification of Diseases version 10 (ICD‐10) was obtained from Statistics Canada.Results For Canada in 2001, 4010 of all deaths in the group below 70 years of age were attributable to alcohol, 3132 in men and 877 in women. This constituted 6.0% of all deaths in Canada in this age group, 7.6% for men, and 3.5% for women. The 4010 deaths are a net figure, already taking into account the deaths prevented by moderate consumption of alcohol. Main causes of alcohol‐attributable death were unintentional injuries, malignant neoplasms and digestive diseases. Ischaemic heart disease (IHD) was the biggest cause of death prevented by alcohol, with 78.7% of all alcohol‐attributable prevented deaths in the age groups of 70 years and above. A total of 144 143 years of life were lost prematurely in Canada in that year, 113 079 years in men and 31 063 years in women.Discussion Regardless of the assumptions made, alcohol is a major contributor to mortality in Canada. The impact of alcohol on social life is not confined to mortality, as other studies indicated that alcohol is linked even more strongly to disability and social harm. Alcohol‐attributable harm could be substantially reduced, however, if known effective policies were introduced.
What drug policies cost. Drug policy spending in the Netherlands in 2003
Authors: Rigter Henk 
Published: February 2006

ABSTRACTAim  To estimate the public spending on drug policy in the Netherlands.Methods  Calculation and extrapolation of expenditures from 2003 budgets of all Ministries of the national government, annual reports from other governments and agencies and White Papers, supported by interviews with and information obtained otherwise from policy makers. Expenditures were allocated to four drug policy functions, i.e. prevention, treatment, harm reduction and enforcement. Where exact data on expenditures were lacking, approximations were made representing expert judgement.Results  The total drug policy spending estimate in 2003 was 2185 million Euros. Allocation to functions amounted to 42 million Euros for prevention, 278 million for treatment, 220 million for harm reduction and 1646 million for enforcement.Conclusions  Drug law enforcement is clearly the dominant expenditure. This can be said with certainty despite the noted pitfalls in estimating drug policy expenditures. Many of the available data are not precise. To achieve better figures, a much more detailed analysis would be needed (which is not planned for the foreseeable future). Even then, it would be hard to separate the drug component from more general budgets.
Highly active antiretroviral therapy (HAART) among HIV‐infected drug users: a prospective cohort study of sexual risk and injecting behaviour
Authors: Smit Colette , Lindenburg Karen , Geskus Ronald B. , Brinkman Kees , Coutinho Roel A. , Prins Maria 
Published: February 2006

ABSTRACTAims  To study sexual risk and injecting behaviour among HIV‐infected drug users (DU) receiving highly active antiretroviral therapy (HAART). Design and setting  As part of an ongoing prospective cohort study, HIV‐infected DU who commenced HAART (n = 67) were matched with those not starting HAART (n = 130) on CD4 cell counts, duration of cohort participation, age and calendar year of visit. Immunological and virological responses of the HAART‐treated DU were compared with the HAART‐treated homosexual men from the same cohort (n = 212).Measurements  Trends in behaviour and therapeutic response were tested with a logistic regression model adjusted for repeated measurements and a piecewise random effects model, respectively.Findings  Non‐HAART users reported more episodes of injecting than HAART users. In both groups injecting declined over time with no effect of HAART initiation. Before HAART initiation an increase in sexual risk behaviour was observed among those who had been assigned to receive HAART; their sexual risk behaviour declined thereafter. No change in sexual risk behaviour was found among non‐HAART users. Relative to homosexual men, DU had a similar initial therapeutic response, but DU started HAART at lower CD4 cell counts and higher viral load levels.Conclusion  DU who are treated with HAART are not increasing their risk behaviour, and their early response to HAART is similar to homosexual men. However, before the treated DU received HAART they were seen to inject less often than those not treated with HAART. This suggests that selection of potential HAART starters is based on limited drug use. Although the DU who commence HAART are a selected group, our results show that HIV‐infected DU can be treated effectively.
Substance use and other psychiatric disorders in first‐degree relatives of opioid‐dependent males: a case–controlled study from India
Authors: Prasant M. Phani , Mattoo Surendra K. , Basu Debasish 
Published: February 2006

ABSTRACTAim  To assess the prevalence of substance use and other psychiatric disorders in first‐degree relatives of males with opioid dependence compared to normal controls. Design  Observational, case–control study using family history method. Setting  A drug addiction treatment centre in northern India. Participants  First‐degree relatives of 100 male probands with opioid dependence and no comorbidity (n = 493) and those of 50 matched probands from normal population (n = 254).Measurement  Family interview of probands and family members, using the Family Interview for Genetic Studies. The main outcome measure was relative risk (expressed as odds ratio after controlling for confounding variables using logistic regression) of familial aggregation of psychiatric and substance use disorders.Findings  First‐degree relatives of opioid‐dependent males were more likely to have a psychiatric disorder than those of normal controls [adjusted odds ratio (OR) 4.47; 95% confidence interval (CI) 1.97–10.11; P < 0.001], especially for opioid use disorders in the brothers (adjusted OR 6.55; 95% CI 1.44–29.88; P = 0.015) and for alcohol use disorders in the fathers of the probands (adjusted OR 5.64; 95% CI 2.39–13.24; P < 0.001). Other disorders (major depression, chronic psychosis and obsessive compulsive disorder) did not have significant aggregation in the first‐degree relatives of opioid‐dependent subjects.Conclusions  This study provides further evidence for the higher rates of alcohol and opioid dependence in first‐degree relatives of opioid‐dependent patients. The exact pattern of this familial aggregation may be influenced by the gender of the relatives and their relation to the proband.
Effectiveness of drug and alcohol counselling during methadone treatment: content, frequency, and duration of counselling and association with substance use outcomes
Authors: Gossop Michael , Stewart Duncan , Marsden John 
Published: February 2006

ABSTRACTAims  The study investigates the relationship between the type and severity of drug and alcohol use problems, and the provision of drug‐ and alcohol‐counselling in methadone programmes. The study also specifically investigates the relationship between content, frequency and duration of counselling provided during the first month of treatment, and heroin, cocaine, and alcohol use outcomes at 6 months. Design, setting and participants  The sample comprised 276 patients receiving outpatient methadone treatment who were followed‐up 6 months after treatment entry.Measurements  Data on client characteristics, drug and alcohol problems and on counselling received were collected by structured face‐to‐face interviews.Findings  Drug‐focused counselling was associated with less frequent heroin and cocaine use at follow‐up, but was not related to pre‐treatment drug use. Alcohol‐focused counselling was provided for those with higher levels of drinking at admission but was not significantly associated with drinking outcome at 6 months.Conclusions  Results indicate that there are complex interactions between presenting substance use problems, provision of counselling and treatment outcomes. These interactions differ by substance type.
Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation
Authors: SENZOLO M. , TIBBALS J. , CHOLONGITAS E. , TRIANTOS C. K. , BURROUGHS A. K. , PATCH D. 
Published: February 2006

SummaryBackgroundTreatment options for patients with portal vein thrombosis are limited.AimTo evaluate the feasibility and efficacy of transjugular intrahepatic portosystemic shunt for portal vein thrombosis with/without cavernomatous transformation.MethodsA survey of such patients, referred for transjugular intrahepatic portosystemic shunt between 1994 and 2005, was performed. Success rates, complications, transjugular intrahepatic portosystemic shunt patency and clinical progression were examined.ResultsTransjugular intrahepatic portosystemic shunt was attempted in 28 patients (13 cirrhotics). Indications were: presurgery/transplantation (2), worsening of ascites (2), variceal bleeding (15 – 8 elective), refractory ascites (3), portal biliopathy (3) and portal vein thrombosis complicating Budd–Chiari syndrome (2). Transjugular intrahepatic portosystemic shunt was placed successfully in 19 of 28 (73%); 23 of 28 had complete portal vein thrombosis and 9 of 23 had cavernous transformation and transjugular intrahepatic portosystemic shunt was successfully placed in six of these. In the 19 patients with transjugular intrahepatic portosystemic shunt, the mean follow‐up was 18.1 months (range 5–70): six patients had stent revisions; three had liver transplantation, one died of bleeding. Most cirrhotic patients had an improvement in the Child‐Pugh score. In the failed transjugular intrahepatic portosystemic shunt group, two of nine died, and three had further bleeding.ConclusionsTransjugular intrahepatic portosystemic shunt should be considered for selected patients with symptomatic complete portal vein thrombosis with/without cavernous transformation, as clinical improvement and less rebleeding occur when transjugular intrahepatic portosystemic shunt placement is successful.
Acetic acid‐enhanced magnification endoscopy in the diagnosis of specialized intestinal metaplasia, dysplasia and early cancer in Barrett's oesophagus
Authors: FORTUN P. J. , ANAGNOSTOPOULOS G. K. , KAYE P. , JAMES M. , FOLEY S. , SAMUEL S. , SHONDE A. , BADRELDIN R. , CAMPBELL E. , HAWKEY C. J. , RAGUNATH K. 
Published: February 2006

SummaryBackgroundBarrett's surveillance is prone to sampling error.AimTo determine whether enhanced magnification endoscopy using acetic acid instillation improves diagnostic accuracy of specialized intestinal metaplasia/dysplasia in Barrett's oesophagus.MethodsWe examined the detection rate of the specialized intestinal metaplasia/dysplasia in 64 consecutive patients with Barrett's oesophagus using acetic acid to enhance mucosal pit patterns. Histology was compared with the previous findings at recent conventional surveillance in 62 patients. We also examined the inter‐/intra‐observer agreement in the assessment of the enhanced magnification endoscopy pit pattern findings.ResultsHistology revealed columnar‐lined oesophagus in six (9%) patients, specialized intestinal metaplasia in 49 (77%), low‐grade dysplasia in five (8%), high‐grade dysplasia in one (2%), and adenocarcinoma in three (5%). There was discordance between the histologic findings from conventional surveillance with random biopsy. Fifteen patients (24%) had a histological upgrade with enhanced magnification endoscopy. There was a high detection rate of specialized intestinal metaplasia even in short segment Barrett's oesophagus (74%), and additionally, there were two cancers, one with 2‐cm Barrett's oesophagus and one ultra‐short (1 cm). The mean kappa values for inter‐ and intra‐observer agreement in assessing the pit patterns were 0.571 (0.041) and 0.709 (0.038), respectively.ConclusionsEnhanced magnification endoscopy allows clear visualization of the epithelial pit patterns within Barrett's oesophagus, and targeted biopsy results in a high yield of specialized intestinal metaplasia and dysplasia.
Recurrence of Helicobacter pylori infection after several eradication therapies: long‐term follow‐up of 1000 patients
Authors: GISBERT J. P. , LUNA M. , GÓMEZ B. , HERRERÍAS J. M. , MONÉS J. , CASTRO‐FERNÁNDEZ M. , SÁNCHEZ‐POBRE P. , COSME A. , OLIVARES D. , PAJARES J. M. 
Published: February 2006

SummaryAimTo study the incidence of Helicobacter pylori recurrence, its chronological aspects, and the variables that might influence it.MethodsA total of 1000 patients in whom H. pylori had been eradicated were prospectively studied. Therapies were classified as low and high efficacy regimens. Four to eight weeks after completion of therapy, 13C‐urea‐breath‐test was performed, and it was repeated yearly up to 5 years. In some patients, endoscopy with biopsies was also performed to confirm H. pylori eradication.ResultsA total of 1000 patients were included, giving 2744 patient‐years of follow‐up. Seventy‐one H. pylori recurrences were observed (2.6% per patient‐year). Probability of being H. pylori‐negative at 1 year was 94.7%, and at 5 years 90.7%. In the multivariate analysis, low age (OR: 1.84; 95% CI: 1.04–3.26) and low efficacy therapies (OR: 2.5; 1.23–5.04) correlated with 1‐year H. pylori recurrence. Differences were observed when Kaplan–Meier curves were compared depending on age and therapy regimen.ConclusionRisk of posteradication H. pylori recurrence is higher during the first year, which suggests that most recurrences during this period are recrudescence and not true reinfections. H. pylori recurrence is more frequent in younger patients and in those treated with low efficacy therapies, but is exceptional if high efficacy therapies are used, in which case post‐therapy eradication can be safely confirmed at 4 weeks with 13C‐urea‐breath‐test.
Genomic variation in the mitochondrially encoded cytochrome b (MT‐CYB) and 16S rRNA (MT‐RNR2) genes: characterization of eight endangered Pecoran species
Authors: Guha S. , Goyal S. P. , Kashyap V. K. 
Published: February 2006

SummaryIn an effort to develop species‐specific identification markers, we examined genetic variants and molecular signatures within genes encoding mitochondrial cytochrome b and 16S rRNA in eight endangered Pecoran species endemic to the Indian peninsula. Our results revealed that the cytochrome b gene exhibited higher sequence diversity than the 16S rRNA gene, both between and within species. However, the 16S rRNA gene harboured a larger number of species‐specific mutation sites compared with the cytochrome b gene, suggesting that it could be useful for species identification. Indeed, we successfully used ‘forensically informative nucleotide sequencing’ (FINS) analysis of the 16S rRNA gene to identify two previously unknown biological specimens.
18Flurodeoxyglucose positron emission tomography in the localization of ectopic ACTH‐secreting neuroendocrine tumours
Authors: Kumar J. , Spring M , Carroll P. V. , Barrington S. F. , Powrie J. K. 
Published: February 2006

SummaryObjective  Neuroendocrine tumours (NET) are a rare cause of Cushing's syndrome. These tumours can be very small and therefore difficult to identify. Current localization techniques include CT, MRI and radioisotope scanning, but in a proportion of cases the NET remains occult. Positron emission tomography (PET) scanning, is a relatively new imaging modality that is increasingly used to detect and monitor lesions with high metabolic activity. We report on the use of PET scanning in the evaluation of the ectopic ACTH syndrome.Patients  Three patients with ectopic ACTH‐dependent Cushing's syndrome with varying difficulty in NET localization are included in the report.Measurement  Positron emission tomography scanning using 18flurodeoxyglucose (FDG) identifies tissue with high metabolic activity. 18FDG‐PET scanning was used in each of these patients and the imaging is presented along with biochemical data.Results  In each case the NET was easily identified using 18FDG‐PET, aiding clinical decision making and therapeutic outcome. A cure was identified by clinical resolution of symptoms and undetectable ACTH levels postsurgery.Conclusions  18FDG‐PET assisted in localizing small metabolically active NETs, suggesting this imaging modality may have a useful role in identifying NET causing Cushing's syndrome as a result of ectopic ACTH production.
Cerebral glutamate metabolism during hypoglycaemia in healthy and type 1 diabetic humans
Authors: Bischof M. G. , Brehm A. , Bernroider E. , Krššák M. , Mlynárik V. , Krebs M. , Roden M. 
Published: February 2006

AbstractBackground  The mechanisms responsible for the progressive failure of hypoglycaemia counterregulation in long‐standing type 1 diabetes are poorly understood. Increased brain glucose uptake during hypoglycaemia or alterations of brain energy metabolism could effect glucose sensing by the brain and thus contribute to hypoglycaemia‐associated autonomic failure.Materials and methods  Type 1 diabetic patients (T1DM) and healthy volunteers (CON) were studied before, during and after a hypoglycaemic (50 mg dL−1) hyperinsulinaemic (1·5 mU kg−1 min−1) clamp test. The 1H magnetic resonance spectroscopy of the occipital lobe of the brain was performed employing the STEAM localization technique. The water signal was suppressed by the modified SWAMP method. All spectra were acquired on a 3 Tesla scanner (80 cm MEDSPEC‐DBX, Bruker Medical, Ettlingen, Germany) using a 10‐cm diameter surface coil.Results  During hypoglycaemia, T1DM showed blunted endocrine counterregulation. At baseline the brain tissue glucose : creatine ratio was lower in CON than in T1DM (CON 0·13 ± 0·05 vs. T1DM 0·19 0·11; P < 0·01). During hypoglycaemia glucose : creatine ratios decreased in both groups (CON 0·07 ± 0·08, P < 0·05; T1DM 0·03 ± 0·03, P < 0·001). A significant drop in the glutamate : creatine ratio could only be found in CON during hypoglycaemia (CON 1·36 ± 0·08 vs. 1·26 ± 0·11; P < 0·01; T1DM 1·32 ± 0·13 vs. 1·28 ± 0·15; P = NS). The ratios of glutamine, N‐acetylaspartate, choline and myo‐inositol : creatine were not different between both groups and did not change throughout the experiment.Conclusions  Only in CON does moderate hypoglycaemia reduce intracerebral glutamate concentrations, possibly owing to a slower substrate flux through the tricarboxylic acid cycle in neurones. The maintenance of normal energy metabolism in T1DM during hypoglycaemia might effect glucose sensing in the brain and contribute to hypoglycaemia‐associated autonomic failure.
Visual impairments in people with severe and profound multiple disabilities: an inventory of visual functioning
Authors: Van Den Broek E. G. C. , Janssen C. G. C. , Van Ramshorst T. , Deen L. 
Published: February 2006

AbstractBackground The prevalence of visual impairments in people with severe and profound multiple disabilities (SPMD) is the subject of considerable debate and is difficult to assess.Methods In a typical Dutch care organization, all clients with SPMD (n = 76) participated in the study and specific instruments adapted to these clients (requiring a minimum of cooperation) were used to measure visual acuity, the visual field, binocular vision, contrast sensitivity, refractive errors and visual functioning behaviour.Results We found an unexpected 92% of clients with SPMD to have visual impairments. Previously, only 30% were known to have visual problems. None of the persons observed had normal visual acuity. Subnormal visual acuity was the best result. The severity of the visual impairment was related to the severity of the intellectual disability. In addition to the problem of acuity, impairments in the visual field, impaired contrast sensibility and impaired binocular functioning were found, as well as impaired visual attention, fixation and following. In 22% of the _clients observed, refractive errors were found and glasses were advised.Conclusions Consequences for caregiving and for modifications of the environment were discussed.
Mechanotransduction and the homeostatic significance of maintaining blood viscosity in hypotension, hypertension and haemorrhage
Authors: MARTINI J. , CABRALES P. , TSAI A. G. , INTAGLIETTA M. 
Published: February 2006

Abstract.The increase of plasma and blood viscosity is usually associated with pathological conditions; however, elevation of both parameters often results in increased perfusion and the lowering of peripheral vascular resistance. In extreme haemodilution, blood viscosity is too low and insufficient to maintain functional capillary density, a problem that in experimental studies is shown to be corrected by increasing plasma viscosity up to 2.2 cP. This effect is mediated by mechanotransduction‐induced nitric oxide (NO) production via shear stress in the endothelium as shown by microelectrode perivascular measurements of NO concentration. Moderate elevations of blood viscosity by increasing haematocrit (∼10%) result in comparable reductions of blood pressure and peripheral vascular resistance, an effect also NO‐mediated as it is absent after Nω‐nitro‐L‐arginine methyl ester treatment and in endothelial nitric oxide synthase‐deficient mice. These findings show that the rheological properties of plasma affect vessel diameter in the microcirculation leading to counterintuitive responses to the changes in blood and plasma viscosity. Application of these findings to haemorrhagic shock resuscitation leads to the concept of hyperosmotic‐hyperviscous resuscitation as a modality for maintaining the recovery of microvascular function.