bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of helminth genes in Leishmania: an experimental transfection system to test immunological function
Authors: MAIZELS R. M. , GOMEZ‐ESCOBAR N. , PRIETO‐LAFUENTE L. , MURRAY J. , AEBISCHER T. 
Published: December 2007

SUMMARY Functional analysis of genes from parasitic helminths requires, at the present time, heterologous expression. We have adapted the well‐characterized system of transfection in Leishmania protozoal parasites, as a means of analysing the effect of single filarial genes on the mammalian immune system. For example, testing the function of the Brugia malayi abundant larval transcript (ALT) gene‐transfected Leishmania mexicana were found to be significantly more virulent in macrophages in vitro. The course of infection in vivo is also aggravated by expression of the ALT gene. Examples are also given of transgenes which reduced in vitro growth within macrophages, as well as others which exert no effect on the protozoal parasitism. Thus, Leishmania transfection provides a tractable system to analyse helminth gene function within the context of the host immune system.
Cytokine expression in the brains of Toxocara canis‐infected mice
Authors: HAMILTON C. M. , BRANDES S. , HOLLAND C. V. , PINELLI E. 
Published: December 2007

SUMMARYToxocara canis can infect a number of hosts including mice and humans. In the murine host, larvae exhibit a predilection for the central nervous system, resulting in an increasing number of parasites migrating to the brain as infection progresses. Previous studies have shown that larval burdens vary between individual outbred mice receiving the same inocula, suggesting a role for immunity in the establishment of cerebral infection. Although the systemic immune response to T. canis has been widely reported, there has been no investigation of the cerebral immune response. The aim of the present study was to characterize the cerebral immune response in two inbred strains of T. canis‐infected mice (BALB/c and NIH) at several time points post‐infection (p.i.). Relative quantification of gene expression in the brains of these mice showed increased expression of IL‐5, IL‐10, IFN‐γ and inducible nitric oxide synthase (iNOS). This response was detected as early as 3 days p.i., persisting up to 97 days p.i., and was more pronounced in BALB/c‐infected mice. These results have implications for the role of these cytokines and iNOS in the cerebral establishment of T. canis, and in the cerebral pathology reported during infection.
A quality audit of the service delivered by the NSW Neonatal and Paediatric Transport Service
Authors: Browning Carmo Kathryn A , Williams Katrina , West Maureen , Berry Andrew 
Published: December 2007

Aim:  To discover areas of NSW Neonatal and Paediatric Transport Service's (NETS) work with which the parents, referring and receiving doctors are dissatisfied and respond to them.Methods:  An anonymous survey of referring doctors, parents of patients transported by NETS and receiving hospital doctors between July and December 2005.Results:  Referring doctors: Fifty‐seven per cent of the 288 (30% response rate) doctors who responded were paediatricians and 43% worked in rural settings. Over 90% responded positively about communication with the NETS team at referral and retrieval. Useful feedback included the need to be more time efficient in phone communication and during stabilisation of the child and to improve feedback about management and patient outcomes. Parents: Forty‐seven per cent of 152 responses (15% response rate) came from rural families. The majority (>98%) of parents felt that the NETS team were helpful and supportive of them. Parents reported being able to travel with their child 60% of the time and of those who could not, 95% could explain why. Receiving doctors: Ninety‐three per cent of 218 responses (42% response rate) thought that the referral was appropriate, that the NETS teams carried out their advice correctly (98%) and that the child's needs were reported accurately by the team (90%). In a minority of retrievals important concerns were raised about ventilation, sedation, patient assessment and management.Conclusion:  Most retrievals happen in a way that referring consultants, parents and receiving consultants find appropriate. Important suggestions for improvement in service delivery and some areas of risk to patient safety have been identified. Processes for overcoming these situations are being developed and implemented.
Randomised controlled trial of intravenous maintenance fluids
Authors: Yung Michael , Keeley Steve 
Published: December 2007

Aim: Traditional paediatric intravenous maintenance fluids are prescribed using hypotonic fluids and the weight‐based 4:2:1 formula for administration rate. However, this may cause hyponatraemia in sick and post‐operative children. We studied the effect of two types of intravenous maintenance fluid and two administration rates on plasma sodium concentration in intensive care patients.Methods: A Factorial‐design, double‐blind, randomised controlled trial was used. We randomised 50 children with normal electrolytes without hypoglycaemia who needed intravenous maintenance fluids for >12 h to 0.9% saline (normal saline) or 4% dextrose and 0.18% saline (dextrose saline), at either the traditional maintenance fluid rate or 2/3 of that rate. The main outcome measure was change in plasma sodium from admission to 12–24 h later.Results: Fifty patients (37 surgical) were enrolled. Plasma sodium fell in all groups: mean fall 2.3 (standard deviation 4.0) mmol/L. Fluid type (P = 0.0063) but not rate (P = 0.12) was significantly associated with fall in plasma sodium. Dextrose saline produced a greater fall in plasma sodium than normal saline: difference 3.0, 95% confidence interval 0.8–5.1 mmol/L. Full maintenance rate produced a greater fall in plasma sodium than restricted rate, but the difference was small and non‐significant: 1.6 (−0.7, 3.9) mmol/L. Fluid type, but not rate, remained significant after adjustment for surgical status. One patient, receiving normal saline at restricted rate, developed asymptomatic hypoglycaemia.Conclusion: Sick and post‐operative children given dextrose saline at traditional maintenance rates are at risk of hyponatraemia.
Prevalence and behavioural correlates of enuresis in young children
Authors: Erdogan Ayten , Akkurt Hanife , Boettjer Nazan K , Yurtseven Eray , Can Gunay , Kiran Sibel 
Published: December 2007

Objectives:  Previous studies based on clinical samples report that enuresis in children is associated with behavioural problems and reduced self‐esteem, but the relationship between behavioural problems and enuresis remains controversial. This population‐based study investigated the prevalence and behavioural correlates of enuresis in a group of preparatory school children.Methods:  This cross‐sectional survey involved 356 parents and their children aged 5–7 years, all residents of Istanbul, Turkey. Parents completed the Child Behaviour Checklist and socio‐demographic data form (response rate: 90%). Fifty‐three children with enuresis were compared with 303 non‐symptomatic children. Differences in the mean scores and the percentages of children falling beyond pre‐selected clinical thresholds were compared between the groups.Results:  The prevalence of enuresis was 14.9%, and enuresis was more frequent among boys. Children with enuresis were reported by their parents to have greater social problems and higher total problem scores than control children (P = 0.019, P = 0.048, respectively). However, there were no differences in the percentages of children falling beyond pre‐selected clinical thresholds between the groups.Conclusions:  Children with enuresis had higher mean scores for total and social behavioural problems than controls; however, clinically relevant behavioural problems did not show differences between the groups. Given the inconsistent research findings across studies, longitudinal research and outcome studies could help determine whether there is a causal relationship between psychopathology and enuresis.
Parental experiences and preferences which influence subsequent use of post‐discharge health services for children born very preterm
Authors: Pritchard Margo A , Colditz Paul B , Beller Elaine M ,   for the Queensland Optimising Preterm Infant Outcomes Group
Published: December 2007

Aim:  Parents are ultimately responsible for organising and accessing health services for their children. How parents experience those services are likely to influence subsequent use. Understanding parental preference for service provision can inform compliance strategies with recommended child health recommendations. The aim of this study was to explore parental experiences and preferences which influence subsequent use of post‐discharge health services for children born preterm with a birthweight ≤1250 g.Methods:  Focus groups consisted of randomly selected families recruited from a population‐based cross‐sectional cohort study of 2‐, 4‐ and 7‐year‐old children corrected age for prematurity. Parents were asked to consider which aspects of childhood health service delivery influenced subsequent use. Transcripts were analysed and themes constructed. SWOT analysis evaluated health service practices by systematically mapping parents' accounts of the perceived strengths (S), weaknesses (W), opportunities (O) and threats (T) of services in relation to subsequent use.Results:  Fifteen parents participated in three groups (by children's age). Three dominant themes emerged and included (i) assistance with accessing appropriate services; (ii) provision of consistent information and comprehensive child health records; and (iii) support of parental self‐efficacy in the health care of their child.Conclusion:  Primary health carers are ideally suited to co‐ordinate and provide continuity to improve parental involvement and compliance with health promoting recommendations for their preterm children. This approach may improve interagency co‐operation and access to services enabling early identification and intervention. Adopting these strategies may be effective in optimising child health follow‐up strategies and improve uptake of recommended intervention and prevention programmes.
Circulatory disturbances during the first postnatal 24 hours in extremely premature infants 25 weeks or less of gestation with histological fetal inflammation
Authors: Furukawa Seishi , Sameshima Hiroshi , Ikenoue Tsuyomu 
Published: December 2007

AbstractAim:  To investigate the effect of pre‐existing fetal inflammation on hemodynamics during the first postnatal 24 h in extremely premature infants ≤25 weeks of gestation.Methods:  We defined fetal inflammation as the infiltration of neutrophils into the chorionic plate vessels or umbilical cord vessels on histological examination. In 41 infants born between 22 and 25 weeks of gestation, 23 displayed fetal inflammation and 18 displayed no fetal inflammation. Circulatory indices including blood pressure, heart rate, average urine flow, catecholamine index, ejection fraction of the left ventricle, and volume load for 24 h were compared between the two groups, as well as the incidence of intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and death. The comparisons were made with repeated measure anova and with Fisher's exact test, or unpaired t‐test. Probability values <0.05 were considered significant.Results:  Infants with and without fetal inflammation had similar birthweights and gestational age. There was no significant difference in incidence of PVL and death. However, infants with fetal inflammation had a significantly higher incidence of IVH ≥3 than infants with no fetal inflammation (49% vs 17%) (P = 0.04). Infants with fetal inflammation had significantly higher heart rate (P = 0.005), catecholamine index (P = 0.019) and volume load (P = 0.021).Conclusion:  Histological evidence of fetal inflammation in extremely premature infants is associated with circulatory disturbances over the first 24 h of life and increases in the incidence of IVH ≥3.
Mouse model for allogeneic immune reaction against fetus recapitulates human pre‐eclampsia
Authors: Nishizawa Haruki , Hasegawa Kiyoshi , Suzuki Machiko , Achiwa Yumiko , Kato Takema , Saito Kuniaki , Kurahashi Hiroki , Udagawa Yasuhiro 
Published: December 2007

AbstractAim:  We have previously demonstrated that mRNA expression and enzyme activity levels of placental indoleamine 2,3‐dioxygenase (IDO), which degrades L‐tryptophan and blocks the proliferation of T cells, are significantly low in patients with severe pre‐eclampsia. From this observation, we hypothesized that induction of maternal allogeneic immune reaction by reduced IDO activity is one of the causes of pre‐eclampsia.Methods:  To examine this hypothesis, we administered an IDO inhibitor to pregnant female mice carrying allogeneic concepti. Since administration of an IDO inhibitor to pregnant mice starting at E4.5 is already reported to cause allogeneic fetal rejection, we modified the regimen and started the administration at E6.5 when the fetus and placenta have already been established.Results:  Pregnant mice treated with an IDO inhibitor developed high blood pressure and proteinuria in addition to local circulation impairment in the placenta, which is analogous to the lesions that are characteristic of human pre‐eclampsia. In contrast, pregnant mice carrying syngeneic concepti did not manifest such symptoms.Conclusions:  Our findings reveal a pivotal role for IDO activity in the etiology of pre‐eclampsia. These data also lend support to the current hypothesis that pre‐eclampsia is one of the possible manifestations of a maternal immunological reaction against an allogeneic fetus.
Adolescent primiparas: Changes in obstetrical risk between 1983–1987 and 1999–2005
Authors: Zeck Willibald , Walcher Wolfgang , Tamussino Karl , Lang Uwe 
Published: December 2007

AbstractAims:  Teenage pregnancies have always been considered at increased risk for obstetric complications. Deliveries in adolescent primiparas in the 5‐year time periods 1983–1987 and 1999–2005 were compared against each other, the general population and against primiparas aged 20–29 years in order to reveal trends and differences in obstetric outcome.Methods:  A total of 186 primiparas delivering at an age of 17 or less between October 1999 and October 2005 were compared with 353 adolescent primiparas delivered between 1983 and 1987. Type of delivery and complications such as low birthweight, pre‐eclampsia, breech presentation and third stage complications were studied.Results:  The percentage of adolescents in the overall obstetric population decreased. The cesarean section rate remained the same in the adolescents while increasing in the general population. Rates of low birthweight and operative vaginal delivery increased in the adolescent group and overall. Third stage complications (abnormally adherent or incomplete placentas) decreased in both groups. There were no intrauterine fetal deaths in adolescent pregnancies in either time period. Other obstetric variables were unchanged in the adolescent as well as in the general population between 1999 and 2005. When comparing the adolescents' outcome with the outcome of the 20–29‐year‐old primiparas between 1999 and 2005, it was noted that the rates of abstracted obstetric variables were higher in the population of the 20–29‐year‐olds.Conclusions:  The obstetric outcome of adolescent pregnancies has remained favorable over the last 18 years. We do not consider adolescence as an obstetrical risk. We suggest that adolescent pregnancy is more a public health issue than a clinical problem.
Positive rates for rubella antibody in pregnant women and benefit of post‐partum vaccination in a Japanese perinatal center
Authors: Okuda Mika , Yamanaka Michiko , Takahashi Tsuneo , Ishikawa Hiroshi , Endoh Masaya , Hirahara Fumiki 
Published: December 2007

AbstractAim:  This study of pregnant women was undertaken to clarify their immune status for rubella and to evaluate the efficacy of, and adverse reaction to, post‐partum rubella vaccination.Methods:  We determined the levels of both rubella antibody by hemagglutination inhibition test and IgM antibody by enzyme‐linked immunosorbent assay in the first gestational trimester and surveyed the positive rates for rubella antibody in pregnant women at our perinatal center; we recommended post‐partum vaccination for women with poor immune status. We also evaluated the effectiveness of the vaccine and any adverse reaction.Results:  Among 2741 pregnant women, 185 cases (6.7%) were seronegative for rubella virus. This rate was especially high (12.4%) in the population who had opted out of the vaccination because of a change in Japanese government policy. A total of 30 cases (1.1%) were positive or false‐positive for IgM antibody, but no congenital rubella syndrome (CRS) developed. The seropositive rate was 93.3% in total, but this figure includes those who required post‐partum vaccination (558 cases or 20.3%) because their titers were 16× or lower. Among 145 cases who received post‐partum rubella vaccine, no severe adverse reaction was detected, and in all 37 cases with hemagglutination inhibition antibody titers of 8× or lower, the efficacy rate was 100%.Conclusions:  It is necessary to appropriately evaluate the CRS risk. Also, we need to emphasize the importance and safety of post‐partum rubella vaccination in Japan.
Abnormal glucose tolerance in polycystic ovary syndrome
Authors: Bhattacharya Sudhindra M. 
Published: December 2007

AbstractAim:  To investigate the incidence of abnormal glucose tolerance (AGT) in women with polycystic ovary syndrome (PCOS), and the reliability of fasting plasma glucose level (FPG) as a screening test for this metabolic abnormality.Methods:  Two hundred and three women (62 adolescents and 141 adults) diagnosed with PCOS underwent estimation of FPG and 2‐h plasma glucose after ingestion of 75 g of glucose on an empty stomach. In each case, body mass index (BMI) was calculated from height and weight measurements.Results:  AGT was found in 16.3% of cases (33/203). AGT was found in 9.7% of adolescent cases (6/62) and 19.1% of adults (27/141) (P = 0.03). Women with abnormal glucose tolerance had higher BMI than those with normal glucose tolerance in the two subgroups (not statistically significant). Difference in BMI between adults and adolescents with normal glucose tolerance was statistically significant, but not in cases with AGT.Conclusion:  AGT was found in 16.3% of women with PCOS (19.1% of adults and 9.7% of adolescents). BMI alone is not a significant contributory factor causing deterioration of glucose tolerance as a woman with PCOS matures. Other clinical parameters of obesity such as upper body obesity need to be studied. All women with PCOS should undergo periodic screening for abnormal glucose tolerance. Fasting plasma glucose is a poor screening test to detect abnormal glucose tolerance.
Surgical adhesives and tubal sterilization: An experimental study
Authors: Rivoire Henri C. , Fagundes Djalma J. 
Published: December 2007

AbstractAim:  Our aim was to assess the application of three currently used surgical adhesives in the tubal lumen of rabbits, to promote sterilization, using a transvaginal approach.Methods:  Fifty‐seven female albino New Zealand rabbits (114 uterine tubes), which became pregnant and delivered before the experiment, were divided into four groups: GS (sham‐24 tubes), GEFIBRI (0.25 mL of fibrin adhesive in 30 tubes), GE‐GRF (0.25 mL of resorcin adhesive in 30 tubes) and GEBUTYL (0.25 mL of n‐butyl‐2‐cyanoacrylate adhesive in 30 tubes). The animals were mated with proven fertile males after the experiment and observed over 30, 90 and 180 days. Pregnancy and patency were macroscopically evaluated. The tubal diameter, tubal mucosa, myosalpinx, total optical density and inflammatory process were microscopically evaluated. The statistical analysis was performed by McNemar and Wilcoxon tests for the subgroups, and Fisher's exact test and Kruskal–Wallis test for the groups, the differences identified by Dunn's multiple comparisons test (P = 5%).Results:  GS showed patency and pregnancies in all subgroups. GEFIBRI showed patency and pregnancies in all subgroups. GE‐GRF did not show patency or pregnancies, but was associated with severe inflammatory process and tubal morphology alterations. GEBUTYL did not show patency, pregnancies or morphological tubal mucosa alterations.Conclusions:  The n‐butyl‐2‐cyanoacrylate adhesive effectively promoted tubal obstruction, did not cause tubal morphological alterations, nor did it impair the rabbit pregnancy. The fibrin adhesive failed to cause the occlusion. The GRF adhesive, in spite of producing tubal occlusion, caused severe uterine tubes damage.
Trichomonas vaginalis infection: Risk indicators among women attending for routine gynecologic examination
Authors: Verteramo Rosita , Calzolari Ettore , Degener Anna Marta , Masciangelo Raffaele , Patella Alfredo 
Published: December 2007

AbstractObjectives:  Trichomonas vaginalis is one of the most common agents of sexually transmitted disease, but trichomoniasis is still considered as an infection of minor importance. The aim of this study was to investigate the risk indicators for trichomoniasis in women attending for routine gynecologic examination.Methods:  The study was conducted comparing demographic and behavioral characteristics in two groups of 122 women with T. vaginalis infection and 853 uninfected women.Results:  Univariate analysis showed a significant increase of T. vaginalis infection among women with older age and multiple sexual partners. In multiple logistic regression analysis, the higher number of lifetime partners and older age remained significantly associated with T. vaginalis infection.Conclusions:  This study suggests that T. vaginalis infection might be mainly related to lifestyle risk factors. Therefore, in our opinion, the diagnosis and treatment of this disease should be encouraged on routine gynecologic examination.
Use of oral glucose tolerance test in early pregnancy to predict late‐onset gestational diabetes mellitus in high‐risk women
Authors: Phaloprakarn Chadakarn , Tangjitgamol Siriwan 
Published: December 2007

AbstractAim:  To evaluate if any single plasma glucose level from the four values of the normal 100‐g oral glucose tolerance test (OGTT) in early pregnancy (≤20 weeks of gestation) could predict gestational diabetes mellitus (GDM) diagnosed from a second OGTT in late pregnancy (28–32 weeks).Methods:  Glucose levels of pregnant women at high‐risk for GDM, who had had a normal early OGTT, and who underwent the second test in late pregnancy, were studied. Each of the four plasma glucose values of the early OGTT was determined for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The receiver operating characteristic curves of these four OGTT values were then constructed to find the optimal value to predict late‐onset GDM.Results:  Of 193 pregnant women who had had a normal early OGTT, 154 also had a normal OGTT in late pregnancy while 39 had an abnormal test and were diagnosed with GDM. Among the four glucose values of the early OGTT, the 1‐h value yielded the best diagnostic performance to predict late‐onset GDM. The sensitivity, specificity, PPV, NPV, and area under the curve achieved from its optimal cutoff level of ≥155 mg/dL (8.6 mmol/L) were 89.7%, 64.3%, 38.9%, 96.1%, and 0.77, respectively.Conclusions:  A 1‐h glucose value ≥155 mg/dL at the early OGTT yielded the best diagnostic performance. However, the low specificity and PPV rendered it suboptimal to predict late‐onset GDM. Nevertheless, a considerable number of high‐risk women could avoid the second OGTT in late pregnancy due to its high sensitivity and NPV.