bluuebunny/crossref_metadata_2025_split huggingface dataset:
Newborn screening: A national public health programme in Brazil
Authors: Marini de Carvalho T. , Pimentel dos Santos H. , dos Santos I. C. G. P. , Vargas P. R. , Pedrosa J. 
Published: August 2007

SummaryThe newborn screening programme started in Brazil (1976) through isolated initiatives, without governmental directions and/or policies. According to Health Ministry (2000) data the coverage was 55% and unevenly distributed. Only 17 out of 27 Brazilian states had more than 30% coverage. Public budgets covered only diagnostic examinations. There were no official data about assistance, patient follow‐up or detected disorders. The creation of the National Programme (2001) has provided new perspective for newborn screening (NBS) in the public health system. It has provided important official data and established management and care units for each state: Reference Services in Newborn Screening. The programme screened about 13 million newborns from October 2001 to December 2005. The coverage increased to 80.2% (2005) and 74% of the states presented coverage of over 70%. Within 34 accredited Reference Services in 27 Brazilian states, all provide screening for PKU and CH. Ten of them provide screening for haemoglobinopathies as well, and three of them provide also for CF. The Reference Services altogether count on at least 170 health professionals, such as paediatricians, endocrinologists, nutritionists, psychologists and social workers. They are qualified to assist positive cases, within the policies established by the National Programme. There has been significant increase in NBS coverage and follow‐up assuredness, including detected cases before the National Programme (10 935 positive cases) mostly in those regions where the programme did not exist. There has been significant evolution in the Newborn Screening as a Public Health Program in Brazil due to the government's commitment (federal and each component state).
Structures for clinical follow‐up: Newborn screening
Authors: Howell R. Rodney , Engelson Gilian 
Published: August 2007

SummaryClinical follow‐up of children identified by newborn screening is critical in ensuring that the short‐term and long‐term needs of the newborn infant are managed. Within the United States, one of the biggest challenges in the newborn screening programme is clinical follow‐up, and there still remains wide variation in practice patterns among states on how infants are followed up. In addition, there is lack of consistency in the treatment and diagnostic protocols used by health care providers. There is growing interest in the establishment of a systematic process for follow‐up and for the development of a nationwide infrastructure that will ensure that all children will be provided consistent and effective treatment in a timely manner. Within this framework of optimal diagnosis and therapy, there must also be opportunities to study the natural history of these conditions, to monitor short‐ and long‐term health outcomes, to assist with policy decision‐making, to validate the effectiveness of screening, to define the clinical spectrum of the diseases, and to provide opportunities for the advancement of novel therapeutic interventions and screening/diagnostic technologies. It will only be through the development of a structured clinical follow‐up system that we will be able to make certain these newborn infants are provided the most appropriate treatment for their disease variants and allow researchers to make more rapid advances in improving the clinical management of these conditions.
Direct comparison of enzyme measurements from dried blood and leukocytes from male and female Fabry disease patients
Authors: Lukacs Z. , Hartung R. , Beck M. , Keil A. , Mengel E. 
Published: August 2007

SummaryAnderson–Fabry disease is an X‐linked disorder that is caused by deficiency of the lysosomal enzyme α‐galactosidase A. Symptoms include chronic progressive painful small‐fibre neuropathy, cornea verticillata, renal failure and heart disease. Interestingly, female heterozygous patients may also show severe symptoms. After clinical suspicion, usually the determination of α‐galactosidase activity in leukocytes is requested first. Alternatively, an enzymatic assay using dried blood specimens has been described. Dried blood samples require less material and are substantially more stable (several months at room temperature) than whole‐blood specimens. To validate the new method and to asses its usefulness for diagnosis of female patients, enzyme activities of α‐galactosidase, β‐galactosidase and β‐glucuronidase from 78 known Fabry patients were compared (29 males, 47 females) between both materials. In summary, the determination of α‐galactosidase activity using dried blood and leukocytes as well as the ratio of α‐galactosidase to β‐glucuronidase in dried blood can improve the diagnostic specificity in cases of female patients who are difficult to identify when only leukocyte enzyme activities are considered.
Continuity, comorbidity and longitudinal associations between depression and antisocial behaviour in middle adolescence: A 2‐year prospective follow‐up study
Authors: Ritakallio Minna , Koivisto Anna‐Maija , von der Pahlen Bettina , Pelkonen Mirjami , Marttunen Mauri , Kaltiala‐Heino Riittakerttu 
Published: August 2007

AbstractThe study investigated continuity, comorbidity and longitudinal associations between depression Beck depression inventory (RBDI) and antisocial behaviour Youth self‐report (YSR) in middle adolescence. Data were used from a community sample of 2070 adolescents who participated in a 2‐year prospective follow‐up study. The results indicate that both depression and antisocial behaviour had considerable continuity, and concurrent comorbidity between these disorders was strong. In contrast to several previous studies, antisocial behaviour did not predict subsequent depression, but conversely, depression predicted subsequent antisocial behaviour among girls. Among boys history of depression seemed to protect from subsequent antisocial behaviour. Gender differences in longitudinal associations are discussed.
Dietary fat intakes for pregnant and lactating women
Authors: Koletzko Berthold , Cetin Irene , Thomas Brenna J. ,   for the Perinatal Lipid Intake Working Group
Published: August 2007

Consensus recommendations on behalf of the European Commission research projects Perinatal Lipid Metabolism (PeriLip;www.perilip.org) and Early Nutrition Programming (EARNEST;www.metabolic-programming.org), developed jointly with representatives of the Child Health Foundation (Stiftung Kindergesundheit;www.kindergesundheit.de), the Diabetic Pregnancy Study Group (DPSG;www.medfak.uu.se/dpsg), the European Association of Perinatal Medicine (EAPM;www.europerinatal.com), the European Society for Clinical Nutrition and Metabolism (ESPEN;www.espen.org), the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, Committee on Nutrition (ESPGHAN;www.espghan.org), the International Federation of Placenta Associations (IFPA;http://aculeate.hopto.org/IFPA) and the International Society for the Study of Fatty Acids and Lipids (ISSFAL; emailwww.issfal.org.uk).Members of the Perinatal Lipid Intake Working GroupGioia Alvino, Juliana von Berlepsch, Hans Konrad Biesalski, Tom Clandinin, Hildegard Debertina, Tamás Decsi, Hans Demmelmaira, Gernot Desoyebc, Veronika Dietz, Peter Dodds, Pauline Emmett, Fabio Facchinettid, Matthew W. Gillman, Joachim Heinrich, Emilio Herrerab, Irene Hoesli, William C. Heird, Matthew Hyde, Kirsi Laitinen, John Laws, Elvira Larqué Daza, Iliana Lopez-Soldado, Maria Makrides, Kim Fleischer Michaelsene, Sjurdur Olsen, Henar Ortega, Guy Putet, Imogen Rogers, Paola Roggero, Lubos Sobotkaf, Hania Szajewskag, Hope Weiler.(Representing:aChild Health Foundation,bDPSG,cIFPA,dEAPM,eISSFAL,fESPEN,gESPGHAN.)Dietary fat intake in pregnancy and lactation affects pregnancy outcomes and child growth, development and health. The European Commission charged the research project PERILIP, jointly with the Early Nutrition Programming Project, to develop recommendations on dietary fat intake in pregnancy and lactation. Literature reviews were performed and a consensus conference held with international experts in the field, including representatives of international scientific associations. The adopted conclusions include: dietary fat intake in pregnancy and lactation (energy%) should be as recommended for the general population; pregnant and lactating women should aim to achieve an average dietary intake of at least 200 mg DHA/d; intakes of up to 1 g/d DHA or 2·7 g/dn-3 long-chain PUFA have been used in randomized clinical trials without significant adverse effects; women of childbearing age should aim to consume one to two portions of sea fish per week, including oily fish; intake of the DHA precursor, α-linolenic acid, is far less effective with regard to DHA deposition in fetal brain than preformed DHA; intake of fish or other sources of long-chainn-3 fatty acids results in a slightly longer pregnancy duration; dietary inadequacies should be screened for during pregnancy and individual counselling be offered if needed.
Awake insertion of the fibreoptic intubating LMA CTrach™ in three morbidly obese patients with potentially difficult airways*
Authors: Wender R. , Goldman A. J. 
Published: August 2007

SummaryThe Intubating Laryngeal Mask Airway (ILMA) is a supraglottic airway that facilitates ventilation and blind tracheal intubation. The LMA CTrach™ is functionally identical to the ILMA, but has an integrated fibreoptic bundle that provides a view of the larynx. This enables visualisation of tracheal intubation while delivering 100% oxygen, with or without an inhalational anaesthetic. We report awake insertion of the CTrach in three morbidly obese patients (BMI 60–63) with known or anticipated difficult airways. Pre‐operatively, patients were given midazolam and glycopyrrolate intravenously, and then in the operating theatre the airway was anaesthetised with topical lidocaine 4%. The CTrach was inserted into the oropharynx of the still‐awake patient, the vocal cords were visualised, and anaesthetic induction was commenced with sevoflurane and spontaneous ventilation. Neuromuscular blockers were not used and we were able to see the vocal cords during the entire anaesthetic induction and intubation.
A study of airway management using the ProSeal LMA® laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgery
Authors: Hohlrieder M. , Brimacombe J. , Eschertzhuber S. , Ulmer H. , Keller C. 
Published: August 2007

SummaryIn a randomised double blind prospective study, we tested the hypothesis that postoperative pain is lower in patients who receive an ProSeal LMA™ laryngeal mask airway compared with a tracheal tube. One hundred consecutive female patients (ASA I–II, 18–75 years) undergoing laparoscopic gynaecological surgery were divided into two equal‐sized groups for airway management with the ProSeal LMA or tracheal tube. Anaesthesia management was identical for both groups and included induction of anaesthesia using propofol/fentanyl, and maintenance with propofol/remifentanil, muscle relaxation with rocuronium, positive pressure ventilation, gastric tube insertion, dexamethasone/tropisetron for anti‐emetic prophylaxis, and diclofenac for pain prophylaxis. All types of postoperative pain were treated using intravenous patient‐controlled analgesia (PCA) morphine. Patients and postoperative staff were unaware of the airway device used. Data were collected by a single blinded observer. We found that pain scores were lower for the ProSeal LMA at 2 h and 6 h but not at 24 h. Morphine requirements were lower for the ProSeal LMA by 30.4%, 30.6% and 23.3% at 2, 6 and 24 h, respectively. Nausea was less common with the ProSeal LMA than with the tracheal tube at 2 h and 6 h but not at 24 h. There were no differences in the frequency of vomiting, sore throat, dysphonia or dysphagia. We conclude that postoperative pain is lower for the ProSeal LMA than the tracheal tube in females undergoing gynaecological laparoscopic surgery.
Apnoeic spells following general anaesthesia in a patient with familial hemiplegic migraine
Authors: Willson J. , Kapur S. 
Published: August 2007

SummaryHemiplegic migraine is an unusual variant of migraine, characterised by a temporary hemiparesis or hemiplegia associated with headache. We report a patient with hemiplegic migraine who developed atypical migraine with apnoeic spells, aphasia and hemiparesis following general anaesthesia. We review the clinical features of hemiplegic migraine and the considerations for its anaesthetic management.
The utility of B‐type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non‐cardiac surgery
Authors: Cuthbertson B. H. , Card G. , Croal B. L. , McNeilly J. , Hillis G. S. 
Published: August 2007

SummaryB‐type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non‐cardiac surgery. Forty patients were studied with a primary end‐point of a new postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all‐cause mortality at 6 months. Pre‐operative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p = 0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI = 0.72–0.98, p = 0.001). A pre‐operative BNP value > 170 pg.ml−1 has a sensitivity of 82% and a specificity of 79% for the primary end‐point. In this small study, pre‐operative BNP levels identify patients undergoing major emergency non‐cardiac surgery who are at increased risk of early postoperative cardiac events. Larger studies are required to confirm these data.
Effects of normobaric hyperoxia on haemodynamic parameters of healthy full‐term parturients
Authors: Litchfield K. N. , Harten J. M. , Anderson K. J. , Kinsella J. , McGrady E. M. 
Published: August 2007

SummaryFifteen healthy, full‐term women with singleton pregnancies were exposed to an increased FIo2 of 0.4 and their haemodynamic responses measured with a non‐invasive transthoracic bio‐impedance monitor. There was a mean reduction in cardiac index from 3.18 to 3.03 l.min−1.m−2 (4.7%, p = 0.004). The mean indexed systemic vascular resistance increased from 2049 to 2178 dynes.cm−5.m−2 (5.7%, p = 0.005). There were no significant changes in stroke index, heart rate or mean arterial pressure. This study demonstrates that even a moderate increase in inspired oxygen fraction has significant effects on the cardiovascular system of the term parturient.
Comparison of the Airway Scope®, gum elastic bougie and fibreoptic bronchoscope in simulated difficult tracheal intubation: a manikin study
Authors: Koyama Y. , Inagawa G. , Miyashita T. , Kikuchi T. , Miura N. , Miki T. , Kurihara R. , Kamiya Y. , Goto T. 
Published: August 2007

SummaryWe compared the Airway Scope® with a gum elastic bougie and fibreoptic bronchoscope in a manikin with a simulated Cormack and Lehane Grade 3 laryngoscopic view. Twenty‐seven anaesthetists intubated the trachea of the manikin with these devices and the time required for intubation was measured. They were then asked to rate the subjective difficulty of intubation (1 = very easy; 5 = very difficult). Mean (SD) intubation times were 16.6 (11.2) s with the Airway Scope, 29.4 (10.9) s with the gum elastic bougie (p < 0.0001), and 30.6 (20.0) s with the fibreoptic bronchoscope (p < 0.0001). The median (range) difficulty was 2 (1–4) with the Airway Scope, 3 (2–4) with the gum elastic bougie (p < 0.001), and 2 (1–5) with the fibreoptic bronchoscope (p = 0.014). In Cormack and Lehane grade 3 laryngoscopic views, the Airway Scope may enable faster and easier tracheal intubation than does a Macintosh laryngoscope with a gum elastic bougie or a fibreoptic bronchoscope.
Bacterial contamination of anaesthetists' hands by personal mobile phone and fixed phone use in the operating theatre
Authors: Jeske H.‐C. , Tiefenthaler W. , Hohlrieder M. , Hinterberger G. , Benzer A. 
Published: August 2007

SummaryFollowing hand disinfection, 40 anaesthetists working in the operating room (OR) were asked to use their personal in‐hospital mobile phone for a short phone call. After use of the cell phone, bacterial contamination of the physicians' hands was found in 38/40 physicians (4/40 with human pathogen bacteria). After repeating the same investigation with fixed phones in the OR anteroom 33/40 physicians showed bacterial contamination (4/40 with human pathogen bacteria). The benefit of using mobile phones in the OR should be weighed against the risk for unperceived contamination. The use of mobile phones may have more serious hygiene consequences, because, unlike fixed phones, mobile phones are often used in the OR close to the patient.
Peri‐operative respiratory failure in a cirrhotic patient: a misleading diagnosis
Authors: Busani S. , Rinaldi L. , Barbieri E. , Drago A. , Barbieri A. , Girardis M. 
Published: August 2007

SummaryPatients with chronic liver disease may present with different degrees of respiratory dysfunction whose differential diagnosis is important before elective surgery. We report the case of a misleading diagnosis of peri‐operative respiratory failure in a cirrhotic patient who underwent mastectomy. Intra‐operative respiratory failure was ascribed by the anaesthetic team to pulmonary embolism and after the operation this diagnosis was still suspected. Despite postoperative heparin treatment, pulmonary gas exchange remained severely impaired. On the hypothesis of a right to left shunt, we performed transoesophageal echocardiography with a bubble test and confirmed hepatopulmonary syndrome. We administered anticoagulant therapy to the patient following surgery, increasing the risk of haemorrhage. We also continued orotracheal intubation and mechanical ventilation longer than was needed. Respiratory symptoms in a patient with liver disease should not be underestimated and up to 20% of these patients may have hepatopulmonary syndrome.
An evaluation of the TruView EVO2 laryngoscope
Authors: Li J. B. , Xiong Y. C. , Wang X. L. , Fan X. H. , Li Y. , Xu H. , Ma Y. , Deng X. M. 
Published: August 2007

SummaryThe TruView EVO2 laryngoscope was compared with the traditional Macintosh laryngoscope in 200 patients who required tracheal intubation for elective surgery. Mallampati score determined prior to laryngoscopy was significantly related to the view of the glottis during laryngoscopy for both laryngoscopes. The view of the larynx was better with the TruView EVO2 laryngoscope than with the Macintosh laryngoscope in patients with a Cormack and Lehane grade greater than 1 (p < 0.01). The mean time to intubate was significantly shorter with the Macintosh laryngoscope (34 s) than with the TruView laryngoscope (51 s) (p < 0.01).
Ischaemic complications of Glypressin in liver disease: a case series
Authors: Donnellan Fergal , Cullen Garret , Hegarty John E. , McCormick P. Aiden 
Published: August 2007

Aim To report three cases of extensive skin necrosis in cirrhotic patients treated with the vasoconstrictor agent terlipressin (Glypressin).Methods We identified three patients who developed skin necrosis and determined any factors, which put them at an increased risk of doing so.Results Two patients were obese and developed extensive abdominal wall skin necrosis. The third patient had lower limb chronic venous insufficency and developed extensive necrosis of both lower limbs.Conclusions With increasing clinical use of terlipressin and an increasing incidence of obesity and non‐alcoholic fatty liver disease‐related cirrhosis, the incidence of these serious complications is likely to rise. Earlier recognition and treatment may lead to improved outcome.
Nonsteroidal anti‐inflammatory drug use and the risk of severe skin and soft tissue complications in patients with varicella or zoster disease
Authors: Mikaeloff Yann , Kezouh Abbas , Suissa Samy 
Published: August 2007

What is already known about this subject • Three previous epidemiological studies found an increased risk of severe skin and soft tissue infectious complications associated with exposure to NSAIDs in children with varicella.• In vitro studies demonstrated that decreases in defences against infections induced by NSAIDs could be due to impairment of neutrophil blood cell function. What this study adds • The use of NSAIDs is associated with an increased risk of severe skin and soft tissue complication of varicella in children.• The use of NSAIDs is also associated with a small increased risk of such complications in zoster disease in adults and the elderly.• This study supports the limited prescription of NSAIDs in VZV infection.Aims To assess the risk of severe skin and soft tissue complications associated with the use of nonsteroidal anti‐inflammatory drugs (NSAIDs) in treating patients with varicella zoster virus infection.Methods The design was a nested case‐control study, with matching for age and practice. The setting was primary care in the United Kingdom (United Kingdom's General Practice Research Database). Two population‐based cohorts of all patients with a primary varicella (n = 140 111) or zoster (n = 108 257) diagnosis during 1994–2005 were followed up for 2 months after diagnosis. Main outcome measures of severe skin or soft tissue complications (mostly cellulitis and abscess) associated with current NSAID or paracetamol use were estimated, and adjusted for potential confounding factors, including sex, drug use, and comorbidity.Results In patients with varicella, there were 386 cases of severe skin or soft tissue complications (rate 2.8 per 1000) during the 2 month follow‐up period (mean age 10.7 years). The rate of complications associated with exposure to NSAIDs was increased (rate ratio 4.9; 95% CI 2.1, 11.4). In patients with zoster disease, there were 681 cases of severe skin or soft tissue complications (rate 6.3 per 1000) during the 2 month follow‐up (mean age 60.9 years). The rate ratio of complications associated with exposure to NSAIDs was 1.6 (95% CI 1.1, 2.4). In both conditions, there was no increased risk of complication associated with a current exposure to paracetamol.Conclusions The use of NSAIDs is associated with an elevated risk of severe skin and soft tissue complications of varicella zoster virus infection, mostly in children with varicella.