bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological and developmental outcome of neonatal jaundice and sepsis in rural Kenya
Authors: Gordon Anne L. , English Michael , Tumaini Dzombo J , Karisa Mary , Newton Charles R. J. C. 
Published: October 2005

SummaryNeonatal jaundice (NJ) and sepsis are common causes of neonatal mortality in sub‐Saharan Africa, but little is known about the long‐term morbidity in this setting. This study aimed to describe the neurological and developmental sequelae of severe neonatal hyperbilirubinaemia and neonatal sepsis (NS) in a district hospital in rural Kenya. Twenty‐three term infants with NJ [total serum bilirubin (TSB) >300 μmol/l] and 24 infants with a history of NS were identified from hospital records. These children were compared to 40 children from the community (CC) without neonatal problems. At ages 18–32 months, the children's neurological, motor and developmental status were assessed, and blood groups of the NJ and NS subjects and their mothers were determined. Ten (43%) of the NJ subjects were unable to sit and/or stand independently. The NJ subjects had significantly more neurological, motor and developmental difficulties and caused greater maternal concern than the CCs. Five (21%) of the NJ subjects had possible blood group incompatibility. The NS subjects had significantly more motor and eye‐hand difficulties and maternal concerns expressed than the CCs. Severe NJ in term infants (of mainly non‐haemolytic origin) was associated with a high prevalence of neurological and developmental sequelae at ages 18–32 months. The NS is also associated with neuro‐developmental sequelae, but the pattern is different to those seen in NJ. Since NS is common in resource poor countries, this may be an important cause of neuro‐developmental impairment in children living in this setting.
Use of intermittent preventive treatment for malaria in pregnancy in a rural area of western Kenya with high coverage of insecticide‐treated bed nets
Authors: van Eijk A. M. , Blokland I. E. , Slutsker L. , Odhiambo F. , Ayisi J. G. , Bles H. M. , Rosen D. H. , Adazu K. , Lindblade K. A. 
Published: October 2005

SummaryKenya established intermittent preventive treatment (IPT) with sulfadoxine‐pyrimethamine (SP) for malaria in pregnancy as national policy in 1998. We assessed the coverage of IPT among women who had recently delivered in a rural area of western Kenya with perennial malaria transmission and high coverage with insecticide treated nets (ITNs) through a cross‐sectional, community‐based survey in December 2002. Antenatal clinic (ANC) attendance was high (89.9% of the 635 participating women); 77.5% of attendees visited an ANC before the third trimester and 91.9% made more than one visit. Delivery of SP by the ANC was reported by 19.1% of all women but only 6.8% reported receiving more than one dose. Given the high rate of use of ANC services, if SP were given at each visit after the first trimester, the potential coverage of IPT (two doses of SP) would be 80.3% in this study population. ITNs were used by 82.4% of women during pregnancy, and almost all mothers (98.5%) who slept under an ITN shared the nets with their newborns after delivery. Women who thought malaria in pregnancy caused foetal problems were more likely to have used an ITN (adjusted odds ratio [AOR] 1.6, 95% confidence interval [CI] 1.0–2.4), and to have visited ANC more than once (AOR 2.4, 95% CI 1.2–4.7) compared to women who thought malaria in pregnancy was either not a problem or caused problems for the mother only. These findings illustrate the need for improved IPT coverage in this rural area. Identification and removal of the barriers to provision of IPT during ANC visits can help to increase coverage. In this area of Kenya, health messages stressing that foetal complications of malaria in pregnancy may occur in the absence of maternal illness may improve the demand for IPT.
Strategies for evaluating B*18 allelic diversity by sequence‐based typing applied to studies of a population from Singapore and African‐Americans
Authors: Hou L. , Tu B. , Ling G. , Tang T. , Cao K. , Steiner N. K. , Lazaro A. , Ng J. , Hartzman R. J. , Hurley C. K. 
Published: October 2005

AbstractStrategies to resolve B*18 alleles which carry a deletion in intron 1 close to the 5′ end of exon 2 relative to other HLA‐B alleles or a null allele mutation in exon 1 and to resolve ambiguities among allele combinations including B*18 are described. B*18 allele frequencies from volunteer donors recruited for two hematopoietic stem cell registries show the presence of two alleles, B*180101 and B*1802, in a population from Singapore and only B*180101 in African‐Americans.
HLA analysis of the Parsi (Zoroastrian) population in Pakistan
Authors: Mohyuddin A. , Mehdi S. Q. 
Published: October 2005

AbstractThe Parsis of Pakistan are descendants of Zoroastrians from Iran who fled to Gujarat in India after the Arab invasion in 900 AD. A small group eventually migrated from India to Karachi in Pakistan. In this study, the Parsis from Pakistan were analyzed at the HLA‐B, ‐C, ‐DRB1 and ‐DQB1 loci using the polymerase chain reaction with sequence‐specific primers (PCR‐SSP). The most common alleles at the HLA loci were HLA‐B*35 (15.9%), HLA‐Cw*0602 (21.4%), HLA‐DRB1*11 (23.0%), and HLA‐DQB1*02 (24.7%). Data analysis suggests that the Parsis of Pakistan and India descended from the same stock and may have the closest ancestry with Jewish and Italian populations.
Three cases of adenocarcinoma following restorative proctocolectomy with hand‐sewn anastomosis for ulcerative colitis: a review of reported cases in the literature
Authors: Lee S. W. , Sonoda T. , Milsom J. W. 
Published: October 2005

AbstractRestorative proctocolectomy (RPC) has been accepted as optimal surgical therapy for most patients with ulcerative colitis. The occurrence of adenocarcinoma adjacent to the ileoanal anastomotic site for ulcerative colitis is a serious but rare outcome. There are 16 reported cases. We report three additional cases and review previous cases in the literature.
Microarray profiling of colorectal cancer in Bangladeshi patients
Authors: Ahmed S. , Banerjea A. , Hands R. E. , Bustin S. , Dorudi S. 
Published: October 2005

AbstractObjective  We have carried out a retrospective analysis of all cases of colorectal cancer at the Royal London Hospital between April 1998 and March 2002 and determined the differences in presentation and outcome between Bangladeshi and Non‐Bangladeshi patients. DNA microarrays were used to explain any potential genetic differences between these two groups that may explain the different phenotypes.Materials and methods  We examined the colorectal database at our institution. Microarray profiles, using Affymetrix HU133A Genechips™ (Santa Clara, CA USA) were obtained from 10 Bangladeshi patients and an age‐, sex‐ and stage‐matched group of 10 Non‐Bangladeshi patients.Results  Three hundred and sixty‐three patients have been treated for colorectal cancer at the Royal London Hospital. Eighteen (5%) patients were of Bangladeshi origin. The prevalence was 27/100 000 compared to 342/100 000 of the Non‐Bangladeshi population. Eleven (61%) of 18 Bangladeshi patients were under the age of 40 and 4 (22%) patients presented with locally advanced or metastatic disease. In comparison 39/345 (11%) of non‐Bangladeshi patients presented with advanced disease. None of the Bangladeshi patients gave a positive family history. Microarray profiling between these two groups demonstrated 1203 differentially expressed genes (P < 0.05).Conclusion  Colorectal cancer is uncommon in the Bangladeshi patients compared to the non‐Bangladeshi population. This cancer presents in younger patients and at a more advanced stage. There is no positive family history within this ethnic community and therefore the cancers are sporadic. However, microarray profiling is able to delineate different gene expression between these two groups. Therefore, there should be a low threshold for investigating young Bangladeshi patients with symptoms of colorectal neoplasia and any future national screening programme should allow for ethnic variation.
Iron deficiency anaemia – useful diagnostic tool for right sided colon cancers?
Authors: Rai S. , Hemingway D. 
Published: October 2005

AbstractObjective  Diagnosis of right‐sided colon cancers requires total colonic imaging. The decision as to when a symptomatic patient should undergo a complete colonic imaging is difficult. It has been suggested that the presence of iron deficiency anaemia in such patients can be a useful tool in making that decision, as the vast majority of proximal colon cancers are anaemic. Our study aimed to evaluate the relation between proximal colon cancers and anaemia.Methods  A list of 194 patients who underwent a right hemicolectomy for colon cancer was extracted from our hospital cancer database. The haemoglobin levels of each of these patients at the time of their referral were identified. The proportion of these patients, who had anaemia as per locally agreed guidelines, was determined.Results  Only 44% of the men and 57% of women with proximal colon cancer were found to be anaemic. Even after using higher cut‐off levels for ‘low’ haemoglobin, a significant proportion of patients were not anaemic.Conclusions  Anaemia is a poor predictor of right‐sided colon cancers and cannot be used as an effective investigative tool in symptomatic patients.
Male sexual function improves after ileal pouch anal anastomosis
Authors: Gorgun E. , Remzi F. H. , Montague D. K. , Connor J. T. , O'Brien K. , Loparo B. , Fazio V. W. 
Published: October 2005

AbstractPurpose  Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis has become the gold standard surgical therapy for the majority of patients with mucosal ulcerative colitis. However sexual functional disturbances after this procedure can be a concern for patients. Therefore the aim of this study was to determine the outcome of sexual‐function related quality of life in male patients undergoing restorative proctocolectomy.Methods  One hundred and twenty‐two male patients who underwent restorative proctocolectomy with ileal pouch anal anastomosis between 1995 and 2000 were evaluated by the validated International Index of Erectile Function (IIEF) scoring instrument. This index scale examines sexual function in five categories. These are erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. The IIEF instrument was administered after surgery and then scores before and after RP/IPAA were evaluated and compared. The significance of age at the time of the surgery, type of surgery, type of anastomotic technique (mucosectomy vs stapled) and septic complications on sexual functional outcome were also investigated.Results  Mean age at the time of the surgery was 39.9 ± 11.5 years. The mean follow‐up period (time between pouch surgery and IIEF completed) was 3.6 ± 1.8 years. There was statistically significant improvement in 4 of 5 categories of sexual function (erectile function, sexual desire, intercourse satisfaction, and overall satisfaction) where patients had improved scores after surgery compared to prior to surgery. The mean erectile function score increased pre to post surgery by 2.12 points (P = 0.02), which indicates better sexual results. Anastomotic technique and septic complication did not influence the results, however, older age had a negative impact on results.Conclusions  Despite some adverse sexual functions, male patients who undergo RP/IPAA for the surgical management of their colitis may preserve or improve their overall sexual functional outcome.
POVERTY AND INEQUALITY: CHALLENGES FOR THE IAB: IAB PRESIDENTIAL ADDRESS
Authors: LUNA FLORENCIA 
Published: October 2005

ABSTRACTThis paper focuses on poverty and inequality in the world today. First, it points out how this topic is a main concern for the IAB. Second, it proposes ‘new’ theoretical tools in order to analyze global justice and our obligations towards the needy. I present John Rawls's denial that the egalitarian principle can be applied to the global sphere, his proposed weak duty of assistance, and his consideration of endemic poverty as essentially homegrown. In opposition, I focus on Thomas Pogge as representative of a cosmopolitan view who also holds a critical position towards the international systems which allow and cause poverty. I endorse the general normative proposal that defends every human being as an ultimate unit of moral concern, as well as the strategy of moving away from the charity model of bilateral aid to the realm of rights and duties. These ideas should redesign and broaden the normative and practical roles of institutions, and should also help provide a new approach on bioethical issues such as drug patenting or the imbalance in global research and neglected diseases.
GLOBAL HEALTH AND JUSTICE
Authors: DWYER JAMES 
Published: October 2005

ABSTRACTIn Australia, Japan, Sweden, and Switzerland, the average life expectancy is now greater than 80 years. But in Angola, Malawi, Sierra Leone, and Zimbabwe, the average life expectancy is less than 40 years. The situation is even worse than these statistics suggest because average figures tend to mask inequalities within countries. What are we to make of a world with such unequal health prospects? What does justice demand in terms of global health? To address these questions, I characterize justice at the local level, at the domestic or social level, and at the international or global level. Because social conditions, structures, and institutions have such a profound influence on the health of populations, I begin by focusing attention on the relationship between social justice and health prospects. Then I go on to discuss health prospects and the problem of global justice. Here I distinguish two views: a cosmopolitan view and a political view of global justice. In my account of global justice, I modify and use the political view that John Rawls developed in The Law of Peoples. I try to show why an adequate political account must include three duties: a duty not to harm, a duty to reconstruct international arrangements, and a duty to assist.
HIV INTERNATIONAL CLINICAL RESEARCH: EXPLOITATION AND RISK
Authors: BALLANTYNE ANGELA 
Published: October 2005

ABSTRACTThis paper aims to show that to reduce the level of exploitation present in (some) international clinical trials, research sponsors must aim to provide both an ex‐ante expected gain in utility and a fair ex‐post distribution of benefits for research subjects. I suggest the following principles of fair risk distribution in international research as the basis of a normative definition of fairness: (a) Persons should not be forced (by circumstance) to gamble in order to achieve or protect basic goods; (b) In cases where one party is gambling with basic goods and the other party is not, the distribution of benefits and burdens must be arranged so that they are of greatest benefit to the worst off; (c) In relationships where one party is gambling for basic goods and the other party is not, the party gambling for basic goods must be assured of some guaranteed benefits in addition to the chance of gaining some potential benefits.These principles are applied to the case of HIV international research. I conclude that the research (as described) is mutually advantageous but still exploitative because the distribution of surplus benefits is unfair. It is unfair because research subjects are gambling with and for basic goods but they are not assured of a fair ex‐post distribution of benefits. Principles (b) and (c) are not satisfied. Research participants are not accorded enough guaranteed benefits to outweigh the risks they undertake.
TO KNOW OR NOT TO KNOW? GENETIC IGNORANCE, AUTONOMY AND PATERNALISM
Authors: WILSON JANE 
Published: October 2005

ABSTRACTThis paper examines some arguments which deny the existence of an individual right to remain ignorant about genetic information relating to oneself – often referred to as ‘a right to genetic ignorance’ or, more generically, as ‘a right not to know’. Such arguments fall broadly into two categories: 1) those which accept that individuals have a right to remain ignorant in self‐regarding matters, but deny that this right can be extended to genetic ignorance, since such ignorance may be harmful to others, particularly those to whom one is genetically related (the ‘harm to others objection’) and 2) those which contend that, even if genetic ignorance is only self harming, it is not something to which individuals can rationally or morally claim to have a ‘right’ at all, since they defend their claims on autonomy‐respecting grounds and ignorance is inimical to autonomy (the ‘incoherence objection’). I argue that defenders of a right not to know have some plausible responses to the ‘harm to others objection’, but that in trying to respond to the ‘incoherence objection’, they and their opponents reach an impasse in which both sides are left voicing concerns about the paternalistic implications of the other's point of view. I conclude that defenders of a right not to know would, therefore, advance their position further by analysing it in terms of values other than those of autonomy and rights.
Prospective epidemiologic study of the outcome and cost‐effectiveness of antenatal screening to detect neonatal alloimmune thrombocytopenia due to anti‐HPA‐1a
Authors: Turner Marc L. , Bessos Hagop , Fagge Timothy , Harkness Mairi , Rentoul Frances , Seymour Janelle , Wilson David , Gray Irene , Ahya Ridheesh , Cairns John , Urbaniak Stan 
Published: October 2005

BACKGROUND: To assess the value of antenatal screening to detect neonatal alloimmune thrombocytopenia (NAIT) due to anti‐HPA‐1a, a prospective study was carried out to quantify the potential clinical benefits and determine whether screening would be cost‐effective.STUDY DESIGN AND METHODS: An observational prospective controlled study was carried out on 26,506 pregnant women over 2 years. HPA‐1a phenotyping was performed in the first trimester and women confirmed HPA‐1a‐negative were tested for anti‐HPA‐1a during pregnancy, at delivery, and 10 to 14 days after birth. Babies of HPA‐1a‐negative women were tested at delivery for thrombocytopenia and examined for signs of bleeding. Economic evaluation was undertaken on the basis of the data collected during the study.RESULTS: Twenty‐five of 318 women (7.9%) had anti‐HPA‐1a detected for the first time. Eight women (43 per 100,000) gave birth to babies with NAIT, and 5 (27 per 100,000) had severe thrombocytopenia. Three babies had mild signs of bleeding, and no cases of intracranial hemorrhage (ICH) or fetal loss were detected. It is estimated that it would cost £60,596 (US$98,771) to detect a case of severe NAIT, where anti‐HPA‐1a has been identified for the first time, and £1,151,323 (US$1,876,656) to prevent a case of ICH, assuming that detection allowed successful intervention.CONCLUSIONS: Our data suggest that severe HPA‐1a NAIT is underdiagnosed in the absence of routine antenatal screening. Serious bleeding complications and ICH, however, occur less frequently in first cases of NAIT than suspected from the literature, and the costs of screening and possible intervention must be balanced against the procedural risks.
Inducers and inhibitors of biomineralization: lessons from pathological calcification
Authors: Giachelli CM 
Published: October 2005

Structured AbstractAuthor –  Giachelli CMObjectives –  Ectopic calcification is a common response to soft tissue injury and systemic mineral imbalance and can lead to devastating clinical consequences when present in joints, heart valves and blood vessels. We have hypothesized that mineralization of matrices in any tissue is normally controlled by a balance between procalcific and anticalcific regulatory proteins such that abnormal deposition of apatite is avoided. Alterations in this balance induced by injury, disease or genetic deficiency are postulated to induce ectopic mineral deposition. Over the past several years, we have developed in vitro and in vivo models of ectopic calcification to investigate potential inducers and inhibitors of this process.Results –  Osteopontin, a secreted phosphoprotein, has emerged as a major inhibitor of ectopic mineralization. Osteopontin is a potent inhibitor of vascular cell calcification in vitro and mice lacking osteopontin are highly susceptible to ectopic calcification. Furthermore, osteopontin treatment of biomaterials protected against ectopic mineralization. Our studies indicate that in addition to inhibiting apatite crystal initiation and growth, osteopontin stimulates resorption of ectopic calcification via peripheral macrophages and giant cells. In contrast, inorganic phosphate has emerged as a major inducer of mineralization in these systems. Elevated inorganic phosphate (Pi) was shown to induce smooth muscle cell matrix calcification with morphological properties similar to those observed in calcified human valves and atherosclerotic plaques. Furthermore, mineralization induced by inorganic phosphate was dependent on the activity of the sodium‐dependent phosphate cotransporter, Pit‐1.Conclusions –  These studies implicate controlled, transcellular transport of Pi as a major requirement for matrix calcification.
Analysis of developmental potentials of dental pulp in vitro using GFP transgenes
Authors: Balic A , Mina M 
Published: October 2005

Structured AbstractAuthors –  Balic A, Mina MBackground –
In recent years there has been increasing progress in identifying stem cells from adult tissues and their potential application for tooth replacement/regeneration. Our previous in vivo studies show that pOBCol3.6GFP and pOBCol2.3GFP transgenic animals provide a unique model to gain insight into progenitor/stem cells in the dental pulp capable of giving rise to odontoblasts.Objectives –  To characterize the behavior of dental pulp cells derived from pOBCol3.6GFP animals in vitro.Experimental design –  Primary cultures were established from the coronal portions of the pulps isolated first molars from 5‐day‐old pOBCol3.6GFP heterozygous mice and grown for 21 days. In these cultures proliferation, clonogenic capacity, activation of 3.6‐GFP and mineralization were examined.Results –  Our observations show that dental pulp cells derived from 3.6‐GFP contain a population of proliferative, clonogenic cells with the ability to mineralize. We also show the stage specific activation/upregulation of 3.6‐GFP in primary cultures derived from dental pulp. In these cultures, expression of Col1a1‐3.6‐GFP occurs prior to the appearance of mineralized nodules and is unregulated in mineralized nodules.Conclusions –  Col1a1‐GFP transgenes appear to fulfill many of the requirements of a marker gene for cell lineage studies in intact tooth and primary cultures derived from dental pulp.