bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic ultrasound‐guided ethanol injection in the pancreas in a porcine model: A preliminary study
Authors: Matsumoto Kakuya , Yamao Kenji , Okubo Kenji , Hara Kazuo , Sawaki Akira , Mizuno Nobumasa , Tajika Masahiro , Kawai Hiroki , Ashida Reiko 
Published: May 2007

AbstractBackground and Aim:  Despite aggressive multimodal treatments, survival rates for patients with pancreatic cancer remain disappointing. Local progression is problematic, and minimally invasive procedures allowing locoregional control are needed. In this study, we attempted endoscopic ultrasound (EUS)‐guided injection of ethanol into the pancreas.Methods:  Under EUS guidance, pure ethanol (2 mL) was injected into normal tissue of the pancreatic body in two anesthetized domestic pigs. Serum concentrations of amylase, aspartame aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase were measured before treatment and at 2 h, 48 h and 2 weeks after injection. Body weight and clinical signs were also observed. After the animals were euthanized, the pancreases were analyzed histologically.Results:  EUS imaging allows real‐time surveillance of the injection procedure. Mild diarrhea was noted in one animal, but no other adverse effects were observed. No marked changes in laboratory tests were noted. Histologically, parenchymal necrosis extending over a wide area was seen without severe inflammation.Conclusion:  EUS‐guided ethanol injection in the pancreas seems to be technically simple. More detailed assessments of the safety and dose–effect relationship issues associated with this procedure are required.
Metabolic syndrome in severe chronic kidney disease: Prevalence, predictors, prognostic significance and effects of risk factor modification
Authors: JOHNSON DAVID W , ARMSTRONG KIRSTEN , CAMPBELL SCOTT B , MUDGE DAVID W , HAWLEY CARMEL M , COOMBES JEFF S , PRINS JOHANNES B , ISBEL NICOLE M 
Published: May 2007

SUMMARY:Background:  Metabolic syndrome (MS) is a significant risk factor for cardiovascular disease, mortality and chronic kidney disease (CKD) in the general population. However, the prevalence, predictors, prognostic value and treatment of MS in the CKD population have not been rigorously studied.Methods:  The study involved 200 stages 4 and 5 CKD patients enrolled in a randomized controlled trial of intensive multiple risk factor modification (targeting hypercholesterolaemia, hyperhomocysteinaemia, anaemia and disordered bone mineral metabolism) versus usual care. Participants were followed for a median period of 22 months.Results:  The overall prevalence of MS was 30.5%. MS was independently predicted by older age, peritoneal dialysis and Maori/Pacific Islander origin. When laboratory parameters were included as covariates, the only significant predictors of MS were higher serum malondialdehyde and lower serum adiponectin concentrations. MS was an independent predictor of time to composite end‐point of cardiovascular death, acute coronary syndrome, revascularization, non‐fatal stroke and amputation (adjusted hazard ratio 2.46, 95% CI 1.17–5.18). No significant difference in cardiovascular event‐free survival was observed in those allocated to intensive risk factor modification compared with usual care.Conclusion:  Metabolic syndrome occurs in 30.5% of stages 4 and 5 CKD patients and is associated with older age, peritoneal dialysis, ethnicity, increased oxidative stress, lower serum adiponectin concentrations and a significantly increased risk of future cardiovascular events. Intervention strategies targeting hypercholesterolaemia, hyperhomocysteinaemia, anaemia and disordered bone mineral metabolism may not be effective in ameliorating the heightened cardiovascular risk of CKD patients with MS.
Predictors of long‐term survival in patients with restrictive thoracic disorders and chronic respiratory failure undergoing non‐invasive home ventilation
Authors: BUDWEISER Stephan , MÜRBETH Raymund E. , JÖRRES Rudolf A. , HEINEMANN Frank , PFEIFER Michael 
Published: May 2007

Background and objectives:  Non‐invasive positive pressure ventilation (NPPV) is an established treatment in restrictive thoracic disorders (RTD) with chronic hypercapnic respiratory failure. The aim of this study was to identify predictors of long‐term survival for patients on NPPV therapy.Methods:  In a 10‐year retrospective cohort of patients with RTD and chronic hypercapnic respiratory failure, survival and the predictive value of nocturnal and daytime blood gases, lung function and laboratory data measured before initiation of NPPV were assessed. The impact of ventilator settings and daily use of NPPV on survival were also evaluated. Patients were re‐admitted every 6 months for follow‐up assessment.Results:  The study recruited 77 patients; 18 died during the study period and three ceased NPPV. Respiratory failure caused eight of the nine respiratory deaths (88.9%). One‐, 2‐ and 5‐year survival rates were 92.5%, 81.0% and 59.0%, respectively. In univariate analyses, higher night‐time PaCO2, base excess (night‐ and daytime) and lower Hb at baseline were associated with significantly worse survival (P < 0.05). Multivariate Cox regression analysis revealed night‐time PaCO2 as an independent predictor of survival (P = 0.042). The small differences in daily duration of use of NPPV and ventilator settings were not significantly related to survival. At follow up, significant improvements were observed for blood gases, lung and respiratory muscle function, as well as a decrease in Hb level (P < 0.01 each).Conclusions:  Base excess, Hb and particularly nocturnal PaCO2 are relevant prognostic factors for survival in RTD and should be considered in assessing patients receiving NPPV.
Seroepidemiology of hepatitis B virus infection among children in Mongolia: Results of a nationwide survey
Authors: DAVAALKHAM DAMBADARJAA , OJIMA TOSHIYUKI , NYMADAWA PAGVAJAV , TSEND NAVAANSODOV , LKHAGVASUREN TSERENKHUU , WIERSMA STEVEN , UEHARA RITEI , WATANABE MAKOTO , OKI IZUMI , NAKAMURA YOSIKAZU 
Published: May 2007

AbstractBackground: Because Mongolia is one of the highly endemic countries for hepatitis B virus (HBV) infection in the world, hepatitis B (HB) vaccine was introduced into the National Expanded Program on Immunization in 1991. However, relatively few data are available concerning HBV infection among children born after the start of the program, so far. The aim of the present paper was to describe the seroepidemiology of HBV infection among primary school children using representative national data.Methods: In 2004, a nationwide school‐based cross‐sectional serosurvey was carried out throughout Mongolia, covering both urban and rural areas. Serum samples were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti‐HBc) and hepatitis B e antigen (HBeAg) as well as for liver enzymes.Results: A total of 1145 children aged 7–12 years were studied, which represents nearly 2% of the second grade population of elementary schools in Mongolia. The overall prevalence of HBsAg and anti‐HBc was 5.2% (95% confidence interval [CI]: 3.9–6.5%) and 15.6% (95%CI: 13.5–17.7%), respectively. Among HBsAg‐positive children 67.8% (95%CI: 55.9–79.7%) were also positive for HBeAg. The prevalence of chronic HBV infection increased by age and was significantly higher among children from rural areas compared to those from urban areas (7.7% vs 3.0%; P < 0.001). In the multivariate logistic regression analysis, rural residence (odds ratio [OR]: 2.57; 95%CI: 1.45–4.58), male sex (OR: 1.9; 95%CI: 1.08–3.26) and age (OR: 1.5; 95%CI: 1.10–2.05) were independent demographic predictors for chronic HBV infection.Conclusions: The prevalence of chronic HBV infection has been decreasing in the Mongolian young generation, most likely due to infant HB vaccination. However, significant rural–urban differences in the prevalence of HBV infection were found that demand further investigation to estimate the potential causes.
Prader–Willi syndrome in Taiwan
Authors: LIN HSIANG‐YU , LIN SHUAN‐PEI , YEN JUI‐LUNG , LEE YANN‐JINN , HUANG CHI‐YU , HUNG HAN‐YANG , HSU CHYONG‐HSIN , KAO HSIN‐AN , CHANG JUI‐HSING , CHIU NAN‐CHANG , HO CHE‐SHENG , CHAO MEI‐CHYN , NIU DAU‐MING , TSAI LI‐PING , KUO PAO‐LIN 
Published: May 2007

AbstractBackground: Prader–Willi syndrome (PWS) is a congenital disorder caused by absent expression of paternal genes in 15q11‐13 affecting multiple systems. The information concerning the clinical features of this genetic disorder is incomplete in Taiwan.Methods: A retrospective analysis was carried out of 70 PWS patients (39 male, 31 females; age range, 1 month–22 years) seen in four major medical centers in Taiwan from January 1980 through June 2005. All cases were confirmed by methylation‐specific polymerase chain reaction. The molecular characteristics, birth history, clinical presentation and laboratory studies were analyzed.Results: Complete genetic analysis was performed in 52 of the 70 patients with PWS. The abnormalities found included deletions in 45 (87%), maternal uniparental disomy (UPD) in five (10%), and a probable imprinting center deletion or an imprinting defect in two (4%). The average weight of the patients at birth was 2588 ± 540 g. Bone age delay of >2 years and growth hormone (GH) deficiency were noted in 11/40 (28%) and 12/20 (60%), respectively. In the 18 in whom both bone age and GH were assessed, abnormalities of both were found in two (11%). In 2000, Taiwan instituted the Rare Diseases and Orphan Drugs Act and mandated a three‐phase screening protocol for PWS. Of the 41 patients diagnosed with PWS before 2000, only four (10%) were diagnosed before the age of 3 months; in the 29 patients diagnosed after 2000, in 15 (52%) the syndrome was confirmed before 3 months of age (P < 0.001).Conclusions: The present finding is in contrast to that of most previous reports that indicated a higher incidence of UPD in PWS. It is unclear whether this discrepancy in the incidence of UPD arises from under‐diagnosis or because of ethnic differences, a question worthy of further study. The three‐phase screening protocol has generated notable improvement in the early diagnosis of PWS in Taiwan.
Renal replacement therapies in pediatric intensive care patients: Experiences of one center in Turkey
Authors: KENDİRLI TANIL , EKİM MESİHA , ÖZÇAKAR ZEYNEP BİRSİN , YÜKSEL SELÇUK , ACAR BANU , ÖZTÜRK‐HIİŞMİ BURCU , DERELLİ EMEL , KAVAZ ASLI , YALAKİ ZAHİDE , YALÇINKAYA FATOŞ 
Published: May 2007

AbstractBackground: Despite constant improvements in caring for critically ill neonates and infants with congenital cardiac disease, sepsis, bone marrow and solid organ transplantation, acute renal failure (ARF) is an important problem in these children. ARF, severe fluid overload and inborn errors of metabolism are some of the indications for acute dialysis in infants and children.Methods: The authors had retrospectively evaluated the medical records of Pediatric Intensive Care Unit, Ankara University School of Medicine, Ankara, Turkey patients who had required acute renal replacement therapy between the dates of January 2002 to February 2005.Results: Medical records of 332 patients were reviewed. Acute renal replacement therapy was performed in 21 patients (6.3%; mean age, 9.6 ± 7.4 years). Dialysis modalities were peritoneal dialysis in 15 patients (71.4%; mean age, 3.9 ± 5.6 years) and hemodialysis in six patients (28.6%; mean age, 12.1 ± 3.2 years). A total of 90% of patients had severe systemic disease leading to ARF. A total of 95% of patients had multiple organ dysfunction syndrome. The most common cause of ARF was refractory shock. At the beginning of renal replacement therapy, 10 patients were anuric, nine patients had volume overload, seven patients had decompensated metabolic acidosis and nine patients had hypotension. The average dialysis period was 4.7 ± 6.4 days. Mortality rate was 66.7%. Eight patients recovered from ARF and chronic renal failure had developed in one patient.Conclusion: In the Pediatric Intensive Care Unit, ARF is frequently seen together with multiple organ dysfunction syndrome and the mortality rate is high. Both peritoneal dialysis and hemodialysis are important renal replacement treatment modalities in patients with ARF. The age and hemodynamic status of the patients are important when choosing treatment modality; generally peritoneal dialysis is preferred in infants and toddler, while hemodialysis is preferred in older children.
Intraventricular hemorrhage in preterm newborns: Risk factors and results from a University Hospital in Istanbul, 8 years after
Authors: VURAL MEHMET , YILMAZ IKBALE , ILIKKAN BARBAROS , ERGINOZ ETHEM , PERK YILDIZ 
Published: May 2007

AbstractBackground: In this prospective study, the authors aimed to show intraventricular hemorrhage (IVH) incidence of premature newborns in the Neonatal Intensive Care Unit of Cerrahpasa Faculty of Medicine, Istanbul, Turkey, and its risk factors, and they tried to compare these results with those they reported 8 years ago.Methods: A total of 103 premature newborns, hospitalized between August 2003 and January 2005 with a gestational age equal or less than 33 weeks, were included in this study. IVH rates and changes in the incidences of risk factors were compared with those that had been reported between January 1995 and January 1997.Results: Mean birthweight of this population was 1400 ± 380 g (min, 550 g; max, 2000 g) and gestational age 30.3 ± 2.1 weeks (min, 25 weeks; max, 33 weeks). IVH was diagnosed in 13 (13%) of them. IVH rates were 37, 10 and 5% for birthweight groups 501–1000, 1001–1500 and 1501–200 g, respectively. Statistically significant risk factors were found to be birthweight, gestational age, clinical risk index for babies score >5, mechanical ventilation, sepsis and hypotension. Maternal corticosteroid administration was found to be significantly protective. IVH rates and incidences of risk factors in this study were decreased compared to those reported 8 years ago.Conclusions: In developing countries, where well equipped Neonatal Intensive Care Units are limited, prevention of prematurity, better prenatal care and maternal corticosteroid administration become essential points for the prevention of IVH and its neurological consequences.
Effects of Spascupreel versus hyoscine butylbromide for gastrointestinal cramps in children
Authors: MÜLLER‐KRAMPE BRIGITTE , OBERBAUM MENACHEN , DIPL‐MATH PETER KLEIN , WEISER MICHAEL 
Published: May 2007

AbstractBackground: Gastrointestinal spasms and cramps are common in children as well as in adults. Alternative medical practices such as chiropractice and homeopathy are becoming increasingly popular in Europe and the USA. The effectiveness and tolerability of the homeopathic preparation Spascupreel was compared with that of hyoscine butylbromide treatment in children <12 years of age.Methods: An observational cohort study in 204 children <12 years was conducted over a 1 week treatment period. The efficacy of the respective therapies were evaluated on the effect on severity of spasms and clinical symptoms (pain/cramps, sleep disturbances, distress, eating or drinking difficulties and frequent crying). Compliance was evaluated on a four‐point scale from ‘very good’ to ‘low’. Evaluation was done by the practitioner based on information given by the patient or minder.Results: The analysis showed comparative improvements with the homeopathic preparation and hyoscine butylbromide therapy on severity of spasms, pain/cramps, sleep disturbances, eating or drinking difficulties, and frequent crying, all as evaluated by the practitioner. Both treatments were very well tolerated.Conclusions: For patients opting for a homeopathic therapy, Spascupreel seems to be an effective and well tolerated alternative to conventional therapies in children suffering from gastrointestinal spasms.
Decline of soil microbial diversity does not influence the resistance and resilience of key soil microbial functional groups following a model disturbance
Authors: Wertz Sophie , Degrange Valérie , Prosser James I. , Poly Franck , Commeaux Claire , Guillaumaud Nadine , Le Roux Xavier 
Published: May 2007

SummaryAnalysing the consequences of the decrease in biodiversity for ecosystem functioning and stability has been a major concern in ecology. However, the impact of decline in soil microbial diversity on ecosystem sustainability remains largely unknown. This has been assessed for decomposition, which is insured by a large proportion of the soil microbial community, but not for more specialized and less diverse microbial groups. We determined the impact of a decrease in soil microbial diversity on the stability (i.e. resistance and resilience following disturbance) of two more specialized bacterial functional groups: denitrifiers and nitrite oxidizers. Soil microbial diversity was reduced using serial dilutions of a suspension obtained from a non‐sterile soil that led to loss of species with low cell abundance, inoculation of microcosms of the same sterile soil with these serial dilutions, and subsequent incubation to enable establishment of similar cell abundances between treatments. The structure, cell abundance and activity of denitrifying and nitrite‐oxidizing communities were characterized after incubation. Increasing dilution led to a progressive decrease in community diversity as assessed by the number of denaturating gradient gel electrophoresis (DGGE) bands, while community functioning was not impaired when cell abundance recovered after incubation. The microcosms were then subjected to a model disturbance: heating to 42°C for 24 h. Abundance, structure and activity of each community were measured 3 h after completion of the disturbance to assess resistance, and after incubation of microcosms for 1 month to assess resilience. Resistance and resilience to the disturbance differed between the two communities, nitrite oxidizers being more affected. However, reducing the diversity of the two microbial functional groups did not impair either their resistance or their resilience following the disturbance. These results demonstrate the low sensitivity of the resistance and resilience of both microbial groups to diversity decline provided that cell abundance is similar between treatments.
Detergent‐induced cell aggregation in subpopulations of Pseudomonas aeruginosa as a preadaptive survival strategy
Authors: Klebensberger Janosch , Lautenschlager Karin , Bressler Daniel , Wingender Jost , Philipp Bodo 
Published: May 2007

SummaryDuring growth of Pseudomonas aeruginosa strain PAO1 with the toxic detergent SDS, a part of the population actively formed macroscopic cell aggregates while the other part grew as freely suspended cells. The physiological function of aggregation for growth with SDS was investigated. Three mutants growing with SDS without aggregation were isolated: the spontaneous mutant strain N and two mutants with transposon insertions in the psl operon for exopolysaccharide synthesis. SDS‐induced aggregation in strain N but not in a pslJ mutant was restored by complementation with two genes encoding diguanylate cyclases responsible for synthesis of cyclic‐di‐guanosine monophosphate (c‐di‐GMP). By expressing a c‐di‐GMP‐specific phosphodiesterase SDS‐induced aggregation of strain PAO1 was reduced. Upon exposure to SDS in the presence of the uncoupler carbonyl cyanide chlorophenylhydrazone, the aggregating strains had ca. 500‐fold higher survival rates than the non‐aggregating strains. Co‐incubation experiments revealed that strain N could integrate into aggregates of strain PAO1 and thereby increase its survival rate more than 1000‐fold. These results showed that SDS‐induced aggregation involved c‐di‐GMP signalling with the psl operon as a possible target. Cell aggregation could serve as a pre‐adaptive strategy ensuring survival and growth of P. aeruginosa populations in environments with multiple toxic chemicals.
The Pharmacy Diabetes Care Program: assessment of a community pharmacy diabetes service model in Australia
Authors: Krass I. , Armour C. L. , Mitchell B. , Brillant M. , Dienaar R. , Hughes J. , Lau P. , Peterson G. , Stewart K. , Taylor S. , Wilkinson J. 
Published: May 2007

AbstractAim  To assess the impact of a community pharmacy diabetes service model on patient outcomes in Type 2 diabetes.Methods  The study utilized a multisite, control vs. intervention, repeated‐measures design within four states in Australia. Fifty‐six community pharmacies, 28 intervention and 28 control, were randomly selected from a representative sample of urban and rural areas. Intervention pharmacies delivered a diabetes service to patients with Type 2 diabetes, which comprised an ongoing cycle of assessment, management and review, provided at regular intervals over 6 months in the pharmacy. These services included support for self monitoring of blood glucose, education, adherence support, and reminders of checks for diabetes complications. Control pharmacists assessed patients at 0 and 6 months and delivered no intervention.Results  A total of 289 subjects (149 intervention and 140 control) completed the study. For the intervention subjects, the mean blood glucose level decreased over the 6‐month study from 9.4 to 8.5 mmol/l (P < 0.01). Furthermore, significantly greater improvements in glycaemic control were seen in the intervention group compared with the control: the mean reduction in HbA1c in the intervention group was −0.97% (95% CI: −0.8, −1.14) compared with −0.27% (95% CI: −0.15, −0.39) in the control group. Improvements were also seen in blood pressure control and quality of life in the intervention group.Conclusion  A pharmacy diabetes service model resulted in significant improvements in clinical and humanistic outcomes. Thus, community pharmacists can contribute significantly to improving care and health outcomes for patients with Type 2 diabetes. Future research should focus on clarifying the most effective elements of the service model.
The Big Picture: understanding learning and meta‐learning challenges
Authors: CARNEIRO ROBERTO 
Published: May 2007

The future learning agenda is fraught with uncertainty. This opening article attempts to pose broad societal questions that determine the learning agenda‐setting as well as the emergence of new knowledge paradigms. It begins with a quick overview of the futures of learning agenda. Then, it moves on to depict the value chain that departs from industrial societies to reach post‐knowledge learning societies, including a tentative explanation of the constitutive role of technology in such a transition. As a consequence, three scenarios leading to a learning society are offered. In the following section, the article discusses the related evolution taking place in delivery strategies that are moving up the ladder from ODL methods to flexible and new learning solutions.The article advances a proposal of a new social contract combining the right to education with the duty of learning. This 21st century social contract serves both the goal of a more equitable distribution of knowledge and also that of a more inclusive learning society.A final section provides the outline of the whole issue, as well as summaries of each specialised contribution comprised in the present publication.