bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and predictors of ocular manifestations of RA: is there a need for routine screening?
Authors: Piper Holly , Douglas Karen MJ , Treharne Gareth J , Mitton Debbie L , Haider Sajjad , Kitas George D 
Published: April 2007

AbstractBackground: People with rheumatoid arthritis (RA) have an increased risk for eye problems caused by associated conditions or medication side‐effects. Consequent visual impairment may increase the risk of falls or difficulties self‐administering medications.Aims: The aim of the present study was to estimate the prevalence and predictors of ocular manifestations and visual impairment in a local sample of people with RA. The Visual Functioning Questionnaire (VFQ‐25) was evaluated as a screening tool in people with RA.Methods: Seventy‐five participants with RA attended a visual screening clinic. Demographic, medication and disease characteristics were recorded, a full ophthalmological assessment was performed by an expert ophthalmologist and the VFQ‐25, Health Assessment Questionnaire and Self‐administered Comorbidity Questionnaire were completed.Results: Twenty‐nine participants (38.7%) had impaired visual acuity; this was correctable by appropriate refraction in 93.1%. The prevalence of cataracts was 22.7% and this was predicted by older age and steroid use. An abnormal Schirmer's test, suggesting dry eyes, was seen in 70.7% of participants but only 12.0% were using artificial tears. Answers to the VFQ‐25 suggested misinterpretation of questions as relating to disability attributed to arthritis rather than caused by visual impairment.Conclusions: Visual impairment does not appear to be particularly prevalent in RA, obviating the need for a screening programme. Utilization of the VFQ‐25 as a screening tool in RA requires further consideration. The high prevalence of cataracts in participants on steroids emphasizes the need to prescribe the minimum required dose. The high prevalence of dry eyes suggests that a Schirmer's test should be performed regularly, with prescription of artificial tears if required. Copyright © 2007 John Wiley & Sons, Ltd.
Physiologie des Schlafes: Ein Prozess aktiver Erholung
Authors: Zulley Jürgen 
Published: April 2007

AbstractSchlaf ist ein aktiver Erholungsvorgang, dessen zeitliches Auftreten durch biologische Rhythmen vorgegeben ist. Dieser tagesperiodische Verlauf betrifft praktisch sämtliche Körperfunktionen. Der Schlaf selber ist ein uneinheitlicher Zustand, der vor allem durch den Wechsel von REM‐ und NREM‐Phasen gekennzeichnet ist. Während des Schlafes finden, mit unterschiedlicher Intensität, Regenerationsprozesse statt. Der natürliche Schlaf ist Grundbedingung für Gesundheit, Leistung und Wohlbefinden.
H1‐Antihistaminika der ersten Generation. Problemlos in der Empfehlung?
Authors: Bennack Edith , Holzgrabe Ulrike 
Published: April 2007

AbstractDoxylamin, Diphenhydramin und Dimenhydrinat sind Antihistaminika der ersten Generation, die in der Lage sind, die Blut‐Hirn‐Schranke zu überwinden und zentral gelegene H1‐Rezeptoren anzugreifen. Sie wirken daher nicht nurperipher antiallergisch, sondern auch zentral sedierend und – außer Doxylamin, auch antiemetisch. In der Selbstmedikation spielen diese H1‐Antihistaminika als rezeptfreie Schlafmittel eine große Rolle; häufig wird aber zu wenig darauf geachtet, dass sie mit zahlreichen anderen Arzneimitteln teils schwerwiegende Interaktionen auslösen können und ihre Anwendung häufig kontraindiziert ist.
Pflanzliche Sedativa: Neue Aspekte zu altbewährten Arzneipflanzen
Authors: Unger Matthias 
Published: April 2007

AbstractExtrakte oder Extraktkombinationen aus Baldrianwurzeln, Hopfenzapfen, Melissenblättern und Passionsblumenkraut hatten in klinischen Studien eine sedierende oder anxiolytische Wirkung, verkürzten die Einschlafzeit und verbesserten die Schlaf‐ und Lebensqualität. Inwiefern die fixe Kombination von Extrakten das Wirkungsspektrum bzw. die Wirkstärke der Zubereitungen beeinflusst, ist noch unklar. Während die Wirkmechanismen von Zubereitungen aus Hopfen, Melisse und Passionsblume noch im Dunkeln liegen, wurden in Baldrianextrakten Substanzen identifiziert, die in tierexperimentellen Studien eine sedative und schlaffördernde Wirkung besitzen. Das in Extrakten von Valeriana officinalis identifizierte hydrophile Lignan 4'‐O‐β‐D‐Glucosyl‐9‐O‐(6”‐desoxysaccharosyl)olivil ist ein Partialagonist am Adenosin‐A1‐Rezeptor, der die schlaffördernde Wirkung von Adenosin vermittelt. Erste klinische Daten deuten darauf hin, dass die Substanz auch beim Menschen an diesen Rezeptor bindet. Die für pflanzliche Schlaf‐ bzw. Beruhigungsmittel beanspruchten Indikationen, wie z.B. Schlafstörungen und nervöse Unruhe‐ oder Spannungszustände erscheinen gerechtfertigt und es ist zu erwarten, dass weitere experimentelle und klinische Studien den therapeutischen Stellenwert der pflanzlichen Sedativa belegen.
Wirkstoffe in der Pipeline. Können wir die Schlaflosigkeit demnächst besser behandeln?
Authors: Zlotos Darius Paul 
Published: April 2007

AbstractNachdem die Benzodiazepine weitgehend von den Z‐Hypnotika (Zolpidem, Zopiclon und Zaleplon) verdrängt wurden, kommen auf den Schlafmittelmarkt große Veränderungen zu. In den nächsten Jahren ist mit der Einführung von neuen Hypnotika mit z.T. innovativen Wirkprinzipien zu rechnen. Bei den Arzneistoffkandidaten handelt es sich um GABAerge‐, serotoninerge‐ und melatoninerge Wirkstoffe.
Nichtmedikamentöse Verfahren in der Insomniebehandlung. Verhaltenstherapie bietet eine Alternative
Authors: Crönlein Tatjana , Hajak Göran 
Published: April 2007

AbstractEin erhöhtes körperliches und seelisches Anspannungsniveau zusammen mit schlechten Schlafgewohnheiten führen zur Chronifizierung von Schlafstörungen. Dieser so genannte Teufelskreis ist für Patienten selbstständig meist nicht zu durchbrechen. Verhaltenstherapeutische Verfahren umgehen Nachteile einer medikamentösen Behandlung wie ein mögliches Abhängigkeitspotenzial oder eine limitierte Zeit der Einnahme und sind mittlerweile gut validiert. Kernelemente der Therapie sind die Aufklärung des Patienten über die Störung und die aufrechterhaltenden Mechanismen. Darauf aufbauend kommen verschiedene Verfahren zur Anwendung, wobei die Bettzeitenrestriktion und Entspannungsverfahren die Eckpfeiler darstellen. Die Methoden werden mittlerweile aus Gründen der Ökonomie und Effektivität in multimodalen Gruppenprogrammen erfolgreich angeboten. Für das Gelingen der Behandlung ist wie bei jeder psychosomatischen Störung eine gründliche Differentialdiagnostik bezüglich körperlicher Schlafstörungen indiziert.
Innovative Pränataldiagnostik
Authors: Nicke Annette 
Published: April 2007

AbstractDie invasive Pränataldiagnostik ist zurzeit die einzig zuverlässige und zugleich Standardmethode zur Analyse von Chromosomenanomalien und kann bisher nicht durch sonographische Methoden oder die Bestimmung maternaler Serumparameter ersetzt werden.
Prenatal diagnosis of a Turkish Bartsocas–Papas syndrome case with upper limb pterigia
Authors: Ceylaner Gülay , Güven Melih A. , Ceylaner Serdar , Uzel Murat , Müftüoǧlu Kamil 
Published: April 2007

AbstractObjectivesBartsocas–Papas syndrome is a severe, autosomal recessive syndrome. The major findings are severe popliteal webbing, ankyloblepharon, syndactyly, orofacial clefts, filiform bands, hypoplastic nose and ectodermal anomalies. We report a Turkish family with three affected pregnancies and a fetus prenatally diagnosed and terminated in pregnancy.MethodsObstetric ultrasound, amniocentesis and postmortem evaluation were done.ResultsObstetric ultrasound presented lower limb malformations and facial findings. Postmortem fetal evaluation showed severe lower limb findings, less severe upper limb involvement and classical facial features of the syndrome.ConclusionUpper limb pterygia is an unusual finding and reported in just two patients who were classified as having multiple pterygium syndrome, Aslan Type (605203) in the OMIM catalogue. We thought, as did many other authors, that those cases were consistent with Bartsocas‐Papas syndrome and upper limb involvement less severe than lower limb findings as rare findings of this syndrome. Copyright © 2007 John Wiley & Sons, Ltd.
Changing GPs' prescription patterns through guidelines and feedback. Intervention study
Authors: Schaefer Kirsten , Hansen Anders Onsberg , Maerkedahl Henrik , Rehfeld Claus , Birk Hans Okkels , Henriksen Lars Onsberg 
Published: April 2007

AbstractPurposeTo investigate whether and how a multi‐dimensional intervention including clinical guidelines on the choice of medical treatment in the primary and the secondary health care sector, and individual feedback to general practices about their own and other practices' prescription patterns in five Anatomical Therapeutic Chemical classification system (ATC)‐groups was followed by changes in the practices' prescription pattern.MethodsProspective historical registry study and a questionnaire study of GPs' self‐reported use of guidelines and feedback.ResultsIn every ATC‐group the number of prescribed defined daily doses (DDDs) kept growing after the intervention, while potential savings by DDD decreased. Individual practices' changes in the prescription pattern differed by ATC‐group and practices with high potential savings/DDD before the intervention showed the greatest relative reduction in potential savings/DDD. The county's average cost/DDD for the five ATC‐groups declined from above the Danish average before the intervention to a level below the average cost/DDD after the intervention. In the questionnaire study (response rate: 79%), 69% of respondents had read the guidelines and 78% reported that the feedback influenced their prescription of drugs.ConclusionsThe observed changes in drug costs and potential savings were not due to volume effects but a combination of price effects, including generic substitution and choice of less expensive analogues, demonstrating that it is possible to change GPs' prescription patterns without interfering with patients' access to treatment or with GPs' clinical freedom.' Copyright © 2007 John Wiley & Sons, Ltd.
Optimizing information on drug exposure by collection of package code information in questionnaire surveys
Authors: Quinzler R. , Schmitt S. P. W. , Szecsenyi J. , Haefeli W. E. 
Published: April 2007

AbstractPurposeThe thorough analysis of special drug characteristics requires information on the specific brand of a drug. This information is often not sought in pharmacoepidemiologic surveys although in many countries packages are labelled with an unequivocal code (in Germany called Pharmazentralnummer (PZN)). We aimed to assess the benefit and quality of PZN information collected in self‐completed questionnaires.MethodsWe performed a survey in 905 ambulatory patients who were asked to list brand name, strength, and the PZN of all drugs they were taking.ResultsThe medication list was completed by 97.5% (n = 882) of the responding patients (mean age 67.3 years). Altogether 5543 drugs (100%) were mentioned in the questionnaires and for 4230 (76.3%) the exact drug package could be allocated on the basis of the PZN. When PZN was considered in addition to the drug name the quality of drug coding was significantly improved (p < 0.001) with regard to the allocation of drug package (74% versus 2%), brand (90% versus 70%), and strength (96% versus 86%). The time needed for drug coding was three times shorter.ConclusionsThe high response rate and high fraction of correct PZN indicate that the collection of package code information is a valuable method to achieve more accurate drug data in questionnaire surveys and to facilitate the drug coding procedure. Copyright © 2007 John Wiley & Sons, Ltd.
Risk of myocardial infarction associated with selective COX‐2 inhibitors: Meta‐analysis of randomised controlled trials
Authors: Chen Li‐Chia , Ashcroft Darren M 
Published: April 2007

AbstractPurposeTo evaluate the risk of myocardial infarction (MI) associated with the use of selective cyclooxygenase‐2 (COX‐2) inhibitors (coxibs).MethodsSystematic review and meta‐analysis of randomised controlled trials (RCTs) using a fixed‐effect model to estimate the odds ratios (ORs) for risk of MI associated with coxibs compared against placebo, non‐steroidal anti‐inflammatory drugs (NSAIDs) and other coxibs.ResultsFifty‐five trials (99 087 patients) were included in the meta‐analysis. The overall pooled OR for MI risk for any coxib compared against placebo was 1.46 (95%CI: 1.02, 2.09). We found celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib were associated with higher MI risks compared against placebo. The pooled OR for any coxib compared against other NSAIDs was 1.45 (95%CI: 1.09, 1.93). Rofecoxib had a significantly higher risk of MI than naproxen (OR: 5.39; 95%: 2.08, 14.02) and valdecoxib had lower MI risk than diclofenac (OR: 0.14, 95%CI: 0.03, 0.73). There were no significant differences identified in the risk of MI from the available head‐to‐head comparisons of coxibs.ConclusionsCoxibs were associated with increased risks of MI when compared against placebo or non‐selective NSAIDs. Differences in MI risk were also apparent between comparisons of individual NSAIDs. Future work should consider using individual patient data (IPD) meta‐analysis to explore differences in MI risk between different subgroups of patients. Copyright © 2007 John Wiley & Sons, Ltd.
Assessing spiritual growth and spiritual decline following a diagnosis of cancer: reliability and validity of the spiritual transformation scale
Authors: Cole Brenda S. , Hopkins Clare M. , Tisak John , Steel Jennifer L. , Carr Brian I. 
Published: April 2007

AbstractThis study assessed the factor structure, reliability, and validity of an instrument designed to assess spiritual transformations following a diagnosis of cancer—the Spiritual Transformation Scale (STS). The instrument was administering to 253 people diagnosed with cancer within the previous 2 years. Two underlying factors emerged (spiritual growth (SG) and spiritual decline (SD)) with adequate internal reliability (alpha=0.98 and 0.86, respectively) and test–retest reliability (r=0.85 and 0.73, respectively). Validity was supported by correlations between SG and the Positive and Negative Affect Scale (PANAS) Positive Affect Subscale (r=0.23, p<0.001), the Daily Spiritual Experiences Scale (r=0.57, p<0.001), and the Post‐traumatic Growth Inventory (r=0.68, p<0.001). SD was associated with higher scores on the Center for Epidemiological Studies Depression scale (r=0.38, p<0.001) and PANAS‐Negative Affect Subscale (r=0.40, p<0.001), and lower scores on the PANAS‐Positive Affect Subscale (r=−0.23, p<0.001), and the Daily Spiritual Experiences Scale (r=−0.30, p<0.001). Hierarchical regression analyses indicated that the subscales uniquely predicted adjustment beyond related constructs (intrinsic religiousness, spiritual coping, and general post‐traumatic growth). The results indicate that the STS is psychometrically sound, with SG predicting better, and SD predicting poorer, mental and spiritual well‐being following a diagnosis of cancer. Copyright © 2007 John Wiley & Sons, Ltd.
Statistical methods for monitoring the AIDS epidemic
Authors: Zeger Scott L. , See Lai‐Chu , Diggle Peter J. 
Published: April 2007

AbstractThis article describes statistical methods for monitoring the epidemic of the acquired immunodeficiency syndrome (AIDS). A log‐linear model is proposed to estimate AIDS incidence and its growth rate while taking account of delays in case reporting. An empirical Bayes approach for estimating the epidemic growth rate in low prevalence subgroups is introduced. These methods are illustrated with an analysis of AIDS incidence trends for seven risk groups in each of six geographic regions using the Centers for Disease Control AIDS case registry data as of September 1987. The analysis finds that AIDS incidence is currently doubling about once every two years and that the relative composition of new cases is shifting away from the older epidemics such as in north‐eastern homosexual communities.
Models for the HIV infection and AIDS epidemic in the United States
Authors: Taylor Jeremy M. G. 
Published: April 2007

AbstractStatistical models of the HIV infection epidemic in the U.S. which account for the observed incidence of AIDS cases in the years 1978–1987 are considered. The models assume a known distribution of times from infection to AIDS. The best model estimates that there were approximately 563,000 to 1,110,000 individuals infected in the U.S. in April 1987. These estimates do not take into account underreporting of AIDS cases.The sensitivity of the conclusions to the model's assumptions is ascertained by investigating a variety of parametric models for the infection epidemic, a variety of likely distributions for the time from infection to AIDS, and some plausible alternatives for the history of AIDS cases in the U.S. It is concluded that there is too much uncertainty in the data and the models to be able to give highly accurate predictions of the number of people currently infected in the U.S., however, the results from the best fitting models suggest that there are less than the 1 to 1·5 million infected as estimated by the Centers for Disease Control. A Bayesian scheme is suggested for incorporating the uncertainty in the models.
Disease prevention models of voluntary confidential screening for human immunodeficiency virus (HIV)
Authors: Gail Mitchell H. , Preston Dale , Piantadosi Steve 
Published: April 2007

AbstractEpidemic models are developed to evaluate the potential benefits of voluntary confidential testing (VCT) for HIV. The number of tests required to prevent one case (called the economic ratio ER), and the number of cases prevented by the screening programme are calculated. Methods differ from commonly used epidemic models because susceptibles and infecteds are subdivided according to testing status, to permit modelling of the efficacy of knowledge of HIV status in retarding epidemic spread. The methods also allow for subdivision into several homogeneous subpopulations whose members may be attracted in varying degrees to members of other subpopulations. Thus the common assumption of free mixing across subpopulations is relaxed. The following conclusions which refer to a population of 100,000 persons over a period of 5 to 15 years, are robust to wide variations in assumed parameter values and other aspects of modelling:

VCT prevents hundreds or thousands of infections in isolated high risk populations and ER values are typically less than 100, making VCT very attractive economically.
VCT prevents only a few infections in isolated low risk populations with initial prevalence 0‐1 per cent or less, and the ER values are well above 2000. However, in ‘low risk’ populations with 1 per cent initial prevalence, tens or hundreds of infections may be prevented, and ER values fall below 2000 for plausible spread rates, indicating that VCT may be economically feasible in such settings.
In a mixed population of gays, bisexuals and heterosexuals, a VCT programme that aims primarily at the gay/bisexual subpopulations prevents more disease in the gay/bisexual populations, prevents more disease in the heterosexual populations, and requires fewer tests per case prevented than a VCT programme that tests all subpopulations equally.
Heterogeneity in the probability of HIV transmission per sexual contact: The case of male‐to‐female transmission in penile—vaginal intercourse
Authors: Wiley James A. , Herschkorn Stephen J. , Padian Nancy S. 
Published: April 2007

AbstractRecent studies have indicated variation in the infectivity β of HIV among heterosexual couples. We represent this heterogeneity by modelling β as a random variable. Using data on the number of contacts and seroconversion of couples, we fit the model by maximum‐likelihood estimation with a beta distribution and a discrete distribution for β. The estimates indicate the heterogeneity is extreme. The limitations of the model and the implications of the results for epidemiologic spread and further research are discussed.
A model of the spread of HIV infection and the demographic impact of AIDS
Authors: Bongaarts John 
Published: April 2007

AbstractThe objective of the computer simulation model described here is to project, for periods up to one or more decades, the annual incidence and prevalence of HIV infection and AIDS in a population with given epidemiological, behavioural and demorgraphic characteristics. In addition, the epidemic's impact on a range of demographic variables is calculated. The epidemiological components of the model use a compartmental approach and they are described with sets of linear differential equations. The demographic framework in which the epidemiological components are integrated, is based on a standard cohort component method of population projection. The simulated population is stratified by age, gender, sexual behaviour, marital status and infection/disease status. The concluding section provides an illustrative application of the model to a Central African population. In this hypothetical simulation covering the period from 1975 to 2000, HIV prevalence in the adult population rises from 0 to 21 per cent. By the end of the projection period mortality is about double the level that would have prevailed in the absence of the epidemic, but, owing to the very high birth rates that prevail in most of Africa, the growth rate of the population remains substantially positive.
Analysis of surveillance data with poisson regression: A case study
Authors: Parker R. A. 
Published: April 2007

AbstractOne way to examine the ability of a statistical technique to detect changes in surveillance data is to analyse data sets with known changes and observe how accurately these changes can be detected. The elimination of restrictions on legal abortions should have reduced mortality associated with abortions, particularly mortality associated with illegal abortions. The sensitivity of Poisson regression to detect changes in abortion associated mortality from 1962 to 1984 was assessed for the entire United States of America and for specific states. Although it is clear that this change occurred using data from the entire United States, only the largest of the individual state data sets examined (370 events over 23 years) consistently demonstrated the expected pattern. Inconsistent patterns were found in data sets from two states with between one‐fourth and one‐half this number of events. The legal change was not detected at all in three states with a small number of events (1 event per year or less). From this case study, a minimum of two or three events per year seems to be necessary before Poisson regression can detect outliers. Comparisons of the four tests used suggest that tests based on model deviance are superior to tests based on comparison of observed and expected number of events.
A surveillance system based on a short memory scheme
Authors: Shore David Lee , Quade Dana 
Published: April 2007

AbstractA surveillance system is proposed to detect an increase in the mean of a Poisson distribution of cases of a disease. This system, called short memory (SM), is based on conditional binomial tests which are performed sequentially at fixed time intervals. The probability of rejection at each test defines the run length distribution which has a geometric tail. A standard SM scheme outperforms other SM schemes. The CUSUM outperforms the SM schemes when the baseline mean is specified correctly. This type of misspecification does not affect the SM scheme.