bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of methotrexate on pulmonary involvement in patients with rheumatoid arthritis
Authors: Gökhan Tas , Kürsat Özoran , Gülseren Ak , Sevinç Bostanoglu , Serpil Arikan , Bedriye Mermerci 
Published: April 2004

AbstractObjective:  The aim of this study is to determine the effects of methotrexate (MTX) therapy on pulmonary involvement in patients with rheumatoid arthritis (RA).Method:  Fifty‐five non‐smoking RA patients were included in the study. Routine laboratory investigations, pulmonary function tests (PFT), high resolution computed tomography (HRCT) and arterial blood gas analysis were performed in all of the patients. Randomly dividing the patients into two groups, the first group were given 7.5 mg/week MTX and the second group were given 250 mg/day chloroquine phosphate. At the end of the sixth month all the tests and the analysis were repeated and evaluated by using χ2 and Student's t‐test; P < 0.05 was considered statistically significant.Results:  At the beginning of the study, HRCT examination revealed 92.7% pulmonary involvement in 55 RA patients. At the sixth month although the RA patients in the chloroquine group did not show any difference, RA patients in the MTX group displayed statistically significant increases in their pulmonary involvement (P < 0.05). Patients in the MTX group also displayed significant decreases at FEV1/FVC and significant increases at FEV1 in PFT and O2 saturation (P < 0.05, P < 0.05 and P < 0.01, respectively). In the chloroquine group we observed significant increases in FEV1 and vital capacity (P < 0.05).Conclusion:  Although the MTX therapy increases the risk of pulmonary involvement in patients with RA, it also increases the ventilation which in turn increases the functional capacity of the patient. Considering the beneficial effect on the radiological progression of the disease, we think that MTX therapy should be taken into account as the first choice in the treatment of RA.
Normative bone mineral density values in Filipino women
Authors: Torralba Tito P. , Tan‐Ong Millicent Y. , Navarra Sandra V. , Dy Sarah H. , Saavedra Sue Celle T. , Bermudez Charito C. , Mercado‐asis Leilani , Llamado Lyndon Q. , Yu Julie L. 
Published: April 2004

AbstractObjective:  To obtain reference values of bone mineral density (BMD) for Filipino women in order to make a population‐specific diagnosis of osteoporosis.Method:  Sudy design: Cross‐sectional. Setting: Osteoporosis Unit, Joint and Bone Center, Section of Rheumatology and Clinical Immunology, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines. Participants: 442 healthy Filipino women volunteers recruited from the outpatient department, Rheumatology and Clinical Immunology Clinic of the University of Santo Tomas Hospital and from within the University of Santo Tomas campus. Subjects with known underlying illness or conditions or intake of drugs that predispose to osteoporosis were excluded from the study. Intervention: Bone mineral density (BMD) measurements, expressed in grams per square centimenter of the lumbar spine, non‐dominant femur and non‐dominant forearm were done in 442 consecutive healthy Filipino women using the LUNAR DPX‐IQ machine.Results:  Means and standard deviations of BMD measurements at each site were calculated using Kwikstat software Version 3.6, Release 7. Results were grouped in decades to serve as reference per decade.Conclusion:  Bone mineral density measurements of these 442 healthy Filipino women may serve as an initial reference guide for the diagnosis of osteoporosis in Filipino women.
Comparative analysis of Behcet's disease in the APLAR region
Authors: Davatchi Fereydoun , Shahram Farhad , Kumar Ashok , Cheng Yew Kuang , Cheong Cheung Tak , Bendrups Andrea 
Published: April 2004

AbstractAims:  Behcet's disease (BD) was originally a disease of the Silk Road. Some authors think that BD from the Silk Road is different from those seen in other countries. The aim of this study was to analyze the clinical manifestations of BD in APLAR countries, where some of them are in the Silk Road (SR) and some others not (NSR).Methods:  Data from Australia (NSR), Hong Kong (NSR), India (SR), Iran (SR), and Singapore (SR) were selected and analyzed under the same protocol. Prior published data from China (SR) Japan (SR) and Korea (SR) were included in the analysis.Results:  The mean age at the onset of the disease was under 30 for all countries except Japan and Singapore. The male gender was more frequent except in Australia and Korea. Oral aphthosis was the most frequent manifestation (90–100%). Genital aphthosis was less frequent (57–82%). Skin manifestations were also frequent (61–87%). Ocular manifestations were reported from 21–69% of patients. The difference was mainly due to patients’ selection bias and the low number of patients in some reports. The same was true for joint (30–87%), gastrointestinal (6–38%), neurological (2.5–29%) and vascular manifestations (5–28%).Conclusion:  Despite the percentage difference among some countries, the general pattern of the disease was the same, suggesting that the minor differences seen in different parts of the world were not enough to call the disease a syndrome, or to differentiate Behcet's disease of the Silk Road from those seen in Western countries.
Therapeutic advances in rheumatoid arthritis
Authors: Mok Chi Chiu , Mak Anselm 
Published: April 2004

AbstractOver the past 15 years or so, there have been revolutionary changes in the treatment strategies of rheumatoid arthritis (RA). The traditional pyramidal approach has largely been replaced by the aggressive use of disease‐modifying antirheumatic drugs (DMARDs) in early disease. There has been continuing excitement with the introduction and use of the newer biological agents. While these novel agents have added to the armamentarium of RA treatment, rheumatologists are faced with the dilemma of drug cost and treatment effectiveness. In this article, the current concept of RA therapies and data regarding the newer biological response modifiers are discussed.
Successful usage of tacrolimus (FK506) in resistant/relapsed rheumatic diseases
Authors: Yoon Kam Hon 
Published: April 2004

AbstractAim:  This study reports the first successful usage of tacrolimus in various resistant or relapsed rheumatic diseases in Asian patientsMethods:  This is an open prospective study of the efficacy of tacrolimus for patients with various relapsed/resistant rheumatic diseases who were intolerant of or failed conventional therapy. Patients were enrolled in the study from the period November 2001 to September 2002.Results:  A total of 20 patients were included in the study. Their disease conditions were as follows: SLE with relapsed lupus nephritis (six patients); SLE with antiphospholipid syndrome (APS) (two patients); rheumatoid arthritis (five patients); psoriatic arthritis (three patients); scleroderma (two patients); anti–Jo−1 syndrome (two patients). Improvement in their conditions were noted in all but one patient who was intolerant to tacrolimus.Conclusions:  Tacrolimus (FK506) is a new armamentarium that can be added to the choice of immunosuppressive agents for rheumatologists, especially for those patients with severe or resistant diseases.
Factors affecting on the change of mood among Japanese RA patients
Authors: Sadamoto Kiyomi , Saito Eizo 
Published: April 2004

AbstractAim:  To evaluate factors affecting the change of mood among rheumatic arthritis (RA) patients.Method:  Fifty‐five patients who satisfied ACR criteria for RA were given modified AIMS (Arthritis Impact Measurement Scales) test twice with a 1 year interval (2000, 2001). We also asked patients to write the average mood during the previous month. The questionnaire was performed using Lorish's Face Scale (FS). A correlation analysis was undertaken to examine the association between changes of FS (ΔFS) from the first year examination to the second year examination, and changes of disease activity (CRP, number of affected joints), and each questionnaire item.Results:  Mean FS improved after 1 year. Patients of shorter therapy groups and younger patients showed larger improvement. Male patients showed larger improvement than female patients. ΔFS was strongly correlated with ΔCRP and Δnumber of affected joints. ΔFS were also strongly correlated with those of items which were related to activities of daily living (ADL). Especially, those related to the function of lower extremities showed stronger correlation with ΔFS than those related to functions of upper extremities. ΔFS among RA patients showed relatively weak correlation with Δpain factors as compare with ΔADL items.Conclusion:  ΔADL is a larger influential factor on ΔFS than Δpain. Therefore, improvement of ΔADL seems to be one of the most important issues for the treatment of RA patients.
Photoactive benzophenone labelled peptide
Authors: Ali Marina , Amon Michael , Kurosaka Nozomu , Manolios Nicholas 
Published: April 2004

AbstractBenzophenone and biotin labelled core peptide (CP) was prepared using benzophenone‐4‐maleimide. This photoactive peptide can be used in crosslinking experiments to give information of peptide–receptor association at molecular level.
A pilot trial of BIS monitoring for procedural sedation in the emergency department
Authors: Fatovich Daniel M , Gope Monica , Paech Michael J 
Published: April 2004

AbstractObjective:  Procedural sedation is common in the ED. However, there is no objective physiologic parameter available to monitor a patient's conscious state. The Bispectral Index (BIS) monitor has been validated as an objective measure of depth of anaesthesia. We studied the BIS monitor for this role in procedural sedation.Methods:  A prospective, observational study with convenience sampling of adult patients in ED who underwent procedural sedation. Patients were treated according to standard practice and sedated as determined by the treating physician. Treating physicians were blinded to the BIS value. BIS values were recorded and compared to the Observer's Assessment of Alertness/Sedation Scale (OAAS). Upon recovery, patients were asked about recall of events while they were sedated.Results:  Twelve patients were enrolled and 110 paired readings from 11 patients (7 male) were obtained. It was not possible to obtain readings from one patient. The mean age was 58 years (range 20–94). The Spearman correlation between BIS and OAAS was 0.027 (95% CI −0.582−0.617). For the three patients who received propofol, the correlation was 1.0. There were no episodes of explicit recall of events during the period of sedation.Conclusions:  BIS monitoring is feasible in the ED. Our small study suggests that there is a poor correlation between BIS values and the OAAS scale. Larger studies are required to further explore this relationship. Further developments in brain monitoring technology are also needed before this form of monitoring becomes clinically useful for procedural sedation.
Practicality of performing medical procedures in chemical protective ensembles
Authors: Garner Alan , Laurence Helen , Lee Anna 
Published: April 2004

AbstractObjective:  To determine whether certain life saving medical procedures can be successfully performed while wearing different levels of personal protective equipment (PPE), and whether these procedures can be performed in a clinically useful time frame.Methods:  We assessed the capability of eight medical personnel to perform airway maintenance and antidote administration procedures on manikins, in all four described levels of PPE. The levels are: Level A — a fully encapsulated chemically resistant suit; Level B — a chemically resistant suit, gloves and boots with a full‐faced positive pressure supplied air respirator; Level C — a chemically resistant splash suit, boots and gloves with an air‐purifying positive or negative pressure respirator; Level D — a work uniform. Time in seconds to inflate the lungs of the manikin with bag‐valve‐mask, laryngeal mask airway (LMA) and endotracheal tube (ETT) were determined, as was the time to secure LMAs and ETTs with either tape or linen ties. Time to insert a cannula in a manikin was also determined.Results:  There was a significant difference in time taken to perform procedures in differing levels of personal protective equipment (F21,72 = 1.75, P = 0.04). Significant differences were found in: time to lung inflation using an endotracheal tube (A vs. C mean difference and standard error 75.6 ± 23.9 s, P = 0.03; A vs. D mean difference and standard error 78.6 ± 23.9 s, P = 0.03); time to insert a cannula (A vs. D mean difference and standard error 63.6 ± 11.1 s, P < 0.001; C vs. D mean difference and standard error 40.0 ± 11.1 s, P = 0.01).Conclusions:  A significantly greater time to complete procedures was documented in Level A PPE (fully encapsulated suits) compared with Levels C and D. There was however, no significant difference in times between Level B and Level C. The common practice of equipping hospital and medical staff with only Level C protection should be re‐evaluated.
Can serum mast cell tryptase help diagnose anaphylaxis?
Authors: Brown Simon GA , Blackman Konrad E , Heddle Robert J 
Published: April 2004

AbstractObjective:  We aimed to determine the utility of serum mast cell tryptase to diagnose anaphylaxis.Methods:  As part of a venom immunotherapy trial, we performed 64 sting challenges. Blood samples were taken before the sting (baseline), and 15 min and 60 min after the sting. Tryptase was measured in baseline, 15 minute and 60 minute serum samples. Histamine was measured in baseline and 15 minute plasma samples. Eleven people had undisputed severe anaphylactic reactions; tryptase and histamine levels were assessed against this clinical gold standard diagnosis.Results:  Excluding mild reactions from the analysis, peak tryptase readings had sensitivity of 0.36 and specificity of 0.93 using the recommended cut‐off range (< 12.0 µg/L). Receiver‐operator curve analysis found a cut‐off of 9.0 µg/L would improve diagnostic performance (sensitivity 0.55, specificity 0.93). Serial tryptase measurement was significantly more discriminatory; an increase in tryptase of 2.0 µg/L or greater had a sensitivity of 0.73 and specificity of 0.98. The addition of histamine measurements, defining a positive result by either a rise in tryptase or a rise in histamine, appeared to further increase sensitivity (0.90).Conclusions:  Clinicians should use caution when using serum tryptase to refute or support a diagnosis of anaphylaxis. Serial tryptase measurement increases sensitivity and specificity. Further studies using serial tryptase determinations in general emergency department practice, perhaps supplemented by histamine determinations, are warranted.
Management of septic shock in childhood
Authors: Sparrow Annie , Willis Frank 
Published: April 2004

AbstractObjective: The object of this review is to discuss the recognition and treatment of septic shock in children based on principles of resuscitation, antibiotic use and recent therapeutic advances.Methods: A comprehensive literature search combining these methods: on‐line searches of Ovid, PubMed, and Medline; hand searches of 25 international journals; a trawl of 26 textbooks; searches of reference lists of pertinent articles; and scans of abstracts of recent international meetings. Various national and international units were contacted with regard to current research therapeutic strategies, both published and unpublished.Conclusions: Septic shock remains a leading cause of morbidity and mortality in children. Early administration of empirical antibiotic therapy reduces mortality. The keystone of resuscitation is aggressive volume replacement. Adjunctive therapies to modulate the inflammatory response may further enhance outcome, but do not replace principles of resuscitation.
Where to now with carbon monoxide poisoning?
Authors: Scheinkestel Carlos D , Jones Kerry , Myles Paul S , Cooper D Jamie , Millar Ian L , Tuxen David V 
Published: April 2004

AbstractThe controversy regarding the role of hyperbaric oxygen (HBO) in the treatment of carbon monoxide (CO) poisoning has been re‐ignited following the publication of a further randomized controlled trial by Weaver et al., the results of which appear to conflict with our findings. Comparative analysis suggests that the apparent outcome differences may be secondary to the design, analysis and interpretation of the results of the two studies. Following careful analysis of these two papers and further results from a study by Raphael et al on 385 CO‐poisoned patients, we can still find no convincing evidence favouring HBO therapy. Pending further research to determine optimal oxygen therapy for CO‐poisoning, current therapy should involve stratifying patients for risk of a poor outcome.This stratification may be aided by the evolving availability of biochemical markers of brain injury and the finding that patients with transient loss of consciousness and poor performance on neuropsychological tests of the supervisory attention system are at higher risk of neuropsychological sequelae. We propose that those patients most at risk be admitted and receive more prolonged normobaric oxygen therapy whilst those with more minor CO‐poisoning should be provided with normobaric oxygen of no less than 6 h duration and certainly until sign and symptom free.
Developing a decision tree algorithm for the diagnosis of suspected spider bites
Authors: Isbister Geoffrey K , Sibbritt David 
Published: April 2004

AbstractObjective:  To develop a diagnostic algorithm (decision tree) to improve the ability to identify or predict medically important spider bites (funnel‐web and redback spiders) from information about the circumstances and initial clinical effects of spider bites.Methods:  A dataset of definite spider bites with expert identification of all spiders was used from a previous Australia‐wide prospective study. Spider bites were categorized as: big black spider (BBS), redback spider (RED) and other spider (OTH). Big black spider included funnel‐web spiders (most medically significant), but also other spiders of similar appearance. Fifteen predictor variables were based on univariate analysis from previous studies and clinical experience. They included information about the circumstances and early clinical effects of bites. The data were analyzed using CART® (Classification and Regression Trees), a ‘decision tree’ algorithm used to create a tree‐like structure to describe a data set.Results:  Of 789 spider bites there were 49 (6.2%) bites by BBS, 68 (8.6%) bites by RED and 672 (85.2%) bites by OTH. A decision tree was developed that included six predictor variables (fang marks/bleeding; state/territory; local diaphoresis; month; time of day; and proximal or distal bite region). The decision tree accurately classified 47 out of the 49 (96%) BBS, and no funnel‐web spiders were incorrectly classified (100% sensitivity). Two hundred and forty‐four of 789 were classified as OTH and included no BBS.Conclusions:  A decision tree based on a small amount of information about the circumstances and early clinical effects of spider bites safely predicted all funnel‐web spider bites. Application of this algorithm would allow the early institution of appropriate treatment for funnel‐web spider bites and the immediate discharge of 31% as other spider bites (reassurance only).
Prolonged pre‐procedure fasting time is unnecessary when using titrated intravenous ketamine for paediatric procedural sedation
Authors: Treston Greg 
Published: April 2004

AbstractBackground: Paediatric procedural sedation (PPS) is a common procedure in most general EDs. Many departmental guidelines suggest mandatory fasting times for children undergoing PPS, in an attempt to decrease the incidence of postoperative vomiting and (theoretically) aspiration pneumonitis, despite there being little or no evidence in the literature to support these mandatory fasting times.Objectives: To prospectively address the relationship between preprocedure fasting time and intraprocedure or postprocedure vomiting in children aged 1–12 years undergoing procedural sedation with intravenous ketamine in the ED.Methods: From January 1999 to May 2000 all children presenting to the Royal Darwin Hospital Emergency Department with a condition requiring ketamine PPS were enrolled for data collection after parental consent was obtained. Titrated intravenous ketamine was administered via protocol. Prospective ED procedural sedation data collection forms of 272 consecutive cases of titrated intravenous ketamine sedation were reviewed.Results: Fasting time was accurately recorded on 257 (95%) data collection forms. There was no intraprocedure vomiting. Overall rate of postprocedure vomiting was 13.9%. No statistically significant association between decreased fasting time and increased incidence of vomiting was found. In fact, there was a trend towards increased incidence of vomiting with increased fasting time (P = 0.08). The rate of vomiting of those children fasted 3 h or greater preprocedure (20/127 or 15.8%) was over twice the rate of those fasted less than 1 hour (2/30 or 6.6%). Incidence of vomiting was significantly associated with increasing age (P = 0.0007). No clinically evident aspiration pneumonitis occurred.Conclusion: Prolonged preprocedure fasting time did not reduce the incidence of postprocedure vomiting in this case series; to the contrary there was a increased incidence of vomiting with longer fasting times (P = 0.08). There was an increase in postprocedure vomiting with increasing age of the patients.
Study of the Ecology of Fresh Sausages and Characterization of Populations of Lactic Acid Bacteria by Molecular Methods
Authors: Cocolin Luca , Rantsiou Kalliopi , Iacumin Lucilla , Urso Rosalinda , Cantoni Carlo , Comi Giuseppe 
Published: April 2004

ABSTRACT

In this study, a polyphasic approach was used to study the ecology of fresh sausages and to characterize populations of lactic acid bacteria (LAB). The microbial profile of fresh sausages was monitored from the production day to the 10th day of storage at 4°C. Samples were collected on days 0, 3, 6, and 10, and culture-dependent and -independent methods of detection and identification were applied. Traditional plating and isolation of LAB strains, which were subsequently identified by molecular methods, and the application of PCR-denaturing gradient gel electrophoresis (DGGE) to DNA and RNA extracted directly from the fresh sausage samples allowed the study in detail of the changes in the bacterial and yeast populations during storage.
Brochothrix thermosphacta
and
Lactobacillus sakei
were the main populations present. In particular,
B. thermosphacta
was present throughout the process, as determined by both DNA and RNA analysis. Other bacterial species, mainly
Staphylococcus xylosus
,
Leuconostoc mesenteroides
, and
L. curvatus
, were detected by DGGE. Moreover, an uncultured bacterium and an uncultured
Staphylococcus
sp. were present, too. LAB strains isolated at day 0 were identified as
Lactococcus lactis
subsp.
lactis
,
L. casei
, and
Enterococcus casseliflavus
, and on day 3 a strain of
Leuconostoc mesenteroides
was identified. The remaining strains isolated belonged to
L. sakei
. Concerning the yeast ecology, only
Debaryomyces hansenii
was established in the fresh sausages.
Capronia mansonii
was initially present, but it was not detected after the first 3 days. At last,
L. sakei
isolates were characterized by randomly amplified polymorphic DNA PCR and repetitive DNA element PCR. The results obtained underlined how different populations took over at different steps of the process. This is believed to be the result of the selection of the particular population, possibly due to the low storage temperature employed.