bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the efficacy of octreotide, vasopressin, and omeprazole in the control of acute bleeding in patients with portal hypertensive gastropathy: A controlled study
Authors: ZHOU YONGNING , QIAO LIANG , WU JING , HU HAIWEN , XU CAIPU 
Published: March 2003

AbstractBackground: Portal hypertensive gastropathy is an important complication of liver cirrhosis and it contributes to acute gastric bleeding. Effective management of this condition remains a clinical challenge. We assessed and compared the efficacy of octreotide, vasopressin, and omeprazole in the treatment of acute bleeding in patients with portal hypertensive gastropathy.Methods: Sixty‐eight patients with portal hypertensive gastropathy were randomized into Octreotide, Vasopressin, and Omeprazole groups. Bleeding was monitored by observing the contents of the nasogastric tube. Blood transfusion requirements and side‐effects of drugs were recorded. Repeat endoscopies were scheduled 2 weeks after treatment.Results: Complete bleeding control after 48 h of drug infusion was achieved in all patients receiving octreotide (100%), 14/22 patients receiving vasopressin (64%), and 13/22 patients receiving Omeprazole (59%). Octreotide required much less time and significantly fewer blood transfusions to control bleeding. Patients receiving vasopressin experienced more side‐effects than those receiving octreotide and omeprazole. In the 17 patients whose bleeding was not controlled within 48 h by either vasopressin or omeprazole, complete bleeding control was achieved by combined use of these two agents. Follow‐up endoscopy showed dramatic improvement in gastric mucosal erosions, superficial ulceration and erythema.Conclusions: Octreotide appeared to be more effective in controlling acute bleeding in patients with hypertensive gastropathy, with significantly rapid action, smaller transfusion requirements, and minor side‐effects. Simultaneous administration of vasopressin and omeprazole appeared to have additive effects.© 2002 Blackwell Publishing Asia Pty Ltd
Genotype‐specific mechanisms for hepatic steatosis in chronic hepatitis C infection
Authors: Hui Jason M , Kench James , Farrell Geoffrey C , Lin Rita , Samarasinghe Dev , Liddle Christopher , Byth Karen , George Jacob 
Published: March 2003

Abstract Background: Hepatic steatosis is common in hepatitis C, but the relative importance of host and viral factors is controversial. In the present prospective study, we examined metabolic factors associated with non‐alcoholic fatty liver and viral genotype as predictors of steatosis and fibrosis in chronic hepatitis C infection.Methods: In 124 chronic hepatitis C patients, the association between liver histology and the following was investigated: demographic and anthropometric data, alcohol intake, alanine aminotransferase (ALT), total cholesterol, low‐density lipoprotein–cholesterol, high‐density lipoprotein–cholesterol, triglyceride, transferrin saturation, ferritin, insulin, c‐peptide, glucose and insulin resistance (homeostasis model).Results: By multivariate analysis, genotype 3 was associated with increased steatosis grade (P
= 0.02). There were significant pairwise interactions between genotype 3 status and total cholesterol (P
= 0.01), current alcohol intake (P
= 0.04) and serum ALT (P
= 0.01). This showed that the etiology of steatosis was different in patients with genotype 3 and those with non‐genotype 3 chronic hepatitis C infection. In genotype 3 patients, the degree of steatosis was inversely associated with serum cholesterol (P
= 0.005) and positively associated with serum triglyceride (P
= 0.02). There was no association between body mass index (BMI) and the extent of steatosis. Among patients with other genotypes, the steatosis grade was strongly influenced by BMI (P < 0.0001) and serum ALT (P < 0.01). Independent predictors of fibrosis were age (P
= 0.001), past alcohol intake (P
= 0.04), ALT (P
= 0.002), serum insulin (P
= 0.001) and portal inflammation (P < 0.001).Conclusions: Hepatitis C genotype 3 may interfere with pathways of hepatic lipid metabolism, whereas increased BMI appears to be a more important pathogenic factor in other genotypes. Although steatosis and BMI were not associated with hepatic fibrosis, their relationship with serum insulin suggests that metabolic factors related to insulin action could influence fibrogenesis in hepatitis C.
Prevalence of irritable bowel syndrome in Hong Kong
Authors: Kwan Ambrose Chi‐Pong , Hu Wayne Hsing‐Cheng , Chan Yiu‐Kay , Yeung Yat‐Wah , Lai Thomas Sik‐To , Yuen Hon 
Published: March 2003

Abstract
Background and Aims:
As part of a public education program, the Hong Kong Society of Gastrointestinal Motility studied the prevalence of irritable bowel syndrome (IBS) in the community, which was based on the recently published Rome II criteria. The distribution of diarrhea or constipation‐predominant IBS subtypes, the prevalence of bowel symptoms and the predictors of health‐care seeking were also studied.
Methods:
Among 1797 randomly selected respondents, 1000 successful telephone interviews (56%) were conducted from August 2000 to December 2000, using a validated questionnaire in Chinese that looked into demographic data and various bowel symptoms during the past year.
Results:
The 12‐month prevalence of IBS as defined by the Rome II criteria in Hong Kong was 6.6%. The female to male ratio was 1.3:1, but this ratio was the same in the control group. The distribution of IBS patients into diarrhea predominant, constipation predominant, and non‐specific subtypes was 27, 17 and 56%, respectively. The predominant symptom in the IBS group was pain (54.5%), followed by urgency (15%), abdominal distension (15%) and diarrhea (11%). Forty‐seven percent of IBS patients sought medical attention and only 21% of them knew that they had IBS. Moderate to severe pain severity (odds ratio 3.7, 95% CI 1.02–13) and mucus in stool (odds ratio 3.57, 95% CI 1.18–10.7) were associated with health‐care seeking in univariate analysis. The prevalence of bowel symptoms such as urgency, straining, feeling of incomplete defecation, mucus in stool and abdominal distension ranged from 11 to 41%.
Conclusion:
The prevalence of IBS in Hong Kong was 6.6%, and the female to male ratio was similar to the control group. The majority was of non‐specific IBS subtype. Gross underdiagnosis (21%) by Western practitioners was noted.© 2002 Blackwell Publishing Asia Pty Ltd
Preoperative assessment of hepatic function: Utility of a new convenient two‐compartment model analysis using galactosyl human serum albumin scintigraphy
Authors: KINOSHITA KOICHI , UKIKUSA MINORU , IWAISAKO KEIKO , ARIMOTO AKIRA , FUJISAWA NORIYOSHI , OZAKI TAKESHI , TANAKA HIRONORI , SEO SATOSHI , NAITOH MASATO , NOMURA AKINARI , INOMOTO TAKUYA , KITAI TOSHIYUKI , INO KEIICHI , HIGASHIYAMA HIROSHI , HANAFUSA TETSUJI , NAKAJIMA YASUO 
Published: March 2003

AbstractBackground and Aim: Preoperative hepatic function was evaluated using technetium‐99 m‐diethylenetriaminepenta‐acetic acid‐galactosyl‐human serum albumin (Tc‐GSA) and a scintillation camera to detect hepatic Tc‐GSA uptake by the asialoglycoprotein receptor.Methods: Sixty‐two preoperative patients with liver cancer, including hepatocellular and cholangiocellular carcinomas, were studied, using two‐parameter two‐compartment model analysis. This model is simpler than either the three‐ or five‐compartment model, both of which are accurate but which require complicated analysis and enormous calculation. The parameters k1 and k2 represented the transfer rate constant from the blood to the liver and from the liver to the blood, respectively. We calculated k1, k2, and k1/k2 from time‐radioactivity curves of the heart and liver as well as VLmg, which represented the maximal amount of Tc‐GSA in the liver.Results: The results were compared to those of conventional liver function analysis using Tc‐GSA (the index of blood clearance (HH15) and the receptor index (LHL15)) or indocyanine green (ICGR15). Both HH15 and LHL15 were significantly correlated with k1, k1/k2, and VLmg. In addition, they closely correlated with the results of ICGR15 and some serum hepatic function tests (aspartate aminotransferase, choline esterase, albumin, platelet). The pathological grading for liver cirrhosis also correlated with k1, k1/k2, and VLmg. From a clinical point of view, VLmg had a significant correlation with the Child–Pugh score.Conclusions: These results suggest that this new compartment analysis will be useful in evaluating liver function, as it is accurate, simple and convenient.© 2003 Blackwell Publishing Asia Pty Ltd
Impaired expression of proteasome subunits and human leukocyte antigens class I in human colon cancer cells
Authors: MIYAGI TAKUYA , TATSUMI TOMOHIDE , TAKEHARA TETSUO , KANTO TATSUYA , KUZUSHITA NORIYOSHI , SUGIMOTO YOSHIKO , JINUSHI MASAHISA , KASAHARA AKINORI , SASAKI YUTAKA , HORI MASATSUGU , HAYASHI NORIO 
Published: March 2003

AbstractBackground and Aim: The presentation of human leukocyte antigens (HLA) class I requires the coordinated expression of numerous components involved in antigen processing and antigen presentation. Tumor cells may alter the expression of these components to decrease HLA class I expression, allowing them to escape immune surveillance. The aim of this study is to investigate the expressions of these components, including proteasome subunits, and their involvement in the expression of HLA class I in human colon cancer cells.Methods: Four human colon cancer cell lines, HCT116, SW403, LoVo and DLD‐1, were used to examine the expression of HLA class I by flow cytometry. Reverse transcription–polymerase chain reaction was performed to assess the expression of β2‐microglobulin, heavy chains, transporter subunits, immunoproteasomes subunits and proteasome activator 28 (PA28) subunits.Results: Human leukocyte antigen class I was expressed highly in HCT116 and SW403 cells and weakly in LoVo cells, but was not expressed in DLD‐1 cells. The DLD‐1 cells were deficient in the expression of proteasome subunits including low molecular weight polypeptide proteasome subunit 2 (LMP2), multicatalytic endopeptidase complex‐like‐1 (MECL‐1), PA28α and PA28β, whereas other HLA class I‐expressing cell lines expressed all components tested. γ‐Interferon (IFN‐γ) treatment of DLD‐1 cells restored the expression of LMP2, MECL‐1 and PA28β, but not the expression of HLA class I. Enforced expression of PA28α induced the expression of HLA class I in IFN‐γ‐treated DLD‐1 cells, but not in untreated DLD‐1 cells.Conclusion: These results suggest that the impaired expression of proteasome subunits is involved in the loss of HLA class I expression in human colon cancer cells.© 2003 Blackwell Publishing Asia Pty Ltd
Meta‐analysis of randomized controlled trials on the benefits and risks of using cisapride for the treatment of gastroesophageal reflux in children
Authors: DALBY‐PAYNE JACQUELINE R , MORRIS ANNE M , CRAIG JONATHAN C 
Published: March 2003

AbstractBackground and Aim:  Gastroesophageal reflux is a common problem in infancy. Cisapride is a commonly used therapy for gastroesophageal reflux in children. In view of recent concern regarding adverse effects this study aims to evaluate the benefits and risks of cisapride for the treatment of gastroesophageal reflux in children.Methods:  A meta‐analysis of randomized controlled trials of cisapride using a random‐effects model.Results:  Ten trials involving 415 children were identified. There was no evidence of a significant reduction in vomiting severity with cisapride as measured by a clinical score (five trials, standardized weighted mean difference −0.18; 95% confidence interval (CI) −0.51 to 0.15). Twenty‐four‐hour esophageal pH monitoring data showed the mean reflux index was significantly lower in the children treated with cisapride compared with controls (five trials, weighted mean difference −6.24; 95% CI −8.81 to −3.67). With cisapride treatment, there was no reduction in the mean number of reflux episodes lasting greater than 5 min (three trials, weighted mean difference −0.72; 95% CI −1.92 to 0.47) or in the number of children with esophagitis at final follow up compared with baseline (two trials, relative risk 0.80; 95% CI 0.40 to 1.61). There was no significant difference in reported side‐effects or adverse events (six trials, relative risk 1.16; 95% CI 0.95 to 1.41).Conclusions  No clinically important benefits of cisapride in children with gastroesophageal reflux have been demonstrated. Nor was there any evidence of adverse or harmful events.
Camphor toxicity
Authors: Emery DP , Corban JG 
Published: March 2003

ABSTRACTCamphor ingestion led to status epilepticus in a 20‐month‐old girl who required intubation and ventilation. She was treated with intravenous valium and phenobarbitone, and nasogastric activated charcoal. She made a complete neurological recovery. A number of products containing a high concentration of camphor were found to be available in the local community.
True hermaphroditism
Authors: Walker AM , Walker JL , Adams S , Shi E , McGlynn M , Verge CF 
Published: March 2003

Objective: True hermaphroditism is a rare cause of atypical genitalia which presents significant diagnostic and management challenges. We present the clinical and laboratory findings and management of four patients with true hermaphroditism. Methodology: Case studies from a teaching hospital and literature review. Results: All four patients had atypical genitalia identified at birth. All had a palpable gonad, only one of which was palpable at birth. Three patients were 46XX (SRY – ve) and one 46XY (SRY + ve). Three patients were raised as females (two 46XX and one 46XY) and one as a male. All four patients were found to have an ovotestis present. Conclusions: The management of true hermaphroditism is controversial and requires a multidisciplinary approach. It has many implications for both the parent and child. We discuss the issues involved for the patients and their parents.
A follow‐up pilot study of objective measures in children with attention deficit hyperactivity disorder
Authors: Aggarwal A , Lillystone D 
Published: March 2003

Objectives: Attention deficit hyperactivity disorder (ADHD) is a common childhood problem requiring stimulant medications in a significant proportion of cases. The aim of this pilot study was to assess the effects of prolonged stimulant medication therapy on a continuous performance test, the Test of Variables of Attention (TOVA), which measures objectively features of ADHD.Methods: Eighteen children aged 8 to 16 years who were diagnosed with ADHD, based on the Diagnostic and Statistical Manual of Mental Disorders 4th edn criteria, were included in the study. Assessment on a continuous performance test (TOVA) was performed initially and the children were administered stimulant medications for at least 12 months. The medications were stopped for 1 week, followed by a repeat TOVA assessment which was compared to the initial TOVA assessment.Results: Follow up TOVA scores showed a significant improvement in mean commission errors (impulsivity) after the stimulant medication therapy. No significant improvement was found in omission errors (inattention), response time and variability. There was a significant positive correlation between commission and omission scores (Pvalue 0.0001).Conclusions: The results of this pilot study indicate that there is objective improvement in impulsivity in children with ADHD after a prolonged period of stimulant medication therapy. The study suggests that it would be useful to perform formal studies to investigate this further and also to assess the role of continuous performance test (TOVA) as a method for monitoring the need for ongoing therapy.
Congenital and neonatal varicella in Australia
Authors: Forrest JM , Mego S , Burgess MA 
Published: March 2003

Objective: To establish the incidence and severity of congenital and neonatal varicella in Australia. Methodology: Demographic and clinical details were obtained by postal questionnaire regarding cases notified to the Australian Paediatric Surveillance Unit by over 930 participating clinicians in 1995–97 inclusive. Results: Seven cases of congenital varicella (1 : 107 000 pregnancies/year) followed maternal infection at 8–26 weeks: five had defects, two did not. Four of the seven infants with congenital varicella developed herpes zoster in the first 15 months of life. Forty‐four infants had neonatal varicella (1 : 17 000 pregnancies/year). Conclusion: There is an ongoing, albeit low, incidence of congenital and neonatal varicella in Australia.
Trends in the specialist workforce in paediatrics in Australia, 1981–1997
Authors: Goulston Kj , Dent Of 
Published: March 2003

Objective: The Royal Australasian College of Physicians has conducted periodic workforce censuses of Fellows practising paediatric medicine in Australia since 1981. The aim of this study was to document trends in the supply of paediatricians and to project these trends into the early 21st century. Methodology: Time series analysis using least squares regression. Results: The paediatric consultant workforce in Australia increased in a linear manner from 374 in 1981 to 777 in 1997. If this trend persists, the number of paediatricians will grow by 62% to 1255 in 2016. The ratio of population aged 0–14 years per paediatrician fell from 9960:1 in 1981 to 5040:1 in 1997. The projected national decline in the child population will result in a ratio of 3050 children per paediatrician in the year 2016. The proportion of women in the paediatric workforce was 22.4% in 1997 and is projected to rise to at least 36% by 2016. The proportion aged 50 years and older rose from 22% in 1981 to 33.6% in 1997 and is projected to be 45% by the year 2016. The average total weekly working hours fell from 58.2 in 1984 to 53.4 in 1997. The proportion practising in regional centres rose from 12 to 17.9%. Conclusions: The paediatric workforce in Australia has grown rapidly over the past 16 years. If this trend continues, the ratio of child population per paediatrician will continue to fall, acccentuated by the projected decline in the child population. The trends towards an ageing workforce with an increasing proportion of women, declining working hours and rising proportion practising in regional centres are expected to continue unless workforce intake or retirement change dramatically.
Sudden infant death syndrome in South Australia 1968–97. Part 3: Is bed sharing safe for infants?
Authors: Beal S M , Byard R W 
Published: March 2003

Objective: To examine the risk of death for bed‐sharing infants.Methodology: All unexpected infant deaths occurring in South Australia between 1970 and 1997, occurring after the infant was put to rest and diagnosed by after death scene investigation and autopsy as sudden death infant syndrome, accidental death, or ‘undetermined’ were studied.Results: Accidents were the most likely cause of death for 5% of infants who died in designated infant containers (cots, cradles, etc), 24% of those who were sharing a bed or couch, and 72% of those who were placed alone on a bed or couch.Conclusions: While bed sharing showed an increased risk of dying accidentally, when compared with infants sleeping in designated infant containers, the risk of accidental death in this study was even greater for infants left alone on adult beds or couches.
Perception of fear, distress and pain by parents of children undergoing a micturating cystourethrogram: A prospective study
Authors: Srivastava T , Betts G , Rosenberg AR , Kainer G 
Published: March 2003

Objectives: To investigate whether parents’ expectations of their child's fear, distress or pain during a micturating cystourethrogram (MCU) are realized. Methodology: Prospective study in which parents were asked to fill out two questionnaires using a visual analogue scale, one before (pre) and the other after the MCU procedure (post), was conducted at a tertiary level paediatric hospital in Sydney, Australia. The questionnaires were designed to compare the parents’anticipated and experienced anxiety about their child's procedure and their perception of fear, distress and pain in their child during and after the procedure. The parents’ satisfaction with information provided to them on the procedure was also recorded. Twenty‐five parents participated in the study. Results: There were significant differences between anticipated and experienced parental anxiety. Parents’ reporting of fear, distress and pain in their child during the MCU and after the procedure was lower than they had anticipated. There was a significant correlation between the parents’ anxiety and their perception of severity of their child's fear (r = 0.52, P = 0.009), distress (r = 0.48, P = 0.017) and pain (r = 0.50, P = 0.01) during the procedure, but less so with the child's distress after the procedure (r = 0.39, P = 0.059). The parents were satisfied with the information given to them regarding the MCU procedure. Conclusions: Parents’ perception of their child's fear, distress and pain during the MCU, as well as distress following the MCU, was not as severe as they had anticipated. Parental anxiety is an important factor in the perception of fear, distress and pain in children during and after the procedure.
Effect of recombinant human erythropoietin on transfusion needs in preterm infants
Authors: Yeo CL , Choo S , Ho LY 
Published: March 2003

Objective: To study the efficacy, safety and cost effectiveness of recombinant human erythropoietin (r‐HuEPO) in reducing erythrocyte transfusion needs in very low birthweight (VLBW) infants. Methods: We conducted a non‐blind randomized controlled trial and assigned 100 VLBW infants, less than 33 weeks gestation, to receive either r‐HuEPO 750 U/kg per week subcutaneously from day 5 to day 40 or no erythropoietin (EPO). Infants received oral iron 3–;6 mg/kg per day from day 10. Transfusion needs were analysed for all enrolled infants and in five weight subgroups: birthweight of less than 600 g, 600–;799 g, 800–;999 g, 1000–;1199 g and infants more than 1200 g. Results: VLBW infants on r‐HuEPO attained higher reticulocyte counts and haematocrit than control infants but the mean number of transfusions and volume of erythrocyte transfused per infant were not statistically different. Of infants 800–;999 g at birth, the mean number of transfusions per infant was 2.1 compared with 3.5 transfusions per control infant (P = 0.04). Volume of erythrocytes transfused was 34.9 ± 32.1 mL/kg in r‐HuEPO‐treated infants and 56.6 ± 25.8 mL/kg in control infants (P = 0.03). The cost per patient for transfusion and EPO was S$388 for r‐HuEPO recipient and S$438 for control infant. Blood pressure, neutrophil count, platelet count and complications of prematurity were not significantly different in both groups of VLBW infants. Conclusion: r‐HuEPO at 750 U/kg per week stimulates erythropoiesis in VLBW infants but significantly reduces the need for erythrocyte transfusion only in infants weighing 800–;999 g at birth.