bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increase in colorectal epithelial apoptotic cells in patients with ulcerative colitis ultimately requiring surgery
Authors: HAGIWARA CHIKARA , TANAKA MASANORI , KUDO HAJIME 
Published: March 2003

Abstract
Background and Aims
: Up to one‐third of patients with ulcerative colitis (UC) need to undergo surgery, but the factors that exacerbate inflammation remain unclear. The authors hypothesize that excessive apoptosis reported in active UC may disrupt epithelial defenses and exacerbate the disease. The aim of the present study was to clarify whether apoptotic epithelial cells and histiocytes engulfing them increased in patients with active UC who ultimately require surgery (UC‐S) rather than those receiving medication alone (UC‐M).
Methods:
The study included 29 patients with UC‐S, 35 with UC‐M, 18 with infectious colitis, and 16 healthy controls. Apoptotic cells were detected by terminal deoxynucleotidyl transferase‐mediated dUTP nick end‐labeling (TUNEL). Using biopsy specimens taken from the most severely inflamed rectosigmoid mucosa as determined endoscopically, the apoptotic index (apoptotic cells/epithelial cells,%) and density (per mm2) of lamina propria histiocytes positive for CD68 were then evaluated. Statistical differences were tested with the Mann–Whitney U‐test.
Results
: The apoptotic indices in UC‐M patients were significantly higher than those in controls (P < 0.05) but almost equal to those in infectious colitis patients. In the upper and lower halves of the mucosa, both apoptotic indices and histiocyte densities were significantly higher for UC‐S than in UC‐M (P < 0.01). Ratios of the mean apoptotic index for UC‐S to that for UC‐M exceeded 3.4, while ratios of the mean histiocyte density were limited to approximately 1.6.
Conclusions
: The results suggest that epithelial apoptosis is a non‐specific phenomenon and that an increased number of apoptotic cells exceeding histiocyte phagocytic capacity may play a part in the disruption of epithelial defenses and further accelerate mucosal inflammation.© 2002 Blackwell Publishing Asia Pty Ltd
Efficacy of Stronger Neo‐Minophagen C compared between two doses administered three times a week on patients with chronic viral hepatitis
Authors: Miyake Kazuhiko , Tango Toshiro , Ota Yasuhiko , Mitamura Keiji , Yoshiba Makoto , Kako Makoto , Hayashi Shigeki , Ikeda Yusei , Hayashida Norimasa , Iwabuchi Shogo , Sato Yuzuru , Tomi Toshiaki , Funaki Naoya , Hashimoto Naoaki , Umeda Tomoyuki , Miyazaki Jun , Tanaka Katsuaki , Endo Yasuo , Suzuki Hiroshi 
Published: March 2003

Abstract
Background:
A daily injection of glycyrrhizin (Stronger Neo‐Minophagen C (SNMC) containing 40 mg glycyrrhizin in a 20 mL ampoule) lowers alanine aminotransferase (ALT) levels in patients with chronic viral hepatitis.
Methods:
The therapeutic effects of intermittent administration of SNMC three times a week for 12 weeks were evaluated and compared between two doses (40 and 100 mL) in a randomized clinical trial.
Results:
Overall, the therapeutic response was better in the 53 patients allocated 100 mL than the 59 who were allocated to have 40 mL SNMC (P = 0.0243). At the completion of SNMC treatment, ALT levels decreased more extensively in the patients on 100 mL than those on 40 mL SNMC (−29 vs−50% in comparison with the baseline value, P = 0.0002). Minor side‐effects occurred in both the patients on 100 mL (20%) and those on 40 mL (12%), but they did not require any therapies.
Conclusions:
Intermittent SNMC would be efficient in suppressing ALT levels in patients with chronic viral hepatitis in a dose‐dependent manner. Taken along with infrequent and very mild side‐effects, long‐term intermittent SNMC would benefit patients with chronic hepatitis by maintaining their quality of life with easier compliance.© 2002 Blackwell Publishing Asia Pty Ltd
Prediction of relapse after interferon therapy in hepatitis C virus‐infected patients by the use of triple assay
Authors: EL‐AWADY MOSTAFA K , ABDEL RAHMAN MOHAMED M , ISMAIL SOMAYIA M , AMR KHALDA S , OMRAN MOATAZA , MOHAMED SABRY A 
Published: March 2003

AbstractBackground and Methods: In recent years, several tests have been used as predictive factors for relapse after the end of interferon therapy of chronic hepatitis C carriers. Serum hepatitis C virus (HCV)‐RNA has proved insensitive for predicting relapse because more than 50% of patients with undetectable reverse transcription–polymerase chain reaction (RT‐PCR) levels of HCV at the end of therapy become positive for viral RNA after interferon withdrawal. The detection of a minus RNA strand of HCV in liver also failed to efficiently predict relapses in chronic hepatitis patients. Furthermore, the use of a whole blood assay of HCV‐RNA has been controversial. We used a triple assay comprised of RT‐PCR tests for the detection of HCV‐RNA plus strand in serum and peripheral blood mononuclear cells (PBMC), together with testing for the minus strand in PBMC for prediction of relapse after interferon + ribavirin combination therapy in 45 patients with chronic hepatitis C.Results: The only four patients with a negative triple assay had no relapse 1 year after the end of therapy. In contrast, two‐thirds of the 12 patients who tested negative for viral RNA in serum at the end of therapy relapsed 1 year later.Conclusion: We concluded that the absence of both minus and plus strands in patients who tested negative for serum PCR may indicate the total eradication of HCV.© 2003 Blackwell Publishing Asia Pty Ltd
Young people with spina bifida: Transfer from paediatric to adult health care
Authors: SAWYER SM , COLLINS N , BRYAN D , BROWN D , HOPE MA , BOWES G 
Published: March 2003

ABSTRACT:An expectation of health care for young people with disability is that quality coordinated care continues to be available as they pass from the paediatric to the adult health care system. While individual clinicians provide this service well, the widespread absence of coordinated multidisciplinary care for young people with spina bifida in the adult health care system is a major deficiency. This paper describes the planning and implementation that underpinned the transfer of 10 young people with spina bifida from a paediatric to an adult service. The range of structural, financial and ‘cultural’ barriers that need to be overcome before patients can be successfully transferred is highlighted; lessons learned from this model may serve to facilitate the development of other transfer services.
The musculoskeletal complications of cystic fibrosis
Authors: MASSIE RJH , TOWNS SJ , BERNARD E , CHAITOW J , HOWMAN‐GILES R , ASPEREN PP VAN 
Published: March 2003

Objective:To determine the spectrum of musculoskeletal complications of cystic fibrosis (CF) in a paediatric population in Australia.Method:Clinical assessment followed by serology and bone scan on patients attending a specialized CF clinic.Results:Of 125 patients studied, 21 had musculoskeletal complications, 17 attributable to CF. Eleven had joint involvement (six hypertrophic pulmonary osteoarthropathy (HPOA)), one CF arthropathy, two ciprofloxacin induced arthralgia, one joint contracture following long‐line placement, one chest infection associated arthralgia), four kyphosis (two also with HPOA) and two thoracic deformity. HPOA was associated with older age, lower average pulmonary function and lower average Shwachman score. Three patients with HPOA died within 12 months of reporting symptoms. Kyphosis was also associated with older age and lower pulmonary function.Conclusion:Increasing age with deteriorating clinical and pulmonary function were associated with a higher incidence of musculoskeletal involvement. The development of symptomatic HPOA is a marker of poor prognosis.
Methylxanthines and sensorineural outcome at 14 years in children < 1501 g birthweight
Authors: Davis PG , Doyle LW , Rickards AL , Kelly EA , Ford GW , Davis NM , Callanan C 
Published: March 2003

Objectives: Methylxanthines, including theophylline, have been used extensively and successfully to treat apnoea in preterm infants. However, long‐term consequences of such therapy are largely unknown. The aim of this study was to determine the relationship between theophylline therapy and outcome at 14 years of age in surviving preterm children of birthweight < 1501 g. Methodology: The subjects of this study were 154 consecutive survivors with birthweights < 1501 g born from 1 October 1980 to 31 March 1982; 130 (84.4%) were assessed at 14 years of age. Outcomes included motor function, psychological test scores, and growth. Results: Of the 130 children assessed, 69 (53.1%) had been exposed to theophylline; 13.0% had cerebral palsy, significantly higher than 1.6% in the 61 children not exposed to theophylline (P < 0.02). This difference remained statistically significant after adjusting for potential confounding variables including the presence of cerebroventricular haemorrhage. In contrast, after adjusting for known confounding variables, children who had received theophylline achieved higher psychological test scores. There was no association between theophylline therapy and growth. Conclusions: Theophylline therapy in the newborn period is associated with some evidence of harmful, but also helpful sensorineural effects at 14 years of age.
Early motor development of blind children
Authors: Levtzion‐Korach O , Tennenbaum A , Schnitzer R , Ornoy A 
Published: March 2003

Objectives: The purpose of this study was to assess the characteristic motor developmental pattern in blind children in Israel. Methodology: The study compared the developmental data concerning 10 motor skills of 40 blind children to a control group of sighted children and to the motor developmental milestones of the Bayley Developmental Scale and the Revised Denver Developmental Screening Test. Results: The motor development of blind children was delayed, the delay being significant in all 10 motor skills that were examined. This delay emphasizes the major importance of vision as a sensory input modality for the process of sensory– motor development. Conclusion: An adequate stimulating environment and proper parental handling could potentially shorten the motor developmental delay but probably not eliminate it entirely.
Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia
Authors: Boo Ny , Chandran V , Zulfiqar Ma , Zamratol Sm , Nyein Mk , Haliza Ms , Lye Ms 
Published: March 2003

Objectives: To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants. Methodology: This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age. Results: Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic‐ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor. Conclusions: Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.
Hepatic glycogenosis: Reversible hepatomegaly in type 1 diabetes
Authors: Munns Cfj , McCrossin Rb , Thomsett Mj , Batch J 
Published: March 2003

Objective: To describe the aetiology, clinical features and appropriate treatment for hepatic glycogenosis in poorly controlled type 1 diabetes. Methods: A review of three adolescents with poor diabetes control, hepatomegaly and elevated serum liver transaminase concentrations. Results: Symptoms included abdominal pain, anorexia, nausea and vomiting. All had tender hepatomegaly; two had splenomegaly. Liver biopsy was performed on two patients. Histology revealed hepatic glycogenosis in both; one also demonstrated macrovesicular steatosis. With improved glycaemic control, all three showed resolution of their symptoms, organomegaly and elevated serum liver transaminase concentrations. Conclusions: Insulin‐reversible hepatic glycogenosis is the most common cause of hepatomegaly and raised serum liver transaminase concentrations in children and adolescents with type 1 diabetes. Having excluded other causes of hepatic dysfunction, a 4 week therapeutic trial of improved glycaemic control is recommended prior to more invasive investigations.
Quality of life of mothers and families caring for preterm infants requiring home oxygen therapy: A brief report
Authors: McLean A , Townsend A , Clark J , Sawyer Mg , Baghurst P , Haslam R , Whaites L 
Published: March 2003

Objective: To investigate the impact on mothers and families of caring for a premature infant receiving home oxygen therapy (HOT). Methods: Standard questionnaires were used to compare the functioning of mothers and families of 10 premature infants receiving HOT, 10 premature infants who were discharged from hospital on HOT but who no longer required it and 20 premature infants who had never required treatment with HOT. Results: After adjustment for gestational age, chronological age, birthweight and place of residence (urban/rural), the care required by premature infants receiving HOT had a significantly greater impact on their families than the care of infants not receiving HOT. Mothers of premature infants receiving HOT reported significantly less vitality and more mental health problems than mothers of infants not receiving HOT. Conclusions: The use of HOT for premature infants may have a significant adverse impact on their mothers and families.
Participation in research: Informed consent, motivation and influence
Authors: Hayman RM , Taylor BJ , Peart NS , Galland BC , Sayers RM 
Published: March 2003

Objective: To investigate the process and quality of informed consent, motivation and influence in parents who were invited to enrol their baby in a research project. Methodology: A mixed quantitative/qualitative questionnaire was sent to a cohort invited to participate in a physiological research project on sudden infant death syndrome (SIDS) at the Dunedin Public Hospital, Dunedin, New Zealand. Separate questionnaires were used for parents who participated (94) and those who declined to participate (103). Response rates were 69% and 47%, respectively. Results: All consenting parents felt they understood the purpose and procedure of the study. The majority (90%) thought the information about the study was very good; 6.5% felt more detail was required. Eighty‐five per cent found the verbal explanation the most useful source of information. All participated for altruistic reasons such as to aid SIDS research. Although 27% had concerns about safety of the tests, after the tests all responders felt happy with the safety of the tests. Inconvenience was the main reason (53%) for declining to participate. Twenty‐eight per cent of declining parents were concerned about the safety of the tests. Conclusion: Of those who responded to the questionnaire, the process for obtaining informed consent in the SIDS studies was satisfactory. Parents’ motives for participating were mostly altruistic. The role of recall bias and selection bias may make the implications of this study unclear.
Perforation complications of percutaneous central venous catheters in very low birthweight infants
Authors: Leipälä JA , Petäjä J , Fellman V 
Published: March 2003

Objective: To prospectively survey perforation complications of consecutively inserted percutaneous central venous catheters (PCVC) in very low birthweight (VLBW) infants over a 2 year period. Methodology and Results: Three serious perforation complications were encountered in a series of 100 consecutive PCVC. One infant (birthweight 685 g) developed pericardial effusion and fatal cardiac tamponade during the use of a polyurethane PCVC. At autopsy, the pericardial sac contained 8 mL fluid with a glucose concentration of 109 mmol/L and the catheter tip was embedded in the right ventricular wall. The second infant (birthweight 1380 g) showed pleural effusion and transient immobility of the right diaphragmatic leaf after perforation of a similar PCVC into the right pleural cavity. The third perforation, causing subcutaneous oedema, occurred in a 655 g infant who had a silastic PCVC. Conclusions: The data suggest a 3% incidence for PCVC‐associated symptomatic perforation complications and a 1% incidence for fatal perforations, despite a policy of careful placement. The data also indicate that perforation complications occur regardless of the size or material of the PCVC. Proper visualization of the PCVC and vigilant attention to its location is required to prevent these rare but potentially fatal complications.
Risk factors for small‐for‐gestational‐age babies: The Auckland Birthweight Collaborative Study
Authors: Thompson JMD , Clark PM , Robinson E , Becroft DMO , Pattison NS , Glavish N , Pryor JE , Rees K , Mitchell EA 
Published: March 2003

Objective: This case‐control study determined whether internationally recognized risk factors for small‐for‐gestational‐age (SGA) term babies were applicable in New Zealand. Methodology: All babies were born at 37 or more completed weeks of gestation in one of three hospitals in Auckland. Cases weighed less than the sex specific 10th percentile for gestational age at birth, and controls (appropriate‐for‐gestational‐age (AGA)) were a random selection of heavier babies. Information was collected by maternal interview and from obstetric databases. Results: Information from 1714 completed interviews (844 SGA and 870 AGA) was available for analysis. Computerized obstetric records were available for 1691 of the 1701 women who consented to such access. In a multivariate analysis allowing for sex, gestational age at birth, social class and other potential confounders, mothers who smoked had a significantly increased risk of an SGA baby (adjusted OR 2.41; 95% CI 1.78–;3.28), as did primiparous mothers (adjusted OR 1.34; 95% CI 1.03–;1.73), mothers of Indian ethnicity (adjusted OR 3.22; 95% CI 1.95–;5.30), women with pre‐eclamptic toxaemia (adjusted OR 2.42; 95% CI 1.08–;5.40) and those with pre‐existing hypertension toxaemia (adjusted OR 5.49; 95% CI 1.81–;16.71). Mothers of SGA infants were shorter (P < 0.001) and reported lower prepregnancy body weights (P < 0.001) than mothers of AGA infants. The population attributable fraction for smoking suggests that up to 18% of SGA infants born in the ABC Study could be related to maternal smoking. Conclusions: Risk factors associated with SGA births in other countries are also important in New Zealand. Smoking in pregnancy is an important and potentially modifiable behaviour, and efforts to decrease the number of women who smoke during pregnancy should be encouraged.
Transcatheter patent ductus arteriosus occlusion: Evolution of techniques and results from the 1990s
Authors: O'Donnell C , Neutze JM , Skinner JR , Wilson NJ 
Published: March 2003

Objective: To review the evolution of transcatheter patent ductus arteriosus (PDA) occlusion techniques and results. Methods: A single institution, retrospective review including all patients with intention to close a PDA from 1991 to 1998, with no exclusions. Results: Rashkind occluder (n = 65), sideris double‐button (n = 6), Cook detachable coil (n = 28) and Amplatzer ductal occluder (n = 4) were used. Successful implantation occurred in 99 of 103 patients. There was a need for a second transcatheter procedure to close residual ductal shunting in 12% of patients: Rashkind umbrellas (n = 8), double‐button (n = 1), coils (n = 3). Eight patients (8%) required surgery, including 4 of 6 patients with the double‐button occluder. Conclusions: The Rashkind occluder and the Sideris double‐button device both had an unacceptably high rate of residual shunts requiring a second transcatheter procedure or surgical closure. Detachable coils and the Amplatzer ductal occluder have become the current technology of choice for transcatheter PDA closure with high success rates.
Use of a behavioural programme in the first 3 months to prevent infant crying and sleeping problems
Authors: St James‐Roberts I , Gillham P 
Published: March 2003

Objective: To assess the effectiveness of a behavioural programme introduced in the first 3 months of age in preventing infant crying and sleeping problems. Two issues were addressed: (i) which elements of the behavioural programme would parents implement; and (ii) whether the behavioural programme was more effective in reducing infant crying and encouraging night‐time sleeping than an educational intervention or the routine services. Methodology: Mothers and newborns were assigned at random to the behavioural programme (n = 205), educational intervention (n = 202), or control (n = 203) group. Behaviour diaries kept before randomization and at 3, 6, 9 and 12 weeks of age were used to measure implementation of the interventions and infant behaviour, including crying and sleeping. Crying and sleeping problems were followed up using questionnaire measures at 9 months of age. Results: The educational intervention did not change parental care behaviour. One element of the behavioural programme, a focal feed between 10 PM and midnight, was not implemented. A second element, stretching of interfeed intervals after 3 weeks of age, was implemented initially, but not maintained at older ages. The third element, which asked parents to emphasise day and night differences in the environment, and to settle their babies in the cot and minimise interaction at night, was carried out by more parents in the behavioural group than in the other groups. This led to an increase of around 10% in the number of babies who slept for 5 or more hours at night (a definition of sleeping through the night) at 12 weeks of age. Fewer behavioural programme parents sought help for crying and sleeping problems between 3 and 9 months of age. Conclusion: The behavioural programme produced a modest increase in the number of infants who slept through the night by 12 weeks of age. The results are discussed in relation to other findings, which bear on the programme's adoption for routine health‐care policy and practice.