bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mucosal Injuries of the Upper Aerodigestive Tract After Smoking Crack or Freebase Cocaine
Authors: Meleca Robert J. , Burgio Don L. , Carr Richard M. , Lolachi Christopher M. 
Published: October 2004

AbstractThe introduction of “crack” and “freebase” cocaine to the United States has resulted in an increased number of patients presenting to emergency rooms with cocaine‐related burns of the upper aerodigestive tract. Because symptoms are nonspecific and histories often unreliable, the emergency room physician must keep a high index of suspicion for cocaine use when confronted with these types of patients. We present seven patients who had burns to the upper aerodigestive tract as a result of smoking crack or freebase cocaine. Two of seven patients underwent an emergency tracheotomy, probably because of delayed diagnosis and inadequate early medical intervention. This article reviews the history behind cocaine use, its different modes of administration, potential complications associated with smoking cocaine, diagnostic workup, and treatment options.
Computer‐Assisted Surgery in the Frontal and Maxillary Sinus
Authors: Gunkel Andreas Rüdiger , Freysinger Wolfgang , Thumfart Walter Franz 
Published: October 2004

AbstractWe report the intraoperative use of bent probes for 3‐dimensional computer‐assisted navigation in ENT surgery with the ISG Viewing Wand. Probe calibration is standardized and the new probes comply with the overall application accuracy of the navigation system. The bent probes permit an easy access to the remotest locations of the maxillary and the frontal sinus and are beneficial for application in paranasal sinus surgery. We present our clinical experiences with these probes.
Immune Responses against Streptococcus pyogenes in Human Palatine Tonsils
Authors: Hideomi Kerakawauchi , Yuichi Kurono , Goro Mogi 
Published: October 2004

AbstractWe investigated cellular immunity against Streptococcus pyogenes in human tonsils by measuring antigen‐specific immunoglobulin‐secreting cells and the production of cytokines from CD4+ T cells in response to M proteins. The incidence of S pyogenes in tonsils was significantly higher in patients with recurrent tonsillitis (RT) than in patients with tonsillar hypertrophy (TH). M protein‐specific immunoglobulin A (IgA) and immunoglobulin G spot‐forming cells were increased in patients with RT compared with patients with TH. In RT the number of M protein‐specific IgA spot‐forming cells was significantly greater in the S pyogenes‐negative subjects than in the S pyogenes‐positive subjects. Proliferation of CD4+ T cells and production of interferon‐gamma (IFN‐γ) and interleukins−2,− 4, −5, and −6 (IL‐2, IL‐4, IL‐5, and IL‐6) from those T cells were observed in response to M protein. The concentrations of IFN‐γ and IL‐4 were higher in RT than in TH. These findings suggest thatS pyogenes is associated with the pathogenesis of RT and that immune responses against M protein may play an important role in preventing the colonization of this bacteria in tonsils.
Contralateral External Carotid‐Middle Cerebral Artery Bypass for Carotid Artery Resection
Authors: Numata Tsutomu , Konno Akiyoshi , Takeuchi Yousuke , Katahashi Tatsuaki , Yuza Jun , Hanazawa Toyoyuki , Ono Junichi 
Published: October 2004

AbstractResection of the common carotid or internal carotid artery is occasionally unavoidable in cases of advanced head and neck carcinoma with carotid artery involvement. To prevent the consequent decrease in cerebral perfusion, we have developed a contralateral external carotid‐middle cerebral artery bypass grafting technique. From 1990 through 1995, six patients with advanced head and neck cancer involving the carotid artery underwent total tumor resection combined with vascular reconstruction using the contralateral external carotid‐ middle cerebral artery bypass grafting. No bypass‐related complications occurred in any patient postoperatively. Cerebral hemodynamics after surgery indicated that this bypass graft worked steadily over a long term and supplied sufficient volume of blood to the cerebral cortex on the opposite side in every case.
Nonseptic Lateral Sinus Thrombosis: The Otolaryngologic Perspective
Authors: Rosen Arie , Scher Nattan 
Published: October 2004

AbstractNonseptic lateral sinus thrombosis (NSLST) differs from septic lateral thrombosis (SLST) in that it is not associated with ear or sinus infection, it usually occurs in the adult population, and it has an ambiguous clinical presentation. The otolaryngologist is often consulted about diagnostic findings associated with lateral sinus thrombosis. We report three cases of NSLST that required otolaryngologic assessment. The patients were women, ages 23 to 31 years. Presenting symptoms were headaches in all three patients; one also had concomitant ear pain. Two patients had negative head computed tomography scans; only magnetic resonance imaging was diagnostic. Treatment of NSLST consists of anticoagulation and elimination of predisposing factors. Familiarity with this condition is fundamental for early diagnosis and initiation of appropriate therapy. We discuss the origins and causes of NSLST, clinical presentation, preferred diagnostic strategy, and treatment alternatives.
The Influence of Prescription Drug Use on Long‐Term Care Insurance Ownership
Authors: Bernet Patrick Michael 
Published: October 2004

AbstractLong‐term care insurance (LTCI) can be an effective way of protecting individual assets from nonacute medical costs not covered by traditional health insurance. Prior research suggests a number of economic, health, and family structure factors related to the decision to purchase LTCI. Theories that health and income shocks precipitate precautionary saving introduce the possibility that prescription drug use may also play a role in such decisions. Findings that poor health increases the propensity to insure against risk in asset holdings provide another possible relation to LTCI. This study extends prior research to investigate the link between the routine use of prescription drugs and the decision to purchase LTCI. Using data from the Health and Retirement Survey, logistic regression is employed to test the significance of LTCI policy ownership determinants. In addition to lending empirical support to theories on intrafamily moral hazard, results indicate that there is a positive relationship between routine drug use and LTCI purchase decisions.
A Pedagogical Note on Risk Framing
Authors: Barth Michael M. , Hatem John J. , Yang Bill Z. 
Published: October 2004

AbstractThis article presents several classroom games that help illustrate the effect of risk framing on choices under uncertainty. These games are presented in the context of Kahneman and Tversky's prospect theory that is an alternative to the traditional expected utility theory. Expected utility theory is a prescriptive model of decision making that explains how people should react to risk, while prospect theory is a descriptive model that explains how people actually do react to risk. These classroom games can be used in introductory risk management courses, insurance courses, and financial risk management courses to help students to understand the effect of context on choices made under uncertainty. Although results from actual classroom experiments are included, these results are not meant to be indicative of normal results but are rather illustrative of the type of results that may arise when alternative framing contexts are used.
Risk Aversion and the Willingness to Pay for Insurance: A Cautionary Discussion of Adverse Selection
Authors: Eisenhauer Joseph G. 
Published: October 2004

AbstractTextbooks frequently describe adverse selection as an almost inevitable feature of insurance markets with heterogeneous buyers and asymmetric information. But if low‐risk applicants are more risk averse than their high‐risk counterparts, the former may be as willing or more willing than the latter to purchase insurance at any given price. The present article discusses this possibility in several forms suitable for different levels of instruction, to help bridge the gap between insurance education and current research on this topic.
A User‐Friendly Introduction to Property‐Casualty Claim Reserves
Authors: Calandro Joseph , O'Brien Thomas J. 
Published: October 2004

AbstractProperty‐casualty (P&C) claim reserves are financial statement liabilities that represent estimated future claims. An understanding of P&C reserves is important to both risk managers and investment analysts, since this information is crucial in assessing solvency and value. We review some basics of P&C reserves, and add some of our own thoughts, in a way that tries to be user‐friendly for practitioners and students.
Grade‐Risk: An Insurable Event in the Classroom
Authors: Pope Nat , Ma Yu‐Luen 
Published: October 2004

AbstractGrade‐risk provides a powerful ally in establishing relevance between course content and the lives of students. As used in this article, grade‐risk refers to the potential for the loss of points on examinations, quizzes, etc. This article describes the rationale and feasibility associated with the introduction of a student‐centered grade insurance project that provides some measure of protection against grade‐risk. The project engages students on multiple levels and in various capacities resulting in a significantly enriched learning experience. The authors include examples employed in their own classroom in demonstrating the feasibility and validity of grade insurance as a learning tool.
Applicability of a monoclonal antibody‐based dipstick in diagnosis of urinary schistosomiasis in the Central Region of Ghana
Authors: Bosompem Kwabena M. , Owusu Osei , Okanla E. O. , Kojima Somei 
Published: October 2004

SummaryWe tested a rapid visually read monoclonal antibody (MoAb) based dipstick assay for specific diagnosis of urinary schistosomiasis against microscopy and the use of haematuria and proteinuria in a schistosomiasis haematobia endemic area in the Central Region of Ghana. The study group consisted of 141 school children (83 males, 58 females) aged 8–19 years. A total of 129 of 141 (91.5%) submitted stool samples, and 7.8% had Schistosoma mansoni, 55% had hookworms and 6.2% had tapeworms. The presence of S. mansoni and intestinal parasites did not appear to influence the results of the MoAb‐dipstick assay. The urinary schistosomiasis prevalence by MoAb‐dipstick (78%) was higher (P < 0.05) than the estimate by microscopy (60.3%), microhaematuria (27%) and proteinuria (30.5%). The MoAb‐dipstick correctly identified 98.8% of microscopically confirmed cases and missed one (1.3%). The dipstick was also positive for 26 of 56 (46.4%) egg‐negative individuals, thereby giving a sensitivity of 98.8% and a specificity of 53.6%. On the other hand, microhaematuria and proteinuria were 38.8% and 30.6% sensitive, and 91.1% and 69.6% specific, respectively. Microhaematuria and proteinuria were less sensitive (P < 0.05) than both microscopy and MoAb‐dipstick.
The difference between effectiveness and efficacy of antimalarial drugs in Kenya
Authors: Amin Abdinasir A. , Hughes Dyfrig A. , Marsh Vicki , Abuya Timothy O. , Kokwaro Gilbert O. , Winstanley Peter A. , Ochola Sam A. , Snow Robert W. 
Published: October 2004

SummaryObjective  To demonstrate the difference between effectiveness and efficacy of antimalarial (AM) drugs in Kenya.Methods  We undertook a series of linked surveys in four districts of Kenya between 2001 and 2002 on (i) community usage of nationally recommended first‐ and second‐line AM drugs; (ii) commonly stocked AM products in the retail and wholesale sectors; and (iii) quality of the most commonly available first‐ and second‐line AM products. These were combined with estimates of adherence and clinical efficacy to derive overall drug effectiveness.Results  The overall modelled effectiveness for sulphadoxine–pyrimethamine (SP) was estimated to be 62% compared with 85% for reported SP clinical efficacy. For amodiaquine the modelled effectiveness was 48% compared with 99% reported efficacy during the same time period.Conclusions  The quality of AM products and patient adherence to dosage regimens are important determinants of drug effectiveness, and should be measured alongside clinical efficacy. Post‐registration measures to regulate drug quality and improve patient adherence would contribute significantly to AM drug performance.
Artemisinin‐based combination therapy reduces expenditure on malaria treatment in KwaZulu Natal, South Africa
Authors: Muheki Charlotte , McIntyre Di , Barnes Karen I. 
Published: October 2004

SummaryIntroduction  There is growing international evidence that artemisinin‐based combination therapy (ACT) is one of the few effective measures available to ‘Roll Back Malaria’. However, concerns about the costs and affordability of ACT are obstacles to its widespread implementation. This paper explores some economic aspects of the implementation of artemether–lumefantrine (AL) to replace sulphadoxine–pyrimethamine (SP) in the KwaZulu Natal (KZN) province, South Africa.Methods  Recurrent and capital costs for malaria treatment were compared at baseline and post‐intervention for nine clinics and a sentinel rural district hospital. Changes in the unit costs of, and total expenditure on, malaria services were calculated and the cost effectiveness of AL relative to SP was assessed.Results  The number of outpatient malaria cases and inpatient admissions both declined by 94% between 2000 and 2002. After accounting for the role of concurrent improvements in vector control, it was conservatively estimated that 36% of the decline in outpatient cases and 46% for inpatient admissions was attributable to changing the first‐line drug to AL. Although AL is considerably more expensive than SP, its improved cure rate and reduced malaria transmission resulted in an estimated US$ 201 065 cost saving in 2002 alone for the subdistrict studied.Discussion  In the context of effective vector control and low efficacy of existing monotherapy, ACT can reduce total expenditure on malaria services. However, the relevance of these findings requires careful consideration in countries with currently effective treatment policies and higher intensity malaria transmission.
An outbreak of leptospirosis in Orissa, India: the importance of surveillance
Authors: Jena Abani Bhusan , Mohanty Kailash C. , Devadasan N. 
Published: October 2004

SummaryObjective  To demonstrate the importance of surveillance systems in detecting emerging diseases and highlighting the strengths and weaknesses of an existing one.Methods  The Orissa multi‐disease surveillance system (OMDSS) was introduced in November 1999. Reporting units from the periphery send data to the district on a weekly basis. These reports are analysed regularly. A district task force (DTF) was available to intervene in the event of an outbreak. The OMDSS detected an increasing number of cases with fever and jaundice in June 2002. The DTF investigated this outbreak using clinical, epidemiological and laboratory tools to identify its cause.Results  This outbreak, in a remote corner of India, was detected within 4 days by an existing surveillance system. Action was initiated within 24 h, but it took approximately two more weeks for the causative agent to be diagnosed. A total of 143 people were suspected to have leptospirosis between 23 June 2002 and 31 July 2002. The attack rate was 5.95% and the case fatality ratio (CFR) was 7.69%, both lower than outbreaks reported elsewhere in India. While males were infected more often than females, the CFR was higher among females and among the 6–15 year age groups. Exposure to infected water in a canal was the probable cause of the outbreak. IgM antibodies were positive in 33 of the patients and six patients tested positive for PCR and culture. Leptospirosis interrogans serovar canicola, Leptospirosis interrogans serovar pomona and Leptospirosis interrogans serovar hebdomadis were isolated.Conclusions  Leptospirosis is a new disease in this region of India. This outbreak was detected and diagnosed because of the surveillance system. The prompt response helped in containing the outbreak early enough. However, the morbidity and mortality could have been further mitigated if the delays in transmitting information had been minimized. An adequate laboratory support would have also helped considerably. We conclude stressing the importance of surveillance as a public health tool.
Anti‐leishmanial activity of a new formulation of amphotericin B
Authors: Dea‐Ayuela M. A. , Rama‐Íñiguez S. , Sánchez‐Brunete J. A. , Torrado J. J. , Alunda J. M. , Bolás‐Fernández F. 
Published: October 2004

SummaryThe effectiveness of albumin microspheres loaded with amphotericin B was tested in an in vivo model of visceral leishmaniasis using the golden hamster. Free and encapsulated amphotericin B was tested at the dose of 1 mg/kg given by the intracardiac route on days 25, 26 and 27 post‐infection (p.i.) to treat animals previously infected with 107 stationary promastigotes by the intracardiac route. Encapsulated amphotericin was highly effective against infection causing a reduction of 88.8% and 87.2% in the early stage of infection (day 32 p.i.) and of 66.7% and 54% in a later stage of infection (day 135 p.i.) in liver and spleen parasite load respectively, compared with untreated animals, whereas free amphotericin was inactive. Lymphocyte proliferation was restored together with an increase in CD4+ subsets in animals treated with encapsulated amphotericin B, but not in those treated with the non‐encapsulated compound. Antibody responses did not increase after treatment with encapsulated amphotericin B with antibody levels remaining at base levels for most animals in contrast to those of untreated or treated with free amphotericin, where in most animals the antibody levels sharply increased. This new formulation could be a more economical alternative to liposomes for the treatment of visceral leishmaniasis with amphotericin B.
Effectiveness of two annual, single‐dose mass drug administrations of diethylcarbamazine alone or in combination with albendazole on soil‐transmitted helminthiasis in filariasis elimination programme
Authors: Mani T. R. , Rajendran R. , Sunish I. P. , Munirathinam A. , Arunachalam N. , Satyanarayana K. , Dash A. P. 
Published: October 2004

SummaryA longitudinal community‐trial on the control of soil‐transmitted helminths (STHs), as part of a lymphatic filariasis elimination campaign, was taken up in two revenue blocks of southern India in the years 2001 and 2002 to assess the impact of two annual single‐dose mass drug administration (MDA) of diethylcarbamazine (DEC) + albendazole (ALB) with that of DEC alone. The prevalences and intensities of STHs were studied among cross‐sectional samples of school children aged 9–10 years by using the Kato‐Katz technique at baseline and 11 months after each MDA. The combined drug mass treatment produced a higher reduction in the prevalence (RIP) (51–77%) and the egg reduction rate (ERR) (92–98%) compared with 12–15% RIP and 58–62% ERR of DEC alone mass treatment. The effect of two‐drug therapy after two annual treatments was relatively long lasting as shown by RIP and ERR indicating that the reinfection rates were relatively lower in this approach than single‐drug therapy. This study demonstrates that mass drug co‐administration of DEC + ALB in Global Programme for Elimination of Lymphatic Filariasis (GPELF) targeted at the community had a synergistic and sustainable effect against soil‐transmitted helminthiasis and provided considerable ‘beyond filariasis’ benefits. The additional advantages accrued to the community underscore the importance of scaling‐up GPELF to cover the entire population at risk.
Helicobacter pylori antigens in the faeces of asymptomatic children in the Buea and Limbe health districts of Cameroon: a pilot study
Authors: Ndip R. N. , Malange A. E. , Akoachere J. F. T. , MacKay W. G. , Titanji V. P. K. , Weaver L. T. 
Published: October 2004

SummaryObjective  To determine the prevalence and identify intra‐familial risk factors associated with Helicobacter pylori infection in a paediatric population.Methods  Cross‐sectional study in the Buea and Limbe health districts, South West Cameroon. Stool samples were collected from 176 randomly selected apparently healthy children from two communities with different socioeconomic status. They comprised 86 males and 90 females aged 0–10 years with a mean age of 4.29. Helicobacter pylori status was determined using an enzyme‐linked immunosorbent assay, the H. pylori stool antigen (HpSA) test. The test uses polyclonal anti‐H. pylori capture antibody to detect H. pylori antigens in human stool. Epidemiological data were analysed using the Fisher test and odds ratio (OR) at 95% confidence intervals (CI).Results  The overall prevalence of H. pylori was 52.27% (92 of 176). Univariate analysis showed that H. pylori prevalence was significantly higher in children of the low socioeconomic class, 62.50% (55 of 88) than in those of the high socioeconomic class, 42.05% (37 of 88) (P < 0.05; OR = 2.41, 95% CI: 1.26–4.64). Helicobacter pylori prevalence increased with age from 37.50% (12 of 32) for children aged <3 years, 50.00% (53 of 106) aged 3–6 years and 71.05% (27 of 38) aged 7–10 years (P > 0.05; OR = 0.81, 95% CI: 0.34–1.91). The frequency of infection was significantly higher in males, 64.00% (55 of 86) than in females, 41.11% (37 of 90), (P < 0.05; OR = 2.67, 95% CI: 1.39–5.17).Conclusions  This study highlights the continuing importance of age, sex and socioeconomic status in the acquisition of H. pylori infection.
Environmental control of schistosomiasis through community participation in a Moroccan oasis
Authors: Boelee Eline , Laamrani Hammou 
Published: October 2004

SummaryAkka oasis, in the province of Tata, southern Morocco, is one of the oldest foci of urinary schistosomiasis in Morocco where transmission is still taking place. We report the results of two studies: a cross‐sectional snail survey investigated the distribution of Bulinus truncatus in relation to habitat factors in the Akka traditional irrigation system. The presence of aquatic vegetation, especially Potamogeton sp. was identified as a key factor determining snail occurrence and abundance in canals, impoundments and isolated small puddles and streamlets in the Akka riverbed. In a participatory rapid appraisal, the community identified snail control as a way to reduce transmission of schistosomiasis. Without any further outside incentives, the local irrigation committee implemented repeated cleaning and vegetation removal in canals. A longitudinal study evaluated the effect of these measures on populations of B. truncatus. Snail and egg mass densities showed significant reductions after repeated vegetation clearing in the study sites. The participatory approach led to low‐cost, environment‐friendly schistosomiasis control measures that were effective and sustainable.
Circulating concentrations of cardiac proteins in complicated and uncomplicated Plasmodium falciparum malaria
Authors: Ehrhardt S. , Wichmann D. , Hemmer C. J. , Burchard G. D. , Brattig N. W. 
Published: October 2004

SummaryIn an unmatched case–control study of 63 non‐immune European patients with uncomplicated (n = 52) and complicated (n = 11) falciparum malaria, serum levels of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), heart‐type fatty acid‐binding protein (H‐FABP), myoglobin, troponin T and creatin kinase‐muscle brain were compared. Elevated levels of NT‐proBNP and H‐FABP indicated myocardial impairment in complicated but not in uncomplicated falciparum malaria. The clinical impact of these findings remains to be evaluated. The pathophysiology of cardiac impairment in complicated falciparum malaria warrants further investigation.