bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate hypersensitivity to Malassezia furfur and Candida albicans mannans in vivo and in vitro
Authors: Kosonen J. , Lintu P. , Kortekangas‐Savolainen O. , Kalimo K. , Terho E. O. , Savolainen J. 
Published: August 2005

Background:  Elevated and correlative Malassezia furfur (M. furfur) and Candida albicans (C. albicans) mannan‐specific IgE have been demonstrated in atopic eczema dermatitis syndrome (AEDS) of the head, neck and shoulder (HNS) region of the skin. The significance of these antibodies in vivo has not been demonstrated.Methods:  Sixty‐five AEDS patients with HNS distribution were included. Serum total IgE (S‐IgE) and yeast antigen‐specific (Cetavlon‐purified mannan and whole extract antigens of M. furfur and C. albicans) IgE were measured and skin prick tests (SPT) were performed with the yeast antigens.Results:  Mannan‐specific IgE and SPT were positive in 51 and 48% of patients with M. furfur and in 42 and 22% with C. albicans, respectively. Whole extract‐specific IgE and SPT were positive in 85 and 95% of patients with M. furfur and in 91 and 57% with C. albicans, respectively. The highest correlation between specific IgE and SPT was seen with M. furfur mannan (r = 0.60; P < 0.0001). Both M. furfur mannan‐specific IgE (r = 0.76; P < 0.0001) and SPT (r = 0.44; P = 0.0005) correlated with S‐IgE.Conclusions:  Mannan‐induced immediate hypersensitivity in vivo was demonstrated in SPT. The significant correlation between M. furfur mannan‐specific IgE and SPT suggests that mannan is an important allergen in yeast hypersensitive AEDS in vivo.
Investigation into relative slip during fretting fatigue under partial slip contact condition
Authors: SABELKIN V. , MALL S. 
Published: August 2005

ABSTRACTA finite element analysis based methodology was developed to compute local relative slip on contact surface from the measured global relative slip away from contact surface. A set of springs was included in finite element model to simulate fretting fatigue test system. Compliance of springs was calibrated by comparing experimental and computed global relative slips. This methodology was then used to investigate local relative slip during fretting fatigue in cylinder‐on‐flat contact configuration under partial slip contact condition for unpeened and shot‐peened titanium alloy, Ti–6Al–4V. Relative slip on contact surface is significantly smaller (about one order) than the measured global relative slip by using a conventional extensometer near the contact surface. Effects of coefficient of friction, rigidity of fretting fatigue system and applied stress to specimen on the global and local relative slips were characterized. Coefficient of friction and contact load have considerable effect on local relative slip, and practically no effect on global relative slip. Gross slip condition can develop at some locations on contact surface in spite of overall partial slip condition. Increase in rigidity of fretting fatigue system increases local relative slip but decreases global relative slip. Finally, fatigue life diagrams based on relative slip on contact surface are established for both unpeened and shot‐peened titanium alloy. These show the same characteristics as of the conventional S–N diagram where fatigue life decreases with increase of relative slip.
Quality of Phenobarbital Solid‐dosage Forms in the Urban Community of Nouakchott (Mauritania)
Authors: Laroche Marie‐Laure , Traore Hamidou , Merle Louis , Gaulier Jean‐Michel , Viana Marylene , Preux Pierre‐Marie 
Published: August 2005

Summary:  Purpose: Epilepsy is a major public‐health problem in Africa. The quality of available drugs is a limiting factor for an adequate management. The aim of this study was to describe the proportion of poor‐quality phenobarbital (PB) solid‐dosage forms and evaluate the factors associated with its quality in Nouakchott (Mauritania). Methods: A cross‐sectional study was carried out within pharmacies, hospitals, and on the parallel market in March 2003. PB samples were bought by a native person and then assayed by a liquid chromatography method. A package was considered to be of good quality if the active‐substance average content was between 85 and 115% of the stated content printed on the packet. Results: Forty‐five pharmaceutical stores were visited, enabling us to collect 146 samples of PB. Three brand names were available in Nouakchott. They originated from France, Morocco, Senegal, and Egypt. Results: A prevalence of 13.7%[95% confidence interval (CI), 8.8–20.0] of poor‐quality PB was found. All samples from Morocco were underdosed. The generic active content was satisfactory, but saccharose, an excipient with a potential side effects, was identified. Two factors associated with the good quality of PB have been put forward: tablets manufactured in France and loose packaging as generics conditioned in such a way were of good quality. Conclusions: This study shows that the quality of antiepileptic drugs in Africa is still worrying. The setting up of medicine quality control in Mauritania is legitimate. Considering the good quality of generic PB and its lower cost, this type of medicine should be promoted in this region.
Management of Women with Epilepsy: Are Guidelines Being Followed? Results from Case‐note Reviews and a Patient Questionnaire
Authors: Kampman Margitta T. , Johansen Stein‐Vegar , Stenvold Helge , Acharya Ganesh 
Published: August 2005

Summary:  Purpose: Several international guidelines for the management of women with epilepsy (WWE) have been developed since 1989. We aimed to determine whether guidelines for the management of WWE are followed and whether active implementation of such guidelines makes a difference to clinical practice. Methods: The study covered a 2‐year period of “passive dissemination” of guidelines followed by a 2‐year period of “active implementation.” Documentation reflecting adherence to the guidelines was abstracted retrospectively from electronic medical records on 215 WWE aged 16–42 years. Data abstracted from case notes included counselling on contraception and pregnancy‐related issues; follow‐up during pregnancy; advice on supplementation of folic acid, calcium, and vitamin D; and serum folate measurements. A questionnaire assessing the knowledge of WWE issues was completed by 112 (71%) of 157 patients. Results: Documentation that WWE issues had been addressed was found in approximately one third of medical case records with no measurable effect of active implementation. Only the follow‐up during pregnancy seemed to have improved. Serum folate measurements in 51 women treated with enzyme‐inducing antiepileptic drugs (AEDs) revealed folate deficiency in 11 (22%). Respondents to the questionnaire recalled having received information from their neurologists on the interaction between AEDs and oral contraceptives (46%), need to plan pregnancy (63%), and folic acid requirement (56%). Conclusions: Judged by a review of documentation in case notes, active implementation of guidelines had no measurable effect on clinical practice. However, the follow‐up during pregnancy seemed to have improved. Patients' knowledge of WWE issues compared favorably with published studies. Better strategies are needed to secure successful implementation of guidelines.
Time Course and Mapping of Cerebral Perfusion during Amygdala Secondarily Generalized Seizures
Authors: Chassagnon Serge , De Vasconcelos Anne Pereira , Ferrandon Arielle , Koning Estelle , Marescaux Christian , Nehlig Astrid 
Published: August 2005

Summary:  Purpose: Measurement of local cerebral blood flow (LCBF) is routinely used to locate the areas involved in generation and spread of seizures in epilepsy patients. Because the spatial distribution and extent of ictal CBF depends on the epileptogenic network, but also on the timing of injection of tracer, we used a rat model of amygdala‐kindled seizures to follow the time‐dependent changes in the distribution of LCBF changes. Methods: Rats were implanted in the left amygdala and were fully kindled. LCBF was measured by the quantitative [14C]iodoantipyrine autoradiographic technique bilaterally in 35 regions. The tracer was injected at 30 s before seizure induction (early ictal), simultaneous with the application of stimulation (ictal), at 60 s after stimulation (late ictal), at the end of the electrical afterdischarge (early postictal), and at 6 min after the stimulation (late postictal). Results: Rates of LCBF increased over control levels during the early ictal phase ipsilaterally in medial amygdala, frontal cortex, and ventromedian thalamus and bilaterally in the whole hippocampus, thalamic nuclei, and basal ganglia. During the ictal phase, all regions underwent hyperperfusion (81–416% increases). By 60 s after stimulation, rates of LCBF returned to control levels in most brain areas, despite ongoing seizure activity. At later times, localized foci of hypoperfusion were observed in hippocampus bilaterally, with a slight predominance in CA1 on the side of origin of the seizures. Conclusion: This study shows a rapid spread of activation from the stimulated amygdala bilaterally to numerous limbic, cortical, and subcortical structures. The largest hyperperfusion was recorded during the ictal period with tracer injections simultaneous with the stimulation. The unilateral site of origin of seizures led to minor asymmetrical and lateralized findings, merely at early ictal and late postictal times, whereas intermediate tracer injections induced bilateral changes. Only late postictal measurements allowed the identification of significant changes in focal structures: the hippocampus is known to play a critical role in the spread of limbic seizures.
Socioeconomic Status Is a Risk Factor for Epilepsy in Icelandic Adults but Not in Children
Authors: Hesdorffer Dale C. , Tian Hong , Anand Kishlay , Hauser W. Allen , Ludvigsson Petur , Olafsson Elias , Kjartansson Olafur 
Published: August 2005

Summary: Purpose:Two earlier population‐based studies provide conflicting information on the association between low socioeconomic status (SES) and risk for epilepsy. Seizure etiologies (e.g., head injury, stroke) associated with low SES were not addressed in prior analyses. We assess the relation between SES indices and incident epilepsy separately for children and adults and in subgroups defined by seizure etiology.Methods:In this population‐based case–control study, a surveillance system identified incident unprovoked seizure or first diagnosis of epilepsy throughout Iceland (n = 418). Controls were selected from the population registry as the next two same‐sex births alive, residing in Iceland at the time of the index seizure, and without a history of unprovoked seizure on the date of the case's incident seizure (n = 835). The odds ratio measured the association between SES and epilepsy.Results:An association was found between epilepsy and SES among adults, but not among children. Among adults, low education was associated with an increased risk for epilepsy [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.21–4.34), and home ownership was protective (OR, 0.63; 95% CI, 0.43–0.92). When analyses were repeated by seizure etiology, this association remained only in the group with epilepsy of unknown cause, even after adjusting for alcohol consumption.Conclusions:Low SES, indexed by low education or lack of home ownership, is a risk factor for epilepsy in adults, but not in children, suggesting a cumulative effect of SES on risk for epilepsy. This association is not explained by established risk factors for epilepsy (e.g., head injury, stroke). We find no evidence of a downward social drift among cases whose parents had epilepsy.
Prognostic Factors for the Surgery for Mesial Temporal Lobe Epilepsy: Longitudinal Analysis
Authors: Jeong Sang‐Wuk , Lee Sang Kun , Hong Keun‐Sik , Kim Kwang‐Ki , Chung Chun‐Kee , Kim Ho 
Published: August 2005

Summary:  Purpose: Determining long‐term prognostic factors of surgery for mesial temporal lobe epilepsy (MTLE) is important for identifying ideal candidates and predicting the prognosis for individual patients. We tried to identify the prognostic factors of anterior temporal lobectomy (ATL) for MTLE with longitudinal multivariate analysis. Methods: Two hundred twenty‐seven patients with MTLE were included in this study. The primary outcome variable was patient status 1–5 years after surgery: seizure free, or not. Clinical characteristics and recent diagnostic modalities were considered as prognostic factors. Univariate and standard multiple logistic‐regression analysis for outcome at 1 and 5 years after surgery and the generalized estimation equation (GEE) model for longitudinal multiple logistic regression of the 5‐year follow‐up period were used. Results: The seizure‐free rate at 1 year was 81.1% and decreased to 75.2% at 5 years after surgery. By the univariate or standard multiple logistic‐regression analysis, age at surgery or hippocampal sclerosis on magnetic resonance imaging (MRI) ipsilateral to surgery was significant for the postsurgical outcome. However, the longitudinal analysis by the GEE model revealed that younger age at surgery [odds ratio (OR), 0.59; 95% confidence interval (CI), 0.43–0.81], absence of secondarily generalized tonic–clonic seizure (2°GTCS; OR, 0.45; 95% CI, 0.26–0.79), and hippocampal sclerosis on MRI (OR, 2.44; 95% CI, 1.11–5.26) were significant predictors of a good surgical outcome. Conclusions: Age at surgery, presence of 2°GTCS, and hippocampal sclerosis on MRI are independent prognostic factors for ATL in MTLE. These findings suggest that MTLE is a progressive disorder, and surgical outcome is better when early ATL is performed.
Separation of Antiepileptogenic and Antiseizure Effects of Levetiracetam in the Spontaneously Epileptic Rat (SER)
Authors: Yan Hai‐Dun , Ji‐qun Cai , Ishihara Kumatoshi , Nagayama Takashi , Serikawa Tadao , Sasa Masashi 
Published: August 2005

Summary: Purpose:The long‐lasting antiseizure effects of levetiracetam (LEV) have been observed in the spontaneously epileptic rat (SER) that expresses both tonic and absence‐like seizures. Furthermore, the antiepileptogenic effects of LEV in addition to antiseizure effects have been reported in the amygdala‐kindling model in rats. This suggests that the long‐lasting seizure protection of LEV may be at least partly due to its antiepileptogenic effects. Therefore this study aimed to differentiate the antiseizure and potential antiepileptogenic effects of LEV by administering LEV continuously to SERs before the appearance of any seizure expression.Methods:LEV was administered to the SERs at 80 mg/kg/day (i.p.) from postnatal weeks 5 to 8. The period of observation for tonic convulsions was from postnatal week 5 to 13. Absence‐like seizures were recorded by using conventional EEG in weeks 12 and 13.Results:After age 7–8 weeks, SERs exhibit spontaneous tonic convulsions. Development of tonic convulsions was significantly inhibited in the LEV group, compared with the control group, by the middle of week 9. A significant reduction of tonic convulsions also was observed in the LEV group until week 13 (5 weeks after termination of the administration). In week 12, the absence‐like seizures were significantly lower in the LEV group, compared with the control group.Conclusions:This study demonstrates a significant inhibition of seizures after prolonged treatment with LEV before the developmental expression of seizure activity in SERs. This effect is suggested to be due to an antiepileptogenic effect and not an antiseizure effect of LEV, because the half‐life of the drug in plasma is short (2–3 h in rats) after single and long‐term administration. Furthermore, the inhibition of seizure expression in SERs was still apparent 5 weeks after termination of LEV treatment. These results further suggest that LEV possesses not only antiseizure effects but also antiepileptogenic properties.
History of evidence‐based medicine. Oranges, chloride of lime and leeches: Barriers to teaching old dogs new tricks
Authors: Doherty Steven 
Published: August 2005

AbstractKnowledge translation is the process of taking evidence from research and applying it in clinical practice. In this article I will cite some pivotal moments in the history of medicine to highlight the difficulties and delays associated with getting evidence into practice. These historical examples have much in common with modern medical trials and quality improvement processes. I will also review the reasons why evidence is not used and consider what factors facilitate the uptake of evidence. Understanding these concepts will make it easier for individual clinicians and institutions to change clinical behaviour and provide a starting point for those looking at implementing ‘new’ practices, new therapies and clinical guidelines. Finally, I will offer a list of criteria that clinicians might choose to consider when deciding on whether or not to adopt a new practice, treatment or concept.
Rapid health assessment in Aceh Jaya District, Indonesia, following the December 26 tsunami
Authors: Brennan Richard J ,   Kamaruddin Rimba
Published: August 2005

AbstractObjectives:  To rapidly determine the public health impact of the Asian tsunami on the population of three communities in Aceh Jaya District, Indonesia, and to prioritize health interventions.Methods:  Rapid health assessment, utilizing direct observations, interviews with key informants, a single focus group discussion, town mapping, a review of medical records and a systematic random sample of the entire town of Calang, capital of Aceh Jaya District, Indonesia.Results:  Almost 100% of dwellings were destroyed in all three communities. For the town of Calang: only 18.2% of the pre‐tsunami population remained 2 weeks following the disaster, with an estimated 70% of the population having died at the time of impact; government estimates of the remaining population were inflated by approximately 250%; mortality rates were not elevated post‐tsunami; 100% of the population lacked access to sanitation and clean water; 85% of children under 5 years reported diarrhoea over the preceding 2 week period; 95% of individuals with a medical complaint reported satisfactory access to clinical care; acute malnutrition was not a significant problem; and over one‐fifth of households were hosting an orphan. For the villages of Rigah and Sayeung: approximately 46.2 and 86.0% of the population survived the tsunami impact, respectively; mortality rates were not elevated post tsunami; 100% of the population lacked access to sanitation and clean water; diarrhoea was the main cause of morbidity; primary care services were available only in Rigah; and only Rigah had received external assistance.Conclusions:  Almost two‐thirds of the population of the three communities died as a result of the tsunami's impact. Although mortality rates were not elevated post tsunami, significant threats to public health persisted, especially water‐borne diseases. Priority activities included emergent environmental health interventions, mobile clinics to the two villages and a more detailed assessment of the needs of orphans. Data were shared with agencies better placed to address needs in the areas of shelter and food aid.
Substance misuse, anxiety and depression and urgency of presentation to a public emergency department in Australia
Authors: Kinner Stuart A , Alati Rosa , Watt Kerrianne , Najman Jake M , Fowler Greg , Green David 
Published: August 2005

AbstractObjectives:  To establish the prevalence and comorbidity of substance‐related problems and anxiety and depression, among ED presentations, and to compare the prevalence of these conditions among more and less urgent presentations.Design and setting:  Cross‐sectional survey of ED presentations over a 14 day period (24 h/day) at the Gold Coast Hospital Emergency Department in south‐east Queensland, Australia, in October 2002.Measures:  Usual level of alcohol consumption (Alcohol Use Disorders Identification Test), acute alcohol and illicit drug use (during 24 h prior to interview), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) and triage category (Australasian Triage Scale).Results:  Thirty‐one per cent of the sample reported usually consuming alcohol at a hazardous or harmful level. Twenty per cent of participants reported clinically significant levels of anxiety and/or depression, which were in turn significantly associated with hazardous and harmful levels of alcohol use. Hazardous/harmful alcohol consumption was over‐represented among less urgent ED presentations, whereas anxiety and depression were more prevalent among more urgent ED presentations.Conclusions:  Emergency departments in Australia are appropriate settings for the detection of both substance use and mental health problems in the wider community. The prevalence of these problems in ED settings is high and there is a need for the development of systematic screening and referral processes. The evidence of a link between urgency of presentation and these problems needs to be further explored.
Helicopter primary retrieval: Tasking who should do it?
Authors: Cameron Stephen , Pereira Peter , Mulcahy Richard , Seymour Jamie 
Published: August 2005

AbstractBackground:  Cairns Base Hospital utilizes a helicopter retrieval system, which until 2001 had been tasked and staffed by emergency physicians. Since 2001, the ambulance service has assumed the role of both tasking and staffing the helicopter with intensive care paramedics. The present study examines whether the change has resulted in different activation patterns and patient outcomes.Method:  A retrospective chart review over 4 consecutive years, comparing the two groups, was carried out examining 30 day mortality, length of in‐hospital stay, transfer rates, the Revised Trauma Score where appropriate and rates of discharge directly from the ED.Results:  A total of 374 patients were retrieved (211 patients in the emergency physician group from 1 April 1999 to 31 March 2001 and 163 in the ambulance group from 1 April 2001 to 31 March 2003) over the 4 year period. The demographics of the two groups were similar. Fifty‐four patients in the ambulance group (33.1%) were discharged from the ED without admission while 31 (14.7%) were discharged from the physician group. This was statistically significant (P = 0.0001). There were no other significant differences between the two groups. The subgroup of patients admitted also did not show any significant difference in outcomes.Conclusion:  The similarities in outcomes for admitted patients support the view that both groups have similar tasking criteria for high‐acuity patients and suggest that paramedics are as efficacious as physicians in delivering prehospital care in this group of patients. However, for lower‐acuity patients, there is a statistically significant higher rate of clinically unnecessary taskings by the ambulance group. Given the recent fatal aeromedical accidents in Queensland (Thursday Island 1998, Rockhampton 1999 and Mackay 2003), it would seem prudent to reduce clinically unnecessary retrievals through clinical coordination with appropriately qualified emergency physicians.