bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duplication of chromosome 2 in association with ventriculomegaly — a case report
Authors: Martin W. L. , Pretlove S. , Mercer A. , Platt C. C. , Roberts E. , Davison V. , Kilby M. D. 
Published: August 2002

AbstractThis is a case report of the prenatal diagnosis of a de novo interstitial duplication of chromosome 2 (46,XX,dup(2)(p13p21) de novo) with an associated phenotypic abnormality. This chromosomal duplication is rare, only one has previously been described prenatally. Postnatal reports of similar duplications in this region have described associated dysmorphic features and significant neurodevelopmental delay. In our case, the only ultrasound finding was moderately severe ventriculomegaly. At post‐mortem, ventriculomegaly was confirmed and there was associated macrocephaly (head circumference above the 97th centile) with no dysmorphic features seen. Copyright © 2001 John Wiley & Sons, Ltd.
Improvement of mesenteric superior artery Doppler velocimetry by amnio‐infusion in fetal gastroschisis†
Authors: Volumenie Jean‐Luc , de Lagausie Pascal , Guibourdenche Jean , Oury Jean‐François , Vuillard Edith , Saizou Carole , Luton Dominique 
Published: August 2002

AbstractThis study aimed to analyse the influence of amnio‐infusion on superior mesenteric Doppler velocimetry and to correlate Doppler data with outcome in fetuses presenting with gastroschisis. Umbilical and intra‐ and extra‐abdominal superior mesenteric artery Doppler velocimetry was measured prospectively before and after amnio‐infusion in fetuses with gastroschisis. Doppler index values and changes were correlated with the following outcome parameters: importance of fibrous coating, duration of hospitalization in the neonatal intensive care unit, total duration of hospitalization, duration of parenteral feeding, duration of ventilatory assistance, and the interval to initiation of oral feeding. A significant improvement of diastolic flow was observed in the extra‐abdominal superior mesenteric artery with amnio‐infusion. No similar change was seen in the intra‐abdominal superior mesenteric or in the umbilical artery. Pre‐amnioinfusion extra‐abdominal mesenteric Doppler index was correlated with maximal diameter of exteriorized bowel and slightly with duration of hospitalization in the neonatal intensive care unit, but no other relation between Doppler index and outcome parameter could be ascertained. Amnio‐infusion induces modifications in the vascularization of exteriorized bowel in gastroschisis. This could partly explain the beneficial effect of this procedure on fetal gut. Copyright © 2001 John Wiley & Sons, Ltd.
AZFc deletion detected in a newborn with prenatally diagnosed Yq deletion
Authors: Tóth András , Tardy Erika P. , Gombos Sándor , Hajdu Krisztina , Bátorfi József , Krausz Csilla 
Published: August 2002

AbstractA case of prenatally diagnosed Yq deletion is described. Fluorescence in situ hybridisation (FISH) was used to identify the abnormal chromosome and to exclude mosaicism. Based on the cytogenetic result and the ultrasound investigation the pregnancy was continued. A newborn with normal male genitalia was delivered. Microdeletion analysis of the Yq showed the absence of the AZFc region. This type of deletion has been described as being associated with azoospermia or oligozoospermia with a progressive decrease of sperm number over time. Long‐term andrological follow‐up of the newborn will be necessary with eventual cryoconservation of sperm at early adulthood. The present report proposes that AZF analysis combined with FISH has an important role in accurate genetic counselling in sex chromosome anomalies. Copyright © 2001 John Wiley & Sons, Ltd.
Prenatal evaluation of fetal neck masses in preparation for the EXIT procedure: the value of pulmonary Doppler ultrasonography (PDU)
Authors: Kalache Karim D. , Masturzo Bianca , Pierro Agostino , Peebles Donald , Chitty Lyn S. 
Published: August 2002

AbstractSonographic demonstration of normal tracheal diameter and breathing‐related lung fluid flow at 30 weeks' gestation in a fetus with a giant neck mass confirmed patent airways, thus avoiding an EXIT procedure. Copyright © 2001 John Wiley & Sons, Ltd.
Role of amniotic fluid interphase fluorescence in situ hybridization (FISH) analysis in patient management
Authors: Cheong Leung Wing , Chitayat David , Seaward Gareth , Windrim Rory , Ryan Greg , Barrett Jon , Winsor Elizabeth J. T. 
Published: August 2002

AbstractWe retrospectively reviewed 309 amniotic fluid interphase fluorescence in situ hybridization (FISH) analyses performed from October 1995 to June 1999 to assess the role of interphase FISH in the management of patients at increased risk for fetal aneuploidies. Gestational age and indications for amniocentesis, clinical interventions after FISH results, as well as interventions after final culture reports were analyzed. There were 244 (79%) normal, 50 (16%) abnormal and 15 (5%) inconclusive FISH results. There were no false‐positive or false‐negative results, but there were nine (3%) clinically significant chromosomal abnormalities not detectable by FISH. Of the 50 women with abnormal FISH results, 26 (52%) elected to terminate the pregnancy prior to the availability of the standard chromosome analysis. In two of the fetuses with trisomy 21 no abnormalities were reported by ultrasound examination. Our experience indicates that interphase FISH results played an important role in decision making, especially for pregnancies close to 24 weeks' gestation. Standard karyotype analysis is still required for detection of chromosome abnormalities not detectable by interphase FISH techniques and for clarification of unusual or inconclusive FISH results. Copyright © 2001 John Wiley & Sons, Ltd.
Confined placental mosaicism for trisomy 14 and maternal uniparental disomy in association with elevated second trimester maternal serum human chorionic gonadotrophin and third trimester fetal growth restriction
Authors: Towner Dena R. , Shaffer Lisa G. , Yang Sam P. , Walgenbach Donna D. 
Published: August 2002

AbstractA case of confined placental mosaicism (CPM) and maternal uniparental isodisomy 14 identified after placental karyotype revealed trisomy 14 in a newborn with intrauterine growth restriction (IUGR) and minor dysmorphic features is reported. During the second trimester of the pregnancy, multiple marker screening revealed an increased risk for Down syndrome of >1 in 10. The maternal serum human chorionic gonadotrophin (MShCG) was markedly elevated at 4.19 MoM. Amniocentesis revealed a normal 46,XX karyotype. Fetal growth restriction has been associated with elevated MShCG and placental aneuploidy with CPM for chromosomes 2, 7, 9 and 16. The present case of CPM for chromosome 14 was also associated with fetal growth restriction and elevated second trimester MShCG, suggesting a common link. Further studies need to be done to determine if indeed elevation of second trimester MShCG is associated with increased risk of CPM. The present case again demonstrates the need to perform placental karyotype in unexplained fetal growth restriction. Copyright © 2001 John Wiley & Sons, Ltd.
A phenomenological study of chronic sorrow in people with type 1 diabetes
Authors: Hayes Mary 
Published: August 2002

AbstractThis qualitative study has been designed to examine chronic sorrow in a population of individuals with type 1 diabetes. Teel1defines chronic sorrow as ‘a recurring sadness interwoven with periods of neutrality; satisfaction and happiness’. The sample chosen are five adult subjects with type 1 diabetes for an average of 22.4 years. Data was collected using audio taped, semi‐structured, interviews. Tapes were transcribed and analysed. Four themes emerged; fear of the future, negative attitudes of others, regrets and difficulties in managing the condition. The study discusses the causes of sadness. Results are of relevance to people with diabetes, and those who care for them. Copyright © 2001 John Wiley & Sons, Ltd.
Outcome of insulin treatment in type 2 diabetic patients with secondary oral hypoglycaemic failure
Authors: Akber M. , Clegg C. , Connor S. , Casson I.F. 
Published: August 2002

AbstractA retrospective survey was carried out in patients with type 2 diabetes who had secondary failure with oral hypoglycaemic agents. Data were collected from the case notes of 100 patients converted to insulin treatment attending the Diabetes Centre at Broadgreen Hospital. Ten patients died within the first year of conversion to insulin; four patients were lost to follow‐up. Outcomes were assessed in 86 patients, who completed at least 1 year on insulin after conversion, at 6 months and 12 months. 20 of these patients were studied at 24 months. There were 39 males and 47 females, aged from 34 to 87 years (mean 67 years). The duration of diabetes was from 6 months to 40 years (mean 11 years). At 6 months their mean HbA1c improved from 10.8 to 8.3%, and at 12 months it was 8.0% (p<0.01). BMI increased from (mean) 24.3 to 26.9 at 6 months and 27.3 at 12 months (p<0.01). 64% of the patients gained weight, and in 27% BMI increased to more than 30.This effect persisted at 24 months in 20 patients. Where HbA1c improved from (mean) 10.5% at 0 months to 8.1% at 24 months (p<0.01), the BMI increased from 25.1 (mean) to 28.6 (mean) (p<0.01).95% of patients felt better on insulin, even though most of these patients were reluctant to start insulin at first. One patient asked to stop insulin on social grounds. 20% patients experienced mild hypoglycaemia; only 3% had severe hypoglycaemia. The final total daily insulin dose varied between 14 and 112 units (mean 40 units), and could not be predicted. Insulin treatment is well tolerated, achieves better metabolic control and gives a feeling of well‐being but results in weight gain. Copyright © 2001 John Wiley & Sons, Ltd.
Quality assurance in diabetes care: a population‐based study
Authors: Lundman Berit , Engström Lars , Kallioinen Marcus 
Published: August 2002

AbstractStudy objective.The aim was to evaluate to what degree the recommendations in a health care programme for diabetes were fulfilled.Design.A population based study. Information was obtained from medical records.Settings.One county with 125 000 inhabitants in Northen Sweden.Patients: 4057 adult patients with either type 2 diabetes (n=3581) or type 1 diabetes (n=446).Main results.Of the patients 34% had good, 22% acceptable and 24% poor metabolic control. Documentation of HbA1c was missing for 22% of the patients. Of patients with type 2 95% were examined for nephropathy, 57% for retinopathy, 63% for neuropathy and 68% for peripheral circulation. The corresponding figures for patients with type 1 were 99%, 90%, 95% and 95% respectively.Conclusions.For patients with type 1 the aims of the health care programme were largely fulfilled concerning examination of long‐term complications. In this respect screening of patients with type 2 was unsatisfactory. There is a need to optimise both metabolic control and screening for long‐term complications for a large proportion of the patients. Copyright © 2001 John Wiley & Sons, Ltd.
CODE‐2† UK: our contribution to a European study of the costs of type 2 diabetes
Authors: Williams R. , Baxter H. , Bottomley J. , Bibby J. , Burns E. , Harvey J. , Sheaves R. , Young R. 
Published: August 2002

AbstractCODE‐2 UK is the UK contribution to the Cost of Diabetes in Europe – Type 2 (CODE‐2) study, the first to examine the health care resource use of people with type 2 diabetes in more than one European country. CODE‐2 UK studied samples of people with type 2 diabetes from population based registers in Bradford, Jersey and Salford. Data on NHS resource use were obtained retrospectively, covering the period 1 January 1998 to 31 December 1998, from the registers and from primary and secondary care records. Hospital admissions and ambulatory care accounted for 36.2% and 37.7% of total direct costs, which were, on average, £1505 per patient per year. Oral anti‐diabetic drugs accounted for 2.7% of total costs. Based on these data and an estimated prevalence of type 2 diabetes in the UK of 2%, the estimated total annual NHS cost of type 2 diabetes is £1.8 billion or 4.1% of total NHS expenditure. Similar findings were evident in other European countries. Copyright © 2001 John Wiley & Sons, Ltd.
A retrospective case–control study of initiating insulin therapy in type 2 diabetes
Authors: Dickinson PJ , Dornhorst A , Frost GS 
Published: August 2002

AbstractObjective.To assess the impact of the introduction of insulin therapy in individuals with type 2 diabetes mellitus (DM) on weight gain, glycaemic control and serum lipids.Design and subjects.A retrospective study of weight gain and metabolic parameters among type 2 DM subjects initiated on insulin between 1993 and 1999 while attending the Hammersmith Hospital diabetic outpatient clinic in London, UK. A comparison of weight gain and access to dietetic advice, as assessed from the hospital records, was made on 148 type 2 DM outpatients (78 female, 53%) started on insulin and a control group of 53 type 2 diabetic subjects (26 female, 49%), with similar starting weights but not taking insulin.Results.The insulin treated subjects compared with the non‐insulin treated controls were of similar age and disease duration. The time from diagnosis to initiation of insulin was 6 ± 4.76 years (SD). The year prior to insulin initiation (year −1) was considered the reference year when the weights of the two groups were similar but the HbA1c values higher in the group that went on to insulin than the controls (10.5 ± 2.1% versus 7.6 ± 2.2%, p < 0.001). After the first year of insulin treatment the HbA1c fell by 1.5 ± 2.1% (p < 0.001) and the fasting blood glucose (FBG) by 4 ± 5.8 mmol/L (p < 0.001). No change in HBA1c or FBG occurred during this time in the control subjects. There were no changes in plasma lipids, cholesterol or triglyceride, nor was there any change in blood pressure during this study in either group. Despite an improvement in glycaemic control in the insulin treated group, their HbA1c and FBGs remained higher than those of the control (8.5 versus 7.3%, p < 0.001, and 10.3 versus 9.1 mmol/L, p < 0.001 respectively). Weight gain after one year of insulin treatment was 4.2 ± 4.0 kg, equivalent to 6% increase in body weight. This retrospective study showed that only 26% of subjects started on insulin saw a dietitian prior to insulin treatment, even though over 20% had patients had a BMI greater than 30 kg/m2.Conclusion.Glycaemic control but not fasting lipids improved significantly following a year of insulin treatment; however, this was associated with an average weight gain of 6%. During this time 74% of subjects in whom insulin treatment was started had no access to a dietitian. Prospective studies are required to determine whether increased access to specialist dietetic programmes in patients starting insulin therapy can limit weight gain. Copyright © 2002 John Wiley & Sons, Ltd.
Prospective cohort study of adverse events monitored by hospital pharmacists
Authors: Emerson Angela , Martin Richard M. , Tomlin Mark , Mann Ronald D. 
Published: August 2002

AbstractPurposeTo examine the feasibility of pharmacist‐led intensive hospital monitoring of adverse events (AEs) associated with newly marketed drugs.Subjects/setting303 patients admitted to Southampton Hospitals who were prescribed selected newly marketed drugs during their inpatient stay in 1998.MethodsProspective observational study. Patients were identified from computerized pharmacy records, clinical pharmacist ward rounds, dispensary records or via nursing staff. The pharmacist reviewed medical notes and recorded AEs, suspected adverse drug reactions (ADRs) and reasons for stopping drugs.OutcomesIncidence of AEs, ADRs; proportionate agreement between the physician's and pharmacist's event recording.Results303 patients were monitored. Of the patients taking newly marketed drugs 92% were identifiable using pharmacy computer systems and pharmacist ward visits. There were 21 (7%) suspected ADRs detected during this pilot study. The types of adverse events detected were broadly similar to those identified by general practice‐based prescription event monitoring. However, biochemical changes featured more frequently than in general practice. Differences between adverse events recorded by pharmacist and physician were systematic and attributed to differences in event coding.ConclusionPharmacist‐led monitoring in a typical NHS hospital setting was effective at detecting ADRs in newly marketed drugs. However, this effort might have been substantially less time‐consuming and more effective were electronic patient records (EPRs) available. Pharmacy computer systems are not designed to be patient focused and are therefore unable to identify patients taking newly marketed drugs. It is argued that future EPR and computerised patient‐specific prescribing systems should be designed to capture this data in the same way as some US systems are currently able to do. Copyright © 2001 John Wiley & Sons, Ltd.
An audit of the use of antirheumatic drugs in a North Indian referral hospital
Authors: Balakrishnan S. , Bambery Pradeep , Gupta Nidhi , Pandhi Promila 
Published: August 2002

AbstractObjectiveThis study was conducted with the aim of auditing the pattern of use of antirheumatic drugs in a tertiary care hospital in Northern India.MethodsThe study was carried out in 1000 patients recruited sequentially from the clinic for a period of 1 year (January to December 1999). Patient data such as age, sex, income, family size, diagnosis, duration of illness, drugs prescribed/duration, adverse drug reaction were noted and used to calculate core drug use indicators and pattern of drug use.ResultsThe pattern of drug use was in accordance with the standard practices followed internationally. In rheumatoid arthritis the most common prescriptions were for non‐steroidal antiinflammatory drugs (NSAIDs) alone, followed by the combination of NSAIDs, disease modifying agents (DMARDs) and steroids. Of the NSAIDs diclofenac was the most frequently prescribed drug, while chloroquine was the most commonly used DMARD. The most commonly seen adverse drug reactions were gastritis, Cushings syndrome and decreased visual acuity.ConclusionsIn conclusion, this study has demonstrated that in this clinic, the pattern of use of antirheumatic drugs follows standard guidelines. Copyright © 2001 John Wiley & Sons, Ltd.
Risk factors for the development of Clostridium difficile toxin‐associated diarrhoea: a pilot study
Authors: Aziz E. E. , Ayis S. , Gould F. K. , Rawlins M. D. 
Published: August 2002

AbstractThis study was a pilot investigation of risk factors for the development of Clostridium difficile toxin‐associated diarrhoea and in particular the differential influence of antimicrobial agents. The study was a retrospective case—control design conducted at Freeman Hospital, Newcastle upon Tyne. Cases were inpatients with stool positive C. difficile toxin diarrhoea and two controls were drawn for each case matched for age (+/−5 years) and type of admission (emergency or elective). Using conditional logistic regression analysis, cephalosporins and erythromycin were found to be statistically significantly associated with Clostridium difficile toxin associated‐diarrhoea. The results form the basis for designing a larger, prospective study. Copyright © 2001 John Wiley & Sons, Ltd.
Antidepressant medication and suicide in Sweden
Authors: Carlsten Anders , Waern Margda , Ekedahl Anders , Ranstam Jonas 
Published: August 2002

AbstractObjectiveTo explore a possible temporal association between changes in antidepressant sales and suicide rates in different age groups.MethodsA time series analysis using a two‐slope model to compare suicide rates in Sweden before and after introduction of the selective serotonin reuptake inhibitors, SSRIs.ResultsAntidepressant sales increased between 1977–1979 and 1995–1997 in men from 4.2 defined daily doses per 1000 inhabitants and day (DDD/t.i.d) to 21.8 and in women from 8.8 to 42.4. Antidepressant sales were twice as high in the elderly as in the 25–44‐year‐olds and eight times that in the 15–24‐year‐olds. During the same time period suicide rates decreased in men from 48.2 to 33.3 per 105 inhabitants/year and in women from 20.3 to 13.4. There was significant change in the slope in suicide rates after the introduction of the SSRI, for both men and women, which corresponds to approximately 348 fewer suicides during 1990–1997. Half of these ‘saved lives’ occurred among young adults.ConclusionWe demonstrate a statistically significant change in slope in suicide rates in men and women that coincided with the introduction of the SSRI antidepressants in Sweden. This change preceded the exponential increase in antidepressant sales. Copyright © 2001 John Wiley & Sons, Ltd.
Privacy considerations in the context of an Australian observational database
Authors: Duszynski Katherine M. , Beilby Justin J. , Marley John E. , Walker Don C. , Pratt Nicole L. 
Published: August 2002

AbstractObservational databases are increasingly acknowledged for their value in clinical investigation. Australian general practice in particular presents an exciting opportunity to examine treatment in a natural setting. The paper explores issues such as privacy and confidentiality—foremost considerations when conducting this form of pharmacoepidemiological research. Australian legislation is currently addressing these exact issues in order to establish clear directives regarding ethical concerns. The development of a pharmacoepidemiological database arising from the integration of computerized Australian general practice records is described in addition, to the challenges associated with creating a database which considers patient privacy. The database known as ‘Medic‐GP’, presently contains more than 950 000 clinical notes (including consultations, pathology, diagnostic imaging and adverse reactions) over a 5‐year time period and relates to 55 000 patients. The paper then details a retrospective study which utilized the database to examine the interaction between antibiotic prescribing and patient outcomes from a community perspective, following a policy intervention. This study illustrates the application of computerized general practice records in research. Copyright © 2001 John Wiley & Sons, Ltd.
Ethical issues in a Brazilian hospital
Authors: de Castro Mauro Silveira , Goldim José Roberto , Ferreira Maria Beatriz Cardoso 
Published: August 2002

AbstractPurposeThe objective of this paper is to discuss ethical issues such as data protection, confidentiality, and patient freedom taking two ongoing studies as examples.MethodsThe two studies are being carried out at a public hospital in southern Brazil. Study 1 evaluates inadequate use of drugs (mainly vancomycin) and aims at reviewing criteria for drug use control. It includes records of 100 patients whose prescriptions are dispensed at the hospital's pharmacy. A major ethical concern in this study was to ensure data confidentiality. Study 2 evaluates treatment adherence by hypertension patients with a focus on hydrochlorothiazide. Here, in addition to data protection, a major ethical concern was the ability of patients to understand the informed consent form and therefore freely enter or refuse to enter the study. Both projects were approved by the Institutional Review Board at Hospital de Clínicas de Porto Alegre.ResultsIn both studies, data confidentiality is ensured by the removal of all personal information from the forms used for data analysis. In Study 2, readability of the informed consent was considered adequate by the IRB for the population served by the clinic, and one‐third of the patients who were contacted agreed to participate in the study.ConclusionsTo obtain reliable results, basic ethical principles must be observed throughout the planning and execution of research projects, whether data are obtained from medical records or from actual interaction with patients. Thus, monitoring by an Institutional Review Board or equivalent is of paramount importance. Copyright © 2001 John Wiley & Sons, Ltd.