bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vivo evaluation of a colonic delivery system using isotope techniques
Authors: Verbeke K. , de Preter V. , Geboes K. , Daems T. , van den Mooter G. , Evenepoel P. , Rutgeerts P. 
Published: January 2005

SummaryAim:  To evaluate, using isotope techniques, the in vivo effectiveness of a pH‐dependent colonic delivery system.Methods:  In order to dispose of differently labelled substrates for measurement of orocaecal transit time, inulin‐14C‐carboxylic acid was evaluated as an alternative substrate to inulin and lactose‐13C‐ureide. Secondly, the time of release of 13C‐ and 15N‐urea from the colonic delivery system was compared with the orocaecal transit time, measured using inulin and inulin‐14C‐carboxylic acid. This study was repeated after a 2‐week lactulose intake period.Results:  The orocaecal transit time determined using inulin‐14C‐carboxylic acid (398 min) was not significantly different from the orocaecal transit time determined using inulin (420 min) or lactose‐13C‐ureide (396 min). Before lactulose intake, the 13CO2 excretion time was 358 min and the orocaecal transit times determined with the inulin‐14C‐carboxylic acid and inulin breath test were 376 and 375 min respectively. After lactulose, the 13CO2 excretion time was 383 min and orocaecal transit times were 354 min for inulin‐14C‐carboxylic acid and 392 min for inulin. A highly significant correlation was found. Good agreement was found between the urinary 15N excretion and the appearance of 13CO2 in breath.Conclusion:  Isotope techniques provide an excellent non‐invasive tool for the in vivo evaluation of a colonic delivery system.
Factors associated with adolescent abortion in a rural area of Bangladesh
Authors: Kapil Ahmed M. , Van Ginneken Jeroen , Razzaque Abdur 
Published: January 2005

SummaryThis study examines levels and trends in abortion among adolescent girls in 1982–98 and identifies groups of adolescents who are at high risk for having an abortion. The study used data sets collected in Matlab in Bangladesh where the Center for Health and Population Research at ICDDR,B, has maintained a demographic surveillance system, since 1966. Both bivariate and multivariate techniques of analysis were employed. We also used qualitative information derived from in‐depth interviews with adolescents. The incidence of abortion was 35 times higher for unmarried than for married adolescents. Abortion ratios were also higher for adolescents who were <18 years old and for those with more than primary education. A little less than half of the abortions were induced by biomedical health workers (by means of menstrual regulation) which means that traditional providers fulfilled an important function in this rural area. The findings suggest that high‐quality abortion services provided to adolescents in the framework of comprehensive reproductive health services will help to lower abortions in general and of unsafe abortions provided by traditional providers in particular.
Efficacy and effectiveness of the combination of sulfadoxine/pyrimethamine and a 3‐day course of artesunate for the treatment of uncomplicated falciparum malaria in a refugee settlement in Zambia
Authors: Depoortere Evelyn , Guthmann Jean‐Paul , Pressé Jacinthe , Sipilanyambe Naawa , Nkandu Esther , Balkan Suna , De Pécoulas Philippe Eldin , Legros Dominique 
Published: January 2005

SummaryIn the Maheba Refugee Settlement, in the clinics supported by Médecins Sans Frontières, all children aged up to 5 years with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulfadoxine/pyrimethamine (SP) and artesunate (AS). We compared the treatment's efficacy and effectiveness. Patients were randomized in order to receive the treatment supervised (efficacy) or unsupervised (effectiveness). Therapeutic response was determined after 28 days of follow up. The difference between recrudescence and re‐infection was ascertained by polymerase chain reaction (PCR). We also assessed genetic markers associated to SP resistance (dhfr and dhps). Eighty‐five patients received treatment under supervision and 84 received it unsupervised. On day 28, and after PCR adjustment, efficacy was found to be 83.5% (95% CI: 74.1–90.5), and effectiveness 63.4% (95% CI: 52.6–73.3) (P < 0.01). Point mutations on dhfr (108) and dhps (437) were found for 92.0% and 44.2% respectively of the PCR samples analysed. The significant difference in therapeutic response after supervised and unsupervised treatment intake can only be explained by insufficient patient adherence. When implementing new malaria treatment policies, serious investment in ensuring patient adherence is essential to ascertain the effectiveness of the new treatment schedules.
How do patients use antimalarial drugs? A review of the evidence
Authors: Yeung Shunmay , White Nicholas J. 
Published: January 2005

SummaryPatient adherence is a major determinant of the therapeutic response to antimalarial drugs, as most treatments are taken at home without medical supervision. With the introduction of new, effective, but more expensive antimalarials, there is concern that the high levels of efficacy observed in clinical trials may not be translated into effectiveness in the normal context of use. We reviewed available published evidence on adherence to antimalarial drugs and community drug usage; 24 studies were identified of which nine were ‘intervention’ studies, seven were classified as ‘outcome studies’, and the remainder were purely descriptive studies of antimalarial adherence. Definitions, methods, and results varied widely. Adherence was generally better when treatments were effective, and was improved by interventions focusing on provider knowledge and behaviour, packaging, and provision of correct dosages. There is insufficient information on this important subject, and current data certainly do not justify extrapolation from results with ineffective drugs to new effective treatments. Research in this area would benefit from of standardization of methodologies and the application of pharmacokinetic modelling.
Substantial increase of malaria in inland areas of eastern French Guiana
Authors: Carme Bernard 
Published: January 2005

SummaryThis study includes malaria cases diagnosed by the Parasitology Unit of the Cayenne Hospital (French Guiana) using the same procedure from 1996 to 2003. We provide data for two main rural communities in slightly inland areas of eastern French Guiana (Cacao, Régina) and for Cayenne, the capital of this French department. The frequency of bouts of malaria has been increasing rapidly since mid‐2001, in these regions that were virtually considered to be malaria‐free. This substantial increase of malaria appears mainly to involve Plasmodium vivax and recent Brazilian immigrants. Other plausible explanations which could account for the observed trend are discussed.
Evidence basis for antimalarial policy change in Sierra Leone: five in vivo efficacy studies of chloroquine, sulphadoxine–pyrimethamine and amodiaquine
Authors: Checchi Francesco , Roddy Paul , Kamara Sarian , Williams Arthur , Morineau Guy , Wurie Abdul Rahman , Hora Bona , Lamotte Nadine de , Baerwaldt Tim , Heinzelmann Annette , Danks Alison , Pinoges Loretxu , Oloo Aggrey , Durand Rémy , Ranford‐Cartwright Lisa , de Smet Martin ,   on behalf of the Sierra Leone Antimalarial Efficacy Study Collaboration
Published: January 2005

SummaryObjectives  To provide nationally relevant information on the antimalarial efficacy of chloroquine (CQ), sulphadoxine–pyrimethamine (SP) and amodiaquine (AQ) in Sierra Leone, with a view to updating antimalarial policy in the country.Methods  Between October 2002 and May 2003, standard WHO methodology for in vivo efficacy assessment was used in five sites to study the therapeutic response of 6–59 months old uncomplicated Plasmodium falciparum malaria cases treated with CQ (n = 247), SP (n = 353) or AQ (n = 434). Follow‐up was of 28 days, with polymerase chain reaction genotyping to distinguish late recrudescences from re‐infections.Results  Overall 85.3% of patients reached an analysable endpoint. CQ failure proportions were very high, ranging from 39.5% (95% CI: 25.0–55.6) in Kabala to 78.8% (65.3–88.9) in Kailahun. Early failures under CQ were frequent. SP efficacy was also disappointing, with failure from 23.2% (13.9–34.9) in Kabala to 46.1% (35.4–57.0) in Kailahun. AQ resistance was more moderate, ranging from 5.4% (1.8–12.1) in Makeni to 29.8% (20.3–40.8) in Kailahun, with almost no early failures. AQ also provided more rapid fever and parasite clearance.Conclusion  In a consensus meeting organized by the Ministry of Health and Sanitation, and based on these findings, artesunate (AS) + AQ and artemether–lumefantrine (Coartem™) were identified as the only options to rapidly replace CQ. The choice fell on AS + AQ because of expected high efficacy, lower cost in a blister presentation, and the absence of safety data on artemether–lumefantrine in pregnancy. Donor support is required to support this policy change. Throughout Africa, as SP resistance increases, these two regimens are probably the only options available while newer combinations are developed. Efficacy studies should focus on testing AQ and AS + AQ.
Topical quinolone vs. antiseptic for treating chronic suppurative otitis media: a randomized controlled trial
Authors: Macfadyen Carolyn , Gamble Carrol , Garner Paul , Macharia Isaac , Mackenzie Ian , Mugwe Peter , Oburra Herbert , Otwombe Kennedy , Taylor Stephen , Williamson Paula 
Published: January 2005

SummaryObjective  To compare a topical quinolone antibiotic (ciprofloxacin) with a cheaper topical antiseptic (boric acid) for treating chronic suppurative otitis media in children.Design  Randomized controlled trial.Setting and participants  A total of 427 children with chronic suppurative otitis media enrolled from 141 schools following screening of 39 841 schoolchildren in Kenya.Intervention  Topical ciprofloxacin (n = 216) or boric acid in alcohol (n = 211); child‐to‐child treatment twice daily for 2 weeks.Main outcome measures  Resolution of discharge (at 2 weeks for primary outcome), healing of the tympanic membrane, and change in hearing threshold from baseline, all at 2 and 4 weeks.Results  At 2 weeks, discharge was resolved in 123 of 207 (59%) children given ciprofloxacin, and in 65 of 204 (32%) given boric acid (relative risk 1.86; 95% CI 1.48–2.35; P < 0.0001). This effect was also significant at 4 weeks, and ciprofloxacin was associated with better hearing at both visits. No difference with respect to tympanic membrane healing was detected. There were significantly fewer adverse events of ear pain, irritation, and bleeding on mopping with ciprofloxacin than boric acid.Conclusions  Ciprofloxacin performed better than boric acid and alcohol for treating chronic suppurative otitis media in children in Kenya.
Itinéraire thérapeutique des malades indigents au Bénin (Pauvreté et soins de santé)
Authors: Ouendo Edgard‐Marius , Makoutodé Michel , Paraiso Moussiliou N. , Wilmet‐Dramaix Michèle , Dujardin Bruno 
Published: January 2005

ResuméDans un système de soins payants, il y a un risque de marginaliser les pauvres. L'Initiative de Bamako suggère que des dispositions soient prises pour éviter les exclusions. Donc les itinéraires thérapeutiques ne devraient plus dépendre de la capacitééconomique.Objectif  L'objectif de l’étude est d‘identifier les étapes de l'itinéraire thérapeutique des indigents et non indigents en cas de maladie.Méthodes  Il s'agit une étude prospective de 12 mois. Seize sites ont été sélectionnés aléatoirement après une division en quatre strates du Bénin. L’échantillon est constitué de 1312 mènages (668 indigents, 644 non indigents) pour un total de 9554 personnes. Ceux qui ont été malade pendant la période d’étude ont èté interviewés sur l'itinéraire thérapeutique adopté.Résultats  Sur les 9554 personnes de notre échantillon, 1959 (20,5%) dont 1091 indigents ont été malades au moins une fois. Au 1er recours, les indigents utilisent moins les centres de santé que les non indigents (20%vs. 26,3%; P < 0,001). Mais l'automédication moderne et traditionnelle sont les recours les plus utilisés par la majorité (66,4% chez les indigents et 63,9% chez les non indigents). A l'intérieur des strates (régions), une différence se note au 1er recours entre les choix des indigents et non indigents dans les régions urbaine et nord (P < 0,001). Quel que soit le type de 1er recours utilisé, il n'existe pas de différence statistiquement significative entre la satisfaction thérapeutique des indigents et des non indigents. Les malades non satisfaits au 1er recours sont surtout ceux qui ont utilisé l'automédication traditionnelle et moderne. Malgré cela, au 2 recours l'automédication moderne et traditionnelle restent encore les recours privilégiés et ces choix sont semblables chez indigents et non indigents.Conclusion  L’étude met l'accent sur les différences entre indigents et non indigents dans l'itinéraire thérapeutique. Le premier recours étant l’étape clé où on note des diffèrences.
Ole e 2 and Ole e 10: new clinical aspects and genetic restrictions in olive pollen allergy
Authors: Quiralte J. , Llanes E. , Barral P. , Arias de Saavedra J. M. , Sáenz de San Pedro B. , Villalba M. , Florido J. F. , Rodríguez R. , Lahoz C. , Cárdaba B. 
Published: January 2005

Background:  The clinical characteristics in olive pollen allergy are dependent on the antigenic load, the allergens profile, and the genetic restrictions. Our objective was to determine specific response pattern in Ole e 2 and Ole e 10 sensitization at those levels.Methods:  We studied 146 patients with seasonal rhinitis and/or asthma and positive prick test to Olea europaea pollen. IgE against Ole e 2 and Ole e 10 were detected by skin prick test and ELISA. HLA‐DRB1 and HLA‐DQB1 loci were typed by polymerase chain reaction sequence‐specific primers method.Results:  A total of 102 (69.9%) and 79 (54.0%) patients showed significant IgE antibody response against Ole e 2 and Ole e 10, respectively. There was a significant association between Ole e 2 (OR 2.2, P = 0.04) and Ole e 10 reactivities (OR 2.8, P = 0.007) with asthma. In addition, total and specific IgE antibody levels significantly correlated with asthma (P < 0.05). Patients who reacted to both allergens reached the highest asthma risk factor (OR 4.3, P = 0.002). Phenotypic frequency of DR7 (OR 5.4, Pc = 0.003) and DQ2 (OR 3.6, Pc = 0.02) were increased in positive Ole e 2 patients compared with control subjects. DR2(15) phenotypic frequency was significantly increased (OR 5.6, Pc = 0.02) in positive Ole e 10 patients compared with control subjects.Conclusions:  Our data suggest an association of Ole e 2 and Ole e 10 with bronchial asthma. Also, we found a genetic control of Ole e 2 and Ole e 10 IgE‐specific responses that could be relevant to clinical disease in olive pollen allergy.
cDNA cloning and immunologic characterization of a novel EF‐1β allergen from Penicillium citrinum
Authors: Tang R.‐B. , Chen Y.‐S. , Chou H. , Lee S.‐S. , Tai H.‐Y. , Shen H.‐D. 
Published: January 2005

Background:  We have identified previously that Penicillium citrinum is the most prevalent Penicillium species in the Taipei area. It is important to delineate the whole spectrum of allergenic components of this prevalent airborne fungus. The purpose of this study was to identify novel P. citrinum allergens through molecular cloning of allergen genes using a cDNA library of P. citrinum and sera from patients with bronchial asthma.Methods:  A lambda‐Uni‐ZAP XR‐based cDNA library of P. citrinum was screened with sera from asthmatic patients. An IgE‐binding cDNA clone was isolated and heterologously expressed in Escherichia coli. The frequency of IgE‐binding to the expressed protein and the IgE reactivity to allergen subunits were analyzed by immunoblotting.Results:  An IgE‐reactive cDNA clone (clone B) was isolated by plaque immunoassay. The cDNA insert is 876‐bp long and encodes a 228‐amino acid polypeptide with a calculated molecular mass of 25 035 Da. Protein database search with the deduced clone B sequence revealed that 121 (53%) and 82 (36%) of the 228 amino acids were identical to those of the elongation factor 1‐beta (EF‐1β) proteins from the yeast Saccharomyces cerevisiae and the parasite Echinococcus granulosus, respectively. His‐tagged recombinant clone B proteins were constructed and expressed in E. coli. Seven (8%) of the 92 serum samples from patients with bronchial asthma showed IgE‐binding to the recombinant clone B protein. Among these seven positive sera, five demonstrated IgE‐binding to the C‐terminal fragment (aa 119–228) while the other two sera showed IgE reactivity to the N‐terminal fragment (aa 1–118) of this newly identified EF‐1βPenicillium allergen.Conclusions:  A novel P. citrinum allergen (Pen c 24) was identified and characterized in the present study. Results obtained provide more information about allergens of prevalent airborne fungi and a basis to understand more about the IgE responses in human atopic disorders and in parasitic infections.
Skin reactivity to aeroallergens is reduced in human T‐lymphotropic virus type I‐infected healthy blood‐donors (asymptomatic carriers)
Authors: Souza‐Machado A. , Galvão T. S. , Porto A. , Figueiredo J. , Cruz Á. A. 
Published: January 2005

Background:  A type 2 immune response, characterized by high levels of interleukin‐4 and immunoglobulin E synthesis is a hallmark of respiratory allergic diseases. Individuals infected with human T‐lymphotropic virus type I (HTLV‐I) virus have spontaneous T‐cell proliferation and increased interferon γ production, which are immunological functions associated with a type 1 immune response.Objective:  To determine the frequency of asthma and rhinitis symptoms and immediate skin reactivity to aeroallergens in HTLV‐I infected individuals, compared with noninfected subjects.Methods:  Cross sectional study of 101 HTLV‐I infected and 101 control uninfected blood donors, assessed by enzyme‐linked immunosorbent assay and Western blot assays. The subjects were age and sex‐matched, identified as presenting allergy history by questionnaire, which was complemented by a complete clinical examination and skin prick tests for aeroallergens.Results:  The frequency of atopy was lower in infected than uninfected subjects, 14.9 and 29.7% (P = 0.017), respectively. Skin reactivity to Dermatophagoides pteronissynus, Dermatophagoides farinae and Blomia tropicalis were the most frequently observed among all the tested antigens in both groups. Skin reactivity to histamine was also reduced in the infected individuals compared with uninfected subjects (medians 4.0 vs 5.0, respectively; P < 0.0001). Infection by HTLV‐I was found to be a factor of protection to atopy (RP 0.44; P = 0.005).Conclusions:  The HTLV‐I infection reduces the frequency of respiratory allergy and skin reactivity to aeroallergens.
Rhinitis is an independent risk factor for developing cough apart from colds among adults
Authors: Guerra S. , Sherrill D. L. , Baldacci S. , Carrozzi L. , Pistelli F. , Di Pede F. , Viegi G. 
Published: January 2005

Background:  In cross‐sectional clinical studies, rhinitis has been shown to be strongly associated with co‐existing chronic cough. However, to date, this association has been poorly delineated from a prospective and epidemiological standpoint.Methods:  We used data from the ‘Pisa Prospective Study’, a population‐based longitudinal cohort study composed of a baseline and a follow‐up survey taken approximately 5 years apart from each other. Information on cough, rhinitis, and other risk factors was collected by standardized questionnaire. Cough apart from colds was defined as either ‘chronic’ (most days for at least 3 months for at least two consecutive years) or ‘occasional’ (if the three above temporal conditions were not met). ‘Any’ cough was defined as the presence of either occasional or chronic cough.Results:  Complete information was available for 1670 subjects who were ≥15 years old and had no positive history of cough apart from colds at the baseline survey. Among them, 299 (18%) had rhinitis at baseline. By the follow‐up survey, 16% of the subjects with rhinitis had developed any cough apart from colds, as compared with only 10% of the subjects without rhinitis (OR 1.7, 95% CI 1.2–2.5, P < 0.005). After adjustment for age, gender, asthma status, smoking, and occupational exposure, rhinitis remained significantly associated with an increased risk both for any cough (OR 1.8, 95% CI 1.2–2.6) and for occasional and chronic cough separately (OR 2.2, 95% CI 1.1–4.5, and OR 1.7, 95% CI 1.1–2.6, respectively).Conclusions:  Rhinitis is a significant and independent risk factor for developing cough among adults. Further research is needed to assess potential implications in terms of prevention.
CD4+IL‐13+ cells in peripheral blood well correlates with the severity of atopic dermatitis in children
Authors: La Grutta S. , Richiusa P. , Pizzolanti G. , Mattina A. , Pajno G. B. , Citarrella R. , Passalacqua G. , Giordano C. 
Published: January 2005

Background:  In atopic dermatitis (AD) a Th1/Th2 imbalance has been reported, and interleukin (IL)‐13 seems to play a pivotal role in the inflammatory network. We tried to assess the correlation between the immunological marker CD4+IL‐13+ and the clinical phase of extrinsic AD in children.Methods:  Twenty children with AD were studied. Assessed parameters were: clinical severity (SCORAD index), total serum immunoglobulin E (IgE), blood eosinophil count, and percentage of CD4+IFNγ+, CD4+IL‐4+, CD4+IL‐13+ T cells. Determinations were carried out in the acute phase and after clinical remission were achieved. Ten nonatopic‐matched children served as controls.Results:  At baseline, AD was mild in 25%, moderate in 50% and severe in 25% of children. In the acute phase a significant relationship between the eosinophil count and the SCORAD index was found (P = 0.0001). Blood CD4+IL‐4+ were significantly higher in the AD group (median 17.0, range: 13.7–21.4) than in controls (12.6, 6.4–17.2, P < 0.0001). CD4+IL‐13+ cells in the AD group well correlated (P = 0.0007) with SCORAD index. At remission, a significant correlation between SCORAD index and eosinophil count was found (P < 0.03) and the percentage of CD4+IL‐13+ cells globally decreased (P < 0.0001), while no difference was found among SCORAD classes.Conclusion:  This study confirms the Th2 profile predominance in the peripheral blood of children with AD, and evidences close relationship between the number of CD4+IL‐13+ T cells and the disease's severity.
Birth‐related increase in intracolonic hydrogen gas and nitric oxide as indicator of host–microbial interactions
Authors: Sobko T. , Norman M. , Norin E. , Gustafsson L. E. , Lundberg J. O. 
Published: January 2005

Background:  Bacterial colonization of the intestine early in life might have implications for allergy development. We studied early host–bacterial interactions in the gut by simultaneous measurements of hydrogen gas (H2) and faecal short chain fatty acid pattern (SCFAs), i.e. bacterial products, as well as of nitric oxide (NO), a marker of mucosal immune activation.Methods:  A novel minimally invasive technique was used for repeated measurements of luminal colonic H2 and NO in 32 healthy newborn infants delivered vaginally or by Caesarean section. Luminal gas was sampled and analysed at five occasions: immediately after birth, day 1, days 3–5, 1 and 5–6 months after birth.Results:  Colonic H2, NO and faecal SCFAs were undetectable at birth. The H2 and SCFAs appeared within 24 h and continued to increase during the 6 months follow‐up. Nitric oxide remained very low until 3–5 days after birth at which time it markedly increased. In some apparently healthy infants NO transiently reached levels similar to those seen in adults with inflammatory bowel disease.Conclusion:  Intracolonic measurements of H2 and NO may be useful to monitor the developmental colonization process as well as mucosal responses.