bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico‐pathological study of 12 cases of patients with leprosy admitted to Sina Hospital, Hamadan, Iran, from 1991 to 2000
Authors: Farshchian Mahmood , Kheirandish Abulfazl 
Published: November 2004

AbstractBackground  Leprosy is considered a chronic disabling condition. Many clinical and immunological aspects of the disease remain ill defined.Aim  The study of clinico‐pathological and laboratory findings of patients with leprosy admitted to Sina Hospital, Hamadan, Iran, from 1991 to 2000.Methods and patients  This is a descriptive retrospective cross‐sectional study. The statistical community comprised all patients diagnosed leprosy. This diagnosis was clinical and confirmed through pathology (skin‐biopsy) and laboratory (peripheral smear) measures.Results  In this study, the disease was more common in males than females with a mean age of 48.5 ± 16.2 years. Most of the patients were more than 40 years old. Among 12 patients in this study, six cases were urban and six cases were rural. Six cases were living in Hamadan province and two cases migrated to Hamadan province (one of them from Afghanistan and the other from Kurdestan). Clinical diagnosis was confirmed by pathology in 11 cases, but in one case the clinical diagnosis did not match the pathology. In four cases the clinical diagnosis did not match the peripheral smear. Eight cases were admitted just once. Four cases had a history of recurrence and readmission (two patients had one time recurrence and the other two patients had two recurrences). There was no difference in the clinical findings between first presentation and recurrence. From the point of complication and disability, extremity disability was more common than eye disability. Increased severity of complications was found in patients with a delayed diagnosis and incomplete treatment.Conclusion  This study showed that a rapid and correct diagnosis and complete treatment was necessary for prevention of complication and disability in patients with leprosy. Also the accuracy of pathology (skin biopsy) in the diagnosis exceeded the peripheral smear. Skin biopsy is recommended to confirm the diagnosis in all cases of leprosy. In the absence of pathology, patients must be considered as multibacillary patients and treated as such.
The clinical appearance of clonal nevi (inverted type A nevi)
Authors: Huynh Phung M. , Glusac Earl J. , Bolognia Jean L. 
Published: November 2004

AbstractBackground  The term “clonal nevus” is used to describe a variant of melanocytic nevus that histologically exhibits a localized proliferation of pigmented epithelioid dermal melanocytes within an otherwise ordinary nevus (Ball NJ, Golitz LE. Melanocytic nevi with focal atypical epithelioid cell components: a review of seventy‐three cases. J Am Acad Dermatol 1994; 30: 724–729). Reports to date have focused on the histologic appearance of these lesions.Aim  To characterize the clinical appearance of clonal nevi.Methods  Clinical and histologic examinations were performed of a single clonal nevus from each of five patients (two men and three women; age range, 37–80 years).Results  All nevi were round to oval in shape with smooth, well‐defined borders. They were uniformly tan to light brown in color, except for a single blue–gray to blue–black focus of hyperpigmentation. The diameters of the nevi ranged from 2.5 to 10 mm. In individual nevi, the hyperpigmented focus was either centrally or eccentrically located and measured 1–2 mm in diameter. Histologically, these lesions showed banal melanocytes associated with a localized proliferation of melanocytes with abundant pigmented cytoplasm in the dermis, admixed with melanophages.Conclusions  The appearance of clonal nevi – tan with a focus of blue–gray to blue–black pigmentation – allows one to recognize the lesion clinically.
Clonidine poisoning in children: A recent experience
Authors: Sinha Y , Cranswick NE 
Published: November 2004

Objectives:  To identify cases of clonidine poisoning presenting to a tertiary paediatric hospital and to investigate trends in presentation, outcome and prevention. Furthermore, any public health implications of the use of clonidine in children are to be explored.Methods:  Cases of clonidine poisoning presenting to Royal Children's Hospital were reviewed over the period from 1997 to 2001 (inclusive), with significant data obtained from coded medical records.Results:  Twenty‐four cases of clonidine poisoning were identified over the 5‐year period. Nine patients ingested their own medication, which was prescribed for attention‐deficit hyperactivity disorder. Clonidine was prescribed for a child in 16 cases (67%). Impaired conscious state and bradycardia were the most common presenting features. Activated charcoal was given in 14 cases and volume expansion in six. There were 12 children (50%) who required admission to intensive care for monitoring, including three who received mechanical ventilation. The average length of stay was 25.7 h with no long‐term complications.Conclusions:  This is the largest series of clonidine poisoning in children recorded in Australia, with morbidity considerable. Emphasis needs to be placed on educating parents of clonidine's dangers in overdose to their own children as well as others.
Paediatric resuscitation by phone: The call back
Authors: Mullane MC , Wilson RG , Bedwani S 
Published: November 2004

Objective:  To assess whether the nationwide introduction of standardized paediatric resuscitation training has resulted in an increase in resuscitation knowledge from 1995 and whether this increase in knowledge is greater in those who have attended a resuscitation training course within the last year.Methods:  National telephone survey of paediatric residents.Results:  A total of 128 out of a possible 140 residents responded. The mean score in 2002 was significantly higher than in 1995. Those 2002 respondents who had attended a course scored significantly higher than both 1995 respondents, and those 2002 respondents who had not attended a course. There was no significant difference between those 2002 respondents who had not attended a course and the 1995 respondents.Conclusion:  There has been a significant increase in resuscitation knowledge from 1995 to 2002. This improvement has occurred over a period coinciding with the nationwide introduction of standardized resuscitation training. The authors suggest that this improvement is, in part, due to the introduction of standardized paediatric resuscitation training.
Effect of an early intervention programme on low birthweight infants with cerebral injuries
Authors: Ohgi S , Fukuda M , Akiyama T , Gima H 
Published: November 2004

Objective:  To determine the effect of an early intervention programme (EIP) on low birthweight infants with cerebral injuries.Methods:  Subjects were 23 high‐risk low birthweight infants (periventricular leukomalacia 15, intraventricular haemorrhage 5, both 3) receiving care in the neonatal intensive care unit (NICU) at Nagasaki University Hospital. Subjects were randomly assigned to the EIP group (n = 12) or the control group (n = 11). Participants in the EIP group received a Neonatal Behavioral Assessment scale (NBAS)‐based intervention combined with developmental support designed to enhance the infants’ development and the quality of the parent−infant relationship. The control group received routine medical nursing care without the EIP. The EIP began prior to discharge from the NICU and lasted until 6 months of corrected age. All children were examined on the NBAS preintervention and again at 44 weeks postconceptional age. Maternal anxiety status (STAI) and maternal feelings of confidence in dealing with her baby (LCC) were measured pre and postintervention. Mental and motor development was assessed postintervention using the Bayley Scale of Infant Development.Results:  Orientation and State Regulation of infant behavioural profiles, the STAI and LCC scores significantly improved in the EIP group (mean difference (95% CI): Orientation 0.7 (0.4, 1.1), State Regulation 0.9 (0.3, 1.5), STAI −5.5 (− 9.1, −1.9, LCC 5.3 (4.2, 6.5)), but not in the control group. Bayley mental developmental index (MDI) score in the EIP group was higher than in the control group, but there was no significant difference between the two groups (mean difference (95% CI): MDI 8.5 (− 0.8, 17.8), PDI 6.7 (− 1.9, 15.4)).Conclusion:  The EIP has beneficial effects on neonatal neurobehavioural development and maternal mental health of low birthweight infants with cerebral injuries. This evidence suggests that short‐term changes in maternal mental health and infant neurobehaviour promoted by an EIP may serve to initiate a positive interaction between parents and infants.
Childhood autism spectrum disorder in the Barwon region: A community based study
Authors: Icasiano F , Hewson P , Machet P , Cooper C , Marshall A 
Published: November 2004

Objective:  To establish a community database for children with autism spectrum disorder (ASD) to determine prevalence and identify subgroups based on key intellectual, clinical and family parameters.Methods:  Data were collected for children previously diagnosed with an ASD in the Barwon region using parental interview and review of the child's paediatric and psychological records. Preschool diagnoses were typically made by specialist psychologists and school‐age diagnoses made by a multidisciplinary team.Results:  One hundred and seventy‐seven children in the Barwon region were identified as having ASD (82% response rate). The prevalence of ASD was one per 255 children aged two to 17 years. The prevalence increased 10 fold over a 16‐year period and this increase was relatively even across all levels of child intellectual functioning. Forty‐two percent of children were intellectually disabled (IQ < 70) and performance IQ was significantly higher than verbal IQ but typical block design‐comprehension subtest patterns were not common. Nine sibling pair families were identified, 24% were labelled as having attention deficit hyperactivity disorder (ADHD), 6% had epilepsy, and 18.3% were macrocephalic where data were available. Family difficulty was associated with the degree of obsessions/rituals, frequency and intensity of anger/aggression, and ADHD but overall was not associated with the child's intellectual status.Conclusions:  The relatively rapid increase in prevalence is consistent with overseas studies and suggests significant changes in diagnostic criteria, increasing community awareness and the need for support at all levels of intellectual functioning. Increased occurrence in siblings and relatives gives further evidence for a genetic cause.
Constructing Organizational Identities on the Web: A Case Study of Royal Dutch/Shell*
Authors: Coupland Christine , Brown Andrew D. 
Published: November 2004

abstract In this paper we analyse two of the e‐mail exchanges that had been posted on Royal Dutch/Shell's Web site in order to investigate how organizational identities are constructed through processes of description, questioning, contestation and defence. Organizational identities may be regarded as ongoing arguments between insiders and between ostensible insiders and outsiders, who deploy various persuasive techniques in their efforts to render hegemonic their versions of an organization's identity. Making plausible through persuasive rhetoric is a complex task, and requires a discourse analytic methodology and an analytical focus on whole utterances, in order to explicate how identity‐as‐argument is enacted. The research implications of our paper are twofold. First, by focusing on language as an opaque phenomenon, taken‐for‐granted ways of being persuasive are made strange and hence more visible. Second, our understanding of organizations as situated in ongoing, multi‐focused arguments, illustrates a new way of conceptualizing the polyphonic, genre‐relevant nature of institutional identities.
In Search of Theory Development in Grounded Investigations: Doctors’ Experiences of Managing as an Example of Fitted and Prospective Theorizing
Authors: Hallier Jerry , Forbes Tom 
Published: November 2004

abstract This article draws on a study of doctors’ experiences of clinical managing to highlight research conventions that limit the development and use of middle range theories in grounded studies. Using sensemaking and the psychological contract as example frameworks, we illustrate how customary deductive evaluations of middle range theories turn grounded researchers away from theory building. As a correction to these conventions, we offer an inductive approach to building existing theory in grounded investigations that does not depend solely on working with frameworks under different empirical conditions. We suggest that forward theorizing is most likely to progress from a synthesis of fitted explanation and prospective thinking that presses at the limits of the data's usefulness. To illustrate this approach, trialled thinking about novel theoretical juxtapositions and alternative sources was used in conjunction with our clinical director data. The value of this approach was supported in two ways. First, a number of fitted and prospective conjectures are offered about how social identity articulates with psychological contracts and sensemaking in role change situations. Second, new light is shed on the process by which particular social conditions differentially modify employees’ social categorizations, and how these inform employee responses to the evolving experience of role change. The article concludes with some tentative proposals for promoting more discussion of theory building in grounded investigations.
Microfinance, the Labour Market and Social Inclusion: A Tale of Three Cities
Authors: Mosley Paul , Steel Lucy 
Published: November 2004

Abstract Great hopes have been held out for microfinance and other community development finance institutions (CDFIs) in industrialized countries as an instrument of “financially sustainable welfare provision”, following on from their success in many developing countries. Using interview data drawn from an exploratory sample of 45 clients, this paper examines the social and economic impact of three microfinance institutions in Glasgow, Sheffield and Belfast. The tentative conclusion is that most loans we examined do hit the target of the “financially excluded but bankable”, and exert an impact on poverty and social exclusion through the labour market and through helping to build social networks which reduce interpersonal risk. Our initial estimate is that each loan studied here was responsible for about 0.67 exits from unemployment over the two years 2000–2. If this ratio holds good outside the sample (and we emphasize the limitations of small sample size), this could mean that in the absence of microfinance services, the national unemployment total would be higher by some 2.4 per cent (or 22,000 individuals). The loans we have examined also save about £0.4 million on what would otherwise have been social security payments; grossed up again to all microfinance organizations, this implies an annual saving of about £250 million (1.4 per cent) on the total social security budget. However, to achieve this optimal impact microfinance institutions need to diversify their product: for example by switching from business loans into consumption loans, micro‐insurance, and equity, particularly in the rehabilitation of run‐down council estates.
Policy Targets and Ethical Tensions: UK Nurse Recruitment
Authors: Deeming Christopher 
Published: November 2004

Abstract In July 2000 Britain's New Labour government set a target of 20,000 extra nurses for the NHS by 2004. In February 2002, two years ahead of schedule, the target was achieved. The government is to be congratulated on meeting its target but ethical questions over recruitment practices remain. Nurse registrations to the UK from the (then) fifteen EU countries remain flat despite government guidance making this the first priority for international recruitment. Registrations from developing countries with nursing shortages continue despite repeated guidance discouraging this. The government appears to have been caught in a policy bind. On the one hand it needed to be seen to be acting to prevent “poaching” while waiting for fresh intakes of trainees to come through; on the other, if it had succeeded it would have struggled to meet a key policy pledge and certainly not ahead of schedule. New Labour's stated commitment to an ethical foreign policy seems more apparent than real. The paper reports a clear dissonance between the thrust of national policy on nurse recruitment and current employment practices within the UK.
The Local and the National in Community Care: Exploring Policy and Politics in Finland and Britain
Authors: Burau Viola , Kröger Teppo 
Published: November 2004

AbstractInternational literature on community care tends to focus on the national level of welfare institutions and policies. However, community care is largely a locally tailored service and this paper makes a case for local comparisons of community care policies. Using local case studies from Finland and Britain, the paper argues that focusing on the local level contributes to the comparative study of community care in two ways. First, local comparisons highlight the often distinctively local nature of community care policies and thereby add to our understanding of community care. Second, local comparisons extend existing cross‐country explanations of community care by showing that community care is largely shaped by local politics, together with indirect structuring by national contexts. As such, the local case studies highlight the importance of the relationship between policy and politics, which has often been neglected in comparative research.
A novel display of reconstruction computed tomography for the detection of small hepatocellular carcinoma
Authors: Teratani Takuma , Haruhiko Yoshida , Shuichiro Shiina , Shuntaro Obi , Shinpei Sato , Yukihiro Koike , Keisuke Hamamura , Masatoshi Akamatsu , Tomonori Fujishima , Yasuo Imai , Takao Kawabe , Yasushi Shiratori , Masao Omata 
Published: November 2004

Abstract: Purpose: To evaluate the usefulness of the alternate display of arterial and equilibrium phase images (ADAEI) of 2 mm‐pitch reconstruction computed tomography (CT) in the detection of hepatocellular carcinoma (HCC).Materials and methods: One hundred and eleven nodules in 72 patients were confirmed as HCC by radiology, histology, or clinical course. Blinded to the outcome, we retrospectively reviewed the CT images obtained with dual‐phase spiral CT (Radix Prima, Hitachi Medical, Tokyo, Japan) by ADAEI and by conventional display on cut films. Scanning for the arterial and equilibrium phases was initiated at 33 and 120 s, respectively, after starting the injection of contrast medium (iopamidol 3 ml/s) with a section thickness of 5 mm and a table feed speed of 5–7 mm/s. In ADAEI, all images were reconstructed with a 2‐mm interval, and displayed on the monitor in an alternating fashion so that an image in the arterial phase was followed by the corresponding image in the equilibrium phase, and then by the next pair of images in the craniocaudal direction.Results: All 20 HCC nodules larger than 20 mm in diameter were detected by both ADAEI and the conventional display (NS). On the other hand, detectability of smaller HCC nodules was 91/91 (100%) and 72/91 (79%), respectively (P<0.0001 by McNemar' test). False‐positively identified HCC nodules, including those diagnosed as possible HCC, were 11 by ADAEI and eight by conventional display.Conclusion: The novel, alternate display, ADAEI of 2 mm‐pitch reconstruction CT images was useful in detecting small HCC nodules while not requiring additional equipment or expense.
Presence of markers for liver progenitor cells in human‐derived intrahepatic biliary epithelial cells
Authors: Liu Chao , Schreiter Thomas , Dirsch Olaf , Gerken Guido , Oldhafer Karl J. , Broelsch Christoph E. , Treichel Ulrich 
Published: November 2004

Abstract: Aims: Rodent intrahepatic bile duct may harbor bipotential liver progenitor cells. In this study, human‐derived intrahepatic biliary epithelial cells (BECs) were investigated in terms of whether they have the character of liver progenitor cells.Methods: Ten liver tissue specimens were obtained after partial hepatectomy or liver explantation. Intrahepatic BECs were isolated by density‐gradient centrifugation and immunomagnetic separation using anti‐human epithelial antigen and cultured in medium containing epidermal growth factor and hepatocyte growth factor. The isolated and cultured cells were characterized by immunostaining and reverse transcription polymerase chain reaction with a variety of markers for fetal hepatocytes and liver progenitor cells.Results: These cells had proliferated for up to 18 weeks in vitro. They continuously expressed epithelial markers (cytokeratin (CK) 8 and CK 18) as well as biliary markers (CK 7 and CK 19). Remarkably, some isolated and cultured cells also expressed markers for fetal hepatocytes and liver progenitor cells, including albumin, α‐fetoprotein, α1‐antitrypsin, c‐kit and chromogranin‐A.Conclusion: Some human‐derived intrahepatic BECs coexpressed markers for liver progenitor cells. This finding further supports the hypothesis that the human biliary tree may also consist of liver progenitor cells.
Chemokine receptor 5 and primary biliary cirrhosis: a two‐centre genetic association study
Authors: Baragiotta A. , Floreani A. , Agarwal K. , Venturi C. , Craggs A. , Jones D. E. J. , Donaldson P. T. , Bassendine M. F. 
Published: November 2004

Abstract: Background: Chemokines and their receptors are important mediators of leucocyte trafficking and are suggested to be critical for establishment of inflammatory autoimmune processes. CC chemokine receptor 5 (CCR5) is expressed preferentially by CD4+ T cells. We hypothesised that the CCR5delta(Δ)32 genotype, which impairs surface expression of CCR5 in heterozygotes and is linked to a functional polymorphism of CD45RA expressed on suppressor‐inducer‐like ‘naïve’ CD4+ T cells, may modulate the inflammatory process in primary biliary cirrhosis (PBC).Methods: CCR5Δ32 polymorphism was determined by PCR in 226 Caucasian PBC patients and 197 racially matched controls from two geographical areas, Newcastle, UK and Padua, Italy. (UK: 144 PBC, 105 controls, Italy: 82 PBC, 92 controls).Results: When the two series were analysed separately, there were no significant differences in the genotype distribution comparing patients and controls (UK: wt/wt 72% vs 76%; wt/Δ32 28% vs 22%; Δ32/Δ32 0% vs 2%, P=0.24; Italy: wt/wt 72% vs 82%; wt/Δ32 27% vs 17%; Δ32/Δ32 0% vs 1%, P=0.14). However, when the data for the two series were pooled and reanalysed, we found an increase in the CCR5Δ32 mutation in PBC patients vs controls (28% vs 21%, OR=1.43, P=0.03), but there was no evidence that this Δ32 polymorphism is associated with less severe disease.Conclusions: Although this two‐centre genetic association study is large compared with others performed in PBC, taken separately, each geographically based cohort of patients and controls is underpowered to detect a small effect of this functional polymorphism. This emphasises the need for far larger case–control collections to address which polymorphic markers or haplotypes might modify the pathogenesis and clinical course of PBC. We propose that multi‐centre collaboration on an international scale in ‘orphan’ complex liver diseases such as (PBC) is supported by the International Association for the Study of the Liver and promoted via their journal with development of a brief format for web‐based publication of studies.