bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of mortality, length of stay and discharge destination in blunt trauma
Authors: Gabbe Belinda J. , Cameron Peter A. , Wolfe Rory , Simpson Pam , Smith Karen L. , McNeil John J. 
Published: August 2005

Background:  The present study explored a range of variables to identify predictors of mortality and morbidity and to develop prediction models based on these variables.Methods:  Tools for predicting mortality, hospital length of stay and a patient's destination post‐hospital discharge were developed using logistic regression in one dataset (design) and evaluated for prediction performance in a separate dataset (validation). The performance of the mortality model was compared to the trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT).Results:  The profile of variables contributing to the final prediction models developed from the design dataset varied across the different outcomes of interest although age, injury severity score, development of complications and triage category were common predictors of all three outcomes. The performance of the new mortality prediction model was superior to both TRISS and ASCOT in the validation dataset. Overall, the new models did not meet the prespecified performance criteria.Conclusions:  The present study identified key predictors of mortality and morbidity (length of hospital stay and discharge destination). The newly developed mortality model out‐performed published trauma scoring methods. However, further development and trial of the new prediction models is required before implementation as definitive audit and benchmarking tools could be recommended.
Musculoskeletal tissue banking in Western Australia: review of the first ten years
Authors: Winter Joyleen M. , Cowie Anne I. , Wood David J. , Zheng Ming H. 
Published: August 2005

Background:  Musculoskeletal tissue allotransplantation has been used as a standard approach for reconstructive surgery. The present study has reviewed the banking of musculoskeletal tissue at the Perth Bone and Tissue Bank (PBTB) and provided evidence of quality assurance on musculoskeletal tissue allotransplantation.Methods:  All donor tissues were processed in accordance with the Therapeutic Goods Administration's relevant codes of good manufacturing practices. Microbiological monitoring at each step of manufacture and postoperative surveying of the musculoskeletal allotransplantations were both conducted. The possible contribution of contaminants in allografts to postoperative infections was also assessed.Results:  Of the 5276 donors obtained over the last 10 years, 1672 were rejected, giving an overall donor rejection rate of 32%. Milled femoral heads were the most frequently implanted allografts, followed by whole femoral heads. In the postoperative survey an infection rate of 4.9% was found (113/2321 recipients). The infectious agents were identified in 65 cases but for 60 of these there were no correlations with the positive culture test results for the allografts. The organism most commonly identified in postoperative infections was Staphylococcus species.Conclusions:  The present study shows evidence that musculoskeletal tissue allotransplantation is a safe procedure when accompanied by high standards of quality assurance.
Dysmorphology and the spectacle of the clinic
Authors: Featherstone Katie , Latimer Joanna , Atkinson Paul , Pilz Daniella T. , Clarke Angus 
Published: August 2005

AbstractDysmorphology is the medical study of abnormal forms in the human and is concerned with the identification and classification of a variety of congenital malformations. Such diagnostic work rests on the inspection of images of affected individuals. Based on physical appearance individuals are classified in terms of a wide range of conditions, often with ‘exotic’ nomenclatures. This paper will describe the features of clinical dysmorphology and the process of classification. It derives from an ethnographic study of clinical consultations and meetings among medical geneticists in UK hospitals. We suggest that contemporary dysmorphology can be understood in terms of long‐standing forms of medical knowledge, medical representations and medical discourse. Notwithstanding the new forms of technology provided by genetic science, ‘the clinic’ still asserts its symbolic and functional power: the ‘gaze’ of the clinician and the clinician's warrant of personal knowledge exert their influence. The adjudication of dysmorphology is a contemporary exemplar of the spectacular.
Stress in Parents of Adults with Intellectual Disabilities Attending Special Olympics Competitions
Authors: Weiss Jonathan A. , Diamond Terry 
Published: August 2005

Background  It is important to determine how programmes serving the individual with intellectual disability may also help to reduce stress in parents of adult children with intellectual disabilities. The aim of this study was to test whether parents who frequently watch their children at Special Olympics (SO) competitions report less stress than those who watch with less frequency.Methods  A total of 57 mothers and 39 fathers completed the Parenting Stress Index in reference to their children with intellectual disability, whose ages ranged from 17 to 42.3 years. Frequency of parental attendance at competition and volunteering for SO was also assessed.Results  Parents who frequently attended their children's competitions reported less stress than those who attended with less frequency. Mothers who volunteer, reported more child‐related stress than those who did not. A number of other gender‐specific relations were found.Conclusions  These results support the hypothesis that parents who frequently see their children compete in SO have a more positive parent–child experience than those who do not attend with the same frequency. Experimental research, with controlled pre–post designs, is needed to directly assess any causal effect.
Investigating Sexual Abuse: Findings of a 15‐Year Longitudinal Study
Authors: McCormack Bob , Kavanagh Denise , Caffrey Shay , Power Anne 
Published: August 2005

Background  There is a lack of longitudinal large‐scale studies of sexual abuse in intellectual disability services. Such studies offer opportunities to examine patterns in disclosure, investigation and outcomes, and to report on incidence and trends.Methods  All allegations of sexual abuse (n = 250) involving service users as victims or perpetrators of sexual abuse over a 15‐year period in a large Irish community‐based service were analysed based on the data extracted from extensive contemporaneous case notes.Results  Victims or families were the most common concern raisers of abuse. Following multidisciplinary investigation, almost half (47%) of all allegations of sexual abuse were confirmed (n = 118). In confirmed episodes, more than half the perpetrators were adolescents and adults with intellectual disabilities, while almost a quarter were relatives. The most common type of abuse was sexual touch, although 31% of episodes involved penetration or attempted penetration. The most common location was the family home, followed by the day service and public places. A notable feature was the variation in the incidence of abuse over the study period, largely caused by episodes of multiple abuse.Conclusions  The incidence of confirmed episodes of sexual abuse of adults with intellectual disabilities may be higher than previously estimated. There is an urgent need for statutory guidelines, which require reporting of adult abuse, and provide protection for bona fide whistle blowers, similar to existing child protection legislation.
Hydroquinone and its analogues in dermatology – a potential health risk
Authors: Westerhof W , Kooyers T J 
Published: August 2005

SummaryHydroquinone has been used for decades as a skin lightening agent. Since January 1, 2001, its use in cosmetics has been banned. This ban is as a result of mid‐term effects such as leukoderma‐en‐confetti/occupational vitiligo and exogenous ochronosis. However, a recent literature search on hydroquinone as a skin lightening agent suggests that possible long‐term effects such as carcinogenesis may be expected as well.Metabolites of hydroquinone formed in the liver, e.g., p‐benzoquinone and glutathione conjugates of hydroquinone, are mainly responsible for this. In the bone marrow, hydroquinone is oxidized into p‐benzoquinone because of the high myeloperoxidase activity. Topically applied hydroquinone‐containing creams may give rise to accumulation of these compounds, which can cause DNA damage and mutations. They also have the capability to disrupt protective mechanisms, whereby they facilitate further development of cancer. In the bone marrow, long‐term effects such as aplastic anemia and acute myeloid leukemias may occur. Most of the evidence stems from research on benzene toxicity, which appears to arise via its metabolite hydroquinone.There is no report yet demonstrating carcinogenesis resulting from the application of hydroquinone‐containing creams. However doctors should be aware of these potential health risks which were up until now disregarded.
Seizures Associated with Propofol Anesthesia
Authors: Mäkelä J. P. , Iivanainen M. , Pieninkeroinen I. P. , Waltimo O. , Lahdensuu M. 
Published: August 2005

Summary:Propofol is a new, fast‐acting intravenous (i.v.) anesthetic. Involuntary movements or epileptic sei zures have occurred during or after propofol‐induced an esthesia in ∼50 reported cases; a third of the patients have had epilepsy. We report 5 patients with seizures in association with propofol anesthesia. A female epileptic patient developed severe status epilepticus; the other patients with short‐lasting seizures had no previous epi lepsy. Although propofol has been used in treatment of patients of status epilepticus, the risk of precipitation of epileptic seizures warrants consideration especially when planning anesthesia for epileptic patients.
Carbamazepine‐Valnoctamide Interaction in Epileptic Patients: In Vitro/In Vivo Correlation
Authors: Pisani F. , Haj‐Yehia A. , Fazio A. , Artesi C. , Oteri G. , Perucca E. , Kroetz D. L. , Levy R. H. , Dialer M. 
Published: August 2005

Summary:Six patients stabilized with carbamazepine (CBZ) therapy received an 8‐day “add‐on” supplement of valnoctamide (VCD), a tranquilizer available over the counter (OTC) in several European countries that exhibits promising anticonvulsant activity in animal models. During VCD intake, serum levels of the active CBZ metabolite, carbamazepine‐10,ll‐epoxide (CBZ‐E), increased fivefold from 1.5 ± 0.7 μg/ml at baseline to 7.4 ± 4.4 μg/ml after 4 days of VCD therapy and 7.7 ± 3.1 ^g/ml after 7 days of VCD therapy (means ± SD, p < 0.01). In 4 patients, the increase in serum CBZ‐E levels was associated with clinical signs of CBZ intoxication. CBZ‐E levels returned to baseline after VCD therapy was discontinued. Serum CBZ levels remained stable throughout the study. The interaction observed in this study is similar to that described in patients treated with CBZ and valpromide (VPD, an isomer of VCD). In a mechanistic study, therapeutic concentrations of VCD inhibited hydrolysis of styrene oxide in human liver mi‐crosome preparations. Thus, VCD is a potent inhibitor of microsomal epoxide hydrolase (IC50 15 μM). There was a striking similarity between in vitro and in vivo inhibition potencies. In this study, VCD clearance was higher in epileptic patients (treated with CBZ) than in healthy subjects.
Periodontal Condition of Epileptic Adults Treated Long‐Term with Phenytoin or Carbamazepine
Authors: Dahllof Goran , Preber Hans , Eliasson Soren , Ryden Hans , Karsten Johan , Modéer Thomas 
Published: August 2005

Summary:The periodontal condition of 40 adult epileptic subjects (mean age 51 years) receiving long‐term therapy (mean 18 years) with phenytoin (PHT) or carbamazepine (CBZ) was studied. The subjects completed a questionnaire and underwent clinical and radiologic examination. Patients receiving PHT exhibited the same level of alveolar bone loss as those receiving CBZ. Patients receiving PHT exhibited more units with gingival overgrowth, reflected by the significantly higher number of gingival units with increased probing depth (p < 0.05). The results indicate that long‐term PHT does not result in increased risk for alveolar bone loss as compared with CBZ.
Neuron‐Specific Enolase Is Increased After Single Seizures During Inpatient Video/EEG Monitoring
Authors: Rabinowicz Adrian L. , Correale Jorge , Boutros Raja B. , Couldwell William T. , Henderson Carlton W. , DeGiorgio Christopher M. 
Published: August 2005

Summary:Neuron‐specific enolase (NSE) is a marker of brain injury after acute neurologic insults. We report changes in serum NSE (s‐NSE) in 25 patients (15 with epilepsy and 10 patients with nonepileptic events) during continuous inpatient video/EEG monitoring. s‐NSE was significantly increased as compared with baseline and normal controls after the first ictal event in the epileptic group, especially in patients with secondarily generalized tonic‐clonic seizures (p = 0.01), but s‐NSE was not increased in patients with nonepileptic events. These preliminary data indicate that s‐NSE may be increased after complex partial seizures‐and generalized tonic‐clonic seizures (GTCS).
Prevalence of Epilepsy in the Elderly: The Rotterdam Study
Authors: de la Court Annette , Breteler Monique M. B. , Meinardi Harry , Hauser W. Allen , Hofman Albert 
Published: August 2005

Summary:We assessed the prevalence of epilepsy in an elderly population in The Netherlands. The study was conducted from 1991 to 1993 as part of the Rotterdam Study, a population‐based door‐to‐door study of all elderly people living in Ommoord, a suburb of Rotterdam, and included 5,559 persons aged 55–95 years. All subjects were screened for epilepsy through direct questions regarding the existence of epilepsy and antiepileptic drug (AED) use, in addition to relevant questions from the World Health Organization (WHO) protocol for epidemiologic studies of neurologic diseases. Further evaluation of screen positives was made by a panel of 1 study physician and 4 epileptologists, who also classified all confirmed cases of epilepsy according to the classifications of ‘the International League Against Epilepsy (ILAE). The overall prevalence of active epilepsy in our study population was 0.9% including special syndromes and 0.8% excluding special syndromes. The prevalence increased with age from 0.7% for those aged 55–64 years to 1.2% for those aged 85–94 years. The increase with age was detected among men and women both. Our study confirms other findings showing that the prevalence of active epilepsy increases with age in the elderly. The prevalence figures in our study were high as compared with those of other population‐based studies. Epilepsy appears to be a major cause of morbidity in the elderly.
The Clinical Course of Epilepsy and Its Psychosocial Correlates: Findings from a U.K. Community Study
Authors: Jacoby Ann , Baker Gus A. , Steen Nick , Potts Pauline , Chadwick David W. 
Published: August 2005

Summary:As part of a large community‐based study, we retrospectively examined the clinical course of epilepsy in an unselected population of people who had a recent history of seizures or were receiving antiepileptic drugs (AEDs). Clinical information was collected from medical records, and information about psychosocial functioning was obtained by means of postal questionnaires sent to identified subjects. The response rate to the postal questionnaire was 71%. There were some deficiencies in the recording of clinical data, which is not unusual since data were taken from records held by primary physicians rather than from hospital clinics. Nevertheless, findings regarding the clinical course of epilepsy corresponded to those of earlier studies. Fifty‐seven percent of the sample had had at least a 2‐year seizure‐free period and 46% of subjects were currently in a remission of at least 2‐year duration. There was a clear relationship between current seizure frequency and levels of anxiety and depression, perceived impact of epilepsy, perceived stigma, and marital and employment status. The relationship of seizure frequency and other clinical variables to psychosocial function was explored by multivariate analysis techniques. The amount of variation in scores on the various measures of function accounted for by the clinical variables was small. The most important predictor was current seizure activity, which was the first variable to enter the regression analyses for six of the eight measures of psychosocial function considered. Age at epilepsy onset also emerged as a significant predictor for depression, stigma, and marital status. In individuals with epilepsy in remission, there was little evidence that psychosocial functioning was associated with length of remission, a finding which may in part reflect the nature of this study population. The results indicate that there are several more important predictors of psychopathology and social dysfunction in epilepsy and suggest several implications for treatment interventions.
Cognitive Consequences of Two‐Thirds Anterior Temporal Lobectomy on Verbal Memory in 144 Patients: A Three‐Month Follow‐Up Study
Authors: Helmstaedter C. , Elger C. E. 
Published: August 2005

Summary:Previous studies have shown that left temporal lobectomy for intractable epilepsy can lead to verbal memory deficits. However, patients with left temporal lobe epilepsy (LTLE) frequently have impaired verbal memory preoperativel. The present analysis of 144 patients who underwent temporal lobe resections for either left (n = 68) or right (n = 76) temporal lobe epilepsy (LTLE, RTLE) addressed the questions of (a) whether a left two‐thirds anterior temporal lobectomy (ATL) increases deficits in these qualitative aspects of verbal memory already impaired preoperatively, and (b) whether other aspects of verbal memory are additionally affected. We also evaluated possible determinants of preoperative abilities and postoperative changes, using multiple regression analysis. Preoperatively, patients with LTLE differed from patients with RTLE only in poorer performance on measures of long‐term consolidation/retrieval (delayed recall). This was related to hippocampal pathology and seizure severity. Only left temporal lobe resections resulted in significant deterioration in verbal learning and memory. Acquisition over learning trials and recognition deteriorated most markedly, whereas performance in long‐term consolidation/retrieval showed only minor changes. Preoperative performance levels, chronological age, the extent of the en bloc resection, preoperative performance on figural memory, and preoperative seizure severity were valuable determinants of postoperative changes in acquisition and recognition. In contrast, changes in consolidation/retrieval related only to preoperative ability. Left two‐thirds ATL leads to new impairment in addition to preexisting memory deficits. The finding that left temporal lobectomy affects verbal acquisition and recognition more than long‐term consolidatiodretrieval, including the different determinants of these changes, most likely reflects the differential effects of surgery on mesial temporal and neocortical temporal functions.
Incidence and Clinical Characterization of Unprovoked Seizures in Adults: A Prospective Population‐Based Study
Authors: Forsgren Lars , Bucht Gösta , Eriksson Sture , Bergmark Lars 
Published: August 2005

Summary:In a population‐based prospective study of epileptic seizures in adults aged ≥17 years, we identified 563 patients with possible seizures in a period of 34 months. Seizures were unprovoked in 160 patients, an incidence of 56 in 100,000 person‐years. There was no difference in incidence between sexes. Age‐specific incidences of unprovoked seizures increased sharply in men from age 60 years and in women from age 70 years. The incidence of unprovoked seizures in those aged ≥65 years was 139 (men 166, women 116). The cumulative incidence of unprovoked seizures between the ages of 17 and 84 years was 4.6%. The proportion with an identified presumptive cause for unprovoked seizures increased with advancing age. A presumed etiology was identified in 77% of persons aged ≥60 years. Stroke was the most common etiology, detected in 30% (incidence 16) and in 45% at ages ≥60 years. Tumors were detected in 11% (incidence 6) and Alzheimer's disease was detected in 7% (incidence 4). Eighteen percent of patients were demented. Unprovoked seizures were partial in 68% of cases (incidence 38), and generalized in 16% (incidence 9). Another 13% of patients had generalized seizures, but seizure onset was not witnessed (incidence 7). In 16%, there was a delay of ≥1 year from the first unprovoked seizure to initial diagnosis.
Epidemiology and Clinical Characteristics of Seizures in Patients with Acute Intermittent Porphyria
Authors: Bylesjö Ingemar , Forsgren Lars , Lithner Folke , Boman Kurt 
Published: August 2005

Summary:The objectives of this study were to investigate the lifetime prevalence of epileptic seizures in a population with acute intermittent porphyria (AIP) and to characterize the seizures and the seizure‐triggering factors. A letter was sent to all patients with known AIP in Sweden registered at the National Porphyria Center (n = 294). The medical records of patients who had had epileptic seizures were reviewed in detail. The letter was answered by 268 patients (91.2%). Ten patients (3.7%) reported epileptic seizures. Eight were women (mean age 54.1 years, range 30–81 years), and 2 were men (mean age 19 years, range 9–29 years). Six patients had tonic‐clonic seizures and 4 had partial seizures becoming secondarily generalized. Serum sodium levels were low in 3 patients (mean 110, range 103–120 mM), and normal in 5. Excretion of 5–aminolevulinic acid (ALA) in the urine was increased in 4 patients at the time of the seizures. In 6 patients, the seizures were associated with an acute attack of AIP (all patients with hyponatremia included). The lifetime prevalence of AIP‐associated seizures was 2.2% of all those with known AIP and 5.1% of all those with manifest AIP. Epileptic seizures among persons with AIP are less common than has been previously described.
Cortical Stimulation Elicits Regional Distinctions in Auditory and Visual Naming
Authors: Malow Beth A. , Blaxton Teresa A. , Sato Susumu , Bookheimer Susan Y. , Kufta Conrad V. , Figlozzi Christina M. , Theodore William H. 
Published: August 2005

Summary:We used electrical stimulation mapping to compare performance on auditory and visual naming tasks in inferotemporal, lateral temporal, frontal, and parietal cortex in 8 temporal lobe epilepsy (TLE) patients with subdural electrodes placed for preoperative language localization. Performance on auditory responsive naming (ARN) and visual confrontation naming (VCN) was best during stimulation of parietal cortex and was equally impaired during stimulation of inferotemporal and frontal cortex. In contrast, ARN performance was significantly poorer than VCN performance during stimulation of anterior and posterior lateral temporal cortex. In most patients, stimulation of inferotemporal cortex at relatively low stimulus intensities (≥ 5 mA) during either ARN or VCN elicited reproducible errors in which patients could describe, gesture, spell, or draw, but not name, in response to auditory or visual cues. Inferotemporal and frontal cortex appear to be multimodality language regions distinct from lateral temporal cortex.