bluuebunny/crossref_metadata_2025_split huggingface dataset:
Favorable Short- and Long-Term Outcomes of Prolonged Translaryngeal Intubation in Critically Ill Children
Authors: Kadilak Patrick R. , Vanasse Shannon , Sheridan Robert L. 
Published: September 2004

Abstract
In those children who require protracted mechanical ventilation, we use long-term intubation in order to avoid the consequences of tracheostomy in young children. A retrospective 9-year review was performed to document the efficacy and safety of this practice. A retrospective review of children admitted from January 1, 1991, to December 31, 1998, who required mechanical ventilatory support for at least 7 consecutive days was performed. Data are presented as mean ± standard deviation. There were 98 children, ventilated for a total of 1967 days, who satisfied review criteria. They had an average age of 6.1 ± 5.3 years (range, 3 months to 17 years) a total body surface area burn of 53 ± 25% (range, 0–100%), and 71 of 98 (72%) had suffered an inhalation injury. They were ventilated for 19.7 ± 16.8 days (range, 7–92 days) and were hospitalized for 67.8 ± 48.9 days (range, 9–211 days). Ninety-three percent (91 of 98) of the patients were maintained on morphine infusions at a mean hourly rate of 0.35 ± 0.33 mg/kg/hr (range, 0.01–4.38) and 78% (76 of 98) on midazolam infusions at a mean hourly rate of 0.14 ± 0.17 mg/kg/hr (range, 0.01–1.82). Neuromuscular blocking agents were administered in 39% (38 of 98) of patients during all or part of 355 (18%) of the 1967 ventilator days. Patients were ventilated with an oral endotracheal (ET) tube in 82% of ventilator days and nasal ET tube in 18% of ventilator days. Two patients (2%) required tracheostomies for long-term management, and five patients (5.1%) died during the study period unrelated to airway issues. There were five unplanned extubation events, for an incidence rate of 2.54 per 1000 ventilator days. All patients were reintubated successfully. Thirteen ET tubes needed to be changed for issues such as leaking cuffs. Patients were followed up for a mean of 2.99 ± 2.24 years (range, 1 month to 8 years). Possible sequelae related to prolonged intubation were noted in follow-up visits in 8 patients, including sinusitis (one; resolved without treatment), subglottic stenosis (one; required reconstructive surgery), persistent cough (three; all resolved spontaneously), occipital breakdown because of ET ties (one; healed after 1 month), soft voice (two; resolved spontaneously), and decreased pharyngeal sensation (one; resolved without treatment). Translaryngeal intubation is a safe and effective method to provide long-term ventilatory support in children.
Glycosaminoglycan Hydrogels as Supplemental Wound Dressings for Donor Sites
Authors: Kirker K. R. , Luo Y. , Morris S. E. , Shelby J. , Prestwich G. D. 
Published: September 2004

Abstract
Chemically crosslinked glycosaminoglycan (GAG) hydrogel films were evaluated as biointeractive dressings in a porcine model for donor-site autograft wounds. Multiple 5 × 5 × 0.03 cm3 wounds were created on the dorsum of pigs. Half of the wounds were treated with a GAG film plus an occlusive dressing (Tegaderm™), whereas the other half were treated with Tegaderm™ alone. At 3, 5, or 7 days after surgery, the partially healed wounds were excised and evaluated histologically for three animals at each time point. By day 3, epithelial cells had proliferated and migrated from wound edges and from epithelial islands associated with residual hair follicles to begin to cover the wound bed. A statistically significant increase in coverage was observed for GAG + Tegaderm™-dressed wounds than for those with Tegaderm™ alone at day 3 and day 5 post-surgery. By day 7, all treatment groups were completely healed. Thus, GAG hydrogels accelerated wound healing by enhancing re-epithelialization.
Sentinel Lymph Node Biopsy Identifies Occult Nodal Metastases in Patients with Marjolin's Ulcer
Authors: Eastman A. L. , Erdman W. A. , Lindberg G. M. , Hunt J. L. , Purdue G. F. , Fleming J. B. 
Published: September 2004

AbstractSince Marjolin's description, the management of burn scar carcinoma has remained controversial. A multitude of options and recommendations exist for the management of both primary lesions and regional nodal metastasis. This work reviews six cases of Marjolin's ulcer staged using sentinel lymph node biopsy. All primary lesions were confirmed to be squamous cell carcinoma and occurred a median of 29.5 years after burn. No patient had clinically detectable lymphadenopathy. In all cases, preoperative lymphoscintigraphy successfully identified a single draining regional nodal basin. Subsequent intraoperative lymphatic mapping/sentinel lymph node (SLN) biopsy was successful in five of six cases (83%). A successful intraoperative lymphatic mapping/SLN biopsy was defined as the identification of blue (uptake of isosulfan blue dye) or “hot” (uptake of radiolabeled sulfur colloid as measured with a handheld gamma counter) node(s) and subsequent excision. Four of five SLN biopsies identified previously occult nodal metastasis. SLN biopsy represents a minimally invasive and accurate staging procedure for Marjolin's ulcer.
Review of Evidenced-Based Practice for the Prevention of Pressure Sores in Burn Patients
Authors: Gordon Mary D. , Gottschlich Michele M. , Helvig Elizabeth I. , Marvin Janet A. , Richard Reginald L. 
Published: September 2004

AbstractPressure ulcers represent a complex clinical problem, with a reported incidence of 2.7% to 29.5% in hospitalized patients and an etiology that is multifactorial. The prevention of pressure sores in the burn patient population is clearly an area of practice in need of guidelines for care. A multidisciplinary group of advanced burn care professionals have compiled, critiqued, and summarized herein the current evidence of practice in nursing, nutrition, and rehabilitation as it pertains to the prevention of pressure sores after burn injuries. A broad overview of risk factors and assessment scales is described, and current intervention practices and recommendations for care are provided based, whenever possible, on research findings. In addition, research questions are generated in an attempt to move the specialty of burns toward the formal investigation of pressure sores with the ultimate goal being the development of evidence-based practice guidelines.
Bacterial enteritis and the development of the larval digestive tract in olive flounder, Paralichthys olivaceus (Temminck & Schlegel)
Authors: Kim D‐H , Han H‐J , Kim S‐M , Lee D‐C , Park S‐I 
Published: September 2004

AbstractThree bacterial isolates obtained from diseased olive flounder larvae, Paralichthys olivaceus, were identified as Vibrio ichthyoenteri based on the results of phenotypic characterization and 16S rRNA gene sequencing studies. Bacterial enteritis was reproduced in 16 and 22 days post‐hatch (dph) larvae by administering brine shrimp nauplii, Artemia salina, dosed with the environmental isolates and reference strains of V. ichthyoenteri. To investigate the effect of the disease on development of the stomach, a pepsin activity assay and reverse transcription‐polymerase chain reaction (RT‐PCR) analysis of the expression of the pepsinogen gene were performed. Expression of olive flounder pepsinogen was detected from 30‐dph larvae and the increased level of pepsin activity coincided with reduced susceptibility to the disease. Growth rates of V. ichthyoenteri, V. anguillarum and Edwardsiella tarda were tested in artificial stomach conditions using HCl and porcine pepsin. All the strains of V. ichthyoenteri were inhibited by low pH conditions which corresponded with an increase in pepsin levels. This suggests that differentiation of the stomach in olive flounder larvae and juveniles, an essential physiological development, also provides the host with a non‐immunological defence mechanism.
Nutritional changes among premenopausal women undertaking a soya based dietary intervention study in Hawaii
Authors: Acharya S. , Maskarinec G. , Williams A. E. , Oshiro C. , Hebshi S. , Murphy S. P. 
Published: September 2004

AbstractBackground  We conducted a 2‐year nutritional intervention among premenopausal women. The goal was to incorporate two daily servings of soya into the regular diet. This report describes the dietary modifications and assesses their nutritional adequacy with regard to major nutrients.Methods  In this analysis of 100 intervention and 106 control subjects, women completed a validated food‐frequency questionnaire at baseline; throughout the study, they participated in at least three unannounced 24‐h recalls.Results  At randomization, both groups were similar in age and body weight, reported low soya intake, and did not differ by intake of major nutrients and foods. According to the 24‐h recalls, women in the intervention group consumed nearly two servings of soya per day, while the control women remained at 0.2 servings. In comparison with the control group, the intervention group consumed fewer dairy products, primarily milk, but also less meat, nuts and seeds. As a result of the dietary modification, the intervention women consumed less‐saturated fat and cholesterol and more protein, dietary fibre, calcium and vitamins than the control group.Conclusion  These results suggest that women in the intervention group improved the overall quality of their diet by adding two servings of soya per day.
The health benefits of omega‐3 polyunsaturated fatty acids: a review of the evidence
Authors: Ruxton C. H. S. , Reed S. C. , Simpson M. J. A. , Millington K. J. 
Published: September 2004

AbstractThe UK dietary guidelines for cardiovascular disease acknowledge the importance of long‐chain omega‐3 polyunsaturated fatty acids (PUFA) – a component of fish oils – in reducing heart disease risk. At the time, it was recommended that the average n‐3 PUFA intake should be increased from 0.1 to 0.2  g day−1. However, since the publication of these guidelines, a plethora of evidence relating to the beneficial effects of n‐3 PUFAs, in areas other than heart disease, has emerged. The majority of intervention studies, which found associations between various conditions and the intake of fish oils or their derivatives, used n‐3 intakes well above the 0.2 g day−1 recommended by Committee on Medical Aspects of Food Policy (COMA). Furthermore, in 2004, the Food Standards Agency changed its advice on oil‐rich fish creating a discrepancy between the levels of n‐3 PUFA implied by the new advice and the 1994 COMA guideline. This review will examine published evidence from observational and intervention studies relating to the health effects of n‐3 PUFAs, and discuss whether the current UK recommendation for long‐chain n‐3 PUFA needs to be revisited.
Eyewitness testimony and perceived credibility of youth with mild intellectual disability
Authors: Peled M. , Iarocci G. , Connolly D. A. 
Published: September 2004

AbstractBackground  Individuals with intellectual disability (ID) are more vulnerable to abuse compared to individuals without disabilities yet have limited access to the legal system. This study examined perceived credibility of youth with mild intellectual disability (MID) who provide courtroom testimony.Method  Participants, 187 undergraduates, were asked general questions about credibility. They also read eyewitness testimony and answered questions about a particular witness's credibility. Half the participants were informed that the youth has MID [chronological age (CA) 15 years, mental age (MA) 10 years] and the others were informed that the youth is a typically developing 10‐year‐old.Results  When participants were asked general questions about credibility they rated 15‐year‐olds with MID (MA 10 years) as less credible than typically developing 15‐year‐olds and as less credible than typically developing 10‐year‐olds. However, when participants read eyewitness testimony and answered questions about a particular witness's credibility, no statistically significant differences were found between participants who were informed that the witness was a 15‐year‐old with MID (MA 10 years) and those who were informed that the witness was a typically developing 10‐year‐old.Conclusions  The present study provided a preliminary investigation of perceived credibility of witnesses with MID and suggests directions for future research in this area.
Effects ofHelicobacter pylorieradication among adults with intellectual disability
Authors: Wallace R. A. , Schluter P. J. , Webb P. M. 
Published: September 2004

AbstractBackground Compared to the general population,Helicobacter pyloriinfection is more common among adults with intellectual disability (ID) and is associated with greater levels of disability, maladaptive behaviour, and institutionalization. Little information exists about the effects of eradication therapy in this group, so we aimed to evaluate: (1) success of a standardH. pylorieradication protocol; (2) frequency of side‐effects; and (3) impact of eradication on level of functional ability and maladaptive behaviour.Method A cohort of adults with ID underwent assessment of their levels of function and maladaptive behaviour, medical history, physical examination, andH. pyloritesting using serology and faecal antigen tests. Some received standardH. pylorieradication therapy. Twelve months later, participants underwent repeat assessment, were grouped by change inH. pyloristatus and compared.Results Of 168 participants, 117 (70%) were currently infected withH. pyloriat baseline, and 96 (82%) of the 117 were given standardH. pylorieradication therapy. The overall eradication rate was 61% but 31% reported side‐effects. Institutional status of the participants, their level of behaviour or function, and number of comorbid medical conditions were not associated with failure of eradication. There were no statistically significant differences in level of behaviour or function, ferritin, or weight between the groups in whomH. pyloriwas eradicated or stayed positive.Conclusion Adults with ID have lowerH. pylorieradication and higher side‐effect rates than the general population. Levels of maladaptive behaviour and disability did not improve with eradication and thus greater levels of maladaptive behaviour or disability appear to be risk factors for, rather than consequences of,H. pyloriinfection.
Two cases of generalized seizures and the Velocardiofacial syndrome – a clinically significant association?
Authors: El Tahir M. O. , Kerr M. , Jones R. G. 
Published: September 2004

AbstractBackground  Velocardiofacial syndrome (VCFS) is caused by a micro deletion of chromosome 22q11 and associated with multiple system abnormalities. There is an increasing recognition of associations with psychiatric disorders. Neurological and brain abnormalities have been reported but to date no association with generalized epilepsy has been reported in literature.Methods  We report two cases of adults with VCFS and primary generalized epilepsy. The details on their background, psychiatric history and history of epilepsy including results of investigations will be discussed.Results  Case 1 is an adult male with mild learning disability (LD), VCFS, paranoid schizophrenia and primary generalized epilepsy. Case 2 is an adult female with mild LD, VCFS, schizoaffective disorder and primary generalized epilepsy. The diagnosis of epilepsy in both cases was based on clinical and EEG findings of primary generalized abnormalities.Conclusion  As there is an evidence of association between VCFS and psychiatric disorders, this raises the possibility of an association with generalized epilepsy.
Utilization of inpatient care and its determinants among persons with intellectual disabilities in day care centres in Taiwan
Authors: Lin J. D. , Wu J. L. , Lee P. N. 
Published: September 2004

AbstractBackground  In Taiwan, current understanding is limited concerning the manner in which health services are utilized by persons with intellectual disabilities (ID). The objective of this study is to describe the patterns of inpatient care sought by persons with ID, and factors affecting inpatient care utilization.Method  The primary method used in this study was a cross‐sectional survey of 1390 persons with ID in day care centres. Data were obtained from responses to a questionnaire, copies of which were mailed to 30 day care centres catering for persons with ID. The questionnaire assessed demographic and health characteristics, disability status, and inpatient care utilization for the 12 months leading up to the survey. Multivariate logistic regression analysis identified factors independently associated with inpatient care.Results  Findings indicated that the average age of the people with ID in the centres was 13.7 years. Fifty per cent of people were afflicted with multiple handicaps, with an average of 26 outpatient visits made per person during the 12 months, and 16% of persons having been hospitalized within the previous year. The average hospital stay was 6 days. Inpatient care was more likely to be used by those individuals with an ID who were younger, had multiple handicaps, required rehabilitation, and had other disabilities and existing illnesses.Conclusions  The study concluded that the parameters describing age of persons with ID, as having an existing illness, and requiring rehabilitative care were statistically significant in the logistic regression model of the inpatient care.
Mild intellectual disability in children in Lahore, Pakistan: Aetiology and risk factors
Authors: Yaqoob M. , Bashir A. , Zaman S. , Ferngren H. , Von Dobeln U. , Gustavson K.‐H. 
Published: September 2004

AbstractBackground  One of the main objectives of studying intellectual disability (ID) in children is to explore its causes. A specific aetiological diagnosis is important in determining the prognosis, nature and extent of services needed to support affected children.Methods  Aetiology and risk factors in mild ID were studied in a cohort of longitudinally followed children (6–10 years of age, n = 40) in four population groups in and around Lahore, Pakistan.Results  The overall prevalence of mild ID was 6.2%. In 22% of the cases the onset of mild ID was prenatal with small for gestational age and multifactorial inheritance as the main underlying factors. During the postnatal period (28% of the cases), social deprivation and malnutrition were the major causes of ID. In a substantial proportion of the cases (50%), the cause of ID could not be traced.Conclusion  The present study indicates a clear relationship of mild ID with prenatal and postnatal malnutrition and social deprivation. Two independent variables, maternal illiteracy and small head circumference at birth, showed a clear association with the development of mild mental disability among children in the study population.
An analogue assessment of repetitive hand behaviours in girls and young women with Rett syndrome
Authors: Wales L. , Charman T. , Mount R. H. 
Published: September 2004

AbstractBackground Rett syndrome is a neurodevelopmental disorder that almost exclusively affects females. In addition to neurodevelopmental regression and loss of hand skills, apraxia, deceleration of head growth, and increasing spasticity and scoliosis, a number of behavioural features are also seen, including stereotypic hand movements, hyperventilation and breath holding. The aim of the study was to investigate the extent to which analogue environmental conditions affected the frequency of repetitive hand behaviour in eight girls and young women with Rett syndrome.Method The frequency of repetitive hand movements was observed every 10 s for four 4‐min sessions under the following conditions: Continuous Adult Attention, Adult Demands, Stimulation and No Stimulation.Results The frequency of repetitive hand movements was high – they occurred in above 60% of all intervals in all conditions for all participants and at nearly 100% for some participants in some conditions. For one participant the frequency of repetitive hand movements was somewhatreducedin the Stimulation condition; for another it was relativelyincreasedin the No Stimulation condition.Conclusions Overall, environmental manipulations had relatively limited effects on repetitive hand behaviours. Repetitive hand behaviour in Rett syndrome may be maintained by automatic reinforcement or neurochemical processes and may not be primarily influenced by contingent reinforcement.
Late diagnosis in severe and mild intellectual disability in adulthood
Authors: Verri A. P. , Maraschio P. , Uggetti C. , Pucci E. , Ronchi G. , Nespoli L. , Destefani V. , Ramponi A. , Federico A. 
Published: September 2004

AbstractBackground  The diagnosis of intellectual disability (ID) is highly dependent on a comprehensive personal and family medical history, a complete physical examination and a careful developmental assessment of the patient. Our study intended to: (1) classify the aetiology of mild and severe ID in an adult population of 140 Italian subjects; (2) evaluate the frequency of associated medical conditions; (3) evaluate the age of diagnosis in both groups; and (4) underline the importance of aetiological diagnosis for adult ID patients also.Methods  The study involved 140 consecutive adult Italian ID inpatients and outpatients neurologically investigated at the Neurological Institute C. Mondino of Pavia Service for Mental Retardation. A total of 80 patients had mild ID (MID group) (39 females, 41 males), mean age 34 years (range 19–61 years), mean IQ = 64 (range 51–75), and 60 had severe ID (SID group) (32 females, 28 males), mean age 30 years (range 19–69 years). They underwent a complete diagnostic work‐up that comprised prenatal, perinatal and postnatal history, physical examinations, laboratory investigations, genetic survey and neuroradiological investigations to determine the aetiology of ID and to evaluate the presence of associated medical conditions.Results  ID aetiology was classified as prenatal in 34% of the MID and 28% of the SID group. Perinatal and postnatal events were found in 6% of the MID and in 5% of the SID group. Associated medical conditions were found in 97 patients (47% MID and 26% SID). A genetic diagnosis was possible in 6% of patients above 20 years of age and in 5% of patients above 40 years. A diagnosis of cerebral dysgenesis was possible in 5% of patients above 20 years and 4% of patients above 40 years.Conclusions  A long interval between the diagnosis of ID and the aetiological definition can be observed in a significant percentage (24%) of our population, leading to unfortunate consequences of late diagnosis: late onset of a specific therapeutic program, genetic counselling that is frequently no more useful, and ineffective prenatal diagnosis, leading to the birth of other affected subjects (for familiar ID).