bluuebunny/crossref_metadata_2025_split huggingface dataset:
House dust mite allergen levels in carpeted sleeping accommodation are higher in private houses than public places
Authors: Mamoon HA , Henry RL , Stuart JE , Gibson PG 
Published: March 2003

Objective:  To compare mite allergen levels in carpeted sleeping accommodation in private dwellings and public places.Methods:  The concentration of Dermatophagoides pteronyssinus Group 1 allergen in house dust was measured in mat­tresses and bedroom floors in 12 homes, 5 hotels, 11 child care centres and a university hall of residence. Indoor temperature and relative humidity were also measured. A questionnaire clarified details regarding the age of the building, age of the carpet, method and frequency of cleaning, frequency of room use and use of air‐conditioning.Results:  Median allergen levels in mattresses and carpets in private homes (21.1 and 20.6 µg/g dust, respectively) were significantly higher than in public places (2.5 and 3.1 µg/g, respectively; P < 0.0001). Mean relative humidity was significantly higher in private houses (68.5%; 95% CI 67.2−69.3%) than in public places (56.4%; 95% CI 52.7−60.1%; P < 0.0001).Conclusions:  Carpeted sleeping accommodation in public places has lower house dust mite allergen levels than private houses. Lower levels of relative humidity may be an important component of the explanation.
Marked increase in serum transferrin receptor among Thai children with Hb‐E‐β‐thalassaemia
Authors: Boonchalermvichian C , Paritpokee N , Bhokaisawan N , Nuchprayoon I , Wiwanitkit V 
Published: March 2003

Objective:  To determine the serum transferrin receptor (sTfR) level in patients with Hb‐E‐β‐thalassaemia attending a paediatric haematology clinic.Methods:  Sixty‐four patients with Hb‐E‐β‐thalassaemia aged 2.9−10.8 years were attending a paediatric haematology clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Circulating transferrin receptor was measured, as was the complete blood count and percentage of reticulocytes. A transfusion regimen recommended by the Thalassaemia International Federation was used whenever parents agreed to the treatment.Results:  In patients with Hb‐E‐β‐thalassaemia, the concentration of sTfR varied from 1.88 to 28.44 mg/L (mean ± SD 13.99 ± 5.37), while in the control group, it varied from 0.95 to 2.56 mg/L (mean ± SD 1.58 ± 0.41; n = 31). The sTfR level correlated inversely to a single measurement of haemoglobin in the same specimen (r = − 0.433; P = 0.00) and was elevated compared to the control group (P = 0.00; α < 0.05). In addition, the sTfR level correlated inversely to mean pre‐transfusion haemoglobin (r = − 0.36; P = 0.003).Conclusions:  The level of sTfR is elevated in children with Hb‐E‐β‐thalassaemia. The sTfR level can be used as an adjunct real‐time assessment of erythropoietic activity, comparable with mean pre‐transfusion haemoglobin. Measurement of sTfR is easy using most automated chemical analyzers, and material can be obtained from routine specimen collections. Further studies should be carried out in a larger population to verify the benefits of this test to patients.
Facilitation of neonatal nasotracheal intubation with premedication: A randomized controlled trial
Authors: Oei J , Hari R , Butha T , Lui K 
Published: March 2003

Objectives: To determine if premedication reduces the time and number of attempts by junior medical staff to achieve nasotracheal intubation in neonates. The experimental design was a non‐blinded randomized controlled pilot trial. The setting was a perinatal centre in a university teaching hospital. Methods: Twenty infants (within the ranges of 25–40 weeks gestation, 650–3660 g and 1 h to 81 days of age) requiring semi‐urgent intubation were randomized to either premedication with morphine, atropine and suxamethonium, or to awake intubation. Results: There were no significant differences between the two groups in
regard to prior intubation experience of the staff or infant weight or gestation.
The intubation procedure, including intervening events, to completion was significantly
faster in premedicated infants (median 60 s vs 595 s; P = 0.002) who
were intubated at a younger postnatal age. It took twice as many attempts to intubate
a conscious infant (median 2 vs 1; P = 0.010). There was a greater
decrease in heart rate from the baseline in the unpremedicated group (mean 68 b.p.m.
vs 29 b.p.m.; P = 0.017), but decreases in oxygen saturation were not different. Blood was observed in the oral and nasal passages after intubation in five of the awake infants and in one of the premedicated infants. Conclusions: The use of premedication reduces the total time and number of attempts taken to achieve successful nasotracheal intubation of neonates by junior medical staff under supervision.
Transfusion in premature infants impairs production and/or release of red blood cells, white blood cells and platelets
Authors: Frey B 
Published: March 2003

Objective:  To examine whether red blood cell transfusion in infants with anaemia of prematurity alters peripheral counts of red blood cell precursors, total white blood cells and white cell differential and platelets.Methodology:  In 18 consecutive stable premature infants with anaemia of prematurity, peripheral cell counts were prospectively recorded immediately before transfusion of 20 mL/kg packed red blood cells (given over 6 h), and at 48 h after completion of the transfusion.Results:  The median (interquartile range) haematocrit increased from 22.0% (21.3−24.0%) pre‐transfusion to 37.0% (36.0−38.0%) post‐transfusion (P < 0.001). Red‐cell precursors decreased: median (interquartile range) reticulocytes from 3.7% (3.0−7.7%) to 3.7% (2.6−4.1%) (P = 0.03); and median (interquartile range) nucleated red blood cells from 0 G/L (0−0.2 G/L) to 0 G/L (0−0 G/L) (P = 0.03). The mean (SD) platelet count decreased from 420 G/L (154 G/L) to 313 G/L (101 G/L) (P = 0.001). The total white blood cell count and neutrophils did not change significantly; however, median (interquartile range) immature neutrophils decreased from 0.12 G/L (0.06−0.74 G/L) to 0.08 G/L (0.01−0.24 G/L) (P = 0.03). Lymphocytes, eosinophils, basophils and plasma cells remained unchanged. Monocytes increased (P = 0.01).Conclusions:  Forty‐eight hours after red blood cell transfusion to premature infants, there is an absolute decrease in red blood cell precursors, immature white blood cells and platelets, probably due to erythropoietin‐suppression.
Fundoplication in children with gastro‐oesophageal reflux disease
Authors: Norrashidah AW , Henry RL 
Published: March 2003

Objectives: The associations between gastro‐oesophageal reflux (GOR), chronic respiratory symptoms and gastrointestinal complications have been well described. The aim of this study was to compare the characteristics of children in whom the main indication for fundoplication was respiratory disease with children who had gastrointestinal indications for surgery. Methods: A retrospective review of 79 children who underwent fundoplication between January 1995 and December 1999. Results: Forty‐nine of the children (62%) had a respiratory indication
for fundoplication. Children with neurological impairment tended to have a respiratory
rather than a gastrointestinal indication for surgery. Congenital anomalies were
present in 47%. Fundoplication in older children was more likely to be for
a gastrointestinal indication. Children with neurological impairment were more likely
to have a gastrostomy compared to children with normal neurological status (P
< 0.01). Children with a respiratory indication were more likely to have three
or more diagnostic investigations (P < 0.001). Ninety‐two per cent of children with a respiratory indication and 90% with a gastrointestinal indication for fundoplication had at least one positive test for GOR (barium meal or 24‐h oesophageal pH monitoring). Oesophagoscopy showed reflux oesophagitis in 46/61. Eighty‐five per cent of the children had complete resolution of their symptoms after fundoplication. Conclusions: Neurological comorbidity was common in children who had surgery for gastro‐oesophageal reflux disease, whether for gastrointestinal or respiratory indications. The majority of fundoplications were performed for respiratory indications.
Surgical programme at Royal Alexandra Hospital, Sydney, for Papua New Guinea children with congenital heart disease, 1978–1994
Authors: Tefuarani N , Hawker R , Vince J , Sleigh A , Williams GM 
Published: March 2003

Objective: To report the history of the Royal Alexandra Hospital for Children (RAHC) Papua New Guinea (PNG) cardiac surgical programme and describe the selection, preoperative clinical features and postoperative outcome of children with congenital heart disease managed by the programme. Methods: Details for each of the PNG cardiac patients admitted to RAHC following selection by visiting cardiologists between 1978 and 1994 were entered into a database, and analysed and interpreted. Results: A congenital heart defect was confirmed in 165 of the 170 children selected. The male to female ratio was 1:1 and the mean age on admission to RAHC was 5.5 years. Almost all of the children for whom data were available (98%) had a weight for age and 41% had a height for age less than the 3rd centile. One‐sixth had delayed milestones. A large number were tachypnoeic, in heart failure, or had pulmonary hypertension on admission. Ventricular septal defect and tetralogy of Fallot were the commonest defects, and lesions such as aortic stenosis, coarctation of the aorta and transposition of the great arteries were absent or rare. Thirty‐one (19%) of the children selected initially did not receive surgery because of pulmonary hypertension, or because the lesions did not fall within the programme guidelines for operation. One hundred and twenty‐nine children had corrective and four had palliative procedures. Half of the operated children had postoperative complications. Eight children died, all following open‐heart procedures, giving a case fatality rate of 6%. Preoperative tachypnoea, hepatomegaly, cardiac failure and pulmonary hypertension were strongly associated with poor outcome. Conclusions: The programme was an arduous exercise for all organizations concerned, but achieved comparatively good short‐term outcomes. The experience gained should assist in planning for similar programmes.
Allogeneic bone marrow transplant improves outcome for juvenile myelomonocytic leukaemia
Authors: Maguire AM , Vowels MR , Russell S , Cohn RJ , Cole C , Saxon B , Alvaro F , Marshall GM 
Published: March 2003

Objective: To correlate clinical presentation and therapeutic outcomes in children with a diagnosis of juvenile myelomonocytic leukaemia. Methods: The medical records of 14 children who fulfilled the International Juvenile Myelomonocytic Leukaemia Working Group Criteria for a diagnosis of juvenile myelomonocytic leukaemia (JMML) presenting to a single institution were reviewed, and their clinical status at September 2000 was documented. Results: The most common presenting features were hepatosplenomegaly and lymphadenopathy. Fifty per cent of cases presented in the first year of life. Nine of 14 patients initially received chemotherapy otherwise used in the treatment of acute myeloid or lymphoblastic leukaemia with no apparent benefit. All six patients who received conditioning therapy with chemotherapy alone, followed by allogeneic bone marrow transplant (BMT), are in complete remission at a median follow‐up duration of 12 months (range 5–91 months). Five of six patients surviving post‐allogeneic BMT received marrow from an unrelated donor. Only one of seven patients who did not receive BMT survived long‐term. Conclusion: Children with a diagnosis of JMML should be treated with allogeneic BMT as soon as a suitable donor is found. The role of anti‐leukaemic therapy in this disease, prior to BMT, requires further investigation in the context of a multicentre clinical trial.
Evaluation of laboratory tests in dehydrated children with acute gastroenteritis
Authors: Yilmaz K , Karaböcüoglu M , Çitak A , Uzel N 
Published: March 2003

Objective:  The aim of the present study was to demonstrate the utility of laboratory tests in predicting dehydration severity.Methodology:  We evaluated retrospectively 168 dehydrated children aged 1−21 months with acute gastroenteritis. The degree of dehydration in each patient was calculated as the percentage change in weight from admission to after rehydration. The associations between degree of dehydration, urea, bicarbonate and serum sodium were examined.Results:  Dehydration severity was significantly related to concentrations
of urea (P < 0.00001) and bicarbonate
(P = 0.01), but not to serum sodium or age. Children were divided into three groups on the basis of blood urea: (i) normal (< 6.7 mmol/L or < 40 mg/dL); (ii) intermediate (6.8−16.6 mmol/L); and (iii) high (≥16.7 mmol/L or ≥100 mg/dL). Groups 1 and 3 had statistically significant associations with the degree of dehydration and combining the urea groups with plasma bicarbonate levels enhanced the accuracy of predictions. Group 1 had only mild to moderate dehydration, but if bicarbonate was 15 mmol/L or higher, there was a positive predictive value (PPV) of 93% for mild dehydration. Group 3 had moderate to severe dehydration, but if bicarbonate was 15 mmol/L or higher, moderate dehydration could be predicted (PPV 100%). Sixty per cent of mildly dehydrated children (32/53) had low bicarbonate, but only 7% (2/29) with bicarbonate 15 mmol/L or higher had severe dehydration. Serum sodium did not have any significant association with the degree of dehydration, or the levels of bicarbonate or urea.Conclusions:  The results suggest that serum urea and bicarbonate concentrations can be helpful in the estimation of fluid deficit independently from serum sodium concentration, and may be considered to be adjuncts to clinical evaluation in assessing the degree of dehydration.
School‐aged children with Kawasaki disease: High incidence of cervical lymphadenopathy and coronary artery involvement
Authors: Fan PC , Chiu CH , Yen MH , Huang YC , Li CC , Lin TY 
Published: March 2003

Objective: We describe 10 school‐aged children with Kawasaki disease (KD) with a high incidence of cervical lymphaden­opathy and coronary abnormality. Methods: Based on a database of 1002 children with KD in Chang Gung Children's Hospital from January 1983 to March 2001, 10 (1%) school‐aged patients (five boys, five girls) who met the diagnostic criteria of KD were included for analysis. Results: Cervical lymphadenopathy was noted in all (100%) of these patients. Unilateral neck mass mimicking acute suppurative infections not responding to antibiotic therapy was the initial presentation in nine (90%) of the 10 patients. The mean interval between disease onset and diagnosis was 9.9 ± 3.3 days (range, 6−15 days). Seven (70%) of these patients responded to one course of high‐dose intravenous immunoglobulin (IVIG) therapy (2 g/kg) and oral aspirin (80−100 mg/kg per day), two (20%) required a second course of IVIG, and one (10%) responded to high‐dose aspirin treatment only. Coronary artery abnormality (dilatation or aneurysm) was documented by echocardiography in seven (70%) patients (four boys, three girls). In six patients, the coronary artery abnormalities resolved in 1 year, while one patient had persistent right coronary artery aneurysm, which necessitated continued anticoagulant and low‐dose aspirin therapy. Conclusion: The incidence of school‐aged children among patients with KD is about 1% in our hospital. These patients are notable for the high incidence of initial manifestations of unilateral neck mass and coronary artery involvement. This disease should be listed as the differential diagnosis in school‐aged children presenting with fever and neck mass that do not respond to antibiotic therapy.
Prediction of Lake Baikal ecosystem behaviour using an ecosystem disturbance model†
Authors: Silow Eugene A. , Baturin Vladimir A. , Stom Devard J. 
Published: March 2003

AbstractThis paper combines predictions of the effects of anthropogenic impacts on the plankton of Lake Baikal with models of ecosystem disturbance. Increases in mineralization, non‐toxic organic matter, nutrients, phenolic compounds, oil products and heavy metals were simulated. Significantly higher sensitivity of the community below the ice to external influences was demonstrated compared to the summer–autumn community, when there was no ice layer. Models of the distribution of aquatic pollutants demonstrate the occurrence of deviations from ecosystem state parameters in the bottom layer under the influence of pollutant input with precipitation and the distribution of perturbations over greater (up to 500 km) distances. Simulation of pollutant input at present levels shows that Lake Baikal is already perturbed. This is indicated by increases in bacterial and summer phytoplankton biomass and nutrient concentration, and by fluctuations in the zooplankton biomass.
Analytical techniques for monitoring harmful cyanobacteria in lakes
Authors: Hummert C. , Dahlmann J. , Reichelt M. , Luckas B. 
Published: March 2003

AbstractThe toxins of cyanobacteria include potent neurotoxins and hepatotoxins. Deaths after exposure by ingestion of cyanobacterial cells and toxins from freshwater sources have been reported. The hepatotoxins are cyclic peptides, which comprise microcystins (MC) and nodularin (NOD), and they cause poisonings with an established syndrome of human and animal illnesses. The identification and determination of these hepatotoxic peptides are challenges for analytical chemists. Methods based on solid phase extraction and size exclusion chromatography are available for the clean up of raw extracts. Both principles are also used for the enrichment of MC from low contaminated sample material. The separation of MC is achieved by high‐pressure liquid chromatography methods with ultraviolet (UV) detection or mass spectrometric detection. The unambiguous identification of MC not available as standards is possible by mass spectrometry (MS) or, under optimal conditions, by UV spectrometry using diode array detection. To date, 60 different MC and four NOD have been described, but new compounds are frequently identified. Therefore, powerful tools for the elucidation of the structure of unknown MC are an important need. In addition to classical methods for structure elucidation (e.g. nuclear magnetic resonance spectrometry), microwave‐assisted hydrolysis of cyclic peptides followed by enantio‐selective determination of the amino acid profiles can be used. More recently, MS with collision‐activated dissociation has become an important tool for obtaining structure information. The present paper discusses the advantages and disadvantages of the various analytical techniques used for monitoring of cyanobacteria in lakes, optimized or developed at the Institute of Nutrition, Jena, Germany. A pathway for handling MC‐containing samples with regard to different analytical tasks (i.e. the identification and elucidation of structure followed by qualitative and quantitative determination) is proposed.
Long‐term changes in the aquatic biota of Lake Abashiri, a meromictic lake in northeastern Hokkaido, Japan
Authors: Kuwabara Ren 
Published: March 2003

AbstractLake Abashiri is an example of a meromictic lake under the stability of upper oligohaline water and lower polyhaline water, but a brackish lake on the whole. Nevertheless, boundary depth of the hypolimnetic layer has gradually decreased with time. At the same time, this has led to an increase in salinity and eutrophication in the epilimnion and to an acceleration of deoxygenation of the hypolimnion, attributed to the upwelling of bluish water. In order to investigate succession of the aquatic biota linked to these hydrological changes, results of occasional long‐term studies on the distribution of plankton and benthos were summarized, mostly from Japanese publications of lake surveys. In each result, the boundary of the polyhaline hypolimnetic layer has gradually risen from 13 to 7 m depth between 1932 and 1955, and has been determined, in recent years, to be 5.5 m. Salinity of the epilimnion was lower than 0.1‰ in 1930s, and 0.5–0.6‰ in the 1940s before 1949. Thereafter, salinity increased to 1.8–2.3‰ until recently, with levels now often over 3‰. Following these hydrological changes, the succession of planktonic fauna and flora, particularly of the dominant species, has exhibited a gradual change from freshwater to brackish or salinity tolerant species during the 72 year period from 1926 to 1997, including a period of variable species composition in 1975–1980 and a period of degradation after that. In contrast, according to available data, the benthic community has remained unchanged in terms of the composition of dominant species in all habitats during the same 72 year period. The dominance of some plankton and benthos species has been maintained over several decades, although the community structures have displayed a few phases of abundance and regression during these 72 years.
Environmental surveys of toxic chemicals in aquatic environments in Japan
Authors: Kadokami Kiwao , Hiraki Toshikazu , Jyotatsu Taiji 
Published: March 2003

AbstractA law concerning the examination and regulation of manufacture of chemical substances (the Chemical Substances Control Law) was enacted in 1973 to prevent environmental pollution by chemical substances, such as polychlorinated biphenyl‐like chemicals. In response to the enactment of the law, Environment Agency Japan (the former Ministry of the Environment) began successive environmental safety inspections a year later, including environmental surveys for existing chemicals. Since then, approximately 800 kinds of chemical substances have been investigated and 40% of them have been detected. Many substances suspected of posing risks to humans have been regulated on the basis of results of these environmental surveys. At present, five environmental surveys of water, bottom sediment and aquatic organisms are being carried out by cooperation between the Environment Ministry and all Local Governments in Japan. These surveys have been designed to collect information about chemical contamination across the whole country, and will measure change and variation in chemical contamination over time and space, and also examine measures for reducing the risks posed by chemical substances. Furthermore, the data obtained may contribute to an understanding of environmental contamination by chemical substances in Japan and in other industrial countries.
Laminin in the interstitium indicates prognosis in patients with IgA nephropathy
Authors: Jinde Kiichiro , Yagame Mitsunori , Sun Wei , Kurokawa Kiyoshi , Sakai Hideto 
Published: March 2003

SUMMARY:Laminin is implicated in cell migration, remodelling of the extracellular matrix and basement membrane. Therefore, laminin deposition could be of concern in the progression of some renal diseases. In the present study, immunohistochemical and in situ hybridization studies were performed for laminin in IgA nephropathy (IgAN) specimens in order to reveal the importance of laminin deposition for their prognosis. Fifteen patients were used as the stable group who maintained stable renal function for more than 10 years after biopsy. Thirteen patients formed the progressive group who reached end‐stage renal failure within 10 years after biopsy. Immunohistochemically, laminin was specifically deposited in damaged glomeruli and strong immunoreactivity was particularly shown in the expanded interstitial area containing infiltrating mononuclear cells. Although the staining score in glomeruli was not significantly different between these two groups (P = 0.181), deposition in the expanded interstitium was extensive and significantly greater in the progressive group (P < 0.01). In situ hybridization revealed that most of the interstitial cells and some of the tubular cells expressed laminin messenger ribonucleic acid. In conclusion, the extent of interstitial laminin deposition was an important prediction of adverse renal outcome. This laminin could be produced by interstitial cells and/or tubular cells.