bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiological small bowel malabsorption of carbohydrates protects against large bowel diseases in Africans
Authors: SEGAL ISIDOR 
Published: March 2003

Abstract In African black people there is a paucity of ‘developed society’ large bowel diseases such as diverticular disease, colorectal adenomas and carcinomas, ulcerative colitis and Crohn’s disease. Appendicitis has an incidence of about 5–10% of the number likely to be observed in a white population. The conundrum is that the disparity exists despite many Africans having adopted an urbanized lifestyle with major changes in their dietary pattern. Dietary fiber intake, which was previously 30–35 g, has decreased to 12–14 g daily. Studies on small bowel function in black people have shown that physiological malabsorption of lactose, fructose, sucrose and maize (the staple food) occurs. It is hypothesized that the increased concentration of substrate available for fermentation in the colon compensates for the low dietary fiber intake, is protective to the large bowel and is a factor in the prevention of ‘developed society’ large bowel diseases in the African population.© 2002 Blackwell Science Asia Pty Ltd
Escherichia coli as a cause of diarrhea
Authors: Robins‐Browne Roy M , Hartland Elizabeth L 
Published: March 2003

Abstract
Escherichia coli is the best‐known member of the normal microbiota of the human intestine and a versatile gastrointestinal pathogen. The varieties of E. coli that cause diarrhea are classified into named pathotypes, including enterotoxigenic, enteroinvasive, enteropathogenic and enterohemorrhagic E. coli. Individual strains of each pathotype possess a distinct set of virulence‐associated characteristics that determine the clinical, pathological and epidemiological features of the diseases they cause. In the present brief review, we summarize the key distinguishing features of the major pathotypes of diarrheagenic E. coli. Knowledge of the pathogenic mechanisms of these bacteria has led to the development of rational interventions for the treatment and prevention of E. coli‐induced diarrhea. In addition, investigations into E. coli virulence are providing useful insights into the origins and evolution of bacterial pathogens more generally.© 2002 Blackwell Publishing Asia Pty Ltd
Apoptosis and cell proliferation in the development of gastric carcinomas: Associations with c‐myc and p53 protein expression
Authors: Ishii Hideaki H , Gobé Glenda C , Pan Wenshen , Yoneyama Juichi , Ebihara Yoshiro 
Published: March 2003

Abstract
Background and Aim:
Patients with gastric carcinomas have a poor prognosis and low survival rates. The aim of the present paper was to characterize cellular and molecular properties to provide insight into aspects of tumor progression in early compared with advanced gastric cancers.
Methods:
One hundred and nine graded gastric carcinomas (early or advanced stage, undifferentiated or differentiated type) with paired non‐cancer tissue were studied to define the correlation between apoptosis (morphology, terminal deoxyribonucleotidyl transferase‐mediated dUTP–digoxigenin nick end‐labeling), cell proliferation (Ki‐67 expression, morphology) and expression and localization of two proteins frequently having altered expression in cancers, namely p53 and c‐myc.
Results:
Overall, apoptosis was lower in early stage, differentiated and undifferentiated gastric carcinomas compared with advanced‐stage cancers. Cell proliferation was comparatively high in all stages. There was a high level of p53 positivity in all stages. Only the early‐ and advanced‐stage undifferentiated cancers that were p53 positive had a significantly higher level of apoptosis (P < 0.05). Cell proliferation was significantly greater (P < 0.05) only in the early undifferentiated cancers that had either c‐myc or p53‐positivity.
Conclusions:
The results indicate that low apoptosis and high cell proliferation combine to drive gastric cancer development. The molecular controls for high cell proliferation of the early stage undifferentiated gastric cancers involve overexpression of both p53 and c‐myc. Overexpression of p53 may also control cancer development in that its expression is associated with higher levels of apoptosis in early and late‐stage undifferentiated, cancers.© 2002 Blackwell Publishing Asia Pty Ltd
Hepatitis C risk factors in Iranian volunteer blood donors: A case–control study
Authors: Alavian Seyed Moayed , Gholami Bardia , Masarrat Sadegh 
Published: March 2003

AbstractBackground: In order to evaluate some possible risk factors for the spread of hepatitis C infection a case–control study was undertaken.Methods: The study population consisted of first time blood donors referred to the Iranian Blood Transfusion Organization. Enzyme‐linked immunosorbent assay and recombinant immunoblot assay anti‐hepatitis C virus (HCV) tests were performed for all samples. Risk factors were evaluated using a questionnaire. A stepwise forward logistic regression analysis was used.Results: The case group consisted of 193 HCV‐positive donors, and 196 HCV‐negative donors comprised the control group. Transfusion, undergoing endoscopy, extramarital sexual activities, non‐intravenous (i.v.) drug abuse, i.v. drug abuse, and receiving wounds at war were found to be independent risk factors of being HCV‐positive (Odds ratio: 17, 4, 42.2, 34.4, 52.8 and 5.2, respectively). No apparent risk factors could be demonstrated in 24.5% of the positive cases.Conclusion: This study could be of particular interest because of the low seroprevalence of hepatitis C and the religious culture of the study population. There are certain medical procedures, lifestyle patterns, and customs and cultural matters in Iran that predispose people to a number of HCV risk factors.
Influence of lansoprazole, famotidine, roxatidine and rebamipide administration on the urea breath test for the diagnosis of Helicobacter pylori infection
Authors: ADACHI KYOICHI , FUJISHIRO HIROFUMI , MIHARA TAKAFUMI , KOMAZAWA YOSHINORI , KINOSHITA YOSHIKAZU 
Published: March 2003

AbstractBackground and Aim:  The sensitivity of the urea breath test (UBT) has been reported to be influenced by the administration of omeprazole, lansoprazole and ranitidine. However, it is unclear whether other H2 receptor antagonists (H2RA), except ranitidine, and rebamipide, a mucosal protective agent, affect UBT sensitivity. The aim of this study is to clarify the effects of lansoprazole, famotidine, roxatidine and rebamipide administration on UBT sensitivity.Methods:  Subjects comprised 30 volunteers with Helicobacter pylori infection. All subjects were examined by the 13C‐UBT on four occasions: (i) without medication (control); (ii) after the administration of 30 mg lansoprazole (u.i.d) for 14 days; (iii) after the administration of 100 mg rebamipide (t.i.d) for 14 days; and (iv) after the administration of 20 mg famotidine or 75 mg roxatidine (b.i.d) for 14 days. In the H2RA study, individuals were randomized into two groups of 15 subjects and were administered either famotidine or roxatidine.Results:  Five of the 30 cases administered lansoprazole and one of the 15 cases given roxatidine gave a false‐negative UBT result. No negative UBT results were observed in patients administered famotidine or rebamipide.Conclusion:  Patients showing negative UBT results during the administration of proton pump inhibitors and H2RA should be re‐examined after the cessation of these drugs to confirm the true negativity of H. pylori infection.
Interobserver reliability of the click test: A rapid bedside test to determine surfactant function
Authors: OSBORN DA , LOCKLEY C , JEFFERY HE , LLOYD J , LAZARUS And R 
Published: March 2003

Objective:To determine the interobserver reliability of the click test, a rapid bedside test of surfactant function.Methodology:One hundred samples (48 amniotic fluid, 28 gastric aspirates, 24 tracheal aspirates) were obtained from pregnant women, term and preterm infants managed at two perinatal centres. Gestational ages of the pregnancies or infants at time of sampling ranged from 24 to 40 weeks (mean±sd: 31±5). The click test was performed independently by two observers, with differing levels of experience, and blinded to each other’s results. Interobserver reliability was determined for samples classified as negative (no clicking bubbles), equivocal (a few clicking bubbles seen after 2 min of looking), and positive (clicking bubbles seen easily on first look). As negative and equivocal test results suggest surfactant dysfunction, these results were also combined to provide a dichotomised result.Results:For samples classified as negative, equivocal and positive the interobserver agreement was 0.83, with agreement beyond chance shown by a quadratic weighted Kappa of 0.74 (95% CI=0.62–0.86). When negative and equivocal results were combined, the simple Kappa was 0.73 (95% CI=0.59–0.87).Conclusions:The click test has a high level of interobserver reliability. It is rapid, simple, accurate and able to be taught to medical and nursing staff with appropriate training. It has many potential applications including the prediction of fetal lung maturity in women with premature rupture of membranes, and in term and preterm infants who require the bedside testing of surfactant function.
Hospital admissions in the first year of life in very preterm infants
Authors: Elder DE , Hagan R , Evans SF , Benninger HR , French NP 
Published: March 2003

Objective: To analyse hospital readmissions to 1 year in infants <33 weeks’ gestation. Study design: Cohort of very preterm infants born in Western Australia. Methods: Parental social class, history of asthma, race, gestational age, birthweight, sex, severity of respiratory disease and oxygen requirement at 28 days chronic lung disease (CLD), 36 weeks and term, maternal smoking, cohabitation with siblings, breast‐feeding duration and hospital readmissions were recorded prospectively. Results: Data were available for 538 of 560 (96%) infants discharged. Eight died in the first year. Two hundred and twenty‐five infants (42%) had 443 readmissions, of which 370 were medical and 73 surgical. Risk factors for medical readmission were Aboriginal race, male sex and CLD. Breast‐feeding was protective. Risk factors for surgical admission were male sex, lower gestation, severe hyaline membrane disease, severe CLD and birthweight <10th centile. Conclusions: Readmission is common after very preterm birth. Risk factors for medical and surgical admission differ with CLD being the only perinatal factor associated with both medical and surgical admission.
The influence of growth on development outcome in extremely low birthweight infants at 2 years of age
Authors: Connors JM , O'Callaghan MJ , Burns YR , Gray PH , Tudehope DI , Mohay H , Rogers YM 
Published: March 2003

Objective: To determine if weight <3rd and <10th centile at 2 years in extremely low birthweight (ELBW) infants is associated with problems of development and motor skills, and whether this association is explained by perinatal risk status. Methodology: One hundred and ninety‐eight of 226 (88%) surviving ELBW infants born between January 1987 and December 1992 were assessed at 2 years corrected age. Children were classified as being at low perinatal risk (n = 128) or high perinatal risk (n = 70) for adverse developmental outcome based on perinatal risk factors. Weight at 2 years was classified as <3rd, 3rd–9th or ≥10th centile for age and gender. Development was assessed using the Griffiths Mental Development Scales and motor skills using the Neurosensory Motor Developmental Assessment (NSMDA). Results: For the total study group weight centile was strongly related to General Quotient (GQ) and motor abilities. For children <3rd percentile (n = 48) mean (GQ) was 90.4 (SD, 15.9), for children between the 3rd–9th percentile (n = 49) 91.5 (SD, 17.9), and for children ≥10th percentile (n = 99) mean GQ was 99.8 (SD, 8.6). The association with mean GQ and NSMDA category occurred for the high‐risk subgroup and became non‐significant in the low‐risk subgroup if neurologically abnormal children were excluded. Other perinatal risk factors, exposure to breast milk, level of maternal education, marital status and history of feeding problems or infections over the 2 years did not confound this association. Conclusion: Low weight percentile at 2 years was related to adverse developmental outcome in ELBW infants at high perinatal risk or with neurological impairment, though minimal association was present for neurologically normal infants at low perinatal risk.
Angel trumpet lily poisoning in five adolescents: Clinical findings and management
Authors: Francis PD , Clarke CF 
Published: March 2003

Objective: To describe clinical features and management of Angel trumpet lily poisoning in adolescents. Methodology: Case notes of five adolescent males who presented to the emergency department of a teaching hospital were reviewed. Results: All five boys ingested a mixture of coca‐cola and a brew prepared by boiling the leaves and flowers of the plant. They presented to the emergency department with various degrees of agitation and confusion and specific clinical signs. All were treated with charcoal and cathartics and discharged after 36 h. Conclusions: Due to its hallucinogenic effects, abuse of Angel trumpet lily is not uncommon and should be suspected in adolescents presenting with altered mental state and hallucinations in conjunction with other anticholinergic symptoms and signs.
Duration of breast‐feeding and Bayley's Mental Developmental Index at 1 year of age
Authors: Paine BJ , Makrides M , Gibson RA 
Published: March 2003

Objective: To examine the association between duration of exclusive breast‐feeding and developmental indices in initially breast‐fed infants at 1 year of age. Methodology: A cohort of 96 healthy term infants, aged between 10 and 14 months, were recruited from public immunization clinics and child care centres in southern metropolitan Adelaide. Infants were assessed using the Bayley Scales of Infant Development (Mental and Psychomotor Developmental Indices) within 2 weeks of enrolment. Information regarding duration of breast‐feeding was provided retrospectively by the mothers of the infants. Duration of exclusive breast‐feeding and socio‐demographic variables were used as independent variables to determine their effects on development. Results: Due to a significant interaction between duration of breast‐feeding and gender on mental development scores, separate regression models for boys and girls were explored. Duration of breast‐feeding significantly predicted mental development scores for boys (partial r2 = 0.14, P < 0.005), but not for girls. Duration of breast‐feeding did not predict psychomotor development scores. Conclusions: These findings deserve further examination in large, prospective studies.
The effect of draw‐up volume on the accuracy of electrolyte measurements from neonatal arterial lines
Authors: Davies M.W , Mehr S , Morley C.J 
Published: March 2003

Objectives: Contamination by infusate of blood samples withdrawn from arterial lines has been recognized but not well documented for neonates. The aim of this study was to investigate, using in vitro and in vivo studies, the effects of different draw‐up volumes (withdrawn from the line prior to the sample being taken) on the concentration of sodium. Methods: In‐vitro study: The tip of an umbilical artery catheter (dead space 0.6 mL), infused with half normal saline containing 1 unit/mL of heparin was placed in a beaker of normal saline. The line was flushed with 1 mL of this infusate just before each sample was taken. Volumes from 0.5 mL to 2.0 mL of infusate/normal saline were withdrawn in 0.1 mL increments from a three‐way tap and discarded. A sample was then taken from the line into a blood gas syringe for analysis of the sodium concentration by the 860 Blood Gas Analyzer (Chiron Diagnostics, Bayer, Scoresby). Control samples were taken from the beaker. In‐vivo study: A 22 gauge intravenous catheter was inserted into a vein of an adult male volunteer. The dead space was also 0.6 mL. The line was flushed with 5 mL of half‐normal saline immediately before sampling. Draw‐up volumes of 0.6, 0.9, 1.3, and 1.6 mL were withdrawn and discarded. 10 mL was used as a control. A 0.5‐mL blood sample was then taken and the electrolyte concentrations analysed immediately. Results: In‐vitro: A minimum draw‐up volume of 1.3 mL was required before the sodium concentration was not significantly different from the control samples. In‐vivo: A minimum draw‐up volume of 1.6 mL was required before the sodium concentration was not significantly different from the control samples. There were similar trends in the effect of draw‐up volume for glucose, calcium, potassium, chloride and lactate. Conclusion: A minimum volume of 1.6 mL should be withdrawn from neonatal arterial lines (dead space 0.6 mL) before taking blood for analysis.
Postnatal corticosteroids in preterm infants: Systematic review of effects on mortality and motor function
Authors: Doyle LW , Davis PG 
Published: March 2003

Background: Postnatal corticosteroid therapy has been proved in randomized controlled trials to reduce ventilator dependence and the rate of chronic lung disease in preterm infants with few serious short‐term side effects. However, there are other consequences that might follow postnatal corticosteroid therapy that are more important, including mortality or cerebral palsy. Objectives: To review the evidence from reported randomized controlled trials on the effects of postnatal corticosteroid on long‐term mortality and motor dysfunction, including cerebral palsy. Methods: The methods involved a meta‐analysis of reported randomized controlled trials, following guidelines of the Cochrane Collaboration, including calculation of event rate differences (ERD) and 95% confidence intervals (CI). Results: The mortality rate difference was non‐significant both statistically and clinically (ERD – 0.1% favouring corticosteroids, 95% CI –2.9% to 2.8%). There were no subgroups in which a beneficial effect of postnatal corticosteroids on survival could be demonstrated. The rate of motor dysfunction in survivors was significantly higher in survivors from the postnatal corticosteroid group (ERD 11.9% favouring controls, 95% CI 4.6% to 19.2%). The rate of survival, free of motor dysfunction, was significantly lower in the postnatal corticosteroid group (ERD 7.8% favouring controls, 95% CI 0.5% to 15.1%). Conclusions: Although postnatal corticosteroids have short‐term benefits, they do not increase the survival rate, and they may cause motor dysfunction in survivors. A large‐scale, placebo‐controlled randomized trial, with survival free of sensorineural impairments and disabilities as the major endpoint, is urgently needed.
Clinical markers of serious illness in young infants: A multicentre follow‐up study
Authors: Hewson P H , Poulakis Z , Jarman F , Kerr J F , McMaster D , Goodge J , Silk G 
Published: March 2003

Objective: To perform a multicentre follow‐up study to determine if previously identified markers of serious illness in early infancy were robust and statistically reliable. Methods: Infants aged 1 week to 26 weeks presenting to the Emergency Departments of the Royal Children’s Hospital and two Melbourne metropolitan hospitals were seen over a 12‐month period. Eleven clinical markers as well as their temperature were documented by nursing staff and resident medical officers. Serious illness was defined if infants had a positive body fluid bacterial culture, a positive chest X‐ray or if significant treatment was required in hospital. The predictive values, sensitivity and specificity for the individual and the best combination of clinical markers were determined. Results: Assessments (3806) were performed with 312 infants being assessed as seriously ill (8.2%). The combination of either drowsiness on history or examination, pallor on history or examination, breathing difficulty (chest wall recession), temperature above 38°C and a lump being present, identified 82.5% of all babies deemed subsequently to be seriously ill. The positive predictive value of an infant who was febrile, drowsy and pale on examination was 70.7% (previous study 74%). Conclusions: This study confirmed the high individual predictive value of arousal variables, pallor, and chest wall recession, especially when associated with fever, reaffirming their utility in the recognition of serious illness in infants under 6 months of age.
Insulin infusions in the neonatal unit: Delivery variation due to adsorption
Authors: Hewson M P , Nawadra V , Oliver J R , Odgers C , Plummer J L , Simmer K 
Published: March 2003

Objective: To assess the extent of the variability in insulin delivery over time, under conditions used in Australian neonatal units, studying the following variables: diluent, preconditioning, flushing, sequential preconditioning and flushing, insulin concentration, flow rate, catheter type, and addition of albumin. Methodology: A range of simulated insulin infusions was studied. Infusions were run over 22 h, with aliquots of infusate collected at baseline and after 15 min, 30 min, 1 h, 2 h, 6 h and 22 h. Insulin concentration was assayed using a radioimmunoassay. Results: An infusion of 50 mU insulin/mL at 1 mL/h gave negligible insulin delivery until 22 h. However, after preconditioning and flushing the tubing, consistent insulin delivery was attained by 6 h. An infusion of 200 mU insulin/mL at 1 mL/h did not provide consistent delivery until 6 h. At this concentration and rate, consistent insulin delivery was attained within 30 min of the start of the infusion either by preconditioning and flushing the tubing, or by addition of albumin to the infusate. Conclusion: Clinically significant variation in intravenous insulin delivery will occur in the neonatal setting unless counter‐measures are taken, such as sequential preconditioning and flushing of the delivery system or the addition of albumin to the infusate.
Determining the best method for first‐line assessment of neonatal blood glucose levels
Authors: Thomas Cl , Critchley L , Davies Mw 
Published: March 2003

Objective: To evaluate and compare the accuracy and performance of two electrochemical glucose meters. To determine the user acceptability of these glucose meters and the ABL 620 Blood Gas Analyser (Radiometer, Copenhagen, Denmark) with an electrochemical glucose oxidase electrode for use in a Level 2 special care baby unit. Methodology: A total of 108 blood samples were collected from 47 babies at risk for hypoglycaemia. The blood glucose level was measured with two glucose meters, the Advantage Glucose Meter (Roche Diagnostics, Castle Hill, Australia) and the Precision‐G Blood Glucose Testing System (Medisense, Melbourne, Australia), and the true blood glucose (TBG) measured with the ABL 620 blood gas analyser. Results from the glucose meters were compared with the TBG (as a percentage of the TBG). Results: The mean (SD) percentage difference between the Advantage Glucose Meter and TBG was 4.5% (12.5), and Precision‐G Glucose Meter and TBG was 15.4% (12.4). The sample haematocrit did not significantly influence the glucose meter/TBG differences. There was an overall preference by the nursing staff for the Advantage Glucose Meter. Conclusions: The Advantage Glucose Meter was significantly more accurate than the Precision‐G with similar precision. It was the preferred method of screening for neonatal hypoglycaemia.