bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Meal‐Stimulated Serum Gastrin Response in Helicobacter pylori–Positive Duodenal Ulcer and Asymptomatic Volunteers With and Without H. pylori Infection
Authors: Kamada Tomoari , Haruma Ken , Komoto Kunihiko , Mihara Mitsuhiro , Sumii Koji , Kajiyama Goro 
Published: March 2003

Background. Duodenal ulcer (DU) patients exhibit raised postprandial gastrin release as compared to that in healthy controls. It is believed that serum pepsinogen I (PG I) concentration reflects the chief cell mass and that hyperpepsinogenemia I plays an important role in the pathogenesis of DU. Currently, strong evidence suggests that Helicobacter pylori (H. pylori) infection plays an important role in the pathogenesis of DU.Materials and Methods. Subjects consisted of 15 patients with H. pylori–positive DU, 10 H. pylori–positive volunteers, and 35 H. pylori–negative volunteers. Blood samples were taken before and at 15, 30, and 60 minutes after eating the test meal, which consisted of 100 gm rice, 130 gm chicken, and 1 egg. The 1‐hour integrated gastrin response (IGR) was taken as the area under the serum gastrin time curve, calculated by the trapezoid method. Serum gastrin (SG) and fasting serum PG I concentrations were measured by radioimmunoassay.Results. Meal‐stimulated SG response and fasting PG I concentration were significantly higher in DU patients than in H. pylori–positive and –negative volunteers. The DU patients were divided into two groups in accordance with their IGR levels as follows: hyper‐IGR and normo‐IGR. Serum PG I concentration was significantly higher in the hyper‐IGR than in the normo‐IGR group.Conclusions. The DU patients differed in some way (other than H. pylori infection) from the H. pylori–positive healthy volunteers. The fact that hyper‐IGR DU patients had higher serum PG I concentrations suggests that patients in this group may be acid hypersecretors.
A Population‐Based Survey on Gastrointestinal Tract Symptoms and Helicobacter pylori Infection in Children and Adolescents
Authors: De Giacomo Costantino , Valdambrini Valeria , Lizzoli Francesca , Gissi Anna , Palestra Marina , Tinelli Carmine , Zagari Maurizio , Bazzoli Franco 
Published: March 2003

ABSTRACTBackground.  Helicobacter pylori infection is a frequent infection mainly acquired in childhood. Even if the infection is almost invariably associated with mild to severe gastro‐duodenal lesions, no specific clinical picture has been identified. The aim of this study was to evaluate the presence of dyspeptic symptoms and their relationship with the presence of H. pylori infection in the first two decades of life.Materials and Methods.  A school‐population sample size of 808 subjects from 6‐ to 19‐year‐olds was investigated for the presence of gastrointestinal tract symptoms and evaluated by a 13C‐urea breath test for H. pylori infection. The relationship between clinical findings and H. pylori infection was evaluated by χ2 statistic or Fisher's exact test, as appropriate.Results.  Symptoms of dyspepsia were identified in 45% of subjects, while the picture of ulcer‐like and dysmotility‐like forms were present in 3–4%. H. pylori infection was demonstrated in 95 (11.8%) subjects, 49.5% of them without symptoms. Severe epigastric pain and ulcer‐like dyspepsia were significantly associated with H. pylori infection, while recurrent abdominal pain or dysmotility‐like dyspepsia were not.Conclusions.  Dyspeptic symptoms are frequent in children, and its association with H. pylori infection is more evident than with recurrent abdominal pain. The age at which the infection is acquired seems to be under 6 years of age.
Cancer Screening and Early Detection Managing Malpractice Risk
Authors: Frank‐Stromborg Marilyn , Bailey Lara J. 
Published: March 2003

purpose
: The purpose of this report is to educate healthcare professionals aboutthe legal risks of conducting cancer screening examinations and necessaryrisk reduction practices.
overview
: The authors describe the elements of a medical malpractice claim, thehealthcare professionals' legal standard of care, theories of malpractice liability, common factors related to missed or delayed diagnoses,malpractice defenses, and risk reduction practices.
clinical implications
: Healthcare professionals, including physicians, physician assistants,advanced practice nurses, and social workers, have been shown to be clinically effective in cancer screening, and early detection of many cancersleads to improved long‐term survival rates. Healthcare professionals who conduct cancer early detection examinations and counsel patients in cancerscreening programs need to be aware of the common legal theories under which lawsuits are brought related to cancer detection examinations. Importantsteps in reducing the risk of malpractice include developing creative strategies to address the theories of liability in the area of cancerscreening and early detection; keeping abreast of changes in national and international cancer screening recommendations; monitoring the literature forapproaches to decrease liability; and scrupulously maintaining documentation of all findings and interactions among providers and between providers and patients.
Genetic Testing for Prostate Cancer
Authors: Diefenbach Michael A. , Schnoll Robert A. , Miller Suzanne M. , Brower Lisa 
Published: March 2003

Abstract Purpose:As researchers come closer to identifying the genes responsible for prostate cancer, the possibility of genetic testing for men at risk for prostate cancer becomes more likely. This study examined the following: 1) the degree to which men with (n = 43) or without (n = 83) a family history of prostate cancer would be interested in genetic testing; and 2) the degree to which interest in testing was associated with demographic, family history, and psychosocial factors.Description of study: Participants (N = 126) were accrued through patients who had been treated for prostate cancer at Fox Chase Cancer Center (n = 39) and through newspaper advertisements (n = 87). All participants completed a questionnaire sent by mail.Results:Seventy‐four percent of men were probably (50%) or definitely (24%) interested in testing. Participants with a family history of prostate cancer reported that they would be willing to pay substantially more for a genetic test compared with those without a family history. Elevated worry about prostate cancer and concerns about treatment‐related side effects were associated with greater interest in genetic testing. Clinical implications:Findings demonstrate a need for the development of genetic counseling protocols for at‐risk men who are interested in genetic testing, once this test becomes available.
Exercise and Weight Gain in Breast Cancer Patients Receiving Chemotherapy
Authors: Schwartz Anna L. 
Published: March 2003

Purpose: Weight gain is a common side effect for women receiving adjuvant chemotherapy and may have negative long‐term implications for survival. The purpose of this study was to examine the effects of aerobic exercise on weight gain in women with breast cancer receiving adjuvant chemotherapy.description of Study: Seventy‐eight women who had recently received a diagnosis of breast cancer and who were beginning adjuvant chemotherapy were enrolled in a home‐based exercise study during the first four cycles of chemotherapy. Weight change, body mass index, anorexia, nausea, fatigue, caloric expenditure during exercise, and functional ability were recorded.Results: Women who adhered to the exercise program maintained their body weight, while nonexercisers steadily gained weight (P < .05). There were no differences in incidence or intensity of nausea or anorexia between the exercisers and nonexercisers. Women who exercised over the four cycles of chemotherapy improved their functional ability (mean 23%) compared to the nonexercisers who showed significant declines in functional ability (mean −15%).clinical Implications: Exercise may be an effective intervention to minimize weight gain in women with breast cancer who are receiving adjuvant chemotherapy. Preventing weight gain in these patients may be important in preventing recurrent disease and other comorbidities associated with excess weight.
Thoughts and Progress
Authors: Sauer  , Frank  , Bücherl  
Published: March 2003

It is the goal of this section to publish material that provides information regarding specific issues, aspects of artificial organ application, approach, philosophy, suggestions, and/or thoughts for the future. Proposal of a New Electromechanical Total Artificial Heart: The TAH SerpentinaA new type of energy converter for an electromechanical total artificial heart (TAH) based on the principle of a unidirectional moving motor is described. Named the TAH Serpentina, the concept consists of 2 major parts, a pendulum shaped movable element fixed on one side using a joint bearing and a special shaped drum cam. Pusher plates are mounted flexibly to the crossbar of the pendulum. A motor drives the special shaped drum cam linked to the pendulum through a ball bearing. The circular motion of the unidirectional moving brushless DC motor is transferred into the linear motion of the pendulum to drive the pusher plates. Using a crossbar with a variable length, the stroke of the pendulum and therefore the displaced blood volume is alterable. To achieve a variable length, an electric driven screw thread or a hydraulic system is possible. Comparable to the natural heart, cardiac output would be determined by frequency and stroke volume.
Implementing Ethics in the Professions: Toward Ecological Integrity
Authors: Soskolne Colin L. , Sieswerda Lee E. 
Published: March 2003

ABSTRACTEthics guidelines for professionals in the risk sciences are relatively recent. The need for accountability is recognized by many professionals, and has led to the development of ethics guidelines, anchored in organization‐specific mission statements or sets of core values. Almost none of the professions’ existing codes reflect on broader social consequences such as concern for ecological integrity. The importance of this consideration was recently noted in The Toronto Resolution where ensuring ecological integrity was directly linked to professional conduct. Guidelines are useful and necessary for professional development and day‐to‐day functioning, but alone they are insufficient to ensure that professionals learn about ethics and how to apply the guidelines while simultaneously recognizing the broader social consequences of their professional pursuits. In the interests both of professional accountability, as well as concern for the seamless web upon which all life‐support systems depend, each profession needs an ethics infrastructure. This paper provides a comprehensive organizational infrastructure, comprising a seven‐step program—focusing more on process than on content—for the integration of ethics into professional life. A framework for action is developed, integrating several operationalizable process steps. Difficulties in raising professional awareness and introducing an ethics infrastructure are discussed in the context of epidemiology. Professional organization and consensus on core values are seen as laying the foundation for an ethics program. To implement a program, codifying professional conduct in the form of ethics guidelines, establishing consistent procedures and review processes, and establishing ethics education and training, are essential. Furthermore, introducing incentives to encourage ethical conduct, an ethics consultation service, and ongoing oversight and commitment, are critical components for success. Its process goals would include ongoing review, education, dissemination, and adherence to the professions’ core values, into which concern for issues beyond the narrow confines of professional pursuits would be integrated.
Entrapment: Global Ecological and/or Local Demographic? Reflections Upon Reading the BMJ's Six Billion Day Special Issue
Authors: Butler Colin 
Published: March 2003

ABSTRACT Global human population recently passed six billion. To mark this, the BMJ (formerly the British Medical Journal) published a special edition that was both controversial and innovative. It had 12 complimentary essays, written by leading demographers, epidemiologists, and public health workers. A key issue highlighted was a debate between the nondemographer Maurice King and many demographers, regarding the concept of “demographic entrapment.” King and his supporters argue that the limited reserve carrying capacity of Rwanda was a major factor in that country's devastating civil war, a consequence of which was the release of spare carrying capacity. In contrast to this body of opinion, the key importance of population pressure as a factor in Rwanda's war is denied, not only by demographers but most other analysts of Rwanda.A second major issue highlighted in the journal was that of overconsumption, particularly of natural capital. The importance of this was partially recognized by the demographic papers, but none exhibited the sense of urgency concerning this conveyed in the two relevant papers written by epidemiologists and public health workers.This article discusses relevant sections of the 12 papers with regard to demographic entrapment and overconsumption. In addition, several other examples of demographic entrapment, both historic and contemporary, are suggested and described.Finally, the suggestion by King that the whole world may be demographically entrapped is refined by consideration of ongoing global environmental changes, both anthropogenic and natural, which are likely to reduce future global carrying capacity. While such changes are, themselves, unlikely to cause global under‐nutrition, the negative political and economic consequences of increased regional scarcity, consequent to approaching or passing local carrying capacities, are likely to exacerbate the risk of regional conflict. These areas of conflict could widen, and be aggravated by an increased frequency of natural disasters, predicted by some computerized climate change models. At the worst case, “civilization failure” or “barbarianization” could result. The complex pathway to this, substantially caused by adverse global environmental change, is called global “ecological entrapment.”
Early and Transient Side Effects of Repetitive Intravenous Dihydroergotamine
Authors: Queiroz Luiz P. , Weeks Randall E. , Rapoport Alan M. , Sheftell Fred D. , Baskin Steven M. , Siegel Sheryl E. 
Published: March 2003

Side effects associated with administration of repetitive intravenous dihydroergotamine (DHE) were prospectively studied in 72 patients with chronic daily headache who ware hospitalized in a dedicated inpatient headache treatment program. All patients received 11 consecutive doses of DHE, starting with 0.25 mg and increasing by 0.25 mg up to a maximum dose of 1.25 mg, depending on side effects and/or headache relief. The adverse events were recorded after each dose administered.The great majority of patients (91.6%) reported at least one side effect. The most common were: nausea (72.2%), increase in previous headache (47.2%), lightheadedness (33.3%), “new” headache (27.8%), and leg cramps (23.6%). The overall number of side effect complaints did not increase proportionally with the strength of the dose of DHE administered. These complaints declined from the earlier to the later doses of DHE, except for leg cramps, which were more common with the later doses.Side effects determined the strength of subsequent doses of DHE in only 18.1% of patients. Only four patients had to have a decrease in dosage and none required termination of DHE due to side effects.Although repetitive intravenous DHE causes frequent side effects, they are usually mild and transient and decrease with subsequent doses, even at higher doses.
Intranasal Lidocaine to Prevent Headache Following Migraine Aura
Authors: Maizels Morris 
Published: March 2003

Objective.—To report the consistent effect of intranasal lidocaine 4% on preventing headache following aura in one individual.Background.—A treatment that could prevent the headache which follows an aura would be an important advance in the treatment of migraine. No migraine abortive treatment has been shown to have such an effect.Methods.–A 15‐year‐old adolescent boy with a history of recurrent headache since aged 2, fulfilling the criteria for migraine with aura, was seen in consultation. Intranasal lidocaine 4% was used during the aura phase to prevent the headaches.Results.—Before using intranasal lidocaine, the patient invariably experienced a migraine following a typical visual aura. The episodes occurred approximately weekly, with a stable pattern for several years. When given during the aura, intranasal lidocaine prevented the headache following the aura, and remained successful on all but two occasions over 1 ½ years of use (approximately 75 episodes). Them was no effect on the duration of the aura itself.Conclusions.–Intranasal lidocaine consistently prevented the development of headache symptoms following aura in this individual. Such an effect suggests a role for the sphenopalatine ganglion in the development of migraine pain.
Relationships Among Hippocampal Volumetry, Proton Magnetic Resonance Spectroscopy, and Verbal Memory in Temporal Lobe Epilepsy
Authors: Sawrie Stephen M. , Martin Roy C. , Knowlton Robert , Faught Ed , Gilliam Frank , Kuzniecky Ruben 
Published: March 2003

Summary:  Purpose: To examine the relationship between hippocampal volumes, 1H magnetic resonance spectroscopy (MRS)‐identified hippocampal metabolic function, and verbal memory in patients with unilateral mesial temporal lobe epilepsy (MTLE).Methods: Hippocampal volumes, 1H MRS‐derived hippocampal creatine to N‐acetylaspartate (Cr/NAA), and verbal memory assessment were obtained preoperatively in 22 patients (six right, 16 left) with EEG‐defined unilateral MTLE.Results: Left hippocampal volume correlated significantly with left hippocampal Cr/NAA (r = −0.549, p < 0.01), whereas right volume correlated significantly with right Cr/NAA (r = −0.478, p < 0.05). Verbal memory correlated significantly with left hippocampal Cr/NAA (r = −0.594, p < 0.01), but not with left hippocampal volume or right hippocampal measures.Conclusions: Hippocampal volumes and 1H MRS‐derived metabolite ratios are statistically related, but share only a small percentage of variance, suggesting separate but related pathophysiologic processes. Left hippocampal Cr/NAA appears to be more sensitive to verbal memory function than volumes.
Prolonged Vigabatrin Treatment Modifies Developmental Changes of GABAA‐Receptor Binding in Young Children with Epilepsy
Authors: Juhász Csaba , Muzik Otto , Chugani Diane C. , Shen Chengang , Janisse James , Chugani Harry T. 
Published: March 2003

Summary:  Purpose: To determine whether prolonged treatment with vigabatrin (VGB), an antiepileptic drug (AED) that acts by elevating brain γ‐aminobutyric acid (GABA) levels, interferes with age‐related changes of in vivo GABAA‐receptor binding in children with epilepsy.Methods: Using [11C]flumazenil (FMZ)–positron emission tomography (PET) imaging, 15 children (aged 1–8 years) with medically intractable epilepsy were studied. Seven of these children were treated with VGB (1,000–2,500 mg/day) for ≥3 months before the FMZ‐PET study. The remaining eight patients were medicated with other drugs that are known not to act directly on the GABAergic system. Absolute quantification of PET data was performed by using the volume of distribution (VD) of FMZ in brain tissue representing FMZ ligand binding.Results: After controlling for age, hemispheric FMZ VD values were significantly lower in children treated with VGB as compared with the non‐VGB group (p = 0.012). Regional FMZ VD values of the VGB‐treated patients were significantly lower in all cortical regions and the cerebellum, whereas the difference was not significant in the thalamus and basal ganglia. No significant drug effect or drug‐by‐region interaction could be determined when the patients were separated according to treatment with carbamazepine (p = 0.97) or valproate (p = 0.55).Conclusions: VGB induces a decrease in GABAA‐receptor binding in the cortex and cerebellum of the developing epileptic brain. A similar effect of other drugs and substances of abuse targeting the GABAergic system may be hypothesized. Because of the important role of the GABAergic system in developmental plasticity, the reversibility and functional consequences of this age‐specific drug effect should be further studied.
Melatonin Effect on Seizures in Children with Severe Neurologic Deficit Disorders
Authors: Peled Nir , Shorer Zamir , Peled Eli , Pillar Giora 
Published: March 2003

Summary:  Purpose: Recently, melatonin has been associated with antiepileptic activity, most probably because of its antioxidant activity as a free radical scavenger. This study aimed to expand the clinical experience with melatonin as an antiepileptic drug (AED) in humans.Methods: Six children (aged 2–15 years), with severe intractable seizures, were treated with 3 mg of oral melatonin 30 min before bedtime, in addition to their previous AED treatment for 3 months. A diary of clinical seizure activity (time of day, duration, and type) was kept by parents for a month before and during treatment. Five patients underwent a baseline polysomnography, and three also were monitored during melatonin treatment.Results: With the exception of the parents of one child, all reported a significant clinical improvement in seizure activity during treatment, particularly during the night. Sleep studies showed a decrease in epileptic activity in two of the three patients who were monitored during treatment, and a change of sleep efficiency from 84.2% to 89.7% (NS). Improvement in daytime behavior and in communication abilities was reported by parents, although it was not objectively measured.Conclusions: This clinical observation adds to the growing data showing the antiepileptic effect of melatonin. However, owing to the paucity of well‐controlled studies, using melatonin as an AED should be limited to this specific group of patients with intractable seizures.
Monotherapy versus Polytherapy for Epilepsy: A Multicenter Double‐Blind Randomized Study
Authors: Deckers Charles L. P. , Hekster Yechiel A. , Keyser Antoine , Van Lier Henk J. J. , Meinardi Harry , Renier Willy O. 
Published: March 2003

Summary:  Purpose: Monotherapy has been the gold standard in epilepsy treatment for the last 20 years, partly because of the reputation for increased toxicity of polytherapy. However, monotherapy and polytherapy have not been compared in a double‐blind clinical trial. Open trials that compared the two treatments were not optimally designed and compared the two at unequal drug loads (i.e., at nonequivalent dosages). We report on a double‐blind clinical trial in which a combination of carbamazepine (CBZ) and valproate (VPA) was compared with CBZ monotherapy. Patients started with equal drug loads, and neurotoxicity was the primary outcome measure.Methods: The 130 adult patients with untreated generalized tonic–clonic and/or partial seizures were randomized to equal drug loads of either monotherapy (400 mg CBZ per day) or polytherapy (200 mg CBZ plus 300 mg VPA per day). Outcome was measured by seizure counts, clinimetric epilepsy scales, and neuropsychological tests at baseline, at 2 and 12 months, and irregularly between 2 and 12 months.Results: No statistical differences were found between the two treatments in the reduction of seizure frequencies, in overall neurotoxicity, or in overall systemic toxicity. The frequencies and clinimetric scores of certain adverse effects did differ (e.g., more monotherapy patients remained sedated, and more polytherapy patients gained weight). Fewer polytherapy patients withdrew because of adverse effects (14 vs. 22%), although this did not reach statistical significance (p = 0.15). Neuropsychological assessment did not show significant differences.Conclusions: No differences were found in overall neurotoxicity between monotherapy and polytherapy.