bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maximum a posteriori Bayesian estimation of epirubicin clearance by limited sampling
Authors: Ralph Lorraine D. , Thomson Alison H. , Dobbs Nicola A. , Twelves Chris 
Published: May 2004

Aims  To develop a limited sampling strategy for estimation of epirubicin clearance.Methods  The data set comprised 1051 concentrations measured in 105 patients with advanced or metastatic breast cancer treated with epirubicin alone. Ten limited sampling designs comprising two or three blood samples were proposed, taken at times identified by D‐optimality from population pharmacokinetic parameter estimates. The data set was then truncated to include the sampling times for each of the designs. MAP Bayesian estimates of clearance were generated for each design and compared with clearance estimates obtained using all the data. The limited sampling designs were also validated using a separate data set obtained from 18 patients with either breast cancer or hepatocellular carcinoma. The sensitivity of the best limited sampling designs to sample time recording errors of 0–10% or 10–20% was then assessed using a simulated data set including 200 patients.Results  The optimum sampling times were: end of the injection and 18 min, 40 min, 3 h, 10 h and 48 h after the start of the injection. The best three‐sample design included samples at 40 min, 3 h and 48 h and gave unbiased estimates of clearance with an imprecision of 9.1% (95% CI 7.3, 10.5). The best two sample design included samples at 3 and 48 h and gave unbiased estimates of clearance with an imprecision of 12.4% (95% CI 9.6, 14.6). Using the validation data set, these two and three sample designs gave unbiased estimates of clearance with an imprecision of 5.6% (95% CI 3.7, 7.0) and 4.2% (95% CI 2.6, 5.3), respectively. Simulations that included 0–10% or 10–20% errors in the recording of the blood sampling times had negligible effects on the bias and imprecision of clearance estimates.Conclusions  Limited sampling designs have been identified and validated that estimate epirubicin clearance with adequate precision and without bias from two or three blood samples. These designs also allow flexibility in blood sample collection and are robust with regard to sample time recording errors.
Stroke prevention and atrial fibrillation: reasons leading to an inappropriate management. Main results of the SAFE II study
Authors: Deplanque Dominique , Leys Didier , Parnetti Lucilla , Schmidt Reinhold , Ferro Jose , De Reuck Jacques , Mas Jean‐Louis , Gallai Virgilio ,   the SAFE ll Investigators
Published: May 2004

Aims  The aim of the Stroke and Atrial Fibrillation Ensemble (SAFE) II study was to identify the reasons underlying the under‐utilization of oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (NVAF).Methods  We investigated from all available sources the reasons why patients hospitalized for a stroke, who had a previously known NVAF, were not receiving OAC beforehand. We interviewed general practitioners (GPs) and cardiologists with a structured questionnaire, to identify the reasons for their therapeutic choice.Results  Of 370 patients, 257 were theoretically eligible for OAC according to guidelines and the presence of contra‐indications, but only 82 (22.2%) of them had actually received OAC before. We found that factors independently associated with the prescription of OAC were being followed‐up by a cardiologist and having a younger GP. The leading reason evoked by GPs or cardiologists to explain why patients were not treated with OAC was the presence of a ‘potential contra‐indication’, which was often inappropriate, followed by ‘there was no indication’, ‘low compliance’ and ‘fear of bleeding’.Conclusions  An important reason for not prescribing OAC was the lack of knowledge about trials and guidelines. Medical education about OAC in NVAF should therefore be improved.
The calcimimetic agent KRN 1493 lowers plasma parathyroid hormone and ionized calcium concentrations in patients with chronic renal failure on haemodialysis both on the day of haemodialysis and on the day without haemodialysis
Authors: Ohashi Naro , Uematsu Toshihiko , Nagashima Satoru , Kanamaru Mitsutaka , Togawa Akashi , Hishida Akira , Uchida Eiji , Akizawa Tadao , Koshikawa Shozo 
Published: May 2004

Aims  Treatment with vitamin D sterols can lower plasma parathyroid hormone (PTH) in patients with secondary hyperparathyroidism; however, hypercalcaemia, hyperphosphataemia, or both, often develop. Calcimimetic agents, employed in alternative therapeutic approaches, directly inhibit PTH secretion by activating the calcium‐sensing receptor in the parathyroid glands.Methods  In this study, patients were given orally 25, 50, and 100 mg doses of the calcimimetic agent KRN 1493 each on two occasions, on the day of haemodialysis and on the day without haemodialysis.Results  In the pharmacokinetic results, because the clearance of KRN 1493 by haemodialysis was much smaller than the systemic clearance, the influence of haemodialysis was not remarkable. In the pharmacodynamic study, on both the days with or without haemodialysis, plasma PTH concentrations decreased in a dose‐dependent manner. Serum calcium concentrations decreased in association with the decrease in plasma PTH concentrations. Mild dose‐dependent adverse effects (mainly nausea) were seen after the administration of KRN 1493 on both the day of haemodialysis and the day without haemodialysis.Conclusions  We conclude that the pharmacokinetics of KRN 1493 after a single administration were similar on the day of haemodialysis and the day without haemodialysis. KRN 1493 is safe and effective in suppressing PTH secretion and serum calcium concentrations on the day of haemodialysis and on the day without haemodialysis in patients with secondary hyperparathyroidism.
Tolerance of interferon‐alpha therapy in children with chronic hepatitis B
Authors: Liberek A , Łuczak G , Korzon M , Szlagatys‐Sidorkiewicz A , Bako W , Góra‐Gębka M , Rytlewska M , Sikorska‐Wiśniewska G 
Published: May 2004

Objective:  To assess the side‐effects of interferon‐α (IFN‐α) therapy in children with chronic hepatitis B.Methods:  This prospective study was performed on one hundred children by interviewing the patients and their parents; clinical examinations and laboratory investigations were performed during and after therapy.Results:  The most frequent side‐effects of IFN‐α therapy were fever, flu‐like symptoms, and headaches. Lowering of the mean haemoglobin level, leukocyte and platelet count was significant, but transient during INF‐α treatment. No increase in autoantibody titres or significant alterations in thyroid function was observed. Twelve months after treatment, hepatitis Be antigen (HBeAg) elimination and alanine aminotransferase (ALT) normalization was achieved in 46% of the children; HBeAg and hepatatis B surface antigen (HBsAg) elimination, together with ALT normalization, was achieved in 14% of the cases.Conclusion:  The side‐effects of the IFN‐α therapy in children such as fever, flu‐like symptoms and bone marrow suppression are common, but transient and mild.
Skin exposure during conventional phototherapy in preterm infants: A randomized controlled trial
Authors: Pritchard MA , Beller EM , Norton B 
Published: May 2004

Objective:  To assess the effect of reduced skin exposure in preterm infants receiving overhead phototherapy treatment on total serum bilirubin (TSB).Methods:  Randomized controlled trial. Preterm infants (>1500 g birthweight and ≤ 36 weeks gestation) were randomized to being nursed either partially clothed with only disposable nappies and in posturally supported positions (n = 30) or naked without postural support (n = 29). Primary outcome was mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment (irradiance of 6 µWcm−2/nm at a wavelength of 425−475 nm). The incidence of rebound jaundice, number of infants continuing to receive phototherapy treatment at 24 h periods, parental stress, mother−infant interaction and mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment were examined.Results:  Mean TSB percentage change at 24 h of completed treatment for the partially clothed group was 15.4% (±18) and for the naked group 19% (±15) (mean difference 3.6% 95% CI −5.1, 12.3). No other outcomes were significantly affected by reduced skin exposure to overhead phototherapy treatment.Conclusion:  Our results show no statistically significant difference in TSB level change using either nursing practice.
Behavioural and physiological reactivity to noise in the newborn
Authors: Trapanotto M , Benini F , Farina M , Gobber D , Magnavita V , Zacchello F 
Published: May 2004

Objective:  To assess the electromyographic (EMG) and behavioural reactivity of a group of newborn infants exposed to noisy stimulation of various intensity recorded in the Paediatric intensive care Unit (PICU).Methods:  The study was performed at the nursery of the Paediatrics Department (University of Padova) on a group of 21 healthy newborns (mean 39 weeks of gestation), assessed between 24 and 72 h after birth. The study involved taking EMG recordings of the corrugator supercilii muscle and assessing the infant's behaviour at the baseline (15 seconds before stimulation), during noisy stimulation (for 1−2 seconds) and during recovery (15 seconds in three subphases). The noises, previously recorded in PICU, had four different intensities and were administered in random order to all infants. Descriptive analysis and repeated‐measures analysis of variance (anova) were performed on the EMG and behavioural data.Results:  The infants demonstrated a significant reaction to the noises both in the EMG recordings and in behavioural changes, especially during intense noisy stimulation. The reaction lasted longer than the stimulation period, preventing the infants from returning to the baseline condition.Conclusions:  Exposure to high‐intensity noise produced in PICU causes evident behavioural and physiological effects (EMG). This is a field of study that could have important repercussions, given the medium‐ and long‐term effects of repeated noise stimulation.
Predictors of chronic lung disease in the ‘CPAP era’
Authors: Groves AM , Briggs KA , Kuschel CA , Harding JE 
Published: May 2004

Objective:  To assess predictors of chronic lung disease (CLD), in infants requiring nasal continuous positive airway pressure (CPAP) support in the first 4 weeks of life.Methods:  A retrospective case note audit of infants of birthweight 1250 g or less was undertaken.Results:  Of 290 infants identified, 50% were initially treated with ventilation, 41% with CPAP, 4% required no support, and 5% had care withdrawn. Of infants initially treated with CPAP, 23% subsequently required ventilation. Overall mortality was 19%, with a further 21% of infants developing CLD. For infants requiring CPAP support, requirement for supplementary oxygen at between 10 and 21 days predicted increased risk of CLD, and receiver operating characteristic curves suggest requirement for supplementary oxygen at 14 days to be the most reliable cut‐off (area under curve = 0.72). Positive predictive values for future CLD or death for FiO2 .25, .30 and .40 while on CPAP at 14 days were 0.56, 0.61 and 0.76, respectively.Conclusions:  CLD remains prevalent in very low birthweight infants in the CPAP era. Oxygen requirement at 14 days is the strongest predictor of CLD. Infants requiring 30% oxygen or more while on CPAP at 14 days have a 60% risk of subsequent CLD or death.
Outcomes of a nutrition audit in a tertiary paediatric hospital: Implications for service improvement
Authors: O'Connor J , Youde LS , Allen JR , Hanson RM , Baur LA 
Published: May 2004

Objective:  To examine the process of anthropometric assessment of nutritional status in a tertiary paediatric hospital, to identify the barriers and to make recommendations for service improvement.Methods:  The accuracy of height and weight scales in wards was checked. Dietitians measured height and weight of a representative sample of 245 inpatients and checked whether these measurements had been recorded on bed charts. Patients were classified as overweight, obese or under‐nourished. Diagnoses and procedures were obtained for each patient. Funding implications were modelled for inappropriate coding of nutritional status.Results:  The barriers to nutritional assessment and management of nutritional comorbidities were: (i) inaccurate height scales in seven out of 12 wards; (ii) under‐recording of height and weight on patient bed charts (73% height missing, 12% both height and weight missing); (iii) under‐reporting of obesity and under‐nutrition in medical notes (one of eight obese patients, and none of 28 undernourished patients, reported); and (iv) low referral rate of obese or under‐nourished children to dietetic services (two of 42 overweight/obese patients referred, five of 28 undernourished patients referred). Funding simulation showed that if under‐nourished patients were correctly diagnosed then the potential facility reimbursement would have increased by $A52 326.Conclusions:  Barriers to nutritional assessment can lead to failure to diagnose and treat both over‐ and under‐nutrition, thereby affecting quality of patient care, and may have financial implications for hospitals. Suggestions for service improvement include provision of accurate equipment, adequate training of staff undertaking nutritional assessments and clear definitions of staff responsibilities in all aspects of the process.
Infant bath seats, drowning and near‐drowning
Authors: Byard RW , Donald T 
Published: May 2004

Objective:  To investigate the possible role of infant bathtub seats in drowning and near‐drowning episodes in infants.Methods:  A review was conducted of the files of the Forensic Science Centre and Child Protection Unit, Women's and Children's Hospital, Adelaide, South Australia, for significant immersion incidents in infants involving bathtub seats from January 1998 to December 2003.Results:  A total of six cases of drowning occurred over the 6‐year period of the study in children under 2 years of age, including two infants. One of these cases, a 7‐month‐old boy, had been left unattended for some time in an adult bath in a bathtub seat. He was found drowned, having submerged after slipping down and becoming trapped in the seat. Three near‐drowning episodes occurred in children under the age of 2 years, including two boys aged 7 and 8 months, both of whom had been left for some time in adult baths in bath seats. Both were successfully resuscitated and treated in hospital.Conclusions:  These cases demonstrate the vulnerability of infants to immersion incidents when left unattended in bathtubs. Bathtubs are particularly dangerous for infants as the slippery and smooth surfaces predispose to loss of balance and make escape from water difficult. Infant bathtub seats may give parents and child carers a false sense of security leading to infants being left unattended. Unfortunately, however, infants may fall out of, or slip and become trapped in, such seats. Infants and young children cannot be left unsupervized in water, and devices used as bathing aids such as bathtub seats may contribute to immersion incidents.
Staphylococcal enterotoxin‐specific IgE antibodies in atopic dermatitis
Authors: Ide Fumihito , Matsubara Tomoyo , Kaneko Miho , Ichiyama Takashi , Mukouyama Tokuko , Furukawa Susumu 
Published: May 2004

Abstract
Background
: The authors clarified the clinical significance of the measurement of serum concentrations of specific IgE antibodies to staphylococcal enterotoxin (SE) A‐ and SEB in atopic dermatitis (AD).
Methods
: The serum concentrations of SEA‐ and SEB‐specific IgE antibodies in 140 pediatric patients with AD were measured with an immuno CAP −radioallergosorbent test system (RAST). To check the cross‐reaction of specific IgE antibodies to SEA/SEB and other allergens, the CAP RAST fluorescent enzyme immunoassay inhibition test was performed.
Results
: Forty‐seven patients (33.6%) tested positive for either SEA‐ or SEB‐specific IgE antibodies. School children showed higher positive rates of SEA/SEB‐specific IgE antibodies than infants or young children. The patients with severe AD and those with exacerbation of symptoms in summer, had higher positive rates of SEA/SEB‐specific IgE antibodies than patients with mild AD or those with exacerbation in winter. In addition, the positive rates of specific IgE antibodies to both dog‐dander and cat‐dander were higher in patients with positive SEA/SEB‐specific IgE antibodies than in patients with negative ones. No cross‐reactions occurred among specific IgE antibodies to SEA/SEB and dog/cat dander with one patient's serum, which had positive IgE‐specific antibodies against cat/dog dander and SEA/SEB. The positive rate of SEA/SEB‐specific IgE antibodies in the patients with dogs and/or cats as pets was 48.4%, which was higher than in those with no pets.
Conclusions
: Atopic dermatitis patients who exhibit high positive rates of SEA/SEB‐specific IgE antibodies were found to be school children, severe cases, cases with high serum concentrations of total IgE, cases with exacerbation in summer, and cases with dogs and/or cats as pets. The measurement of serum concentrations of specific IgE antibodies to SEA and SEB, thus has some value for evaluating AD patients.
Population attributable fraction of smoking to low birth weight in Japan
Authors: Ojima Toshiyuki , Uehara Ritei , Watanabe Makoto , Tajimi Morihiro , Oki Izumi , Nakamura Yosikazu 
Published: May 2004

Abstract
Background
: The purpose of this study is to quantify the population attributable fraction of active and passive smoking for low birth weight in Japan.
Methods
: A population‐based case‐control study was conducted by mailing self‐report questionnaires. The cases were all singleton low birth weight babies who were born between 1 January 1998 and 30 June 1999 in Tochigi prefecture, Japan. The controls were randomly selected from all singleton babies who were born during the same period as cases in the prefecture.
Results
: The number of cases and controls were 286 and 404, respectively. Population attributable fractions of active smoking during and before pregnancy were 7.0% and 8.8%, respectively. Population attributable fraction of passive smoking at home was 15.6% and at the workplace was 1.1%. Combined population attributable fraction of both active and passive smoking was 17.3%.
Conclusion
: Public education to eliminate passive smoking for pregnant women and smoking prevention in adolescence is very important in order to reduce the risk of low birth weight.
Semiquantitative scoring in children under treatment for atopic dermatitis
Authors: Murao Yoshinori , Mae Hiromu , Konishi Tomoko , Gao Xiaojie , Tanizawa Takakuni 
Published: May 2004

Abstract
Background
: Atopic dermatitis is the most frequently seen childhood allergic disease in outpatient clinics. Improvement, exacerbation, and response to treatment are typically assessed subjectively and occasionally inaccurately.
Methods
: The authors developed two forms for scoring of dermal manifestations and used them to assess 56 children. The correlation between two pediatricians’ scores and correspondence to established categories (mild, moderate, and severe) were determined.
Result
: The two physicians’ scores for the children correlated well for both forms of scoring. Correspondence of scores as ‘mild’ and ‘moderate’ categories were significant (few children participating were ‘severe’).
Conclusion
: Use of well‐constructed scoring forms should improve clinical assessment of patient course and treatment response.
Significance of hypocarbia in the development of periventricular leukomalacia in preterm infants
Authors: Giannakopoulou Christina , Korakaki Eftichia , Manoura Antonia , Bikouvarakis Stellios , Papageorgiou Maria , Gourgiotis Dimitrios , Hatzidaki Eleftheria 
Published: May 2004

Abstract
Background
: Despite rapid advances in the management of preterm infants, periventricular leukomalacia (PVL) remains a considerable problem in neonatal intensive care. The aim of this study was to determine whether hypocarbia is associated with the development of PVL in mechanically ventilated, preterm infants and to emphasize the importance of avoiding this disturbance.
Methods
: The authors evaluated 52 mechanically ventilated infants with a gestational age of <34 weeks, who exhibited hypocarbia in the first three postnatal days (lowest carbon dioxide tension being <25 mmHg). These infants were then compared with 52 infants in a control group not exhibiting hypocarbia, matched for birthweight and gestational age. A diagnosis of PVL was made on the basis of the results of cranial ultrasonography. Confounding factors potentially associated with the development of PVL were controlled in logistic regression analyses.
Results
: Of the 52 mechanically ventilated preterm infants with hypocarbia, 10 (19.2%) developed cystic PVL, and six (11.5%) developed periventricular echodensity. Of the 52 infants in the control group only two (3.8%) developed cystic PVL, and one (1.9%) infant developed periventricular echodensity. The authors observed no significant differences in other prenatal and perinatal risk factors between the two groups.
Conclusion
: Hypocarbia in mechanically ventilated preterm infants during the first days of life is suggested as being an independent predictor of PVL, predisposing these infants to subsequent neurodevelopmental delay.
Utility of scalp‐recorded ictal electroencephalograms in childhood epilepsy with complex partial seizures
Authors: Yoshinaga Harumi , Ohtsuka Yoko , Abiru Kiyoko , Nakano Kosuke , Oka Eiji 
Published: May 2004

Abstract
Background
: The authors evaluated the usefulness of scalp‐recorded ictal electroencephalograms (EEG) in diagnosing the epileptogenic area in epilepsy with complex partial seizures.
Methods
: The authors analyzed the ictal EEG of 395 seizures in 43 patients with complex partial seizures. Based on EEG findings the patients were classified according to the degree of localization of their onset areas. The results were then compared with neuroimaging findings.
Results
: Only 10 patients fell into the category ‘discrete’, meaning that all the onset areas (as measured by ictal EEG) were localized in the same lobe of the same hemisphere. Seven patients were categorized as ‘lateralized’, meaning that all the onset areas were clearly lateralized in the same hemisphere but without consistent localization. Eleven patients were classified as ‘localized’, meaning that the onset area were localized simultaneously in bilateral same lobes, or changed consistently from one lobe in one hemisphere to the same lobe in the opposite hemisphere. The onset area could not be defined in 15 patients and these were categorized as ‘not defined’. No patient who underwent seven or more ictal recordings was categorized as discrete. However, when confined only to those patients in whom over 75% of the ictal recordings showed the same onset area, there was a high correlation between the epileptogenic lesions detected by ictal EEG and those detected by neuroimaging techniques.
Conclusions
: The findings of the present study indicate that ictal EEG recordings are useful for determining the epileptogenic area in epilepsy with complex partial seizures, provided that more than 75% of the ictal recordings show the same ictal onset area.