bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asymptomatic gastritis in naproxen‐treated North Indian children with juvenile rheumatoid arthritis
Authors: Rongali Atchum Naidu , Singh Surjit , Thapa Babu Ram , Vaiphei Kim 
Published: April 2004

AbstractAims:  Nonsteroidal anti‐inflammatory drugs (NSAIDs) are the agents of choice in patients with juvenile rheumatoid arthritis (JRA). While NSAIDs have been associated with gastritis in adults with rheumatoid arthritis (RA), not much is known about children with JRA. In this prospective study we set out to evaluate 31 children with JRA, who fulfilled the diagnostic criteria given by the American College of Rheumatology (ACR).Methods:  All patients had received naproxen for at least 3 months prior to their enrolment. Mean age of children was 9.02 years (range 2.5–16 years) with the male : female ratio being 1.8 : 1 (boys 20; girls 11). Eleven (35.5%) patients had polyarticular, 15 (48.4%) had pauciarticular and the remaining five (16.1%) had systemic onset JRA. Duration of disease varied from 5–84 months (mean ± 2, SD = 25.32 ± 20 months) with a mean duration of therapy of 14.19 months (range 4–72 months). Six patients had complaints of mild non‐specific upper abdominal pain.Results:  On upper gastrointestinal endoscopic examination none of the children showed any significant gross findings. However, histopathology of antral biopsies showed features of active and/or chronic gastritis in almost all the patients. Helicobacter pylori was identified in 16 (51.8%) of these on hematoxylin and eosin staining and the findings were confirmed with Giemsa/Gram staining. Fourteen (85.5%) were also positive by the rapid urease test (RUT). Ten of the 16 patients with H. pylori infection showed evidence of active inflammation in the antral biopsies.Conclusions:  Asymptomatic gastritis is a common finding in children with JRA who are receiving naproxen. There appears to be no correlation between the presence of H. pylori infection or histological gastritis and presence of abdominal symptoms in children with JRA.
Leflunomide in the treatment of rheumatoid arthritis and other autoimmune disorders
Authors: Fox Robert , Helfgott Simon 
Published: April 2004

AbstractLeflunomide (Arava) is an isoxazole derivative approved by the US Food and Drug Administration (FDA) for the treatment of rheumatoid arthritis (RA). Its mechanism of action is based on the inhibition of dihydro‐orotate dehydrogenase, an enzyme that controls the pathway for denovo synthesis of uridine ribose monophosphate (rUMP) in activated T‐cells. Leflunomide is structurally unrelated to other known immunomodulatory drugs in clinical use. Data have demonstrated benefit in control of clinical symptoms and quality of life in RA and prevention of radiologic progression after 24 months of treatment. Further, studies suggest a role for the combination of methotrexate plus leflunomide in the treatment of some patients with refractory RA. Recent studies have also indicated efficacy in psoriatic arthritis, other autoimmune disorders and in prevention of allograft rejection. A recent important issue is reports of potentially serious liver toxicity and guidelines for monitoring toxicity.
Churg–Strauss syndrome confined to calf muscles
Authors: Ching Daniel W. T. 
Published: April 2004

AbstractA 42‐year‐old Caucasian man presented with spontaneous bilateral calf pain. Past history included asthma for 8 months and sinusitis for 1 month. Investigations revealed eosinophilia, raised ESR, CRP, IgE and antimyeloperoxidase antibodies. Ethmoid sinus tissue excised during otolaryngological surgery showed non‐specific mixed inflammatory infiltrate including eosinophilia. A calf muscle biopsy demonstrated vasculitis with extravascular eosinophilia. He responded promptly to treatment with prednisone which was eventually stopped after 6 months. There is no recurrence at 6‐year follow up. It is important to recognize this presentation because prompt treatment might prevent progression of localized vasculitis to more widespread and life‐threatening vasculitis.
Analyses of serum levels of type 1, type 2 and type 3 cytokines reveal multiple abnormalities in lupus‐prone (NZB × NZW) F1 mice
Authors: De Albuquerque Deijanira A. , Ebling Fanny M. , Lienesch Douglas W. , Singh Ram Raj , Hahn Bevra H. 
Published: April 2004

AbstractAim:  Inherent in vivo cytokine milieu may help protect normal subjects from developing clinical autoimmunity, whereas changes in cytokine milieu may contribute to the development of lupus‐like autoimmunity.Method:  Here, we measured circulating levels of the three prototypic cytokines, type 1 (IFN‐γ and IL‐2), type 2 (IL‐4) and type 3 (TGFβ) in the NZB/NZW F1 model of lupus and MHC‐matched nonautoimmune mice.Results:  Our results demonstrate that circulating IFN‐γ and IL‐4 levels were higher and active TGFβ levels were lower in lupus‐prone animals than in nonautoimmune mice.Conclusion:  Such an in vivo cytokine milieu may contribute to the development of lupus in NZB/NZW F1 mice and to the nonautoimmune phenotype in normal animals.
Therapy with biologic agents in SLE
Authors: Zandman‐Goddard Gisele , Shoenfeld Yehuda 
Published: April 2004

AbstractThe revolution of biologic targeted therapy for autoimmune disease is underway. While anticytokine treatment (anti‐TNF‐α and anti‐IL‐1Ra) are proving beneficial in such diseases as rheumatoid arthritis and spondyloarthropathies, the road to successful treatment in systemic lupus erythematosus (SLE) is more complex, and perhaps because the mechanisms of disease remain unelucidated. The aims of novel therapies in SLE are to target the autoimmune disease at different points: B‐cell depletion (Lymphostat‐B, Rituximab), inhibition of T–B interaction (IDEC‐131), blockade of cytokines (anti‐IL‐10 antibodies), manipulation of idiotypes (IVIG), tolerance induction to DNA and to Ig‐peptides and peptide therapy (Riquent). We review the current knowledge on biologic agents in SLE patients. We utililized MEDLINE for relevant information from 2000 to 2003. Since biologic agents in this disease are at preliminary stages, we include information from abstracts, open trials, as well as phase I, II, and III studies. Anecdotal reports are not included. B‐cell depletion therapy is promising.
Intravascular lymphoma associated with systemic lupus erythematosus
Authors: Naya Masanao , Mukai Masaya , Bohgaki Miyuki , Notoya Atsushi , Kohno Michifumi , Matsubara Izumi 
Published: April 2004

AbstractWe report a case of systemic lupus erythematosus (SLE) associated with intravascular (angiotropic) lymphoma. A 27‐year‐old woman had been suffering from uncontrolled severe eruptions for a long time and was admitted because of high fever due to hemophagocytic syndrome (HPS). As her SLE had not been well‐controlled by moderate doses of steroids and azathioprine, autoimmune associated HPS was first considered. She was initially treated with steroid pulses and γ‐globulin for HPS. However, chromosomal analysis of bone marrow cells revealed severe abnormalities. After malignant lymphoma‐associated HPS was diagnosed, chemotherapy was commenced in the intensive care unit with artificial respiration and continuous hemodiafiltration. The patient died of cerebral infarction at day 45. It is suggested that the SLE itself was associated with the development of the intravascular lymphoma rather than due to the azathioprine.
The potential role of procalcitonin in the emergency department management of febrile young adults during a sustained meningococcal epidemic
Authors: Bugden Simon A , Coles Clare , Mills Graham D 
Published: April 2004

AbstractObjective:  To prospectively investigate the diagnostic characteristics of procalcitonin as an aid in the diagnosis of meningococcal disease in febrile young adults presenting to the Waikato Hospital emergency department during a sustained meningococcal epidemic.Methods:  The study population were emergency department patients aged 14–40 years presenting with either a temperature ≥ 38.0°C without an obvious focus of infection, or symptoms consistent with meningococcal disease. All had procalcitonin levels, N. meningitidis PCR, blood ± CSF cultures.Results:  One hundred and eighty‐three patients presented with undifferentiated febrile illness over a 9 month study period. Nine were subsequently shown to have meningococcal disease. A positive procalcitonin (≥ 0.5 ng/mL) had a sensitivity of 100% (CI 66.4–100), specificity 89% (CI 83.1–93.1), negative predictive value 100% (CI 97.6–100) and positive predictive value 32% (CI 15.9–52.4) for meningococcal disease.Conclusions:  The finding of a procalcitonin level ≥ 0.5 ng/mL in young adults with undifferentiated fever indicates an increased chance that the presenting illness may be meningococcal disease. In New Zealand's continuing meningococcal epidemic empirical antibiotics should be strongly considered in those with elevated procalcitonin levels in the hope of reducing meningococcal disease deaths due to delays in antibiotic administration.
How long does stridor at rest persist in croup after the administration of oral prednisolone?
Authors: Parker Robyn , Powell Colin VE , Kelly Anne‐Maree 
Published: April 2004

AbstractObjectives:  To determine the duration of stridor at rest (SAR) after the administration of oral prednisolone (1 mg/kg) to children admitted to hospital with croup from the ED. The secondary objective was to determine whether children with mild croup had a more rapid resolution of SAR.Methods:  This was a retrospective explicit chart review of all children admitted to the paediatric ward of a community, paediatric teaching hospital with a diagnosis of croup over one year. Data collected included patient demographics, Westley and Geelhoed croup scores on presentation to the ED and the duration of SAR after administration of steroids.Results:  For the 188 cases analyzed, median duration of SAR was 6.5 h (95% CI 6–7 h, range 0.5–82 h). Children with a Westley score of ≤ 2 or a Geelhoed score of ≤ 3 had a shorter duration of SAR than those with higher scores (6 h vs. 7 h, P < 0.05), which although statistically significant is unlikely to be of clinical significance.Conclusions:  Stridor at rest resolves promptly after the administration of oral steroids in the vast majority of cases. This suggests that a subset of patients previously admitted to hospital with croup may be able to be treated and discharged from the ED.
A paediatric trauma study of scooter injuries
Authors: Fong Christina PH , Hood Natalie 
Published: April 2004

AbstractObjective:  To investigate the incidence and describe the nature of non‐motorized scooter related injuries in children presenting to the ED.Setting:  Paediatric ED of a metropolitan tertiary referral hospital.Methods:  A prospective observational study of patients aged under 19 years presenting with injuries sustained while using a non‐motorized scooter. Clinicians recorded the data in the patient record. Main outcome measures: type of injury sustained; period of experience on the scooter; the use of protective gear; the presence of adult supervision; the place of accident; and the patient outcome.Results:  Sixty‐two eligible patients were recruited over an 18 month period. The incidence of scooter‐ related injuries was 1.3% of all paediatric trauma presentations. There was a fall in scooter injury presentations over the study period; however, this was not statistically significant. The most common injury sustained using a scooter was an upper limb fracture (41.9%). Closed head injury comprised 8.1% of all scooter related injuries. The majority of patients were not wearing protective gear and were unsupervised at the time of their accident. Most patients (79%) were managed in the ED and discharged.Conclusions:  There has been no significant change in scooter injury presentations over the two summer periods of 2000 and 2001. Children presenting to the ED with a scooter related injury tend to be primary school aged, which may have implications on scooter design, age recommendations and safety guidelines.
Mental health and alcohol and other drug training for emergency department workers: One solution to help manage increasing demand
Authors: King Diane L , Kalucy Ross S , De Crespigny Charlotte F , Stuhlmiller Cynthia M , Thomas Lyndall J 
Published: April 2004

AbstractObjective:  To evaluate a training course for ED staff aiming to improve knowledge and skills in working with mental health and drug/alcohol patients attending EDs.Methods:  Pre‐ and postcourse questionnaires assessed attitudes and self‐ratings of confidence, knowledge and skills in working with these patients. Follow‐up interviews assessed if new skills or approaches to patient management had been integrated into daily ED practice.Results:  Little change was observed in the course participants’ attitudes, although reported attitudes were generally appropriate. Self‐ratings of confidence in skills and knowledge showed a significant improvement on all questions following the course. Responses to the follow‐up interviews suggest course information has been retained and integrated into practice, especially in conducting triage and other assessments and taking more time to talk to patients.Conclusion:  The course has led to staff feeling more confident and competent to help mental health or drug/alcohol patients who attend the ED.
Congenital diaphragmatic hernia masquerading as pneumonia
Authors: Ng Chung‐por , Lo Chi‐biu , Chung Chin‐hung 
Published: April 2004

AbstractPatients with congenital diaphragmatic hernia usually present in the immediate neonatal period with respiratory distress. However, presentation beyond the neonatal period has sporadically been reported. We report a case of a 4‐year‐old girl who presented with a 1 month history of chronic cough and low‐grade fever, with no response to multiple antibiotics. Initially, both clinical and radiological findings suggested inflammatory chest disease. Fortunately, after performing ultrasound, suspicion was raised and she was later diagnosed to have left congenital diaphragmatic hernia of Bochdalek type. Although rare, this entity should form one of the differential diagnoses of unresolving pneumonia in children.
Postcoital haemoperitoneum: A cause for shock
Authors: Goswami Anu , S Raghavan Subrahmanian , Ghotekar Lekharaj H 
Published: April 2004

AbstractPostcoital haemoperitoneum rarely occurs without evident vaginal injury. A 21‐year‐old second gravida woman presented to the ED in shock with a history of 8 weeks amenorrhoea and abdominal pain of 20 h duration. The ultrasound examination revealed a live intrauterine pregnancy and fluid in peritoneal cavity. There was a history of coitus 2 hours prior to the onset of pain. At laparotomy, more than 2 L of free blood was found in the peritoneal cavity. A small bleeding peritoneal vessel in pouch of Douglas was identified and ligated.
An unusual knee injury: Isolated tibiofibular dislocation
Authors: Petter Alastair , Davidson Jennifer 
Published: April 2004

AbstractIsolated proximal tibiofibular dislocation is an extremely rare condition with potentially serious complications if missed. The mechanism of injury, clinical presentation and treatment options are discussed. This injury was more common in previous centuries, when horse riding was the preferred method of transport. The young man we present was involved in a pastime that is rising in popularity and it is therefore likely that this injury will be a more common presentation to EDs.
Relative Ability of Orally AdministeredLactobacillus murinusTo Predominate and Persist in the Porcine Gastrointestinal Tract
Authors: Gardiner Gillian E. , Casey Pat G. , Casey Garrett , Lynch P. Brendan , Lawlor Peadar G. , Hill Colin , Fitzgerald Gerald F. , Stanton Catherine , Ross R. Paul 
Published: April 2004

ABSTRACTFive porcine-derivedLactobacillusorPediococcusisolates administered to pigs (n= 4), either singly or as a combination at ∼1010CFU per day varied with respect to intestinal survival and persistence. TwoLactobacillus murinusstrains survived best and were excreted at ∼107to 108CFU/g of feces. In contrast,Pediococcus pentosaceusDPC6006 had the lowest fecal count at ∼105CFU/g and was excreted at a significantly lower level than bothL. murinusstrains. FecalL. murinusDPC6003 counts were also significantly higher than bothLactobacillus salivariusDPC6005 andLactobacillus pentosusDPC6004 (∼106CFU/g). TheL. murinusstrains persisted for at least 9 days postadministration in both the feces and the cecum. Animals fed a combination of all five strains excreted ∼107CFU of the administered strains/g, withL. murinuspredominating, as determined by randomly amplified polymorphic DNA PCR. Postadministration, variation was observed between animals fed the strain combination, but in general,L. murinusDPC6002 and DPC6003 andL. pentosusDPC6004 predominated in the feces and the cecum whileP. pentosaceusDPC6006 was detected only in the cecum. Fifteen days after the start of culture administration, mean fecalEnterobacteriaceaecounts were significantly lower in some of the treatment groups. In addition, when mean preadministration counts were compared with those obtained after 21 days of culture administration,Enterobacteriaceaecounts were reduced by ∼87 to 98% in pigs fedL. salivariusDPC6005,P. pentosaceusDPC6006,L. pentosusDPC6004, and the culture mix. In conclusion, the porcine intestinal isolates have potential as probiotic feed additives for pigs, with differences in strain performance highlighting the advantages of using culture combinations.
Simultaneous Degradation of Atrazine and Phenol by
Pseudomonas
sp. Strain ADP: Effects of Toxicity and Adaptation
Authors: Neumann Grit , Teras Riho , Monson Liis , Kivisaar Maia , Schauer Frieder , Heipieper Hermann J. 
Published: April 2004

ABSTRACT

The strain
Pseudomonas
sp. strain ADP is able to degrade atrazine as a sole nitrogen source and therefore needs a single source for both carbon and energy for growth. In addition to the typical C source for
Pseudomonas
, Na
2
-succinate, the strain can also grow with phenol as a carbon source. Phenol is oxidized to catechol by a multicomponent phenol hydroxylase. Catechol is degraded via the
ortho
pathway using catechol 1,2-dioxygenase. It was possible to stimulate the strain in order to degrade very high concentrations of phenol (1,000 mg/liter) and atrazine (150 mg/liter) simultaneously. With cyanuric acid, the major intermediate of atrazine degradation, as an N source, both the growth rate and the phenol degradation rate were similar to those measured with ammonia as an N source. With atrazine as an N source, the growth rate and the phenol degradation rate were reduced to ∼35% of those obtained for cyanuric acid. This presents clear evidence that although the first three enzymes of the atrazine degradation pathway are constitutively present, either these enzymes or the uptake of atrazine is the bottleneck that diminishes the growth rate of
Pseudomonas
sp. strain ADP with atrazine as an N source. Whereas atrazine and cyanuric acid showed no significant toxic effect on the cells, phenol reduces growth and activates or induces typical membrane-adaptive responses known for the genus
Pseudomonas
. Therefore
Pseudomonas
sp. strain ADP is an ideal bacterium for the investigation of the regulatory interactions among several catabolic genes and stress response mechanisms during the simultaneous degradation of toxic phenolic compounds and a xenobiotic N source such as atrazine.
Fum3p, a 2-Ketoglutarate-Dependent Dioxygenase Required for C-5 Hydroxylation of Fumonisins in
Fusarium verticillioides
Authors: Ding Yousong , Bojja Ravi S. , Du Liangcheng 
Published: April 2004

ABSTRACT

Fumonisins are polyketide-derived mycotoxins produced by several agriculturally important
Fusarium
species. The B series fumonisins, FB
1
, FB
2
, FB
3
, and FB
4
, are fumonisins produced by wild-type
Fusarium verticillioides
strains, differing in the number and location of hydroxyl groups attached to the carbon backbone. We characterized the protein encoded by
FUM3
, a gene in the fumonisin biosynthetic gene cluster. The 33-kDa
FUM3
protein (Fum3p) was heterologously expressed and purified from
Saccharomyces cerevisiae.
Yeast cells expressing the Fum3p converted FB
3
to FB
1
, indicating that Fum3p catalyzes the C-5 hydroxylation of fumonisins. This result was verified by assaying the activity of Fum3p purified from yeast cells. The C-5 hydroxylase activity of purified Fum3p required 2-ketoglutarate, Fe
2+
, ascorbic acid, and catalase, all of which are required for 2-ketoglutarate-dependent dioxygenases. The protein also contains two His motifs that are highly conserved in this family of dioxygenases. Thus, Fum3p is a 2-ketoglutarate-dependent dioxygenase required for the addition of the C-5 hydroxyl group of fumonisins.
Occurrence and Phylogenetic Diversity ofSphingomonasStrains in Soils Contaminated with Polycyclic Aromatic Hydrocarbons
Authors: Leys Natalie M. E. J. , Ryngaert Annemie , Bastiaens Leen , Verstraete Willy , Top Eva M. , Springael Dirk 
Published: April 2004

ABSTRACTBacterial strains of the genusSphingomonasare often isolated from contaminated soils for their ability to use polycyclic aromatic hydrocarbons (PAH) as the sole source of carbon and energy. The direct detection ofSphingomonasstrains in contaminated soils, either indigenous or inoculated, is, as such, of interest for bioremediation purposes. In this study, a culture-independent PCR-based detection method using specific primers targeting theSphingomonas16S rRNA gene combined with denaturing gradient gel electrophoresis (DGGE) was developed to assessSphingomonasdiversity in PAH-contaminated soils. PCR using the new primer pair on a set of template DNAs of different bacterial genera showed that the method was selective for bacteria belonging to the familySphingomonadaceae. Single-band DGGE profiles were obtained for mostSphingomonasstrains tested. Strains belonging to the same species had identical DGGE fingerprints, and in most cases, these fingerprints were typical for one species. Inoculated strains could be detected at a cell concentration of 104CFU g of soil−1. The analysis ofSphingomonaspopulation structures of several PAH-contaminated soils by the new PCR-DGGE method revealed that soils containing the highest phenanthrene concentrations showed the lowestSphingomonasdiversity. Sequence analysis of cloned PCR products amplified from soil DNA revealed new 16S rRNA geneSphingomonassequences significantly different from sequences from known cultivated isolates (i.e., sequences from environmental clones grouped phylogenetically with other environmental clone sequences available on the web and that possibly originated from several potential new species). In conclusion, the newly designedSphingomonas-specific PCR-DGGE detection technique successfully analyzed theSphingomonascommunities from polluted soils at the species level and revealed differentSphingomonasmembers not previously detected by culture-dependent detection techniques.