bluuebunny/crossref_metadata_2025_split huggingface dataset:
WOMEN'S PUBLIC HEALTH POLICY IN THE 21ST CENTURY
Authors: Santiago Julie Mottl 
Published: February 2003

ABSTRACTMidwives share a historic commitment with maternal and child public health (MCH) agencies to protect and improve perinatal health among vulnerable populations. Both professions are now beginning to broaden their responsibilities to include the comprehensive health needs of women. Because midwifery's unique woman‐centered primary care practices reflect the goals and aims of the developing MCH women's health agenda, continued partnerships between midwives and the maternal and child public health community are imperative to promote the health of women and their families. To facilitate such collaboration, this article presents an overview of women's public health policy and articulates the unique contributions midwives can and do make to women's health care and public health policy.
ST. JOHN'S WORT AND ORAL CONTRACEPTIVES: REASONS FOR CONCERN?
Authors: Murphy Patricia Aikins 
Published: February 2003

ABSTRACTSt. John's wort (Hypericum perforatum) is one of the best‐selling herbal remedies in the United States. It has been implicated as an inducer of the P450 enzyme system, and as such, may cause increased metabolism of certain drugs, including oral contraceptives. Women using oral contraceptives have been warned against using St. John's wort. To date, there are some case reports but little clinical data demonstrating risk of contraceptive failure if they do. This article reviews available data and discusses theoretical reasons for concern about possible drug‐herb interactions.
THE PENICILLINS: A REVIEW AND UPDATE
Authors: Miller Elissa Lane 
Published: February 2003

ABSTRACTThe penicillin family is one of the most valuable groups of antibiotics in primary care. They are bacteriocidal, well distributed, and highly efficacious against susceptible organisms. Development of synthetic penicillins has both broadened the spectrum of activity and enhanced the efficacy of these medications. However, emergence of resistant bacterial strains has limited the usefulness of penicillins in recent years. Nonetheless, penicillins remain the drugs of choice for many mild, localized soft tissue infections and are particularly important in specific situations during pregnancy. History of penicillin allergy does not necessarily prohibit the use of penicillin. In patients with a self‐reported history of allergy, skin testing often fails to elicit signs of a true allergy to penicillin. Failure to prescribe penicillin for penicillin‐sensitive infections in these patients contributes to the development of bacterial resistance. This paper provides a review of the modes of action, spectrums of activity, adverse effects for the various classes of penicillin most often used in primary care and highlights clinical issues in managing women with penicillin allergy.
EARLY‐ONSET NEONATAL GROUP B STREPTOCOCCAL INFECTION: 2002 GUIDELINES FOR PREVENTION
Authors: Jolivet R. Rima 
Published: February 2003

ABSTRACTIn 1996, the Centers for Disease Control and Prevention (CDC) and relevant professional organizations jointly released guidelines for prevention of early‐onset neonatal group B streptococcal infections. The guidelines recommended that all obstetric providers and institutions providing intrapartum services follow one of two strategies. This year, on the basis of multistate surveillance data collected since prevention strategies were initiated, the CDC has released revised prevention recommendations. This article reviews the new guidelines and discusses clinical implications for practice in a variety of settings.
HLA‐DRB1*0403 is associated with dominant protection against IDDM in the general Dutch population and subjects with high‐risk DQA1*0301‐DQB1*0302/DQA1*0501‐DQB1*0201 genotype
Authors: Roep B.o. , Schipper R. , Verduyn W. , Bruining G.j. , Schreuder G.m.th. , De Vries R.r.p. 
Published: March 2003

Abstract:Insulin‐dependent (Type 1) diabetes mellitus (IDDM) is a genetically controlled T‐cell mediated autoimmune disease. Recently, subtyping of HLA‐DRB1*04 identified the HLA‐DRB1*0403 allele to be associated with protection in Caucasoids with the highest risk heterzygous genotype DQA1*0301‐DQB1*0302/DQA1*0501‐DQB1*0201. Some studies confirmed this finding, but other reports were not consistent with a dominantly protective trait. We here report the frequency of HLA‐DRB1*0403 in a large cohort (n=200) of Dutch patients with IDDM, their first‐degree family members (n=370), and random controls (n=420) of the general population in The Netherlands. We found that HLA‐DRB1*0403 is strongly associated with dominant protection against development of IDDM in unrelated subject, even in the context of the highest risk HLA‐DQ phenotypes and HLA‐DR4‐DQB1*0302 (P<0.0001).
OUR EARLY EXPERIENCE OF TACROLIMUS CONVERSION IN THE KIDNEY TRANSPLANTS
Authors: Moray G , Yağmurdur MC , Emiroğlu R , Başaran Ö , Haberal M 
Published: March 2003

Tacrolimus has been known as an effective immunosuppressive drug since 1987, and in our clinic we have used this agent since November 1999.Our transplantation team has performed 1359 kidney transplantations since 1975. Until November 1999, all of these recipients received a standard low‐dose triple‐drug immunosuppressive regimen of prednisolone, azathioprine, and cyclosporine A. Since November 1999, cyclosporine A was replaced by tacrolimus in 95 kidney recipients. In this study, our early results are analyzed.The mean follow‐up period after alteration of the immunosuppressive protocol was 12 (1–24) months. The mean time interval between the transplantation and the tacrolimus replacement was 34±11.4 months (1–158 months). Chronic allograft nephropathy in 16 (17%) patients, nephrotoxicity related to cyclosporine A in 22 (23%) patients and steroid‐resistant acute rejection in 57 (58%) were the indications of tacrolimus conversion. One acute‐rejection episode in 30 patients, two in 17, and three in 10 patients were observed before starting the tacrolimus. After the drug conversion, one acute rejection in 17 and two acute rejections in four patients were observed. Graft loss was seen in 15 (15%) patients after the drug conversion. Tacrolimus was withdrawn because of diabetes mellitus in seven patients, epilepsy in four, and severe Nocardia sepsis, lymphoma and Kaposi sarcoma in one patient each. Decreases of serum creatinin levels and also increases in blood glucose levels showed a statistically significant association with the tacrolimus doses (P=0.0004, P=0.04, respectively). The decrease in creatinin clearance values was closely related to the increase in tacrolimus levels. The target range with maximum efficacy and minimum toxicity seems to be 10–15ng/ml.Tacrolimus conversion can be successful in cases of rejection and nephrotoxicity, but dose‐dependent blood glucose elevations must be followed closely in these patients.
Pediatric cardiac transplant: Results using a steroid‐free maintenance regimen
Authors: Leonard H. , Hornung T. , Parry G. , Dark J.H. 
Published: March 2003

Abstract: We report on survival, rejection, lymphoma and renal function following cardiac transplant using a steroid‐free maintenance immunosuppressive regimen. We have performed 73 cardiac transplants in 71 children under 16 yr of age in the last 12 yr. There were eight perioperative and four late deaths giving actuarial survival of 88, 88, 85 and 70% at 1, 2, 5 and 10 yr, respectively. A total of 11 (15.3%) children had one episode of rejection (grade 3) in the first 6 months; one died and one was re‐transplanted because of rejection. There was only one episode of late rejection (8 yr post‐transplant) because of low drug levels in a patient with lymphoma and sepsis. This patient did not survive. Three other children (5.6%) also developed lymphoma and recovered but one died subsequently of graft failure. Four children have developed severe renal failure (glomerular filtration rate GFR <30 mL/min/m2). Two have not survived and one is expected to commence dialysis soon. The remainder have mild to moderate renal impairment. We report excellent survival and low rejection rates without use of long‐term steroids. However the doses of cyclosporin used have had a significant effect on renal function in many cases.
Adaptation of potassium translocation into the shoot of maize (Zea mays) to shoot demand: Evidence for xylem loading as a regulating step
Authors: Engels Christof , Marschner Horst 
Published: March 2003

In order to manipulate the shoot demand for mineral nutrients per unit root weight, maize (Zea mays L.) seedlings were grown in nutrient solution with different temperatures in the root zone and at the shoot base. The aerial temperature was kept uniform at 24/20°C day/night. At a root zone temperature (RZT) of 24°C, shoot growth was reduced by decreasing the shoot base temperature (SBT) to 12°C; at a RZT of 12°C, shoot growth was increased by raising the SBT to 24°C. At both RZT root growth was not affected by the SBT. Thus, the shoot demand for nutrients per unit root was either increased by raising, or decreased by lowering the SBT. The net uptake rate of potassium (K), as determined from accumulation rates between sequential harvests, was not affected within the first 3 days after lowering the SBT, whereas net translocation rates of K into the shoot and translocation rates in the xylem exudate of decapitated plants were markedly reduced. Obviously, translocation of K into the shoot seems to be regulated independently from K uptake into the root cells. Translocation rates of K in the xylem exudate of decapitated plants were markedly reduced when the nutrient solution was replaced by CaCl2 solution during exudation. But, depending on the SBT before decapitation, significant differences remained in the translocation rates of K even when K uptake from the nutrient solution was prevented.From the results it is suggested that xylem loading of K is regulated separately from K uptake from the external solution and that the adaptation of K translocation to shoot demand is coupled with an altered capacity of the root for xylem loading.
A comparative study on carbohydrate reserves and ethanolic fermentation in the roots of two wetland and non‐wetland species after commencement of hypoxia
Authors: Albrecht Gerd , Biemelt Sophia 
Published: March 2003

The problem of availability of storage carbohydrates (fructans and starch) in oxygen‐deficient roots was investigated in wetland species (Senecio aquaticus Hill., Myosotis palustris[L.] L. Em. Rchb.) and compared with related non‐wetland species (Senecio jacobaea L., Myosotis arvensis[L.] Hill.) with respect to ethanolic fermentation (PDC activity, ethanol production).In response to 24 h of hypoxic treatment, the pyruvate decarboxylase (PDC) activity in roots increased 4‐fold in M. arvensis and S. jacobaea, 2‐fold in S. aquaticus and only slightly in M. palustris. The rise in PDC activity was accompanied by an increase in ethanol content in the roots. The increase in ethanolic fermentation in roots of intact plants was associated with a slight increase in fructose and glucose and in a clear rise in sucrose content during the first 24‐48 h after commencement of the hypoxic treatment. Following 24 h of hypoxia, the content of fructans started to increase significantly for the duration of the experiment (9 days) in the four species. Since starch content changed only slightly during this period, the fructan:starch ratio increased under low energy availability. In the roots of flooding‐tolerant Senecio aquaticus, the ratio shifted most clearly from 2:1 in normoxia to 9:1 in hypoxia. For the roots of the two wetland species investigated, the results indicate a stronger accumulation of carbohydrates accompanied by a lower increase in PDC activity under root hypoxia, when compared with the related non‐wetland species respectively.
Reactivation of chronic Chagas’ disease following allogeneic bone marrow transplantation and successful pre‐emptive therapy with benznidazole
Authors: Altclas J. , Sinagra A. , Jaimovich G. , Salgueira C. , Luna C. , Requejo A. , Milovic V. , De Rissio A. , Feldman L. , Riarte A. 
Published: March 2003

Abstract:This report shows the early detection of reactivation of chronic Chagas’ disease (CCd) in a 27‐year‐old man with chronic myelogenous leukemia undergoing allogeneic bone marrow transplantation (ABMT). Pre‐emptive therapy with benznidazole during a period of 7 weeks led to a rapid recovery of the patient, who remains free of parasitemia 2 years after the bone marrow transplantation.
Microbiological diagnosis of invasive fungal infections in transplant recipients
Authors: Verweij P.E. , Meis J.F.G.M. 
Published: March 2003

Abstract:Invasive fungal infections remain an important cause of morbidity and mortality in transplant recipients. Since conventional diagnostic tools such as culture lack sensitivity and specificity, alternative diagnostic assays have been developed. Among the most promising techniques are the detection of fungal DNA and serology. Fungal DNA can be detected with high sensitivity and specificity when performed with specimens from sterile sites such as blood. Polymerase chain reaction (PCR) assays can be used to detect a broad range of fungal pathogens and combined with species identification. Multicenter diagnostic studies are needed to establish the diagnostic value of PCR but lack of standardization hampers such studies. The serodiagnosis of invasive fungal infections has become an important tool in the management of invasive fungal infections. Especially the detection of circulating galactomannan has been shown to be a sensitive marker for invasive aspergillosis. Both serology and PCR can be used to monitor the response to antifungal therapy. The optimal use of non‐culture‐based methods is in prospective screening of patients at high risk. Since the incidence of disease greatly influences the positive predictive value, screening should take place only in those patients at very high risk for invasive fungal disease.
Human granulocytic ehrlichiosis in a renal allograft recipient: review of the clinical spectrum of disease in solid organ transplant patients
Authors: Vannorsdall M.D. , Thomas S. , Smith R.P. , Zimmerman R. , Christman R. , Vella J.P. , Vannorsdall M.D. , Thomas S. , Smith R.P. , Zimmerman R. , Christman R. , Vella J.P. 
Published: March 2003

Abstract: Background. Ehrlichiosis is a recently described zoonotic infection with two major expressions: human granulocytic ehrlichiosis (HGE) and human monocytic ehrlichiosis (HME). The organisms associated with HGE and HME have been detected in a tick vector in several regions of United States and cases of ehrlichiosis have been reported in the general population. Methods. We report a case of HGE in a renal allograft recipient and review the clinical spectrum of disease in solid organ transplant recipients and the epidemiological basis for risk. Results. Our patient demonstrated the typical epidemiological, clinical and laboratory features of human granulocytic ehrlichiosis and responded to treatment with doxycycline. Conclusions. Human ehrlichiosis should be considered in the differential diagnosis of patients with solid organ transplants, who present with fever and thrombocytopenia. The incidence of ehrlichiosis in the solid organ transplant population is similar to that in the United States general population. As reported in immunocompetent patients, prompt diagnosis and treatment results in the rapid resolution of symptoms in transplanted individuals.
Cleft lip with or without cleft palate and dermatoglyphic asymmetry: evaluation of a Chinese population
Authors: Neiswanger K , Cooper ME , Weinberg SM , Flodman P , Keglovits A Bundens , Liu Y , Hu D‐N , Melnick M , Spence MA , Marazita ML 
Published: March 2003

Structured AbstractAuthors –Neiswanger K, Cooper ME, Weinberg SM, Flodman P, Bundens Keglovits A, Liu Y, Hu D‐N, Melnick M, Spence MA, Marazita MLObjective –To determine if Chinese individuals with non syndromic cleft lip with or without cleft palate (CL/P) display more dermatoglyphic asymmetry than unaffected relatives or controls.Design –Case – control study with two control groups (genetically related and unrelated).Setting and Sample Population –A total of 500 CL/P probands from Shanghai, China, 421 unaffected relatives, and 66 controls of Chinese heritage.Methods –Finger and palm prints were collected, and pattern frequencies, total ridge counts (TRC), and atdangles were calculated. Asymmetry scores between right and left hands were defined for each of the three dermatoglyphic measures. Probands' asymmetry scores were compared statistically with the scores of unaffected relatives and controls.Results –In general, the probands' asymmetry scores for TRC and atdangle did not differ significantly from the scores of either unaffected relatives or controls. However, probands with a positive family history of clefting showed significantly more asymmetry in their pattern types than either probands without a family history, unaffected relatives or controls.Conclusion –These results suggest that a unique genetic mechanism of developmental instability may obtain in CL/P individuals with a positive family history of clefting.
Distribution of fibroblast growth factors (FGFR‐1 and ‐3) and platelet‐derived growth factor receptors (PDGFR) in the rat mandibular condyle during growth
Authors: Visnapuu V , Peltomäki T , Rönning O , Vahlberg T , Helenius H 
Published: March 2003

Structured Abstract
Authors –
Visnapuu V, Peltomäki T, Rönning O, Vahlberg T, Helenius H
Objectives –
To elucidate the role of the fibroblast growth factors 1 and 3 (FGFR‐1, ‐3) and the platelet derived growth factor (PDGFR) in the growth of the mandibular condylar cartilage in the rat.
Setting and sample population –
Institute of Dentistry and Department of Biostatistics, University of Turku, Turku, Finland. The material consisted of 1‐ to 21‐day‐old Long–Evans/Turku rats (total of 24 animals, three in each age group).
Design – An immunohistological in vivo study combined with histomorphometry and biostatistical analysis.
Experimental variable – The animals were killed with an overdose of carbon dioxide and thereafter decapitated. Heads were fixed in 4% paraformaldehyde, decalcified in 12.5% ethylenediaminetetraacetic acid, cut sagittally into two halves and sectioned sagittally at 6 μm. In order to detect FGFR‐1, ‐3 and PDGFR the sections were treated with H2O2/methanol (1:100), after which FGFR‐1 and PDGFR monoclonal and FGFR‐3 polyclonal antibodies were applied. The reaction products were visualized by using the Vectastain ABC Elite Kit using peroxidase substrate kit DAB as substrate. Negative and positive controls were also prepared. The sections were counterstained with hematoxylin.
Outcome measure –
In order to measure the depth of the cell layer labeled with FGF‐1, ‐3 and PDGF receptors, the condylar head was divided into four regions: anterior, superior, posterosuperior and posterior. The measurements were made perpendicular to the articular surface using a computerized image analysis system, the images being acquired by means of a microscope connected to a CCD camera. The mean of five equally distributed measurements of each region was used to indicate the depth of the cell layers secreting the receptors. Regression analysis was used to evaluate the association between the depth of the labeled cell layer in relation to total depth of the condylar head, as a function of age.
Results –
Our results show that the depth of the cell layer labeled for FGFR‐1, ‐3 and PDGFR increase significantly as a function of age in the mandibular condylar head of rats.
Conclusion –
Increase in the cell layer labeled for FGFR‐1, ‐3 and PDGFR occurs during the stage when the articular function of the mandibular condyle intensifies. FGFR‐1, ‐3 and PDGFR evidently have an important role in the growth regulation of the condylar cartilage during the most rapid growth period in the rat.
Elemental sulphur and alkali elutable melanin detected in oral melanosis and malignant melanoma by energy‐filtering transmission electron microscopy
Authors: Nagai Noriyuki , Lee You‐Jin , Nagaoka Noriyuki , Gunduz Mehmet , Nakano Keisuke , Nojima Tetsundo , Tsujigiwa Hidetsugu , Gunduz Esra , Siar Chong Huat , Nagatsuka Hitoshi 
Published: March 2003

AbstractBackground:  The morphology and contents of melanosomes are important features for differentiating melanocyte‐derived melanotic lesions such as melanosis and malignant melanoma.Methods:  In this study, we attempted to elucidate the structure of melanin and sulphur content in oral melanosis and malignant melanomas by ultrastructural analysis.Results:  In oral melanosis, the essential pathological findings were overproduction of eumelanin and discharge of melanin into keratinocytes. In malignant melanoma in situ, pleomorphic and ellipsoid abnormal melanosomes with an increase in sulphur content and alkali elution rate were detected. In invasive malignant melanoma, the irregular ellipsoid and spheroid melanosomes existing either as discrete bodies or compound melanosomes with furtherly increased sulphur content and alkali elution were detected.Conclusions:  Our findings suggest that abnormal melanosome morphology and high sulphur content are predictive markers for assessment of early or precancerous melanotic lesions and malignant melanoma.
Immunohistochemical analysis of inducible nitric oxide synthase (iNOS) and heat shock proteins (HSPs) in ameloblastomas
Authors: Kumamoto Hiroyuki , Suzuki Takahiro , Ooya Kiyoshi 
Published: March 2003

AbstractBackground:  To clarify the possible role of nitric oxide (NO) and stress proteins in oncogenesis and cytodifferentiation of odontogenic epithelium. Inducible NO synthase (iNOS) and heat shock proteins (HSPs) were analyzed in ameloblastomas as well as in tooth germs.Methods:  Specimens of seven tooth germs, 36 benign ameloblastomas and five malignant ameloblastomas were examined by immunohistochemistry using antibodies against iNOS and 27‐, 60‐ and 70‐kDa HSPs (HSP27, HSP60 and HSP70).Results:  Immunoreactivity for iNOS was detected in normal and neoplastic odontogenic epithelial cells and was higher in malignant ameloblastomas than in tooth germs and benign ameloblastomas. HSP27 was expressed constitutively in all odontogenic epithelial cells in tooth germs and benign and malignant ameloblastomas. Expression of HSP60 and HSP70 was detected in normal and neoplastic odontogenic epithelial cells and was prominent in cells neighboring the basement membrane. HSP60 reactivity showed no apparent difference between normal and neoplastic odontogenic epithelium, whereas HSP70 expression was slightly higher in benign and malignant ameloblastomas than in tooth germs.Conclusions:  Activation of iNOS might be associated with malignant potential of epithelial odontogenic tumors. Elevated expression of HSP70 is considered to be involved in neoplastic transformation of odontogenic epithelial cells.