bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liquid chromatography–Atmospheric pressure chemical ionisation/Mass spectrometry: a rapid and selective method for the quantitative determination of ginkgolides and bilobalide in ginkgo leaf extracts and phytopharmaceuticals
Authors: Jensen Anette Gemal , Ndjoko Karine , Wolfender Jean‐Luc , Hostettmann Kurt , Camponovo Fabrizio , Soldati Fabio 
Published: August 2002

AbstractIn order to evaluate the composition of active constituents in phytopharmaceutical preparations, valid analytical methods are required. For the determination of the active terpene constituents of Ginkgo biloba (the ginkgolides and bilobalide), a liquid chromatography–mass spectrometry (LC‐MS) method has been developed using atmospheric pressure chemical ionisation (APCI) in the negative ion mode. This detection mode was found to be much more sensitive and selective compared to UV; indeed the ginkgo terpene trilactones lack strong UV chromophores and flavonoids interfere with their UV detection. LC‐APCI/MS detection allowed a considerable reduction in analysis time when compared to LC‐UV, because LC resolution was only needed between the pair of isomers ginkgolide B and ginkgolide J. All compounds were selectively detected by single ion monitoring of their specific deprotonated molecules [M‐H]−. The samples were directly injected without pre‐purification, and a fast gradient was applied, reducing the total time of analysis to 14 min. With this method, the ginkgo terpene trilactones were detected on‐line in the picogram range. Several commercial ginkgo preparations on the Swiss market were analysed, and the ginkgolide and bilobalide contents were evaluated using the method described. Copyright © 2001 John Wiley & Sons, Ltd.
Reliability of prenatal sonographic lung biometry in the diagnosis of pulmonary hypoplasia
Authors: Heling Kai‐Sven , Tennstedt Cornelia , Chaoui Rabih , Kalache Karim D. , Hartung John , Bollmann Rainer 
Published: August 2002

AbstractObjectiveThe purpose of the present study was to assess the value of biometric lung measurements for the diagnosis of severe fetal pulmonary hypoplasia by investigating whether a significant correlation between two‐dimensional lung biometry measurements and autopsy findings could be established.MethodsThis was a prospective study carried out between 1995 and 1997. Nomograms for normal fetuses of the arterior–posterior and transverse inner thoracic diameters, which describe the growth and shape of the lung, were used as a basis for diagnosis of pulmonary hypoplasia in fetuses at high risk of developing the condition (the fetuses had bilateral renal agenesis or multicystic kidneys; chronic PROM <25 gestational weeks or hydrothorax). Pregnancy was terminated by abortion or intrauterine death in 29/43 high‐risk fetuses and autopsies were performed. Only the 29 fetuses for which there were autopsy findings were included in the study.ResultsThe best plane for diagnosing pulmonary hypoplasia was the four‐chamber view. The diagnostic accuracy for this view as expressed by the sensitivity was 57% for the anterior–posterior diameter and 44% for the transverse diameter; as expressed by the specificity it was 42% for the anterior–posterior diameter and 50% for the transverse diameter. The results for the four‐chamber view for the various high‐risk conditions were as follows: for fetuses with chronic PROM we obtained sensitivities of 75% and 50% (anterior–posterior and transverse dimensions, respectively) and specificities of 80% and 60% (anterior–posterior and transverse dimensions, respectively). The sensitivities of lung biometry in fetuses with hydrothorax were 1% and 80% for the two diameters, but there was a low specificity. In fetuses with bilateral renal agenesis or multicystic kidneys we obtained sensitivities of 36% and 30% (anterior–posterior and transverse dimensions, respectively) and a specificity of 50% (anterior–posterior dimension).ConclusionsThe pesent results show that two‐dimensional lung biometry is not a suitable method for antenatal detection of pulmonary hypoplasia. However, in individual cases with high risk for pulmonary hypoplasia, lung biometry might prove to be an additional diagnostic parameter. Copyright © 2001 John Wiley & Sons, Ltd.
Prenatal diagnosis of a homologous Robertsonian translocation involving chromosome 15
Authors: Abrams Debra J. , Aronoff Amy R. , Ann Berend Sue , Roa Benjamin B. , Shaffer Lisa G. , Geier Mark R. 
Published: August 2002

AbstractWe report the prenatal diagnosis of a fetus with a de novo Robertsonian translocation: 45,XY,der(15;15)(q10;q10). Although Robertsonian translocations are common chromosomal rearrangements, those involving homologous chromosomes are infrequent. Since chromosome 15 is imprinted, uniparental disomy (UPD) is a concern when chromosomal rearrangements involving chromosome 15 are identified. In the present case, UPD studies showed normal biparental inheritance. In contrast to the fact that most homologous acrocentric rearrangements are isochromosomes, these results indicate postzygotic formation of a Robertsonian translocation between biparentally inherited chromosomes 15. Copyright © 2001 John Wiley & Sons, Ltd.
Clinical outcome of treatment cycles using preimplantation genetic diagnosis for structural chromosomal abnormalities
Authors: Fridström Margareta , Ährlund‐Richter Lars , Iwarsson Erik , Malmgren Helena , Inzunza José , Rosenlund Björn , Sjöblom Peter , Nordenskjöld Magnus , Blennow Elisabeth , Hovatta Outi 
Published: August 2002

AbstractObjectivesTo explore oocyte recovery, embryo quality, the number of transferable embryos and pregnancy rate after preimplantation genetic diagnosis (PGD) in patients with structural chromosomal aberrations.MethodsPGD was performed in seven couples with Robertsonian translocations (Rob), eight couples with reciprocal translocations (Rec), two couples with inversions and one couple with a deletion. A total of 43 treatment cycles were carried out.ResultsA total of 14.2 oocytes per cycle were retrieved. Fertilisation and cleavage rates were 63% and 58%, respectively. Of the biopsied embryos 20% were transferable. Comparison of the Rob and Rec group revealed no significant differences in number of oocytes, fertilisation or cleavage rates. The number of transferable embryos after biopsy was significantly higher in the Rob group than in the Rec group. When embryo transfer (ET) was performed the pregnancy rate did not differ between the Rob and the Rec groups. Twenty‐eight embryo transfers (one or two embryos) were carried out leading to eight clinical pregnancies (29% per ET): two twins, four singletons, one miscarriage and one ectopic pregnancy. All the children are carriers of balanced chromosomal aberrations.ConclusionAn acceptable pregnancy rate can be achieved among couples with structural chromosomal abnormalities. Copyright © 2001 John Wiley & Sons, Ltd.
Heterogeneity in fetal akinesia deformation sequence (FADS): autopsy confirmation in three 20–21‐week fetuses
Authors: Yfantis H. , Nonaka D. , Castellani R. , Harman C. , Sun C.‐C. 
Published: August 2002

AbstractFetal akinesia deformation sequence (FADS) is a rare condition characterized by intrauterine growth retardation (IUGR), congenital limb contractures, pulmonary hypoplasia, hydramnios and craniofacial abnormalities. The present report comprises an autopsy study of three fetuses to illustrate the variable clinical manifestations and neuropathological findings. Fetus 1 had arthrogryposis and no movement on fetal ultrasound examination. Aborted at 21 weeks, the fetus showed micrognathia, bilateral joint contracture with pterygia at the elbow and axilla. Growth retardation and pulmonary hypoplasia were not major features. Neuropathologic examination revealed anterior horn cell loss and lateral corticospinal tract degeneration in spinal cord, with marked muscular atrophy. Fetus 2, 20 weeks' gestation, had fetal akinesia, nuchal thickening, left pleural effusion, and Dandy‐Walker malformation on ultrasound examination. Autopsy showed low‐set ears, ocular hypertelorism, cleft palate, flexion contractures with pterygia over axilla, elbow and groin, pulmonary hypoplasia, Dandy‐Walker malformation, unremarkable spinal cord and skeletal muscle. Fetus 3, 21 weeks' gestation, was aborted for fetal akinesia, neck and limb webbing and severe arthrogryposis. At autopsy, similar facial abnormalities, contracture and pterygia in neck and multiple major joints were found. Borderline pulmonary hypoplasia and severe lumbar scoliosis were also present. The brain, spinal cord and muscle were unremarkable.In these three fetuses, the prenatal ultrasound and autopsy findings were characteristic of FADS. Neurogenic spinal muscular atrophy was the basis of fetal akinesia in Case 1. Dandy‐Walker malformation was present in Case 2, but the pathogenetic mechanism of fetal akinesia was not clear as spinal cord and muscle histology appeared normal. The etiology of akinesia was undetermined in Case 3; no extrinsic or intrinsic cause was identified. Copyright © 2002 John Wiley & Sons, Ltd.
Accuracy of Down syndrome risks produced in a first‐trimester screening programme incorporating fetal nuchal translucency thickness and maternal serum biochemistry
Authors: Spencer Kevin 
Published: August 2002

AbstractOver the past three years approximately 12 000 women have been screened in the first trimester through our OSCAR programme, which utilizes fetal NT and maternal serum free β‐hCG and PAPP‐A. During this time 30 cases of Down syndrome were identified either prenatally or postnatally. Using an established procedure the accuracy of predicted risk for Down syndrome was assessed in a population of 30 cases of Down syndrome and 11 758 unaffected pregnancies. The correlation between predicted risk and prevalence of Down syndrome was very high (r=0.9995). It is concluded that risks produced by the Fetal Medicine Foundation combined risk algorithm agree very closely with Down syndrome prevalence and can be used with confidence when counselling women of their risk. Copyright © 2002 John Wiley & Sons, Ltd.
Prenatal diagnosis of congenital nephrosis by in utero kidney biopsy
Authors: Wapner Ronald J. , Jenkins Thomas M. , Silverman Neil , Kaufmann Marion , Hannau Cheryl , McCue Peter 
Published: August 2002

AbstractThe diagnosis of congenital nephrosis is difficult during the antepartum period. The combination of an elevated amniotic fluid alpha‐fetoprotein, a negative acetylcholinesterase, and a negative ultrasound examination is highly indicative of congenital nephrosis; however, these findings can also be associated with a normal gestation. This is the first report of pathologic confirmation of congenital nephrosis from an in utero fetal kidney biopsy. Copyright © 2001 John Wiley & Sons, Ltd.
Prenatal detection of free sialic acid storage disease: genetic and biochemical studies in nine families
Authors: Salomäki Pirjo , Aula Nina , Juvonen Vesa , Renlund Martin , Aula Pertti 
Published: August 2002

AbstractSialic acid storage disorders, Salla disease (SD) and a severe infantile form of disease (ISSD), are recessively inherited allelic lysosomal storage disorders due to impaired egress of free sialic acid from lysosomes. Fourteen pregnancies at risk of adult‐type free sialic acid storage disease, SD, were monitored by sialic acid assays, genetic linkage or mutation detection analyses using chorionic villus samples. Three affected and 12 unaffected fetuses were identified. The first studies were based on the sialic acid assays alone, but the location of the gene enabled the use of genetic linkage analysis and, more recently, the identification of the SLC17A5 gene and disease‐causing mutations added yet another possibility for prenatal studies. A missense mutation 115C→T (R39C) is present in 95% of all Finnish SD alleles, providing an easy and reliable means of diagnostic studies. Both molecular and biochemical (sialic acid assay) studies can be used for prenatal diagnosis of free sialic acid storage diseases. Copyright © 2001 John Wiley & Sons, Ltd.
Caribbean people's health beliefs about the body and their implications for diabetes management: a South London study
Authors: Scott Penelope 
Published: August 2002

AbstractThis article presents the findings of a study into Caribbean people's health beliefs about the body and their body related health practices in diabetes management. The study used quantitative and qualitative methods to explore these beliefs and practices, as well as those relating to food and eating and health and disease, among 80 people with diabetes and 80 people who did not have the disease. The findings showed that the sample had distinctive beliefs about blood and having ‘washouts’, i.e. taking laxatives, and some also observed fasts for various reasons. As regards weight management, having a ‘normal’ BMI was associated with health and attractiveness and there was no evidence that being large in size was culturally valued. The vast majority were unaware, however, of the relationship between obesity and the potential onset of diabetes. The implications of these health beliefs and practices for patient education are also discussed. Copyright © 2001 John Wiley & Sons, Ltd.
Impact of diabetes mellitus on Sudanese women
Authors: Mohamed Ahmed Awad , Hussein Abashar , Mohamed Kheir Musa , Hassan Ahmed Nada 
Published: August 2002

AbstractAs there are increasing numbers of Sudanese women with diabetes, there is a great need for investigating the gender‐specific factors in presentation or management of this disease. We studied 150 diabetic non‐pregnant women who attended a medical clinic in Khartoum in July 1999–January 2000. The mean age was 45.3 years, 126 (84%) had type 2 diabetes, the mean duration of diabetes was 7.3 years, 58.6% of patients were poorly controlled and there was a lack of diabetic knowledge among them. Our patients were of poor physical activity, and 28% of them were obese. They were poorly adherent to diet or treatment. The patients were, generally, illiterate (58.6%) and lacking professional skills (78.7%), and 38% were unmarried or divorced. Our patients reported marital and sexual problems, poor performance at home or work and lack of family support. The young patients were worried about their academic achievement and chances of marriage. Our diabetic women, in our society, suffer a gender‐related impact of diabetes in addition to the disease itself. Management protocols tailored for diabetic women are needed. Copyright © 2001 John Wiley & Sons, Ltd.
Changes in the care of the diabetic foot: part one
Authors: Foster A 
Published: August 2002

AbstractKeypoints

The diabetic foot remains an enormous public health problem despite modern advances in foot care.
There is a lack of evidence for many diabetic foot interventions: however, there is consensus between experts that a multi‐disciplinary spproach helps reduce amputations.
Diabetic amputations are on the increase.

Copyright © 2001 John Wiley & Sons, Ltd.
Does opportunistic screening for diabetic retinopathy result in timely and appropriate referral?
Authors: Prasad S. , Jones W.A. , Jones K. , Kamath G.G. , Bowen‐Jones D. , Phillips R.P. 
Published: August 2002

AbstractAimsWe studied the quality of opportunistic screening for diabetic retinopathy, which existed in the absence of a formal screening programme.MethodsPatients referred during the period from June 1992 to May 1997 were identified. The findings and outcome at first ophthalmic consultation were used as surrogate measures to determine the appropriateness of referral. We considered patients to have had sight‐threatening retinopathy (STDR) if laser treatment or fluorescein angiography was recommended, or follow‐up at 6 months or less was arranged. Patients whose fundi could not be visualised were also included in the STDR group.ResultsTwo hundred and eighty‐nine case records were available for analysis; 190 of these (65.7%) were considered to have STDR and 41 (14.2%) had other pathology, without concurrent diabetic retinopathy. The agreement between the referrer's diagnosis and the diagnosis made by the ophthalmologist was only fair, when comparing major diagnostic categories (kappa 0.35, 95% CI 0.30–0.41) and also for grading of retinopathy (kappa 0.30, 95% CI 0.23–0.37).ConclusionsOur findings suggest that opportunistic screening can identify retinopathy only at a late stage. Our data should be valuable in measuring the benefits of formal screening for diabetic retinopathy as compared to previously existing services. Copyright © 2001 John Wiley & Sons, Ltd.
Time to reflect – what makes a difference in diabetes care?1
Authors: Avery Lorraine 
Published: August 2002

AbstractDiabetes care is constantly evolving in response to new developments, innovative research, and the national agenda. The development of new technical advances, such as pen devices and glucose monitors, as well as the implementation of new working practices, has led to significant improvement in the management of diabetes. If, however, too much emphasis is placed on the advantages offered by these new advances, it is often easy to overlook or fail to recognise what makes a real difference to patients in the self‐management of diabetes. It is, therefore, essential to constantly reappraise and develop the provision of diabetes care, to ensure the best possible service for patients. The diabetes nurse specialist (DNS) plays a major part in shaping the future of diabetes care. How changes in care are translated into tangible benefits for patients depends largely on the dedication and commitment of the DNS, whose important role in the planning and implementation of diabetes care continues to increase and expand. The role of the DNS extends much further than simply providing medical care. DNSs are key contributors both to patient education and in ensuring that help and support is available to enable patients to feel more confident about managing their diabetes. Copyright © 2001 John Wiley & Sons, Ltd.
The ethical issues of the postmarketing surveillance of drug teratogenicity in Hungary
Authors: Czeizel Andrew E. 
Published: August 2002

AbstractPurposeTo discuss some ethical issues of the postmarketing surveillance of drug teratogenicity.MethodsTo describe the three study groups of the Hungarian Case–Control Surveillance of Congenital Abnormalities with the three sources of data collection.ResultsThis large population‐based surveillance system comprised 22 843 cases with congenital abnormalities, 38 151 population controls without congenital abnormalities and 834 patient controls with Down syndrome between 1980 and 1996. The major ethical issue is connected with personal data protection (confidential handling of data and informed consent). However, the Hungarian experiences displayed the ethical dilemma between the balance of individual and community rights and interest (mandatory notification, mandatory autopsy of infant deaths, personal identification number). Finally the medical consequences of publication bias at the evaluation of drug teratogenicity are presented as these also have some ethical aspects.ConclusionThe ethical issues of postmarketing surveillance of drug teratogenicity show similarities with general epidemiological research but this public health system also has some special aspects. Copyright © 2001 John Wiley & Sons, Ltd.
Ethical issues arising in pharmacoepidemiologic research in a community hospital in Crete, Greece
Authors: Tzimis Leonidas 
Published: August 2002

AbstractThis paper presents the various issues encountered in planning, designing, performing, and reporting pharmacoepidemiologic research. Five hundred and fifty‐one indigent patients insured by Social Care visited the Hospital Pharmacy of Chania General Hospital, and were compared with 551 patients insured under Social Security funds who visited three community pharmacies. The study had no external funding. Before we started the study, we officially sought approval from the Scientific Committee of our Hospital and from the local Pharmaceutical Association. We asked also for approval from the Medical School of the University of Crete. Patient privacy was of great concern in the design and performance of the study. The law in Greece, according to the directives of the European Union, affects the way we use records in hospitals and protect patient rights. After these studies were completed, we made proposals to the authorities concerning continuous health education for both patients and health workers. Pharmacoepidemiologic research is difficult in hospitals outside universities or institutions, because of the lack of adequate funding and grants to support research staff. Copyright © 2001 John Wiley & Sons, Ltd.
Drug epidemiology in Italy: methods and ethical issues. The example of psychiatry
Authors: Barbui Corrado 
Published: August 2002

AbstractPurposeThese notes aim at analysing current methods, ethical issues and major legislation changes related to drug epidemiology in Italy.MethodsThe design and conduct of two pharmacoepidemiological surveys carried out in the context of recent law dispositions on psychiatric care and confidentiality are presented.ResultsIn 1978 law 180 stated that no more patients had to be admitted to psychiatric hospitals, and no more psychiatric hospitals had to be built. Chronic long‐stay patients were allowed to remain in hospitals. In 1994, however, financial law 724 established a deadline for the final closure of Italian psychiatric hospitals. A survey of more than 1000 patients living in eight state psychiatric hospitals was carried out to describe the social and clinical characteristics of the inpatient population and to monitor their community placement. In 1996 law 675 established that private and confidential information could not be used for any purpose without the patient's informed consent. However, this law was not implemented that year. A survey of benzodiazepine use among general practice patients was conducted without written informed consent.ConclusionsThe Italian legislation has been changing for some years, and regulations might still be modified in the near future. To increase ethical practices in pharmacoepidemiology scientists and clinical researchers should guarantee high standards in terms of research objectives, design and analyses. Potential conflict of interest should always be declared. Copyright © 2001 John Wiley & Sons, Ltd.
Precautions for proactive surveillance
Authors: Walker Alexander M. , Wise Robert P. 
Published: August 2002

AbstractFour barriers confront the architects and users of surveillance systems. Bonferroni's Bind blunts our ability to act on real safety signals when the surveillance scheme is capable of producing realistic but wrong signals just by chance. The paradox of definitive data is that the results of a truly comprehensive scheme become untestable because there is no further relevant information to be had. Flexible priors augment the first two barriers by intensifying our instinctive cautions, and by giving almost any claim the appearance of empiric proof. The poverty of tabular summaries is that they presuppose the existance of relevant categories for tabulation, and that they fail to persuade. The resolution for proactive surveillance is sen/cen: high sensitivity to signals and vigorous censoring to filter out the noise. Copyright © 2001 John Wiley & Sons, Ltd.