bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV‐infected mothers
Authors: Poggensee Gabriele , Schulze Katja , Moneta Ilaria , Mbezi Paulina , Baryomunsi Chris , Harms Gundel 
Published: April 2004

SummaryCurrent infant feeding guidelines of UNICEF/UNAIDS/WHO for HIV‐infected women recommend the avoidance of breastfeeding or to breastfeed exclusively. In the context of a prevention of HIV mother‐to‐child transmission programme we assessed the feeding practices in peripheral areas of Tanzania and Uganda. A total of 237 mothers in south‐western Tanzania and 424 mothers in western Uganda attending urban and rural antenatal care services as well as village women were interviewed with regard to duration of breastfeeding, time of introduction of additional nutrients and type of solid and liquid nutrients. The average reported duration of breastfeeding was 24 months in Tanzania but 18 months in Uganda (P < 0.001). Solid nutrients were added on average at month 6 in both areas while liquids were given significantly earlier in Tanzania (month 4) than in Uganda (month 5; P < 0.001). A total of 19% and 48% of the study participants, respectively, stated to breastfeed their infants exclusively at the age of 4 months in Tanzania and Uganda. Age between 26 and 35 years, urban residence and ethnic group were the risk factors for earlier introduction of nutrients in Uganda. In Tanzania, solid maize porridge was the most frequent (94%) and often single nutrient given during breastfeeding, while in Uganda combinations of nutrients such as bananas, millet and beans were used. Milk was the most frequently added fluid in Uganda whereas in Tanzania various liquids such as liquid maize porridge, milk, juice or water were used. Feeding practices differed considerably in the two countries. According to the interviewees, exclusive breastfeeding was rarely practiced in Tanzania. Our findings underline the necessity to promote exclusive breastfeeding if infant feeding recommendations are to be realized and emphasize the need to assess the local situation in order to ensure that locally appropriate information and recommendations are given to the target groups.
Spatial and temporal analysis of the distribution of hantavirus pulmonary syndrome in Buenos Aires Province, and its relation to rodent distribution, agricultural and demographic variables
Authors: Busch M. , Cavia R. , Carbajo A. E. , Bellomo C. , Gonzalez Capria S. , Padula P. 
Published: April 2004

SummaryWe studied the spatial and temporal distribution of Hantavirus Pulmonary Syndrome (HPS) cases from 1998 to 2001 in the Buenos Aires Province, Argentina. HPS is a severe viral disease whose natural reservoir are rodents of the subfamily Sigmodontinae (Muridae) and which occurs in many countries of South and North America. We considered two spatial arrangements: cells of 18.5 × 18.5 km2; and departments, the political subdivisions of the province, as spatial units. We tested the departure from a Poisson distribution of the number of cases per cell and per month with the Variance/Mean index, while the interaction between spatial and temporal clustering was tested by means of the Knox and Mantel tests. We constructed probability maps in which the HPS rates per department were considered Poisson variates according to population, area and the product of population and area. We analysed the relation between rodent distribution, environmental and demographic variables and HPS cases conducting preliminary univariate analysis from which we selected variables to enter in general linearized models. We found that both the spatial and temporal distribution of cases is strongly aggregated. The spatiotemporal interaction appears to be related to a strong seasonality and the existence of particular ecological conditions rather than epidemic transmission of the disease. The main explanatory variables for the distribution of HPS cases among the departments of the Buenos Aires Province were human population, the distribution of the rodent Oxymycterus rufus and evapotranspiration. The last two variables are probably indicators of favourable ecological conditions for the reservoirs, which encompass other variables not taken into account in this study.
Maternal anaemia and its impact on perinatal outcome
Authors: Lone Farah Wali , Qureshi Rahat Najam , Emanuel Faran 
Published: April 2004

SummaryObjective  To find out the relationship between maternal anaemia and perinatal morbidity and mortality.Method  A cohort of 629 pregnant women was studied from October 2001 to October 2002. Of these, 313 were anaemic (haemoglobin <11 g/dl in labour and on two previous occasions in current pregnancy). A total of 316 women had haemoglobin >11 g/dl at all times in pregnancy and were labelled as non‐anaemic. Perinatal outcomes included preterm delivery, low birth weight (LBW) at delivery, intrauterine growth restriction, perinatal mortality, APGAR score at 1 and 5 min, intrauterine foetal demise (IUD).Results  The risk of preterm delivery and LBW among exposed group was 4 and 1.9 times higher among anaemic women, respectively. Newborns of anaemic mothers had 1.8 times increased risk of having an APGAR score of <5 at 1 min and the risk of IUD was 3.7 times higher for anaemic women.Conclusion  Low maternal haemoglobin levels are associated with increased risk of preterm delivery, LBW babies, APGAR score <5 at 1 min and IUD.
Propranolol alone may not be acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients: Randomized controlled trial
Authors: TOMIKAWA MORIMASA , SHIMABUKURO RINSHUN , OKITA KEISHI , TSUTSUMI NORIFUMI , AKAHOSHI TOMOHIKO , HASHIZUME MAKOTO , SUGIMACHI KEIZO 
Published: April 2004

AbstractBackground and Aim:  In Japan, endoscopic injection sclerotherapy (EIS) is widely used to prevent first esophageal variceal bleeding, in contrast to pharmacological therapy which is the main treatment used in the rest of the world. The present study investigated if propranolol alone is acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients. This was compared with EIS.Methods:  Twenty‐five Japanese cirrhotic patients with endoscopically proven, likely to bleed esophageal varices were randomly assigned for propranolol administration (12 patients; group A) and EIS (13 patients; group B) to prevent first esophageal variceal bleeding. Complications, non‐recurrence rate, bleeding rate and probability of survival were compared between the two groups.Results:  One patient in group A had severe bradycardia with loss of consciousness that seriously worsened his quality of life. The cumulative non‐recurrence rate of group A was significantly lower compared with that of group B (P < 0.05). In group A, 2 of the 12 patients requested to discontinue taking propranolol and were excluded from the trial. The EIS treatment (group B) showed excellent results. No patient in group A or group B bled from esophageal varices throughout this study. The two groups showed no statistically significant differences in probability of survival.Conclusions:  Propranolol alone may not be acceptable to prevent first esophageal variceal bleeding in Japanese cirrhotic patients.
Increased expression of transforming growth factor‐alpha and epidermal growth factor receptors in rat chronic reflux esophagitis
Authors: FUJIWARA YASUHIRO , HIGUCHI KAZUHIDE , HAMAGUCHI MASAKI , TAKASHIMA TAKASHI , WATANABE TOSHIO , TOMINAGA KAZUNARI , OSHITANI NOBUHIDE , MATSUMOTO TAKAYUKI , ARAKAWA TETSUO 
Published: April 2004

AbstractBackground and Aim:  Transforming growth factor‐alpha (TGF‐α), which binds to epidermal growth factor receptors (EGF‐R), stimulates esophageal epithelial cell proliferation, enabling rapid repair after mucosal injury. The aim of the present study was to examine epithelial proliferation and dynamics of TGF‐α and EGF‐R gene and protein expression in rat chronic acid reflux esophagitis.Methods:  Gastric acid reflux esophagitis was induced in Wistar rats by ligating the transitional region between the forestomach and the glandular portion, and by covering the duodenum near the pyloric ring with a small piece of an 18Fr Nélaton catheter. Epithelial cell proliferation was assessed by bromodeoxyuridine (BrdU) uptake. Expression of TGF‐α and EGF‐R mRNA and protein was assessed by reverse transcription‐polymerase chain reaction (RT‐PCR) and immunohistochemistry.Results:  Esophageal lesions were observed in the lower and middle esophagus. Histologically, a significant increase in mucosal thickening with elongation of lamina propria papillae and basal cell hyperplasia was observed. The BrdU labeling index was significantly increased from 2.7 ± 1.0 in normal mucosa and 2.8 ± 1.2 in background mucosa adjacent to the esophageal lesion, to 60.3 ± 32.7 in the lesions of chronic esophagitis. Expression of TGF‐α and EGF‐R mRNA in the esophageal lesion significantly increased compared to those in the control and background tissue, whereas treatment with rabeprazole significantly inhibited increases in TGF‐α and EGF‐R mRNA expression. According to immunohistochemical study, TGF‐α and EGF‐R revealed strong expression in esophageal lesions compared with control and background mucosa. The superficial layer of the esophagus was strongly positive for TGF‐α and most cells in regions of basal hyperplasia had a positive reaction for EGF‐R in the esophagitis lesion.Conclusion:  Epithelial proliferation and expression of TGF‐α and EGF‐R were significantly increased in rat chronic reflux esophagitis. Activation of TGF‐α and EGF‐R genes in response to acid reflux may facilitate rapid mucosal healing by stimulating epithelial proliferation. These results suggest that TGF‐α and EGF‐R play crucial roles in rat chronic reflux esophagitis.
Evaluation of esophageal varices using contrast‐enhanced coded harmonic ultrasonography
Authors: TAMANO MASAYA , YONEDA MASASHI , KOJIMA KAZUO , HASHIMOTO TAKASHI , MUROHISA TOSHIMITSU , MAJIMA YUICHI , KUSANO KOJI , NAKAMURA TETSUYA , SUGAYA HITOSHI , TERANO AKIRA 
Published: April 2004

AbstractAim:  To investigate if esophageal varices can be evaluated using external contrast‐enhanced ultrasonography with Levovist and coded harmonic angio (CHA).Methods:  Subjects were six healthy adult volunteers and 23 patients with liver cirrhosis. After identification of the lower esophagus under B‐mode scanning, 300 mg/mL of Levovist was intravenously injected into the cubital vein at a rate of 1 mL/s under observation by CHA‐mode scanning. Approximately 30 s after intravenous administration, interval‐delay scanning was performed every second to visualize the area around the lower esophageal lumen. The degree of ultrasonographic enhancement was assessed as either no enhancement (negative); linear enhancement along the esophageal wall (weak) or full enhancement of the esophageal lumen (strong). Endoscopic evaluation of esophageal varices was also performed.Results:  The CHA enhancement around the lower esophageal lumen was identified in 21 of the 23 patients. Of these 21 patients, endoscopic assessments of varices were as follows: F0 in four patients, F1 in seven patients, F2 in three patients, and F3 in seven patients. Nine patients were red color sign (RCS)‐positive. Regarding the relationship between ultrasonographic enhancement and endoscopic assessment, enhancement was identified as negative in all four F0 patients, negative in three and weak in three and strong in one of the seven F1 patients, weak in one and strong in two of the three F2 patients, and weak in two and strong in five of the seven F3 patients, respectively. Furthermore, of the nine RCS‐positive patients, enhancement was recognized as strong in seven and weak in two patients. Ultrasonographic enhancement was identified as negative in all six healthy volunteers.Conclusions:  By performing contrast‐enhanced CHA ultrasonography using Levovist, ultrasonographic enhancement was detectable in all patients with varices categorized as F2 or above. Because the present method is easy to perform and causes less pain to patients compared to endoscopy, it is useful for following and assessing esophageal varices in patients with liver cirrhosis.
Correlation between plasma levels of matrix metalloproteinase (MMP)‐9 /MMP‐2 ratio and α‐fetoproteins in chronic hepatitis carrying hepatitis B virus
Authors: CHUNG TAE‐WOOK , KIM JEONG‐RAN , SUH JEONG‐IL , LEE YOUNG‐CHOON , CHANG YOUNG‐CHAE , CHUNG TAI HO , KIM CHEORL‐HO 
Published: April 2004

AbstractBackground:  Matrix metalloproteases (MMP) and α‐fetoproteins (AFP) are involved in hepatitis B virus (HBV)‐induced chronic hepatitis. In the present study, we have determined the correlation between the MMP‐9/MMP‐9 ratio and AFP levels in the serum of patients during chronic viral B hepatitis.Methods:  Twenty‐eight healthy individuals (18 men and 10 women) with a mean age of 36.3 years (range 23–58 years) and 50 patients (42 men, 8 women) with a mean age of 39.7 years (range 22–61 years) participated in the study. Forty‐eight participants had HBV and the remaining two were either hepatitis G virus (HGV) or hepatitis C virus (HCV) carriers. Values of patients were compared with those obtained from 12 blood donor controls (5 men, 7 women), mean age 36 years (range 21–46 years). Patient's sera were subjected to examination of hepatitis B surface (HBs) and hepatitis B early (Hbe) antigen, SGOT, SGPT, AFP, MMP‐2 and MMP‐9. Serum levels of MMP‐2 and MMP‐9 activities were measured by a zymogram protease assay and densitometric measurement. The ratios of MMP‐9 to MMP‐2 were calculated by dividing the densitometric results.Results:  Compared with the healthy controls, the mean serum concentrations of MMP‐2 were slightly increased in the chronic HBV patients. In contrast, compared with the healthy controls, the mean serum concentrations of MMP‐9 were significantly increased in the chronic HBV patients. When the ratios of the MMP‐9/MMP‐2 and amounts of the serum AFP were compared, a specific correlation between these two parameters was observed. Higher amounts of AFP were detected in the patients with a low ratio of MMP‐9/MMP‐2. Patients with hepatocellular carcinoma (HCC) and cirrhosis showed relatively low MMP‐9/MMP‐2 ratios in chronic hepatitis B. In addition, AFP levels of HCC and cirrhosis were higher than in chronic HBV patients.Conclusions:  These results indicate that the AFP level and ratio of MMP‐9 and MMP‐2 is highly correlated in chronic HBV‐induced hepatitis. Because the serum MMP activities were significantly varied between each stage of AFP production in liver disease, an individual profile of these parameters might serve as an easy accessing serum marker to monitor the progression of liver disease.
Below‐ground process responses to elevated CO2 and temperature: a discussion of observations, measurement methods, and models
Authors: Pendall Elise , Bridgham Scott , Hanson Paul J. , Hungate Bruce , Kicklighter David W. , Johnson Dale W. , Law Beverly E. , Luo Yiqi , Megonigal J. Patrick , Olsrud Maria , Ryan Michael G. , Wan Shiqiang 
Published: April 2004

SummaryRising atmospheric CO2 and temperatures are probably altering ecosystem carbon cycling, causing both positive and negative feedbacks to climate. Below‐ground processes play a key role in the global carbon (C) cycle because they regulate storage of large quantities of C, and are potentially very sensitive to direct and indirect effects of elevated CO2 and temperature. Soil organic matter pools, roots and associated rhizosphere organisms all have distinct responses to environmental change drivers, although availability of C substrates will regulate all the responses. Elevated CO2 increases C supply below‐ground, whereas warming is likely to increase respiration and decomposition rates, leading to speculation that these effects will moderate one another. However, indirect effects on soil moisture availability and nutrient supply may alter processes in unexpected directions. Detailed, mechanistic understanding and modelling of below‐ground flux components, pool sizes and turnover rates is needed to adequately predict long‐term, net C storage in ecosystems. In this synthesis, we discuss the current status of below‐ground responses to elevated CO2 and temperature and potential feedback effects, methodological challenges, and approaches to integrating models and measurements.
Responses of spring phenology to climate change
Authors: Badeck Franz‐W. , Bondeau Alberte , Böttcher Kristin , Doktor Daniel , Lucht Wolfgang , Schaber Jörg , Sitch Stephen 
Published: April 2004

SummaryClimate change effects on seasonal activity in terrestrial ecosystems are significant and well documented, especially in the middle and higher latitudes. Temperature is a main driver of many plant developmental processes, and in many cases higher temperatures have been shown to speed up plant development and lead to earlier switching to the next ontogenetic stage. Qualitatively consistent advancement of vegetation activity in spring has been documented using three independent methods, based on ground observations, remote sensing, and analysis of the atmospheric CO2 signal. However, estimates of the trends for advancement obtained using the same method differ substantially. We propose that a high fraction of this uncertainty is related to the time frame analysed and changes in trends at decadal time scales. Furthermore, the correlation between estimates of the initiation of spring activity derived from ground observations and remote sensing at interannual time scales is often weak. We propose that this is caused by qualitative differences in the traits observed using the two methods, as well as the mixture of different ecosystems and species within the satellite scenes.
Almotriptan Improves Response Rates When Treatment Is Within 1 Hour of Migraine Onset
Authors: Dowson A. J. , Massiou H. , Lainez J. M. , Cabarrocas X. 
Published: April 2004

Background.—Results from open‐label trials with almotriptan and sumatriptan have shown higher response rates when treatment was initiated early after acute migraine onset.Objective.—To investigate the temporal component of early intervention by measuring 2‐hour pain‐free and sustained pain‐free responses to almotriptan and sumatriptan when the study drug was taken within 1 hour of onset of moderate to severe pain.Methods.—This was a post hoc analysis from a double‐blind, randomized, placebo‐controlled trial of almotriptan and sumatriptan. Men and women, 18 to 65 years of age, who met International Headache Society criteria for migraine with or without aura were eligible. Patients were randomized to receive a single oral dose of almotriptan 12.5 or 25 mg, sumatriptan 100 mg, or placebo at the onset of a severe or moderate migraine attack. For this post hoc analysis, the almotriptan 25‐mg dose was excluded because 12.5 mg is the recommended dose. The primary efficacy assessment was sustained pain‐free, defined as pain‐free at 2 hours postdose with no recurrence from 2 to 24 hours and no use of rescue medication. Only patients who took study medication within 1 hour of migraine onset were included in the analysis.Results.—Of the 475 patients involved in the original study, 253 (53.3%) initiated treatment within the 0‐ to 1‐hour interval. For these patients, 2‐hour pain‐free rates were 37.9% for almotriptan 12.5 mg (P= .016 versus placebo), 35.7% for sumatriptan 100 mg (P= .028 versus placebo), and 18.9% for placebo. Only almotriptan was significantly higher than placebo on the sustained pain‐free rate—34.7% (P= .022 versus placebo); the sustained pain‐free rate for sumatriptan was 29.6% and for placebo, 17.0%.Conclusion.—Initiation of treatment with almotriptan 12.5 mg within the first hour after acute migraine onset resulted in a significantly higher sustained pain‐free response compared with placebo. There was no significant difference in sustained pain‐free rates between sumatriptan and placebo. These results are consistent with those from a previous open‐label trial, and suggest that early intervention with almotriptan can improve clinical outcome.
Validation of a Brief Nurse‐Administered Migraine Assessment Tool
Authors: Marcus Dawn A. , Kapelewski Cindy , Jacob Rolf G. , Rudy Thomas E. , Furman Joseph M. 
Published: April 2004

Objective.—To validate a brief tool for screening migraine.Background.—Migraine is a common, but underdiagnosed condition. Effective utilization of nonphysician personnel to reliably screen patients for migraine may improve identification of migraineurs for clinical treatment and research.Methods.—An 8‐question Migraine Assessment Tool (based on International Headache Society criteria) was designed for administration by a nurse with no specialized headache training as a pre‐assessment for the diagnosis of migraine for use in either a research or clinical environment. A community sample of 80 adults (71 women, 9 men; mean age, 33.7 years; 80% white, 14% African American, 2.5% Asian American) with self‐reported headache was recruited through advertisements. A headache specialist independently diagnosed subjects using clinical assessment, and a nurse who works in a balance disorder clinic used the Migraine Assessment Tool. Agreement between physician and nurse‐administered Migraine Assessment Tool diagnoses was determined. Each subject returned in 2 to 4 weeks for a second assessment, administered by the same nurse. Agreement between the 2 diagnoses from the Migraine Assessment Tool was calculated.Results.—Comparison between diagnosis by the physician versus the Migraine Assessment Tool revealed a positive predictive value of 0.85; negative predictive value, 0.84; sensitivity, 0.89; specificity, 0.79; and observed agreement, 0.85. Cohen's kappa reliability measure was 0.69, indicating good test reliability. Interestingly, in 8 of the 12 cases of disagreement, the examiner diagnosing nonmigraine diagnosed analgesic overuse headache. Comparing diagnoses assigned by the 2 separate administrations of the Migraine Assessment Tool revealed a Cohen's kappa of 0.69. Notably, 9 of the 12 cases of nonagreement on the 2 assessments were due to subjects endorsing analgesic overuse in only 1 of the 2 testing sessions.Conclusions.—This study showed good reliability and stability of a new, brief, nurse‐administered migraine questionnaire. In addition, the study also showed that consistency in self‐reporting analgesic overuse within individuals with headache is poor. This suggests the need for repeat questioning about analgesic overuse on subsequent appointments to ensure absence of analgesic overuse headache.