bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Increase in Laryngeal Aerosol Deposition by Ultrasonic Nebulizer Therapy With Intermittent Vocalization
Authors: Kumazawa Hirobumi , Asako Mikiya , Yamashita Toshio , Ha‐Kawa SanG Kil 
Published: October 2004

AbstractIn acute or chronic laryngitis as well as pharyngitis, nebulization with steroid and antibiotics is considered to be a safe and effective treatment. However, the optimal dose, frequency, duration, and method of administration by ultrasonic nebulization is not known. To evaluate whether there is continual improvement using ultrasonic nebulizer therapy, the deposition rate of aerosol particles into the upper airway was studied. We analyzed the deposition rate in the upper airway by a counting system of radioactive isotope (99mTc‐diethylene triaminepentaacetic acid; 99mTc DTPA). Volunteers in good health inhaled an aerosol containing 99mTc DTPA under various conditions of inhalation. Deep and slow inhalation at a respiratory rate of 12 breaths/minute resulted in a high deposition rate of 99mTc DTPA in the lung and a low deposition rate in the larynx. In contrast, faster inhalation at a respiratory rate of 36 breaths/minute resulted in an increase in the isotope deposition rate in the larynx. Furthermore, when the volunteers vocalized intermittently during the fast inhalation at a respiratory rate of 36 breaths/minute, the isotope deposition rate in the volunteer's larynx was higher than in all other inhalation conditions. These results suggest that fast inhalation with intermittent vocalization is one of the important inhalation methods used to improve the deposition rate of aerosol particles into the upper airway with an ultrasonic nebulizer.
Posterior Glottic Stenosis Mechanism and Surgical Management
Authors: Hoasjoe Denis K. , Franklin Scott W. , Aarstad Robert F. , Day Terry A. , Stucker Fred J. 
Published: October 2004

AbstractPosterior glottic stenosis with arytenoid fixation is an uncommon complication of laryngeal injury. Though etiologies vary; the most common is prolonged intubation. Patients with this problem are tracheotomy dependent and have compromised voice production. There has been no acceptable approach to reconstruction of the larynx, the majority of patients being treated with some type of vocal fold lateralization. The success rate with this approach varies, and this procedure does not take advantage of the intact neuromuscular status of the larynx. Over the past 3 years we have utilized an alternative approach, to repair the stenosis and mobilize the arytenoids in 10 patients. Our surgical technique involves laryngeal exposure via a laryngofissure, the removal of posterior glottic cicatricial tissues, and the application of an autologous graft. Subsequently, all but one of the patients were able to be decannulated. Subjective postoperative voice analysis showed improved voice production. The pathophysiology for this disorder and a review of different treatment modalities are discussed.
Compositional Differences Between Bilateral Middle Ear Effusions in Otitis Media With Effusion: Evidence for a Different Etiology?
Authors: Johnson I. J.M. , Brooks T. , Hutton D. A. , Birchall J. P. , Pearson J. P. 
Published: October 2004

AbstractThe aim of this study was to clarify the site of primary pathology in otitis media with effusion. Effusions were collected from 64 children with bilateral effusions at the time of myringotomy. The rheological properties and biochemical compositions of effusions were measured for 23 pairs of effusions, and the levels of the inflammatory mediators TNFα, IL‐1β, and IL‐8 were measured in 41 pairs using specific enzyme‐linked immunosorbent assays(ELISAs). Measurements from paired ears were compared using analysis of variance (ANOVA) tests and significant differences were found for reduced specific viscosity, mucin content, protein content, and levels of IL‐8. The results demonstrate that the two ears have different immunological processes or rates of processes which might explain the significantly different rheological properties of effusions. This suggests that each ear undergoes pathological changes independently and has implications for using the opposite ear as a control in clinical trials.
The Impact of Institutional Ownership on the Reinsurance Decision
Authors: Shortridge Rebecca Toppe , Avila Stephen M. 
Published: October 2004

AbstractRisk management has a central role in corporate America. Insurance companies frequently manage risk by purchasing reinsurance because it reduces the downside risk (i.e., bankruptcy risk) of an insurer. Because reinsurance is costly, Mayers and Smith (1990, Journal of Business, 63: 19‐40) argue that reinsurance purchases should be negatively associated with the diversification of the owners' portfolios. Further, institutional owners play a significant role in equity markets yet we know little about their effect on firm behavior. The purpose of this study is to examine empirically the influence of institutional ownership on reinsurance for a sample of widely held property‐liability insurers. We hypothesize that insurers with higher levels of institutional ownership purchase less reinsurance. Using a sample of 45 publicly traded property‐liability insurers from 1995 to 1997, we demonstrate that the utilization of reinsurance decreases as the level of institutional ownership increases. This suggests that the diversification of the owners' portfolios is a determinant of the insurers' reinsurance decisions.
University‐Provided Retirement Planning Support and Retiree Financial Satisfaction During Retirement: Differences by Gender, Job Classification, and Planning Behavior
Authors: Power Mark L. , Hira Tahira K. 
Published: October 2004

AbstractSound financial planning and financial advice is necessary to achieve retirement income adequacy. The shift from defined benefit to defined contribution pension plans and the recent bankruptcy of Enron Corporation underscore the importance of managing retirement accumulation and liquidation risks. This study analyzes the effectiveness and adequacy of institutional‐provided information and advice on employees' retirement planning decisions and their satisfaction with financial resources during retirement. Results suggest that retirement planning should begin earlier in an employee's career and that employer‐provided retirement information and advice is a highly valued service. Gender, planning practices, job classification, and age are all significant predictors of satisfaction with financial resources during retirement. Targeting women and union employees with retirement information and advice that focuses on allocating contributions using a balanced portfolio approach should result in significant increases in satisfaction with financial resources during retirement. Regulatory objectives should focus on reducing retirement accumulation and liquidation risks, improving the delivery of professional financial advice to plan participants, and expanding qualified retirement plan choice for all labor force participants. To encourage employer participation in employee retirement planning, employers acting in “good faith” should be federally protected from liability for providing retirement planning information and advice to employees.
Efficacy of chloroquine, sulphadoxine–pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan
Authors: Stivanello Elisa , Cavailler Philippe , Cassano Francesco , Omar Sabah Ahmed , Kariuki Daniel , Mwangi Jonathan , Piola Patrice , Guthmann Jean‐Paul 
Published: October 2004

SummaryTo provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine–pyrimethamine (SP) and amodiaquine (AQ) were measured in a 28‐day in vivo study, with results corrected by PCR genotyping. Of 2010 children screened, 115 children aged 6–59 months with uncomplicated Plasmodium falciparum malaria were randomized into each group to receive a supervised course of treatment. Of these, 114, 103 and 111 were analysed in the CQ, SP and AQ groups, respectively. The overall parasitological failure rates at day 28 were 93.9% [95% confidence interval (CI) 87.3–97.3] for CQ, 69.9% (95% CI 60.0–78.3) for SP, and 25.2% (95% CI 17.7–34.5) for AQ. These results provide important missing data on antimalarial drug efficacy in southern Sudan. They indicate that none of the drugs could be used in monotherapy and suggest that even in combination with artemisinin, cure rates might not be efficacious enough. We recommend a combination of artemether and lumefantrine as first‐line treatment for uncomplicated P. falciparum malaria cases in Kajo Keji county.
Submicroscopic Plasmodium falciparum infections and multiplicity of infection in matched peripheral, placental and umbilical cord blood samples from Gabonese women
Authors: Mayengue Pembe Issamou , Rieth Horst , Khattab Ayman , Issifou Saadou , Kremsner Peter G. , Klinkert Mo‐Quen , Ntoumi Francine 
Published: October 2004

SummaryIn malaria‐endemic regions, pregnant women are more susceptible to malarial infections than non‐pregnant women. The main objective of this study, which was conducted in the malaria hyperendemic town of Lambaréné (Gabon, Central Africa), was to characterize Plasmodium falciparum infections in peripheral, placental and cord blood from women of different gravidities with submicroscopic infections. Using the P. falciparum merozoite surface protein 2 (MSP 2)* gene as a polymorphic marker in polymerase chain reactions, we analysed genetic diversity and multiplicity of infection in isolates from all three kinds of samples of 184 pregnant women at delivery. We detected infection in 44% of the women who were originally negative by microscopy. Equally important was the finding that the placenta had the highest prevalence of infection (P < 0.001). There was no correlation with gravidity status or age of the patients. The multiplicities of infection in the peripheral and placental blood samples did not differ and single infection was observed in cord blood, independently of the gravidity. The FC27/MSP 2 was the predominant allelic family. The major FC27 alleles detected in the peripheral, placental and cord blood were sequenced and found to be closely related to the published K1 form sequence. Below microscopy level, the placenta remains the most infected organ and this submicroscopic carriage of parasites may contribute to the development and maintenance of immunity to malaria during pregnancy.
Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand
Authors: Wichmann Ole , Hongsiriwon Suchat , Bowonwatanuwong Chureeratana , Chotivanich Kesinee , Sukthana Yoawalark , Pukrittayakamee Sasithon 
Published: October 2004

SummaryObjectives  Dengue haemorrhagic fever (DHF) is an important cause of morbidity in South‐east Asia and used to occur almost exclusively in young children. In recent years, there has been a progressive shift in age‐distribution towards older children and adults. We investigated an outbreak in 2001 in both children and adults, in an endemic area of Thailand.Methods  Retrospective study of 347 patients with serologically confirmed dengue infection admitted to Chonburi Hospital during an epidemic in 2001.Results  A total of 128 (37%) patients had dengue fever (DF) and 219 (63%) had DHF. Patients with DHF were significantly older than patients with DF (11 years vs. 8 years). Clinical bleeding was noted in 124 individuals, both with DF (n = 24) and DHF (n = 100), and significantly more frequently in adults. Twenty‐nine (13.2%) of all DHF cases were caused by primary infection. Secondary dengue infection was associated significantly with the development of DHF in children, OR (95% CI) = 3.63 (1.94–6.82), P < 0.0001, but not in adults, OR (95% CI) = 0.6 (0.02–6.04), P = 1. Unusual clinical manifestations were observed in 23 patients: three presented with encephalopathy and 20 with highly elevated liver‐enzymes. In the latter group, four patients were icteric and nine had gastrointestinal bleeding.Conclusion  These results indicate that DHF in South‐east Asia is common in both children and adults. In dengue‐endemic countries, dengue should be considered as a differential diagnosis in patients with clinical gastrointestinal bleeding in association with increased liver enzymes.
Soil‐transmitted helminthiasis in Myanmar and approximate costs for countrywide control
Authors: Montresor Antonio , Zin Thet Thet , Padmasiri Eswara , Allen Henrietta , Savioli Lorenzo 
Published: October 2004

SummaryPrevious surveys in Myanmar indicate that soil‐transmitted helminths (STH) are a significant public health problem. However the majority of these surveys are small scale or hospital based. To date there has been no countrywide assessment of the prevalence and intensity of STH infection. We conducted a survey (June 2002–June 2003) to assess the magnitude of STH infection in school age children in each of the different ecological areas of the country. In each area, five schools were selected and from each one, 50 children were randomly chosen. Parasitological and nutritional data were collected from each child. We found an overall prevalence of infection of 69%: 18% had a moderate–heavy intensity of infection, 22% were anaemic. A pilot exercise to treat 25 000 school age children in the 200 schools of Nyangdone Township tested the strategy before scaling up and to generate some rough costings. A crude calculation of the expenditure to buy and deliver the drugs, including the costs incurred in the teacher training, concluded that the cost per child was approximately 0.05 USD.
Stage‐specific effects of host plasma factors on the early sporogony of autologous Plasmodium falciparum isolates within Anopheles gambiae
Authors: Gouagna L. C. , Bonnet S. , Gounoue R. , Verhave J. P. , Eling W. , Sauerwein R. , Boudin C. 
Published: October 2004

SummaryQuantitatively assessing the impact of naturally occurring transmission‐blocking (TB) immunity on malaria parasite sporogonic development may provide a useful interpretation of the underlying mechanisms. Here, we compare the effects of plasma derived from 23 naturally infected gametocyte carriers (OWN) with plasma from donors without previous malaria exposure (AB) on the early sporogonic development of Plasmodium falciparum in Anopheles gambiae. Reduced parasite development efficiency was associated with mosquitoes taking a blood meal mixed with the gametocyte carriers’ own plasma, whereas replacing autologous plasma with non‐immune resulted in the highest level of parasite survival. Seven days after an infective blood meal, 39.1% of the gametocyte carriers’ plasma tested showed TB activity as only a few macrogametocytes ingested along with immune plasma ended up as ookinetes but subsequent development was blocked in the presence of immune plasma. In other experiments (60.9%), the effective number of parasites declined dramatically from one developmental stage to the next, and resulted in an infection rate that was two‐fold lower in OWN than in AB infection group. These findings are in agreement with those in other reports and go further by quantitatively examining at which transition stages TB immunity exerts its action. The transitions from macrogametocytes to gamete/zygote and from gamete/zygote to ookinete were identified as main targets. However, the net contribution of host plasma factors to these interstage parasite reductions was low (5–20%), suggesting that irrespective of the host plasma factors, mosquito factors might also lower the survival level of parasites during the early sporogonic development.
Childhood malignancies in French Polynesia during the 1985–1995 period
Authors: Vathaire Cécile Challeton‐de , De Vathaire Florent , Vu Béatrice Le , Gleize Laurence , Sun Laure Yen Kai , Gestas Philippe , Paaofaite John , Pasche Jérôme , Champenois Sophie , Lhoumau François , Laudon François 
Published: October 2004

SummaryWe report an estimation of the incidence of childhood cancer among natives of French Polynesia (FP) during the 1985–1995 period. Our data were acquired from the Cancer Registry of FP and through an extensive investigation of other potential sources of information. The mean population of children between 1985 and 1995 was estimated to be 63 401 inhabitants, 32 487 of whom were boys and 30 914 girls, born and residing in FP. During the 1985–1995 period, 87 incident cases of childhood cancer were recorded among inhabitants born in FP or of an unknown place of birth (n = 2). Childhood cancer incidence had attained 125 cases/million child years and was very similar among girls (126 × 10−6) and boys (123 × 10−6), this incidence being slightly lower than among other populations of similar ethnic origin: Standardized Incidence Ratio (SIR) = 0.8 (95% CI: 0.7–1.0) when compared with New Zealand Maoris and SIR = 0.8 (95% CI: 0.6–1.0) when compared with natives from Hawaii. For both sexes considered together, the most frequent cancer type was leukaemia, followed by central nervous system (CNS) malignancies, neuroblastoma, and non‐Hodgkin's lymphoma (NHL). Only one case of gonadal and germ cell tumours and one case of carcinoma were reported. Childhood cancer incidence was predominant among children living in the Windward, Leeward and Marquesas Islands and the Tuamotu‐Gambier archipelago, but lower in the Austral Islands. The incidence of acute non‐lymphocytic leukaemia (ANLL) decreased from 3.3 × 10−5 between 1985 and 1989, an unexpectedly high incidence, to 0.8 × 10−5 between 1990 and 1995.
Reliable and frequent detection of adult Wuchereria bancrofti in Ghanaian women by ultrasonography
Authors: Mand Sabine , Debrah Alex , Batsa Linda , Adjei Ohene , Hoerauf Achim 
Published: October 2004

SummaryDetection of adult Wuchereria bancrofti by ultrasonography of the scrotal region in men is a suitable diagnostic tool for lymphatic filariasis, whereas there are only a few case reports of adult filariae observed by ultrasonography in women. We examined 35 microfilaraemic women ultrasonographically in sites of the body suspected as locations for worm nests. In 15 women the ‘filaria dance sign’ (FDS) was detected in various locations, some being novel, such as adult worms within lymphatic vessels between muscular fibres of the thighs. The surprisingly high number of worm nests detectable in microfilaraemic women recommends ultrasonography for diagnosis and treatment efficacy monitoring of female patients infected with W. bancrofti.
Impact of a double dose of sulphadoxine–pyrimethamine to reduce prevalence of pregnancy malaria in southern Mozambique
Authors: Challis K. , Osman N. B. , Cotiro M. , Nordahl G. , Dgedge M. , Bergström S. 
Published: October 2004

SummaryMalarial infection during pregnancy increases the risks of severe sequelae for the pregnant woman and the risk of delivering a low birthweight baby. The aim of this intervention study was to reduce significantly the prevalence of malaria parasitaemia in adolescent parturients in Matola and Boane in Mozambique. The study was focused upon the most malaria‐vulnerable group, adolescent nulliparous and primiparous women. After completing the usual antenatal clinic and giving informed consent, 600 pregnant women were randomly chosen in a double blind manner to one of two regimens comparing the prevailing routine (placebo) for malaria prevention with a two dose regimen of sulphadoxine–pyrimethamine (SP). The first dose was given at enrolment with a second dose at the beginning of the third trimester. At delivery maternal and placental malaria parasitaemia as well as birthweight and gestational duration were analysed. At booking the prevalence of malaria parasitaemia was 35.3% in the placebo group and 30.6% in the SP group. At the second dose, the prevalence of malaria parasitaemia in the placebo group and SP group was 19.7% and 8.7%, respectively. This implies a relative risk (RR) of 2.24 with 95% CI (1.34, 3.75). The corresponding figures at delivery were 13.6% and 6.3% with an RR of 2.22 (1.07, 4.60) and in placenta 13.3% and 2.4% with an RR of 4.87 (1.58, 15.0). Newborns with malaria within 7 days were significantly more frequent in the placebo group, 6.4% and 0.7% respectively, with an RR of 6.55 (1.20, 35.7). Almost all (approximately 98%) of the women studied had Plasmodium falciparum, the remainder had P. malariae and P. ovale. The mean birthweight in the SP group was 3077 g and in the placebo group 2926 g. The estimated mean difference between the two groups was 151 g with 95% CI (51, 252). The mean placental weight in the placebo group was 596 and 645 g in the SP group, implying a difference of 49 g with a 95% CI (11, 88). The mean gestational duration was 6.1 days longer in the SP group, 95% CI (1.5, 10.6). In the placebo group there were two cases of urticaria and one case of nausea; in the SP group there was one case of vomiting. No newborn showed any sign of serious SP side‐effect. Two doses of SP were enough to significantly reduce the prevalence of peripheral and placental malaria parasitaemia among young nulliparous and primiparous pregnant women in Matola and Boane.
Malaria epidemiology in a rural area of the Mekong Delta: a prospective community‐based study
Authors: Erhart A. , Thang N. D. , Bien T. H. , Tung N. M. , Hung N. Q. , Hung L. X. , Tuy T. Q. , Speybroeck N. , Cong L. D. , Coosemans M. , D'Alessandro U. 
Published: October 2004

SummaryOver the past 10 years, the Mekong Delta region in Vietnam has experienced fast socio‐economic development with subsequent changes in malaria vectors ecology. We conducted a 2‐year prospective community‐based study in a coastal rural area in the southern Mekong Delta to re‐assess the malaria epidemiological situation and the dynamics of transmission. The incidence rate of clinical malaria, established on 558 individuals followed for 23 months by active case detection and biannual cross‐sectional surveys, was 2.6/100 person‐years. Over the 2‐year study period, the parasite rate and malaria seroprevalence (Plasmodium falciparum and P. vivax) decreased significantly from 2.4% to almost 0%. Passive case detection (PCD) of clinical cases and serological follow‐up of newborns carried out in a larger population confirmed the low and decreasing trend of malaria transmission. The majority of fever cases were seen in the private sector and most were unnecessarily treated with antimalarials. Training and involvement of the private sector in detection of malaria cases would greatly improve the quality of health care and health information system.