bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis
Authors: Buscher H C J L , Jansen J B M J , van Dongen R , Bleichrodt R P , van Goor H 
Published: December 2004

AbstractBackgroundThe management of pain in patients with chronic pancreatitis is difficult. The aim of this prospective study was to evaluate the early and long-term pain relief provided by bilateral thoracoscopic splanchnicectomy.MethodsFrom August 1995 to August 1999, 44 patients with chronic pancreatitis underwent bilateral thoracoscopic splanchnicectomy. Data were collected prospectively. Thirty-six patients required opioids. Pain intensity was registered before operation and at regular intervals after surgery by means of a visual analogue scale (VAS). Use of analgesics (opioids; non-steroidal anti-inflammatory drugs and acetaminophen; no analgesics or aminocetophen) was noted before and after splanchnicectomy. Median follow-up was 36 (range 12–60) months.ResultsThe procedure was technically successful in 40 patients. Thirty-six patients had no complications. Eleven of 24 patients who have been followed up for 24 months or more had a significantly reduced VAS score at 2 years (median (range) 8·5 (7–10) versus 2·5 (0–5); P &lt; 0·01). The cumulative rate of pain relief was 46 per cent 48 months after splanchnicectomy.ConclusionBilateral thoracoscopic splanchnicectomy alleviated pain in patients with chronic pancreatitis. It was associated with a low morbidity rate and no deaths. Pain eventually recurred in approximately 50 per cent.
Role of mast cells in the development of pancreatitis-induced multiple organ dysfunction
Authors: Dib M , Zhao X , Wang X D , Andersson R 
Published: December 2004

AbstractBackgroundActivated mast cells can produce and release a number of inflammatory mediators involved in the pathophysiology of acute conditions. The aim of the present study was to evaluate the role of activated tissue mast cells in the pathogenesis of multiple organ dysfunction syndrome following acute pancreatitis (AP).MethodsAP was induced by the intraductal infusion of 5 per cent sodium taurodeoxycholate in the rat. Some 30 min before induction of AP, a mast cell stabilizer (sodium cromoglycate (SCG)) or antihistamines (pyrilamine, cyproheptadine, meclizine and amitriptyline) were administered intra peritoneally. Plasma exudation of radiolabelled albumin, histamine, myeloperoxidase (MPO), monocyte chemoattractant protein (MCP) 1 and adhesion molecules (platelet endothelial cell adhesion molecule (PECAM) 1 and L-selectin) were measured.ResultsThe mast cell stabilizer significantly reduced plasma exudation in the pancreas, colon and lungs (P &lt; 0·05), decreased the release of histamine at 1 h (P &lt; 0·05), and reduced MPO activity and MCP-1 levels in the colon and lungs (P &lt; 0·05) but not in the pancreas. Expression of PECAM-1 and L-selectin on total circulating leucocytes in rats with AP and SCG pretreatment did not differ from that in sham controls, while levels in animals that had AP and saline pretreatment were half of those seen following sham operation.ConclusionActivation of mast cells after induction of AP is involved in the development of endothelial barrier dysfunction in both the pancreas and extrapancreatic organs/tissues, particularly in the lungs and colon. This may, at least partly, contribute to the sequential development of multiple organ dysfunction and organ/tissue-specific endothelial barrier dysfunction.
Randomized clinical trial of Ligasure™versus open haemorrhoidectomy
Authors: Palazzo F F , Francis D L , Clifton M A 
Published: December 2004

Abstract

Background
Postoperative pain associated with open haemorrhoidectomy remains problematic. Haemorrhoidectomy performed using bloodless bipolar diathermy – Ligasure™ – may have advantages over conventional open haemorrhoidectomy in terms of operating time and postoperative pain.

Methods
Thirty-four patients were randomized to undergo Ligasure™ (18 patients) or diathermy (16) haemorrhoidectomy. The operating time, amount of pain and postoperative analgesic requirement, postoperative complications and overall patient satisfaction were documented.

Results
The median duration of operation was shorter in the Ligasure™ haemorrhoidectomy group (5·1 versus 9·2 min; P &lt; 0·001). There was no statistically significant difference in the postoperative pain score, but the median analgesic requirement was lower in the Ligasure™ group (850 versus 1600 mg tramadol; P = 0·013). Patient satisfaction was similar in both groups.

Conclusion
Ligasure™ haemorrhoidectomy is quick and bloodless and, although as painful as diathermy haemorrhoidectomy, is associated with a reduced analgesic requirement.
The morphological and spectral phenotype of apoptosis in HeLa cells varies following exposure to UV‐C and the addition of inhibitors of ICE and CPP32
Authors: Miller M. L. , Andringa A. , Elliott J. , Conwell Ii K. , Dixon K. , Carty M. P. 
Published: December 2004

Numerous extra‐ and intracellular factors, including UV radiation, can initiate a programme of cell death by apoptosis. While apoptosis is commonly defined morphologically, the relationships between morphology and molecular events are not well established. To investigate these relationships in HeLa cells, eight morphometric criteria for cell proliferation and damage and 10 criteria for apoptotic phenotype were examined using light microscopy, and corroborated by ultrastructure and spectral imaging. They were identified (1) during a time course after irradiation with 0, 10 or 30 J/m2 UV‐C; (2) after separation of apoptotic from normal cells on a Percoll gradient; and (3) after irradiation with UV‐C plus perturbation of the apoptotic pathway by treatment with inhibitors of two caspases, ICE and CPP32.The number of cells in apoptosis increased in a dose‐dependent manner after UV‐C treatment. Centrifugation of irradiated cells on a Percoll gradient increased the collection of apoptotic cells tenfold. The stereotypical apoptotic phenotype, in which cells have deep cytoplasmic blebbing and highly condensed DNA, comprised only a few percent of all apoptoses, and was rarely seen in groups receiving caspase inhibitors. The most common apoptotic phenotype was a rounded cell with large spherical nucleolus and associated DNA. After treatment with UV‐C plus inhibitors the apoptotic index was decreased by about 30% compared to UV‐C radiation alone. These apoptotic cells had dark spherical cytoplasm with small blebs, greatly increased numbers of cytoplasmic ribosomes, abundant nucleolar material with a large separate granular component, and chromatin condensed at the nuclear membrane. Using the technique of spectral imaging, it was found that the spectrum obtained from the granular component of the nucleolus, which was elevated in apoptotic cells treated with UV‐C plus inhibitors, was similar to the dense accumulation of ribosomes in the apoptotic cytoplasm. The data indicate that spectral imaging may be a useful tool for identifying and characterizing variations in the apoptotic process, and that the caspase inhibitors used here do not completely abolish UV‐C induced apoptosis, but rather alter its incidence and progression.
Organizational support for evidence‐based practice within child and family social work: a collaborative study
Authors: Barratt Moira 
Published: December 2004

ABSTRACTResearch in Practice works in collaboration with over 50 English local authorities and voluntary childcare organizations, to explore new and dynamic ways to increase the use of quality evidence to improve services to children and families. One Research in Practice initiative was a two‐year collaborative project involving the social services departments of six local authorities. This paper reports on how the views of more than 100 professional staff involved with the provision of services to children and families have been gathered to offer insight into how evidence‐based practice can be supported or frustrated in social care organizations. The findings suggest considerable uncertainty about the nature of evidence in social care and its validity in relation to decision‐making, policy and planning. Mechanisms essential for the dissemination, implementation and adoption of research messages are underdeveloped and tensions exist around the explicit use of research evidence within reports and reviews. Many practitioners and teams may be excluded from making decisions based on the best available research evidence through lack of access to internet resources and adequate information dissemination mechanisms. The paper concludes that there remain considerable areas for further debate if evidence‐based practice is to become a reality in work with children and families.
Who manages the care of students with Attention Deficit Hyperactivity Disorder (ADHD) in higher education?
Authors: Baverstock A. C. , Finlay F. 
Published: December 2004

AbstractObjective  To identify who provides medical support to students with Attention Deficit Hyperactivity Disorder (ADHD) while in higher education.Methods  A questionnaire pack was sent to 50 undergraduate student health centres attached to higher education colleges/universities.Results  Eighty‐two per cent of practices returned questionnaires. Forty‐nine per cent had undergraduate students with ADHD, of those 76% were on methylphenidate. Fifty‐two per cent saw only their general practitioner (GP) for follow up and the rest were jointly managed by GP with: psychiatrists, paediatricians, psychologists or physicians. Eighty‐seven per cent of GPs had not attended recent courses or training on ADHD.Conclusion  Those caring for undergraduate students with ADHD are still largely unfamiliar with the condition. Guidelines need to be drawn up to establish handover from paediatric to adult care.
The effects of work on the growth of Jordanian boys
Authors: Hawamdeh H. , Spencer N. 
Published: December 2004

AbstractObjective  To examine the effects of work on growth among boys aged 10–16 years in Jordan.Study design  Cross‐sectional health survey comparing working and non‐working boys.Main outcomes  Height for age z‐score; weight for age z‐score.Methods  One hundred and thirty‐five working and 405 non‐working boys aged 10–16 years were studied in the Jordanian areas of Irbid, Jarash and North Jordan Valley. The boys and their mothers were interviewed and data collected on work status, child's smoking status, and family socio‐economic characteristics including per capita income, family size, maternal and paternal education, area of the house in square metres and expenditure on household durables. Height and weight were obtained at the time of interview. Linear regression models were fitted on height for age z‐score and weight for age z‐score.Results  In bivariate analysis, child's work status (r = −0.221), household per capita income (r = 0.104), family size (r = −0.102), house m2 per capita (r = 0.090) and monthly expenditure on durables (r = 0.086) were significantly correlated with height z‐score. Work status (P < 0.0001) and household m2 per capita (P = 0.002) were retained in the regression model fitted on height z‐score which explained 9.8% of the variance. The model fitted on weight z‐score explained 6.5% of the variance and work status (P < 0.0001), household per capita income (P = 0.041) were retained.Conclusions  The results of this study suggest that, independent of a range of socio‐economic factors, work has a negative effect on child growth. Given the extent of child labour internationally these findings have profound implications for global child well‐being and for global social and economic policy.
Child health profiles: the viewpoints of adults
Authors: Hill M. , Morton P. 
Published: December 2004

AbstractThe child health profile  The teenage years have been identified as an important time to influence attitudes and behaviour likely to affect current and future health. The child health profile was developed partly to provide appropriate health information to young people aged 10 and older, but was also intended to recognize their right to assume greater responsibility for their health records. It was seen as an extension of the popular parent held record for younger children.Methods  A Scottish child health profile was introduced through schools in three health board areas. Data about usage and views were obtained from children and relevant adults by means of questionnaires. In this paper, the perspectives of parents, health professionals and teachers are reported.Findings  The majority of the adults were keen on the idea of the profile in principle. However, most parents knew little about it, even though all their children had been issued with one. Teachers had little involvement with the profile and the majority of health professionals had some doubts about its application. The adults indicated that a small number of children made effective use of the profile, but information from both adults and children indicated that it was seldom discussed during consultations with health professionals, few of whom routinely asked to see it.Conclusions  The paper outlines implications for the provision of health information and records for this age group.
Behavioural problems, social competence and self‐concept in siblings of children with autism
Authors: Verté S. , Roeyers H. , Buysse A. 
Published: December 2004

AbstractIntroduction  This study investigated the psychological adjustment of siblings of children with high‐functioning autism (HFA) in comparison with siblings of normally developing children in the domain of behavioural problems, social competence and self‐concept.Method   Twenty‐nine siblings of children with HFA and 29 siblings of children without a disorder participated in the study. Standardized, written questionnaires were used.Results   Siblings of children with HFA, especially brothers and sisters between 6 and 11 years old, had more behavioural problems than siblings of the control group. Sisters of children with HFA ascribed higher social competence to themselves. Sisters of children with HFA between 12 and 16 years old had a more positive self‐concept. In both groups siblings with a more negative self‐concept had less social skills and siblings with a more positive self‐concept scored better in the social domain. Finally, in accordance with the control group, the perception of the siblings’ social competence of parents of children with HFA broadly matched the perception siblings had of themselves.Discussion  Overall, siblings of children with HFA are not more susceptible to adaptation problems than siblings of children without a disorder. Implications for practice and further research are discussed.
Current practice in the management of Attention Deficit Disorder with Hyperactivity (ADHD)
Authors: Parr J. R. , Ward A. , Inman S. 
Published: December 2004

AbstractBackground  The management of Attention Deficit Disorder with Hyperactivity (ADHD) is controversial and guidance published by the National Institute for Clinical Excellence (NICE) suggests a multidisciplinary approach.Methods  We evaluated the patterns of referral and techniques used in the diagnosis and management of ADHD in Wirral Health Authority by studying the case notes of 391 children diagnosed between 1994 and August 2000.Results  The majority of cases were referred from Primary Care and the detected prevalence was 8/1000. Boys were diagnosed more frequently than girls (12 : 1) and the mean age at diagnosis was 8.7 years; girls were more likely to have been diagnosed prior to age 8. The use of behaviour rating questionnaires and school visits as an aid to diagnosis increased during the study period. Management by Child Psychiatry and Community Paediatric services was similar with stimulant medication prescribed in 91% of cases; Child Psychiatry services were more likely to give advice on behaviour management than Paediatric services. Twelve per cent of cases were managed by both services, or in joint Outpatient clinics. Outpatient follow‐up was most likely to occur at six monthly intervals and required 1312 appointments per year.Conclusions  This study shows that the management of children with ADHD in Wirral Health Authority is compatible with NICE guidance. Attention Deficit Disorder with Hyperactivity is a significant burden on clinical services and long‐term planning is required.
Current Literature: 3
Authors: Reading Richard 
Published: December 2004

Objective  To identify which clinical situations are the most difficult to manage for general paediatricians in Victoria, Australia.Methods   Self‐administered questionnaires were sent to general paediatricians in Victoria. They were asked their opinions regarding what were the most difficult and the most dangerous clinical situations with which they deal.Results   The response rate was 64% (63 out of 98 questionnaires sent). The general paediatricians surveyed believed that behavioural, developmental and psychosocial conditions were the most difficult to deal with; conduct disorder was the most nominated clinical category (26% of respondents). The ‘dangerous’ cases nominated were predominately traditional medical cases. The most commonly nominated category was sepsis and shock (21% of respondents). The most difficult and dangerous clinical situations overall for general paediatricians in Victoria appear to be in the areas of sepsis, child protection, paediatric and neonatal resuscitation, depression and suicide, raised intracranial pressure, intravenous fluid management, and communication with parents and adolescents.Conclusions   The present survey provides useful information to help with training‐programme design and it gives trainee paediatricians an idea of what experienced paediatricians find difficult. Severe behavioural, family and social difficulties, as well as neonatal and childhood resuscitation, severe sepsis, raised intracranial pressure, and intravenous fluid management were the clinical situations most frequently described as difficult.
Parental history of atopic disease and concentration of cord blood IgE
Authors: JOHNSON C. C. , OWNBY D. R. , PETERSON E. L. 
Published: December 2004

SummaryBackground
A family history of atopy, and cord blood immunoglobulin E concentration, have been shown to be predictors of atopic disease in children. Several studies have suggested that parental atopy may be related to newborn immunoglobulin E. Objective The purpose of our analysis was to evaluate whether parental history of allergic disease was associated with cord blood immunoglobulin E concentration. Methods The study subjects were from a defined population of 777 newborns delivered between 1987 and 1989. The mothers of these children completed a questionnaire during pregnancy concerning themselves and the child's father, including parental history of physician diagnosis of allergic diseases (allergies, hay fever and asthma). Total immunoglobulin E levels were quantitated in cord blood samples with an enzyme‐hnked immunoassay.Results
Median cord blood immunoglobulin E concentration was higher among infants whose mothers had a history of atopic disease, particularly for those with a history of asthma (P<0.022) and allergen immunotherapy (P<0.016) vs infants whose mothers had no history of any atopic disease. Comparing all babies with a maternal history of asthma, to babies where neither parent had a history of any atopic disease, the median cord blood immunoglobulin E was significantly higher (0.36IU/mL vs 0.21 IU/mL; P<0.009). This association was found only among female infants (0.49IU/mL vs 0.20 IU/mL; P<0.001).Conclusion
Maternal, but not paternal, history of atopic disease was associated with an elevated immunoglobulin E among newborns. For maternal asthma, this association was only evident in infant girls.
Maternal fish oil supplementation in pregnancy reduces interleukin‐13 levels in cord blood of infants at high risk of atopy
Authors: Dunstan J. A. , Mori T. A. , Barden A. , Beilin L. J. , Taylor A. L. , Holt P. G. , Prescott S. L. 
Published: December 2004

SummaryBackground and objectives The epidemiological association between higher dietary n‐3 polyunsaturated fatty acids (PUFA) and lower prevalence of asthma, has led to interest in the role of early dietary modification in allergic disease prevention. In this study we examined the effects of maternal n‐3 (PUFA)‐rich fish oil supplementation on cord blood (CB) IgE and cytokine levels in neonates at risk of developing allergic disease.Methods In a randomized double‐blind, placebo‐controlled trial, 83 atopic pregnant women received either fish oil capsules (n = 40) containing 3.7 g n‐3 PUFA/day or placebo capsules (n = 43) from 20 weeks gestation until delivery. CB cytokine levels (IL‐4, IL‐5, IL‐6, IL‐10, IL‐12, IL‐13, TNF‐α and IFN‐γ) and total IgE levels were measured and compared between the two groups. Fatty acid composition of red cell membranes was analysed by gas chromatography and the relationships among PUFA, cytokine and IgE levels were examined.Results Maternal fish oil supplementation resulted in a significant increase in n‐3 PUFA levels (P < 0.001) in neonatal erythrocyte membranes. Neonates whose mothers had fish oil supplementation had significantly lower plasma IL‐13 (P < 0.05) compared to the control group. There was also a significant inverse relationship between levels of n‐3 PUFA in neonatal cell membranes and plasma IL‐13. There was no difference in levels of IgE and the other cytokines measured.Conclusions This study provides preliminary evidence that increasing neonatal n‐3 PUFA levels with maternal dietary supplementation can achieve subtle modification of neonatal cytokine levels. Further assessment of immune function and clinical follow‐up of these infants will help determine if there are any significant effects on postnatal immune development and expression of allergic disease.
Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study
Authors: Van Strien R. T. , Koopman L. P. , Kerkhof M. , Oldenwening M. , De Jongste J. C. , Gerritsen J. , Neijens H. J. , Aalberse R. C. , Smit H. A. , Brunekreef B. 
Published: December 2004

SummaryBackground Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease.Objective To measure the influence of mite allergen‐impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds.Methods A total of 810 children with allergic mothers took part in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Allergen‐impermeable and placebo mattress encasings were applied to the childrens' and the parents' beds before birth. Dust samples were taken from the beds of children and their parents before birth and 3 and 12 months after birth. Extracts of dust samples were analysed for mite allergens (Der p 1 and Der f 1).Results Active mattress encasings were significantly more effective in reducing dust and mite allergen levels than placebo encasings. Mite allergen levels were low in general and the treatment effect was modest. Twelve months after birth, mattresses with active mattress encasings had about half the amount of Der 1 (Der p 1 + Der f 1)/m2, compared to mattresses with placebo encasings, for the child's and the parental mattress.Conclusion This study shows that mite‐impermeable mattress encasings have a significant but modest effect on dust and mite allergen levels of mattresses with low initial mite allergen levels, compared to placebo.