bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot study of botulinum toxin type A in the treatment of chronic pelvic pain associated with spasm of the levator ani muscles
Authors: Jarvis Sherin K. , Abbott Jason A. , Lenart Meegan B. , Steensma Anneke , Vancaillie Thierry G. 
Published: January 2004

AbstractObjective:  To investigate whether botulinum toxin type A (BOTOX) injected into the levator ani muscles of women with objective pelvic floor muscle spasm decreases pain symptoms and improves quality of life.Design:  A prospective cohort study.Setting:  Outpatient clinic in a tertiary referral centre, Sydney, Australia.Sample:  Twelve women, aged 18–55 years, with objective pelvic floor muscle hypertonicity and a minimum 2‐year history of chronic pelvic pain were recruited.Methods:  All women completed visual analog scale pain assessments; questionnaires relating to bladder and bowel symptoms and quality of life; and specific examinations. Forty units of BOTOX at three different dilutions were given bilaterally into the puborectalis and pubococcygeus muscles under conscious sedation.Results:  Median visual analog scale scores were significantly improved for dyspareunia (80 vs 28; P = 0.01) and dysmenorrhea (67 vs 28; P = 0.03), with non‐significant reductions in non‐menstrual pelvic pain (64 vs 37) and dyschesia (47 vs 29). Pelvic floor muscles manometry showed a 37% reduction in resting pressure at week 4 and a 25% reduction was maintained at week 12 (P < 0.0001). Quality of life scores (EQ‐5D and SF‐12) were improved from baseline at week 12, but did not reach statistical significance. Sexual activity scores were markedly improved, with a significant reduction in discomfort (4.8 vs 2.2; P = 0.02) and improvement in habit (0.2 vs 1.9; P = 0.03). These results were not influenced by dilution.Conclusion:  There is evidence from the present pilot study suggesting that women with pelvic floor muscles hypertonicity and pelvic pain may respond to BOTOX injections into the pelvic floor muscles. Further research into this novel treatment of chronic pelvic pain is strongly recommended.
Factors affecting mothers’ knowledge of genetic screening
Authors: Suriadi Christine , Jovanovska Mirjana , Quinlivan Julie A. 
Published: January 2004

AbstractObjective:  To evaluate mothers’ knowledge of terms used in genetic counselling and their participation in Down syndrome and newborn screening.Setting:  An obstetric tertiary referral hospital in Australia.Population:  A total of 232 consecutive women delivering a liveborn baby.Methods:  Participants were interviewed within 24 h of blood being taken from their baby by the heel prick test for the newborn screen. Non‐English speaking women were included using medical interpreters. The questionnaire assessed knowledge of terms used in genetic counselling for Down syndrome and newborn screening. A second researcher, blinded to subject demographics, scored questionnaires using a predefined scoring system.Main outcome:  Demographic factors affecting knowledge and knowledge of Down syndrome and newborn screening test uptake.Results:  A total of 200 women consented to participate in the present study (86.2%). New mothers had limited knowledge of genetic disease (median: 4/15, interquartile range: 2–8). In multivariate analysis, Caucasian ethnic background, English as the first language, higher level of education, and knowledge of family history were significant associations of higher knowledge scores (all P < 0.006). The majority of participants who had Down syndrome testing (54%) were aware that they had done so (51.5%; κ = 90.9%). In multivariate analysis age >35 years, English as a first language and non‐married status were associated with increased test uptake. In contrast, only 26.5% of participants knew that their child had undergone the newborn screen, despite it having been carried out on 98% of babies (κ = 1.5%).Conclusion:  Newborn screening practices may need to be reviewed.
Transperineal repair of obstetric‐related anovaginal fistula
Authors: Chew Simon S.B. , Rieger Nick A. 
Published: January 2004

AbstractBackground:  To describe an operative technique for the repair of anovaginal fistulae secondary to obstetric injury and to assess its functional outcome and patient satisfaction.Methods:  An operative repair involving division of the anovaginal fistula, closure of rectal and vaginal walls, anterior levatoplasty and overlapping sphincteroplasty is described. Postoperative complications and recurrence were recorded. A telephone interview was carried out to assess the functional outcome and the satisfaction score.Results:  Seven consecutive patients had a repair of an obstetric‐related anovaginal fistula. Their mean age was 34 years (range: 22–72). They had a mean duration of symptoms of 14 months (range: 1.5–54). Four patients did not have any previous repair and no stoma was necessary in any of the seven patients. There was no significant postoperative complication and only one recurrence. Telephone interviews were conducted for six patients and one was lost to follow‐up. The mean follow‐up period was 24 months (11–35). The Wexner's continence score improved from a mean preoperative score of 13.4 to a mean postoperative score of 5.6. With satisfaction scores ranging from +3 to −3 (+3 indicating complete satisfaction and −3 indicating complete dissatisfaction), five patients scored 1 and one scored 0.Conclusion:  This technique is straightforward and effective in healing obstetric‐related anovaginal fistula. It achieves improved continence and reasonable satisfaction.
Utility of a Simplified Lidocaine and Potassium Infusion in Diagnosing Long QT Syndrome among Patients with Borderline QTc Interval Prolongation
Authors: Chauhan Vijay S. , Krahn Andrew D. , Klein George J. , Skanes Allan C. , Yee Raymond 
Published: January 2004

Background: Congenital long QT syndrome (LQTS) is caused by mutations in the cardiac Na+ or K+ channels that result in a prolonged QTc interval and increased QT dispersion. Na+ channel blockers and K+ can reverse the repolarization abnormalities in the Na+ channel variant (LQT3) and K+ channel variant (LQT1, LQT2), respectively. The phenotype of LQTS can be difficult to recognize, especially when the QTc interval is mildly prolonged. Additional noninvasive testing methods are needed to enhance the diagnosis of LQTS. This study compared the response of the QTc interval and QT dispersion to a sequential lidocaine/K+ infusion in LQTS patients with borderline QTc interval prolongation and control patients as a means of diagnosing LQTS. Methods: In this study, eight LQTS patients with borderline QTc, defined as QTc < 470 ms, and 10 healthy controls received sequential lidocaine/K+ infusion. Results: At baseline, LQTS patients had a longer QTc (446 ± 29 vs 416 ± 28 ms, P < 0.05) but similar QT dispersion (43 ± 14 vs 29 ± 10 ms) compared to controls. After lidocaine administration, baseline QTc and QT dispersion did not change in either LQTS or controls. One LQTS patient had a 54 ms (12%) reduction in his QTc but no change in QT dispersion. Following K+ infusion, baseline QTc and QT dispersion decreased by 9% (P < 0.005) and 45% (P < 0.005), respectively in LQTS. No effect was seen in control patients, where QTc and QT dispersion shortened by 1% (5 ± 14 ms) and 20% (6 ± 7 ms), respectively, compared to baseline. The combined lidocaine/K+ infusion had a sensitivity, specificity, and accuracy of 88%, 100%, and 94%, respectively, in diagnosing LQTS. Conclusions: A simplified sequential lidocaine/K+ challenge is accurate in diagnosing LQTS among patients with borderline QTc prolongation.
QT Interval Prolongation with Global T‐Wave Inversion: A Novel ECG Finding in Acute Pulmonary Embolism
Authors: Punukollu Gopikrishna , Gowda Ramesh M. , Khan Ijaz A. , Wilbur Sabrina L. , Vasavada Balendu C. , Sacchi Terrence J. 
Published: January 2004

Objective: The purpose of this study was to report a novel electrocardiographic (ECG) phenomenon in acute pulmonary embolism characterized by QT interval prolongation with global T‐wave inversion. Methods: Among a total of 140 study patients with a confirmed diagnosis of acute pulmonary embolism, patients who fulfilled the inclusion criteria for QT interval prolongation with global T‐wave inversion were examined. Each of these patients had undergone a detailed clinical evaluation including testing for myocardial injury and echocardiography. Results: QT interval prolongation with global T‐wave inversion was found in five patients (age 51–68 years) with acute pulmonary embolism. Four were women. Acute pulmonary embolism was diagnosed by ventilation‐perfusion scan in three patients and by spiral computed tomography in other two patients. None of the patients had any right or left ventricular regional wall motion abnormalities on echocardiography. All patients had changes characteristic of hemodynamically significant pulmonary embolism, including right ventricular stunning or hypokinesis and dilatation in five patients with paradoxical septal motion in four. Acute coronary syndrome was ruled out in each patient by clinical evaluation, serial ECGs and cardiac markers, and lack of regional wall motion abnormalities on echocardiography. Prolongation of QT intervals (QTc 456–521 ms) with global T‐wave inversion was noted on presentation. The ECG changes gradually resolved in 1 week in all patients with appropriate treatment of acute pulmonary embolism. One patient died. None of the patients developed torsade de pointes. Conclusions: Acute pulmonary embolism may occasionally result in reversible QT interval prolongation with deep T‐wave inversion, and, thus should be considered among the acquired causes of the long QT syndrome.
Clinical Significance of QS Complexes in V1 and V2 without Other Electrocardiographic Abnormality
Authors: MacAlpin Rex N. 
Published: January 2004

Background: In the absence of other electrocardiographic (ECG) abnormalities, QS deflections simultaneously in both of the leads V1–V2 may have multiple possible causes. Despite much information in the literature indicating that this is an unlikely pattern for pure septal infarction, such an ECG diagnosis is frequently given. Methods: Ninety‐nine cases having QS deflections in both leads V1 and V2 but no other ECG abnormality were compared to 99 other patients with entirely normal ECGs, to whom they were matched by age, gender, and the presence or absence of septal Q waves. Retrospective analysis of medical records was performed to determine the nature of any cardiovascular disease in these two groups, and to find a possible explanation for the ECG abnormality. Results: Because of its intermittence in subjects with multiple ECGs, QS deflections in leads V1–V2 appeared most often to be an artifact of precordial lead placement. Prior myocardial infarction, or presence of clinical coronary disease was present in only about 20% of the cases. Neither the intermittence of Q wave in V2 on repeated ECGs nor the absence of septal Q waves was useful in distinguishing between those with and without coronary heart disease. Conclusions: This ECG pattern is a sign of prior myocardial infarction in only a minority of cases, and in the latter, infarction limited to the interventricular septum is exceptional. This ECG finding should be interpreted as a nonspecific QRS abnormality with multiple possible causes. Clinical correlation and repeat tracings with attention to lead placement will help to clarify its significance.
Electrocardiographic Identification of Drug‐Induced QT Prolongation: Assessment by Different Recording and Measurement Methods
Authors: Sarapa Nenad , Morganroth Joel , Couderc Jean‐Philippe , Francom Steven F. , Darpo Borje , Fleishaker Joseph C. , McEnroe Janet D. , Chen William T. , Zareba Wojciech , Moss Arthur J. 
Published: January 2004

Background: Careful assessment of QT interval prolongation is required before novel drugs are approved by regulatory authorities. The choice of the most appropriate method of electrocardiogram (ECG) acquisition and QT/RR interval measurement in clinical trials requires better understanding of the differences among currently available approaches. This study compared standard and Holter‐derived 12‐lead ECGs for utility in detecting sotalol‐induced QT/QTc and RR changes. Manual methods (digitizing pad and digital on‐screen calipers) were compared for precision of QT and RR interval measurement. Methods and Results: Sixteen hundred pairs of serial 12‐lead digital ECGs were recorded simultaneously by standard resting ECG device and by continuous 12‐lead digital Holter over 3 days in 39 healthy male and female volunteers. No therapy was given on the 1st day followed by 160 mg and 320 mg of sotalol on the 2nd and 3rd day, respectively. Holter‐derived and standard ECGs produced nearly identical sotalol‐induced QT/QTc and RR changes from baseline, as did the manual digipad and on‐screen caliper measurements. The variability of on‐screen QT measurement in this study was greater than that of digipad. Conclusions: Digital 12‐lead Holter and standard 12‐lead ECG recorders, as well as the manual digitizing pad and digital on‐screen calipers, are of equal utility for the assessment of drug‐induced change from baseline in QT and RR interval, although the variability of the on‐screen method in this study was greater than of the digipad.
Xerostomia: Clinical Aspects and Treatment
Authors: Cassolato Sandra F. , Turnbull Robert S. 
Published: January 2004

AbstractXerostomia or dry mouth is a condition that is frequently encountered in dental practice. The most common cause is the use of certain systemic medications, which make the elderly at greater risk because they are usually more medicated. Other causes include high doses of radiation and certain diseases such as SjöUgren's syndrome. Xerostomia is associated with difficulties in chewing, swallowing, tasting or speaking. This results in poor diet, malnutrition and decreased social interaction. Xerostomia can cause oral discomfort, especially for denture wearers. Patients are at increased risk of developing dental caries. A thorough intra‐oral and extra‐oral clinical examination is important for diagnosis. Treatment may include the use of salivary substitutes (Biotene), salivary stimulants such as pilocarpine, ongoing dental care, caries prevention, a review of the current prescription drug regimen and possible elimination of drugs having anticholinergic effects. Because of the ageing population, and the concomitant increase in medicated individuals, dentists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. Therefore, the purpose of this review is to outline for clinicians the common aetiologies, clinical identification, and routine therapeutic modalities available for individuals with xerostomia.
Association between dental health behaviours, mental/physical function and self‐feeding ability among the elderly: a cross‐sectional survey
Authors: Arai Koji , Sumi Yasunori , Uematsu Hiroshi , Miura Hiroko 
Published: January 2004

Abstract Objectives: The aim of this study was to determine the association between dental health behaviour, mental/physical function and self‐feeding ability among the elderly. Subjects: A total of 414 elderly dental patients aged 65 years and older participated in this study. Methods: A survey was carried out for three years and seven months starting in January 1998 at the Chubu National Hospital. The patients or their carers were examined/interviewed about the severity of senile dementia, dental health behaviour, ability to rinse their mouths, ability to manage dentures, and ability to sit at a table during meals. To assess the association with self‐feeding ability among the elderly, cut‐offs were given for these variables, and then the odds ratios were calculated. Results: The strongest association to self‐feeding ability was marked by inability to rinse their own mouth, followed by inability to manage dentures, inability to sit at a table during meals, severe senile dementia and less frequency of toothbrushing. Conclusion: Elderly who have lost the feeding ability often could not maintain their dental health by themselves. Carers must provide not only a feeding service with acknowledgement of aspiration but oral care to prevent dental disease and fatal pneumonia in the elderly.
Continuing dental care for Highlands elderly: Current practice and attitudes of dental practitioners and home supervisors
Authors: Hally J. , Clarkson J.E. , Newton J.P. 
Published: January 2004

Abstract Objective: To investigate current practice and attitudes of Highland dentists and home supervisors to continued dental care of elderly residents. Methods: A cross‐sectional questionnaire was designed to survey the current practice and attitudes of Highland dentists and residential care supervisors in their provision of dental care for the elderly at home and in long stay accommodation. Results: The response rate was 94% of dentists and 79% of homes. Despite 86% of dentists providing domiciliary care and 93% of homes transport to a surgery, no more than a quarter of residents had had contact with a dentist in the previous year. The distribution of residents varied with dependant individuals living in nursing units and the least dependant in residential homes. Only 1% of all residents were totally bed bound. Domiciliary patients were less likely to receive continuing care compared with those seen in a surgery and 75% of homes had to initiate dental care. In terms of patient referral, the majority of GDPs would refer uncooperative patients, salaried dentists would refer those with complex medical histories and community dentists would refer those requiring complex treatments. A dental assessment was undertaken in 46% of homes and 81% of these kept a record of dental care. Conclusion: This study highlights the need for a co‐ordinated, seamless continuing dental care service, tailored to the actual needs of the elderly individuals it is designed to serve, particularly in a remote and rural area.
Clinical reversal of root caries using ozone, double‐blind, randomised, controlled 18‐month trial
Authors: Holmes J 
Published: January 2004

Abstract Objective: To assess the effect of an ozone delivery system, combined with the daily use of a remineralising patient kit, on the clinical severity of non‐cavitated leathery primary root carious lesions (PRCL's), in an older population group. Design: Atotal of 89 subjects, (age range 60–82, mean ± SD, 70.8 ± 6 years), each with two leathery PRCL's, were recruited. The two lesions in each subject were randomly assigned for treatment with ozone or air, in a double‐blind design, in a general dental practice. Subjects were recalled at three, six, 12 and 18 months. Lesions were clinically recorded at each visit as soft, leathery or hard, scored with a validated root caries severity index. Results: There were no observed adverse events. After three months, in the ozone‐treated group, 61 PRCL's (69%) had become hard and none had deteriorated, whilst in the control group, four PRCL's (4%) had become worse (p<0.01). At the six‐month recall, in the ozone group, seven PRCL's (8%) remained leathery, the remaining 82 (92%) PRCL's had become hard, whilst in the control group, 10 PRCL's had become worse (11%) and one had become hard (p<0.01). At 12 and 18 months, 87 Subjects attended. In the ozone group at 12 months, two PRCL's remained leathery, compared to 85 (98%) that had hardened, whilst in the control group 21 (24%) of the PRCL's had progressed from leathery to soft, i.e. became worse, 65 PRCL's (75%) were still leathery, and one remained hard (p<0.01). At 18 months, 87 (100%) of ozone‐treated PRCL's had arrested, whilst in the control group, 32 lesions (37%) of the PRCL's had worsened from leathery to soft (p<0.01), 54 (62%) PRCL's remained leathery and only one of the control PRCL's had reversed (p<0.01). Conclusions: Leathery non‐cavitated primary root caries can be arrested non‐operatively with ozone and remineralising products. This treatment regime is an effective alternative to conventional “drilling and filling”.
In Vitro and In Vivo Efficacies of the New Triazole Albaconazole against
Cryptococcus neoformans
Authors: Miller J. L. , Schell W. A. , Wills E. A. , Toffaletti D. L. , Boyce M. , Benjamin D. K. , Bartroli J. , Perfect J. R. 
Published: January 2004

ABSTRACT

The activity of albaconazole (UR-9825; J. Uriach & Cía. S.A., Barcelona, Spain) was compared to that of fluconazole against 12 isolates of
Cryptococcus neoformans
in vitro and against 1 isolate in vivo in a rabbit model of cryptococcal meningitis. Albaconazole was 100-fold more potent in vitro than fluconazole on a per-weight basis and was fungicidal at potentially relevant concentrations for two isolates. MICs ranged from ≤0.0012 to 1.25 μg/ml, with the MICs for most isolates being between 0.039 and 0.156 μg/ml. Isolates were from human immunodeficiency virus (HIV)-infected and non-HIV-infected patients and were of serotypes A, B, and C; and the fluconazole MICs for some of the isolates were elevated. Infected rabbits were treated with either fluconazole or albaconazole at dosages ranging from 5 to 80 mg/kg of body weight/day. The peak concentrations of albaconazole in serum and cerebrospinal fluid (CSF) averaged 4.14 and 0.62 μg/ml, respectively, in animals receiving 80 mg/kg/day. Comparison of the concentrations in serum and CSF suggested a level of CSF penetration of approximately 15%. Despite limited penetration into the subarachnoid space, at all three doses tested albaconazole was as effective as fluconazole for the treatment of cryptococcal meningitis in rabbits.
In Vitro and In Vivo Activities of the Novel Azole Antifungal Agent R126638
Authors: Odds F. , Ausma J. , Van Gerven F. , Woestenborghs F. , Meerpoel L. , Heeres J. , Vanden Bossche H. , Borgers M. 
Published: January 2004

ABSTRACT

R126638 is a new triazole agent with potent antifungal activity in vitro against various dermatophytes,
Candida
spp., and
Malassezia
spp. Its activity against
Malassezia
spp. in vitro was superior to that of ketoconazole, the agent currently used for the treatment of
Malassezia
-related infections. R126638 showed activity comparable to or lower than that of itraconazole against dermatophytes in vitro; however, in guinea pig models of dermatophyte infections, R126638 given orally consistently showed antifungal activity superior to that of itraconazole, with 50% effective doses (ED
50
s) three- to more than eightfold lower than those of itraconazole, depending on the time of initiation and the duration of treatment. The ED
50
of R126638 in a mouse dermatophytosis model was more than fivefold lower than that of itraconazole. These data indicate that if the effects of R126638 seen when it is used to treat animals can be extrapolated to humans, the novel compound would be expected to show effects at doses lower than those of existing drugs and, hence, present a lower risk for side effects.