bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of isotretinoin therapy on lipoprotein (a) serum Levels
Authors: Georgala Sofia , Schulpis Kleopatra H. , Potouridou Irene , Papadogeorgaki Helen 
Published: November 2003

Abstract Background Increases in plasma concentrations of lipids, triglycerides, and liver enzymes have been reported in patients on isotretinoin therapy. Lipoprotein (a). (Lp (a)), a cholesterol‐rich plasma lipoprotein, influences the clotting system and is related to premature coronary heart disease and stroke. Methods Blood (7 mL) was obtained from 30 patients with cystic acne before and 30 days after the initiation of oral isotretinoin (0.5 mg/kg/day). Results An increase in liver enzymes and lipids, except high density lipoprotein, was found in our patients at the end of the study. The mean Lp (a) levels (initial value, 25.91±3.17 mg/dL) were statistically reduced (p < 0.0001) at the end of treatment (14.80±2.35 mg/dL). Conclusions It is suggested that isotretinoin could be used as an Lp (a) lowering agent in the future.
Evaluating the efficacy of allopurinol for the treatment of cutaneous leishmaniasis
Authors: D'Oliveira Argemiro , Machado Paulo Roberto L. , Carvalho Edgar M. 
Published: November 2003

This study was performed in Corte de Pedra, an area of L. braziliensis braziliensis transmission located 240 km southeast of Salvador, the capital of the state of Bahia in Brazil. This open controlled trial included 34 patients, aged 12 to 45 years, with leishmania‐positive skin test and a maximum of three ulcerated lesions (with a minimum lesion diameter of 10 mm and a maximum diameter of 50 mm) who had received no previous treatment. Exclusion criteria included chronic disease, use of other drugs, history of allergy to allopurinol, pregnancy, breast feeding, or forms of leishmaniasis other than cutaneous. Informed consent was obtained from all subjects after the nature of the procedures had been fully explained to them.Randomly selected patients received 20 mg/kg of allopurinol orally, three times a day, or 10 mg/kg of intravenous antimoniate of meglumine, once a day. Both patient groups used the drugs for a period of 20 days. A clinical history was collected and a physical examination was performed on all patients before initiating the treatment. Lesions were photographed and biopsied, and the tissue was used for histopathologic study and inoculation in hamsters and appropriate culture media. Patients were re‐examined on days 10 and 20 and at monthly intervals for 1 year following the beginning of treatment. Blood samples for serologic and biochemical analysis (measurements of serum uric acid, urea, crsatinine, and transaminases) were collected at days 0, 10, and 22 following the beginning of treatment.The definition of therapeutic failure included incompletion of the treatment protocol, use of a treatment different from the protocol, lesions not healed 3 months after the beginning of treatment, or relapse or development of new cutaneous or mucosal lesions caused by leishmaniasis within 1 year of treatment.The exact Fischer test was used to compare the treatment results between the two patient groups. Student's t‐test was used to compare the age of the patients and the duration of the illness. The Mann‐Whitney test was used to compare the diameter of the lesions at day 0 and 3 months after treatment completion in the two groups, and the Kruskal‐Wallis test was used to compare the number of lesions per patient and their localization.
Anti‐inflammatory activity of antifungal preparations
Authors: Rosen Ted , Schell Barbara J. , Orengo Ida 
Published: November 2003

Abstract Background Although steroid/antifungal combination medications are used extensively, they are associated with potential disadvantages. Antifungal preparations possessing inherent anti‐inflammatory activity, leading to rapid symptomatic relief while providing mycologic cure, would be very useful. Objective Our purpose was to investigate the anti‐inflammatory activity of proprietary antifungal preparations in an in vivo, human experimental model. Methods Using a double‐blind, controlled protocol, we assessed the comparative ability of antifungal preparations to suppress the expected delayed erythema response following in vivo human exposure to ultraviolet B (UVB) irradiation generated by a solar stimulator. Results Currently available allylamine preparations and ciclopirox olamine proved to be the most anti‐inflammatory, while ketoconazole was intermediate in anti‐inflammatory activity under these experimental conditions. These agents were superior to oxiconazole, econazole, and 2.5% hydrocortisone. Conclusions Some antifungal preparations possess inherent anti inflammatory activity, although the exact mechanism remains uncertain.
Efficacy of a 2–mm spot size lens for the treatment of superficial vascular lesions with a flashlamp‐pumped dye laser
Authors: Grekin Roy C. , Flynn Timothy C. , Cooper David , Geisse John 
Published: November 2003

Abstract Background The flashlamp‐pumped dye laser, using either a 3 or 5 mm spot size, is an excellent instrument for the treatment of port‐wine stains and other superficial cutaneous vascular lesions. Problems exist with patient acceptance due to prominent and prolonged blue‐black discoloration and the pain associated with the treatment. Objective To assess the effectiveness of a flashlamp‐pumped dye laser equipped with a 2 mm spot size lens in the treatment of superficial vascular lesions. Methods Twenty‐one patients with telangiectasias, cherry angiomas, and angiokeratomas were treated at a variety of fluences. Results Three of 21 patients had complete clearing of their superficial vascular lesions. An improvement of greater than 75% was noted by 11 patients, and six patients noted a 50%–75% improvement. One patient had less than 50% improvement. Less post‐treatment discoloration and less pain were noted with the 2 mm spot size lens. Conclusions The 2 mm spot size lens, used with the flashlamp‐pumped dye laser is an effective instrument for the treatment of superficial cutaneous vascular lesions.
The progression of nonsegmental vitiligo: clinical analysis of 318 patients
Authors: Chun Woo Hyung , Hann Seung‐Kyung 
Published: November 2003

Abstract Background Vitiligo is an acquired disorder with destruction of melanocytes and is characterized by cutaneous depigmentation with a progressive clinical course. We attempted to evaluate whether there was a relationship between the initial site and ultimate progression of nonsegmental vitiligo. Methods Three hundred and eighteen nonsegmental vitiligo patients were examined. Questionnaires regarding age, sex, duration of disease, family history, distribution of initial lesions, progression, and clinical type were recorded from personal interviews and case notes. Results Two hundred and eighty nine (90.9%) of the 318 patients showed progression of vitiligo at the time of examination. When the initial sites were the posterior trunk, hands, or feet, there was more progression of vitiligo to other body areas. The progression pattern was usually contiguous to the initial site. When the hands were the initial site, however, vitiligo most commonly progressed to the face. Conclusions There may be a possible relationship between the initial site and ultimate progression of nonsegmental vitiligo. The progression pattern is usually contiguous to the initial site.
Incorporation of Bovine Bone Marrow Stromal Cells into Porcine Foetal Tissues after Xenotransplantation
Authors: Troyer D. L. , Weiss M. L. , Mitchell K. E. , Martin P. L. , Davis D. L. 
Published: November 2003

SummaryBovine bone marrow stromal cells (BMSCs) were injected into the liver of foetal pigs at about 40 days of gestation to test whether these cells could populate developing tissue, and if so, which ones. Approximately 40 days after injection, the foetuses were harvested and tissue sections from many areas of the body were analysed for the presence of bovine cells using two different methods. First, using PCR, bovine repetitive DNA was found to be present in DNA extracted from foetal pig tissues. Secondly, using oligonucleotide primed in situ synthesis (PRINS), the in situ presence of bovine cells was found within porcine tissue sections. PRINS‐labelled cells were found within cartilage, perichondrium, connective tissue and smooth muscle. These data suggest that bovine BMSCs integrate throughout the foetal pig.
Retinopathy of prematurity in infants <29 weeks’ gestation at birth in New South Wales from 1986–92
Authors: TODD DA , KENNEDY J , CASSELL C , ROBERTS S , JOHN E 
Published: November 2003

Objective:To study the effect of increased survival of infants <29 weeks’ gestation on the incidence and severity of retinopathy of prematurity (ROP).Methodology:Review of prospective records from 1986 to 1992 kept in the New South Wales (NSW) NICUS database on infants admitted to the neonatal intensive care units (NICU) in NSW. The survival rate and the incidence and severity of ROP on all infants <29 weeks’ gestation admitted to the NICUs in NSW from 1 July 1986 to 31 December 1987 were compared to a similar group of infants admitted from 1 January 1992 to 31 December 1992.Results:There was a significant difference in the survival rate of infants admitted between the two periods (235 of 376, 62.5% survival vs 255 of 336, 75.9% survival, respectively, P<0.0001). The odds ratio for survival adjusted for gestational age in the second period was 1.76 [1.24, 2.48 (95% confidence interval), P<0.002]. There was a slight increase in ROP in the second period (79 of 172 examined, 45.9% ROP vs 133 of 238 examined, 55.8% ROP, respectively). There was a rise in the number of infants with Stage 3 ROP in the second time period (14 of 172 examined, 8.1% ROP vs 41 of 238 examined, 17.2% ROP, respectively). However, fewer infants had detached retinas or ≥Stage 4 ROP in the second group [7 of 172, (4.1%) vs 3 of 238, (1.3%), respectively]. This may be a reflection of the increase in the use of cryo‐ or laser therapy for Stage 3 ROP with ‘plus’ disease [2 of 172 examined, (1.2%) vs 18 of 238 examined, (7.6%), respectively].Conclusions:With the increase in survival of the very preterm infant in recent years, there has been an increase in severe ROP (≥Stage 3) in NSW. Despite the increased survival of the highest at‐risk group (24‐ to 26‐week gestation infants), there have been fewer cases of retinal detachment. There was also a rise in the number of infants receiving cryo‐ or laser therapy intervention.
Should preterm infants born after 29 weeks’ gestation be screened for intraventricular haemorrhage?
Authors: HARDING D , KUSCHEL C , EVANS N 
Published: November 2003

Objectives:To determine whether the current incidence of intraventricular haemorrhage (IVH) of grade 2 or more is high enough in preterm infants born after 29 weeks gestation to justify the cost of screening with ultrasound and to explore clinical indicators for risk of IVH in the more mature preterm infant.Methods:This cohort study examined the incidence and severity of IVH in 800 preterm infants born between January 1992 and August 1996, of whom 436 were born after 29 weeks. Demographic and clinical details were collected from a prospectively maintained database. The Medicare schedule charge rate for cerebral ultrasound was used to calculate costs.Results:1.1% of preterm babies born after 29 weeks gestation who had routine ultrasound scans had an IVH of grade 2 or 3, no infant had a grade 4 IVH. Two infants had a grade 3 IVH, both of which were symptomatic. IVH was poorly predicted by other clinical criteria. Using the Medicare schedule to estimate costs, detecting the five grade 2 or 3 IVH cost A$42 000.Conclusions:The incidence of grade 2–4 IVH is low in infants born after 29 weeks gestation. Screening of this population is expensive and probably not justified. It may be most appropriate to scan these infants only if their condition raises concern.
Farm and tractor‐related fatalities in children in South Australia
Authors: BYARD RW , GILBERT J , LIPSETT J , JAMES R 
Published: November 2003

Objective:To analyse the circumstances surrounding farm and tractor‐related childhood fatalities in South Australia, to identify potentially dangerous situations and to delineate prevention strategies.Methods:A retrospective search of files was conducted at the Women’s and Children’s Hospital Department of Histopathology from 1981 to 1996, and the State Coroner’s Office from 1988 to 1996.Results:Fifteen fatalities were identified comprising 11 boys and four girls (age range, 2 years 11 months to 13 years; average, 6 years). Activities prior to death included riding on a tractor/trailer (n=8); playing near a field grain storage bin (n=2); playing near machinery (n=2); sleeping in a car near a burn off (n=1); walking around a dam (n=1) and riding as a passenger on a motorbike (n=1). Causes of death included multiple skull fractures and cerebral damage (n=11), asphyxia (n=2), drowning (n=1) and incineration (n=1).Conclusions:The most dangerous activity involved children riding unrestrained on tractors; falls resulted in extensive injuries from tractor rear wheels or towed machinery. Allowing children on farms to ride on tractors or machinery only if there is a safe seat with a restraining harness would substantially reduce the number of fatal farm‐related childhood injuries in South Australia.
Isoflavone content of infant foods and formulas
Authors: KNIGHT DC , EDEN JA , HUANG JL , WARING MA 
Published: November 2003

Objective:The purpose of this study was to investigate the phytoestrogen content of different foods, formulas and drinks that may be consumed by infants during their first year of life in an attempt to define levels of exposure on different feeding regimens.Methodology:High performance liquid chromatography (HPLC) was used to determine the levels of genistein, daidzein, biochanin A, formononetin and equol in samples purchased from Australian supermarkets. Single lots of duplicate or triplicate samples of soy beverages, cow’s milks, infant formulas and infant yoghurts were analysed.Results:All foods tested contained isoflavones, at varying levels, suggesting that exposure to these compounds is almost ubiquitous. Casein‐based infant formulas contained between 0.001 and 0.03 mg L−1. Soy‐based infant formulas ranged from 17.2 to 21.9 mg L−1 with the values detected in yoghurt at similar levels to that of cow’s milk. For comparison, the soy‐based beverages (which are not recommended for use under 12 months of age) contained levels of isoflavones from 22.9 to 71.5 mg L−1.Conclusions:Given the relatively broad choice of infant foods becoming available, exposure to dietary isoflavones during the first year of life is virtually ubiquitous. The exposure may be higher if soy infant formulas are consumed, however, the levels attained appear to fall within normal physiological boundaries.
Treatment of acute asthma: Salbutamol via jet nebuliser vs spacer and metered dose inhaler
Authors: ROBERTSON CF , NORDEN MA , FITZGERALD DA , CONNOR FL , VAN ASPEREN PP , COOPER PJ , FRANCIS PW , ALLEN HDW 
Published: November 2003

Objective:To compare the efficacy of salbutamol delivered by jet nebuliser (JN) with salbutamol via a pressurised metered dose inhaler (PMDI) and a large volume spacer (Volumatic) for management of acute asthma.Study population:A total of 160 children aged from 4 to 12 years presenting to an Emergency Department with acute asthma.Methods:The study was of multicentre (n=5) randomised, double blind, parallel design. Children weighing less than 25 kg received salbutamol 2.5 mg via the JN or 600 μg (six puffs) from the PMDI. Children over 25 kg received salbutamol 5 mg via the JN or 1200 μg (12 puffs) via the PMDI. Clinical score (range 0–12) and PEF (over 7 years) were recorded at baseline and 15, 30, 45 and 60 mins post administration.Results:The improvement from baseline at 30 min in the clinical score was 1.87 for JN and 1.43 for PMDI (P=0.09) and at 60 min was 2.15 for JN and 1.12 for PMDI (P=0.0001). The improvement in PEF at 30 min was 51 L min−1 for JN and 27 L min−1 for PMDI (P=0.0007) and at 60 min was 57 L min−1 for JN and 31.5 L min−1 for PMDI (P=0.001).Conclusion:Administration of salbutamol via a PMDI and a large volume spacer device provides effective relief in the management of acute asthma in children, but to a lesser extent than a jet nebuliser. This difference may represent a dose response effect.
The sleep patterns of infants and young children with gastro‐oesophageal reflux
Authors: GHAEM M , ARMSTRONG KL , TROCKI O , CLEGHORN GJ , PATRICK MK , SHEPHERD RW 
Published: November 2003

Objective:Sleep disturbance in gastro‐oesophageal reflux disease (GORD) in infants and young children has not been systematically studied nor has this manifestation been compared with population norms.Methods:Sleep patterns of 102 infants and children aged 1 to 36 months with and without GORD, defined by pH monitoring, were analysed using the same questionnaire as in recent studies of normal sleep behaviour in this age range. Main outcome measures included time taken to settle at night, the number of night time wakenings requiring parental intervention, day time sleep patterns and parents problems with their childs’ sleep behaviour.Results:Compared with the population norms (n=3102), those with GORD (n=76) had greater prevalence of night time waking >3/night (50% vs 13% aged 3–12 months; 60% vs 10% aged 12–24 months, P<0.001), requirement of parental intervention (82% vs 55% aged 3–12 months, P<0.05; 92% vs 55% aged 12–24 months, P<0.001), significantly delayed onset of sleeping through the night, and greater prevalence of daytime sleep beyond 24 months. Similar but less striking differences were seen comparing those with (n=76) and without GORD (n=26).Conclusions:Sleep interruption occurs more frequently in infants and children with GORD than population norms. Objective evaluation of infants and children with sleep disturbance after the age of 3 months may avoid unnecessary over or under diagnosis of GORD. Systematic investigation of the contribution of GORD to sleep disturbance in infants and young children is warranted.
Cataracts in insulin‐dependent diabetes mellitus: Sixteen years’ experience in children and adolescents
Authors: MONTGOMERY EL , BATCH JA 
Published: November 2003

Objective:To report on cases of diabetic cataracts in a paediatric and adolescent population.Methodology:Medical histories of children and adolescents attending the Royal Children’s Hospital Diabetes Service who had developed cataracts between 1981 and 1996 were examined.Results:Nine cases of diabetic cataracts have been managed over the 16‐year time frame. Two cases presented at diagnosis of insulin‐dependent diabetes mellitus (IDDM) and one 3 weeks after. The remaining six presented 1.7–13 years (mean 5.17±4.02) after diagnosis of IDDM. All but one had exhibited poor control of their diabetes with high HbA1C values.Conclusions:Cataracts occurring in the paediatric and adolescent population, though uncommon, lead to marked morbidity. It is recommended that all children have an ophthalmological examination at diagnosis, particularly if they have had a long duration of symptoms before diagnosis. Persistently poor diabetes control and/or blurred vision are indications for prompt ophthalmological review.
The use of medication in children attending childcare in Western Australia
Authors: SLACK‐SMITH LM , READ AW , STANLEY FJ 
Published: November 2003

Objective:This paper reports on medication use and factors affecting use in a cohort of preschool children attending long daycare in centres and family daycare in homes.Methodology:A survey of parents representing 846 children under 6 years old in two types of childcare in Perth, Western Australia. The data were analysed using descriptive and logistic regression techniques to elucidate factors associated with use of medication.Results:Seventy‐three per cent of the children were reported to have used over‐the‐counter medication at some time, whilst current regular use of prescribed medication was 11%. This proportion is comparable to the limited available data for children of similar ages in Western Australia. For both medication categories, the use of medication was higher in long daycare than family daycare. In addition, many other characteristics differed between children in long daycare and family daycare. Initial analysis showed a number of significant associations between child and family factors and both categories of medication. Multivariable analyses indicated that the most important associations with medication use were with children’s illnesses. There was no significant difference between long daycare and family daycare for use of over‐the‐counter medication but attending long daycare was significantly associated with increased use of prescribed medication (OR=2.13; 95% CI 1.24–3.67) after illnesses had been taken into account.Conclusion:Medication use in children attending childcare is closely related to reported illness in the child.
Children’s understanding of sun protection behaviours: A comparative analysis
Authors: MORRIS J , BANDARANAYAKE M , McGEE R 
Published: November 2003

Objective:To investigate awareness of sun protection behaviours in a sample of primary school children in New Zealand.Methodology:Information was collected from 824 primary school children in New Zealand using a drawing and writing technique.Results:The data revealed a bias towards sunscreen as a method of sun protection compared with other methods such as clothing and the use of shade. Comparisons between results obtained from children resident in Australia and England indicated a greater awareness of sun protection methods amongst the children from Australia and New Zealand compared with those children living in England.Conclusions:Children as young as 5 and 6 can describe the consequences of overexposure to the sun, and can illustrate methods of sun protection. Sunscreen is seen as the main method of sun protection.
Developmental‐behavioural problems in general paediatrics
Authors: HOLT JM , McDOWELL MJ 
Published: November 2003

Objective:To determine the current role of private general paediatrics in the care of children with problems of development and behaviour.Methods:We surveyed all general paediatricians registered with the Australian College of Paediatrics to assess their current role in developmental‐behavioural (DB) problems—their rate of referrals, their role in the continuing management, and opinions regarding duration of training in this area.Results:Of 394 questionnaires sent, 284 replies were received (72%). From these 284 we analysed results for all 172 who spent more than 25% of their time in private general paediatric practice. On average, 32% of new referrals were for DB problems. With 10 DB clinical vignettes presented, paediatricians chose to continue to manage in conjunction with allied health services in 65% of cases. Other management choices included referral to a multidisciplinary team (16%), referral elsewhere (10%) and manage alone (7%). For training to be a general paediatrician, they indicated 3 months should be spent during basic training in each of the three areas of; DB paediatrics, developmental disabilities and child psychiatry (separately or concurrently); and 6 months of each during advanced training. Free comments highlighted lack of public allied health and psychosocial services.Conclusion:Private community‐based general paediatricians are deeply involved in this area of work. The results raise questions about services for training and for clinical collaboration between public and private child health providers.