bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis B Vaccination Rate of Homeless Children in Baltimore
Authors: Schwarz K , Garrett B , Lamoreux J , Bowser YD , Weinbaum C , Alter M J 
Published: July 2005

ABSTRACTObjective:To investigate the hepatitis B vaccination rate in homeless children 2 to 18 years old living in Baltimore City.Methods:During a 21‐month period, 250 children from homeless shelters were enrolled.Results:The percent of children who had received 3 or more doses of hepatitis B vaccine was inversely related to age; 90% in 2‐ to 5‐year‐olds and 29% in 13‐ to 18‐year‐olds (P < 0.0001). Seventy percent of 2‐ to 5‐year‐olds had at least some of their vaccine history recorded in the Baltimore Immunization Registry Program but the history was complete in only half. Forty‐two percent of 13‐ to 18‐year‐olds had no hepatitis B vaccine doses recorded in any source; 49 per cent of 10‐ to 18‐year‐olds were either not immunized or had received only one hepatitis B vaccine dose.Conclusions:Hepatitis B vaccine coverage is high in homeless children up to 9 years of age, whereas the majority of homeless children 10 years of age and older are unprotected against hepatitis B virus infection. Tracking the vaccine records in homeless children is labor intensive. Better public health strategies to deliver hepatitis B vaccine to older homeless children are urgently needed.
Drug combinations and impaired renal function – the ‘triple whammy’
Authors: Loboz Katarzyna K. , Shenfield Gillian M. 
Published: July 2005

BackgroundRecent studies have identified the ‘triple whammy’ in which combinations of diuretics, nonsteroidal anti‐inflammatory drugs (NSAIDs), ACE inhibitors (ACEI) and/or angiotensin receptor antagonists (ARA) may impair renal function.MethodsWe performed a cross‐sectional study of patients admitted to a general medical ward of a teaching hospital. Age, sex, disease status and prior consumption of the ‘target’ drugs, diuretics, NSAIDs (including aspirin), ACEI and ARA were correlated with creatinine and creatinine clearance on admission.ResultsThree hundred and one patients (48% male) were included, 135 were on no prior target drugs, 87 on one, 60 on two and 19 on three such drugs. There was a significant (P < 0.01) correlation between both creatinine and creatinine clearance with male sex, age and number of target drugs. Multivariate analysis confirmed these associations but did not support associations between renal function and heart failure or total number of diagnoses. Increasing doses of diuretics, possibly because in many cases this included two drugs, but not the other drugs, were significantly (P < 0.001) associated with impaired renal function. For the other three drug groups patients on doses of any drug at lower than the defined daily dose (DDD) did not have significantly different creatinine or creatinine clearance from those on doses at or above the DDD.ConclusionTaking two or more of the identified drugs was associated with significant renal impairment but did not correlate with heart failure or other diseases for which the drugs might have been prescribed. Care is necessary to balance the demonstrated advantages of these medications against the risk of inducing renal failure.
Drugs with anticholinergic properties and cognitive performance in the elderly: results from the PAQUID Study
Authors: Lechevallier‐Michel Nathalie , Molimard Mathieu , Dartigues Jean‐François , Fabrigoule Colette , Fourrier‐Réglat Annie 
Published: July 2005

ObjectivesTo measure the association between the use of drugs with anticholinergic properties and cognitive performance in an elderly population, the PAQUID cohort.MethodsThe sample studied was composed of 1780 subjects aged 70 and older, living at home in South western France. Data on socio‐demographic characteristics, medical history and drug use were collected using a standardized questionnaire. Cognitive performance was assessed using the following neuropsychological tests: the Mini‐Mental State Examination (MMSE) which evaluates global cognitive functioning, the Benton Visual Retention Test (BVRT) which assesses immediate visual memory, and the Isaacs’ Set Test (IST) which assesses verbal fluency. For each test, scores were dichotomized between low performance and normal to high performance using the score at the 10th percentile of the study sample as the cut‐off point, according to age, gender and educational level. The association between the use of drugs with anticholinergic properties and cognitive performance was examined using logistic regression models, adjusting for several potential confounding factors.ResultsAbout 13.7% of the subjects used at least one drug with anticholinergic properties. In multivariate analyses, the use of these drugs was significantly associated with low performance in the BVRT [odds ratio (OR) = 1.6; 95% confidence interval (CI) 1.1, 2.3] and in the IST (OR = 1.9; 95% CI 1.3, 2.8). The association found with low performance in the MMSE (OR = 1.4; 95% CI 1.0, 2.1) was barely statistically significant.ConclusionThese findings suggest that the use of drugs with anticholinergic properties is associated with low cognitive performance among community‐dwelling elderly people.
The effects of hepatic impairment on the pharmacokinetics of fosfluconazole and fluconazole following a single intravenous bolus injection of fosfluconazole
Authors: Sobue Satoshi , Tan Keith , Haug‐Pihale Gertraud 
Published: July 2005

AimsFosfluconazole is a phosphate pro‐drug of fluconazole (FLCZ). This study was conducted to determine the pharmacokinetics of fosfluconazole and FLCZ following a single intravenous injection of fosfluconazole in subjects with hepatic impairment and to compare them with healthy subjects.MethodsTwenty‐four subjects (12 with normal hepatic function and 12 with chronic stable mild to moderate impaired hepatic function) received a single 1000‐mg bolus intravenous injection of fosfluconazole. Concentrations of fosfluconazole and FLCZ were determined in plasma and urine samples taken up to 192 h and 48 h postdose, respectively.ResultsThe total clearance of fosfluconazole was higher and the t1/2,Z and mean residence time were shorter in hepatically impaired subjects than in normal subjects. This may reflect more rapid conversion to FLCZ. The degree of protein binding of fosfluconazole (> 90%) and the amount of fosfluconazole excreted in the urine were similar in both groups. Slightly higher mean plasma concentrations of FLCZ were observed in the impaired group than in the normal group; however, hepatic impairment had no statistically significant effect on the FLCZ pharmacokinetic parameters apart from tmax. The tmax values were 4.8 h and 3.1 h in the normal and impaired subjects, respectively. The shorter tmax for FLCZ is also consistent with the more rapid conversion in the impaired subjects. The ratios (95% confidence intervals) for Cmax and AUC of FLCZ (impaired/normal) were 106.0% (92.8, 121.2) and 115.6% (86.4, 154.7), respectively. There were no serious adverse events, and no discontinuations due to adverse events or laboratory test abnormalities. The adverse events reported were mostly mild in severity and no trend could be discerned between the groups.ConclusionsFosfluconazole was more rapidly converted to FLCZ in the hepatically impaired subjects but the FLCZ pharmacokinetic parameters (except tmax) were not statistically significantly affected by hepatic impairment. Fosfluconazole was well tolerated by both groups. These results suggest that there is no requirement to adjust the dose of fosfluconazole when administered to subjects with mild to moderate hepatic impairment.
Efficacy and safety of three ophthalmic inserts for topical anaesthesia of the cornea. An exploratory comparative dose‐ranging, double‐blind, randomized trial in healthy volunteers
Authors: Mahé Isabelle , Mouly Stéphane , Jarrin Irène , Otéro Jacqueline , Tavera Catherine , Simoneau Guy , Tillet Yves , Conti Robert , El Meski Saïd , Gaudric Alain , Bergmann Jean‐François 
Published: July 2005

BackgroundCataract surgery requires prolonged anaesthesia, concomitant with permanent hydration and lubrication of the cornea, in order to provide a clear view of the operation area.AimsThe primary objective of the study was to assess several formulae of a soluble ophthalmic insert: TOPICSERT [bupivacaine (Bupi) + hyaluronic acid (HA) or sodium hyaluronate] in terms of complete and long‐lasting anaesthesia of the cornea. The hydration properties of HA were not assessed in this study.MethodsIn a prospective double‐blind, cross‐over, randomized study, with latin‐square allocation of treatments, 16 healthy volunteers received a single dose of each formula (A, 1 mg Bupi and 0.1 mg HA; B, 0.5 mg Bupi and 0.1 mg HA; C, 1 mg Bupi and 0 mg HA, and D acting as a placebo) via the ocular route with 1 week of wash‐out between each period. Corneal anaesthesia was measured using a Cochet‐Bonnet esthesiometer.ResultsThere was a statistically significant difference between treatments with regard to the main criterion (complete anaesthesia lasting at least 20 min) when general association statistics were used (Mantel–Haenzel test, P < 0.0001): 68.75% (n = 11) of subjects receiving treatment A, 37.5% (n = 6) receiving treatment B, and 87.5% (n = 14) on treatment C reached complete and satisfactory anaesthesia, while this was not achieved in any of the subjects receiving placebo. Ninety‐five percent confidence intervals of the difference between treatments were as follows: treatment A vs.  B  (−0.03,  0.66),  treatment  A vs.  C  (−0.47,  0.10),  treatment  B vs.  C  (−0.84, − 0.16). Only the difference between B and C was statistically significant (adjusted probability by the method of Bonferroni, P < 0.001). When complete anaesthesia was reached, mean (±SD) duration of anaesthesia was as follows: 20.7 (±6.5), 15.3 (±11.4) and 24.7 (±7.6) min for treatments A, B, C, respectively.ConclusionsBupivacaine 1 mg seems to be the efficient and safe dose. The value of hyaluronic acid as a corneal hydration agent and used in association with bupivacaine will be the subject of further studies.
The influence of guidelines on the use of statins: analysis of prescribing trends 1998–2002
Authors: Teeling M. , Bennett K. , Feely J. 
Published: July 2005

Aims:To monitor statin prescribing trends over time in order to determine whether prescribers were influenced by study results and/or clinical guidelines in terms of type and dosage of statin prescribed.Methods:The GMS (General Medical Services) prescription database in Ireland was used to identify a cohort of patients, prescribed statins, in order to investigate prescribing trends from January 1998–December 2002. Statin prescribing rates for patients with ischaemic heart disease and diabetes were compared with rates in the general GMS population. Logistic regression analysis was used in patients with ischaemic heart disease and diabetes and adjusted odds ratios and 95% confidence intervals presented.Results:Increased statin prescribing over time was noted (test for linear trend P < 0.0001). Pravastatin was the most frequently prescribed, followed by atorvastatin; simvastatin and fluvastatin showed lower rates of prescribing. Atorvastatin showed the greatest increased rate over time. An increase in the overall dose prescribed (test for trend P < 0.01) was chiefly due to increases in pravastatin dose, but doses were still below those recommended from clinical trials. Statins were prescribed more frequently in patients with ischaemic heart disease and diabetes, 44% (95% CI 43–45%) compared with the total GMS population, 7.7% (95% CI 7.6–7.8%), by December 2002. However, statins were only prescribed to 52% (95% CI 51–53%) of ischaemic heart disease patients and 40% (95% CI 39–41%) of patients with diabetes by December 2002. Patients aged 45–64 years were more likely to receive statins, compared with those aged 65 years and older.Conclusion:These findings suggest that the beneficial effects of statins shown in clinical studies may not be achieved in practice.
Weight related differences in the pharmacokinetics of abacavir in HIV‐infected patients
Authors: Jullien V. , Tréluyer J.‐M. , Chappuy H. , Dimet J. , Rey E. , Dupin N. , Salmon D. , Pons G. , Urien S. 
Published: July 2005

AimTo study the possible influence of patient characteristics on abacavir pharmacokinetics.MethodsA population pharmacokinetic model for abacavir was developed using data from 188 adult patients by the use of a nonlinear mixed effects modelling method performed with NONMEM.ResultsAbacavir pharmacokinetics was well described by a two‐compartment open model with linear absorption and elimination. Typical population estimates for the absorption rate constant (Ka), the apparent central distribution volume (Vc/F), the apparent peripheral distribution volume (Vp/F), the apparent intercompartmental clearance (Q/F) and the apparent plasma clearance (CL/F) were 1.8 h−1, 75 l, 23.6 l, 10 l h−1 and 47.5 l h−1, respectively. Apparent plasma clearance was positively related to bodyweight. Individual Bayesian estimates of CL/F were used to calculate abacavir AUC. The latter decreased from 10.7 ± 5.0 to 5.7 ± 1.6 mgh l−1 when bodyweight increased from 36 to 102 kg. This drop in abacavir exposure could lead to suboptimal treatment for the heaviest patients, as antiviral efficacy of abacavir is known to be related to its AUC. A 400 mg abacavir dose would be necessary to achieve adequate exposure to abacavir in patients weighing more than 60 kg.ConclusionsThe apparent plasma clearance of abacavir was positively related to bodyweight. The efficacy of the current recommended abacavir dosage for patients with high bodyweight should be evaluated in further studies.
Health professionals rarely record history of complementary and alternative medicines
Authors: Cockayne Nicole L. , Duguid Margaret , Shenfield Gillian M. 
Published: July 2005

AimsTo identify the completeness of documentation of Complementary And Alternative Medicine (CAM) use in hospital medical records of patients before and after an education programme.MethodsDocumentation of CAM in all parts of the medical records was compared to patients’ self‐reported use. Data were collected for one month before and one month after an education programme for hospital staff.ResultsAt baseline: 59 (58%) of 101 patients used 129 CAM in the month prior to admission; only 36 (28%) of the CAM were documented in the medical record. After education: 51 (54%) of 94 patients used 91 CAM in the month prior to admission; 40 (44%) of the CAM were documented in the medical record. After education, recording rates increased by 16% (95% CI: 3% to 29%) due to improvements by pharmacists (18%, 95% CI: 5% to 31%). 32 (54%) of CAM users at baseline and 29 (57%) of CAM users after education informed a health professional. The recording rates were only 23 (39%) and 28 (55%) respectively for patients in these two sub‐groups, being an improvement of 16% (95% CI: −2% to 34%).ConclusionsPrevalence of CAM use among patients admitted to hospital is high, but documentation of usage is low. Strategies need to be designed to improve health professionals’ knowledge about the need to record history of CAM use.
Child or family assessed measures of activity performance and participation for children with cerebral palsy: a structured review
Authors: Morris C. , Kurinczuk J. J. , Fitzpatrick R. 
Published: July 2005

AbstractBackground There is a need to measure children's ‘activity performance and participation’ as defined in the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth (WHO ICF). The aim of this review is to identify instruments that are suitable for use in postal surveys with families of children with cerebral palsy.Methods We conducted a structured review of instruments that use child or family self‐assessment of ‘activity performance and participation’. The review involved a systematic search for instruments using multiple published sources. Appraisal of the instruments used the predefined criteria of appropriateness, validity, reliability, responsiveness, precision, interpretability, acceptability and feasibility.Results There are relatively few child or family assessed instruments appropriate for measuring children's activities and participation. Seven instruments were identified that could potentially be administered by mail. The Assessment of Life Habits for Children (LIFE‐H) was the most appropriate instrument as assessed by its content but the reliability of child or family self‐assessment is not known. If the LIFE‐H were shown to be a reliable self‐report measure then the LIFE‐H would be the recommended choice. Currently, the Activities Scale for Kids and the condition‐specific Lifestyle Assessment Questionnaire for cerebral palsy (LAQ‐CP) provide the broadest description of what and how frequently children with cerebral palsy perform a range of activities and thereby indicate participation. The LAQ‐CP also provides additional contextual information on the impact of any disability on the participation of the family unit.Conclusion There remains much scope for developing valid and reliable self‐assessed measures corresponding to the WHO ICF dimensions of activities and participation.
Getting the run around: accessing services for children with developmental co‐ordination disorder
Authors: Rodger S. , Mandich A. 
Published: July 2005

AbstractBackground  Accessing services for children with developmental co‐ordination disorder (DCD) is frequently difficult for parents who have to navigate both health and education systems to find a diagnosis and appropriate interventions.Method  A qualitative study design incorporating a phenomenological perspective was utilized to understand the nature of the experiences of these parents in attempting to access support for their children with DCD. Twelve parents, whose children attended the Kids Skills Clinic at the University of Western Ontario and were identified as having DCD, were interviewed by the second author. Interviews were transcribed verbatim and analysed using constant comparative method. Member checking, peer checking and code‐recoding were carried out to enhance rigour in data analysis.Results  A number of themes emerged focusing on the common problems experienced leading to occupational therapy referral. Parents’ journeys to seek and access services for their children with DCD were characterized by a sense of maternal knowing, experience of frustration, trivialization of the problem, a sense of ‘going it alone’, and ‘getting the run around’.Conclusions  Implications for health and educational professionals working with children, in terms of recognition of DCD and referral for services, are described.
Clinical, socio‐demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction
Authors: Uzun N. , Kendirli Y. 
Published: July 2005

AbstractBackground  Abuse of organic volatile substances in children has become a social health problem that is increasing in the recent years. Among these substances, toluene is highly preferred by abusers because of its euphoric effect, cheapness and easy availability. There is no published research on the clinical and neurophysiological evaluation of children with short‐term volatile substance addiction.Methods  In this study, socio‐demographic characteristics were questioned in 12 children with a mean age of 15 years and a duration of toluene abuse for a mean of 2.3 years, and the clinical characteristics of central and peripheral nervous system damage caused by volatile substances, particularly by toluene were analysed, and probable neurological disorders were investigated by means of neurophysiological and neuropsychological tests. All tests were compared with a control group.Results  Fifty‐eight percent of the children included in the study had pathological findings in the neurological examination. There was pyramidal involvement in 25% and peripheral nerve involvement in 33.3% of the cases. Evaluation of the cognitive functions revealed 33.3% pathology in the ‘Short Test of Mental Status’ which assesses functions of orientation, attention, learning, arithmetic calculation, abstraction, information, construction and recall. Sensorial polyneuropathy was found in 33.3% of the cases in nerve conduction studies. Somatosensory‐evoked potentials revealed pathology in 16.7% of the cases and brainstem‐evoked potentials in 50% of the cases. No pathology was observed in electroencephalography and visual‐evoked potentials.Conclusion  In our study, neurophysiological and neuropsychiatric tests revealed that toluene causes slow progressive, clinical and subclinical central and peripheral nerve damage. In Turkey, because of cheapness, easy availability and legal use of volatile substances, the clinical extent of systemic and neurological toxicity of volatile substance abuse is increasing. Abuse of volatile substances, a currently increasing social issue, may create important physical problems which can be permanent.
Associations of lifestyle factors with quality of life (QOL) in Japanese children: a 3‐year follow‐up of the Toyama Birth Cohort Study
Authors: Chen X. , Sekine M. , Hamanishi S. , Yamagami T. , Kagamimori S. 
Published: July 2005

AbstractPurpose  To examine the associations between lifestyle factors and quality of life (QOL) among Japanese children.Methods  Participants were 7794 children (3869 boys and 3925 girls) aged 9–10. They completed a questionnaire regarding lifestyles at baseline survey and were followed up for 3 years. In the follow‐up survey, QOL was evaluated using a Japanese version of the COOP charts. Children rated their QOL as one of five response categories. Subjects rated as ‘very well’ or ‘pretty good’ were considered to have good QOL, and the remainder was assumed to have poor QOL. Logistic regression analysis was performed to evaluate the relationship between lifestyles or changes in lifestyles and QOL. In the multivariate analysis model, age, sex, body mass index (BMI), and lifestyle factors were simultaneously entered.Results  During the follow‐up period, children became more sedentary. Compared to children participating in physical activity ‘very often’ at baseline, those who exercised ‘almost never’ were more likely to have poor QOL [OR (95% CI): 1.92 (1.26–2.93)]. Children who developed or maintained undesirable lifestyles had high OR for poor QOL. Compared to children taking breakfast ‘often’ during the follow‐up period, those changing from ‘often’ to ‘seldom’ or those taking breakfast ‘seldom’ were more likely to have poor QOL [1.61 (1.24–2.07), 2.05 (1.03–4.09), respectively]. When compared with children maintaining their participation in physical activity ‘often’, those who changed from ‘often’ to ‘seldom’ and those who kept ‘seldom’ were more likely to have poor QOL [2.10 (1.84–2.39), 2.21 (1.88–2.59), respectively].Conclusions  This study shows that unfavourable lifestyles in childhood are associated with poor QOL in early adolescence. Early intervention could be worth considering to keeping desirable lifestyles during childhood.