bluuebunny/crossref_metadata_2025_split huggingface dataset:
High‐resolution contrast‐enhanced magnetic resonance angiography of the carotid arteries using fluoroscopic monitoring of contrast arrival: diagnostic accuracy and interobserver variability
Authors: Butz B. , Dorenbeck U. , Borisch I. , Zorger N. , Lenhart M. , Feuerbach S. , Link J. 
Published: April 2004

Purpose: To evaluate the diagnostic accuracy of high‐resolution contrast‐enhanced magnetic resonance angiography (CE‐MRA) of the supra‐aortic arteries using the CareBolus technique. Digital subtraction angiography was the standard of reference. Material and Methods: Fifty consecutive patients with suspected internal carotid artery stenosis underwent CE‐MRA and digital subtraction angiography. CE‐MRA was performed on a 1.5‐T superconducting scanner with the CareBolus technique. CareBolus combines a nearly real‐time 2D‐FLASH (fast low angle shot) sequence for fluoroscopic triggering and a high‐resolution 3D‐FLASH with elliptical centric view order for the angiographic pulse sequence (6.0/2.16 ms [TR/TE], 30° flip angle, 30.98 s acquisition time, 0.88 mm effective (interpolated) partition thickness and a 160×512 matrix). Intra‐arterial digital subtraction angiography and CE‐MRA studies were evaluated independently by four blinded readers. Internal carotid artery stenoses were graded according to the NASCET criteria. Results: CE‐MRA had an accuracy of 92.53%, a sensitivity of 95.64%, and a specificity of 90.39% for the identification of carotid artery stenoses ≥70% (grade 3). Image quality for suppression of stationary tissue and venous contrast was good, but was reduced in five cases due to patient motion. Conclusion: The CareBolus technique is a useful non‐invasive method for high‐resolution imaging of the supra‐aortic vessels because of its easy application and high sensitivity and specificity. Limitations can occur in non‐compliant patients due to motion artifacts during the measurement time.
Fluoroscopically guided percutaneous gastrostomy with modified gastropexy and a large‐bore balloon‐retained catheter in patients with head and neck tumors
Authors: Chan S.‐C. , Ko S.‐F. , Ng S.‐H. , Cheung Y.‐C. , Chang J. T.‐C. , Liao C.‐T. , Wang H.‐M. , Lui K.‐W. 
Published: April 2004

Purpose: To report on fluoroscopically guided percutaneous gastrostomy (FPG) using a modified gastropexy technique with the insertion of a large‐bore balloon‐retained gastrostomy catheter in patients with head and neck tumors. Material and Methods: Thirty‐four patients with head and neck tumors underwent a modified gastropexy with two T‐fasteners followed by the insertion of a 14‐F balloon‐retained catheter through a peel‐away introducer. The success rate and the complications of the procedures were evaluated at 14 days, 30 days, and 60 days. The complications were classified as: major complications that necessitated intensive and/or surgical treatment; minor complications that could be treated conservatively; and tube‐related complications manageable by tube exchange. Results: FPG was technically successful in all cases. There were no major complications, two minor complications where superficial stoma infection was controlled by antibiotics, three minor tube‐related complications, all three easily managed by catheter replacement via the original tract. Conclusion: FPG with insertion of a large‐bore balloon‐retained catheter using a modified gastropexy technique is a safe and effective method that creates a feeding access for patients with head and neck tumors and esophageal obstruction. Minor complications can be managed conservatively. FPG may be a good alternative to surgical or percutaneous endoscopic gastrostomy.
Evaluation of a wavelet‐based computer‐assisted detection system for identifying microcalcifications in digital full‐field mammography
Authors: Diekmann F. , Diekmann S. , Bollow M. , Hermann K. G. , Richter K. , Heinlein P. , Schneider W. , Hamm B. 
Published: April 2004

Purpose: To evaluate a new wavelet‐based computer‐assisted detection (CAD) system for detecting and enhancing microcalcifications. Material and Methods: A total of 280 mammograms acquired by full‐field digital mammography (Senographe 2000D; G.E. Medical Systems Milwaukee, Wisc., USA) were analyzed with and without a new wavelet‐based CAD system for detecting and enhancing microcalcifications. The mammograms comprised roughly equal numbers of cases from each of the BIRADS (Breast Imaging, Reporting and Data System, according to the American College of Roentgenology) categories 1–5. Histologic confirmation was available for all of the 180 cases assigned BIRADS categories 3–5. Four readers interpreted all 280 images for suspicious microcalcifications using a scale of 1–5. The readers alternately assessed 5 images with and 5 without CAD. In a second reading immediately following the first, the readers had to reassess the 280 mammograms. The images that had already been interpreted without CAD were now presented with CAD and vice versa. The images were interpreted as soft copies on a diagnostic mammography workstation (Image Diagnost GmbH, Neufahrn/Munich, Germany). All images interpreted with CAD were presented with enhancement of microcalcifications by wavelet algorithms and prompting of microcalcifications. ROC (receiver operating characteristic) analyses were performed, and image interpretation time with and without CAD was measured. Results: The overall time for interpretation required by all 4 readers together was 483 min with CAD compared to 580 min without CAD. ROC analysis revealed no significant advantage of CAD for the individual readers. Readers 3 (0.811/0.817) and 4 (0.799/0.843) had a slightly improved AUC (area under the curve) with CAD. Readers 1 and 2 had a slightly lower AUC with CAD (0.832 versus 0.861 and 0.818 versus 0.849). Conclusion: The CAD system significantly ( P<0.05, t test) speeded up image interpretation with respect to the identification of microcalcifications, while the diagnostic quality remained almost identical under the study conditions.
Role of the constructive interference in steady‐state sequence in the classification of sacral meningeal cysts
Authors: Kitis O. , Calli C. , Sener R. N. , YÜnten N. , Yurtseven T. , Ersahin Y. 
Published: April 2004

Purpose: To investigate the role of the CISS (constructive interference in steady state) sequence in sacral meningeal cysts. Material and Methods: Fourteen patients with sacral meningeal cysts were included. Conventional T1W and T2W sequences and the CISS sequence (TR/TE=12.25/5.90) were obtained at 1.5‐T. The 1‐mm‐thick base images and multiplanar reformatted images of the CISS sequence were studied. The sacral meningeal cysts were classified by the CISS sequence in accordance with the previously described surgical and histopathological criteria. Results: A total of 25 sacral meningeal cysts were identified in the 14 patients. The cysts and their contents were visualized by the CISS sequence, and the CISS sequence was superior to the T1W and T2W images. Fifteen of the cysts were consistent with type I lesions (extradural meningeal cysts without nerve fibers inside) and 10 cysts with type II lesions (extradural meningeal cysts with nerve fibers inside). There were no type III lesions (intradural meningeal cysts) in the sacral region. Conclusion: Previous studies have indicated that conventional MRI as well as magnetic resonance myelography are inconsistent for a classification of sacral meningeal cysts. The CISS sequence with its capability to obtain T2W thin slice acquisitions is superior in showing the nerve root fibers contained in the cysts, which is essential in the differentiation of type I and II cysts. Application of the CISS sequence is recommended in the diagnosis of sacral meningeal cysts.
Traumatic cervical injuries in ankylosing spondylitis
Authors: Nakstad P. H. , Server A. , Josefsen R. 
Published: April 2004

Purpose: To demonstrate the importance of magnetic resonance (MR) and computed tomography (CT) in the evaluation of cervical traumas in patients suffering from ankylosing spondylitis. Material and Methods: Eleven patients with advanced ankylosing spondylitis were admitted to neurosurgical treatment after trauma to the neck region. All had neurological symptoms and were evaluated with plain X‐ray, CT, and MR. Results: CT with reformation sagittal and coronal plane was superior to plain X‐ray films in demonstrating fractures and dislocations. MR was considered mandatory when evaluating changes in medulla and epidural hematomas, which were detected in 4 patients. The clinical outcome was poor in 5 patients and good in 6. The poorest outcome was seen in patients with cord contusion and epidural hematoma. Conclusion: We conclude that plain X‐ray is of no greater importance in the acute phase of highest value in follow‐up evaluation of the healing process and final position of the fractured vertebrae. Our protocol in the acute phase in traumatized ankylopoetic patients consists of lateral conventional X‐ray, CT with reformatted images, and MR, the last‐mentioned being important in detecting epidural hematoma that reduces the clinical outcome further if not removed. In our opinion, MR must be part of the radiological protocol following neck traumas in all patients with ankylosing spondylitis.
Maternal smoking: an increasing unique risk factor for sudden infant death syndrome in Sweden
Authors: Chong DSY , Yip PSF , Karlberg J 
Published: April 2004

Aim: To assess the change of risk factors that are specific to sudden infant death syndrome (SIDS) after the initialization of a campaign to reduce the risk (RTR) of SIDS compared to non‐SIDS postneonatal deaths. Methods: Data were extracted from the Swedish Medical Birth Registry, 1982‐1991 and 1993‐1998. 1105 infants died from SIDS during the postneonatal period, 2115 postneonatal deaths were from other causes and 11050 live birth controls were selected. Risk factors previously identified to be related to SIDS were defined as high parity, prematurity, young maternal age, low Apgar score, birth during the night, single motherhood, multiple births, maternal smoking, male gender, short length standard deviation score (SDS) and small weight‐to‐length SDS. Results: Non‐SIDS deaths were more significantly related to a low 5‐min Apgar score, smaller weight‐to‐length SDS, and/or short length SDS values; while SIDS deaths were more closely related to mothers with higher parity or multiple births, mothers who smoked during pregnancy and single‐parent (mother) families. Maternal smoking was even more prominent among SIDS deaths in the post‐campaign period. The adjusted odds ratios, compared with non‐SIDS deaths, increased from 1.84 (95% CI: 1.48, 2.28) in the pre‐campaign period to 4.11 (95% CI: 2.72, 6.21) in the post‐campaign period.Conclusions: Maternal smoking during pregnancy remains the most important modifiable risk factor for SIDS in the post‐campaign period in comparison with non‐SIDS postneonatal deaths. Other than putting babies in a supine sleeping position, maternal smoking should be the next most important issue to be considered, if there is to be a second campaign.
Neonatal management of symptomatic transplacental cryoglobulinaemia
Authors: Laugel V , Goetz J , Wolff S , Beladdale J , Sibilia J , Messer J 
Published: April 2004

This study reports the first case of symptomatic placental transfer of cryoglobulins and discusses the potential pathogenic processes and the basic guidelines for neonatal management. A 32‐y‐old woman was affected by essential type I cryoglobulinaemia and displayed the cold‐triggered cutaneous symptoms of the disease due to a monoclonal immunoglobulin G (IgG) cryoglobulin. She gave birth to healthy dizygotic twins who were placed in incubators immediately after birth and did not show any cutaneous or visceral lesion in the first 2 d. Cyanotic macules appeared on the hand and foot of one of the newborns when they were removed from the incubators. The same monoclonal IgG‐λ cryoglobulin was identified in the two newborns’cord blood and in the mother's serum. The skin lesions disappeared within 1 wk as both twins were transiently replaced in incubators. No recurrence of skin lesions was observed even at room temperature and, 6 mo later, both twins were healthy and their clinical examination was normal.Conclusion: To the authors’knowledge, this is the first report of placental transfer of cryoglobulins and the first description of any neonatal effect. Neonates born to mothers suffering from IgG cryoglobulinaemia should be protected against cold to avoid precipitation of the pathogenic cryoglobulins, until spontaneous resolution.
Antimicrobial resistance in Escherichia coli in urine samples from children and adults: a 12 year analysis
Authors: Storby K Abelson , Österlund A , Kahlmeter G 
Published: April 2004

Aim: To investigate the distribution and antimicrobial resistance in urinary tract pathogens, primarily Escherichia coli, in two age groups, children 2 y and adults 18‐50 y, over a period of 12 y. Methods: From the database of the microbiological laboratory all urinary tract culture data were extracted and structured according to date, patient age, bacteriological findings, antimicrobial susceptibility results and sample type. Statistical longitudinal analysis of bacteriological findings and antimicrobial resistance trends in the two age groups were performed. Results: Statistical significance was obtained for the following results. Escherichia coli was the most common pathogen in both age groups and irrespective of sample type. In E. coli resistance to ampicillin and trimethoprim was higher in children than in adults and increased over time in both age groups. Resistance to fluoroquinolones was higher in adults than in children and increased over time in both groups. Resistance to pivmecillinam, cefadroxil and nitrofurantoin was below 2% in 2001 in both age groups.Conclusion: The steadily increasing and now high E. coli resistance levels in children to ampicillin and trimethoprim render empirical therapy with these drugs doubtful. The stable and low levels of resistance to pivmecillinam, cefadroxil and nitrofurantoin (>2% in 2001) make these drugs reasonable alternatives in uncomplicated lower urinary tract infections.
Preschool outcome in children born very prematurely and cared for according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)
Authors: Westrup B , B+ACQ‐oUhm B , Lagercrantz H , Stjernqvist K 
Published: April 2004

Aim: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the development at preschool age of children born with a gestational age of less than 32 wk.Methods: All surviving infants in a randomised controlled trial with infants born at a postmenstrual age less than 32 wk (11 in the NIDCAP group and 15 in the control group) were examined at 66.3 (6.0) mo corrected for prematurity [mean (SD)]. In the assessment we employed the Wechsler Preschool and Primary Scale of Intelligence‐Revised (WPPSI‐R) for cognition, Movement Assessment Battery for Children (Movement ABC) for motor function, subtests of the NEPSY test battery for attention and distractibility, and the WHO definitions of impairment, disability and handicap. Exact binary logistic regression was employed.Results: There were no significant differences between the intervention group in Full‐Scale IQ 93.4 (14.2) [mean (SD)] versus the control group 89.6 (27.2), Verbal IQ 93.6 (16.4) versus 93.7 (26.8) or Performance IQ 94.3 (14.7) versus 86.3 (24.8). In the NIDCAP group 8/13 (62%) survived without disability and for the children with conventional care this ratio was 7/19 (37%). The corresponding ratios for surviving without mental retardation were 10/13 (77%) and 11/19 (58%), and for surviving without attention deficits 10/13 (77%) and 10/19 (53%). Overall, the differences were not statistically significant, although the odds ratio for surviving with normal behaviour was statistical significant after correcting for group imbalances in gestational age, gender, growth retardation and educational level of the parents.Conclusion: Our trial suggests a positive impact by NIDCAP on behaviour at preschool age in a sample of infants born very prematurely. However, due to problems of recruitment less than half of the anticipated subjects were included in the study, which implies a low power and calls for caution in interpreting our findings. Larger trials in different cultural contexts are warranted.
Introduction of food during the infant's first year: a study with emphasis on introduction of gluten and of egg, fish and peanut in allergy‐risk families
Authors: van Odijk J , Hulthén L , Ahlstedt S , Borres MP 
Published: April 2004

Aim: The aim of the current study was to retrospectively examine introduction of food during the first year in a representative sample of Swedish children. A secondary aim was to study how parents with history of atopy introduced food to their infants. Methods: Data derive from 467 infants who visited child health centres in three different counties in Sweden for health check‐up at 12 mo of age. The parents were asked to fill in a questionnaire about breastfeeding and/or formula feeding, time of introduction of weaning food focusing on cow's milk, follow‐on formula, porridge, fish and egg. Questions regarding hypersensitivity in the family, peanut consumption of mother as well as in the child, and questions about number of siblings, ethnic background and parental education were included. Results: Compliance with suggested introduction of gluten‐containing food was low; as many as 45% had avoided gluten until 6 mo of age, instead of introducing gluten between 4 and 6 mo. Only 33% of parents with stated family hypersensitivity avoided giving their child fish and 23% avoided egg during the first year, even though this recommendation was present at the time of the study. Almost 50% of all mothers had avoided peanuts during pregnancy even though there was no such advice. The avoidance of peanut was not connected to hypersensitivity in the family.Conclusion: These results suggest that time of introduction of gluten was not in accordance with the current recommendation. The results imply that there is a need to follow up if and how this feeding information is distributed to parents with infants and also to sharpen the information to the right target groups, otherwise implementation of preventive strategies will be less useful.
Cerebral blood‐flow velocities in predicting outcome of asphyxiated newborn infants
Authors: Ilves P , Lintrop M , Metsvaht T , Vaher U , Talvik T 
Published: April 2004

Aim: To evaluate the role of early (up to 12h) changes in cerebral blood‐flow (CBF) velocity in predicting the severity of hypoxic‐ischaemic encephalopathy (HIE) and long‐term outcome in asphyxiated term infants. Methods: CBF velocities were investigated by colour Doppler ultrasonography in 81 healthy and 60 asphyxiated term infants at least three times during the first 5 d of life. The psychomotor development of infants was followed up to 18 mo. Results: No differences in CBF velocities were found at the age of 2–6 h between infants with severe and mild‐moderate HIE, mean CBF velocity [mean (95% CI of mean CBF velocity)] in anterior cerebral artery [14.9 (1.4–28.4) cm/s] and [13.9 (11.1–16.7) cm/s], respectively, and between infants with poor outcome (death or severe disability) and with normal development/mild impairments. By the age of 12 h infants with mild‐moderate HIE and infants with normal development/mild impairments had decreased CBF velocity in the anterior cerebral artery, and infants with severe HIE or poor outcome had increased mean CBF velocity in anterior, medial cerebral and basilar artery compared to the control group.Conclusion: The value of CBF velocity changes to predict poor outcome in asphyxiated infants is low 2‐6 h after asphyxia, but increases by the age of 12 ho.
Human neutrophil lipocalin: normal levels and use as a marker for invasive infection in the newborn
Authors: Björkqvist M , Källman J , Fjaertoft G , Xu S , Venge P , Schollin J 
Published: April 2004

Aim: To evaluate human neutrophil lipocalin (HNL) as a marker of neonatal invasive infection and determine the normal serum levels of HNL in newborns. Methods: HNL is released from neutrophil granulocytes and is regarded as a specific marker of neutrophil activity. In 81 newborns 28 d of age with signs of infection on a total of 87 occasions, HNL and C‐reactive protein (CRP) were measured at inclusion and on the three following days. As controls, term healthy newborns were recruited at birth (cord blood, n= 45) and at ages 3‐5 d (n= 46). Serum HNL was measured by a radioimmunoassay. Results: 25/87 episodes were classified as infection and 62 as non‐proven infection. HNLmax was significantly higher in the infected group (mean 587.6 μg/1) than in the non‐proven infected group (mean 217.7 μg/1, p > 0.001). HNL peaked at inclusion, 1 d earlier than CRP. In the healthy controls, HNL was the same at 3‐5 d of age as at birth (mean 82.4‐81.7 μg/1) and similar to normal adult levels.Conclusions: The release of HNL is not increased in healthy newborns at birth, but neonatal neutrophils rapidly release HNL upon microbial stimulation in vivo. HNL might be useful as an early marker of neonatal infection.
Evaluation of quality of life in Indian children with bronchial asthma using a disease‐specific and locally appropriate questionnaire
Authors: Singh M , Mathew JL , Malhi P , Naidu AN , Kumar L 
Published: April 2004

Aim: To evaluate quality of life (QOL) in Indian children with bronchial asthma. Methods: A disease‐specific, locally appropriate QOL questionnaire was administered in asthmatic children and compared with FEV1, FVC, PEFR and asthma symptom score, on three occasions. Results: QOL score had strong negative correlation with symptom score and weaker positive correlation with pulmonary function tests.Conclusion: Disease‐specific QOL score correlates inversely with symptom score in children with bronchial asthma.
Feeding practices of infants through the first year of life in Italy
Authors: Giovannini M , Riva E , Banderali G , Scaglioni S , Veehof SHE , Sala M , Radaelli G , Agostoni C 
Published: April 2004

Aim: To investigate infant feeding practices through the first year of life in Italy, and to identify factors associated with the duration of breastfeeding and early introduction of solid foods. Methods: Structured phone interviews on feeding practices were conducted with 2450 Italian‐speaking mothers randomly selected among women who delivered a healthy‐term singleton infant in November 1999 in Italy. Interviews were performed 30 d after delivery and when the infants were aged 3, 6, 9 and 12 mo. Type of breastfeeding was classified according to the WHO criteria. Results: Breastfeeding started in 91.1% of infants. At the age of 6 and 12mo, respectively, 46.8% and 11.8% of the infants was still breastfed, 68.4% and 27.7% received formula, and 18.3% and 65.2% were given cow's milk. Solids were introduced at the mean age of 4.3 mo (range 1.6–6.5 mo). Introduction of solids occurred before age 3 and 4 mo in 5.6% and 34.2% of infants, respectively. The first solids introduced were fruit (73.1%) and cereals (63.9%). The main factors (negatively) associated with the duration of breastfeeding were pacifier use (p > 0.0001), early introduction of formula (p > 0.0001), lower mother's age (p > 0.01) and early introduction of solids (p= 0.05). Factors (negatively) associated with the introduction of solids foods before the age of 3 mo were mother not having breastfed (p > 0.01), early introduction of formula (p > 0.01), lower infant bodyweight at the age of 1 mo (p= 0.05) and mother smoking (p= 0.05).Conclusion: The duration of breastfeeding in Italy is still inadequate, as well as compliance with international recommendations for timing of introduction of complementary foods. National guidelines, public messages and educational campaigns should be promoted in Italy.