bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Hong Kong index of dyspepsia: A validated symptom severity questionnaire for patients with dyspepsia
Authors: HU WAYNE HC , LAM KWOK‐FAI , WONG YEUK HING , LAM CINDY LK , HUIi WAI MO , LAI KAM‐CHUEN , WONG BENJAMIN CY , LAM SHIU‐KUM 
Published: March 2003

Abstract

Aim:
Locally validated symptom questionnaires are essential instruments in dyspepsia research. A symptom score for Chinese dyspeptics was developed. Multiple aspects of validity and reliability were assessed.
Methods:
Sixty‐five patients with endoscopy‐negative dyspepsia and 65 healthy controls were presented with a list of 24 previously determined common abdominal symptoms and asked to rate the severity in a five point Likert scale. Comprehensibility and relevance of symptoms were assessed. The questionnaire was administered 3 h later to assess for reproducibility. A locally validated Short Form‐36 quality‐of‐life questionnaire was also administered. Cisapride 5 mg thrice daily was prescribed to dyspeptic patients but not to the controls. The dyspepsia symptom and SF‐36 questionnaires were repeated after 3 weeks for patients under treatment. Global change in symptoms and the need for further medical care were assessed. Concept, content, construct and criterion validity, consistency and reproducibility of the dyspepsia symptom questionnaire were assessed.
Results:
All items were considered comprehensible by more than 90% of subjects. Relevance of individual symptoms to dyspeptic patients ranged from 10.8–76.9%. Twelve items were selected by logistic regression to account for most of the differences between control and dyspeptic patients. Test–retest reproducibility and internal consistency were good with the intraclass correlation coefficient of 0.89 and Cronbach's alpha coefficient of 0.90. A cut‐off score of equal to or greater than 16 was determined to discriminate between controls and dyspeptic patients. The dyspepsia score correlated negatively with all domains of the SF‐36 quality of life scale except physical functioning. The dyspepsia questionnaire also discriminated between patients who reported a subjective improvement in symptoms and those who reported no change or worsening.
Conclusions:
The dyspepsia symptom index was easy to understand, internally consistent and reproducible. It predicted global symptom change, and the symptom severity scores correlated negatively with quality of life.© 2002 Blackwell Publishing Asia Pty Ltd
Safety of technology: Infection control standards in endoscopy
Authors: Ramakrishna Balakrishnan S 
Published: March 2003

Abstract  Transmission of infection related to gastrointestinal endoscopy continues to be a subject of much discussion. The principles of infection control during endoscopy are reviewed. Guidelines set forth by a number of gastrointestinal endoscopy associations have emphasized the need for meticulous cleaning of endoscopes immediately after use, followed by appropriate disinfection, rinsing and drying. Most, if not all, episodes of transmission of infection during endoscopy are associated with lapses in cleaning and disinfection protocols. The need for universal compliance with infection control standards, and for the development of strategies to achieve such compliance, is highlighted.© 2002 Blackwell Publishing Asia Pty Ltd
Endoscopic mucosal resection for esophageal and gastric cancers
Authors: Inoue Haruhiro , Fukami Norio , Yoshida Tatsuya , Kudo Shin‐Ei 
Published: March 2003

Abstract  Better outcomes for digestive tract cancers are likely to be possible if the tumors are detected in their earliest stages, particularly when they exist as mucosal lesions without lymph node metastases. Early esophageal squamous cell cancers can be detected with high sensitivity and specificity by iodine staining. Only mucosal cancers are suitable for the curative approach of submucosal resection; the rate of metastasis is 4%, compared to a rate of metastasis of 35% in tumors with submucosal spread. In this review, the history of endscopic mucosal resection is reviewed, including the factors that have refined the technique and technical aspects crucial for effective results. The importance of adequate submucosal injection of dilute epinephrine in saline solution is particularly emphasized. The overall efficacy, low rate of complications and such practical aspects as post‐therapeutic care are discussed. In general, mucosal cancers of the gastrointestinal tract have no risk of lymph node metastases and can be curatively managed by refined endoscopic mucosal resection procedures.© 2002 Blackwell Publishing Asia Pty Ltd
Advances in hepatitis C: What is coming in the next 5 years?
Authors: Locarnini Stephen A , Bartholomeusz Angeline 
Published: March 2003

Abstract
Hepatitis C virus (HCV) is a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Numerous advances have been made in the understanding of HCV replication, including detailed molecular characterization of its viral proteins and genomic RNA. The inability to grow HCV in cell culture had impeded the development of antiviral agents against this virus. To overcome this obstacle, a number of unique tools have been prepared, such as molecular clones that are infectious in the chimpanzee animal model of infection, and the development of a subgenomic replicon system in Huh7 cells. In addition, the major non‐structural proteins have been crystallized, thus enabling rational drug design directed to these targets. Current developments in antiviral agents are reviewed in the context of these potential new viral targets for the future treatment of HCV in chronically infected individuals.© 2002 Blackwell Publishing Asia Pty Ltd
Cholangiocarcinoma: Recent progress. Part 1: Epidemiology and etiology
Authors: Okuda Kunio , Nakanuma Yasuni , Miyazaki Masaru 
Published: March 2003

AbstractAn attempt is made in this review to update the reader on recent developments and progress in the study of cholangiocarcinoma: a major primary carcinoma of the liver with a very poor prognosis. Knowledge of the cell biology and physiological functions of the cholangiocyte has recently so progressed that our understanding of cholangiocarcinogenetic mechanism is expected to follow. The first part of the review deals with semantic problems, temporal changes in the incidence of cholangiocarcinoma and geographic differences in epidemiology, etiologic factors (particularly opistorchiasis in Thailand and hepatolithiasis in the Far East), and discusses a recently disclosed role of hepatitis C virus infection (30% of cholangiocarcinoma patients have antibodies against hepatitis C virus in Japan).
Clinical course, predictive factors and prognosis in patients with cirrhosis and type 1 hepatorenal syndrome treated with Terlipressin: A retrospective analysis
Authors: Colle Isabelle , Durand François , Pessione Fabienne , Rassiat Emmanuel , Bernuau Jacques , Barrière Eric , Lebrec Didier , Valla Dominique‐Charles , Moreau Richard 
Published: March 2003

Abstract Background and Aim: Terlipressin has been proposed to treat renal failure in patients with type 1 hepatorenal syndrome (HRS). However, the predictive factors for improved renal function and survival are unknown in patients with type 1 HRS treated with terlipressin. The aim of the present retrospective study was to investigate the predictive factors and prognosis of patients with type 1 HRS treated with terlipressin.Methods: The clinical charts of 18 consecutive patients with cirrhosis and type 1 HRS treated with terlipressin were studied. The predictive factors for improved renal function and survival were identified using univariate analyses.Results: Improved renal function, indicated by a significant decrease in serum creatinine (61 ± 4%), occurred in 11 (60%) patients. The only predictive factor for improved renal function was a Child–Pugh's score ≤13 at the time of diagnosis of HRS (P
= 0.02). Fifteen patients (83%) died at 45 days and the median survival was 24 days. Of the three patients who survived, two underwent successful orthotopic liver transplantation. Three predictive factors for survival were identified: absence of a precipitating factor for HRS (P
= 0.012); improved renal function during terlipressin therapy (P
= 0.05); and a dose of terlipressin ≥3 mg/day (P = 0.04).Conclusions: In patients with type 1 HRS treated with terlipressin, patients with improved renal function had less severe cirrhosis (Child–Pugh >10 but ≤13) than patients without. The predictive factors for survival were the absence of a precipitating factor for HRS, the terlipressin‐induced improvement in renal function and a dose of terlipressin of at least 3 mg/day. These findings suggest that a randomized controlled trial investigating the effect of terlipressin on survival in patients with type 1 HRS should be performed.© 2002 Blackwell Publishing Asia Pty Ltd
Longer survival in female than male with hepatocellular carcinoma
Authors: DOHMEN KAZUFUMI , SHIGEMATSU HIROHISA , IRIE KOJI , ISHIBASHI HIROMI 
Published: March 2003

AbstractAim: There is a limited amount of data regarding the gender difference in the survival in cases of hepatocellular carcinoma (HCC). The aim of the present study was to investigate the difference in the survival between males and females with HCC and the possible factors affecting the gender difference of survival in HCC.Methods: Analyses were performed based on 704 consecutive patients with HCC observed for 12 years between January 1989 and December 2000 at the Internal Medicine Department, Saga Prefectural Hospital Koseikan, who were retrospectively enrolled in the study. The 1‐, 3‐, 5‐ and 7‐year survivals and various factors at the detection of HCC were compared between 487 male and 217 female patients with HCC using the Kaplan‐Meier method, Mantel‐Cox test, chi squared test and Fisher's exact analysis.Results: There was a significant difference in survival between male and female patients with a 1‐, 3‐, 5‐ and 7‐year survival estimate of 67.7, 40.6, 23.8 and 8.7%versus 73.5, 50.3, 26.3 and 15.4%, respectively (P‐value: 0.0167). Of the clinical variables examined, the significant factors related to gender difference were found to be age, tumor size, the number of tumors, the presence of portal thrombosis and the type of follow‐up. Of the patients with HCC lesions measuring 3 cm or less in the greatest dimension or those with solitary HCCs, however, there was no significant difference in survival between both sexes. The patients were divided into three categories: closely followed‐up group (regular periodic follow‐up with monthly alpha‐fetoprotein measurements plus ultrasonography at least every 4 months); a non‐closely followed‐up group; and an incidental group (incidentally discovered due to related symptoms). The detection rates of HCC through the closely followed‐up, non‐closely followed‐up and incidental groups were 19.3%, 46.2% and 34.5% in men and 28.1%, 46.5% and 25.4% in women, respectively, which reached a significant difference between both sexes (P‐value: 0.0097).Conclusion: The survival of female cases of HCC was longer than that of male cases. Disparities in the type of follow‐up for women in comparison to men exist and may contribute to gender disparities in survival. Women with a high risk for HCC tended to be better cared for during the follow‐up. To reduce gender disparities in survival, efforts should be directed at the earlier identification of HCC.
Increasing incidence of Crohn's disease in Victorian children
Authors: PHAVICHITR NOPAORN , CAMERON DONALD J S , CATTO‐SMITH ANTHONYG 
Published: March 2003

AbstractBackground: The incidence of Crohn's disease has been increasing in Western communities, but there are no published studies which have examined this change in children in Australia. The centralization of pediatric gastroenterology services in Victoria provides an opportunity to examine these changes within one state.Methods: We undertook a retrospective study over a 31‐year period of all children aged 16 years or less initially diagnosed with Crohn's disease at either the Royal Children's Hospital, or Monash Medical Center, Melbourne, Victoria.Results: We identified 351 patients who met the diagnostic criteria between 1971 and 2001. The incidence of Crohn's disease in children aged 16 years or less rose from 0.128 to 2.0 per 100 000 per year over the three decades (r = 0.964, P < 0.01). There was a disproportionate over‐representation of children from an urban background (incidence rate ratio 1.66, 95% CI 1.28–2.16). Children currently being diagnosed had on average a lower erythrocyte sedimentation rate (ESR) and higher albumin than in previous decades. The use of flexible endoscopy has increased markedly (1970s: 60%; 1990s: 96%, P < 0.05) and the proportion of children recognized at diagnosis with upper gastrointestinal and colonic involvement has increased significantly.Conclusion: There has been a significant increase in the incidence of Crohn's disease in Victorian children. The pattern of disease has also changed with colonic disease now more frequent, and inflammatory indices less abnormal. The increased use of endoscopy has established the frequent involvement of the upper gastrointestinal tract.
Sun protection behaviours and the predictors of sunburn in young children
Authors: MORRIS J , McGEE R , BANDARANAYAKE M 
Published: March 2003

Objective:To explore the use of sun protection behaviours and the experience of sunburn in a sample of parents and their children in New Zealand.Methodology:Information was collected from 887 parents using postal questionnaires at the beginning of and during the summer.Results:Thirty per cent of the parents believed their child looked healthier with a suntan, and 40% intended to let their child get a suntan during the summer. Predictors of intention to tan included level of parental education, the child’s age, the child’s sensitivity to burning and experience of sunburn in the parent. At the end of the summer period, 29% of the children were reported as being sunburned. Predictors of sunburn in the child were the age of the child, experience of sunburn in the parent and use of sunscreen SPF15+ by the parent.Conclusion:Despite intense media coverage of the dangers of overexposure to the sun, it is clear that a significant proportion of children are still getting sunburned.
DNA polymorphism analysis in transfusion‐associated graft‐versus‐host disease
Authors: Warren LJ , Simmer K , Roxby D , Grist S , Seshadri R , Morley A 
Published: March 2003

Abstract: During cardiac surgery for transposition of the great arteries at age 7 weeks, a female infant received blood, fresh frozen plasma and platelet transfusions. Eleven days postoperatively, she developed bloody diarrhoea, fever, an erythematous macular rash, hepatomegaly, seizures and pancytopaenia. A clinical diagnosis of transfusion related graft‐versus‐host disease (GVHD) was supported by skin histopathology. DNA polymorphism studies confirmed that circulating lymphocytes in peripheral blood and infiltrating cells in the skin were foreign in origin and were derived from transfused blood cells. No underlying immunodeficiency was identified. Treatment with steroids, cyclosporin and antithymocyte globulin was unsuccessful and death occurred 2 months after surgery.The features of fever, rash, diarrhoea, liver dysfunction and pancytopaenia which characterize GVHD may mimic drug reactions or viral infection. In addition to histological features on skin biopsy, DNA polymorphism studies on skin and blood samples provide a unique and sensitive method to confirm GVHD. Irradiation of blood products should be considered for acutely compromised infants requiring urgent cardiac surgery.
Transverse cerebellar diameter on cranial ultrasound scan in preterm neonates in an Australian population
Authors: Swaminathan M , Davies MW , Davis PG , Betheras FR 
Published: March 2003

Objective: Fetal measurement of transverse cerebellar diameter (TCD) has been shown to correlate well with gestational age (GA), even in the presence of growth retardation. The aim of this study was to define the normal range of TCD in preterm neonates in an Australian population between 23 and 32 weeks GA. Methodology: Infants admitted to the Royal Women’s Hospital, Melbourne, having routine cranial ultrasound scans (< 1500 g and/or of gestational age ≤ 32 weeks at birth) had their TCD measured on a cranial scan performed during the first 3 days of life. The posterior fossa was examined through the asterion using a General Electric LOGIQ 500 scanner (GE Medical Systems, Waukesha, USA) and TCD measurement was taken in the coronal plane. Results: 106 infants < 1500 g and/or of GA ≤ 32 weeks at birth had their TCD measured between 1 January 1997 and 30 November 1997. Transverse cerebellar diameter and associated 95% confidence intervals are described for infants between 23 and 32 weeks GA. The linear regression equation relating TCD and GA was: TCD (mm) = –12.9 + 1.61 × GA (weeks). R2 = 0.80, P < 0.001. Conclusion: This is the only study of TCD measurement using cranial ultrasound in a group of preterm newborns, and forms the basis for nomograms of TCD which can be used as a tool to assist in the assessment of GA, even in growth‐retarded preterm newborns, and in the diagnosis of cerebellar hypoplasia.
Resurgence of measles in Singapore: Profile of hospital cases
Authors: Goh DLM , Chew FT , Khor SH , Lee BW 
Published: March 2003

Objective: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. Methodology: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055.9) seen at the emergency unit or as inpatients were included. Results: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty‐five per cent of the cases occurred between January 1997 and March 1998. There was a bi‐modal age distribution with peaks in the very young (≤ 18 months) and those aged 16–20 years. The majority was unvaccinated (58/87). A proportion (11/87) demonstrated vaccine failure, most likely primary failures. Conclusions: This changing measles epidemiology suggests lowering of herd immunity. ‘Catch up’ vaccinations in July– October 1997 given to school children aged 12–18 years (200 000 individuals or 82% of cohort), may have helped contain the outbreak. These results substantiated the need for a two‐dose policy and ‘catch‐up’ immunization program.
Neutrophil functions of Chinese neonates
Authors: Wan Tsk , Yeung Cy , Tam Ayc 
Published: March 2003

Objective: To delineate neutrophil function of preterm and full‐term neonates of Chinese origin.Methods: Chinese neonates admitted to two major Hong Kong neonatal units were randomly selected for the study. Candidacidal activity, phagocytosis, chemotaxis and nitroblue tetrazolium reduction scores were evaluated from blood.Results: Except for chemotactic activity, the neutrophil functions of Chinese preterm neonates were similar to Chinese full‐term neonates. The candidacidal activity of males was significantly lower when compared with female neonates. Compared with adult controls, both term and preterm infants had similar phagocytic activities although their candidacidal activities and chemotactic index were significantly decreased. Neutrophil function of Chinese infants was nearer to that of adult controls than historically reported for western infants.Conclusion: Preterm Chinese neonates had similar neutrophil function to full‐term infants. Neutrophil function of Chinese infants was more mature than that of western infants.
Serological survey of measles and rubella immunity in Sydney preschool children
Authors: Causer J , Mira M , Karr M , Hueston L , Burgess M , Alperstein G , Fett M , Cunningham A 
Published: March 2003

Objectives: To estimate the prevalence of serological evidence of immunity to measles and rubella in preschool children in central and southern Sydney (NSW, Australia) and the prevalence of immunity in children with either documented or parentally reported immunization. Methods: Geographical cluster random sampling was used to select children aged between 18 and 60 months to participate in the present study. Standardized interviews obtained information on each child’s reported (by parents) immunization status and documentary evidence of immunization was recorded from the Personal Health Record. Venous blood was collected, serum was separated and stored frozen until tested. Measles and rubella antibodies were measured using ELISA, with either immunofluorescence or haemagglutination inhibition being used to clarify equivocal results. The study was conducted from 1992 to 1994 in conjunction with surveys of blood lead concentrations, iron status and micronutrient status. Results: Parents of 726 of 953 children identified between 9 and 60 months of age agreed to participate in the lead, immunization, iron status and micronutrient studies. Sufficient blood for antibody testing was obtained from 580 children, aged 18 to 62 months at the time of collection. Parents reported that 94.7% (95% confidence interval (CI) 92.7–96.5%) of children had received a measles–mumps or measles–mumps–rubella (MMR) immunization. General practitioners administered 72.8% of these immunizations. The prevalence of serological evidence of immunity to measles and rubella was 88.8% (95% CI 86.2–91.4%) and 91.9% (95% CI 89.6–94.2%), respectively. There was documented evidence of measles and rubella immunization for 88.4% (95% CI 85.7–91.2%) and 86.4% (95% CI 83.4–89.3%) of children, respectively. Of children with documented measles immunization, 91.6% (95% CI 89.2–94.0%) had detectable measles antibody. Of children with documented rubella immunization, 97.2% (95% CI 95.8–98.6%) had detectable rubella antibody. Conclusions: Measles and rubella immunization rates in central and southern Sydney are relatively high and most of these immunizations are provided by the private sector. Immunity to rubella in children with documented rubella immunization is at the level that would be expected from seroconversion studies. Immunity to measles in children with documented measles immunization is slightly lower than expected from seroconversion studies, highlighting the need for the second MMR immunization in preschool children, as well as making near universal immunization imperative if this disease is to be eradicated.