bluuebunny/crossref_metadata_2025_split huggingface dataset:
Volunteer Peer Counselors Increase Breastfeeding Duration Among Rural Low‐Income Women
Authors: Schafer Elisabeth , Vogel Mary Kay , Viegas Swarna , Hausafus Cheryl 
Published: March 2003

Background:The purpose of this demonstration project was to test the effectiveness of a volunteer peer counseling program for promoting breastfeeding in a community.Methods:The two‐year project was conducted in Iowa from September 1994 to September 1996. Both intervention and control groups were rural low‐income pregnant and postpartum women who qualified for the Women, Infants and Children's (WIC) nutritional program. The intervention was initiated in two counties with 143 clients, of whom 72 completed the project. The control group was drawn from six counties that had received no significant breastfeeding promotion programs during the previous three years. The intervention was the assignment of trained volunteers with previous successful personal experience with breastfeeding as peer counselors to low‐income pregnant women. Both before and after the baby was born, the volunteers taught a series of in‐home, one‐to‐one lessons about healthy diet and breastfeeding, and maintained informal contact to answer questions or help with concerns.Results:Women in the intervention group improved dietary intake when compared with the control group. Knowledge of breastfeeding and good nutrition improved slightly. Eighty‐two percent of intervention compared with 31 percent of control group women initiated breastfeeding. Mean duration of breastfeeding for intervention and control group women was 5.7 and 2.5 weeks, respectively. At 4 weeks, 56 percent of intervention and 10 percent of control group women were still breastfeeding.Conclusion:A volunteer peer counseling program that provides low‐income women with role models, accurate information, support, and encouragement can increase the duration of breastfeeding, and thus contribute to healthier infants. (BIRTH 25:2 June 1998)
Continuity of Caregivers for Care During Pregnancy and Childbirth
Authors: Hodnett E.D. 
Published: March 2003

A substantive amendment to this systematic review was last made on 04 March 1998. Cochrane reviews are regularly checked and updated if necessary. ABSTRACT Background: Care is often provided by multiple caregivers, many of whom work only in the antenatal clinic, labour ward, or postnatal unit. However, continuity of care is provided by the same caregiver or a small group from pregnancy through the postnatal period. Objectives: The objective of this review was to assess continuity of care during pregnancy and childbirth and the puerperium with usual care by multiple caregivers. Search strategy: The Cochrane Pregnancy and Childbirth Group trials register was searched. Selection criteria: Controlled trials comparing continuity of care with usual care during pregnancy, childbirth and the postnatal period. Data collection and analysis: Trial quality was assessed. Study authors were contacted for additional information. Main results: Two studies involving 1815 women were included. Both trials compared continuity of care by midwives with non‐continuity of care by a combination of physicians and midwives. The trials were of good quality. Compared to usual care, women who had continuity of care from a team of midwives were less likely to be admitted to hospital antenatally (odds ratio 0.79, 95% confidence interval 0.64–0.97) and more likely to attend antenatal education programs (odds ratio 0.58, 95% confidence interval 0.41–0.81). They were also less likely to have drugs for pain relief during labour (odds ratio 0.53, 95% confidence interval 0.44–0.64), and their newborns were less likely to require resuscitation (odds ratio 0.66, 95% confidence interval 0.52–0.83). No differences were detected in Apgar scores, low birthweight, and stillbirths or neonatal deaths. While they were less likely to have an episiotomy (odds ratio 0.75, 95% confidence interval 0.60–0.94), women receiving continuity of care were more likely to have either a vaginal or perineal tear (odds ratio 1.28, 95% confidence interval 1.05, 1.56). They were more likely to be pleased with their antenatal, intrapartum, and postnatal care. Reviewers' conclusions: Studies of continuity of care show beneficial effects. It is not clear whether these are due to greater continuity of care, or to midwifery care. Citation: Hodnett ED. Continuity of caregivers for care during pregnancy and childbirth (Cochrane Review). In: The Cochrane Library, Issue 2, 2000. Oxford: Update Software. The preceding reports are abstracts of regularly updated, systematic reviews prepared and maintained by the Cochrane Collaboration. The full texts of the reviews are available in The Cochrane Library (ISSN 1464‐780X). See
http://www.update‐software.com/cochrane.htm
or contact Update Software,
info@update.co.uk, for information on subscribing to The Cochrane Library in your area. Update Software Ltd, Summertown Pavilion, Middle Way, Oxford OX2 7LG, United Kingdom (Tel.: +44 1865 513902; Fax: +44 1865 516918).
Prevalence and Persistence of Health Problems After Childbirth: Associations with Parity and Method of Birth
Authors: Thompson Jane F. , Roberts Christine L. , Currie Marian , Ellwood David A. 
Published: March 2003

ABSTRACT: Background: Awareness about the extent of maternal physical and emotional health problems after childbirth is increasing, but few longitudinal studies examining their duration have been published. The aim of this study was to describe changes in the prevalence of maternal health problems in the 6 months after birth and their association with parity and method of birth.Methods: A population‐based, cohort study was conducted in the Australian Capital Territory (ACT), Australia. The study population, comprising women who gave birth to a live baby from March to October 1997, completed 4 questionnaires on the fourth postpartum day, and at 8, 16, and 24 weeks postpartum. Outcome measures were self‐reported health problems during each of the three 8‐week postpartum periods up to 24 weeks.Results: A total of 1295 women participated, and 1193 (92%) completed the study. Health problems showing resolution between 8 and 24 weeks postpartum were exhaustion/extreme tiredness (60–49%), backache (53–45%), bowel problems (37–17%), lack of sleep/baby crying (30–15%), hemorrhoids (30–13%), perineal pain (22–4%), excessive/prolonged bleeding (20–2%), urinary incontinence (19–11%), mastitis (15–3%), and other urinary problems (5–3%). No significant changes occurred in the prevalence of frequent headaches or migraines, sexual problems, or depression over the 6 months. Adjusting for method of birth, primiparas were more likely than multiparas to report perineal pain and sexual problems. Compared with unassisted vaginal births, women who had cesarean sections reported more exhaustion, lack of sleep, and bowel problems; reported less perineal pain and urinary incontinence in the first 8 weeks; and were more likely to be readmitted to hospital within 8 weeks of the birth. Women with forceps or vacuum extraction reported more perineal pain and sexual problems than those with unassisted vaginal births after adjusting for parity, perineal trauma, and length of labor.Conclusions: Health problems commonly occurred after childbirth with some resolution over the 6 months postpartum. Some important differences in prevalence of health problems were evident when parity and method of birth were considered. (BIRTH 29:2 June 2002)
Effect of cagA Status on the Sensitivity of Enzyme Immunoassay in Diagnosing Helicobacter pylori–Infected Children
Authors: Plebani Mario , Guariso Graziella , Fogar Paola , Basso Daniela , Gallo Nicoletta , Zambon Carlo Federico , Mozrzymas Renata , Celadin Marilena , Zacchello Franco 
Published: March 2003

Background. The aims of our study were twofold. First, we sought to evaluate in symptomatic children the influence of the Helicobacter pylori genotype on gastritis, abdominal pain, and circulating anti–H. pylori IgG antibodies (anti–H. pylori IgG) or pepsinogen A (PGA) and C (PGC). Additionally, we sought to assess anti–H. pylori IgG, PGA, and PGC patterns in a large cohort (N = 921) of asymptomatic children.Materials and Methods. In 183 symptomatic children, H. pylori infection and the presence of gastritis were evaluated by histology. In a subgroup of 20 H. pylori–positive children, the H. pylori genotype was evaluated also by polymerase chain reaction. Nine hundred and twenty‐one asymptomatic children, aged 11 to 14 years, were studied by anti–H. pylori IgG, PGA, and PGC serum determination.Results. The infection was found in 33 of 183 symptomatic children; among the 20 H. pylori–positive children for which the H. pylori genotype was available, cagA was present or absent in equal percentages. H. pylori infection was associated with more severe gastritis and higher serum levels of anti–H. pylori IgG and PGC but not with abdominal pain. In infected children, higher levels of anti–H. pylori IgG and the presence of abdominal pain were associated with infections caused by cagA‐positive strains. In the cohort of 921 asymptomatic children, raised levels of anti–H. pylori IgG, PGA, and PGC were found in approximately 5% of the cases.Conclusions. Infection with cagA‐positive H. pylori strains can be associated with increased frequency of reported abdominal pain and higher circulating levels of anti–H. pylori IgG. The serological assessment of H. pylori IgG using H. pylori antigens containing significant amounts of cagA protein may, therefore, underestimate the true prevalence of infection.
Helicobacter pyloriVaccine Development and Use: A Cost‐Effectiveness Analysis Using the Institute of Medicine Methodology
Authors: Rupnow Marcia F.T. , Owens Douglas K. , Shachter Ross , Parsonnet Julie 
Published: March 2003

Background.Prophylactic vaccination has been suggested as a better strategy than antibiotics to controlHelicobacter pyloriinfection. We evaluated the cost‐effectiveness (CE) ofH. pylorivaccine development and use in the United States and developing countries, using a method developed by the Institute of Medicine (IOM).Methods.The IOM model includes costs of vaccine development, vaccination program, and averted medical treatments; morbidity and mortality prevented; expected efficacy and use; and proportion of disease that is vaccine‐preventable. The model employs infant mortality equivalence (IME) to estimate disease burden; with IME, the societal cost of infection‐related morbidity is expressed as equivalent to a specific rate of infant deaths. We tested model assumptions by univariate sensitivity analyses.Results.In the United States,H. pylorivaccine would save 1,176 IME and would cost $58.71 million (1997 dollars) annually, yielding a CE ratio of $49,932 per IME; the health benefits would exceed all IOM‐studied vaccines, even when efficacy dropped to 55%.H. pylorivaccine could be cost‐saving if priced at less than $60 per course. In developing countries,H. pylorivaccine would rank unfavorably both in terms of health benefits (33,518 IME) and costs ($5,254 million). None of the changes in assumptions improved significantly theH. pylorivaccine's ranking relative to other IOM‐studied vaccines.Conclusions.Compared to other vaccines evaluated in the IOM study,H. pylorivaccine warrants public resource allocation for accelerated development and use in the United States but not for use in developing countries.
Mucosal Production of Antigastric Autoantibodies in Helicobacter pylori Gastritis
Authors: Faller Gerhard , Ruff Silke , Reiche Nicole , Hochberger Jürgen , Hahn Eckhart G. , Kirchner Thomas 
Published: March 2003

Background. Apart form bacterial virulence factors of Helicobacter pylori, certain host factors influence the pathogenesis of H. pylori gastritis. In particular, antigastric autoantibodies that are detectable in the sera of a substantial proportion of H. pylori were shown to correlate with the development of gastric atrophy. The aim of this study was to analyze the possible antigastric autoimmune response in H. pylori gastritis at the site where the action is, i.e., in the gastric mucosa.Material and Methods. Gastric biopsy specimens from antrum and corpus mucosa of 24 H. pylori–infected and of 33 noninfected patients were cultured for 3 days, and tissue culture supernatants were analyzed for the amount of locally produced IgA and IgG. Antigastric autoantibodies were screened in the sera and in the supernatants by means of immunohistochemistry.Results. The infected patients had significantly higher concentrations of locally produced IgA, whereas the IgG concentrations were virtually the same in infected and noninfected patients. IgG or IgA antigastric autoantibodies, or both, were detectable only in the sera (38%) and supernatants (17%) of infected patients. Interestingly, the patient with the strongest local autoimmune response showed body‐predominant H. pylori gastritis, with destruction of gastric glands and atrophy of the body mucosa.Conclusions. These results demonstrate that antigastric autoimmune reactions are detectable at the site of the disease and might be relevant for the pathogenesis of gastric mucosa atrophy in H. pylori gastritis.
Helicobacter pylori Infection in Asymptomatic Children: Comparison of Diagnostic Tests
Authors: Malaty Hoda M. , Logan Nancy D. , Graham David Y. , Ramchatesingh Jacqueline E. , Reddy Siddharta G. 
Published: March 2003

Background. Childhood is known to be a major risk period for acquiring Helicobacter pylori infection. Studies of the epidemiology of H. pylori infection depend on the validity of the diagnostic tools used to detect the infection in the pediatric setting. This study aims to conduct a combination of diagnostic tests on the same children, evaluate the sensitivity and the specificity of IgG antibody testing compared with the 13C‐urea breath test, and examine the variability in the prevalence of H. pylori infection in asymptomatic children based on the use of different diagnostic tests.Methods. 13C‐urea breath test (13C‐UBT), whole blood FlexSure (systemic antibodies), and OraSure (salivary antibodies) tests were conducted on 287 asymptomatic children (151 boys, 136 girls; ages 2–18 years). The three tests were conducted on each child during the same day. The prevalence was calculated using each test independently.Results. H. pylori infection was detected in 32%, 22%, or 18% of the studied children, based on UBT, OraSure, or FlexSure, respectively. A total of 103 children tested positive for any one test (92 on UBT, 8 on FlexSure, 3 on OraSure), giving a prevalence of 35% based on the “parallel” method. Only 39 children tested positive in all three tests, giving a prevalence of 14% based on the “serial” method. Using the UBT as the gold standard, the sensitivity of FlexSure and OraSure were 48% and 65%, respectively, and the specificity of both tests was greater than 95%. When we applied the parallel method, the sensitivity and specificity of the combined antibody tests (FlexSure+OraSure) compared to the UBT were 71% and 95%, respectively.Conclusions. Among asymptomatic children, there is a wide variation in the prevalence of H. pylori infection based on the diagnostic test used. The study shows that antibody assays are less suitable than the UBT. However, under certain conditions, the IgG assays (combined systemic, salivary, or both) are less expensive alternative tools to the UBT for epidemiological studies in children.
p53 Expression in the Gastric Mucosa Before and After Eradication of Helicobacter pylori
Authors: Satoh Kiichi , Kihira Ken , Kawata Hiroshi , Tokumaru Kenkichi , Kumakura Yasuhisa , Ishino Yumiko , Kawakami Satoshi , Inoue Keiko , Kojima Toshichika , Satoh Yukihiro , Mutoh Hiroyuki , Sugano Kentaro 
Published: March 2003

AbstractBackground.Accumulation of p53 has been recognized in the gastric mucosa infected with Helicobacter pylori. We investigated the prevalence of p53‐positive cells in the gastric mucosa before and one month after eradication of H. pylori and the relationship between p53 positivity and inflammation and cell proliferation.Methods.The subjects included 24 H. pylori‐positive patients. They achieved eradication one month after anti‐H. pylori therapy. Biopsies were taken from the greater curvatures of the antrum and middle body. H. pylori status was assessed using culture and tissue section (Giemsa stain). Serial sections were used for examination of gastritis (hematoxylin and eosin stain) and for immunostaining of p53, Ki‐67 and myeloperoxidase (MPO). p53 index and Ki‐67 labeling index (LI) were calculated by counting p53‐positive and Ki‐67‐positive cells in the entire gastric pits longitudinally sectioned and expressing them as a percentage of the total cells in a gastric pit. In the neck regions with and without p53‐positive cells, polymorphonuclear leukocytes (PMNs) were counted in the corresponding area (/50 × 50 µm2) of the sections stained both with p53 and MPO.Results.p53‐positive cells decreased significantly after eradication of H. pylori. Before eradication, the number of PMNs was significantly higher in the neck regions with p53‐positive cells than in those without.Conclusions.In the gastric mucosa infected with H. pylori, p53‐positive cells were found in the neck region infiltrated with PMNs. p53 expression decreased significantly one month after eradication of H. pylori.
Probing 23S Ribosomal RNA Cleavage Sites in Coccoid Helicobacter pylori
Authors: Monstein Hans‐Jürg , De La Cour Charlotta D. , Jonasson Jon 
Published: March 2003

ABSTRACTBackground.Previous studies have revealed that extensive nonrandom fragmentation of ribosomal RNA occurs during conversion of Helicobacter pylori to the coccoid form. The 16S rRNA fragmentation has been characterised in some detail. The aim of the present study was to define corresponding cleavage‐sites in the 3′‐half of the 23S rRNA molecule.Materials and Methods.Northern blot analysis using 23S rRNA specific antisense riboprobes and a 5′‐end‐labelled oligonucleotide probe was used to analyse the 23S rRNA fragmentation pattern in coccoid H. pylori type strain CCUG 17874T and H. pylori 26695, for which the genome has been sequenced. A double‐stranded cDNA‐dependent (ds‐cDNA) primer‐extension analysis technique using 23S rRNA ds‐cDNA and a primer targeting the vicinity of the peptidyl‐transferase centre was used to determine cleavage sites at the nucleotide level.Results.We report here the mapping of putative cleavage sites within domains IV and V, enclosing the peptidyl transferase centre, in the 3′‐half of the 23S rRNA molecule. Three cleavage sites were located in domain IV. Two other cleavage sites were located in the peptidyl transferase centre, and one presumptive multiple‐break site between helices 77 and 78 in domain V. The DNA motifs were different from the postulated A + U rich single‐strand cleavage sites recognised by RNase E, which has been implicated in rRNA degradation in Escherichia coli.Conclusions.The present analysis suggests that a hitherto unknown mechanism is responsible for the nonrandom fragmentation of rRNA in coccoid H. pylori, which may have important consequences for the growth, and survival of the bacterium.
Caspase‐3 Activity and Expression of Bcl‐2 Family in Human Neutrophils by Helicobacter pylori Water‐Soluble Proteins
Authors: Kim Joo Sung , Kim Jung Mogg , Jung Hyun Chae , Song In Sung 
Published: March 2003

AbstractBackground.Persistent infiltration of neutrophils is an almost invariable feature of Helicobacter pylori‐infected gastric mucosa. A prolongation of neutrophil life‐span could contribute to the pathogenesis of H. pylori infection. Recently, we have demonstrated that H. pylori water extracts (HPWE) inhibited neutrophil apoptosis. To elucidate the regulation of intracellular apoptotic signals by HPWE, we examined the activity of caspase‐8, ‐3 and expression of Bcl‐2 family in neutrophils.Materials and methods.Human neutrophils were obtained from the peripheral blood of healthy volunteers by density gradient separation. HPWE was prepared from a supernatant of the H. pylori suspension in distilled water. After neutrophils were incubated with HPWE, expression of Bcl‐2 family [antiapoptotic (Bcl‐2, Bcl‐XL and Mcl‐1) and proapoptotic (Bax, Bak and Bcl‐XS)] was determined by RT‐PCR and Western blotting, respectively. Western blot for Bcl‐2 family also performed in neutrophilic differentiated HL‐60 cells by all‐trans‐retinoic acid. The activity of caspase‐8, ‐3 was measured by the detection of p‐nitroanilide after cleavage from labeled substrate.Results.HPWE suppressed the activation of caspase‐8 and ‐3, and upregulated the expression of Bcl‐XL mRNA and proteins in neutrophils. The expression of Bax and Bak was upregulated and Bcl‐2, Bcl‐XL and Mcl‐1 downregulated in HL‐60 cells during neutrophilic differentiation.Conclusion.Bcl‐XL may have an important role in the neutrophilic development and inhibition of neutrophil apoptosis by H. pylori.
The Relationship Between Helicobacter pylori Infection, the Virulence Genotypes of the Infecting Strain and Gastric Cancer in the African Setting
Authors: Louw J. A. , Kidd M. S. G. , Kummer A. F. , Taylor K. , Kotze U. , Hanslo D. 
Published: March 2003

AbstractBackground.The relationship between Helicobacter pylori infection and gastric carcinoma remains controversial, especially in the African setting where infection is common, while gastric cancer is perceived to be uncommon, the basis of the so called ‘African enigma’. This discrepancy between infection and the development of disease is commonly attributed to differences in host, environment and bacterial factors. Interest in the bacterial factors has focused on heterogeneity in the so‐called ‘virulence genes’.Aim.The aim of this prospective, case‐controlled study was to establish whether H. pylori infection is significantly associated with gastric cancer and to investigate whether gastric cancer is associated with genotypically distinct (as it relates to the candidate virulence genes) organisms in this population.Methods.Patients with histologically confirmed gastric cancer were matched with nonulcer dyspeptic controls for age (within 5 years), gender and ethnicity. Helicobacter pylori status was determined by RUT, histology, culture and serology (locally validated and used as default determinant of H. pylori status). Tumors were classified according to the Lauren classification. The ‘virulence genotype’ of 17 paired culture samples was determined by previously described and validated molecular techniques (cagA presence, vacA alleles, structure of the cag pathogenicity island and analysis of the iceA alleles). Categorical variables were analysed by the χ2 test.Results.Forty‐eight patients (median age 59 years) could be adequately matched to controls. 39/48 (81%) cases and 43/48 (90%) controls were H. pylori positive (NS). Significant differences in the virulence genotypes of infecting strains were noted: vacAs2‐controls 24%, cases 0%, p < .00001; vacAs1 present – cases 100%, controls 76%, p < .05; cagA‐3′‐length > 650 bp – cases 47%, controls 0%, p < .002; cag pathogenicity island intact – cases 82%, controls 43%, p < .04; iceA1 – cases 53%, controls 6%, p < .005. cagA was found in all subjects.Conclusion.This study indicates that, in this African population at least, there is no difference in the prevalence of H. pylori infection when comparing gastric cancer cases with matched controls. However, the findings suggest that gastric cancer may be associated with infection by organisms that are genotypically different from those not associated with disease.