bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing obesity and overweight in a high mountain Pakistani population
Authors: Shah Syed M. , Nanan Debra , Rahbar Mohammad H. , Rahim Musa , Nowshad Gul 
Published: April 2004

SummaryObjectives  To estimate the prevalence of obesity and overweight among adults in a high mountain rural population of Pakistan, and to determine the correlates of excess body weight.Design  Cross‐sectional study.Methods  A random sample of 4203 adults (aged 18 years and over) was selected by stratified random sampling from 16 villages in north Pakistan. Trained medical students measured height, weight and blood pressure. Trained interviewers obtained information from participants on sociodemographic variables, use of snuff, daily cigarette consumption, hypertension and family history of hypertension. Body mass index (BMI) calculated as kg/m2 was used to define overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2).Results  Using weight and height data available for 1391 men and 2754 women, mean BMI was 22.4 (95% CI 21.9, 22.9) for men and 22.6 (95% CI 21.9, 23.2) for women. The age‐adjusted prevalence of BMI ≥ 25 (overweight/obesity) was 13.5% for men and 14.1% for women. Overweight/obesity increased with age and the increase per year was identical for both men and women [adjusted odds ratio (AOR) = 1.01, 95% CI 1.01, 1.03]. Overweight/obese men and women were more likely to be hypertensive (men, AOR = 3.32, 95% CI 2.16, 5.09; women, AOR = 1.70, 95% CI 1.21, 2.39). Overweight/obese women were more likely to work in business or as skilled workers (AOR = 6.24, 95% CI 1.18, 32.83) while overweight/obese men were more likely to work as government employees (AOR = 2.59, 95% CI 1.66, 4.03). Family history of hypertension was a significant correlate of overweight/obesity in men (P value 0.004) and women (P value 0.000). Overweight/obese men and women were less likely to use smokeless tobacco (men, AOR = 0.65, 95% CI 0.43, 0.97; women, AOR = 0.54, 95% CI 0.35, 0.85).Conclusion  The prevalence of risk factors for non‐communicable diseases (NCDs) in Pakistan is expected to increase as further epidemiologic, nutritional and demographic changes occur. The assessment of excess body weight, and patterns and determinants of other risk factors for NCDs is important to provide useful guidelines in the planning of interventions to counter a growing problem.
Importance of nosocomial respiratory syncytial virus infections in an African setting
Authors: Madhi Shabir A. , Ismail Kuraysha , O'Reilly Cathryn , Cutland Clare 
Published: April 2004

SummaryObjective  To define the importance of nosocomial‐acquired respiratory syncytial virus (RSV) infection in an area with a high prevalence of paediatric HIV‐1 infection.Methods  A prospective study was performed that involved all children hospitalized to a general paediatric ward during the course of an RSV epidemic. These children were screened within 24 h of admission and subsequently at 3–4 day intervals for RSV infection using a direct immunofluorescence assay.Results  RSV was detected in 36 (11.8%) of the 305 children upon initial investigation. Fourteen (38.9%) of the 36 children with community‐acquired RSV infection were HIV‐1 infected. Repeat sampling for RSV infection was performed in 130 children who tested negative for RSV infection on initial screening and who were hospitalized for ≥3 days. Nosocomial acquisition of RSV occurred among 11.5% of these children, of whom 33% were HIV‐1 infected. Fourteen (93.3%) of the children with nosocomial RSV acquisition were clinically symptomatic and treated for ‘nosocomial‐sepsis’. Furthermore, RSV was isolated from 54% of all children who were investigated for clinically diagnosed nosocomial sepsis. Two (13%) of 15 children with nosocomial RSV infection died; both had other underlying medical conditions.Conclusion  RSV is an important under‐recognized cause of nosocomial infection and sepsis among children in this African country. Active interventions are warranted in addressing this problem, as has been successfully undertaken in developed countries.
Improving malaria home treatment by training drug retailers in rural Kenya
Authors: Marsh V. M. , Mutemi W. M. , Willetts A. , Bayah K. , Were S. , Ross A. , Marsh K. 
Published: April 2004

SummaryRecent global malaria control initiatives highlight the potential role of drug retailers to improve access to early effective malaria treatment. We report on the findings and discuss the implications of an educational programme for rural drug retailers and communities in Kenya between 1998 and 2001 in a study population of 70 000. Impact was evaluated through annual household surveys of over‐the‐counter (OTC) drug use and simulated retail client surveys in an early (1999) and a late (2000) implementation area. The programme achieved major improvements in drug selling practices. The proportion of OTC anti‐malarial drug users receiving an adequate dose rose from 8% (n = 98) to 33% (n = 121) between 1998 and 1999 in the early implementation area. By 2001, and with the introduction of sulphadoxine pyrimethamine group drugs in accordance with national policy, this proportion rose to 64% (n = 441) across the early and late implementation areas. Overall, the proportion of shop‐treated childhood fevers receiving an adequate dose of a recommended anti‐malarial drug within 24 h rose from 1% (n = 681) to 28% (n = 919) by 2001. These findings strongly support the inclusion of private drug retailers in control strategies aiming to improve prompt effective treatment of malaria.
Structural and functional analysis of full‐length hepatitis B virus genomes in patients: Implications in pathogenesis
Authors: WEN YU‐MEI 
Published: April 2004

AbstractThe structural analysis, replicative efficiency and immunogenicity of hepatitis B virus (HBV) full‐length genomes isolated from different patients or asymptomatic carriers are presented in the present review. Data indicate the importance of viral genome‐based studies in elucidating the pathogenesis of HBV infections. Comparison of structural and functional characteristics of viral genomes isolated from various geographical regions might contribute to explaining the differences in HBV clinical manifestation and prognosis in different geographical regions.
Expression of cyclooxygenase‐2 in cholangiocarcinoma: Correlation with clinicopathological features and prognosis
Authors: KIM HONG JOO , LEE KYU TAEK , KIM EUN KYUNG , SOHN TAE SUNG , HEO JIN SEOK , CHOI SEONG HO , CHOI DONG IL , LEE JONG KYUN , PAIK SEUNG WOON , RHEE JONG CHUL 
Published: April 2004

AbstractBackground and Aims:  No information is available on the nature of the correlation between cyclooxygenase‐2 (COX‐2) expression and the clinicopathological features and prognosis of cholangiocarcinoma (CC). The goal of the present study was to determine the possible roles and clinical significance of COX‐2 expression in CC.Methods:  We investigated the immunohistochemical expression of COX‐2 in 102 patients with CC with respect to clinicopathological characteristics, namely evidence of Clonorchis sinensis infection, proliferation index (PI, assessed by Ki‐67 expression), apoptotic index (AI, assessed by TUNEL stain), and microvessel density (MVD, assessed by CD34 expression). Evidence of C. sinensis infection was assessed by the microscopic examination of stools for C. sinensis ova, serological testing (ELISA), and the detection of peripheral bile duct dilations by imaging studies.Results:  An immunohistochemical investigation demonstrated the immunolabeling of tumor cells, mainly in the cytoplasmic and perinuclear regions, in 53 (52%) of the 102 patients with CC. No significant differences were found in terms of age, sex, tumor differentiation, involvement of the resection margin, presence of lymph nodes or liver metastases, or in pTNM stage between COX‐2 positive and COX‐2 negative patients. However, evidence of C. sinensis infection was more common in COX‐2 positive patients (P < 0.05). No significant differences were found for PI, AI, MVD, or cumulative survival between COX‐2 positive and COX‐2 negative patients.Conclusion:  Clonorchis sinensis infection is related to aberrant COX‐2 expression in patients with CC. However, COX‐2 expression is not related to clinical outcome in CC patients.
Contrast‐free unilateral endoscopic palliation in malignant hilar biliary obstruction: New method
Authors: SINGH V , SINGH G , VERMA GR , SINGH K , GULATI M 
Published: April 2004

AbstractBackground:  Bilateral endoscopic drainage is difficult in malignant hilar biliary obstruction. Recently, unilateral drainage in malignant hilar biliary obstruction has been shown to be equally effective. However, contrast injection leads to cholangitis. There have been no reported studies on contrast‐free metal stenting in malignant hilar biliary obstruction. The present study was undertaken to evaluate the results of contrast‐free unilateral metal stenting in type II malignant hilar biliary obstruction.Methods:  We prospectively studied the results of unilateral metal stenting in type II malignant hilar biliary obstruction without contrast injection in 18 patients.Results:  A successful endoscopic drainage was achieved in 100% (18/18) of patients with hilar strictures. Cholangitis and 30‐day mortality occurred in none.Conclusions:  Unilateral endoscopic metal stenting without contrast in type II malignant hilar biliary obstruction is a safe and effective method of palliation.
Mucosal irritative and healing impairment action of risedronate in rat stomachs: Comparison with alendronate
Authors: KANATSU KENJI , AIHARA EITARO , OKAYAMA MITUAKI , KATO SHINICHI , TAKEUCHI KOJI 
Published: April 2004

AbstractBackground and Aim:  We used alendronate and risedronate as bisphosphonates and examined whether or not these agents have a mucosal irritative action in the stomach and impair the healing of pre‐existing gastric ulcers in rats.Methods:  Male Sprague Dawley (SD) rats were used in the following two studies: (i) the effects of risedronate and alendronate on gastric potential difference (PD), gastric mucosal blood flow (GMBF) and acid back‐diffusion in the stomach mounted on ex vivo chamber under urethane anesthesia and; (ii) the influence of daily treatment with these drugs on the healing of acetic acid‐induced gastric ulcers was examined.Results:  Mucosal application of risedronate produced PD reduction in the saline‐perfused stomachs in a dose‐dependent manner. Alendronate also produced a marked PD reduction, the effect being more potent than that of risedronate. In the stomach exposed to acid (100 mM HCl), both drugs produced a marked reduction in PD, followed by acid back‐diffusion and a small increase in GMBF, resulting in hemorrhagic lesions, and the effects again were more pronounced with alendronate. These irritative effects were dependent on the pH of drug solution and the action was more potent at pH 7 than pH 4. Conversely, the healing of acetic acid‐induced gastric ulcers was significantly delayed by daily administration of these drugs, yet this effect was less pronounced in the case of risedronate. The healing impairing effect of these bisphosphonates was potentiated by coadministration of indomethacin.Conclusion:  Both alendronate and risedronate have mucosal irritative and healing impairing effects in the stomach, yet the effect of risedronate was much less pronounced compared to alendronate. It is assumed that risedronate is safer than alendronate as the antiresorptive agent in patients with diseases related to bone remodeling.
Helicobacter pylori and gastrointestinal symptoms in school children in Russia
Authors: NIJEVITCH ALEXANDER A , SHCHERBAKOV PETER L 
Published: April 2004

AbstractBackground and Aims:  Helicobacter pylori is considered to be the major cause of chronic gastritis and duodenal ulcer disease recurrence in childhood. However, the association between H. pylori and recurrent abdominal pain (RAP) syndrome is still controversial. Therefore, the spectrum of clinical variants of gastrointestinal symptoms associated with H. pylori‐positive status was studied in consecutive symptomatic children who were undergoing diagnostic endoscopy.Methods:  A consecutive series of 225 school children from the Ural area of Russia (mean age 11.1 + 1.4 years, age range 7–15 years) who presented with RAP were investigated using esophagogastroduodenoscopy, including three antral biopsies for histology and polymerase chain reaction. Helicobacter pylori immunoglobulin G antibodies were found using a second‐generation enzyme immunoassay. Information about the clinical symptoms was collected using a special questionnaire.Results:  The authors found a high incidence of H. pylori infection (80%) and peptic ulcers (16%) in 225 school children from the Ural area of Russia who were referred for upper gastrointestinal (UGI) endoscopy for chronic abdominal pain. Of the overall 225 symptomatic children who underwent endoscopy, 182 (80,8%) were found to be H. pylori‐positive. Duodenal ulcers were detected in 36 H. pylori‐positive children. A family history of peptic ulcers was significantly more frequent in the children infected with H. pylori (P < 0.001). Symptom score and duration of symptoms were similar, but night‐time pain (P < 0.0001) and fasting pain relieved by food (P < 0.001) were more frequent in the H. pylori‐positive children as compared with the H. pylori‐negative children.Conclusions:  The present results provide further evidence for a significant association between H. pylori and some patterns of gastrointestinal symptoms in children who underwent UGI endoscopy in order to exclude an organic cause of severe chronic gastrointestinal disorders.
Double point mutation in the core promoter region of hepatitis B virus (HBV) genotype C may be related to liver deterioration in patients with chronic HBV infection
Authors: NAKASHIMA HISASHI , FURUSYO NORIHIRO , KUBO NORIHIKO , KASHIWAGI KENICHIRO , ETOH YOSHITAKA , KASHIWAGI SEIZABUROU , HAYASHI JUN 
Published: April 2004

AbstractBackground and Aim:  Hepatitis B virus (HBV) genotype C has a more severe pathogenesis than genotype B in Japan. We retrospectively investigated the relationship between HBV genotype and the core promoter (CP) (nt 1762 and 1764) and precore (PreC) (nt 1896) mutations of the HBV genome.Methods:  A total of 129 Japanese patients (42 genotype B and 87 genotype C) with chronic HBV infection, living in two different geographical areas in Japan, were evaluated (mean follow‐up period 10.1 ± 3.8 years). In 2000, CP and PreC HBV mutations were analyzed by direct sequencing from sera. Hepatitis B e antigen (HBeAg), HBV DNA and serial alanine aminotransferase (ALT) changes were followed and determined using serological methods.Results:  Genotype C patients had significantly higher rates of HBeAg (40.2%vs 2.4%), HBV DNA positivity (75.9%vs 7.1%) and ALT abnormality (71.3%vs 11.9%) than genotype B patients (all P < 0.05). Among genotype B patients, CP wild type (92.9%) was predominant and PreC mutation (88.1%) was predominant. However, among genotype C patients, CP mutation (75.9%) was predominant and PreC mutation (66.7%) was predominant. The CP mutation was found significantly more in genotype C than in genotype B (P < 0.05). Of the 67 patients with ALT abnormality, five (7.5%) genotype B and 62 (92.5%) genotype C patients (31 HBeAg positive and 31 negative) were found. Among the 31 genotype C patients who were HBeAg positive, the combination of CP mutation and PreC wild (54.8%) was predominant, while among the remaining 31 genotype C patients who were HBeAg negative, the combination of CP mutation and PreC mutant (71.0%) was predominant.Conclusion:  Genotype C might be one of the worse prognostic markers in patients with chronic HBV infection, possibly because of mutation in the CP region.
Lafutidine inhibits Helicobacter pylori‐induced interleukin‐8 production in human gastric epithelial cells
Authors: NOZAWA YOSHIHISA , NISHIHARA KATSUSHI , AKIZAWA YUSHIRO , ORIMOTO NAOKI , NAKANO MOTOKO , UJI TATSUYA , AJIOKA HIROFUSA , KANDA ATSUHIRO , MATSUURA NAOSUKE , KINIWA MAMORU 
Published: April 2004

AbstractBackground and Aim:  Attachment of Helicobacter pylori to gastric epithelial cells leads to the production of chemokines, such as interleukin‐8 (IL‐8), which in turn activate and recruit neutrophils to the site of infection. Lafutidine [(+/–)‐2‐(furfurylsulfinyl)‐N‐(4‐(4‐(piperidinomethyl)‐2‐pyridyl)oxy‐(Z)‐2‐butenyl)acetamide] is a new type of antiulcer drug that possesses an antisecretory action as well as gastroprotective activity, independent of its antisecretory action. In the present study, we examined the effects of lafutidine on H. pylori‐induced IL‐8 release and H. pylori adhesion to MKN45 cells.Methods:  MKN45 cells were stimulated with H. pylori, tumor necrosis factor (TNF)‐α, or IL‐1β, then IL‐6 and IL‐8 levels in the culture supernatants were determined with a specific enzyme‐linked immunosorbent assay kit.Results:  Lafutidine significantly inhibited both the release of IL‐8 induced by H. pylori and the adhesion of H. pylori to cells in a dose‐dependent manner. These properties of lafutidine are unrelated to the blockade of histamine H2‐receptors, because the same effects have not been observed with other H2‐receptor antagonists, such as cimetidine and famotidine. Lafutidine also significantly inhibited H. pylori‐induced IL‐6 release. Both TNF‐α and IL‐1β‐induced IL‐8 releases, conversely, were little affected by lafutidine up to a concentration of 10−5 M.Conclusions:  These results suggest that lafutidine inhibits IL‐8 release by inhibiting H. pylori adherence to gastric epithelial cells, indicating a novel mechanism by which lafutidine protects against the mucosal inflammation associated with H. pylori infection.
Mucosal concentration of basic fibroblast growth factor in the healing process in human giant gastric ulcers
Authors: MIZUKI AKIRA , TATEMICHI MASAYUKI , NISHIYA HIROMI , FUKUI KAZUTO , HAYASHI TATSUHIKO , TSUKADA NOBUHIRO , NAGATA HIROSHI , ISHII HIROMASA 
Published: April 2004

AbstractObjectives:  Basic fibroblast growth factor (bFGF) is a key factor in the healing of human and experimental peptic ulcers, but the behavior of bFGF in human giant gastric ulcer remains to be determined. We determined the bFGF content in the rim of giant ulcers (bFGF rim) and in non‐ulcerated mucosa located opposite the ulcer (bFGF opposite) before and during treatment.Methods:  Biopsy specimens were endoscopically obtained from 31 patients with giant gastric ulcers and 17 patients with small ulcers before and 2, 4 and 8 weeks after treatment. The bFGF concentrations in the specimens were measured using a sandwich enzyme immunoassay.Results:  Before treatment, the bFGF rim and bFGF opposite concentrations were not associated with ulcer size. The bFGF rim concentration before treatment in the rapid healing group was higher than that in the slow healing group, but no significant difference in bFGF opposite concentrations were found between the two groups. The bFGF rim concentration in the rapid healing patients decreased during treatment, while the slow healing patients showed an inverse response. The bFGF opposite concentration did not change during treatment and bFGF rim concentrations in Helicobacter pylori‐positive stomachs were significantly lower than those in H. pylori‐negative stomachs.Conclusions:  The bFGF rim concentration is not involved in the formation of giant gastric ulcers in humans. However, the bFGF rim concentration does appear to promote healing. The bFGF opposite concentration is not related to either the formation or healing of giant gastric ulcers.
Monitoring Elite Capture in Community‐Driven Development
Authors: Platteau Jean‐Philippe 
Published: April 2004

AbstractRecently, a lot of attention has been paid to improving ways of assessing the effectiveness of development interventions. This is to be welcomed, especially with regard to community‐based or participatory aid projects, since considerable resources are currently being earmarked for these by almost all types of donor agencies, including large international organizations. Such projects are vulnerable to elite capture at local level, and this problem must be mitigated if most of the aid funds thus disbursed are to reach the intended beneficiaries. This article discusses several methods available to achieve that objective. In particular, it argues that the sequential and conditional release of aid funds may not be sufficient to keep elite capture well under control, making it necessary to resort to co‐ordination mechanisms among aid agencies, such as multilateral reputation mechanisms. Even these are not going to be effective enough, however. In the end, an active role will have to be played by the ultimate purveyors of aid money, whether the taxpayers or the contributors in fund‐raising campaigns.
War, Livelihoods and Vulnerability in Sri Lanka
Authors: Korf Benedikt 
Published: April 2004

AbstractAs the number of de‐stabilized regions of warfare or post‐war conditions worldwide continues to grow, this article investigates how civilians survive in the context of a civil war. It analyses livelihood strategies of farmers in the war‐torn areas of Sri Lanka, using an analytical framework based on a revised form of DFID's sustainable rural livelihoods approach, placing particular attention on the institutional reproduction of household capital assets in the war economy. The author delineates a three pillar model of household livelihood strategies focusing on how households (1) cope with the increased level of risk and uncertainty; (2) adjust their economic and social household assets for economic survival; and (3) use their social and political assets as livelihood strategies. Empirical evidence comes from four case study villages in the east of Sri Lanka. Although the four case studies were very close together geographically, their livelihood outcomes differed considerably depending on the very specific local political geography. The role of social and political assets is essential: while social assets (extended family networks) were important to absorb migrants, political assets (alliances with power holders) were instrumental in enabling individuals, households or economic actors to stabilize or even expand their livelihood options and opportunities. The author concludes that civilians in conflict situations are not all victims (some may also be culprits in the political economy of warfare), and that war can be both a threat and an opportunity, often at the same time.