bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight loss and hypernatremia in breast‐fed babies: Frequency in neonates with non‐hemolytic jaundice
Authors: Tarcan Aylin , Tiker Filiz , Vatandaş Nilgün Şalk , Haberal Ayşegül , Gürakan Berkan 
Published: September 2005

Objective:  The aim of this study was to determine what proportion of newborns admitted with idiopathic non‐hemolytic hyperbilirubinemia exhibit severe weight loss and hypernatremia. Methods:  The prospective study involved 115 infants >48 h old who were admitted with jaundice between July 2002 and July 2003, and had unconjugated bilirubin levels >12 mg/dL. Premature babies (gestational age <37 weeks) and those with hemolytic jaundice and other pathologic causes of non‐hemolytic jaundice were excluded. Postnatal age (days) at admission, bodyweight at admission, weight change since birth (percentage weight loss calculated at admission) and mode of feeding (breast‐feeding, formula feeding, mixed feeding) were recorded. Severe weight loss was defined in babies who showed >10% weight loss or had not regained enough to reach birthweight by postnatal day 10. Serum Na levels and breast‐milk Na levels were also measured. Results:  Twenty‐eight (33%) of the 86 newborns with idiopathic hyperbilirubinemia in the study exhibited severe weight loss. Almost all the 86 babies were exclusively breast‐fed, and 10 babies (12%) had severe weight loss combined with hypernatremia. The group with severe weight loss and hypernatremia had higher breast‐milk Na levels than the other infants. Conclusion:  The results indicate that a large proportion of babies with non‐hemolytic jaundice have severe weight loss, and that breast‐fed newborns with the combination of weight loss and hypernatremia may present with non‐hemolytic jaundice.
Can Australian general practitioners tackle childhood overweight/obesity? Methods and processes from the LEAP (Live, Eat and Play) randomized controlled trial
Authors: McCallum Zoë , Wake Melissa , Gerner Bibi , Harris Claire , Gibbons Kay , Gunn Jane , Waters Elizabeth , Baur Louise A 
Published: September 2005

Background:  General practitioners (GPs) could make an important contribution to management of childhood overweight. However, there are no efficacy data to support this, and the feasibility of this approach is unknown. Objectives:  To determine if GPs and families can be recruited to a randomized controlled trial (RCT), and if GPs can successfully deliver an intervention to families with overweight/obese 5‐ to 9‐year‐old children. Methods:  A convenience sample of 34 GPs from 29 family medical practices attended training sessions on management of childhood overweight. Practice staff trained in child anthropometry conducted a cross‐sectional body mass index (BMI) survey of 5‐ to 9‐year‐old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution‐focused behaviour change consultations over 12 weeks. Results:  General practitioners were recruited from across the sociodemographic spectrum. All attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight/obese (17.5% overweight, 10.5% obese), with children drawn from all sociodemographic quintiles. Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT; 96% of intervention families attended at least their first consultation. Conclusions:  Many families are willing to tackle childhood overweight with their GP. In addition, GPs and families can participate successfully in the careful trials that are needed to determine whether an individualized, family‐based primary care approach is beneficial, harmful or ineffective.
Early case conferences shorten length of stay in children admitted to hospital with suspected child abuse
Authors: Smith J Anne S , Efron Daryl 
Published: September 2005

Objective:  To compare the outcomes of two models for the management of children admitted to hospital with suspected child abuse: routine early case conferencing versus standard evaluation. Methods:  Between March 2001 and February 2002 professionals from the Royal Children's Hospital, Melbourne, Victoria Police and Child Protection services collaborated on a randomized controlled study involving children admitted to hospital with suspected child abuse. The intervention group (n = 13) received a case conference within 24 h of the child's admission to hospital. The control group (n = 12) were managed according to standard procedures whereby each organization conducted their own evaluation (and a case conference might or might not have been held). Patients were followed for 3 months with data collected from all three professional groups. Results:  The process of evaluation, the eventual diagnosis of child abuse and the confidence with which professionals made this diagnosis was not significantly different between the groups. Case conferences were judged to be useful regardless of their timing. Mean length of stay in the intervention group was significantly less than in controls (42.4 h vs 99.7 h, P = 0.01). Conclusion:  Early case conferences appear to shorten the period of time children spend in hospital when child abuse is suspected. This has significant implications for reducing costs for all organizations involved in the evaluation of suspected child abuse.
Volume‐targeted ventilation and arterial carbon dioxide in neonates
Authors: Dawson Catherine , Davies Mark William 
Published: September 2005

Objectives: To review the arterial carbon dioxide tensions (PaCO2) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Dräger Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg. Methods: Data on ventilator settings and arterial PaCO2 levels were collected on all arterial blood gases (ABG; n = 288) from 50 neonates (<33 weeks gestational age) ventilated using the Dräger Babylog 8000+ ventilator (Dräger Medizintechnik GmbH, Lübeck, Germany) in SIMV plus volume guarantee mode. Data were analysed for all blood gases done on the entire cohort in the first 48 h of life and a subanalysis was done on the first gas for each infant (n = 38) ventilated using volume guarantee from admission to the nursery. The number of ABG showing severe hypocapnoea (PaCO2 < 25 mmHg) and/or severe hypercapnoea (PaCO2 > 65 mmHg) were determined. Results: The mean (SD) PaCO2 during the first 48 h was 46.6 (9.0) mmHg. The mean (SD) PaCO2 on the first blood gas of those infants commenced on volume guarantee from admission was 45.1 (12.5) mmHg. Severe hypo‐ or hypercapnoea occurred in 8% of infants at the time of their first blood gas measurement, and in <4% of blood gas measurements in the first 48 h. Conclusions: Infants ventilated with volume guarantee ventilation targeting approximately 4 mL/kg (range: 2.9–5.1) have acceptable PaCO2 levels at the first blood gas measurement and during the first 48 h of life; and avoid severe hypo‐ or hypercapnoea over 90% of the time.
Clinical outcomes of deep atypical lipomas (well‐differentiated lipoma‐like liposarcomas) of the extremities
Authors: Sommerville Scott M. M. , Patton James T. , Luscombe Jon C. , Mangham D. Chas , Grimer Robert J. 
Published: September 2005

Aim:  Controversy exists with regard to the nomenclature, treatment and outcome of a group of well‐differentiated lipomatous tumours sometimes labelled as atypical lipomas. The purpose of the present paper is to attempt to clarify these controversies by reporting our experience with this lesion.Methods:  The clinical features and follow up of 61 patients with the diagnosis of deep atypical lipoma and a minimum two‐year follow up were examined.Results:  All patients were treated by marginal excision alone. A local recurrence was seen in five patients (8%). Three recurred once and two recurred twice. No patient had a metastasis or died as a result of the tumour. No lesion dedifferentiated.Conclusion:  We believe the term atypical lipoma is appropriate for these tumours, as they appear not to have any metastatic potential, merely a propensity to recur locally. The chance of dedifferentiation is small and radiotherapy may play a role in its causation. We suggest that a simple marginal resection (shelling‐out) is adequate treatment for these lesions. Radiotherapy should not be used.
Abdominal trauma: a disease in evolution
Authors: Smith Jason , Caldwell Erica , D’Amours Scott , Jalaludin Bin , Sugrue Michael 
Published: September 2005

Background:  The last decade has seen many changes in the way we investigate and manage abdominal injuries. This study assessed the pattern of abdominal injury and its investigation in patients admitted to a major trauma centre.Methods:  A retrospective registry review of all adult trauma patients admitted to Liverpool Hospital between January 1996 and December 2003 was undertaken. All adult trauma patients were included, identifying mechanism of injury, injury severity score, abbreviated injury score for the abdomen, investigations and intervention. The study period was divided (period 1 from 1996 to 1999, period 2 from 2000 to 2003) and the two periods compared to assess change.Results:  The study involved 1224 patients with abdominal injuries. Of these, 969 (79%) were a result of blunt trauma. The main causes were road accidents (61%), interpersonal violence (24%) and falls (7%). Penetrating injury increased from 16% to 25% between the two periods. There were 1274 intra‐abdominal injuries, made up of 607 solid organ (liver (n = 220, 36%), spleen (n = 195, 32%), renal (n = 144, 24%) ), 291 hollow viscus (small bowel (n = 160, 55%), large bowel (n = 104, 36%) ) and 168 vascular. Four hundred and thirty‐six (36%) patients underwent laparotomy, 65% for blunt trauma. Between the two periods there was a 46% decrease in the use of diagnostic peritoneal lavage, with a 40% increase in computed tomography and 325% increase in focused assessment with sonography for trauma.Conclusions:  This study defined abdominal injury pattern and identified a significant shift in mechanism of injury and abdominal investigation at a major trauma centre during an 8‐year study period. Abdominal trauma is indeed a disease in evolution.
The Auburn Elective Surgery Pilot Project
Authors: Singh N. , Brooke‐Cowden G. L. , Whitehurst Catherine , Smith Deborah , Senior John 
Published: September 2005

Background:  The aim of this project was to increase rates of day surgery, reduce elective surgical waiting lists, give patients a guaranteed date of surgery and improve operating theatre utilization. The guiding principle behind the project was to treat the administration of elective surgery as a separate business unit, distinct from emergency surgery.Methods:  Elective surgical referrals for admission from throughout the Western Sydney Health Area Service were pooled. The procedure for surgical admissions was altered in three areas: (i) the use of a new booking and waiting list system administered by a dedicated nurse coordinator who generated the lists for surgery; (ii) restructuring the elective surgical operating sessions; and (iii) planning post‐discharge care at the time of operation using model clinical pathways.Results and conclusions:  During the project period, the number of the selected surgical procedures performed doubled. Fifty‐seven per cent of patients were discharged on the day of surgery. Surgeons took less time to perform procedures. By the end of the trial period, waiting lists for the selected procedures were eliminated. Operating costs as evaluated by the Centre for Health Economics Research and Evaluation were reduced by 25%. The administrative changes to surgical admissions resulted in improved cost and patient throughput for elective surgical admissions with no adverse patient outcomes.
Central nervous system interleukin‐8 production following neck of femur fracture
Authors: Chuang Danny , Power Sharleen E. , Dunbar P. Rod , Hill Andrew G. 
Published: September 2005

Aim:  To establish a proinflammatory cytokine profile of the cerebrospinal fluid (CSF) following trauma.Background:  Trauma is associated with a postinjury syndrome consisting of loss of weight and nitrogen, pyrexia, anorexia and fatigue. It has been proposed that cytokines are pathophysiologically involved in this syndrome but the site of action of these is unclear. Previous work in head injury models, supported by animal work, has suggested that one important site of action is the central nervous system (CNS).Methods:  Women who had sustained neck of femur fractures were enrolled (trauma group). CSF was collected at the time of spinal anaesthetic. Women undergoing elective lower limb surgery were recruited as controls. CSF and serum were assayed for Interleukin (IL) 1, 2, 4, 6, 8, 10, 12, interferon gamma, and tumour necrosis factor by cytometric bead array.Results:  In the trauma group, IL‐8 was elevated in the CSF but not in the serum, while IL‐6 was elevated in the serum but not in the CSF. IL‐1β, associated with elevated IL‐12, was also detected in the serum of three of 11 trauma patients but none of the nine controls. No other cytokines were consistently detected.Conclusions:  This study raises the possibility that IL‐8, acting in the CNS, plays a role in the postinjury syndrome. It is unclear as to the mechanism by which CNS IL‐8 is produced in trauma but a physiological role is supported by the known ability of the CNS to produce IL‐8 and the presence of receptors for its action in the CNS.
Remifentanil versus fentanyl for short‐term analgesia‐based sedation in mechanically ventilated postoperative children
Authors: AKINCI SEDA BANU , KANBAK MERAL , GULER AYGUN , AYPAR ULKU 
Published: September 2005

SummaryBackground : Analgesia‐based sedation techniques are becoming more established in the intensive care unit (ICU) setting. The aim of this study was to compare remifentanil and fentanyl infusions for postoperative analgesia in pediatric ICU patients.Methods : After receiving ethical committee approval, a prospective randomized, double‐blind study was performed. Twenty‐two postoperative orthopedic surgery patients received either remifentanil 0.1 μg·kg−1·min−1 or fentanyl 0.025 μg·kg−1·min−1 infusions diluted to the same volume. Analgesic infusion was titrated to predefined levels of analgesia [behavioral pain scale (BPS) score of 3]. Propofol was added if sedation was unsatisfactory after BPS score 3 had been achieved.Results : There were no differences in groups regarding demographics, tracheal extubation times, and pain scores of the patients. After cessation of the opioid infusion, the sedation scores and the heart rates were always higher in the remifentanil group compared with the fentanyl group. The incidences of nausea, vomiting, apnea, desaturation, reintubation within 24 h and constipation were also similar between the two groups.Conclusions : We conclude that a remifentanil infusion provides clinically comparable analgesia with a fentanyl infusion in mechanically ventilated postoperative pediatric patients. These two drugs are suitable for short‐term analgesia‐based sedation in pediatric postoperative ICU patients.
Tracheoesophageal fistula and associated congenital heart disease: implications for anesthetic management and survival
Authors: DIAZ LAURA K. , AKPEK ELIF A. , DINAVAHI RADHIKA , ANDROPOULOS DEAN B. 
Published: September 2005

SummaryBackground : Infants with tracheoesophageal fistula (TEF) and/or esophageal atresia (EA) frequently have other associated congenital anomalies which can have a significant impact on their anesthetic care and survival to discharge.Methods : A medical record review and retrospective data analysis were performed in a university affiliated children's hospital of all infants undergoing TEF/EA repair between January 1998 and July 2004. The incidence of intraoperative complications during the TEF repair and overall survival to hospital discharge was compared in two groups of infants: 26 patients with TEF/EA and coexisting congenital heart disease (CHD), and 27 patients with TEF/EA and no CHD.Results : The overall incidence of intraoperative critical events during repair of TEF/EA was significantly higher in infants with associated cardiac pathology (P = 0.003). Six of 53 infants died during hospitalization (overall mortality, 11.3%) and all had associated cardiac pathology. In comparison with nonductal‐dependent lesions, the presence of a ductal‐dependent cardiac lesion appeared to significantly increase patient mortality (57% vs. 10%, P = 0.028).Conclusions : Low birth weight (<1500 g) and associated cardiac pathology were found to be independent predictors of mortality in infants undergoing surgery for TEF/EA repair. The presence of a ductal‐dependent cardiac lesion further increased the risk of morbidity and mortality, in addition to necessitating special anesthesia considerations.
Detection of cultured and uncultured Burkholderia cepacia complex bacteria naturally occurring in the maize rhizosphere
Authors: Pirone Luisa , Chiarini Luigi , Dalmastri Claudia , Bevivino Annamaria , Tabacchioni Silvia 
Published: September 2005

SummaryThe species composition of a Burkholderia cepacia complex population naturally occurring in the maize rhizosphere was investigated by using both culture‐dependent and culture‐independent methods. B. cepacia complex isolates were recovered from maize root slurry on the two selective media Pseudomonas cepacia azelaic acid tryptamine (PCAT) and trypan blue tetracycline (TB‐T) and subjected to identification by a combination of restriction fragment length polymorphism (RFLP) analysis and species‐specific polymerase chain reaction (PCR) tests of the recA gene. DNA extracted directly from root slurry was examined by means of nested PCR to amplify recA gene with species‐specific B. cepacia complex primers and to obtain a library of PCR amplified recA genes. Using the culture‐dependent method the species Burkholderia cepacia, Burkholderia cenocepacia, Burkholderia ambifaria and Burkholderia pyrrocinia were identified, whereas using the culture‐independent method also the species Burkholderia vietnamiensis was detected. The latter method also allowed us to highlight a higher diversity within the B. cenocepacia species. In fact, by using the culture‐independent method the species B. cenocepacia recA lineages IIIA and IIID besides B. cenocepacia recA lineage IIIB were detected. Moreover, higher heterogeneity of recA RFLP patterns was observed among clones assigned to the species B. cenocepacia than among B. cenocepacia isolates from selective media.
The active methanotrophic community in hydromorphic soils changes in response to changing methane concentration
Authors: Knief Claudia , Kolb Steffen , Bodelier Paul L. E. , Lipski André , Dunfield Peter F. 
Published: September 2005

SummaryMethanotrophic communities were studied in several periodically water‐saturated gleyic soils. When sampled, each soil had an oxic upper layer and consumed methane from the atmosphere (at 1.75 ppmv). In most gleyic soils the Km(app) values for methane were between 70 and 800 ppmv. These are higher than most values observed in dry upland soils, but lower than those measured in wetlands. Based on cultivation‐independent retrieval of the pmoA‐gene and quantification of partial pmoA gene sequences, type II (Alphaproteobacteria) methanotrophs of the genus Methylocystis spp. were abundant (> 107pmoA target molecules per gram of dry soil). Type I (Gammaproteobacteria) methanotrophs related to the genera Methylobacter and Methylocaldum/Methylococcus were detected in some soils. Six pmoA sequence types not closely related to sequences from cultivated methanotrophs were detected as well, indicating that diverse uncultivated methanotrophs were present. Three Gleysols were incubated under different mixing ratios of 13C‐labelled methane to examine 13C incorporation into phospholipid fatty acids (PLFAs). Phospholipid fatty acids typical of type II methanotrophs, 16:0 and 18:1ω7c, were labelled with 13C in all soils after incubation under an atmosphere containing 30 ppmv of methane. Incubation under 500 ppmv of methane resulted in labelling of additional PLFAs besides 16:0 and 18:1ω7c, suggesting that the composition of the active methanotrophic community changed in response to increased methane supply. In two soils, 16:1 PLFAs typical of type I methanotrophs were strongly labelled after incubation under the high methane mixing ratio only. Type II methanotrophs are most likely responsible for atmospheric methane uptake in these soils, while type I methanotrophs become active when methane is produced in the soil.
Sequence analysis of three plasmids harboured in Rhodococcus erythropolis strain PR4
Authors: Sekine Mitsuo , Tanikawa Satoshi , Omata Seiha , Saito Mika , Fujisawa Takatomo , Tsukatani Naofumi , Tajima Takahisa , Sekigawa Tomohiro , Kosugi Hiroki , Matsuo Yasunori , Nishiko Rika , Imamura Kohsuke , Ito Mio , Narita Hitomi , Tago Shinichi , Fujita Nobuyuki , Harayama Shigeaki 
Published: September 2005

Summary Rhodococcus erythropolis strain PR4 has been isolated as an alkane‐degrading bacterium. The strain harbours one linear plasmid, pREL1 (271 577 bp) and two circular plasmids, pREC1 (104 014 bp) and pREC2 (3637 bp), all with some sequence similarities to other Rhodococcus plasmids. For pREL1, pREC1 and pREC2, 298, 102 and 3 open reading frames, respectively, were predicted. Linear plasmid pREL1 has several regions homologous to plasmid pBD2 found in R. erythropolis BD2. Sequence analysis of pREL1 and pBD2 identified common metal‐resistance genes on both, but pREL1 also encodes alkane‐degradation genes not found on pBD2, with enzyme constituents some of which are quite different from those of other organisms. The alkane hydroxylase consisted of a cytochrome P450 monooxygenase, a 2Fe‐2S ferredoxin, and a ferredoxin reductase. The ferredoxin reductase amino acid sequence resembles the AlkT (rubredoxin reductase) sequence. A zinc‐containing alcohol dehydrogenase further oxydizes alkanols, alkane oxidation products catalysed by alkane hydroxylase. Of the circular plasmids, the pREC1 sequence is partially similar to the sequence of pREAT701, the virulence plasmid found in Rhodococcus equi. pREC1 has no pREAT701 virulence genes and encodes genes for β‐oxidation of fatty acids. Thus, joint actions of enzymes encoded by pREL1 and pREC1 may enable efficient mineralization of alkanes.
Intravesical bacillus Calmette‐Guèrin therapy: experience with a reduced dwell‐time in patients with pronounced side‐effects
Authors: Andius Patrik , Fehrling Marianne , Holmäng Sten 
Published: September 2005

OBJECTIVETo report the side‐effects after a reduction in the dwell‐time in patients who had pronounced symptoms after intravesical bacillus Calmette‐Guèrin (BCG) treatment, as side‐effects such as fever, haematuria, and frequency are common and sometimes severe after BCG treatment in patients with bladder cancer.PATIENTS AND METHODSThe dwell‐time was reduced to ≤ 30 min in 51 patients who had pronounced side‐effects after the preceding BCG instillation. All patients self‐reported side‐effects after each instillation in a questionnaire.RESULTSAfter reducing the BCG dwell‐time, fever, chills, dysuria and the overall time‐to‐recovery were significantly reduced but frequency and haematuria were not influenced. Patients with carcinoma in situ had significantly less dysuria than patients with papillary tumours. There was no difference in the treatment results between patients who had a normal dwell‐time and a reduced dwell‐time, determined at the first and second follow‐up cystoscopy.CONCLUSIONReducing the BCG dwell‐time to ≤ 30 min could be an alternative to a dose reduction in patients who experience pronounced side‐effects after BCG instillations. The long‐term outcome after reducing dwell‐time and after dose reduction has not been studied and warrants further investigation.