bluuebunny/crossref_metadata_2025_split huggingface dataset:
Child and parent perceptions of stimulant medication treatment in attention deficit hyperactivity disorder
Authors: EFRON D , JARMAN FC , BARKER MJ 
Published: November 2003

Objective:To evaluate child and parent perceptions of treatment with stimulant medication in a sample of children with attention deficit hyperactivity disorder (ADHD).Methodology:Child and parent perceptions questionnaires were completed for 102 subjects participating in a double‐blind, crossover trial of methylphenidate (MPH) and dexamphetamine (DEX).Results:Most children viewed medication effects favourably, although 12.7% and 18.8% of children reported feeling worse than usual when taking MPH and DEX, respectively. There was disagreement between the child’s and parents’ perceptions of response in over one quarter of cases. Most disagreements involved parents viewing the child’s response favourably, but the child rating reporting an unfavourable outcome. Side‐effects were the main determinant of children’s perceptions of adverse response.Conclusions:A substantial proportion of children with ADHD experience treatment with stimulant medication adversely. Side‐effects are the principal determinant of negative child perceptions. Parental report is usually in agreement with child report; however, parental report alone is not infallible in providing reliable information regarding effects as experienced by the child.
Outcome of closed head injury in Malaysian children: Neurocognitive and behavioural sequelae
Authors: ONG LC , CHANDRAN V , ZASMANI S , LYE MS 
Published: November 2003

Objective:To compare the neurobehavioural outcome of children aged 6–12 years with severe closed head injury [sCHI] (coma >24 h), mild‐to‐moderate head injury [mCHI] (coma <6 h) and orthopaedic controls.Methods:Twenty‐nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow Outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC‐III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post‐injury. Parental reporting of pre‐ and post‐injury behaviour was documented using the Child Behaviour Checklist (CBCL).Results:Seven (24.1%) children with sCHI and three (10.3%) orthopaedic controls had residual motor deficits. Three (10.3%) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty‐seven (93.1%) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty‐two (81.5%) sCHI, five (18.5%) mCHI and one (3.7%) orthopaedic control reported a deterioration in school performance. manovas identified a significant injury group effect for performance skills (P=0.007), verbal skills (P=0.002), memory and learning (P=0.001) and motor skills (P=0.001). Repeated measures anova for pre‐ and post‐injury CBCL scores showed significant differences related to somatic complaints (P=0.004), problems of socialising (P=0.003), delinquency (P=0.004), aggressiveness (P=0.010), thought (P<0.001) and attention (P<0.001). Post‐hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups.Conclusion:Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.
Aetiology of childhood proptosis
Authors: SINDHU K , DOWNIE J , GHABRIAL R , MARTIN F 
Published: November 2003

Objective:To retrospectively analyse causes of childhood proptosis and their investigations and treatment.Methodology:The records of children under 15 years of age presenting with proptosis to The Children’s Hospital, Camperdown, Sydney, were reviewed for the period 1983–92 inclusive.Results:Fifty‐seven cases of proptosis were found. In order of frequency the causes were: orbital cellulitis 22, thyroid eye disease 8, optic nerve±optic chiasm glioma 8, orbital rhabdomyosarcoma 7, metastatic neuroblastoma 4, orbital neurofibroma 3, orbital haemangioma 2, metastic Ewing’s sarcoma 2 and orbital dermoid cyst 1. Treatment depended on the cause (antibiotics, antithyroid drugs, chemotherapy, radiotherapy, surgery) and was multidisciplinary.Conclusions:The most common cause of proptosis in children presenting to The Children’s Hospital, Camperdown, Sydney, was infective orbital cellulitis. The most useful initial investigation was an orbital computed tomography scan. Treatment depended on the cause of the proptosis and was multidisciplinary.
Measles immunity and immunisation status in under‐5‐year‐old children in New South Wales: A population‐based study
Authors: FERSON MJ , ROBERTSON PW , DONOVAN JW 
Published: November 2003

Objective:To estimate the proportion of 1–4‐year‐old New South Wales children immune to measles and compare the documented immunisation history with serologically defined immune status.Design:Population based seroprevalence survey piggybacked onto the National Survey of Lead in Children. Immune status was determined by two different enzyme immunoassays on plasma samples from subjects.Setting:New South Wales, February‐March 1995.Outcome measures:Documented measles immunisation collected by interview survey and serologically defined immunity.Results:Of 689 survey subjects, 430 (62.4%) provided a blood sample. Adequate plasma remained for both assays for 347 children, of whom 279 (80.4%) were immune by both assays. Parents of 330 stated that their children were immunised, of whom 211 (63.9%) were able to produce corroborating records. Of these 211 subjects, 178 (84.4%) were immune compared to 87 (76.3%) of 114 without records (P=0.07).Conclusions:We estimate the prevalence of true measles immunity in 1–4‐year‐old NSW children to be only 80%, a level inadequate to prevent outbreaks of measles in urban populations. Both long term and immediate strategies are required to increase the prevalence of immunity among NSW children; these may include lowering the age of the routine second measles dose and mounting a mass measles immunisation campaign to include preschool aged children.
Randomized, placebo‐controlled trial of intramuscular vitamin B12 for the treatment of hyperhomocysteinaemia in dialysis patients
Authors: Polkinghorne K. R. , Zoungas S. , Branley P. , Villanueva E. , McNeil J. J. , Atkins R. C. , McGrath B. P. , Kerr P. G. 
Published: November 2003

Abstract Background:  Plasma homocysteine is elevated in patients with end‐stage renal disease (ESRD) and is a risk factor for cardiovascular disease. Folic acid has been shown to partially reduce homocysteine levels in dialysis patients. It is not known whether vitamin B12 reduces homocysteine independent of folic acid in patients who are not vitamin B12 deficient.Aim:  To determine whether 1 mg vitamin B12 lowers homocysteine in stable, chronic, haemodialysis patients independent of folic acid.Methods:  Twenty‐eight haemodialysis patients were randomized to receive three doses of 1 mg vitamin B12 or 1 mL saline placebo in a double‐blind fashion at 1‐month intervals. Fasting plasma total homocysteine, folic acid, red‐cell folate, vitamin B12 and haemoglobin levels were determined prior to each dose and 4 weeks after the final injection. The study was powered to detect a 30% reduction in homocysteine over the 3 months.Results:  Both the two groups were well matched with respect to total homocysteine levels, folic acid, red‐cell folate and vitamin B12 levels. Serum vitamin B12 levels were significantly higher in the treatment group compared to placebo (217.7 pmol/L; 95% confidence interval (CI) 103.0−332.5; P < 0.001) at the end of the trial but homocysteine levels were not significantly different (3.08 µmol/L; 95% CI −4.44−10.61; P= 0.406).Conclusions: The administration of intramuscular vitamin B12 over a 3‐month period does not result in any reduction of plasma homocysteine levels in haemo­dialysis patients independent of folate status, however reductions of <30% cannot be excluded by the present study. High‐dose folic acid remains the treatment of choice in reducing homocysteine, but whether this results in a reduction in cardiovascular events remains to be determined. (Intern Med J 2003; 33: 489−494)
Löfgren syndrome in Turkey
Authors: Yanardaǧ H. , Pamuk Ö. N. , Karayel T. 
Published: November 2003

AbstractIn the 36‐year period between 1966 and 2002, 514 patients were diagnosed with sarcoidosis at Cerrahpala Medical Faculty, Gstanbul, Turkey, and of these 98 (19.1%) had Löfgren syndrome. The frequency of female patients with Löfgren was higher than the frequency among other sarcoidosis patients (female : male ratio 4.8vs. 1.64;P < 0.001). Erythema nodosum was diagnosed in 72.4% of the subjects and arthritis or arthralgia was diagnosed in 51%. Erythema nodosum and arthritis or arthralgia were more frequent in Löfgren; however, pulmonary parenchymal involvement was more frequent in other sarcoidosis patients (allP‐values < 0.001). (Intern Med J 2003; 33: 535−537)
Comparison of large‐ and small‐bore intercostal catheters in the management of spontaneous pneumothorax
Authors: Vedam H. , Barnes D. J. 
Published: November 2003

Abstract Background:  Spontaneous pneumothoraces (SP) are a common cause of presentation to emergency departments and subsequent hospitalization. In recent years there has been an increasing trend towards the use of small‐bore pleural catheters (PC) rather than conventional large‐bore intercostal catheters (ICC) in their initial management.Aims:  To compare the effectiveness and complication rate of ICC and PC in the treatment of SP.Methods:  A retrospective chart audit was conducted of 67 cases of SP admitted to the Royal Prince Alfred ­Hospital, Sydney, Australia, between 1 July 1997 and 30 June 2000. Demographic data were recorded, ­including: (i) patient age, (ii) smoking status, (iii) pneumothorax size, (iv) pneumothorax type and (v) aetiology. Outcome data relating to length of hos­pital stay (LOS) and treatment failure rates and comp­lications of treatment devices were also recorded.Results:  Successful pneumothorax resolution was achieved (P = 0.72) in 20 of the 31 (65%) patients initially treated with a ICC, and in 26 of the 36 (72%) patients treated with a PC. The mean LOS in the ICC and PC group was 7 days and 5 days, respectively (P = 0.11). The complication rates in the PC and ICC group were 25% and 10%, respectively (P = 0.13), and the recurrence rates for each group were 17% and 6% (P = 0.20), respectively. However, the combined rate of complications and pneumothorax recurrence within 2 months was 42% in those initially treated with PC, compared with 16% in those treated with ICC (P = 0.04).Conclusions:  PC were as effective as ICC in treating SP in terms of initial pneumothorax resolution and LOS. There were trends towards higher complication and recurrence rates in those treated with PC, but individ­ually these results did not reach statistical significance. However, the combined rate of complications and pneumo­thorax recurrence was significantly higher in those patients treated with the PC than in those treated with ICC. (Intern Med J 2003; 33: 495−499)
Hypertrophic cardiomyopathy: state‐of‐the‐art review, with focus on the management of outflow obstruction
Authors: Kovacic J. C. , Muller D. 
Published: November 2003

Abstract Significant advances in our understanding and management of hypertrophic cardiomyopathy have been made in the last decade, as the complex genetics and ­phenotype−genotype correlations that characterize the disease are gradually unravelled. The well‐described clinical heterogeneity of hypertrophic cardiomyopathy is now understood to be based on profound genetic vari­ability, with at least 10 genes and over 150 mutations implicated. Several new therapeutic tools have entered clinical practice. The implantable cardioverter‐­defibrillator is now strongly indicated in those at high risk of sudden arrhythmic death. Our ability to abort sudden death in this subgroup has placed added emphasis on risk stratification in newly diagnosed patients. New procedures have also been developed for the relief of outflow obstruction in patients with refractory symptoms and a significant subaortic outflow gradient. Although not as efficacious as the ‘gold‐standard’­surgical myectomy−myotomy, dual‐chamber pacemaker implantation can be of modest benefit in select patients. Percutaneous transluminal septal myocardial ablation is an emerging catheter‐based procedure for the relief of left ventricular outflow obstruction. Long‐term follow‐up data are still awaited. However, intermediate‐term results suggest equivalent efficacy to surgical ­myectomy−myotomy. (Intern Med J 2003; 33: 521−529)
OncoSurge: a strategy for long‐term survival in metastatic colorectal cancer
Authors: Alberts S. , Poston G. 
Published: November 2003

AbstractOncoSurge is a combined modality strategy for the management of colorectal cancer with hepatic metastases. It has emerged as a result of new and expanded patient selection criteria for resectability of metastases, coupled with more effective neoadjuvant and postoperative chemotherapy. By bringing together these developments in surgery and medical oncology, the new approach promises to increase significantly the resectability rate and long‐term survival in colorectal cancer patients with liver metastases.Surgery for colorectal liver metastases should now be considered across a range of clinical circumstances that would historically have been contraindications to resection. These contraindications include multiple or bilobar metastases, large tumour size, a Dukes stage C or poorly differentiated primary tumour, synchronous detection of metastases with the primary tumour, disease in elderly patients, or a resection margin of less than 1 cm. None of these criteria should necessarily exclude a patient from resection, because although they may be associated with a less favourable prognosis they do not exclude the possibility of long‐term survival. Non‐resectable extrahepatic disease and portal lymph node involvement, however, remain contraindications to resection in most circumstances.Retrospective studies of neoadjuvant therapy have indicated that a regimen based on low dose oxaliplatin, 5‐fluorourucil (5‐FU) and leucovorin increased the overall resectability rate of patients presenting with hepatic colorectal metastases from 20% to 30%, with 13.6% of patients with unresectable metastases becoming eligible for curative resection. More recently, studies using more potent oxaliplatin‐based regimens have reported significantly higher resectability rates of at least 40%, with 5‐year survival of 50% reported in one large study among patients whose liver metastases were resected after initial neoadjuvant therapy for unresectable tumours. Following resection, postoperative therapy based on a combination of hepatic artery infusion (HAI) and systemic chemotherapy reduces hepatic recurrence and increases survival, but more potent systemic therapy is required to reduce the rate of extrahepatic recurrence. Studies are now in progress combining HAI with oxaliplatin‐based systemic therapy to address this issue.By combining a more inclusive approach to surgery with more effective neoadjuvant and postoperative chemotherapy, the OncoSurge treatment model is likely to increase significantly the number of patients with hepatic colorectal metastases who can be treated with curative intent, and thus has the potential to improve overall patient survival.
New oxaliplatin‐based combinations in the treatment of colorectal cancer
Authors: Cassidy J. , Hochster H. 
Published: November 2003

AbstractThe synergism between oxaliplatin and 5‐fluorouracil (5‐FU)/leucovorin in the treatment of colorectal cancer raises the prospect of further clinically effective combinations. Phase I/II trials of capecitabine, an oral fluoropyrimidine, plus oxaliplatin have established this combination (XELOX) as an effective treatment for advanced disease, with response rates of over 50% in first line therapy. Phase III studies of XELOX are now in progress, while further studies are investigating the combined use of oxaliplatin and a second oral fluoropyrimidine, UFT, after positive phase I/II results. Studies of combined oxaliplatin and irinotecan treatment have reported response rates varying from 25% to 60% in second‐line therapy of treatment resistant metastatic disease, and 42% in first line therapy. The optimum dosing combination of these two agents has yet to be determined however, and in many patients it is likely that greater overall survival will be achieved by using them in successive lines rather than in combination. Clinical studies have also demonstrated clinically significant response rates when oxaliplatin is combined with other agents including raltitrexed and mitomycin C.Alongside these novel chemotherapeutic combinations, a range of biological therapies is now being investigated in combination with oxaliplatin in advanced colorectal cancer. Cetuximab (C225) is a monoclonal antibody that inhibits signalling through the epidermal growth factor receptor (EGFR), a pathway that has been associated with a variety of pathological process in cancer including dysregulated growth, differentiation, angiogenesis, cell motility and cell adhesion. Studies of second‐line therapy combining oxaliplatin and cetuximab in advanced disease and in patients with unresectable liver‐only metastases are in progress in the United States. A phase I/II study is also investigating the combined use of oxaliplatin and ZD1839 (‘Iressa’), a small molecule inhibitor of the EGFR specific tyrosine kinase activating the same pathways. Anti‐angiogenesis agents are also being studied intensely. A key angiogenic pathway in the stimulation of tumour growth is the vascular endothelial growth factor (VEGF) pathway, inhibited by the monoclonal antibody bevacizumab. Phase II first line and phase III second line studies of oxaliplatin in combination with bevacizumab are now in progress. Oxaliplatin is being investigated in combination with a number of other classes of biological agent, including the proteasome inhibitor PS‐341. The sudden appearance of a wide range of chemotherapeutic and biological agents with activity against colorectal cancer presents many challenges to the current system of clinical trials, given the large number of permutations requiring prospective testing. However, by building upon the encouraging results achieved using oxaliplatin plus 5FU/leucovorin, the introduction of new agents will eventually translate into significantly improved clinical outcomes.
An analysis of child consumers in Turkey
Authors: Özgen Özlen 
Published: November 2003

AbstractThis research was conducted on 402 children going to kindergarten and primary schools with the purpose of analysing the children's interests, responsibilities, economic resources, purchasing activities, and socialization agents and purchase influences as consumers. Data were collected using a questionnaire, which was prepared by considering some previous research. The questionnaire was applied to subjects through face‐to‐face individual interview. The data were analysed by using explanatory variables, including age, gender, socio‐economic status and family type. Findings indicated that consumer socialization of children was connected to selected demographic characteristics, especially age, and they were surprisingly independent and influential consumers. The results of this study are important for those involved in children's and adults’ markets, and for consumer educators.
A review of the ‘consumer interest’ in organic meat
Authors: Brennan Carol , Gallagher Kelly , McEachern Morven 
Published: November 2003

AbstractThe study aims to provide a critical review of the literature on the consumer interest in the UK in organic food, with a particular focus on organic meat. Given that people are more likely to purchase products if they have faith in them, the regulation of organic food standards is reviewed to explore issues affecting consumers. This is followed by a review of the organic meat sector. Aspects of the consumer interest considered in this paper include consumer information, consumer access, consumer safety, consumer choice and consumer representation. As the literature on organic food/meat in the UK is extensive, it was therefore necessary to be selective with regard to the publications suitable for this review. Most of the literature selected for this paper has been drawn from UK publications, although several European and international sources have also been used. The review found that there is a considerable level of interest in the UK organic meat sector. As the regulation of organic food produced is set at varying standards across the European Union, this could lead to consumers being misled regarding the quality of products offered. It was also found that, although consumers perceive organic foods as healthier, more nutritious and tasting better than non‐organic products, the literature shows that this may have only a limited basis on fact. Contamination of organic products with pesticides and even genetically modified ingredients is always possible. Organic farmers are permitted to use other ingredients in organic meat products that may be harmful to health. Escherichia coli and Salmonella risks associated with conventional meat also appear to affect organic meat. Consumers need clear, accurate and reliable information about organic meat. They also need to be provided with safe products, a choice of organic products, access to organic products and to be represented effectively.
A 40Ar/39Ar laser probe study of micas from the Sesia Zone, Italian Alps: implications for metamorphic and deformation histories
Authors: REDDY S. M. , KELLEY S. P. , WHEELER J. 
Published: November 2003

Two samples from the Eclogite Micaschist Complex (EMC) and the Seconda Zona Diorito–Kinzigitica (IIDK) of the Sesia Zone have been studied using a high‐spatial resolution laser probe 40Ar/39Ar technique with the aim of investigating the complexities of argon behaviour in metamorphic rocks and comparing their thermal histories. Data from a single large phengite grain from the EMC show a range of ages from mid‐Jurassic to Upper Cretaceous. These ‘apparent age’ variations are spatially related to both locationwithin the grain and to intragrain microstructure. Modelling of the data shows that the profile formedby the diffusion of an excess argon component into the grain, parallel to the mica cleavage. Profileasymmetry is explained by temporal variations in microstructural development enabling excess argon toenter the grain at different times in different places. The temperatures of the initiation of deformationand the possible time‐scales for the deformation can be calculated as a function of cooling rate. Allestimates suggest deformation at greenschist facies, in accord with the observed retrograde mineral assemblage. Absolute temperature estimates for deformation vary by less than 22 °C for different cooling ratesof 10 and 30 °C Ma−1 but vary by 80 °C with different estimates of diffusion parameters. The durationof deformation was for at least 2 Ma at 10 °C Ma−1 or 0.7 Ma at 30 °C Ma−1. Biotites from the IIDKsample record a Permian to Upper Cretaceous age range that correlates with grain size, the smallestgrain sizes yielding the youngest ages. This relationship is best explained by a partial resetting of biotitesduring an Alpine thermal event initiated not more than 70 Ma ago. Modelling of these data suggest thatthe sample never exceeded 300 °C during the Alpine. The profoundly different thermal histories of thetwo units—the EMC recrystallized at 550 °C whilst the IIDK remained below 300 °C—suggests thatthey may not have been juxtaposed until much later than the eclogite facies metamorphism.