bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, spectrum and antibiotic sensitivity pattern of bacterial infections among patients with acute pancreatitis
Authors: Garg Pramod Kumar , Khanna Sudeep , Bohidar Narendra Prasad , Kapil Arti , Tandon Rakesh Kumar 
Published: March 2003

AbstractBackground and Aim: Secondary infection of pancreatic necrotic tissue and peripancreatic fluid is a serious complication of acute pancreatitis resulting in significant morbidity and mortality. The aim of this study was to find out the spectrum of bacterial infections, and their antibiotic sensitivity pattern in patients with acute pancreatitis.Methods: All consecutive patients with acute pancreatitis were studied prospectively. Detailed investigations were carried out to identify bacterial infections and their antibiotic sensitivities in patients with suspected infection. These investigations included cultures of various body fluids, throat swabs, indwelling cannula and catheter tips. Pancreatic tissue was obtained by using needle aspiration or at surgery for Gram's stain, culture and sensitivity. All cultures were repeated until the presence of infection was confirmed or excluded.Results: A total of 169 patients with acute pancreatitis were studied during the period between January 1997 and June 2000 (mean age 41.3 years; 116 males and 53 females). Of the 169 patients, 63 had infections at various sites. A total of 80 cultures were positive, and 12 different bacterial isolates were cultured from samples taken from these 63 patients. Polymicrobial infection was seen in 32% of patients. Twenty‐four patients had a confirmed pancreatic infection. Blood cultures had a growth of organisms in 19 patients, with evidence of ongoing or worsening pancreatitis, thus raising a strong suspicion of infected necrosis in them. The commonest organisms were Escherichia coli from 20 cultures and Pseudomonas aeruginosa from 18 cultures. The antibiotic sensitivity pattern showed that most bacteria were sensitive to third generation cephalosporins and quinolones; notably among them were cefotaxime, ceftazidime, and ciprofloxacin.Conclusion: Bacterial infections were seen in 37% of patients with acute pancreatitis. The commonest organisms were Pseudomonas aeruginosa and Escherichia coli. Most bacterial isolates were sensitive to third generation cephalosporins and quinolones.
Prevalence of vaccine‐induced escape mutants of hepatitis B virus in the adult population in China: A prospective study in 176 restaurant employees
Authors: He Chuan , Nomura Fumio , Itoga Sakae , Isobe Kazumasa , Nakai Toshiaki 
Published: March 2003

AbstractBackground and Aim: Hepatitis B virus (HBV) variants with mutations in the S gene would pose a substantial risk to the community as current HBV vaccines are not effective in preventing infection with them. The majority of such vaccine escape mutants so far reported have been found while studying vertical transmission of HBV; the vaccine failure rate in connection with vaccine escape mutants in adults is not clear at the moment. The purpose of this study was to evaluate the efficacy of immunization against HBV in the adult population by analysis using polymerase chain reaction (PCR) to detect HBV‐DNA, and also to elucidate the type of mutation encountered in vaccine failure cases.Method: A total of 176 adult restaurant employees in China, who had been vaccinated according to the food epidemic law, were enrolled in a standard vaccination program. Their serum HBV‐DNA was determined before and 1 year after the completion of the vaccination program. In those infected with HBV, despite having received the HBV vaccine, direct sequencing within the S gene of the amplified samples was conducted.Results: Although only two cases were found to be hepatitis B surface antigen (HBsAg) positive 1 year after the completion of the vaccination program, six subjects (3.4%) were found to be HBV‐DNA positive assessed by a nested PCR. Four out of these six cases had a point mutation within the ‘a’ determinant; they were Gly‐145‐Ala, and Ile/Thr‐126‐Asn/Ser.Conclusion: The HBV vaccine failure rate assessed by using PCR analysis was 3.4% (six of 176) in the Chinese adult population undergoing the HBV vaccination program. Hepatitis B virus variants with missense mutation within the ‘a’ determinant were responsible in most cases.
Fusobacterium varium localized in the colonic mucosa of patients with ulcerative colitis stimulates species‐specific antibody
Authors: Ohkusa Toshifumi , Sato Nobuhiro , Ogihara Tatuo , Morita Koji , Ogawa Masayuki , Okayasu Isao 
Published: March 2003

Abstract Background: Microbial agents are a possible cause of ulcerative colitis. We have previously reported evidence of bacteria invading the colonic mucosa of patients with ulcerative colitis. We have isolated bacteria from inflamed colonic mucosa, examined the localization of the species in the mucosa, and assayed for serum antibodies to the bacteria.Methods: Cohorts of 31 per group were enrolled from patients with active ulcerative colitis, Crohn's disease, ischemic colitis, and colon adenomas. A group of 31 healthy controls were also studied. The presence of bacteria in biopsies of patients with ulcerative colitis was analyzed by both isolation and immunohistochemistry. Sera from patients were tested for bacterial antibodies using both Western blots and enzyme‐linked immunosorbent assay (ELISA).Results: Only sera from patients with ulcerative colitis gave specific reactions with Fusobacterium varium in Western blot assays. The detection rate of specific bands was higher for patients with ulcerative colitis (61%) than for subjects with either Crohn's disease (13%) or healthy controls (29%) (P < 0.001 and P
= 0.021, respectively). The ELISA showed that the mean optical densities with extracts of F. varium as antigen were significantly higher for ulcerative colitis patients than for subjects with either Crohn's disease or healthy controls (P < 0.001). Immunohistochemical detection of F. varium in colonic mucosa was significantly higher in patients with ulcerative colitis (84%) than for subjects with either Crohn's disease (16%) or other controls (3–13%) (P < 0.001).Conclusions: Fusobacterium varium
bacteria were present in a significant number of patients with active ulcerative colitis, and should be tested in therapeutic trials in order to confirm the causal relationship between
F. varium and ulcerative colitis.
Preventive effects of parathyroid hormone‐related peptide on stress‐induced gastric hypercontraction in the rat
Authors: ITO MASAHIRO , NAKASHIMA MASAHIRO , NAKAYAMA TOSHIYUKI , SHIKUWA SABURO , OHTSURU AKIRA , SEKINE ICHIRO 
Published: March 2003

Abstract
Background and Aims
: Parathyroid hormone‐related peptide (PTHrP) appears to be a potent smooth muscle relaxant, but there has been no study of its effects on gastric motility in vivo. The purposes of this study were to evaluate the effects of external PTHrP on stress‐induced gastric motility in vivo and on the expression of PTHrP and PTH/PTHrP receptors in the rat stomach.
Methods
: Stress‐induced hypercontraction was evoked by restraint water immersion (RWI). Gastric motility was evaluated with a strain gauge force transducer, and the effects of external PTHrP‐(1–34) (10 µ i.p.) on gastric motility were examined. Expressions of PTHrP and PTH/PTHrP receptor mRNA were evaluated by RNase protection assay.
Results
: External PTHrP significantly suppressed abnormal contraction and mucosal lesions upon RWI stress. Upon RWI stress, the expression of PTHrP mRNA decreased, but that of PTH/PTHrP receptor mRNA was enhanced reciprocally. The PTH/PTHrP receptor was localized in smooth muscle cells of the muscle layers immunohistochemically.
Conclusions
: These findings suggest that smooth muscle contractile activity is modified by the autocrine/paracrine mechanism of PTHrP in the rat stomach and that the external PTHrP prevents stress‐induced hypercontraction and mucosal lesions.© 2002 Blackwell Publishing Asia Pty Ltd
Virtual colonoscopy for the detection of colorectal polyps and cancers in a Chinese population
Authors: WONG BENJAMIN CHUN‐YU , WONG WAI‐MAN , CHAN JOHN KF , LAI KAM‐CHUEN , HU WAYNE HC , CHAN CHI‐KUEN , LAM SHIU‐KUM , CARR‐LOCKE DAVID L 
Published: March 2003

Abstract
Aim:
The aim of this study is to assess the sensitivity of virtual colonoscopy in detecting colorectal polyps and cancers in a Chinese population.
Methods:
Seventy‐one consecutive Chinese patients (38 men and 33 women) referred for diagnostic colonoscopy were recruited. Patients received a routine bowel preparation in the morning followed by a helical abdominal computed tomography (CT) scan with air insufflation of the colon. The CT images were then processed by using surface‐rendered software and interpreted by a single radiologist who was blinded to the clinical information. Colonoscopy was performed in the same afternoon without knowledge of the radiology results. All polyps and cancers were proven histologically.
Results:
Five colorectal cancers were diagnosed and all were detected by virtual colonoscopy. The sensitivity and specificity of virtual colonoscopy for the detection of patients with polyps of all sizes, and patients with polyps ≥10 mm were 59, 92, 88 and 100%, respectively. The procedure was well tolerated by all patients.
Conclusions:
This study was carried out in a real clinical setting without a preselection of cases. Virtual colonoscopy was satisfactory for the detection of polyps greater than 10 mm, and for the diagnosis of cancer, and it is also a promising imaging modality for colorectal neoplasm detection in a Chinese population.© 2002 Blackwell Publishing Asia Pty Ltd
Clinical and laboratory differentiation of cirrhosis and extrahepatic portal venous obstruction in children
Authors: PETER LORANCE , DADHICH SUNIL KUMAR , YACHHA SURENDER KUMAR 
Published: March 2003

AbstractBackground and Aim:  Differentiation between cirrhosis and extrahepatic portal venous obstruction (EHPVO) in children presenting with features of portal hypertension is important for cost‐effective management and proper resource utilization. We undertook this study to differentiate clinical and laboratory features between these two groups of patients.Methods:  Clinical features and laboratory parameters at presentation of children with portal hypertension and cirrhosis of the liver were analyzed. The variables analyzed were age at presentation, duration of symptoms, incidence and frequency of upper gastrointestinal (GI) bleeding, encephalopathy, jaundice, ascites, splenomegaly, and presence of dilated abdominal veins. The laboratory parameters studied were hemoglobin, prothrombin time, serum bilirubin, albumin, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase. Two groups were compared using appropriate statistical methods; and the differentiating features were analyzed using logistic regression analysis.Results:  Of the total of 120 cases, cirrhosis was diagnosed in 28.3% and EHPVO in 71.6%. Children with EHPVO, in comparison to cirrhosis, had significantly higher frequency of upper GI bleeding (61.6%vs 14.7%), increased number of previous bleeding episodes (2.7 ± 0.5 vs 1.2 ± 0.4), longer duration of symptoms (25.7 ± 4.6 vs 12.3 ± 3 months) and a lower frequency of jaundice (2%vs 76.4%). Low hemoglobin (6.4 ± 2.7 g/dL) and preserved liver functions characterized by normal bilirubin, albumin levels and prothrombin time were observed in EHPVO cases. Cirrhosis patients had higher hemoglobin (8.8 ± 2.8 g/dL) and abnormal liver function tests.Conclusion:  Presence of UGI bleeding and the absence of jaundice are 97.5% accurate in predicting diagnosis of EHPVO.
Wnt signaling in hepatocellular carcinoma: Analysis of mutation and expression of beta‐catenin, T‐cell factor‐4 and glycogen synthase kinase 3‐beta genes
Authors: CUI JIAN , ZHOU XINDA , LIU YINKUN , TANG ZHAOYOU , ROMEIH MAHMOUD 
Published: March 2003

AbstractBackground and Aims: Hepatocellular carcinoma (HCC) is a common killer cancer in the world. Recently, abnormal activation of the Wnt pathway has been found to be involved in the carcinogenesis of several human cancers including HCC. The goal of the present study was to investigate the mechanism of inappropriate activation of the Wnt pathway in hepatocarcinogenesis.Methods: We analyzed the alterations of three key components of the Wnt pathway: β‐catenin, glycogen synthase kinase (GSK)‐3β and T‐cell factor (Tcf)‐4 in 34 HCC and paracancerous normal liver by immunohistochemistry, polymerase chain reaction (PCR)–single‐strand conformation polymorphism (SSCP), direct sequencing, and quantitative real‐time reverse transcription (RT)–PCR.Results: We found that 61.8% (21/34) of all HCC examined showed an abnormal β‐catenin protein accumulation in the cytoplasm or nuclei. The RT–PCR–SSCP and direct sequencing showed that β‐catenin exon 3 mutations existed in 44.1% (15/34) of the HCC. No mutations of GSK‐3β or Tcf‐4 were detected in HCC. Moreover, messenger RNA of β‐catenin and Tcf‐4, but not GSK‐3β, was found to be overexpressed in HCC. On analyzing the relationship between alterations of β‐catenin or Tcf‐4 and C‐myc or Cyclin D1 expression, we found that mutations of β‐catenin, as well as overexpression of β‐catenin or the Tcf‐4 gene were independently correlated with C‐myc gene overexpression in HCC.Conclusion: Our present findings strongly suggest that mutations of β‐catenin, as well as overexpression of β‐catenin and the Tcf‐4 gene, independently activate the Wnt pathway in HCC, with the target gene most likely to be C‐myc.
Post‐traumatic stress disorder in paediatric patients and their parents: An exploratory study
Authors: LANDOLT MA , BOEHLER U , SCHWAGER C , SCHALLBERGER U , NUESSLI R 
Published: March 2003

Objective:To determine the prevalence of post‐traumatic stress disorders (PTSD) in a selected population of paediatric patients and their parents.Methodology:Twenty‐three high‐risk patients (serious accidents, newly diagnosed cancer) and 11 low‐risk patients (simple planned surgery) and their parents were consecutively selected and assessed 6–8 weeks after the event with a DSM‐IV based diagnostic interview and the PTSD Symptom Scale.Results:There is a high prevalence of PTSD in children and parents of the high‐risk group. In the low‐risk group such disorders are almost nonexistent. Parents in both groups report more PTSD symptoms than their children. Sex and age of the child and duration of hospitalisation have no significant influence on the development of PTSD.Conclusions:The high prevalence of PTSD in high‐risk paediatric patients and their parents offers support for the applicability of a post‐traumatic stress model for understanding the psychological impact of accidents, severe illnesses and their medical treatment.
Is urethral catheterization a successful alternative to suprapubic aspiration in neonates?
Authors: Austin BJ , Bollard C , Gunn TR 
Published: March 2003

Objective: To compare urine collection by urethral catheterization with suprapubic aspiration in a neonatal intensive care unit. Methodology: All urine collections were documented, the collection methods attempted recorded and success rates calculated. The incidence of contaminated specimens was determined. The infants ranged in weight from 570 g to 4180 g and in gestation from 24 to 44 weeks. Results: Thirty‐two out of 65 (49%) suprapubic aspirations were successful. Overall 33/42 (77%) of catheterizations were successful, 12/18 (67%) were successful when following an unsuccessful SPA. No SPA was contaminated compared to 7/22 (22%) of the catheter specimens. Urinary tract infection was present in 4/63 (6.3%) infants. There were no complications following catheterization. Conclusions: Urethral catheterization is a useful and safe alternative to suprapubic aspiration, but suprapubic aspiration remains the method of first choice.
Favourable neurological outcomes following delivery room cardiopulmonary resuscitation of infants ≤ 750 g at birth
Authors: Jankov RP , Asztalos EV , Skidmore MB 
Published: March 2003

Objective: To study short‐ and long‐term outcomes of infants ≤ 750 g birthweight who received cardiopulmonary resuscitation (CPR) in the delivery room. Methodology: A retrospective analysis of all inborn live births ≤ 750 g birthweight from 1990 to 1996. Cardiopulmonary resuscitation was defined as positive pressure ventilation via an endotracheal tube and chest compressions. Univariate analyses were conducted comparing patients according to the use of CPR or positive pressure ventilation alone. Results: Cardiopulmonary resuscitation was administered to 16 infants: four received chest compressions only and 12 also received adrenaline. Cardiopulmonary resuscitation recipients had significantly lower Apgar scores at both 1 and 5 min, and had delayed onset of spontaneous respiration (P < 0.01). Seven patients died, and eight of nine survivors were free of major neurodevelopmental abnormalities at follow up. All CPR recipients with a 5 min Apgar score of ≤ 5 and delayed onset of spontaneous respiration beyond 5 min had poor outcomes. Conclusion: Contrary to the majority of published evidence, delivery room CPR in our extremely small infants was not associated with a high risk of severe neurodevelopmental disability.
Kingella kingae infections in children
Authors: Dodman T , Robson J , Pincus D 
Published: March 2003

Objective: To increase awareness of Kingella kingae infections in children by presenting four cases seen at the Gold Coast Hospital, Southport, Queensland, and reviewing the literature. Methodology: Records of the four cases were reviewed and relevant information described. A MEDLINE search of the English literature from 1983 to 1998 was conducted. Results: Osteoarticular infections are the commonest type of invasive paediatric infection but bacteraemia and endocarditis also occur. Isolation of the organism is difficult but inoculation of the specimen into enriched blood culture systems improves the recovery rate. The majority of isolates are sensitive to beta‐lactam antibiotics but resistance has been described. Conclusions: Kingella kingae infections in children are more common than previously recognized. The organism should be actively sought in any child with suspected osteoarticular infections. Recommended empiric therapy is a third generation cephalosporin until susceptibility to penicillin is confirmed.
General practitioners: Their contact with maternal and child health nurses in postnatal care
Authors: Mbwili‐Muleya C , Gunn J , Jenkins M 
Published: March 2003

Objective: To assess the level of contact of general practitioners (GP) with maternal and child health nurses (MCHN) in postnatal care. Methodology: A postal survey of 1104 Victorian GP was used, with a response rate of 70%. To account for the clustered sampling frame, hierarchical data analysis techniques were used. Results: Half of the GP (351/710) had no contact with their local MCHN in the previous month; and one in 10 had four or more contacts. Eighty‐eight per cent of GP described the contact as helpful. In 56% of cases the MCHN was reported as the usual initiator of the contact. The most common reason for contact concerned the baby’s physical problems (42%). After adjusting for the number of women seen for the routine 6‐week postnatal review and other GP characteristics, male GP were as likely as female GP to report MCHN contact (odds ratio (OR) = 1.00; 95% confidence interval (CI) = 0.67–1.62). General practitioners aged 31–40 years were more likely to report contact with MCHN than GP aged 51–60 (OR = 0.45; 95% CI = 0.22–0.86) as were GP with the FRACGP qualification (OR = 1.64; 95% CI = 1.21–2.45). Conclusions: This study provides baseline information on the level of GP contact with MCHN as they provide postnatal care. Although there were GP in Victoria who maintained a level of contact with MCHN, almost half reported no contact in the previous month. Most GP who reported contact with MCHN found it useful. This finding should encourage GP and MCHN coordination to improve continuity and postnatal care outcomes.
Echocardiography on neonatal intensive care units in Australia and New Zealand
Authors: Evans N 
Published: March 2003

Objective: To establish the number of neonatal intensive care units (NICU) in Australia and New Zealand where echocardiography is performed by neonatologists, and to establish attitudes to the training of neonatologists in echocardiography. Methodology: A survey was conducted of the directors of all 29 level 3 NICU in the Australian and New Zealand Neonatal Network. Replies were received from all NICU. Results: In 41% of NICU, a neonatologist provides the primary echocardiography service, with half these units having more than one neonatologist with skills. Sixty‐eight per cent of the other units would like a neonatologist to develop these skills in the future. Units without a neonatologist with echocardiographic skills were generally less satisfied with their service, benefits and problems for both types of unit are described. Eleven per cent of units felt neonatologists should not be doing echocardiography and 96% of units felt training guidelines should be established. Conclusions: Ultrasound in neonatology and other specialties is moving beyond its traditional boundaries and becoming part of the acute care doctors’ diagnostic repertoire. This trend needs to be recognized in the specialty training and the ultrasound accreditation processes.
Implementation of evidence‐based management of acute bronchiolitis
Authors: Barben Ju , Robertson Cf , Robinson Pj 
Published: March 2003

Objective: Implementation of clinical guidelines is frequently delayed well beyond their dissemination and the publication of clinical evidence. The recently published Australian guidelines for the management of acute viral bronchiolitis (AVB) have been evaluated by assessing the current practice of Australian paediatricians. Methods: Questionnaire survey of all Australian paediatricians and a review of the literature. Results: Of a total of 891 questionnaires, 555 (62%) were returned. Of the respondents, 373 (67%) treated children with AVB and, of these, 232 (67%) treated 10–50 children per year. A wide variation in management practice for both outpatient and inpatient treatment of AVB was identified. Up to 70% of paediatricians who treated AVB indicated using pharmaceutical agents in their outpatient management (88% in inpatient management), most using these agents ‘sometimes’ or in high‐risk children. Paediatric respiratory physicians tended to use bronchodilators less frequently than general paediatricians. Compared with many countries in Europe, few Australian paediatricians routinely use supplementary drugs in the inpatient management of AVB; in particular, bronchodilators (61 vs 7%) and corticosteroids (11 vs 1%) are used far less often. A review of the literature demonstrated that pharmaceutical agents do not influence the course of AVB. Conclusions: Despite a lack of evidence for their efficacy and the recommendation of the Australian guidelines, pharmaceutical agents are frequently used in the management of AVB by paediatricians in Australia, although far less than reported in a recently published European survey. Guidelines alone are not sufficient to implement change and there is a need for more specific strategies to ensure that children receive appropriate management for this common condition.