Keyword: child
2017 (16)
Systematic Review of Interventions to Reduce Psychiatric Morbidity in Parents and Children After PICU Admissions. Baker S.C. & Gledhill J.A. 2017.
![Systematic Review of Interventions to Reduce Psychiatric Morbidity in Parents and Children After PICU Admissions [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper abstract bibtex
Paper abstract bibtex OBJECTIVE:: To describe and evaluate interventions aimed at reducing psychiatric morbidity in parents and children discharged from PICU. DATA SOURCES:: A systematic review of the literature was undertaken, searching EMBASE, PSYCHinfo, MEDLINE, and CINAHL. Experts in the field were contacted to identify unpublished studies. STUDY SELECTION:: Exclusion criteria: Studies with participants above age 18 or drawn from a neonatal ICU, studies not in English, and those not measuring psychopathology. DATA EXTRACTION:: Seven hundred fifty-three articles initially identified were hand searched which identified three studies, with a further three studies found by contacting experts in the field. Of these, three were randomized controlled trials and three feasibility studies. DATA SYNTHESIS:: The interventions primarily targeted parents (particularly mothers), with the aim of reducing psychopathology especially posttraumatic stress disorder. Findings from these few studies demonstrated that interventions can lead to a reduction in parent and child psychopathology. Key ingredients of these interventions included psychoeducation, parent support after discharge, offering intervention to those families at high risk of developing psychopathology as identified by screening at the point of discharge, follow-up of all families with the aim of case finding, and specific interventions to target posttraumatic stress disorder symptoms. CONCLUSIONS:: Intervention studies are few but do lead to reductions in parent and child psychopathology. There is sufficient information to suggest some of these interventions could be supported and further evaluated. Copyright ©2017The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
@misc{baker_s.c._systematic_2017,
title = {Systematic {Review} of {Interventions} to {Reduce} {Psychiatric} {Morbidity} in {Parents} and {Children} {After} {PICU} {Admissions}},
url = {http://journals.lww.com/pccmjournal},
abstract = {OBJECTIVE:: To describe and evaluate interventions aimed at reducing psychiatric morbidity in parents and children discharged from PICU. DATA SOURCES:: A systematic review of the literature was undertaken, searching EMBASE, PSYCHinfo, MEDLINE, and CINAHL. Experts in the field were contacted to identify unpublished studies. STUDY SELECTION:: Exclusion criteria: Studies with participants above age 18 or drawn from a neonatal ICU, studies not in English, and those not measuring psychopathology. DATA EXTRACTION:: Seven hundred fifty-three articles initially identified were hand searched which identified three studies, with a further three studies found by contacting experts in the field. Of these, three were randomized controlled trials and three feasibility studies. DATA SYNTHESIS:: The interventions primarily targeted parents (particularly mothers), with the aim of reducing psychopathology especially posttraumatic stress disorder. Findings from these few studies demonstrated that interventions can lead to a reduction in parent and child psychopathology. Key ingredients of these interventions included psychoeducation, parent support after discharge, offering intervention to those families at high risk of developing psychopathology as identified by screening at the point of discharge, follow-up of all families with the aim of case finding, and specific interventions to target posttraumatic stress disorder symptoms. CONCLUSIONS:: Intervention studies are few but do lead to reductions in parent and child psychopathology. There is sufficient information to suggest some of these interventions could be supported and further evaluated. Copyright ©2017The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies},
journal = {Pediatric Critical Care Medicine},
author = {{Baker S.C.} and {Gledhill J.A.}},
year = {2017},
keywords = {*morbidity, *psychiatric intensive care unit, Child, Cinahl, Embase, Medline, Neonatal intensive care unit, PsycINFO, adult, case finding, controlled study, family study, feasibility study, female, follow up, human, intervention study, mental disease, mother, newborn, posttraumatic stress disorder, psychoeducation, screening, systematic review, young adult}
}Birth weight and subsequent body mass index in children: an international cross-sectional study. Mitchell, E., A., Stewart, A., W., Braithwaite, I., Hancox, R., J., Murphy, R., Wall, C., & Beasley, R. Pediatric Obesity, 12(4):280-285, 2017.
![Birth weight and subsequent body mass index in children: an international cross-sectional study [pdf]](https://bibbase.org/img/filetypes/pdf.svg "pdf")
Paper abstract bibtex
Paper abstract bibtex Background: The reported association between birth weight and subsequent body mass index (BMI) is conflicting. Objectives: To examine the relationship between birth weight and BMI in children aged 6-7 years. Methods: Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's birth weight, current height and weight and whether their mother smoked in the first year of the child's life. A general linear mixed model was used to determine the association between BMI and birth weight. Results: A total of 72 111 children (17 countries) were included in the analysis. There was a positive association of birth weight with BMI (for each kg increase in birth weight the BMI at 6-7 increased by 0.47 (SE 0.02) kg/m2; p < 0.0001) with a clear gradient by birth weight category. There was no statistically significant interaction between birth weight and Gross National Income (GNI). Conclusions: There is a positive linear relationship between birth weight and BMI in 6-7 year old children, which is present in both high and low income countries. Copyright © 2016 World Obesity Federation
@article{
title = {Birth weight and subsequent body mass index in children: an international cross-sectional study},
type = {article},
year = {2017},
identifiers = {[object Object]},
keywords = {Birth weight,body mass index,child,epidemiology,gross national income},
pages = {280-285},
volume = {12},
id = {acab89e5-0963-362b-87a8-c8859c8ff5c6},
created = {2017-12-18T01:47:09.275Z},
file_attached = {true},
profile_id = {6c9edcaf-81dc-3357-bb56-dee7616baa0c},
group_id = {ac4e17e4-c387-3e1e-aa52-1ae5d129a0ef},
last_modified = {2018-01-14T20:35:43.205Z},
read = {true},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
private_publication = {false},
abstract = {Background: The reported association between birth weight and subsequent body mass index (BMI) is conflicting. Objectives: To examine the relationship between birth weight and BMI in children aged 6-7 years. Methods: Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's birth weight, current height and weight and whether their mother smoked in the first year of the child's life. A general linear mixed model was used to determine the association between BMI and birth weight. Results: A total of 72 111 children (17 countries) were included in the analysis. There was a positive association of birth weight with BMI (for each kg increase in birth weight the BMI at 6-7 increased by 0.47 (SE 0.02) kg/m<sup>2</sup>; p < 0.0001) with a clear gradient by birth weight category. There was no statistically significant interaction between birth weight and Gross National Income (GNI). Conclusions: There is a positive linear relationship between birth weight and BMI in 6-7 year old children, which is present in both high and low income countries. Copyright © 2016 World Obesity Federation},
bibtype = {article},
author = {Mitchell, E. A. and Stewart, A. W. and Braithwaite, I. and Hancox, R. J. and Murphy, R. and Wall, C. and Beasley, R.},
journal = {Pediatric Obesity},
number = {4}
}Teduglutide: A Review in Short Bowel Syndrome. Kim E.S. & Keam S.J. 2017.
Paper abstract bibtex
Paper abstract bibtex Subcutaneous teduglutide (Revestive), a glucagon-like peptide-2 analogue that increases intestinal absorption, is approved in the EU for the treatment of short bowel syndrome (SBS) in patients aged \textgreater1 year who are stable following a period of postsurgical intestinal adaptation. In a phase III trial in adults with SBS intestinal failure (IF) dependent on parenteral support (PS), a significantly greater proportion of teduglutide 0.05 mg/kg/day than placebo recipients achieved a \textgreater20% reduction in weekly PS volume from baseline to week 20 and maintained it to week 24. The proportion of patients who had a reduction in one or more days on PS was also significant with teduglutide compared with placebo. Improved intestinal absorption and reduced PS requirements were generally maintained in the longer term. Results from a phase III trial in paediatric patients with SBS-IF dependent on PS were consistent with those in adults. Adverse events were mostly of mild to moderate severity and generally consistent with the underlying condition or known mechanism of the drug (e.g. central line-related issues, gastrointestinal events). Teduglutide is therefore a useful treatment option in children (aged \textgreater1 year), adolescents and adults with SBS. Copyright © 2017, Springer International Publishing Switzerland. All Right Reserved.
@misc{kim_e.s._teduglutide:_2017,
title = {Teduglutide: {A} {Review} in {Short} {Bowel} {Syndrome}},
url = {http://rd.springer.com/journal/40265},
abstract = {Subcutaneous teduglutide (Revestive), a glucagon-like peptide-2 analogue that increases intestinal absorption, is approved in the EU for the treatment of short bowel syndrome (SBS) in patients aged {\textgreater}1 year who are stable following a period of postsurgical intestinal adaptation. In a phase III trial in adults with SBS intestinal failure (IF) dependent on parenteral support (PS), a significantly greater proportion of teduglutide 0.05 mg/kg/day than placebo recipients achieved a {\textgreater}20\% reduction in weekly PS volume from baseline to week 20 and maintained it to week 24. The proportion of patients who had a reduction in one or more days on PS was also significant with teduglutide compared with placebo. Improved intestinal absorption and reduced PS requirements were generally maintained in the longer term. Results from a phase III trial in paediatric patients with SBS-IF dependent on PS were consistent with those in adults. Adverse events were mostly of mild to moderate severity and generally consistent with the underlying condition or known mechanism of the drug (e.g. central line-related issues, gastrointestinal events). Teduglutide is therefore a useful treatment option in children (aged {\textgreater}1 year), adolescents and adults with SBS. Copyright © 2017, Springer International Publishing Switzerland. All Right Reserved.},
journal = {Drugs},
author = {{Kim E.S.} and {Keam S.J.}},
year = {2017},
keywords = {*short bowel syndrome, *short bowel syndrome/dt [Drug Therapy], *short bowel syndrome/th [Therapy], *teduglutide, *teduglutide/ae [Adverse Drug Reaction], *teduglutide/dt [Drug Therapy], *teduglutide/pd [Pharmacology], *teduglutide/pk [Pharmacokinetics], *teduglutide/sc [Subcutaneous Drug Administration], Child, Parenteral nutrition, abdominal distension/si [Side Effect], acute cholecystitis/si [Side Effect], adolescent, adult, adverse drug reaction, article, catheter infection/co [Complication], central venous catheter, central venous catheter/am [Adverse Device Effect], clinical study, clinical trial, controlled clinical trial, controlled study, decreased appetite/si [Side Effect], disease severity, drug efficacy, drug therapy, drug tolerability, gastrointestinal dysplasia/si [Side Effect], gastrointestinal polyposis/si [Side Effect], gastrointestinal symptom/si [Side Effect], gastrointestinal tract, gastrointestinal tumor/si [Side Effect], human, infant, influenza/si [Side Effect], injection site erythema/si [Side Effect], intestinal failure, intestine absorption, intestine polyp/si [Side Effect], intestine stenosis/si [Side Effect], multicenter study (topic), nonhuman, peripheral edema/si [Side Effect], pharmacodynamic parameters, phase 3 clinical trial, phase 3 clinical trial (topic), placebo, recipient, rectum polyp/si [Side Effect], rhinopharyngitis/si [Side Effect], sepsis/co [Complication], short bowel syndrome/dt [Drug Therapy], side effect, stomach adenoma/si [Side Effect], systematic review, upper abdominal pain/si [Side Effect]}
}Effect of dexmedetomidine infusion on hemodynamics and stress responses in pediatric cardiac surgery: A randomized trial. Totonchi Z., Rezvani H., Ghorbanloo M., Yazdanian F., Mahdavi M., Babaali N., Salajegheh S., & Chitsazan M. 2017.
Paper abstract bibtex
Paper abstract bibtex Background: Infants and children compared with adults have intensified stress responses that lead to increased morbidity and mortality. Stress control reduces the incidence of complications and improves recovery. In clinical and experimental studies, dexmedetomidine reduces the inflammatory and neuroendocrine responses. Objectives: This prospective randomized double-blinded clinical trial was conducted to assess the role of dexmedetomidine in reducing stress responses. Materials and Methods: According to convenient sampling method, 40 patients in two groups (case under treatment with dexmedetomidine and control, each including 20 patients) were selected from whom admitted for open heart surgery. Anesthesia was induced and maintained by fentanyl and midazolam. After central venous and arterial catheter insertion, patients were randomly allocated into one of two equal groups (n = 20 each). In the dexmedetomidine group, patients received an initial loading dose (0.5 micro g/kg) during 10 minutes immediately followed by a continuous infusion of 0.5 micro g/kg. In the control group, normal saline solution with similar volume was infused. Results: Changes in heart rate, systolic and diastolic blood pressures and central venous pressure before administration of dexmedetomidine, in 10, 20 and 30 minutes after the operation, after skin incision, after sternotomy, after separation from the pump and at the end of procedure showed no significant difference between the two groups (P = 0.860, 0.067, 0.888 and 0.482, respectively). Changes in lactate, interleukin 6, tumor necrosis factor, C-reactive protein concentrations before administration of dexmedetomidine, after separation of pump and 24 hours after intensive care unit entrance showed no significant difference between the two groups (P = 0.525, 0.767, 0.868 and 0.840, respectively). Conclusions: According to our findings, using dexmedetomidine as an adjuvant anesthetic medication with initial loading dose of 0.5 micro g/kg and maintenance dose of 0.5 micro g/kg in pediatric heart surgeries is a safe choice. However, further studies are needed to clarify the role of dexmedetomidine to reduce stress responses. Copyright © 2016 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences.
@misc{totonchi_z._effect_2017,
title = {Effect of dexmedetomidine infusion on hemodynamics and stress responses in pediatric cardiac surgery: {A} randomized trial},
url = {http://cardiovascmed.com/72535.pdf},
abstract = {Background: Infants and children compared with adults have intensified stress responses that lead to increased morbidity and mortality. Stress control reduces the incidence of complications and improves recovery. In clinical and experimental studies, dexmedetomidine reduces the inflammatory and neuroendocrine responses. Objectives: This prospective randomized double-blinded clinical trial was conducted to assess the role of dexmedetomidine in reducing stress responses. Materials and Methods: According to convenient sampling method, 40 patients in two groups (case under treatment with dexmedetomidine and control, each including 20 patients) were selected from whom admitted for open heart surgery. Anesthesia was induced and maintained by fentanyl and midazolam. After central venous and arterial catheter insertion, patients were randomly allocated into one of two equal groups (n = 20 each). In the dexmedetomidine group, patients received an initial loading dose (0.5 micro g/kg) during 10 minutes immediately followed by a continuous infusion of 0.5 micro g/kg. In the control group, normal saline solution with similar volume was infused. Results: Changes in heart rate, systolic and diastolic blood pressures and central venous pressure before administration of dexmedetomidine, in 10, 20 and 30 minutes after the operation, after skin incision, after sternotomy, after separation from the pump and at the end of procedure showed no significant difference between the two groups (P = 0.860, 0.067, 0.888 and 0.482, respectively). Changes in lactate, interleukin 6, tumor necrosis factor, C-reactive protein concentrations before administration of dexmedetomidine, after separation of pump and 24 hours after intensive care unit entrance showed no significant difference between the two groups (P = 0.525, 0.767, 0.868 and 0.840, respectively). Conclusions: According to our findings, using dexmedetomidine as an adjuvant anesthetic medication with initial loading dose of 0.5 micro g/kg and maintenance dose of 0.5 micro g/kg in pediatric heart surgeries is a safe choice. However, further studies are needed to clarify the role of dexmedetomidine to reduce stress responses. Copyright © 2016 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences.},
journal = {Research in Cardiovascular Medicine},
author = {{Totonchi Z.} and {Rezvani H.} and {Ghorbanloo M.} and {Yazdanian F.} and {Mahdavi M.} and {Babaali N.} and {Salajegheh S.} and {Chitsazan M.}},
year = {2017},
keywords = {*chemical stress, *dexmedetomidine, *dexmedetomidine/ct [Clinical Trial], *diastolic blood pressure, *heart surgery, *hemodynamics, *infusion, *open heart surgery, *stress, Anesthesia, C reactive protein, C reactive protein/ec [Endogenous Compound], Child, adjuvant, artery catheter, article, cardiopulmonary bypass, central venous catheter, central venous pressure, clinical article, clinical trial, continuous infusion, control group, controlled clinical trial, controlled study, diastolic blood pressure, drug therapy, endogenous compound, female, fentanyl, heart rate, human, hypertension, hypotension, incidence, infant, inflammation, intensive care unit, interleukin 6, interleukin 6/ec [Endogenous Compound], lactate dehydrogenase/ec [Endogenous Compound], lactic acid, loading drug dose, lymphotoxin beta, maintenance drug dose, male, midazolam, normal human, preschool child, prospective study, randomized controlled trial, sampling, single blind procedure, skin incision, sodium chloride, sternotomy, systolic blood pressure, tumor necrosis factor/ec [Endogenous Compound]}
}Increasing the protein quantity in a meal results in dose-dependent effects on postprandial glucose levels in individuals with Type 1 diabetes mellitus. Paterson M.A., Smart C.E.M., Lopez P.E., Howley P., Mcelduff P., Attia J., Morbey C., & King B.R. 2017.
Paper abstract bibtex
Paper abstract bibtex Aim: To determine the glycaemic impact of increasing protein quantities when consumed with consistent amounts of carbohydrate in individuals with Type 1 diabetes on intensive insulin therapy. Methods: Participants with Type 1 diabetes [aged 10-40 years, HbA1c \textless 64 mmol/mol (8%), BMI \textless 91st percentile] received a 30-g carbohydrate (negligible fat) test drink daily over 5 days in randomized order. Protein (whey isolate 0 g/kg carbohydrate, 0 g/kg lipid) was added in amounts of 0 (control), 12.5, 25, 50 and 75 g. A standardized dose of insulin was given for the carbohydrate. Postprandial glycaemia was assessed by 5 h of continuous glucose monitoring. Results: Data were collected from 27 participants (15 male). A dose-response relationship was found with increasing amount of protein. A significant negative relationship between protein dose and mean excursion was seen at the 30- and 60-min time points (P = 0.007 and P = 0.002, respectively). No significant relationship was seen at the 90- and 120-min time points. Thereafter, the dose-response relationship inverted, such that there was a significant positive relationship for each of the 150-300-min time points (P \textless 0.004). Mean glycaemic excursions were significantly greater for all protein-added test drinks from 150 to 300 min (P \textless 0.005) with the 75-g protein load, resulting in a mean excursion that was 5 mmol/l higher when compared with the control test drink (P \textless 0.001). Conclusions: Increasing protein quantity in a low-fat meal containing consistent amounts of carbohydrate decreases glucose excursions in the early (0-60-min) postprandial period and then increases in the later postprandial period in a dose-dependent manner. Copyright © 2017 Diabetes UK.
@misc{paterson_m.a._increasing_2017,
title = {Increasing the protein quantity in a meal results in dose-dependent effects on postprandial glucose levels in individuals with {Type} 1 diabetes mellitus},
url = {http://www3.interscience.wiley.com/journal/119818374/grouphome/home.html},
abstract = {Aim: To determine the glycaemic impact of increasing protein quantities when consumed with consistent amounts of carbohydrate in individuals with Type 1 diabetes on intensive insulin therapy. Methods: Participants with Type 1 diabetes [aged 10-40 years, HbA1c {\textless} 64 mmol/mol (8\%), BMI {\textless} 91st percentile] received a 30-g carbohydrate (negligible fat) test drink daily over 5 days in randomized order. Protein (whey isolate 0 g/kg carbohydrate, 0 g/kg lipid) was added in amounts of 0 (control), 12.5, 25, 50 and 75 g. A standardized dose of insulin was given for the carbohydrate. Postprandial glycaemia was assessed by 5 h of continuous glucose monitoring. Results: Data were collected from 27 participants (15 male). A dose-response relationship was found with increasing amount of protein. A significant negative relationship between protein dose and mean excursion was seen at the 30- and 60-min time points (P = 0.007 and P = 0.002, respectively). No significant relationship was seen at the 90- and 120-min time points. Thereafter, the dose-response relationship inverted, such that there was a significant positive relationship for each of the 150-300-min time points (P {\textless} 0.004). Mean glycaemic excursions were significantly greater for all protein-added test drinks from 150 to 300 min (P {\textless} 0.005) with the 75-g protein load, resulting in a mean excursion that was 5 mmol/l higher when compared with the control test drink (P {\textless} 0.001). Conclusions: Increasing protein quantity in a low-fat meal containing consistent amounts of carbohydrate decreases glucose excursions in the early (0-60-min) postprandial period and then increases in the later postprandial period in a dose-dependent manner. Copyright © 2017 Diabetes UK.},
journal = {Diabetic Medicine},
author = {{Paterson M.A.} and {Smart C.E.M.} and {Lopez P.E.} and {Howley P.} and {Mcelduff P.} and {Attia J.} and {Morbey C.} and {King B.R.}},
year = {2017},
keywords = {*blood glucose monitoring, *insulin dependent diabetes mellitus, Child, body mass, clinical article, clinical trial, controlled clinical trial, controlled study, dose response, female, glucose, hemoglobin A1c, human, insulin, insulin treatment, lipid, lipid diet, male, postprandial state, randomized controlled trial, school child, whey}
}The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial. Soares S.M.F., Arantes V.M., Modolo M.P., dos Santos V.J.B., Vane L.A., Navarro e Lima L.H., Braz L.G., do Nascimento P., & Modolo N.S.P. 2017.
Paper abstract bibtex
Paper abstract bibtex We studied the effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes during tracheal extubation and postoperative laryngotracheal morbidity in children. We randomly allocated 164 children aged 3-13 years undergoing general anaesthesia to one of four groups; tracheal tube cuffs filled with air (n = 41); saline (n = 41); alkalinised lidocaine 0.5% (n = 41); or alkalinised lidocaine 1% (n = 41). Intracuff pressure was monitored and maintained below 20 cmH2O. The mean (SD) increases in systolic blood pressure after tracheal extubation compared with before extubation were 10.9 (10.8) mmHg, 7.3 (17.7) mmHg, 4.1 (10.5) mmHg and 1.9 (9.5) mmHg in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p = 0.021). The mean (SD) increases in diastolic blood pressure after tracheal extubation compared with before extubation were 3.9 (9.7) mmHg, 7.9 (14.6) mmHg, 0.7 (10.4) mmHg and 3.6 (6.9) mmHg in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p = 0.019). The mean (SD) increases in heart rate after tracheal extubation compared with before extubation were 14.2 (7.6) beats.min-1, 15.5 (13.1) beats.min-1, 5.2 (9.6) beats.min-1 and 4.1 (6.6) beats.min-1 in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p \textless 0.001). The incidence of sore throat 8 h after tracheal extubation was 22.0% in the air-filled group, 9.8% in the saline group, 4.9% in the 0.5% alkalinised lidocaine group and 2.4% in the 1% alkalinised lidocaine group, p = 0.015. We conclude that filling the tracheal tube cuff with alkalinised lidocaine-filled reduces the haemodynamic response to tracheal extubation and postoperative laryngotracheal morbidity in children. Copyright © 2016 The Association of Anaesthetists of Great Britain and Ireland
@misc{soares_s.m.f._effects_2017,
title = {The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial},
url = {http://www.interscience.wiley.com/jpages/0003-2409},
abstract = {We studied the effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes during tracheal extubation and postoperative laryngotracheal morbidity in children. We randomly allocated 164 children aged 3-13 years undergoing general anaesthesia to one of four groups; tracheal tube cuffs filled with air (n = 41); saline (n = 41); alkalinised lidocaine 0.5\% (n = 41); or alkalinised lidocaine 1\% (n = 41). Intracuff pressure was monitored and maintained below 20 cmH2O. The mean (SD) increases in systolic blood pressure after tracheal extubation compared with before extubation were 10.9 (10.8) mmHg, 7.3 (17.7) mmHg, 4.1 (10.5) mmHg and 1.9 (9.5) mmHg in the air, saline, 0.5\% and 1\% alkalinised lidocaine groups, respectively (p = 0.021). The mean (SD) increases in diastolic blood pressure after tracheal extubation compared with before extubation were 3.9 (9.7) mmHg, 7.9 (14.6) mmHg, 0.7 (10.4) mmHg and 3.6 (6.9) mmHg in the air, saline, 0.5\% and 1\% alkalinised lidocaine groups, respectively (p = 0.019). The mean (SD) increases in heart rate after tracheal extubation compared with before extubation were 14.2 (7.6) beats.min-1, 15.5 (13.1) beats.min-1, 5.2 (9.6) beats.min-1 and 4.1 (6.6) beats.min-1 in the air, saline, 0.5\% and 1\% alkalinised lidocaine groups, respectively (p {\textless} 0.001). The incidence of sore throat 8 h after tracheal extubation was 22.0\% in the air-filled group, 9.8\% in the saline group, 4.9\% in the 0.5\% alkalinised lidocaine group and 2.4\% in the 1\% alkalinised lidocaine group, p = 0.015. We conclude that filling the tracheal tube cuff with alkalinised lidocaine-filled reduces the haemodynamic response to tracheal extubation and postoperative laryngotracheal morbidity in children. Copyright © 2016 The Association of Anaesthetists of Great Britain and Ireland},
journal = {Anaesthesia},
author = {{Soares S.M.F.} and {Arantes V.M.} and {Modolo M.P.} and {dos Santos V.J.B.} and {Vane L.A.} and {Navarro e Lima L.H.} and {Braz L.G.} and {do Nascimento P.} and {Modolo N.S.P.}},
year = {2017},
keywords = {*air, *childhood mortality, *diastolic blood pressure, *endotracheal tube, *endotracheal tube cuff, *lidocaine, *lung hemodynamics, *morbidity, *pediatrics, *pneumatic cuff, *respiration control, *sodium chloride, *sore throat, Child, adolescent, alfentanil, anesthesia induction, article, atropine, controlled clinical trial, controlled study, diastolic blood pressure, dipyrone, extubation, female, fentanyl, general anesthesia, heart rate, human, major clinical study, male, neostigmine, ondansetron, postoperative analgesia, preschool child, pressure measurement, propofol, randomized controlled trial, rocuronium, sevoflurane, sore throat/co [Complication], surgery, systolic blood pressure, tramadol}
}The effect of prior tetanic stimulation on train-of-four monitoring in paediatric patients. Carlos R.V., De Boer H.D., Torres M.L.A., & Carmona M.J.C. 2017.
Paper abstract bibtex
Paper abstract bibtex Background In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg+/-1 followed by spontaneous recovery. DESIGN A randomised, open-label, controlled trial. SETTING A single-centre trial, study period from January 2014 to July 2015. PATIENTS Fifty children aged 2 to 11 years scheduled for elective paediatric surgery. INTERVENTION Patients were randomly allocated to receive either tetanic stimulation (group T) or not (group C) before calibration of the neuromuscular monitor. MAIN OUTCOME MEASURES Onset and recovery times. Initial and final T1 height, time to obtain initial T1 height stability and monitor settings were also analysed. RESULTS There was no significant difference in mean onset time [(C: 57.5 (+/- 16.9) vs. T: 58.3 (+/- 31.2) s; P = 0.917]. Mean times to normalised train-of-four (TOF) ratios of 0.7, 0.8 and 0.9 were significantly shorter in the tetanic stimulation group [C: 40.1 (+/-7.9) vs. T: 34.8 (+/-10) min; P = 0.047, C: 43.8 (+/-9.4) vs. T: 37.4 (+/-11) min; P = 0.045 and C: 49.9 (+/-12.2) vs. T: 41.7 (+/-13.1) min; P = 0.026, respectively]. The mean time required for T1 height stabilisation was similar in the two groups [C: 195.0 (+/- 203.0) vs. T: 116.0 (+/- 81.6) s; P = 0.093], but the initial and final T1 height values were significantly lower in the tetanic stimulation group (C: 98.0 vs. T: 82.7%; P \textless 0.001 and C: 95.3 vs. T: 69.3%; P \textless 0.001, respectively). CONCLUSION Tetanic stimulation shortened the mean times to normalised TOF ratios of 0.7, 0.8 and 0.9, but there was no difference in the mean onset time or the mean time required for T1 height stabilisation after a single dose of rocuronium 0.6 mg kg+/-1 followed by spontaneous recovery in children aged 2 to 11 years. Copyright © 2017 European Society of Anaesthesiology. All rights reserved.
@misc{carlos_r.v._effect_2017,
title = {The effect of prior tetanic stimulation on train-of-four monitoring in paediatric patients},
url = {http://journals.lww.com/ejanaesthesiology/pages/default.aspx},
abstract = {Background In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg+/-1 followed by spontaneous recovery. DESIGN A randomised, open-label, controlled trial. SETTING A single-centre trial, study period from January 2014 to July 2015. PATIENTS Fifty children aged 2 to 11 years scheduled for elective paediatric surgery. INTERVENTION Patients were randomly allocated to receive either tetanic stimulation (group T) or not (group C) before calibration of the neuromuscular monitor. MAIN OUTCOME MEASURES Onset and recovery times. Initial and final T1 height, time to obtain initial T1 height stability and monitor settings were also analysed. RESULTS There was no significant difference in mean onset time [(C: 57.5 (+/- 16.9) vs. T: 58.3 (+/- 31.2) s; P = 0.917]. Mean times to normalised train-of-four (TOF) ratios of 0.7, 0.8 and 0.9 were significantly shorter in the tetanic stimulation group [C: 40.1 (+/-7.9) vs. T: 34.8 (+/-10) min; P = 0.047, C: 43.8 (+/-9.4) vs. T: 37.4 (+/-11) min; P = 0.045 and C: 49.9 (+/-12.2) vs. T: 41.7 (+/-13.1) min; P = 0.026, respectively]. The mean time required for T1 height stabilisation was similar in the two groups [C: 195.0 (+/- 203.0) vs. T: 116.0 (+/- 81.6) s; P = 0.093], but the initial and final T1 height values were significantly lower in the tetanic stimulation group (C: 98.0 vs. T: 82.7\%; P {\textless} 0.001 and C: 95.3 vs. T: 69.3\%; P {\textless} 0.001, respectively). CONCLUSION Tetanic stimulation shortened the mean times to normalised TOF ratios of 0.7, 0.8 and 0.9, but there was no difference in the mean onset time or the mean time required for T1 height stabilisation after a single dose of rocuronium 0.6 mg kg+/-1 followed by spontaneous recovery in children aged 2 to 11 years. Copyright © 2017 European Society of Anaesthesiology. All rights reserved.},
journal = {European Journal of Anaesthesiology},
author = {{Carlos R.V.} and {De Boer H.D.} and {Torres M.L.A.} and {Carmona M.J.C.}},
year = {2017},
keywords = {*monitoring, *muscle excitation, *neuromuscular monitoring, *stimulus response, *tetanic stimulation, *train of four monitoring, Child, anesthetic recovery, article, calibration, clinical article, controlled clinical trial, controlled study, elective surgery, electric peripheral nerve stimulator, female, gas analysis equipment, height, human, male, open study, parameters, patient monitoring, pediatric surgery, randomized controlled trial, remission, rocuronium, single drug dose, thermal regulating system}
}Universal versus conditional three-day follow up visit for children with uncomplicated fever at the community level: Design of a cluster-randomized, community-based, non-inferiority trial in Tanganyika, Democratic Republic of Congo. van Boetzelaer E., Ho L.S., Gutman J.R., Steinhardt L.C., Wittcoff A., Barbera Y., Ngoy P., Harvey S.A., & Mullany L.C. 2017.
Paper abstract bibtex
Paper abstract bibtex Background: The current recommendation within integrated Community Case Management guidelines that all children presenting with uncomplicated fever and no danger signs be followed up after three days may not be necessary. Such fevers often resolve rapidly (usually within 48-96 h), and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aim to determine the non-inferiority of a conditional versus a universal follow-up visit for these children. Methods: We are conducting a cluster-randomized, community-based, non-inferiority trial enrolling \textasciitilde4300 children (ages 2-59 months) presenting to community health workers (CHWs) with uncomplicated fever in Tanganyika Province, Democratic Republic of the Congo. Clusters (n = 28) of CHWs are randomized to advise caretakers of such children to either 1) return for a follow-up visit on Day 3 following the initial consultation (Day 1), regardless of illness resolution (as per current guidelines) or 2) return for a follow-up visit on Day 3 only if the child's signs have not resolved. Enrolled children are followed up at Day 7 for a repeat assessment and recording of the primary outcome of the study, "failure", which is defined as having fever, diarrhea, pneumonia or decline of health status (e.g. hospitalization, presenting danger signs, or death). Discussion: The results of this trial will be interpreted in conjunction with a similarly designed trial currently ongoing in Ethiopia. If a follow-up visit conditional on continued illness is shown to be non-inferior to current guidelines stipulating universal follow-up, appropriate updating of such guidelines could reduce time and human resource pressures on both providers and caregivers throughout communities of sub-Saharan Africa and South Asia. Trial registration: This trial was registered at ClinicalTrials.gov (NCT02595827) on November 2nd, 2015 Copyright © 2017 The Author(s).
@misc{van_boetzelaer_e._universal_2017,
title = {Universal versus conditional three-day follow up visit for children with uncomplicated fever at the community level: {Design} of a cluster-randomized, community-based, non-inferiority trial in {Tanganyika}, {Democratic} {Republic} of {Congo}},
url = {http://www.biomedcentral.com/bmcpediatr/},
abstract = {Background: The current recommendation within integrated Community Case Management guidelines that all children presenting with uncomplicated fever and no danger signs be followed up after three days may not be necessary. Such fevers often resolve rapidly (usually within 48-96 h), and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aim to determine the non-inferiority of a conditional versus a universal follow-up visit for these children. Methods: We are conducting a cluster-randomized, community-based, non-inferiority trial enrolling {\textasciitilde}4300 children (ages 2-59 months) presenting to community health workers (CHWs) with uncomplicated fever in Tanganyika Province, Democratic Republic of the Congo. Clusters (n = 28) of CHWs are randomized to advise caretakers of such children to either 1) return for a follow-up visit on Day 3 following the initial consultation (Day 1), regardless of illness resolution (as per current guidelines) or 2) return for a follow-up visit on Day 3 only if the child's signs have not resolved. Enrolled children are followed up at Day 7 for a repeat assessment and recording of the primary outcome of the study, "failure", which is defined as having fever, diarrhea, pneumonia or decline of health status (e.g. hospitalization, presenting danger signs, or death). Discussion: The results of this trial will be interpreted in conjunction with a similarly designed trial currently ongoing in Ethiopia. If a follow-up visit conditional on continued illness is shown to be non-inferior to current guidelines stipulating universal follow-up, appropriate updating of such guidelines could reduce time and human resource pressures on both providers and caregivers throughout communities of sub-Saharan Africa and South Asia. Trial registration: This trial was registered at ClinicalTrials.gov (NCT02595827) on November 2nd, 2015 Copyright © 2017 The Author(s).},
journal = {BMC Pediatrics},
author = {{van Boetzelaer E.} and {Ho L.S.} and {Gutman J.R.} and {Steinhardt L.C.} and {Wittcoff A.} and {Barbera Y.} and {Ngoy P.} and {Harvey S.A.} and {Mullany L.C.}},
year = {2017},
keywords = {*Democratic Republic Congo, *Tanzania, *case management, *conditional three day follow up visit, *fever, *follow up, *health auxiliary, *pediatrics, *registration, *uncomplicated fever, *universal follow up visit, Child, Democratic Republic Congo, Ethiopia, South Asia, arm circumference, article, caregiver, clinical assessment, clinical protocol, clinical trial, consultation, controlled clinical trial, controlled study, death, diarrhea, feedback system, female, health auxiliary, health status, hospitalization, human, infant, information processing, major clinical study, male, midupper upper arm circumference, mortality, outcome assessment, patient monitoring, pneumonia, practice guideline, preschool child, quality control, randomization, randomized controlled trial, sample size, study design}
}Beneficial Effects of Omega-3 Supplement to the Enteral Feeding in Children with Mild to Moderate Sepsis. Al-Biltagi M.A.M., Abo-Elezz A.A.E., Abd-Elhafez M.A., Mabrouk M.M., & Suliman G.A. 2017.
abstract bibtex
abstract bibtex
Objective: The objective was to investigate the benefits of supplementing enteral feeding with omega-3 fatty acids in children with mild to moderate sepsis and its effects on acute-phase reactants and interleukin 6 (IL-6) level. Methods: The study was a prospective randomized, double-blind, placebo-controlled study from January 2012 to June 2014, which included 2 groups of children with mild to moderate sepsis tolerating enteral feeding. Group A included 60 children supplemented with omega-3 fatty acids, whereas group B included 60 children who received enteral feeding without omega-3 supplementation. Both groups had complete blood pictures, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum albumin, and IL-6 before and after 7 days from supplementation. Results: There was a significant improvement in hemoglobin percentage (P \textless.0001), total white blood cell (WBC) count (P \textless.0001), and platelet count (P \textless.0001) and significant decrease in CRP (P \textless.0001), ESR (P \textless.0001), IL-6 (P \textless.0001), and albumin level (P \textless.001) in the supplemented group than the nonsupplemented group. The supplemented group also had a significantly shorter duration of stay in pediatric intensive care unit (PICU; P \textless.01) and decreased death rate than the nonsupplemented group. Conclusion: Children with mild to moderate sepsis showed significant improvement in inflammatory markers and had shorter PICU admission when enteral feeding was supplemented with omega-3 essential fatty acids. Copyright © The Author(s) 2015.
@misc{al-biltagi_m.a.m._beneficial_2017,
title = {Beneficial {Effects} of {Omega}-3 {Supplement} to the {Enteral} {Feeding} in {Children} with {Mild} to {Moderate} {Sepsis}},
abstract = {Objective: The objective was to investigate the benefits of supplementing enteral feeding with omega-3 fatty acids in children with mild to moderate sepsis and its effects on acute-phase reactants and interleukin 6 (IL-6) level. Methods: The study was a prospective randomized, double-blind, placebo-controlled study from January 2012 to June 2014, which included 2 groups of children with mild to moderate sepsis tolerating enteral feeding. Group A included 60 children supplemented with omega-3 fatty acids, whereas group B included 60 children who received enteral feeding without omega-3 supplementation. Both groups had complete blood pictures, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum albumin, and IL-6 before and after 7 days from supplementation. Results: There was a significant improvement in hemoglobin percentage (P {\textless}.0001), total white blood cell (WBC) count (P {\textless}.0001), and platelet count (P {\textless}.0001) and significant decrease in CRP (P {\textless}.0001), ESR (P {\textless}.0001), IL-6 (P {\textless}.0001), and albumin level (P {\textless}.001) in the supplemented group than the nonsupplemented group. The supplemented group also had a significantly shorter duration of stay in pediatric intensive care unit (PICU; P {\textless}.01) and decreased death rate than the nonsupplemented group. Conclusion: Children with mild to moderate sepsis showed significant improvement in inflammatory markers and had shorter PICU admission when enteral feeding was supplemented with omega-3 essential fatty acids. Copyright © The Author(s) 2015.},
journal = {Journal of Intensive Care Medicine},
author = {{Al-Biltagi M.A.M.} and {Abo-Elezz A.A.E.} and {Abd-Elhafez M.A.} and {Mabrouk M.M.} and {Suliman G.A.}},
year = {2017},
keywords = {*diet supplementation, *enteric feeding, *erythrocyte sedimentation rate, *interleukin 6, *omega 3 fatty acid/ct [Clinical Trial], *omega 3 fatty acid/dt [Drug Therapy], *sepsis, *sepsis/dt [Drug Therapy], C reactive protein, C reactive protein/ec [Endogenous Compound], Child, acute phase protein, albumin, albumin/ec [Endogenous Compound], article, clinical trial, controlled clinical trial, controlled study, disease severity, docosahexaenoic acid, double blind procedure, drug efficacy, endogenous compound, erythrocyte sedimentation rate, essential fatty acid, female, gene expression, hemoglobin, hemoglobin/ec [Endogenous Compound], human, icosapentaenoic acid, interleukin 6/ec [Endogenous Compound], length of stay, leukocyte count, major clinical study, male, mortality rate, nutritional assessment, omega 3 fatty acid, pediatric intensive care unit, placebo, preschool child, priority journal, prospective study, randomized controlled trial, sepsis/dt [Drug Therapy], serum albumin, thrombocyte count, visually impaired person}
}A Systematic Review and Meta-Analysis of Intensive Multidisciplinary Intervention for Pediatric Feeding Disorders: How Standard Is the Standard of Care?. Sharp W.G., Volkert V.M., Scahill L., McCracken C.E., & McElhanon B. 2017.
Paper abstract bibtex
Paper abstract bibtex Objective To assess models of care and conduct a meta-analysis of program outcomes for children receiving intensive, multidisciplinary intervention for pediatric feeding disorders. Study design We searched Medline, PsycINFO, and PubMed databases (2000-2015) in peer-reviewed journals for studies that examined the treatment of children with chronic food refusal receiving intervention at day treatment or inpatient hospital programs. Inclusion criteria required the presentation of quantitative data on food consumption, feeding behavior, and/or growth status before and after intervention. Effect size estimates were calculated based on a meta-analysis of proportions. Results The systematic search yielded 11 studies involving 593 patients. Nine articles presented outcomes based on retrospective (nonrandomized) chart reviews; 2 studies involved randomized controlled trials. All samples involved children with complex medical and/or developmental histories who displayed persistent feeding concerns requiring formula supplementation. Behavioral intervention and tube weaning represented the most common treatment approaches. Core disciplines overseeing care included psychology, nutrition, medicine, and speech-language pathology/occupational therapy. The overall effect size for percentage of patients successfully weaned from tube feeding was 71% (95% CI 54%-83%). Treatment gains endured following discharge, with 80% of patients (95% CI 66%-89%) weaned from tube feeding at last follow-up. Treatment also was associated with increased oral intake, improved mealtime behaviors, and reduced parenting stress. Conclusions Results indicate intensive, multidisciplinary treatment holds benefits for children with severe feeding difficulties. Future research must address key methodological limitations to the extant literature, including improved measurement, more comprehensive case definitions, and standardization/examination of treatment approach. Copyright © 2016 Elsevier Inc.
@misc{sharp_w.g._systematic_2017,
title = {A {Systematic} {Review} and {Meta}-{Analysis} of {Intensive} {Multidisciplinary} {Intervention} for {Pediatric} {Feeding} {Disorders}: {How} {Standard} {Is} the {Standard} of {Care}?},
url = {http://www.elsevier.com/inca/publications/store/6/2/3/3/1/1/index.htt},
abstract = {Objective To assess models of care and conduct a meta-analysis of program outcomes for children receiving intensive, multidisciplinary intervention for pediatric feeding disorders. Study design We searched Medline, PsycINFO, and PubMed databases (2000-2015) in peer-reviewed journals for studies that examined the treatment of children with chronic food refusal receiving intervention at day treatment or inpatient hospital programs. Inclusion criteria required the presentation of quantitative data on food consumption, feeding behavior, and/or growth status before and after intervention. Effect size estimates were calculated based on a meta-analysis of proportions. Results The systematic search yielded 11 studies involving 593 patients. Nine articles presented outcomes based on retrospective (nonrandomized) chart reviews; 2 studies involved randomized controlled trials. All samples involved children with complex medical and/or developmental histories who displayed persistent feeding concerns requiring formula supplementation. Behavioral intervention and tube weaning represented the most common treatment approaches. Core disciplines overseeing care included psychology, nutrition, medicine, and speech-language pathology/occupational therapy. The overall effect size for percentage of patients successfully weaned from tube feeding was 71\% (95\% CI 54\%-83\%). Treatment gains endured following discharge, with 80\% of patients (95\% CI 66\%-89\%) weaned from tube feeding at last follow-up. Treatment also was associated with increased oral intake, improved mealtime behaviors, and reduced parenting stress. Conclusions Results indicate intensive, multidisciplinary treatment holds benefits for children with severe feeding difficulties. Future research must address key methodological limitations to the extant literature, including improved measurement, more comprehensive case definitions, and standardization/examination of treatment approach. Copyright © 2016 Elsevier Inc.},
journal = {Journal of Pediatrics},
author = {{Sharp W.G.} and {Volkert V.M.} and {Scahill L.} and {McCracken C.E.} and {McElhanon B.}},
year = {2017},
keywords = {*child nutrition, *childhood disease/rh [Rehabilitation], *childhood disease/th [Therapy], *enteric feeding, *feeding behavior, *feeding difficulty, *feeding disorder/rh [Rehabilitation], *feeding disorder/th [Therapy], *health care quality, *treatment outcome, *weaning, Child, Medline, PsycINFO, article, clinical outcome, controlled study, effect size, enteric feeding, follow up, food intake, health program, hospital patient, hospitalization, human, human tissue, ideal body weight, medical record review, medicine, meta analysis, model, nutritional counseling, nutritional health, occupational therapy, parental stress, pediatric rehabilitation, priority journal, quantitative study, randomized controlled trial (topic), reinforcement, speech and language rehabilitation, speech disorder, standardization, study design, systematic review, weight reduction}
}Transcranial direct current stimulation for children with perinatal stroke and hemiparesis. Kirton A., Ciechanski P., Zewdie E., Andersen J., Nettel-Aguirre A., Carlson H., Carsolio L., Herrero M., Quigley J., Mineyko A., Hodge J., & Hill M. 2017.
Paper abstract bibtex
Paper abstract bibtex Objective: To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy. Methods: This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy). Participants were randomized 1:1 to 1 mA cathodal tDCS over the contralesional primary motor cortex (M1) for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure [COPM]), objective (Assisting Hand Assessment [AHA]), safety, and secondary outcomes were measured at 1 week and 2 months after intervention. Analysis was by intention to treat. Results: Twenty-four participants were randomized (median age 11.8 +/- 2.7 years, range 6.7-17.8). COPM performance and satisfaction scores doubled at 1 week with sustained gains at 2 months (p \textless 0.001). COPM scores increased more with tDCS compared to sham control (p = 0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events. Conclusion: TDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect underdosing of therapy. Marked gains in subjective function with tDCS warrant further study. ClinicalTrials.gov identifier: NCT02170285. Classification of evidence: This study provides Class II evidence that for children with perinatal stroke and hemiparetic cerebral palsy, the addition of tDCS to moderate-dose motor learning therapy does not significantly improve motor function as measured by the AHA. Copyright © 2016 American Academy of Neurology.
@misc{kirton_a._transcranial_2017,
title = {Transcranial direct current stimulation for children with perinatal stroke and hemiparesis},
url = {http://www.neurology.org},
abstract = {Objective: To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy. Methods: This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy). Participants were randomized 1:1 to 1 mA cathodal tDCS over the contralesional primary motor cortex (M1) for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure [COPM]), objective (Assisting Hand Assessment [AHA]), safety, and secondary outcomes were measured at 1 week and 2 months after intervention. Analysis was by intention to treat. Results: Twenty-four participants were randomized (median age 11.8 +/- 2.7 years, range 6.7-17.8). COPM performance and satisfaction scores doubled at 1 week with sustained gains at 2 months (p {\textless} 0.001). COPM scores increased more with tDCS compared to sham control (p = 0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events. Conclusion: TDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect underdosing of therapy. Marked gains in subjective function with tDCS warrant further study. ClinicalTrials.gov identifier: NCT02170285. Classification of evidence: This study provides Class II evidence that for children with perinatal stroke and hemiparetic cerebral palsy, the addition of tDCS to moderate-dose motor learning therapy does not significantly improve motor function as measured by the AHA. Copyright © 2016 American Academy of Neurology.},
journal = {Neurology},
author = {{Kirton A.} and {Ciechanski P.} and {Zewdie E.} and {Andersen J.} and {Nettel-Aguirre A.} and {Carlson H.} and {Carsolio L.} and {Herrero M.} and {Quigley J.} and {Mineyko A.} and {Hodge J.} and {Hill M.}},
year = {2017},
keywords = {*brain ischemia/th [Therapy], *cerebral palsy/th [Therapy], *cerebrovascular accident, *hemiparesis, *hemiparesis/th [Therapy], *perinatal morbidity, *transcranial direct current stimulation, Child, adolescent, adult, adverse drug reaction, adverse outcome, arm movement, article, assisting hand assessment, canadian occupational performance measure, cerebral palsy, classification, clinical article, clinical trial, controlled clinical trial, controlled study, cortical electrode, double blind procedure, female, human, intensive care, intention to treat analysis, male, motor learning, motor performance, neurologic disease assessment, nuclear magnetic resonance imaging, patient safety, peer group, population based case control study, primary motor cortex, priority journal, randomized controlled trial, safety, satisfaction, school child, side effect}
}Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., Scheffer, I. E., Thiele, E. A., Wright, S., & Cannabidiol in Dravet Syndrome Study, G. N Engl J Med, 376(21):2011–2020, May, 2017.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram of body weight per day or placebo, in addition to standard antiepileptic treatment. The primary end point was the change in convulsive-seizure frequency over a 14-week treatment period, as compared with a 4-week baseline period. RESULTS: The median frequency of convulsive seizures per month decreased from 12.4 to 5.9 with cannabidiol, as compared with a decrease from 14.9 to 14.1 with placebo (adjusted median difference between the cannabidiol group and the placebo group in change in seizure frequency, -22.8 percentage points; 95% confidence interval [CI], -41.1 to -5.4; P=0.01). The percentage of patients who had at least a 50% reduction in convulsive-seizure frequency was 43% with cannabidiol and 27% with placebo (odds ratio, 2.00; 95% CI, 0.93 to 4.30; P=0.08). The patient's overall condition improved by at least one category on the seven-category Caregiver Global Impression of Change scale in 62% of the cannabidiol group as compared with 34% of the placebo group (P=0.02). The frequency of total seizures of all types was significantly reduced with cannabidiol (P=0.03), but there was no significant reduction in nonconvulsive seizures. The percentage of patients who became seizure-free was 5% with cannabidiol and 0% with placebo (P=0.08). Adverse events that occurred more frequently in the cannabidiol group than in the placebo group included diarrhea, vomiting, fatigue, pyrexia, somnolence, and abnormal results on liver-function tests. There were more withdrawals from the trial in the cannabidiol group. CONCLUSIONS: Among patients with the Dravet syndrome, cannabidiol resulted in a greater reduction in convulsive-seizure frequency than placebo and was associated with higher rates of adverse events. (Funded by GW Pharmaceuticals; ClinicalTrials.gov number, NCT02091375 .).
@article{devinsky_trial_2017,
title = {Trial of {Cannabidiol} for {Drug}-{Resistant} {Seizures} in the {Dravet} {Syndrome}},
volume = {376},
issn = {1533-4406 (Electronic) 0028-4793 (Linking)},
doi = {10.1056/NEJMoa1611618},
abstract = {BACKGROUND: The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram of body weight per day or placebo, in addition to standard antiepileptic treatment. The primary end point was the change in convulsive-seizure frequency over a 14-week treatment period, as compared with a 4-week baseline period. RESULTS: The median frequency of convulsive seizures per month decreased from 12.4 to 5.9 with cannabidiol, as compared with a decrease from 14.9 to 14.1 with placebo (adjusted median difference between the cannabidiol group and the placebo group in change in seizure frequency, -22.8 percentage points; 95\% confidence interval [CI], -41.1 to -5.4; P=0.01). The percentage of patients who had at least a 50\% reduction in convulsive-seizure frequency was 43\% with cannabidiol and 27\% with placebo (odds ratio, 2.00; 95\% CI, 0.93 to 4.30; P=0.08). The patient's overall condition improved by at least one category on the seven-category Caregiver Global Impression of Change scale in 62\% of the cannabidiol group as compared with 34\% of the placebo group (P=0.02). The frequency of total seizures of all types was significantly reduced with cannabidiol (P=0.03), but there was no significant reduction in nonconvulsive seizures. The percentage of patients who became seizure-free was 5\% with cannabidiol and 0\% with placebo (P=0.08). Adverse events that occurred more frequently in the cannabidiol group than in the placebo group included diarrhea, vomiting, fatigue, pyrexia, somnolence, and abnormal results on liver-function tests. There were more withdrawals from the trial in the cannabidiol group. CONCLUSIONS: Among patients with the Dravet syndrome, cannabidiol resulted in a greater reduction in convulsive-seizure frequency than placebo and was associated with higher rates of adverse events. (Funded by GW Pharmaceuticals; ClinicalTrials.gov number, NCT02091375 .).},
number = {21},
journal = {N Engl J Med},
author = {Devinsky, O. and Cross, J. H. and Laux, L. and Marsh, E. and Miller, I. and Nabbout, R. and Scheffer, I. E. and Thiele, E. A. and Wright, S. and Cannabidiol in Dravet Syndrome Study, Group},
month = may,
year = {2017},
keywords = {Adolescent, Anticonvulsants/adverse effects/*therapeutic use, Cannabidiol/adverse effects/*therapeutic use, Child, Child, Preschool, Double-Blind Method, Epilepsies, Myoclonic/*drug therapy, Fatigue/chemically induced, Female, Humans, Liver Function Tests, Liver/drug effects, Male, Seizures/*prevention \& control},
pages = {2011--2020},
}Sub-Tenon's injection versus paracetamol in pediatric strabismus surgery. Ibrahim A.N. & Shabana T. 2017.
Paper abstract bibtex
Paper abstract bibtex Background: Emergence agitation, vomiting, and oculocardiac reflex (OCR) in children undergoing strabismus surgery under general anesthesia are common problems. The purpose of this study was to determine whether the effect of analgesia can reduce the incidence of these problems. We compared the effects of sub-Tenon's injection versus intravenous (IV) and rectal paracetamol in this surgery. Methods: In a prospective, randomized, double-blind study, ninety patients ranging in age from 4 to 8 years scheduled for extraocular muscle surgery for strabismus were included in this study. After induction of anesthesia, just before the surgery, children were divided into three groups (n = 30 for each group) Group A received sub-Tenon's anesthesia with 2.5% bupivacaine (0.08 ml/kg). Group B received IV paracetamol (20 mg/kg). Group C received paracetamol rectal suppository (40 mg/kg). The occurrence of oculocardiac reflex (OCR) intraoperatively was recorded. Then, in the Postanesthesia Care Unit, patients were assessed for their emergence behaviors. Vomiting was also noticed. Results: The OCR developed in few patients, and there was no significant difference between the groups. The highest number of patients with agitation was in Group C followed by Group B then Group A. Vomiting was significantly low in Group A followed by Group B then Group C. Conclusion: Sub-Tenon block in strabismus surgery in children decreased the incidence of postoperative agitation and vomiting compared with IV paracetamol then rectal paracetamol. There was no difference between sub-Tenon block and paracetamol in the incidence of oculocardiac reflex. Copyright © 2017 Saudi Journal of Anesthesia , Published by Wolters Kluwer - Medknow.
@misc{ibrahim_a.n._sub-tenons_2017,
title = {Sub-{Tenon}'s injection versus paracetamol in pediatric strabismus surgery},
url = {http://www.saudija.org/},
abstract = {Background: Emergence agitation, vomiting, and oculocardiac reflex (OCR) in children undergoing strabismus surgery under general anesthesia are common problems. The purpose of this study was to determine whether the effect of analgesia can reduce the incidence of these problems. We compared the effects of sub-Tenon's injection versus intravenous (IV) and rectal paracetamol in this surgery. Methods: In a prospective, randomized, double-blind study, ninety patients ranging in age from 4 to 8 years scheduled for extraocular muscle surgery for strabismus were included in this study. After induction of anesthesia, just before the surgery, children were divided into three groups (n = 30 for each group) Group A received sub-Tenon's anesthesia with 2.5\% bupivacaine (0.08 ml/kg). Group B received IV paracetamol (20 mg/kg). Group C received paracetamol rectal suppository (40 mg/kg). The occurrence of oculocardiac reflex (OCR) intraoperatively was recorded. Then, in the Postanesthesia Care Unit, patients were assessed for their emergence behaviors. Vomiting was also noticed. Results: The OCR developed in few patients, and there was no significant difference between the groups. The highest number of patients with agitation was in Group C followed by Group B then Group A. Vomiting was significantly low in Group A followed by Group B then Group C. Conclusion: Sub-Tenon block in strabismus surgery in children decreased the incidence of postoperative agitation and vomiting compared with IV paracetamol then rectal paracetamol. There was no difference between sub-Tenon block and paracetamol in the incidence of oculocardiac reflex. Copyright © 2017 Saudi Journal of Anesthesia , Published by Wolters Kluwer - Medknow.},
journal = {Saudi Journal of Anaesthesia},
author = {{Ibrahim A.N.} and {Shabana T.}},
year = {2017},
keywords = {*injection, *paracetamol, *paracetamol/ad [Drug Administration], *paracetamol/ct [Clinical Trial], *paracetamol/iv [Intravenous Drug Administration], *paracetamol/rc [Rectal Drug Administration], *pediatric surgery, *strabismus surgery, *subtenon drug administration, Child, agitation, analgesia, anesthesia induction, antiemetic agent/dt [Drug Therapy], article, behavior, bupivacaine, bupivacaine/ct [Clinical Trial], bupivacaine/io [Intraocular Drug Administration], clinical trial, controlled clinical trial, controlled study, double blind procedure, drug dosage form comparison, extraocular muscle, female, human, major clinical study, male, oculocardiac reflex, outcome assessment, patient monitoring, postoperative agitation/co [Complication], postoperative complication/co [Complication], postoperative vomiting/co [Complication], postoperative vomiting/dt [Drug Therapy], priority journal, prospective study, randomized controlled trial, recovery room, rectal drug administration, rectum, risk reduction, strabismus/su [Surgery], surgery, visually impaired person, vomiting}
}Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. Kramer R.D., Rogers M.A.M., Conte M., Mann J., Saint S., & Chopra V. 2017.
Paper abstract bibtex
Paper abstract bibtex Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2% (95% confidence interval [CI], 0.0%-0.5%), and the incidence among nonantimicrobial catheters was 5.3% (95% CI, 2.6%-8.8%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95% CI, 0.06-0.74). Twenty-six patients (95% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc.
@misc{kramer_r.d._are_2017,
title = {Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? {A} systematic review and meta-analysis},
url = {http://www.journals.elsevier.com/ajic-american-journal-of-infection-control/},
abstract = {Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2\% (95\% confidence interval [CI], 0.0\%-0.5\%), and the incidence among nonantimicrobial catheters was 5.3\% (95\% CI, 2.6\%-8.8\%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95\% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6\%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95\% CI, 0.06-0.74). Twenty-six patients (95\% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc.},
journal = {American Journal of Infection Control},
author = {{Kramer R.D.} and {Rogers M.A.M.} and {Conte M.} and {Mann J.} and {Saint S.} and {Chopra V.}},
year = {2017},
keywords = {*adverse device effect, *antiinfective agent, *antiinfective agent/dt [Drug Therapy], *antimicrobial catheter, *antimicrobial catheter/am [Adverse Device Effect], *antimicrobial therapy, *catheter infection, *catheter infection/co [Complication], *catheter infection/dt [Drug Therapy], *catheter infection/pc [Prevention], *infection prevention, *peripherally inserted central venous catheter, *peripherally inserted central venous catheter/am [Adverse Device Effect], *vein, Child, Cinahl, Embase, Medline, Web of Science, adult, article, catheter infection/dt [Drug Therapy], comparative effectiveness, confidence interval, controlled clinical trial, controlled clinical trial (topic), controlled study, data extraction, disease association, drug therapy, evidence based practice, human, incidence, infection prevention, intensive care, long term care, meta analysis, pediatrics, peer review, prevention, publication, randomized controlled trial, randomized controlled trial(topic), risk factor, risk reduction, systematic review, ward}
}Antipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis. Drewry A.M., Ablordeppey E.A., Murray E.T., Stoll C.R.T., Izadi S.R., Dalton C.M., Hardi A.C., Fowler S.A., Fuller B.M., & Colditz G.A. 2017.
Paper abstract bibtex
Paper abstract bibtex OBJECTIVE:: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES:: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION:: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available. Studies were excluded if they enrolled pediatric patients, patients with neurologic injury, or healthy volunteers. Criteria were applied by two independent reviewers. DATA EXTRACTION:: Two reviewers independently extracted data and evaluated methodologic quality. Outcomes included mortality, frequency of shock reversal, acquisition of nosocomial infections, and changes in body temperature, heart rate, and minute ventilation. Randomized and observational studies were analyzed separately. DATA SYNTHESIS:: Eight randomized studies (1,507 patients) and eight observational studies (17,432 patients) were analyzed. Antipyretic therapy did not reduce 28-day/hospital mortality in the randomized studies (relative risk, 0.93; 95% CI, 0.77-1.13; I = 0.0%) or observational studies (odds ratio, 0.90; 95% CI, 0.54-1.51; I = 76.1%). Shock reversal (relative risk, 1.13; 95% CI, 0.68-1.90; I = 51.6%) and acquisition of nosocomial infections (relative risk, 1.13; 95% CI, 0.61-2.09; I = 61.0%) were also unchanged. Antipyretic therapy decreased body temperature (mean difference, -0.38degreeC; 95% CI, -0.63 to -0.13; I = 84.0%), but not heart rate or minute ventilation. CONCLUSIONS:: Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © by 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
@misc{drewry_a.m._antipyretic_2017,
title = {Antipyretic {Therapy} in {Critically} {Ill} {Septic} {Patients}: {A} {Systematic} {Review} and {Meta}-{Analysis}},
url = {http://journals.lww.com/ccmjournal/pages/default.aspx},
abstract = {OBJECTIVE:: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES:: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION:: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available. Studies were excluded if they enrolled pediatric patients, patients with neurologic injury, or healthy volunteers. Criteria were applied by two independent reviewers. DATA EXTRACTION:: Two reviewers independently extracted data and evaluated methodologic quality. Outcomes included mortality, frequency of shock reversal, acquisition of nosocomial infections, and changes in body temperature, heart rate, and minute ventilation. Randomized and observational studies were analyzed separately. DATA SYNTHESIS:: Eight randomized studies (1,507 patients) and eight observational studies (17,432 patients) were analyzed. Antipyretic therapy did not reduce 28-day/hospital mortality in the randomized studies (relative risk, 0.93; 95\% CI, 0.77-1.13; I = 0.0\%) or observational studies (odds ratio, 0.90; 95\% CI, 0.54-1.51; I = 76.1\%). Shock reversal (relative risk, 1.13; 95\% CI, 0.68-1.90; I = 51.6\%) and acquisition of nosocomial infections (relative risk, 1.13; 95\% CI, 0.61-2.09; I = 61.0\%) were also unchanged. Antipyretic therapy decreased body temperature (mean difference, -0.38degreeC; 95\% CI, -0.63 to -0.13; I = 84.0\%), but not heart rate or minute ventilation. CONCLUSIONS:: Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © by 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.},
journal = {Critical Care Medicine},
author = {{Drewry A.M.} and {Ablordeppey E.A.} and {Murray E.T.} and {Stoll C.R.T.} and {Izadi S.R.} and {Dalton C.M.} and {Hardi A.C.} and {Fowler S.A.} and {Fuller B.M.} and {Colditz G.A.}},
year = {2017},
keywords = {*antipyretic agent, *critically ill patient, Child, Cochrane Library, Embase, English (language), Medline, Scopus, adult, body temperature, controlled clinical trial, controlled study, drug therapy, economic evaluation, heart rate, hospital infection, human, hypothermia, licence, lung minute volume, medical literature, meta analysis, mortality, nervous system, nursing, observational study, odds ratio, outpatient department, randomized controlled trial, risk factor, sepsis, systematic review, volunteer}
}Comparison of cycloplegic refraction between Grand Seiko autorefractor and Retinomax autorefractor in the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study. Ying, G., Maguire, M. G., Kulp, M. T., Ciner, E., Moore, B., Pistilli, M., Candy, R., & VIP-HIP Study Group Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 21(3):219–223.e3, June, 2017.
doi abstract bibtex
doi abstract bibtex
PURPOSE: To evaluate the agreement of cycloplegic refractive error measures between the Grand Seiko and Retinomax autorefractors in 4- and 5-year-old children. METHODS: Cycloplegic refractive error of children was measured using the Grand Seiko and Retinomax during a comprehensive eye examination. Accommodative error was measured using the Grand Seiko. The differences in sphere, cylinder, spherical equivalent (SE) and intereye vector dioptric distance (VDD) between autorefractors were assessed using the Bland-Altman plot and 95% limits of agreement (95% LoA). RESULTS: A total of 702 examinations were included. Compared to the Retinomax, the Grand Seiko provided statistically significantly larger values of sphere (mean difference, 0.34 D; 95% LoA, -0.46 to 1.14 D), SE (mean, 0.25 D; 95% LoA, -0.55 to 1.05 D), VDD (mean, 0.19 D; 95% LoA, -0.67 to 1.05 D), and more cylinder (mean, -0.18 D; 95% LoA, -0.91 to 0.55 D). The Grand Seiko measured ≥0.5 D than Retinomax in 43.1% of eyes for sphere and 29.8% of eyes for SE. In multivariate analysis, eyes with SE of \textgreater4 D (based on the average of two autorefractors) had larger differences in sphere (mean, 0.66 D vs 0.35 D; P \textless 0.0001) and SE (0.57 D vs 0.26 D; P \textless 0.0001) than eyes with SE of ≤4 D. CONCLUSIONS: Under cycloplegia, the Grand Seiko provided higher measures of sphere, more cylinder, and higher SE than the Retinomax. Higher refractive error was associated with larger differences in sphere and SE between the Grand Seiko and Retinomax.
@article{ying_comparison_2017,
title = {Comparison of cycloplegic refraction between {Grand} {Seiko} autorefractor and {Retinomax} autorefractor in the {Vision} in {Preschoolers}-{Hyperopia} in {Preschoolers} ({VIP}-{HIP}) {Study}},
volume = {21},
issn = {1528-3933},
doi = {10.1016/j.jaapos.2017.05.008},
abstract = {PURPOSE: To evaluate the agreement of cycloplegic refractive error measures between the Grand Seiko and Retinomax autorefractors in 4- and 5-year-old children.
METHODS: Cycloplegic refractive error of children was measured using the Grand Seiko and Retinomax during a comprehensive eye examination. Accommodative error was measured using the Grand Seiko. The differences in sphere, cylinder, spherical equivalent (SE) and intereye vector dioptric distance (VDD) between autorefractors were assessed using the Bland-Altman plot and 95\% limits of agreement (95\% LoA).
RESULTS: A total of 702 examinations were included. Compared to the Retinomax, the Grand Seiko provided statistically significantly larger values of sphere (mean difference, 0.34 D; 95\% LoA, -0.46 to 1.14 D), SE (mean, 0.25 D; 95\% LoA, -0.55 to 1.05 D), VDD (mean, 0.19 D; 95\% LoA, -0.67 to 1.05 D), and more cylinder (mean, -0.18 D; 95\% LoA, -0.91 to 0.55 D). The Grand Seiko measured ≥0.5 D than Retinomax in 43.1\% of eyes for sphere and 29.8\% of eyes for SE. In multivariate analysis, eyes with SE of {\textgreater}4 D (based on the average of two autorefractors) had larger differences in sphere (mean, 0.66 D vs 0.35 D; P {\textless} 0.0001) and SE (0.57 D vs 0.26 D; P {\textless} 0.0001) than eyes with SE of ≤4 D.
CONCLUSIONS: Under cycloplegia, the Grand Seiko provided higher measures of sphere, more cylinder, and higher SE than the Retinomax. Higher refractive error was associated with larger differences in sphere and SE between the Grand Seiko and Retinomax.},
language = {eng},
number = {3},
journal = {Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus},
author = {Ying, Gui-Shuang and Maguire, Maureen G. and Kulp, Marjean Taylor and Ciner, Elise and Moore, Bruce and Pistilli, Maxwell and Candy, Rowan and {VIP-HIP Study Group}},
month = jun,
year = {2017},
pmid = {28528993},
pmcid = {PMC5614706},
keywords = {Child, Child, Preschool, Cross-Sectional Studies, Cyclopentolate, Female, Humans, Hyperopia, Interdisciplinary Research, Male, Mydriatics, Pupil, Refraction, Ocular, Vision Screening, Visual Acuity},
pages = {219--223.e3}
}2016 (13)
Caregiver-directed home-based intensive bimanual training in young children with unilateral spastic cerebral palsy: A randomized trial. Ferre C.L., Brandao M., Surana B., Dew A.P., Moreau N.G., & Gordon A.M. 2016.
Paper abstract bibtex
Paper abstract bibtex Aim: To examine the efficacy of caregiver-directed, home-based intensive bimanual training in children with unilateral spastic cerebral palsy (USCP) using a randomized control trial. Method: Twenty-four children (ages 2y 6mo-10y 1mo; 10 males, 14 females) performed home-based activities directed by a caregiver for 2 hours per day, 5 days per week, for 9 weeks (total=90h). Cohorts of children were age-matched into groups and randomized to receive home-based hand-arm bimanual intensive therapy (H-HABIT; n=12) or lower-limb functional intensive training (LIFT-control; n=12). Caregivers were trained before the intervention and supervised remotely via telerehabilitation. Dexterity and bimanual hand function were assessed using the Box and Blocks test (BBT) and the Assisting Hand Assessment (AHA) respectively. Caregiver perception of functional goals was measured using the Canadian Occupational Performance Measure (COPM). Results: H-HABIT showed greater improvement on the BBT compared to LIFT-control and no improvement on the AHA. H-HABIT demonstrated significant improvement in COPM-Performance compared to LIFT-control and both groups showed equal improvement in COPM-Satisfaction. Interpretation: H-HABIT improved dexterity and performance of functional goals, but not bimanual performance, in children with USCP compared to a control group receiving intervention of equal intensity/duration that also controlled for increased caregiver attention. Home-based models provide a valuable, family-centered approach to achieve increased treatment intensity. Copyright © 2016 Mac Keith Press.
@misc{ferre_c.l._caregiver-directed_2016,
title = {Caregiver-directed home-based intensive bimanual training in young children with unilateral spastic cerebral palsy: {A} randomized trial},
url = {http://www.wiley.com/bw/journal.asp?ref=0012-1622&site=1},
abstract = {Aim: To examine the efficacy of caregiver-directed, home-based intensive bimanual training in children with unilateral spastic cerebral palsy (USCP) using a randomized control trial. Method: Twenty-four children (ages 2y 6mo-10y 1mo; 10 males, 14 females) performed home-based activities directed by a caregiver for 2 hours per day, 5 days per week, for 9 weeks (total=90h). Cohorts of children were age-matched into groups and randomized to receive home-based hand-arm bimanual intensive therapy (H-HABIT; n=12) or lower-limb functional intensive training (LIFT-control; n=12). Caregivers were trained before the intervention and supervised remotely via telerehabilitation. Dexterity and bimanual hand function were assessed using the Box and Blocks test (BBT) and the Assisting Hand Assessment (AHA) respectively. Caregiver perception of functional goals was measured using the Canadian Occupational Performance Measure (COPM). Results: H-HABIT showed greater improvement on the BBT compared to LIFT-control and no improvement on the AHA. H-HABIT demonstrated significant improvement in COPM-Performance compared to LIFT-control and both groups showed equal improvement in COPM-Satisfaction. Interpretation: H-HABIT improved dexterity and performance of functional goals, but not bimanual performance, in children with USCP compared to a control group receiving intervention of equal intensity/duration that also controlled for increased caregiver attention. Home-based models provide a valuable, family-centered approach to achieve increased treatment intensity. Copyright © 2016 Mac Keith Press.},
journal = {Developmental Medicine and Child Neurology},
author = {{Ferre C.L.} and {Brandao M.} and {Surana B.} and {Dew A.P.} and {Moreau N.G.} and {Gordon A.M.}},
year = {2016},
keywords = {*caregiver, *cerebral palsy, Child, attention, clinical article, clinical trial, control group, controlled clinical trial, controlled study, endogenous compound, female, hand function, human, intensive care, lower limb, male, model, perception, preschool child, randomized controlled trial, satisfaction, telerehabilitation}
}Sterile pyogenic arthritis pyoderma gangrenosum, and acne (PAPA) syndrome: Musculoskeletal imaging findings and common differential diagnosis in children. Martinez-Rios, C., Jariwala, M., Highmore, K., Duffy, K., Laxer, R., & Stimec, J. Pediatric Radiology, 46((Jariwala M.; Highmore K.; Duffy K.W.; Laxer R.; Stimec J.)):S246, 2016.
Paper abstract bibtex
Paper abstract bibtex Purpose or Case Report: Sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome) is a rare autosomal dominant inherited entity due to a missense mutation in the proline serine threonine phosphatase-interacting protein 1 (PSTPIP1/CD2BP1) gene, characterized by typical recurrent episodes of sterile pyogenic arthritis, either spontaneous or following a trauma, and skin manifestations characterized by pyoderma gangrenosum and acne. The articular manifestation is seen in the first decade of life, where most of the initial episodes are treated as septic arthritis. Cutaneous manifestations appear in early adulthood. Although uncommon, the potential therapeutic and clinical implications due to the rapidly destructive nature of PAPA syndrome warrant a prompt diagnosis. We present two unrelated pediatric patients from different institutions with genetically confirmed PAPA syndrome. The purpose of this study was to illustrate the musculoskeletal radiologic spectrum of findings of PAPA syndrome, and to discuss the differential diagnostic entities commonly seen in children. A second objective was to review the clinical and laboratory findings that allow diagnosis of PAPA syndrome Methods & Materials: Patients' consent were obtained. We reviewed the imaging features of PAPA syndrome in different imaging modalities including plain radiograph, ultrasound, and magnetic resonance imaging, and we included representative cases of more common musculoskeletal diagnostic entities that present with similar imaging and clinical features in children Results: Many of the imaging features seen in PAPA syndrome overlap with other clinical conditions including septic arthritis, osteomyelitis and juvenile idiopathic arthritis, including joint effusion, synovial thickening and extensive soft tissue swelling Conclusions: PAPA syndrome would not be suspected initially based on imaging appearance alone, but should be considered in cases of recurrent septic arthritis or in those demonstrating skin manifestations. Radiologists familiarization with the syndrome may allow them to recognize the condition earlier in its course.
@article{martinez-rios_sterile_2016,
title = {Sterile pyogenic arthritis pyoderma gangrenosum, and acne ({PAPA}) syndrome: {Musculoskeletal} imaging findings and common differential diagnosis in children},
volume = {46},
issn = {1432-1998},
url = {http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72287938},
abstract = {Purpose or Case Report: Sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome) is a rare autosomal dominant inherited entity due to a missense mutation in the proline serine threonine phosphatase-interacting protein 1 (PSTPIP1/CD2BP1) gene, characterized by typical recurrent episodes of sterile pyogenic arthritis, either spontaneous or following a trauma, and skin manifestations characterized by pyoderma gangrenosum and acne. The articular manifestation is seen in the first decade of life, where most of the initial episodes are treated as septic arthritis. Cutaneous manifestations appear in early adulthood. Although uncommon, the potential therapeutic and clinical implications due to the rapidly destructive nature of PAPA syndrome warrant a prompt diagnosis. We present two unrelated pediatric patients from different institutions with genetically confirmed PAPA syndrome. The purpose of this study was to illustrate the musculoskeletal radiologic spectrum of findings of PAPA syndrome, and to discuss the differential diagnostic entities commonly seen in children. A second objective was to review the clinical and laboratory findings that allow diagnosis of PAPA syndrome Methods \& Materials: Patients' consent were obtained. We reviewed the imaging features of PAPA syndrome in different imaging modalities including plain radiograph, ultrasound, and magnetic resonance imaging, and we included representative cases of more common musculoskeletal diagnostic entities that present with similar imaging and clinical features in children Results: Many of the imaging features seen in PAPA syndrome overlap with other clinical conditions including septic arthritis, osteomyelitis and juvenile idiopathic arthritis, including joint effusion, synovial thickening and extensive soft tissue swelling Conclusions: PAPA syndrome would not be suspected initially based on imaging appearance alone, but should be considered in cases of recurrent septic arthritis or in those demonstrating skin manifestations. Radiologists familiarization with the syndrome may allow them to recognize the condition earlier in its course.},
number = {(Jariwala M.; Highmore K.; Duffy K.W.; Laxer R.; Stimec J.)},
journal = {Pediatric Radiology},
author = {Martinez-Rios, C. and Jariwala, M. and Highmore, K. and Duffy, K.W. and Laxer, R. and Stimec, J.},
year = {2016},
keywords = {PAPA syndrome, X ray film, acne, adulthood, autosomal dominant inheritance, bacterial arthritis, case report, child, clinical feature, diagnosis, differential diagnosis, edema, gene, human, imaging, injury, joint effusion, juvenile rheumatoid arthritis, laboratory, missense mutation, nuclear magnetic resonance imaging, osteomyelitis, patient, phosphatase, proline, pyoderma gangrenosum, radiologist, radiology, serine, skin manifestation, soft tissue, synapsin I, threonine, ultrasound},
pages = {S246}
}Pharmacokinetics and pharmacodynamics of albuterol multidose dry powder inhaler and albuterol hydrofluoroalkane in children with asthma. Ratnayake A., Taveras H., Iverson H., & Shore P. 2016.
Paper abstract bibtex
Paper abstract bibtex Background: Many children struggle with the use of albuterol hydrofluoroalkane (HFA) inhalers. Albuterol multidose dry powder inhaler (MDPI) may simplify rescue bronchodilator use in children. Objective: To compare the pharmacokinetics (PK), pharmacodynamics (PD), and tolerability of albuterol MDPI and albuterol HFA after a single inhaled dose in children with asthma. Methods: This single-center, open-label, two-period crossover study randomized children to albuterol MDPI or HFA 180 mug on two treatment days with a 4- to 14-day washout. Plasma albuterol concentrations were measured before the dose and up to 10 hours after the dose to determine the primary PK values of area under the plasma concentration-versus-time curve from time 0 to the last measurable concentration (AUC0-t), maximum observed concentration (Cmax), and AUC from time 0 extrapolated to infinity (AUC0-inf). Heart rate and blood pressure before the dose and after the dose were monitored for PD effects, and adverse events (AE) were monitored for overall safety. Results: Fifteen children, ages 6-11 years, were included (PK, n = 13 for time to Cmax and terminal half-life of elimination; n = 12 for AUC and Cmax due to incomplete data). AUC0-t (geometric mean ratio [GMR] 1.056 [90% confidence interval \CI\, 0.88 -1.268]) and AUC0-inf (GMR 0.971 [90% CI, 0.821-1.147]) were comparable between treatments. Cmax was larger for albuterol MDPI versus HFA (GMR 1.340 [90% CI, 1.098 -1.636]). PD parameters between the treatments were comparable. No deaths, serious AEs, treatment-emergent AEs, or withdrawals due to AEs were reported for either treatment. Conclusion: Albuterol MDPI and albuterol HFA had comparable PK and PD in children after a single 180-mug dose. Copyright ©2016, OceanSide Publications, Inc., U.S.A.
@misc{ratnayake_a._pharmacokinetics_2016,
title = {Pharmacokinetics and pharmacodynamics of albuterol multidose dry powder inhaler and albuterol hydrofluoroalkane in children with asthma},
url = {http://www.ingentaconnect.com/search/download?pub=infobike%3a%2f%2focean%2faap%2f2016%2f00000037%2f00000005%2fart00011&mimetype=application%2fpdf&exitTargetId=1473325081442},
abstract = {Background: Many children struggle with the use of albuterol hydrofluoroalkane (HFA) inhalers. Albuterol multidose dry powder inhaler (MDPI) may simplify rescue bronchodilator use in children. Objective: To compare the pharmacokinetics (PK), pharmacodynamics (PD), and tolerability of albuterol MDPI and albuterol HFA after a single inhaled dose in children with asthma. Methods: This single-center, open-label, two-period crossover study randomized children to albuterol MDPI or HFA 180 mug on two treatment days with a 4- to 14-day washout. Plasma albuterol concentrations were measured before the dose and up to 10 hours after the dose to determine the primary PK values of area under the plasma concentration-versus-time curve from time 0 to the last measurable concentration (AUC0-t), maximum observed concentration (Cmax), and AUC from time 0 extrapolated to infinity (AUC0-inf). Heart rate and blood pressure before the dose and after the dose were monitored for PD effects, and adverse events (AE) were monitored for overall safety. Results: Fifteen children, ages 6-11 years, were included (PK, n = 13 for time to Cmax and terminal half-life of elimination; n = 12 for AUC and Cmax due to incomplete data). AUC0-t (geometric mean ratio [GMR] 1.056 [90\% confidence interval \{CI\}, 0.88 -1.268]) and AUC0-inf (GMR 0.971 [90\% CI, 0.821-1.147]) were comparable between treatments. Cmax was larger for albuterol MDPI versus HFA (GMR 1.340 [90\% CI, 1.098 -1.636]). PD parameters between the treatments were comparable. No deaths, serious AEs, treatment-emergent AEs, or withdrawals due to AEs were reported for either treatment. Conclusion: Albuterol MDPI and albuterol HFA had comparable PK and PD in children after a single 180-mug dose. Copyright ©2016, OceanSide Publications, Inc., U.S.A.},
journal = {Allergy and Asthma Proceedings},
author = {{Ratnayake A.} and {Taveras H.} and {Iverson H.} and {Shore P.}},
year = {2016},
keywords = {*albuterol hydrofluoroalkane/ae [Adverse Drug Reaction], *albuterol hydrofluoroalkane/cm [Drug Comparison], *albuterol hydrofluoroalkane/ct [Clinical Trial], *albuterol hydrofluoroalkane/dt [Drug Therapy], *albuterol hydrofluoroalkane/ih [Inhalational Drug Administration], *albuterol hydrofluoroalkane/pk [Pharmacokinetics], *antiasthmatic agent/ae [Adverse Drug Reaction], *antiasthmatic agent/cm [Drug Comparison], *antiasthmatic agent/ct [Clinical Trial], *antiasthmatic agent/dt [Drug Therapy], *antiasthmatic agent/ih [Inhalational Drug Administration], *antiasthmatic agent/pk [Pharmacokinetics], *asthma, *asthma/dt [Drug Therapy], *dry powder inhaler, *dry powder inhaler/ct [Clinical Trial], *dry powder inhaler/dc [Device Comparison], *inhaler, *inhaler/ct [Clinical Trial], *inhaler/dc [Device Comparison], *multidose dry powder inhaler, *multidose dry powder inhaler/ct [Clinical Trial], *multidose dry powder inhaler/dc [Device Comparison], *pharmacodynamics, *salbutamol, *salbutamol/ae [Adverse Drug Reaction], *salbutamol/cm [Drug Comparison], *salbutamol/cr [Drug Concentration], *salbutamol/ct [Clinical Trial], *salbutamol/dt [Drug Therapy], *salbutamol/ih [Inhalational Drug Administration], *salbutamol/pk [Pharmacokinetics], Child, Pharmacokinetics, adverse drug reaction, area under the curve, asthma/dt [Drug Therapy], blood pressure, blood pressure monitoring, clinical article, clinical trial, conference paper, confidence interval, controlled clinical trial, controlled study, crossover procedure, death, drug blood level, drug efficacy, drug elimination, drug half life, drug monitoring, drug safety, drug withdrawal, female, fluorinated hydrocarbon, half life time, heart rate, human, human tissue, male, maximum plasma concentration, pharmacodynamics, phase 1 clinical trial, plasma concentration-time curve, preschool child, randomized controlled trial, safety, side effect, time to maximum plasma concentration, unclassified drug, unspecified side effect/si [Side Effect]}
}Physical Activity Benefits the Skeleton of Children Genetically Predisposed to Lower Bone Density in Adulthood. Mitchell, J. A., Chesi, A., Elci, O., McCormack, S. E., Roy, S. M., Kalkwarf, H. J., Lappe, J. M., Gilsanz, V., Oberfield, S. E., Shepherd, J. A., Kelly, A., Grant, S. F., & Zemel, B. S. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 31(8):1504–1512, 2016.
doi abstract bibtex
doi abstract bibtex
Both genetics and physical activity (PA) contribute to bone mineral density (BMD), but it is unknown if the benefits of physical activity on childhood bone accretion depend on genetic risk. We, therefore, aimed to determine if PA influenced the effect of bone fragility genetic variants on BMD in childhood. Our sample comprised US children of European ancestry enrolled in the Bone Mineral Density in Childhood Study (N = 918, aged 5 to 19 years, and 52.4% female). We used a questionnaire to estimate hours per day spent in total, high-, and low-impact PA. We calculated a BMD genetic score (% BMD lowering alleles) using adult genome-wide association study (GWAS)-implicated BMD variants. We used dual-energy X-ray absorptiometry to estimate femoral neck, total hip, and spine areal-BMD and total body less head (TBLH) bone mineral content (BMC) Z-scores. The BMD genetic score was negatively associated with each bone Z-score (eg, TBLH-BMC: estimate = -0.03, p = 1.3 × 10(-6) ). Total PA was positively associated with bone Z-scores; these associations were driven by time spent in high-impact PA (eg, TBLH-BMC: estimate = 0.05, p = 4.0 × 10(-10) ) and were observed even for children with lower than average bone Z-scores. We found no evidence of PA-adult genetic score interactions (p interaction \textgreater 0.05) at any skeletal site, and there was no evidence of PA-genetic score-Tanner stage interactions at any skeletal site (p interaction \textgreater 0.05). However, exploratory analyses at the individual variant level revealed that PA statistically interacted with rs2887571 (ERC1/WNT5B) to influence TBLH-BMC in males (p interaction = 7.1 × 10(-5) ), where PA was associated with higher TBLH-BMC Z-score among the BMD-lowering allele carriers (rs2887571 AA homozygotes: estimate = 0.08 [95% CI 0.06, 0.11], p = 2.7 × 10(-9) ). In conclusion, the beneficial effect of PA on bone, especially high-impact PA, applies to the average child and those genetically predisposed to lower adult BMD (based on GWAS-implicated BMD variants). Independent replication of our exploratory individual variant findings is warranted. © 2016 American Society for Bone and Mineral Research.
@article{mitchell_physical_2016,
title = {Physical {Activity} {Benefits} the {Skeleton} of {Children} {Genetically} {Predisposed} to {Lower} {Bone} {Density} in {Adulthood}},
volume = {31},
issn = {1523-4681},
doi = {10.1002/jbmr.2872},
abstract = {Both genetics and physical activity (PA) contribute to bone mineral density (BMD), but it is unknown if the benefits of physical activity on childhood bone accretion depend on genetic risk. We, therefore, aimed to determine if PA influenced the effect of bone fragility genetic variants on BMD in childhood. Our sample comprised US children of European ancestry enrolled in the Bone Mineral Density in Childhood Study (N = 918, aged 5 to 19 years, and 52.4\% female). We used a questionnaire to estimate hours per day spent in total, high-, and low-impact PA. We calculated a BMD genetic score (\% BMD lowering alleles) using adult genome-wide association study (GWAS)-implicated BMD variants. We used dual-energy X-ray absorptiometry to estimate femoral neck, total hip, and spine areal-BMD and total body less head (TBLH) bone mineral content (BMC) Z-scores. The BMD genetic score was negatively associated with each bone Z-score (eg, TBLH-BMC: estimate = -0.03, p = 1.3 × 10(-6) ). Total PA was positively associated with bone Z-scores; these associations were driven by time spent in high-impact PA (eg, TBLH-BMC: estimate = 0.05, p = 4.0 × 10(-10) ) and were observed even for children with lower than average bone Z-scores. We found no evidence of PA-adult genetic score interactions (p interaction {\textgreater} 0.05) at any skeletal site, and there was no evidence of PA-genetic score-Tanner stage interactions at any skeletal site (p interaction {\textgreater} 0.05). However, exploratory analyses at the individual variant level revealed that PA statistically interacted with rs2887571 (ERC1/WNT5B) to influence TBLH-BMC in males (p interaction = 7.1 × 10(-5) ), where PA was associated with higher TBLH-BMC Z-score among the BMD-lowering allele carriers (rs2887571 AA homozygotes: estimate = 0.08 [95\% CI 0.06, 0.11], p = 2.7 × 10(-9) ). In conclusion, the beneficial effect of PA on bone, especially high-impact PA, applies to the average child and those genetically predisposed to lower adult BMD (based on GWAS-implicated BMD variants). Independent replication of our exploratory individual variant findings is warranted. © 2016 American Society for Bone and Mineral Research.},
language = {eng},
number = {8},
journal = {Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research},
author = {Mitchell, Jonathan A. and Chesi, Alessandra and Elci, Okan and McCormack, Shana E. and Roy, Sani M. and Kalkwarf, Heidi J. and Lappe, Joan M. and Gilsanz, Vicente and Oberfield, Sharon E. and Shepherd, John A. and Kelly, Andrea and Grant, Struan Fa and Zemel, Babette S.},
year = {2016},
pmid = {27172274},
pmcid = {PMC4970901},
keywords = {Adolescent, Adult, BONE MINERAL DENSITY, Bone Density, Bone and Bones, CHILDREN, Child, Cohort Studies, EXERCISE, Exercise, Female, GENETIC, Genetic Loci, Genetic Predisposition to Disease, Humans, Male, PHYSICAL ACTIVITY, Polymorphism, Single Nucleotide, Risk Factors},
pages = {1504--1512}
}Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: Protocol for a systematic review of quantitative and qualitative research. Bannon L., McGaughey J., Clarke M., McAuley D.F., & Blackwood B. 2016.
Paper abstract bibtex
Paper abstract bibtex Background: Critically ill patients have an increased risk of developing delirium during their intensive care stay. To date, pharmacological interventions have not been shown to be effective for delirium management but non-pharmacological interventions have shown some promise. The aim of this systematic review is to identify effective non-pharmacological interventions for reducing the incidence or the duration of delirium in critically ill patients. Methods: We will search MEDLINE, EMBASE, CINAHL, Web of Science, AMED, psycINFO and the Cochrane Library. We will include studies of critically ill adults and children. We will include randomised trials and controlled trials which measure the effectiveness of one or more non-pharmacological interventions in reducing incidence or duration of delirium in critically ill patients. We will also include qualitative studies that provide an insight into patients and their families' experiences of delirium and non-pharmacological interventions. Two independent reviewers will assess studies for eligibility, extract data and appraise quality. We will conduct meta-analyses if possible or present results narratively. Qualitative studies will also be reviewed by two independent reviewers, and a specially designed quality assessment tool incorporating the CASP framework and the POPAY framework will be used to assess quality. Discussion: Although non-pharmacological interventions have been studied in populations outside of intensive care units and multicomponent interventions have successfully reduced incidence and duration of delirium, no systematic review of non-pharmacological interventions specifically targeting delirium in critically ill patients have been undertaken to date. This systematic review will provide evidence for the development of a multicomponent intervention for delirium management of critically ill patients that can be tested in a subsequent multicentre randomised trial. Systematic review registration: PROSPERO CRD42015016625 Copyright © 2016 Bannon et al.
@misc{bannon_l._impact_2016,
title = {Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: {Protocol} for a systematic review of quantitative and qualitative research},
url = {http://www.systematicreviewsjournal.com/},
abstract = {Background: Critically ill patients have an increased risk of developing delirium during their intensive care stay. To date, pharmacological interventions have not been shown to be effective for delirium management but non-pharmacological interventions have shown some promise. The aim of this systematic review is to identify effective non-pharmacological interventions for reducing the incidence or the duration of delirium in critically ill patients. Methods: We will search MEDLINE, EMBASE, CINAHL, Web of Science, AMED, psycINFO and the Cochrane Library. We will include studies of critically ill adults and children. We will include randomised trials and controlled trials which measure the effectiveness of one or more non-pharmacological interventions in reducing incidence or duration of delirium in critically ill patients. We will also include qualitative studies that provide an insight into patients and their families' experiences of delirium and non-pharmacological interventions. Two independent reviewers will assess studies for eligibility, extract data and appraise quality. We will conduct meta-analyses if possible or present results narratively. Qualitative studies will also be reviewed by two independent reviewers, and a specially designed quality assessment tool incorporating the CASP framework and the POPAY framework will be used to assess quality. Discussion: Although non-pharmacological interventions have been studied in populations outside of intensive care units and multicomponent interventions have successfully reduced incidence and duration of delirium, no systematic review of non-pharmacological interventions specifically targeting delirium in critically ill patients have been undertaken to date. This systematic review will provide evidence for the development of a multicomponent intervention for delirium management of critically ill patients that can be tested in a subsequent multicentre randomised trial. Systematic review registration: PROSPERO CRD42015016625 Copyright © 2016 Bannon et al.},
journal = {Systematic Reviews},
author = {{Bannon L.} and {McGaughey J.} and {Clarke M.} and {McAuley D.F.} and {Blackwood B.}},
year = {2016},
keywords = {*critical illness, *critically ill patient, *delirium, *delirium/pc [Prevention], *delirium/th [Therapy], *intensive care unit, *medical procedures, *qualitative research, *registration, Child, Cinahl, Cochrane Library, Embase, Medline, PsycINFO, Web of Science, adult, article, bright light therapy, cognitive therapy, controlled clinical trial, critically ill patient, ear plug, education, exercise, extract, eye mask, family study, human, incidence, intensive care unit, lighting control, mask, meta analysis, music therapy, noise reduction, orientation, outcome assessment, physiotherapy, priority journal, publication, qualitative research, quality control, quantitative study, randomized controlled trial, randomized controlled trial (topic), risk factor, scientific literature, sensitivity analysis, systematic review}
}Long-acting Insulin Analogs Effect on gh/igf Axis of Children with Type 1 Diabetes: A Randomized, Open-label, Two-period, Cross-over Trial. Cherubini V., Pintaudi B., Iannilli A., Pambianchi M., Ferrito L., & Nicolucci A. 2016.
Paper abstract bibtex
Paper abstract bibtex Background: Growth hormone (GH) secretion is increased in pre-pubertal children with type 1 diabetes and GH excess produces insulin resistance. Early-morning insulinopenia contributes to lower insulin-like growth factor (IGF-I) levels and to GH hypersecretion. Objective: To evaluate differences in GH/IGF-I axis of pre-pubertal children with type 1 diabetes treated with glargine or detemir as long-acting insulin analogues, which was the main outcome measure, and to compare insulin effects in obtaining good metabolic control. Subjects: Children with type 1 diabetes. Methods: This was a 32-week, randomized, open-label, two-period, cross-over comparison between bedtime glargine and twice-daily detemir insulin, involving pre-pubertal children in care at a diabetes pediatric centre. After a 8-week-run-in period subjects were randomized to bedtime glargine or twice-daily detemir insulin administration. After a 12-week period treatments were inverted and continued for additional 12 weeks. Results: Overall, 15 pre-pubertal children (53.3% males, mean age 8.6+/-1.5 years, duration of diabetes 4.2+/-1.5 years) completed the study. Groups did not differ for GH/IGF axis and HbA1c levels. Treatment with glargine was associated with lower fasting glucose values than treatment with detemir (8.1+/-1.5 vs. 8.2+/-1.7 mmol/L, p=0.01). Incidence rate of hypoglycemia was not different between insulin treatments (IRR=1.18, 95%CI 1.00-1.38; p=0.07). Detemir treatment was associated with a higher increase in body weight (p=0.008) and height (p=0.02) when compared with glargine. Conclusion: Detemir and glargine not show significant differential effects on the GH/IGFI axis. The greater weight gain and height associated with detemir treatment, apparently not related to the level of pubertal growth, deserve further investigation. Copyright © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart New York.
@misc{cherubini_v._long-acting_2016,
title = {Long-acting {Insulin} {Analogs} {Effect} on gh/igf {Axis} of {Children} with {Type} 1 {Diabetes}: {A} {Randomized}, {Open}-label, {Two}-period, {Cross}-over {Trial}},
url = {http://www.thieme-connect.com/ejournals/toc/eced},
abstract = {Background: Growth hormone (GH) secretion is increased in pre-pubertal children with type 1 diabetes and GH excess produces insulin resistance. Early-morning insulinopenia contributes to lower insulin-like growth factor (IGF-I) levels and to GH hypersecretion. Objective: To evaluate differences in GH/IGF-I axis of pre-pubertal children with type 1 diabetes treated with glargine or detemir as long-acting insulin analogues, which was the main outcome measure, and to compare insulin effects in obtaining good metabolic control. Subjects: Children with type 1 diabetes. Methods: This was a 32-week, randomized, open-label, two-period, cross-over comparison between bedtime glargine and twice-daily detemir insulin, involving pre-pubertal children in care at a diabetes pediatric centre. After a 8-week-run-in period subjects were randomized to bedtime glargine or twice-daily detemir insulin administration. After a 12-week period treatments were inverted and continued for additional 12 weeks. Results: Overall, 15 pre-pubertal children (53.3\% males, mean age 8.6+/-1.5 years, duration of diabetes 4.2+/-1.5 years) completed the study. Groups did not differ for GH/IGF axis and HbA1c levels. Treatment with glargine was associated with lower fasting glucose values than treatment with detemir (8.1+/-1.5 vs. 8.2+/-1.7 mmol/L, p=0.01). Incidence rate of hypoglycemia was not different between insulin treatments (IRR=1.18, 95\%CI 1.00-1.38; p=0.07). Detemir treatment was associated with a higher increase in body weight (p=0.008) and height (p=0.02) when compared with glargine. Conclusion: Detemir and glargine not show significant differential effects on the GH/IGFI axis. The greater weight gain and height associated with detemir treatment, apparently not related to the level of pubertal growth, deserve further investigation. Copyright © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart New York.},
journal = {Experimental and Clinical Endocrinology and Diabetes},
author = {{Cherubini V.} and {Pintaudi B.} and {Iannilli A.} and {Pambianchi M.} and {Ferrito L.} and {Nicolucci A.}},
year = {2016},
keywords = {*growth hormone blood level, *growth hormone/ec [Endogenous Compound], *insulin dependent diabetes mellitus, *insulin dependent diabetes mellitus/dt [Drug Therapy], *insulin detemir/cm [Drug Comparison], *insulin detemir/ct [Clinical Trial], *insulin detemir/dt [Drug Therapy], *insulin glargine/cm [Drug Comparison], *insulin glargine/ct [Clinical Trial], *insulin glargine/dt [Drug Therapy], *long acting insulin, *protein blood level, *somatomedin/ec [Endogenous Compound], Child, article, bedtime dosage, blood glucose monitoring, body height, body weight, clinical article, clinical trial, comparative effectiveness, controlled clinical trial, controlled study, crossover procedure, diabetic patient, female, glucose blood level, glucose/ec [Endogenous Compound], growth hormone, height, hemoglobin A1c, hemoglobin A1c/ec [Endogenous Compound], hemoglobin blood level, human, hypoglycemia, incidence, insulin dependent diabetes mellitus/dt [Drug Therapy], insulin detemir, insulin glargine, insulin treatment, male, open study, pediatric hospital, prepuberty, priority journal, randomized controlled trial, somatomedin C, weight gain}
}Juvenile idiopathic arthritis-associated uveitis. Clarke S.L.N., Sen E.S., & Ramanan A.V. 2016.
Paper abstract bibtex
Paper abstract bibtex Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, with JIA-associated uveitis its most common extra-articular manifestation. JIA-associated uveitis is a potentially sight-threatening condition and thus carries a considerable risk of morbidity. The aetiology of the condition is autoimmune in nature with the predominant involvement of CD4+ T cells. However, the underlying pathogenic mechanisms remain unclear, particularly regarding interplay between genetic and environmental factors. JIA-associated uveitis comes in several forms, but the most common presentation is of the chronic anterior uveitis type. This condition is usually asymptomatic and thus screening for JIA-associated uveitis in at-risk patients is paramount. Early detection and treatment aims to stop inflammation and prevent the development of complications leading to visual loss, which can occur due to both active disease and burden of disease treatment. Visually disabling complications of JIA-associated uveitis include cataracts, glaucoma, band keratopathy and macular oedema. There is a growing body of evidence for the early introduction of systemic immunosuppressive therapies in order to reduce topical and systemic glucocorticoid use. This includes more traditional treatments, such as methotrexate, as well as newer biological therapies. This review highlights the epidemiology of JIA-associated uveitis, the underlying pathogenesis and how affected patients may present. The current guidelines and criteria for screening, diagnosis and monitoring are discussed along with approaches to management. Copyright © 2016 Clarke et al.
@misc{clarke_s.l.n._juvenile_2016,
title = {Juvenile idiopathic arthritis-associated uveitis},
url = {http://www.ped-rheum.com/},
abstract = {Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, with JIA-associated uveitis its most common extra-articular manifestation. JIA-associated uveitis is a potentially sight-threatening condition and thus carries a considerable risk of morbidity. The aetiology of the condition is autoimmune in nature with the predominant involvement of CD4+ T cells. However, the underlying pathogenic mechanisms remain unclear, particularly regarding interplay between genetic and environmental factors. JIA-associated uveitis comes in several forms, but the most common presentation is of the chronic anterior uveitis type. This condition is usually asymptomatic and thus screening for JIA-associated uveitis in at-risk patients is paramount. Early detection and treatment aims to stop inflammation and prevent the development of complications leading to visual loss, which can occur due to both active disease and burden of disease treatment. Visually disabling complications of JIA-associated uveitis include cataracts, glaucoma, band keratopathy and macular oedema. There is a growing body of evidence for the early introduction of systemic immunosuppressive therapies in order to reduce topical and systemic glucocorticoid use. This includes more traditional treatments, such as methotrexate, as well as newer biological therapies. This review highlights the epidemiology of JIA-associated uveitis, the underlying pathogenesis and how affected patients may present. The current guidelines and criteria for screening, diagnosis and monitoring are discussed along with approaches to management. Copyright © 2016 Clarke et al.},
journal = {Pediatric Rheumatology},
author = {{Clarke S.L.N.} and {Sen E.S.} and {Ramanan A.V.}},
year = {2016},
keywords = {*juvenile rheumatoid arthritis, *juvenile rheumatoid arthritis/di [Diagnosis], *juvenile rheumatoid arthritis/dt [Drug Therapy], *juvenile rheumatoid arthritis/ep [Epidemiology], *juvenile rheumatoid arthritis/et [Etiology], *uveitis/di [Diagnosis], *uveitis/dt [Drug Therapy], *uveitis/ep [Epidemiology], *uveitis/et [Etiology], CD4 T lymphocyte, CD4 antigen/ec [Endogenous Compound], CD8 antigen/ec [Endogenous Compound], CD8+T lymphocyte, Child, HLA B27 antigen/ec [Endogenous Compound], HLA DPB1 antigen/ec [Endogenous Compound], HLA DR1 antigen/ec [Endogenous Compound], HLA DR5 antigen/ec [Endogenous Compound], HLA DRB1 antigen/ec [Endogenous Compound], abatacept/ct [Clinical Trial], abatacept/dt [Drug Therapy], adalimumab/ae [Adverse Drug Reaction], adalimumab/cm [Drug Comparison], adalimumab/ct [Clinical Trial], adalimumab/dt [Drug Therapy], azathioprine/ae [Adverse Drug Reaction], azathioprine/dt [Drug Therapy], biological product/ct [Clinical Trial], biological product/dt [Drug Therapy], blindness, bone marrow suppression/si [Side Effect], cataract, cataract/co [Complication], cataract/si [Side Effect], cataract/su [Surgery], childhood, clinical feature, clinical study, corticosteroid/ae [Adverse Drug Reaction], corticosteroid/dt [Drug Therapy], cyclopentolate/dt [Drug Therapy], cycloplegic agent/dt [Drug Therapy], cyclosporin A/ae [Adverse Drug Reaction], cyclosporin A/dt [Drug Therapy], dexamethasone sodium phosphate/dt [Drug Therapy], diagnosis, disease association, drug substitution, drug withdrawal, environmental factor, etanercept/cm [Drug Comparison], etanercept/ct [Clinical Trial], etanercept/dt [Drug Therapy], ethnicity, eye pain, eye redness, gastrointestinal symptom/si [Side Effect], glaucoma, glaucoma/co [Complication], glaucoma/su [Surgery], glucocorticoid, glucocorticoid/ae [Adverse Drug Reaction], glucocorticoid/dt [Drug Therapy], groups by age, hair loss/si [Side Effect], headache, hematologic disease/si [Side Effect], human, hypertension/si [Side Effect], immunosuppressive agent/dt [Drug Therapy], immunosuppressive treatment, incidence, infection/si [Side Effect], infliximab/cm [Drug Comparison], infliximab/ct [Clinical Trial], infliximab/dt [Drug Therapy], iridocyclitis, juvenile rheumatoid arthritis/dt [Drug Therapy], keratopathy, kidney dysfunction/si [Side Effect], leflunomide/cm [Drug Comparison], leflunomide/dt [Drug Therapy], leukopenia/si [Side Effect], lipodystrophy/si [Side Effect], liver dysfunction/si [Side Effect], liver enzyme/ec [Endogenous Compound], macular edema, meta analysis (topic), methotrexate, methotrexate/ae [Adverse Drug Reaction], methotrexate/cb [Drug Combination], methotrexate/cm [Drug Comparison], methotrexate/ct [Clinical Trial], methotrexate/dt [Drug Therapy], methylprednisolone/dt [Drug Therapy], monitoring, morbidity, mycophenolate mofetil/ae [Adverse Drug Reaction], mycophenolate mofetil/cb [Drug Combination], mycophenolate mofetil/dt [Drug Therapy], nausea/si [Side Effect], pathogenesis, patient monitoring, phacoemulsification, photophobia, placebo, practice guideline, prednisolone acetate/dt [Drug Therapy], prevalence, prevention, priority journal, prognosis, randomized controlled trial (topic), review, risk assessment, screening, screening test, sex difference, systematic review (topic), tacrolimus/ae [Adverse Drug Reaction], tacrolimus/dt [Drug Therapy], topical drug administration, trabeculectomy, treatment failure, tropicamide/dt [Drug Therapy], unindexed drug, unspecified side effect/si [Side Effect], uveitis/dt [Drug Therapy]}
}Two different techniques of facial mask induction of anesthesia in children provide identical intubation conditions despite different anesthetic depth. Hallet C., Venneman I., Hans G., & Bonhomme V. 2016.
Paper abstract bibtex
Paper abstract bibtex Background: Sevoflurane induction in children is performed using different techniques. Constricted, centered, and symmetrical pupils (CCSP) are classically the endpoint to be achieved before laryngoscopy is performed. Objectives: We investigated whether two different inhalation induction techniques with the same clinical end-point provided similar intubating conditions and comparable depth of anesthesia as assessed by the Bispectral Index (BIS). Methods: Following IRB approval, and informed parental consent, 20 children were recruited. They were scheduled for general anesthesia with tracheal intubation, and randomly assigned to Group 1, where the practitioner used 6% inspired sevoflurane in 50% O2/N2O, and no manually assisted ventilation, or Group 2, where inspired sevoflurane was 8% in 50% O2/N2O, and ventilation was manually supported upon loss of consciousness. BIS values were blinded. Laryngoscopy was performed after CCSP. Intubation conditions scoring was based on jaw relaxation (mobile = 1, partially mobile = 2, fixed = 3), position of vocal cords (open = 1, half-closed = 2, closed = 3), and cough (no cough = 1,1 or 2 coughing efforts = 2, persistent coughing = 3). A total score \textgreater3 corresponded to non-optimal conditions. Results: Upon CCSP, BIS values were significantly lower in Group 1 [mean (SD): 30 (8) - 48 (18), p \textless 0.001], despite significantly higher end-tidal sevoflurane concentration in Group 2 [mean (SD): 5.0 (0.7) - 6.2 (0.5); p \textless 0.001]. Time to CCSP was slightly shorter in Group 2. Intubation conditions were always optimal except for one patient of Group 1. Discussion: Both induction techniques achieve good intubating conditions. Possible explanations for the between-group BIS difference include variable appreciation of the CCSP endpoint, different induction lengths or sevoflurane equilibration times, or sevoflurane-induced increase in electroencephalogram power. A better indicator of the best time to intubate is needed to avoid too deep anesthesia in children. Copyright © Ada Anaesthesiologica Belgica, 2016.
@misc{hallet_c._two_2016,
title = {Two different techniques of facial mask induction of anesthesia in children provide identical intubation conditions despite different anesthetic depth},
url = {http://www.arsmb-kvbmg.be/ramsb/contact.html},
abstract = {Background: Sevoflurane induction in children is performed using different techniques. Constricted, centered, and symmetrical pupils (CCSP) are classically the endpoint to be achieved before laryngoscopy is performed. Objectives: We investigated whether two different inhalation induction techniques with the same clinical end-point provided similar intubating conditions and comparable depth of anesthesia as assessed by the Bispectral Index (BIS). Methods: Following IRB approval, and informed parental consent, 20 children were recruited. They were scheduled for general anesthesia with tracheal intubation, and randomly assigned to Group 1, where the practitioner used 6\% inspired sevoflurane in 50\% O2/N2O, and no manually assisted ventilation, or Group 2, where inspired sevoflurane was 8\% in 50\% O2/N2O, and ventilation was manually supported upon loss of consciousness. BIS values were blinded. Laryngoscopy was performed after CCSP. Intubation conditions scoring was based on jaw relaxation (mobile = 1, partially mobile = 2, fixed = 3), position of vocal cords (open = 1, half-closed = 2, closed = 3), and cough (no cough = 1,1 or 2 coughing efforts = 2, persistent coughing = 3). A total score {\textgreater}3 corresponded to non-optimal conditions. Results: Upon CCSP, BIS values were significantly lower in Group 1 [mean (SD): 30 (8) - 48 (18), p {\textless} 0.001], despite significantly higher end-tidal sevoflurane concentration in Group 2 [mean (SD): 5.0 (0.7) - 6.2 (0.5); p {\textless} 0.001]. Time to CCSP was slightly shorter in Group 2. Intubation conditions were always optimal except for one patient of Group 1. Discussion: Both induction techniques achieve good intubating conditions. Possible explanations for the between-group BIS difference include variable appreciation of the CCSP endpoint, different induction lengths or sevoflurane equilibration times, or sevoflurane-induced increase in electroencephalogram power. A better indicator of the best time to intubate is needed to avoid too deep anesthesia in children. Copyright © Ada Anaesthesiologica Belgica, 2016.},
journal = {Acta Anaesthesiologica Belgica},
author = {{Hallet C.} and {Venneman I.} and {Hans G.} and {Bonhomme V.}},
year = {2016},
keywords = {*anesthesia induction, *anesthesia level, *bispectral index, *endotracheal intubation, *face, *pediatric face mask, *pediatric face mask/ct [Clinical Trial], *sevoflurane, Child, anesthesiology monitoring device, article, assisted ventilation, bispectral index, clinical article, clinical trial, controlled clinical trial, controlled study, coughing, double blind procedure, endotracheal tube cuff, exposure, general anesthesia, human, intermethod comparison, jaw, laryngoscopy, leisure, manual ventilation, mechanical ventilator, oxygen, parental consent, physician, prospective study, randomized controlled trial, rebreathing device, sevoflurane/ih [Inhalational Drug Administration], single blind procedure, unconsciousness, vocal cord}
}Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service. Vassiliou L.-V., Kim E.E.-Y., Williams L., & Bentley R.P. 2016.
abstract bibtex
abstract bibtex
Background: Early decompressive craniectomy (DC) for malignant middle cerebral artery (MCA) infarction leads to improved survival, as demonstrated by three multicenter randomized controlled trials (DECIMAL, DESTINY, HAMLET). The survivors of a malignant MCA stroke manifest complex medical and neurological problems along with extensive calvarial defects that require cranioplasty.Aims and methodology: This is a retrospective study from a tertiary referral center. We assess the impact of the new MCA stroke guidelines in the number of craniectomy patients referred for cranioplasty. We analyze the postoperative course of this specific subgroup of patients and we compare it against the contemporary cranioplasties population (craniectomy defects following traumatic brain injury, hemorrhagic strokes, oncological ablation, or infections).Results: Data of 78 patients (46 male, 32 female) referred for cranioplasty were analyzed over a 2-year period. Mean age was 42 years (range 12-73). In a representative year (2011), prior to the new stroke guidelines, only 4/30 (13%) cases had DC for malignant MCA infarction, whereas subsequently in 2015, 15/48 (31%) of the cranioplasty candidates had previously suffered malignant MCA infarction. Whilst the majority of patients were discharged on the third postoperative day and the overall complication rate was low (7%), the postoperative course of post-malignant MCA patients was often complicated due to associated medical comorbidities leading to prolonged hospital stay.Conclusion: Reconstruction of the cranial vault in patients post-craniectomy for malignant MCA infarction poses complex perioperative challenges. The increasing demand for cranioplasty in this subset of patients necessitates appropriate neuro-intensive care infrastructure and expertise.
@misc{vassiliou_l.-v._impact_2016,
title = {Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service},
abstract = {Background: Early decompressive craniectomy (DC) for malignant middle cerebral artery (MCA) infarction leads to improved survival, as demonstrated by three multicenter randomized controlled trials (DECIMAL, DESTINY, HAMLET). The survivors of a malignant MCA stroke manifest complex medical and neurological problems along with extensive calvarial defects that require cranioplasty.Aims and methodology: This is a retrospective study from a tertiary referral center. We assess the impact of the new MCA stroke guidelines in the number of craniectomy patients referred for cranioplasty. We analyze the postoperative course of this specific subgroup of patients and we compare it against the contemporary cranioplasties population (craniectomy defects following traumatic brain injury, hemorrhagic strokes, oncological ablation, or infections).Results: Data of 78 patients (46 male, 32 female) referred for cranioplasty were analyzed over a 2-year period. Mean age was 42 years (range 12-73). In a representative year (2011), prior to the new stroke guidelines, only 4/30 (13\%) cases had DC for malignant MCA infarction, whereas subsequently in 2015, 15/48 (31\%) of the cranioplasty candidates had previously suffered malignant MCA infarction. Whilst the majority of patients were discharged on the third postoperative day and the overall complication rate was low (7\%), the postoperative course of post-malignant MCA patients was often complicated due to associated medical comorbidities leading to prolonged hospital stay.Conclusion: Reconstruction of the cranial vault in patients post-craniectomy for malignant MCA infarction poses complex perioperative challenges. The increasing demand for cranioplasty in this subset of patients necessitates appropriate neuro-intensive care infrastructure and expertise.},
journal = {British Journal of Oral and Maxillofacial Surgery},
author = {{Vassiliou L.-V.} and {Kim E.E.-Y.} and {Williams L.} and {Bentley R.P.}},
year = {2016},
keywords = {*cerebral artery disease, *consensus development, *cranioplasty, Child, adolescent, adult, aged, brain hemorrhage, cancer epidemiology, clinical trial, comorbidity, controlled clinical trial, controlled study, decompressive craniectomy, female, hospitalization, human, infection, intensive care, major clinical study, male, multicenter study, randomized controlled trial, retrospective study, surgery, survivor, tertiary care center, traumatic brain injury}
}Apneic oxygenation: A method to prolong the period of safe apnea. Pratt M. & Miller A.B. 2016.
Paper abstract bibtex
Paper abstract bibtex A difficult intubation poses one of the most challenging tasks for anesthesia professionals, representing 27% of all adverse respiratory events, 93% of which are unanticipated. Unanticipated difficult mask ventilation and intubation may result in serious complications. Safe airway management requires a proper and thorough preoperative airway evaluation and a plan to secure the airway, with alternate plans available when the initial plan fails. Pediatric, obese, and obstetric patients undergoing general anesthesia with endotracheal intubation are considered to be at risk of rapid desaturation. As an adjunct to conventional preoxygenation techniques, continuous oxygen administration during the apneic period, termed apneic oxygenation, assists in the maintenance of oxygenation when tracheal intubation is attempted. Nine articles were selected for appraisal in this literature review: 6 randomized control trials, 2 prospective studies, and 1 retrospective study. Multiple apneic oxygenation techniques, including nasopharyngeal catheter, nasal prongs, endotracheal tube, intratracheal catheter, and high-flow transnasal humidified oxygen, demonstrated effectiveness at delaying the onset of hypoxemia during the apnea period. Prolonging the apneic window changes the nature of airway management in patients at high risk of desaturation and when an unanticipated difficult airway arises.
@misc{pratt_m._apneic_2016,
title = {Apneic oxygenation: {A} method to prolong the period of safe apnea},
url = {http://www.aana.com/newsandjournal/20102019/apneic-oxygenation-1016-pp322-328.pdf},
abstract = {A difficult intubation poses one of the most challenging tasks for anesthesia professionals, representing 27\% of all adverse respiratory events, 93\% of which are unanticipated. Unanticipated difficult mask ventilation and intubation may result in serious complications. Safe airway management requires a proper and thorough preoperative airway evaluation and a plan to secure the airway, with alternate plans available when the initial plan fails. Pediatric, obese, and obstetric patients undergoing general anesthesia with endotracheal intubation are considered to be at risk of rapid desaturation. As an adjunct to conventional preoxygenation techniques, continuous oxygen administration during the apneic period, termed apneic oxygenation, assists in the maintenance of oxygenation when tracheal intubation is attempted. Nine articles were selected for appraisal in this literature review: 6 randomized control trials, 2 prospective studies, and 1 retrospective study. Multiple apneic oxygenation techniques, including nasopharyngeal catheter, nasal prongs, endotracheal tube, intratracheal catheter, and high-flow transnasal humidified oxygen, demonstrated effectiveness at delaying the onset of hypoxemia during the apnea period. Prolonging the apneic window changes the nature of airway management in patients at high risk of desaturation and when an unanticipated difficult airway arises.},
journal = {AANA Journal},
author = {{Pratt M.} and {Miller A.B.}},
year = {2016},
keywords = {*apnea monitoring, *apnea/th [Therapy], *apneic oxygenation, *nasal prong, *nasopharyngeal catheter, *oxygen therapy, *oxygenation, *respiration control, Child, article, carbon dioxide/ec [Endogenous Compound], catheter, clinical effectiveness, controlled clinical trial, controlled study, endotracheal intubation, endotracheal tube, general anesthesia, high flow transnasal humidified oxygen, high risk patient, history of medicine, human, hypoxemia, intratracheal catheter, laryngoscope, nasal prong, nasopharyngeal catheter, obesity, obstetric patient, oxygen, pediatrics, preoperative evaluation, prospective study, randomized controlled trial, randomized controlled trial (topic), respiration control, retrospective study, systematic review}
}Vitamin d deficiency as risk factor for severity of acute lower respiratory tract infections. Cazan C., Neamtu M.L., Neamtu B.M., Bodrug N., & Istrate V. 2016.
abstract bibtex
abstract bibtex
Background and aims Vitamin D deficiency is highly prevalent and it is declared a public health problem for children worldwide. The aim of this study was to investigate the potential relationship between vitamin D deficiency and severity of lower respiratory tract infections. Methods Children aged six to eighteen months, admitted in Pediatric Clinic from September 2015 to March 2016 for lower respiratory tract infection were recruited for the study. Criteria for hospitalization include low oxygen saturation (\textless90-92%), moderate to severe respiratory distress, deshydration and presence of apnea. We measured plasma 25- hydroxyvitamin D concentrations in a random sample of 53 patients. Baseline vitamin D status was classified as deficient level less than 20 ng/mL, insufficient (20-30 ng/mL) or sufficient \textgreater30 ng/mL. Results The prevalence of vitamin D deficiency was 21% and 48% of patients were vitamin D insufficient. Mean +/- SD serum levels of vitamin D were significantly higher (p\textless 0.05) in patients with moderate disease (26.3+/-5.2 ng/mL) compared with those with severe disease (14.5+/-5.9 ng/ mL). Vitamin D deficiency was associated with increased risk of severe bronchiolitis and lower respiratory tract infection in the first year of life. Vitamin D deficiency was associated with a longer length of stay. Vitamin D insufficiency was most commonly diagnosed in the winter / spring season (44%). Conclusions Vitamin D deficiency is related to increased risk and greater severity of respiratory infections. Current recommendations for vitamin D supplementation should be followed especially in infants at high risk.
@misc{cazan_c._vitamin_2016,
title = {Vitamin d deficiency as risk factor for severity of acute lower respiratory tract infections},
abstract = {Background and aims Vitamin D deficiency is highly prevalent and it is declared a public health problem for children worldwide. The aim of this study was to investigate the potential relationship between vitamin D deficiency and severity of lower respiratory tract infections. Methods Children aged six to eighteen months, admitted in Pediatric Clinic from September 2015 to March 2016 for lower respiratory tract infection were recruited for the study. Criteria for hospitalization include low oxygen saturation ({\textless}90-92\%), moderate to severe respiratory distress, deshydration and presence of apnea. We measured plasma 25- hydroxyvitamin D concentrations in a random sample of 53 patients. Baseline vitamin D status was classified as deficient level less than 20 ng/mL, insufficient (20-30 ng/mL) or sufficient {\textgreater}30 ng/mL. Results The prevalence of vitamin D deficiency was 21\% and 48\% of patients were vitamin D insufficient. Mean +/- SD serum levels of vitamin D were significantly higher (p{\textless} 0.05) in patients with moderate disease (26.3+/-5.2 ng/mL) compared with those with severe disease (14.5+/-5.9 ng/ mL). Vitamin D deficiency was associated with increased risk of severe bronchiolitis and lower respiratory tract infection in the first year of life. Vitamin D deficiency was associated with a longer length of stay. Vitamin D insufficiency was most commonly diagnosed in the winter / spring season (44\%). Conclusions Vitamin D deficiency is related to increased risk and greater severity of respiratory infections. Current recommendations for vitamin D supplementation should be followed especially in infants at high risk.},
journal = {European Journal of Pediatrics},
author = {{Cazan C.} and {Neamtu M.L.} and {Neamtu B.M.} and {Bodrug N.} and {Istrate V.}},
year = {2016},
keywords = {*lower respiratory tract infection, *risk factor, *vitamin D deficiency, 25 hydroxyvitamin D, Child, apnea monitoring, bronchiolitis, clinical trial, controlled study, dehydration, diagnosis, hospitalization, human, human tissue, infant, length of stay, major clinical study, oxygen saturation, pediatric hospital, plasma, prevalence, random sample, respiratory distress, spring, winter}
}Automated analysis of overnight oximetry recordings by means of support vector machines to assist in the diagnosis of paediatric sleep apnoea. Sedano A.C., Gonzalez D.A., Kheirandish-Gozal L., Gutierrez-Tobal G.C., Sanchez R.H., Gozal D., & Del Campo Matias F. 2016.
Paper abstract bibtex
Paper abstract bibtex Background. Paediatric obstructive sleep apnoea-hypopnoea syndrome (OSAHS) has emerged as a frequent and concerning medical condition in the past 2-3 decades. In-laboratory overnight polysomnography (PSG) is the gold standard diagnostic technique but is complex and relatively inaccessible. Objectives. Blood oxygen saturation (SpO2) from nocturnal oximetry could provide essential information in order to simplify the diagnostic process. The goal of this study was to design and assess an automated classifier aimed at detecting OSAHS. Methods. The population under study was composed of 176 children referred to the Sleep Unit due to suspected OSAHS. All children underwent complete in-laboratory PSG as gold standard. An apnoeahypopnoea index (AHI) greater than or equal to 5 e/h were considered OSAHScondpositive. The population was randomly divided into training set (60%) and test set (40%). SpO2recordings from PSG were processed offline. Three nonlinear measures were derived from nocturnal SpO2recordings and used to design a support vector machine (SVM) classifier. Conventional oxygen desaturation index of 3% (ODI3) was used for comparison purposes. Results. The SVM classifier reached 85.7% sensitivity, 81.0% specificity, 4.50 LR+, 0.18 LR-, and 82.9% accuracy in the test set. On the contrary, ODI3 achieved 89.3% sensitivity, 69.1% specificity, 2.89 LR+, 0.16 LR-, and 77.1% accuracy in the same test set. Conclusions. The proposed SVM classifier outperforms the conventional desaturation index ODI3. Therefore, SVMs and nonlinear measures could provide useful tools to assist in the diagnosis of paediatric OSAHS.
@misc{sedano_a.c._automated_2016,
title = {Automated analysis of overnight oximetry recordings by means of support vector machines to assist in the diagnosis of paediatric sleep apnoea},
url = {http://erj.ersjournals.com/content/48/suppl_60/OA4556},
abstract = {Background. Paediatric obstructive sleep apnoea-hypopnoea syndrome (OSAHS) has emerged as a frequent and concerning medical condition in the past 2-3 decades. In-laboratory overnight polysomnography (PSG) is the gold standard diagnostic technique but is complex and relatively inaccessible. Objectives. Blood oxygen saturation (SpO2) from nocturnal oximetry could provide essential information in order to simplify the diagnostic process. The goal of this study was to design and assess an automated classifier aimed at detecting OSAHS. Methods. The population under study was composed of 176 children referred to the Sleep Unit due to suspected OSAHS. All children underwent complete in-laboratory PSG as gold standard. An apnoeahypopnoea index (AHI) greater than or equal to 5 e/h were considered OSAHScondpositive. The population was randomly divided into training set (60\%) and test set (40\%). SpO2recordings from PSG were processed offline. Three nonlinear measures were derived from nocturnal SpO2recordings and used to design a support vector machine (SVM) classifier. Conventional oxygen desaturation index of 3\% (ODI3) was used for comparison purposes. Results. The SVM classifier reached 85.7\% sensitivity, 81.0\% specificity, 4.50 LR+, 0.18 LR-, and 82.9\% accuracy in the test set. On the contrary, ODI3 achieved 89.3\% sensitivity, 69.1\% specificity, 2.89 LR+, 0.16 LR-, and 77.1\% accuracy in the same test set. Conclusions. The proposed SVM classifier outperforms the conventional desaturation index ODI3. Therefore, SVMs and nonlinear measures could provide useful tools to assist in the diagnosis of paediatric OSAHS.},
urldate = {0048-01-02},
journal = {European Respiratory Journal},
author = {{Sedano A.C.} and {Gonzalez D.A.} and {Kheirandish-Gozal L.} and {Gutierrez-Tobal G.C.} and {Sanchez R.H.} and {Gozal D.} and {Del Campo Matias F.}},
year = {2016},
keywords = {*oximetry, *sleep disordered breathing, *support vector machine, Child, apnea monitoring, controlled clinical trial, controlled study, diagnosis, endogenous compound, gold standard, human, major clinical study, oxygen desaturation, polysomnography, randomized controlled trial, transcription factor Sp2, transcription factor Sp4}
}Dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia for appropriate surgical field visibility during modified radical mastectomy with i-gel: A randomized control study. Gupta K., Rastogi B., Gupta P.K., Singh I., Singh V.P., & Jain M. 2016.
Paper abstract bibtex
Paper abstract bibtex Background: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. Methods: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each. The patients in Group I received intravenous dexmedetomidine at a loading dose of 1 mug/kg over 10 min, followed by maintenance infusion of 0.4 to 0.7 mug/kg/h, while patients in Group II were administered an identical amount of saline infusion until 15 min prior to the end of surgery. The primary end point was bleeding at the surgical field and hemodynamic changes; requirement of isoflurane, intraoperative fentanyl consumption and recovery time were assessed as secondary outcomes. Results: The patients receiving dexmedetomidine infusion showed significantly less bleeding at the surgical field (P \textless 0.05). A statistically significant reduction was also observed in the percentage of isoflurane required (0.82 +/- 0.80%) to maintain the systolic blood pressure between 100 and 110 mmHg in patients receiving dexmedetomidine infusion compared with the Group II (1.50 +/- 0.90%). The mean intraoperative fentanyl consumption in patients in the Group I was also significantly lower compared with that of the Group II (38.43 +/- 5.40 mug vs. 75.12 +/- 4.60 mug). The mean recovery time from anesthesia did not show any clinically significant difference between the groups. Conclusions: Dexmedetomidine infusion can be used safely to decrease the bleeding at the surgical field with smooth recovery from anesthesia. Copyright © the Korean Society of Anesthesiologists, 2016.
@misc{gupta_k._dexmedetomidine_2016,
title = {Dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia for appropriate surgical field visibility during modified radical mastectomy with i-gel: {A} randomized control study},
url = {http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-69-573.pdf},
abstract = {Background: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. Methods: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each. The patients in Group I received intravenous dexmedetomidine at a loading dose of 1 mug/kg over 10 min, followed by maintenance infusion of 0.4 to 0.7 mug/kg/h, while patients in Group II were administered an identical amount of saline infusion until 15 min prior to the end of surgery. The primary end point was bleeding at the surgical field and hemodynamic changes; requirement of isoflurane, intraoperative fentanyl consumption and recovery time were assessed as secondary outcomes. Results: The patients receiving dexmedetomidine infusion showed significantly less bleeding at the surgical field (P {\textless} 0.05). A statistically significant reduction was also observed in the percentage of isoflurane required (0.82 +/- 0.80\%) to maintain the systolic blood pressure between 100 and 110 mmHg in patients receiving dexmedetomidine infusion compared with the Group II (1.50 +/- 0.90\%). The mean intraoperative fentanyl consumption in patients in the Group I was also significantly lower compared with that of the Group II (38.43 +/- 5.40 mug vs. 75.12 +/- 4.60 mug). The mean recovery time from anesthesia did not show any clinically significant difference between the groups. Conclusions: Dexmedetomidine infusion can be used safely to decrease the bleeding at the surgical field with smooth recovery from anesthesia. Copyright © the Korean Society of Anesthesiologists, 2016.},
journal = {Korean Journal of Anesthesiology},
author = {{Gupta K.} and {Rastogi B.} and {Gupta P.K.} and {Singh I.} and {Singh V.P.} and {Jain M.}},
year = {2016},
keywords = {*adjuvant, *anesthesia, *bleeding, *dexmedetomidine, *dexmedetomidine/ae [Adverse Drug Reaction], *dexmedetomidine/iv [Intravenous Drug Administration], *general anesthesia, *infusion, *modified radical mastectomy, *supraglottic airway device, *visibility, Child, adjuvant therapy, adult, anesthesist, anesthetic recovery, article, artificial ventilation, bradycardia, clinical trial, comparative effectiveness, continuous infusion, controlled clinical trial, controlled study, diclofenac/im [Intramuscular Drug Administration], double blind procedure, electrocardiography, end tidal carbon dioxide tension, female, fentanyl, fentanyl/iv [Intravenous Drug Administration], glycopyrronium/im [Intramuscular Drug Administration], human, isoflurane, isoflurane/cb [Drug Combination], isoflurane/cm [Drug Comparison], loading drug dose, major clinical study, midazolam/iv [Intravenous Drug Administration], middle aged, neostigmine, nitrous oxide plus oxygen/cb [Drug Combination], non invasive blood pressure monitor, operative blood loss, oxygen saturation, palonosetron/iv [Intravenous Drug Administration], postoperative nausea and vomiting/si [Side Effect], preschool child, propofol/cb [Drug Combination], prospective study, randomized controlled trial, respiration depression/si [Side Effect], shivering/si [Side Effect], sodium chloride, supraglottic airway device, surgery, systolic blood pressure, tachycardia, tidal volume, vecuronium}
}2015 (3)
Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II. Yanchar, N., L., Young, J., B., & Langille, D., B. Accident; analysis and prevention, Elsevier Ltd, 1, 2015.
Website bibtex
Website bibtex @article{
title = {Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II.},
type = {article},
year = {2015},
identifiers = {[object Object]},
keywords = {Booster seats,Child,Child restraint systems/utilization,Health knowledge/attitudes/practice,Parents/education},
volume = {74},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/25463955},
month = {1},
publisher = {Elsevier Ltd},
id = {267853cb-3aca-3183-ab42-8fb73523d42f},
created = {2016-09-13T00:48:10.000Z},
accessed = {2016-09-05},
file_attached = {false},
profile_id = {c7856f8a-4963-3e63-90cb-57986d91c9b0},
group_id = {1fd78437-06d9-37cf-b89d-417b03940b66},
last_modified = {2016-09-13T00:58:21.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
bibtype = {article},
author = {Yanchar, Natalie L. and Young, Julian B. and Langille, Donald B.},
journal = {Accident; analysis and prevention}
}Anthropometric models of bone mineral content and areal bone mineral density based on the bone mineral density in childhood study. Short, D. F., Gilsanz, V., Kalkwarf, H. J., Lappe, J. M., Oberfield, S., Shepherd, J. A., Winer, K. K., Zemel, B. S., & Hangartner, T. N. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 26(3):1099–1108, March, 2015.
doi abstract bibtex
doi abstract bibtex
New models describing anthropometrically adjusted normal values of bone mineral density and content in children have been created for the various measurement sites. The inclusion of multiple explanatory variables in the models provides the opportunity to calculate Z-scores that are adjusted with respect to the relevant anthropometric parameters. INTRODUCTION: Previous descriptions of children's bone mineral measurements by age have focused on segmenting diverse populations by race and sex without adjusting for anthropometric variables or have included the effects of a single anthropometric variable. METHODS: We applied multivariate semi-metric smoothing to the various pediatric bone-measurement sites using data from the Bone Mineral Density in Childhood Study to evaluate which of sex, race, age, height, weight, percent body fat, and sexual maturity explain variations in the population's bone mineral values. By balancing high adjusted R(2) values with clinical needs, two models are examined. RESULTS: At the spine, whole body, whole body sub head, total hip, hip neck, and forearm sites, models were created using sex, race, age, height, and weight as well as an additional set of models containing these anthropometric variables and percent body fat. For bone mineral density, weight is more important than percent body fat, which is more important than height. For bone mineral content, the order varied by site with body fat being the weakest component. Including more anthropometrics in the model reduces the overlap of the critical groups, identified as those individuals with a Z-score below -2, from the standard sex, race, and age model. CONCLUSIONS: If body fat is not available, the simpler model including height and weight should be used. The inclusion of multiple explanatory variables in the models provides the opportunity to calculate Z-scores that are adjusted with respect to the relevant anthropometric parameters.
@article{short_anthropometric_2015,
title = {Anthropometric models of bone mineral content and areal bone mineral density based on the bone mineral density in childhood study},
volume = {26},
issn = {1433-2965},
doi = {10.1007/s00198-014-2916-x},
abstract = {New models describing anthropometrically adjusted normal values of bone mineral density and content in children have been created for the various measurement sites. The inclusion of multiple explanatory variables in the models provides the opportunity to calculate Z-scores that are adjusted with respect to the relevant anthropometric parameters.
INTRODUCTION: Previous descriptions of children's bone mineral measurements by age have focused on segmenting diverse populations by race and sex without adjusting for anthropometric variables or have included the effects of a single anthropometric variable.
METHODS: We applied multivariate semi-metric smoothing to the various pediatric bone-measurement sites using data from the Bone Mineral Density in Childhood Study to evaluate which of sex, race, age, height, weight, percent body fat, and sexual maturity explain variations in the population's bone mineral values. By balancing high adjusted R(2) values with clinical needs, two models are examined.
RESULTS: At the spine, whole body, whole body sub head, total hip, hip neck, and forearm sites, models were created using sex, race, age, height, and weight as well as an additional set of models containing these anthropometric variables and percent body fat. For bone mineral density, weight is more important than percent body fat, which is more important than height. For bone mineral content, the order varied by site with body fat being the weakest component. Including more anthropometrics in the model reduces the overlap of the critical groups, identified as those individuals with a Z-score below -2, from the standard sex, race, and age model.
CONCLUSIONS: If body fat is not available, the simpler model including height and weight should be used. The inclusion of multiple explanatory variables in the models provides the opportunity to calculate Z-scores that are adjusted with respect to the relevant anthropometric parameters.},
language = {eng},
number = {3},
journal = {Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA},
author = {Short, D. F. and Gilsanz, V. and Kalkwarf, H. J. and Lappe, J. M. and Oberfield, S. and Shepherd, J. A. and Winer, K. K. and Zemel, B. S. and Hangartner, T. N.},
month = mar,
year = {2015},
pmid = {25311106},
pmcid = {PMC4768717},
keywords = {Absorptiometry, Photon, Adipose Tissue, Adolescent, Age Factors, Algorithms, Anthropometry, Body Height, Body Weight, Bone Density, Bone and Bones, Child, Child, Preschool, Continental Population Groups, Female, Humans, Longitudinal Studies, Male, Models, Theoretical, Sex Factors, Young Adult},
pages = {1099--1108}
}Dexmedetomidine in the pediatric population: A review. Plambech M.Z. & Afshari A. 2015.
Paper abstract bibtex
Paper abstract bibtex Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution, as adjunct for elective surgery, as sedative for magnetic resonance imaging, as intraoperative analgesia, for extracorporeal shock wave lithotripsy, and as adjuvant to ropi- and bupivacaine for nerve blocks. Dexmedetomidine is also used intravenously at different intensive care units with the purpose of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse effects. However, it is important to state that much of the existing evidence favoring dexmedetomidine in children is either extrapolated from adult studies or based on small randomized controlled trials and observational studies with their inherent methodological shortcomings and confounding factors. Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials. Finally, we provide the readers with guidance on how to apply and dose dexmedetomidine for pediatric sedation and for other indications. Copyright COPYRIGHT © 2015 EDIZIONI MINERVA MEDICA.
@misc{plambech_m.z._dexmedetomidine_2015,
title = {Dexmedetomidine in the pediatric population: {A} review},
url = {http://www.minervamedica.it/en/getpdf/sbNvoPlJhvv6bbyfsqY76tEZcB64PRPRZhQ7XFLHe60Q6OIPvcRxmU6QbTTdsDC59xcyai%252BPQuY95g446wPjIA%253D%253D/R02Y2015N03A0320.pdf},
abstract = {Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution, as adjunct for elective surgery, as sedative for magnetic resonance imaging, as intraoperative analgesia, for extracorporeal shock wave lithotripsy, and as adjuvant to ropi- and bupivacaine for nerve blocks. Dexmedetomidine is also used intravenously at different intensive care units with the purpose of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse effects. However, it is important to state that much of the existing evidence favoring dexmedetomidine in children is either extrapolated from adult studies or based on small randomized controlled trials and observational studies with their inherent methodological shortcomings and confounding factors. Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials. Finally, we provide the readers with guidance on how to apply and dose dexmedetomidine for pediatric sedation and for other indications. Copyright COPYRIGHT © 2015 EDIZIONI MINERVA MEDICA.},
journal = {Minerva Anestesiologica},
author = {{Plambech M.Z.} and {Afshari A.}},
year = {2015},
keywords = {*anesthesia, *child, *deep sedation, *dexmedetomidine, *dexmedetomidine/ae [Adverse Drug Reaction], *dexmedetomidine/ct [Clinical Trial], *dexmedetomidine/na [Intranasal Drug Administration], *human, *pediatrics, *population, Child, Europe, adjuvant, adolescent, adult, adverse drug reaction, agitation, agonist, analgesia, article, bupivacaine, cardiovascular effect, clinical protocol, elective surgery, extracorporeal lithotripsy, human, infant, intensive care, intensive care unit, intranasal drug administration, intraoperative analgesia, intraoperative period, meta analysis (topic), nerve block, newborn, nuclear magnetic resonance imaging, observational study, patient, pediatrics, perioperative period, phase 1 clinical trial (topic), premedication, procedures, randomized controlled trial (topic), reading, safety, sedation, sedative agent, side effect/si [Side Effect], systematic review (topic)}
}2014 (2)
Fatal unintentional non-fire-related carbon monoxide poisoning: England and Wales, 1979-2012. Fisher, D. S., Leonardi, G., & Flanagan, R. J. Clinical Toxicology (Philadelphia, Pa.), 52(3):166--170, March, 2014. 00006
doi abstract bibtex
doi abstract bibtex
CONTEXT: Unintentional carbon monoxide poisoning remains a significant cause of morbidity and mortality in England and Wales. METHODS. STUDY DESIGN: observational case series. Data on fatal carbon monoxide poisoning in England and Wales from 1979 to 2012 were obtained from coroner reports. Data on unintentional non-fire-related carbon monoxide poisoning were extracted and were analysed by year of registration of death, sex, age group, and whether death occurred at a private house, flat, associated garage, or residential caravan ('home'), or elsewhere. RESULTS AND DISCUSSION: There were 28,944 carbon monoxide-related deaths, of which 82% were male. Deaths increased from 965 (1979) to 1700 (1987), and then fell to 182 (2012). Of these 2208 (64% male) were recorded as unintentional non-fire-related deaths. Annual numbers of these latter deaths fell from 166 in 1979 to 25 in 2012 (i.e. from 3.37 to 0.44 per million population). Some 81 and 92% of such deaths in males and in females, respectively, occurred at 'home'. A clear preponderance of male versus female deaths was seen in the 10-19, 20-39 and 40-64 years age groups, with similar numbers of deaths in males and in females in the younger (\textless 1 and 1-9 year) and higher (65-79 and 80 + years) age groups. A higher proportion of these excess deaths in males occurred outside the deceased's 'home' in those aged 10-19, 20-39 and 40-64 years. CONCLUSION: Deaths from unintentional non-fire-related carbon monoxide poisoning are now much less common in England and Wales than in earlier years, but remain a cause for concern. Installation and proper maintenance of carbon monoxide alarms in dwellings and outhouses, for example, and education not only of the public, but also of health and other professionals as to the danger posed by carbon monoxide could help prevent such deaths.
@article{fisher_fatal_2014,
title = {Fatal unintentional non-fire-related carbon monoxide poisoning: {England} and {Wales}, 1979-2012},
volume = {52},
issn = {1556-9519},
shorttitle = {Fatal unintentional non-fire-related carbon monoxide poisoning},
doi = {10.3109/15563650.2014.887092},
abstract = {CONTEXT: Unintentional carbon monoxide poisoning remains a significant cause of morbidity and mortality in England and Wales. METHODS.
STUDY DESIGN: observational case series. Data on fatal carbon monoxide poisoning in England and Wales from 1979 to 2012 were obtained from coroner reports. Data on unintentional non-fire-related carbon monoxide poisoning were extracted and were analysed by year of registration of death, sex, age group, and whether death occurred at a private house, flat, associated garage, or residential caravan ('home'), or elsewhere.
RESULTS AND DISCUSSION: There were 28,944 carbon monoxide-related deaths, of which 82\% were male. Deaths increased from 965 (1979) to 1700 (1987), and then fell to 182 (2012). Of these 2208 (64\% male) were recorded as unintentional non-fire-related deaths. Annual numbers of these latter deaths fell from 166 in 1979 to 25 in 2012 (i.e. from 3.37 to 0.44 per million population). Some 81 and 92\% of such deaths in males and in females, respectively, occurred at 'home'. A clear preponderance of male versus female deaths was seen in the 10-19, 20-39 and 40-64 years age groups, with similar numbers of deaths in males and in females in the younger ({\textless} 1 and 1-9 year) and higher (65-79 and 80 + years) age groups. A higher proportion of these excess deaths in males occurred outside the deceased's 'home' in those aged 10-19, 20-39 and 40-64 years.
CONCLUSION: Deaths from unintentional non-fire-related carbon monoxide poisoning are now much less common in England and Wales than in earlier years, but remain a cause for concern. Installation and proper maintenance of carbon monoxide alarms in dwellings and outhouses, for example, and education not only of the public, but also of health and other professionals as to the danger posed by carbon monoxide could help prevent such deaths.},
language = {eng},
number = {3},
journal = {Clinical Toxicology (Philadelphia, Pa.)},
author = {Fisher, D. S. and Leonardi, G. and Flanagan, R. J.},
month = mar,
year = {2014},
pmid = {24533843},
note = {00006 },
keywords = {Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Carbon Monoxide Poisoning, Child, England, Female, Humans, Male, Middle Aged, Sex Characteristics, Time Factors, Wales},
pages = {166--170}
}Serious adverse effects from single-use detergent sacs: report from a U.S. statewide poison control system. Huntington, S., Heppner, J., Vohra, R., Mallios, R., & Geller, R. J. Clinical Toxicology (Philadelphia, Pa.), 52(3):220--225, March, 2014.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: In recent years, serious adverse effects to children from exposure to single-use detergents sacs (SUDS) have been recognized. While most exposures result in minor symptoms, there have been serious outcomes. This study aims to classify which types of serious outcomes follow SUDS exposures, and to assess, if possible, differences in toxicity between various SUDS products. METHODS: An observational case series with data collected retrospectively was performed for cases of SUDS exposures reported to a statewide poison system's records database from 1 January 2012 to 31 March 2013. Cases were identified and analyzed for clinical details and trends. A statewide database was queried for cases involving the American Association of Poison Control Centers (AAPCC) product-specific codes for SUDS products using following search terms: laundry pods, the AAPCC product-specific codes for Tide Pods, Purex Ultrapacks, ALL Mighty Pacs, and a unique agent code (AAPCC ID: 6903138; Generic: 077900) created by AAPCC to track SUDS exposures. RESULTS: A total of 804 cases of exposures to SUDS were identified, the majority of which were exploratory ingestions in young children with a median age of 2 years. Serious adverse effects resulted from 65 (9%) exposures and 27 (3%) exposures resulted in admission to hospital. Binary logistic regression demonstrated that the presence of central nervous system (CNS) or respiratory system effects were associated with more severe outcomes, with a model accuracy of 96.4%. There were significant differences in morbidity among the three most common brand-name products: when compared with Tide Pods, odds ratios (OR) and 95% confidence intervals (CI) for severe outcome and admission rate were significantly greater following Purex Ultrapack exposures (severity OR 5.1 [CI: 2.13-12.23]; admission OR 10.36 [CI: 3.23-33.22]) and ALL Mighty Pac exposures (severity OR 11.22 [CI: 4.78-28.36]; admission OR 15.20 [CI: 5.01-46.12]). CONCLUSIONS: Serious complications from exposure to SUDS occur in a small number of exposures for unclear reasons. Respiratory and CNS effects are associated with more severe outcomes. Some brand-name products are associated with a relatively higher risk of severe adverse effects and rates of admission.
@article{huntington_serious_2014,
title = {Serious adverse effects from single-use detergent sacs: report from a {U}.{S}. statewide poison control system},
volume = {52},
issn = {1556-9519},
shorttitle = {Serious adverse effects from single-use detergent sacs},
doi = {10.3109/15563650.2014.892122},
abstract = {BACKGROUND: In recent years, serious adverse effects to children from exposure to single-use detergents sacs (SUDS) have been recognized. While most exposures result in minor symptoms, there have been serious outcomes. This study aims to classify which types of serious outcomes follow SUDS exposures, and to assess, if possible, differences in toxicity between various SUDS products.
METHODS: An observational case series with data collected retrospectively was performed for cases of SUDS exposures reported to a statewide poison system's records database from 1 January 2012 to 31 March 2013. Cases were identified and analyzed for clinical details and trends. A statewide database was queried for cases involving the American Association of Poison Control Centers (AAPCC) product-specific codes for SUDS products using following search terms: laundry pods, the AAPCC product-specific codes for Tide Pods, Purex Ultrapacks, ALL Mighty Pacs, and a unique agent code (AAPCC ID: 6903138; Generic: 077900) created by AAPCC to track SUDS exposures.
RESULTS: A total of 804 cases of exposures to SUDS were identified, the majority of which were exploratory ingestions in young children with a median age of 2 years. Serious adverse effects resulted from 65 (9\%) exposures and 27 (3\%) exposures resulted in admission to hospital. Binary logistic regression demonstrated that the presence of central nervous system (CNS) or respiratory system effects were associated with more severe outcomes, with a model accuracy of 96.4\%. There were significant differences in morbidity among the three most common brand-name products: when compared with Tide Pods, odds ratios (OR) and 95\% confidence intervals (CI) for severe outcome and admission rate were significantly greater following Purex Ultrapack exposures (severity OR 5.1 [CI: 2.13-12.23]; admission OR 10.36 [CI: 3.23-33.22]) and ALL Mighty Pac exposures (severity OR 11.22 [CI: 4.78-28.36]; admission OR 15.20 [CI: 5.01-46.12]).
CONCLUSIONS: Serious complications from exposure to SUDS occur in a small number of exposures for unclear reasons. Respiratory and CNS effects are associated with more severe outcomes. Some brand-name products are associated with a relatively higher risk of severe adverse effects and rates of admission.},
language = {eng},
number = {3},
journal = {Clinical Toxicology (Philadelphia, Pa.)},
author = {Huntington, S. and Heppner, J. and Vohra, R. and Mallios, R. and Geller, R. J.},
month = mar,
year = {2014},
pmid = {24580062},
keywords = {Adolescent, Child, Child, Preschool, Detergents, Humans, Infant, Infant, Newborn, Logistic Models, Poison Control Centers, Retrospective Studies, United States},
pages = {220--225}
}2013 (9)
Epidemiological features and risk factors of Salmonella gastroenteritis in children resident in Ho Chi Minh City, Vietnam. Thompson, C. N., Phan, V. T. M., Le, T. P. T., Pham, T. N. T., Hoang, L. P., Ha, V., Nguyen, V. M. H., Pham, V. M., Nguyen, T. V., Cao, T. T., Tran, T. T. N., Nguyen, T. T. H., Dao, M. T., Campbell, J. I., Nguyen, T. C., Tang, C. T., Ha, M. T., Farrar, J., & Baker, S. Epidemiology and infection, 141(8):1604–1613, August, 2013.
doi abstract bibtex
doi abstract bibtex
Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged \textless5 years in Ho Chi Minh City to define the epidemiology and examine risk factors associated with Salmonella diarrhoeal infections. From 1419 diarrhoea cases and 571 controls enrolled between 2009 and 2010, 77 (54%) diarrhoea cases were stool culture-positive for non-typhoidal Salmonella. Salmonella patients were more likely to be younger than controls (median age 10 and 12 months, respectively) [odds ratio (OR) 097; 95% confidence interval (CI) 094-099], to report a recent diarrhoeal contact (81% cases, 18% controls; OR 598, 95% CI 18-204) and to live in a household with \textgreater2 children (cases 208%, controls 102%; OR 232, 95% CI 12-47). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home.
@article{thompson_epidemiological_2013,
title = {Epidemiological features and risk factors of {Salmonella} gastroenteritis in children resident in {Ho} {Chi} {Minh} {City}, {Vietnam}.},
volume = {141},
issn = {1469-4409 0950-2688},
doi = {10.1017/S0950268812002014},
abstract = {Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged {\textless}5 years in Ho Chi Minh City to define the epidemiology and examine risk factors associated with Salmonella diarrhoeal infections. From 1419 diarrhoea cases and 571 controls enrolled between 2009 and 2010, 77 (54\%) diarrhoea cases were stool culture-positive for non-typhoidal Salmonella. Salmonella patients were more likely to be younger than controls (median age 10 and 12 months, respectively) [odds ratio (OR) 097; 95\% confidence interval (CI) 094-099], to report a recent diarrhoeal contact (81\% cases, 18\% controls; OR 598, 95\% CI 18-204) and to live in a household with {\textgreater}2 children (cases 208\%, controls 102\%; OR 232, 95\% CI 12-47). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home.},
language = {eng},
number = {8},
journal = {Epidemiology and infection},
author = {Thompson, C. N. and Phan, V. T. M. and Le, T. P. T. and Pham, T. N. T. and Hoang, L. P. and Ha, V. and Nguyen, V. M. H. and Pham, V. M. and Nguyen, T. V. and Cao, T. T. and Tran, T. T. N. and Nguyen, T. T. H. and Dao, M. T. and Campbell, J. I. and Nguyen, T. C. and Tang, C. T. and Ha, M. T. and Farrar, J. and Baker, S.},
month = aug,
year = {2013},
pmid = {23010148},
pmcid = {PMC3733064},
keywords = {*Developing Countries, Bacterial Typing Techniques, Case-Control Studies, Child, Preschool, Diarrhea/*epidemiology/microbiology, Feces/microbiology, Female, Gastroenteritis/*epidemiology/microbiology, Humans, Infant, Male, Prevalence, Risk Factors, Salmonella Infections/*epidemiology/microbiology/transmission, Salmonella/*isolation \& purification, Surveys and Questionnaires, Urban Population, Vietnam/epidemiology},
pages = {1604--1613},
}Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. Starmer, A., J., Sectish, T., C., Simon, D., W., Keohane, C., McSweeney, M., E., Chung, E., Y., Yoon, C., S., Lipsitz, S., R., Wassner, A., J., Harper, M., B., & Landrigan, C., P. JAMA : the journal of the American Medical Association, 310(21):2262-2270, 12, 2013.
abstract bibtex
abstract bibtex
IMPORTANCE: Handoff miscommunications are a leading cause of medical errors. Studies comprehensively assessing handoff improvement programs are lacking. OBJECTIVE: To determine whether introduction of a multifaceted handoff program was associated with reduced rates of medical errors and preventable adverse events, fewer omissions of key data in written handoffs, improved verbal handoffs, and changes in resident-physician workflow. DESIGN, SETTING, AND PARTICIPANTS: Prospective intervention study of 1255 patient admissions (642 before and 613 after the intervention) involving 84 resident physicians (42 before and 42 after the intervention) from July-September 2009 and November 2009-January 2010 on 2 inpatient units at Boston Children's Hospital. INTERVENTIONS: Resident handoff bundle, consisting of standardized communication and handoff training, a verbal mnemonic, and a new team handoff structure. On one unit, a computerized handoff tool linked to the electronic medical record was introduced. MAIN OUTCOMES AND MEASURES: The primary outcomes were the rates of medical errors and preventable adverse events measured by daily systematic surveillance. The secondary outcomes were omissions in the printed handoff document and resident time-motion activity. RESULTS: Medical errors decreased from 33.8 per 100 admissions (95% CI, 27.3-40.3) to 18.3 per 100 admissions (95% CI, 14.7-21.9; P < .001), and preventable adverse events decreased from 3.3 per 100 admissions (95% CI, 1.7-4.8) to 1.5 (95% CI, 0.51-2.4) per 100 admissions (P = .04) following the intervention. There were fewer omissions of key handoff elements on printed handoff documents, especially on the unit that received the computerized handoff tool (significant reductions of omissions in 11 of 14 categories with computerized tool; significant reductions in 2 of 14 categories without computerized tool). Physicians spent a greater percentage of time in a 24-hour period at the patient bedside after the intervention (8.3%; 95% CI 7.1%-9.8%) vs 10.6% (95% CI, 9.2%-12.2%; P = .03). The average duration of verbal handoffs per patient did not change. Verbal handoffs were more likely to occur in a quiet location (33.3%; 95% CI, 14.5%-52.2% vs 67.9%; 95% CI, 50.6%-85.2%; P = .03) and private location (50.0%; 95% CI, 30%-70% vs 85.7%; 95% CI, 72.8%-98.7%; P = .007) after the intervention. CONCLUSIONS AND RELEVANCE: Implementation of a handoff bundle was associated with a significant reduction in medical errors and preventable adverse events among hospitalized children. Improvements in verbal and written handoff processes occurred, and resident workflow did not change adversely.
@article{
title = {Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle},
type = {article},
year = {2013},
identifiers = {[object Object]},
keywords = {Boston,Child,Child, Hospitalized,Communication,Electronic Health Records,Female,Hospitals, Pediatric,Humans,Internship and Residency,Intervention Studies,Male,Medical Errors/prevention & control,Patient Admission,Patient Care Team,Patient Handoff/standards,Prospective Studies,Workload},
pages = {2262-2270},
volume = {310},
month = {12},
day = {4},
city = {Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts2Doernbecher Children's Hospital, Oregon Health and Science University, Portland.},
id = {018db06d-f7e0-3911-8657-5e153547e9fc},
created = {2016-08-21T22:18:53.000Z},
file_attached = {false},
profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
last_modified = {2017-03-14T09:54:45.334Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {JOUR},
notes = {ID: 67732; GR: 1K12HS019456-01/HS/AHRQ HHS/United States; GR: T32 HP10018/PHS HHS/United States; GR: UL1TR000128/TR/NCATS NIH HHS/United States; JID: 7501160; CIN: JAMA. 2013 Dec 4;310(21):2255-6. PMID: 24302086; ppublish},
folder_uuids = {4da8a58e-a2c5-4458-a19c-93e568b77eb4,4481d550-f7a1-48e7-874d-7663267b606b},
private_publication = {false},
abstract = {IMPORTANCE: Handoff miscommunications are a leading cause of medical errors. Studies comprehensively assessing handoff improvement programs are lacking. OBJECTIVE: To determine whether introduction of a multifaceted handoff program was associated with reduced rates of medical errors and preventable adverse events, fewer omissions of key data in written handoffs, improved verbal handoffs, and changes in resident-physician workflow. DESIGN, SETTING, AND PARTICIPANTS: Prospective intervention study of 1255 patient admissions (642 before and 613 after the intervention) involving 84 resident physicians (42 before and 42 after the intervention) from July-September 2009 and November 2009-January 2010 on 2 inpatient units at Boston Children's Hospital. INTERVENTIONS: Resident handoff bundle, consisting of standardized communication and handoff training, a verbal mnemonic, and a new team handoff structure. On one unit, a computerized handoff tool linked to the electronic medical record was introduced. MAIN OUTCOMES AND MEASURES: The primary outcomes were the rates of medical errors and preventable adverse events measured by daily systematic surveillance. The secondary outcomes were omissions in the printed handoff document and resident time-motion activity. RESULTS: Medical errors decreased from 33.8 per 100 admissions (95% CI, 27.3-40.3) to 18.3 per 100 admissions (95% CI, 14.7-21.9; P < .001), and preventable adverse events decreased from 3.3 per 100 admissions (95% CI, 1.7-4.8) to 1.5 (95% CI, 0.51-2.4) per 100 admissions (P = .04) following the intervention. There were fewer omissions of key handoff elements on printed handoff documents, especially on the unit that received the computerized handoff tool (significant reductions of omissions in 11 of 14 categories with computerized tool; significant reductions in 2 of 14 categories without computerized tool). Physicians spent a greater percentage of time in a 24-hour period at the patient bedside after the intervention (8.3%; 95% CI 7.1%-9.8%) vs 10.6% (95% CI, 9.2%-12.2%; P = .03). The average duration of verbal handoffs per patient did not change. Verbal handoffs were more likely to occur in a quiet location (33.3%; 95% CI, 14.5%-52.2% vs 67.9%; 95% CI, 50.6%-85.2%; P = .03) and private location (50.0%; 95% CI, 30%-70% vs 85.7%; 95% CI, 72.8%-98.7%; P = .007) after the intervention. CONCLUSIONS AND RELEVANCE: Implementation of a handoff bundle was associated with a significant reduction in medical errors and preventable adverse events among hospitalized children. Improvements in verbal and written handoff processes occurred, and resident workflow did not change adversely.},
bibtype = {article},
author = {Starmer, A J and Sectish, T C and Simon, D W and Keohane, C and McSweeney, M E and Chung, E Y and Yoon, C S and Lipsitz, S R and Wassner, A J and Harper, M B and Landrigan, C P},
journal = {JAMA : the journal of the American Medical Association},
number = {21}
}Identification of a new cyclovirus in cerebrospinal fluid of patients with acute central nervous system infections. Tan, L. V., van Doorn, H. R., Nghia, H. D. T., Chau, T. T. H., Tu, L. T. P., de Vries, M., Canuti, M., Deijs, M., Jebbink, M. F., Baker, S., Bryant, J. E., Tham, N. T., BKrong, N. T. T. C., Boni, M. F., Loi, T. Q., Phuong, L. T., Verhoeven, J. T. P., Crusat, M., Jeeninga, R. E., Schultsz, C., Chau, N. V. V., Hien, T. T., van der Hoek, L., Farrar, J., & de Jong, M. D. mBio, 4(3):e00231–00213, June, 2013.
doi abstract bibtex
doi abstract bibtex
Acute central nervous system (CNS) infections cause substantial morbidity and mortality, but the etiology remains unknown in a large proportion of cases. We identified and characterized the full genome of a novel cyclovirus (tentatively named cyclovirus-Vietnam [CyCV-VN]) in cerebrospinal fluid (CSF) specimens of two Vietnamese patients with CNS infections of unknown etiology. CyCV-VN was subsequently detected in 4% of 642 CSF specimens from Vietnamese patients with suspected CNS infections and none of 122 CSFs from patients with noninfectious neurological disorders. Detection rates were similar in patients with CNS infections of unknown etiology and those in whom other pathogens were detected. A similar detection rate in feces from healthy children suggested food-borne or orofecal transmission routes, while high detection rates in feces from pigs and poultry (average, 58%) suggested the existence of animal reservoirs for such transmission. Further research is needed to address the epidemiology and pathogenicity of this novel, potentially zoonotic virus.
@article{tan_identification_2013,
title = {Identification of a new cyclovirus in cerebrospinal fluid of patients with acute central nervous system infections.},
volume = {4},
issn = {2150-7511},
doi = {10.1128/mBio.00231-13},
abstract = {Acute central nervous system (CNS) infections cause substantial morbidity and mortality, but the etiology remains unknown in a large proportion of cases. We identified and characterized the full genome of a novel cyclovirus (tentatively named cyclovirus-Vietnam [CyCV-VN]) in cerebrospinal fluid (CSF) specimens of two Vietnamese patients with CNS infections of unknown etiology. CyCV-VN was subsequently detected in 4\% of 642 CSF specimens from Vietnamese patients with suspected CNS infections and none of 122 CSFs from patients with noninfectious neurological disorders. Detection rates were similar in patients with CNS infections of unknown etiology and those in whom other pathogens were detected. A similar detection rate in feces from healthy children suggested food-borne or orofecal transmission routes, while high detection rates in feces from pigs and poultry (average, 58\%) suggested the existence of animal reservoirs for such transmission. Further research is needed to address the epidemiology and pathogenicity of this novel, potentially zoonotic virus.},
language = {eng},
number = {3},
journal = {mBio},
author = {Tan, Le Van and van Doorn, H. Rogier and Nghia, Ho Dang Trung and Chau, Tran Thi Hong and Tu, Le Thi Phuong and de Vries, Michel and Canuti, Marta and Deijs, Martin and Jebbink, Maarten F. and Baker, Stephen and Bryant, Juliet E. and Tham, Nguyen Thi and BKrong, Nguyen Thi Thuy Chinh and Boni, Maciej F. and Loi, Tran Quoc and Phuong, Le Thi and Verhoeven, Joost T. P. and Crusat, Martin and Jeeninga, Rienk E. and Schultsz, Constance and Chau, Nguyen Van Vinh and Hien, Tran Tinh and van der Hoek, Lia and Farrar, Jeremy and de Jong, Menno D.},
month = jun,
year = {2013},
pmid = {23781068},
pmcid = {PMC3684831},
keywords = {Adolescent, Adult, Aged, Animals, Central Nervous System Infections/epidemiology/*virology, Child, Child, Preschool, Circoviridae Infections/epidemiology/*virology, Circoviridae/*classification/genetics/*isolation \& purification, Cluster Analysis, DNA, Viral/chemistry/genetics, Female, Genome, Viral, Humans, Infant, Male, Middle Aged, Molecular Sequence Data, Phylogeny, Prevalence, Prospective Studies, Sequence Analysis, DNA, Vietnam, Young Adult},
pages = {e00231--00213},
}Comparison of three methods (an updated logistic probabilistic method, the Naranjo and Liverpool algorithms) for the evaluation of routine pharmacovigilance case reports using consensual expert judgement as reference. Théophile, H., André, M., Miremont-Salamé, G., Arimone, Y., & Bégaud, B. Drug Safety, 36(10):1033–1044, October, 2013.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: An updated probabilistic causality assessment method and the Liverpool algorithm presented as an improved version of the Naranjo algorithm, one of the most used and accepted causality assessment methods, have recently been proposed. OBJECTIVE: In order to test the validity of the probabilistic method in routine pharmacovigilance, results provided by the Naranjo and Liverpool algorithms, as well as the updated probabilistic method, were each compared with a consensual expert judgement taken as reference. METHODS: A sample of 59 drug-event pairs randomly sampled from spontaneous reports to the French pharmacovigilance system was assessed by expert judgement until reaching consensus and by members of a pharmacovigilance unit using the updated probabilistic method, the Naranjo and Liverpool algorithms. Probabilities given by the probabilistic method, and categories obtained by both the Naranjo and the Liverpool algorithms were compared as well as their sensitivity, specificity, positive and negative predictive values. RESULTS: The median probability for drug causation given by the consensual expert judgement was 0.70 (inter-quartile range, IQR 0.54-0.84) versus 0.77 (IQR 0.54-0.91) for the probabilistic method. For the Naranjo algorithm, the 'possible' causality category was predominant (61 %), followed by 'probable' (35 %), 'doubtful', and 'almost certain' categories (2 % each). Category distribution obtained with the Liverpool algorithm was similar to that obtained by the Naranjo algorithm with a majority of 'possible' (61 %) and 'probable' (30 %) followed by 'definite' (7 %) and 'unlikely' (2 %). For the probabilistic method, sensitivity, specificity, positive and negative predictive values were 0.96, 0.56, 0.92 and 0.71, respectively. For the Naranjo algorithm, depending on whether the 'possible' category was considered in favour or in disfavour of drug causation, sensitivity was, respectively, 1 or 0.42, specificity 0.11 or 0.89, negative predictive value 1 or 0.22 and positive predictive value 0.86 or 0.95; results were identical for the Liverpool algorithm. CONCLUSION: The logistic probabilistic method gave results closer to the consensual expert judgment than either the Naranjo or Liverpool algorithms whose performance were strongly dependent on the meaning given to the 'possible' category. Owing to its good sensitivity and positive predictive value and by providing results as continuous probabilities, the probabilistic method seems worthy to use for a trustable assessment of adverse drug reactions in routine practice.
@article{theophile_comparison_2013,
title = {Comparison of three methods (an updated logistic probabilistic method, the {Naranjo} and {Liverpool} algorithms) for the evaluation of routine pharmacovigilance case reports using consensual expert judgement as reference},
volume = {36},
issn = {1179-1942},
doi = {10.1007/s40264-013-0083-1},
abstract = {BACKGROUND: An updated probabilistic causality assessment method and the Liverpool algorithm presented as an improved version of the Naranjo algorithm, one of the most used and accepted causality assessment methods, have recently been proposed.
OBJECTIVE: In order to test the validity of the probabilistic method in routine pharmacovigilance, results provided by the Naranjo and Liverpool algorithms, as well as the updated probabilistic method, were each compared with a consensual expert judgement taken as reference.
METHODS: A sample of 59 drug-event pairs randomly sampled from spontaneous reports to the French pharmacovigilance system was assessed by expert judgement until reaching consensus and by members of a pharmacovigilance unit using the updated probabilistic method, the Naranjo and Liverpool algorithms. Probabilities given by the probabilistic method, and categories obtained by both the Naranjo and the Liverpool algorithms were compared as well as their sensitivity, specificity, positive and negative predictive values.
RESULTS: The median probability for drug causation given by the consensual expert judgement was 0.70 (inter-quartile range, IQR 0.54-0.84) versus 0.77 (IQR 0.54-0.91) for the probabilistic method. For the Naranjo algorithm, the 'possible' causality category was predominant (61 \%), followed by 'probable' (35 \%), 'doubtful', and 'almost certain' categories (2 \% each). Category distribution obtained with the Liverpool algorithm was similar to that obtained by the Naranjo algorithm with a majority of 'possible' (61 \%) and 'probable' (30 \%) followed by 'definite' (7 \%) and 'unlikely' (2 \%). For the probabilistic method, sensitivity, specificity, positive and negative predictive values were 0.96, 0.56, 0.92 and 0.71, respectively. For the Naranjo algorithm, depending on whether the 'possible' category was considered in favour or in disfavour of drug causation, sensitivity was, respectively, 1 or 0.42, specificity 0.11 or 0.89, negative predictive value 1 or 0.22 and positive predictive value 0.86 or 0.95; results were identical for the Liverpool algorithm.
CONCLUSION: The logistic probabilistic method gave results closer to the consensual expert judgment than either the Naranjo or Liverpool algorithms whose performance were strongly dependent on the meaning given to the 'possible' category. Owing to its good sensitivity and positive predictive value and by providing results as continuous probabilities, the probabilistic method seems worthy to use for a trustable assessment of adverse drug reactions in routine practice.},
language = {eng},
number = {10},
journal = {Drug Safety},
author = {Théophile, Hélène and André, Manon and Miremont-Salamé, Ghada and Arimone, Yannick and Bégaud, Bernard},
month = oct,
year = {2013},
pmid = {23828659},
keywords = {Adolescent, Adult, Adverse Drug Reaction Reporting Systems, Aged, Aged, 80 and over, Algorithms, Child, Preschool, Consensus, Drug-Related Side Effects and Adverse Reactions, Expert Testimony, Female, France, Humans, Infant, Judgment, Logistic Models, Male, Middle Aged, Pharmaceutical Preparations, Pharmacovigilance, Sensitivity and Specificity},
pages = {1033--1044}
}Socio-economic position and childhood multimorbidity: a study using linkage between the Avon Longitudinal Study of Parents and Children and the General Practice Research Database. Cornish, R. P., Boyd, A., Van Staa, T., Salisbury, C., & Macleod, J. International Journal for Equity in Health, 12:66, 2013.
doi abstract bibtex
doi abstract bibtex
INTRODUCTION: In adults, multimorbidity is associated with social position. Socially disadvantaged adults typically experience more chronic illness at a younger age than comparable individuals who are more advantaged. The relation between social position and multimorbidity amongst children and adolescents has not been as widely studied and is less clear. METHODS: The NHS Information Centre (NHS IC) linked participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) to the General Practice Research Database (GPRD). Multimorbidity was measured in three different ways: using a count of the number of drugs prescribed, a count of chronic diseases, and a person's predicted resource use score; the latter two measures were derived using the Johns Hopkins ACG system. A number of different socio-economic position variables measured as part of ALSPAC during pregnancy and early childhood were considered. Ordered logistic and negative binomial regression models were used to investigate associations between socio-economic variables and multimorbidity. RESULTS: After mutually adjusting for the different markers of socio-economic position, there was evidence, albeit weak, that chronic condition counts among children aged from 0 to 9 years were higher among those whose mothers were less well educated (OR = 0.44; 95% confidence interval 0.18-1.10; p = 0.08). Conversely, children whose mothers were better educated had higher rates of chronic illness between 10 and 18 years (OR = 1.94; 95% CI 1.14-3.30). However, living in a more deprived area, as indicated by the Townsend score, was associated with a higher odds of chronic illness between 10 and 18 years (OR for each increasing decile of Townsend score = 1.09; 95% CI 1.00-1.19; p = 0.06). CONCLUSIONS: We have found some evidence that, in younger children, multimorbidity may be higher amongst children whose parents are less well educated. In older children and adolescents this association is less clear. We have also demonstrated that linkage between prospective observational studies and electronic patient records can provide an effective way of obtaining objectively measured outcome variables.
@article{cornish_socio-economic_2013,
title = {Socio-economic position and childhood multimorbidity: a study using linkage between the {Avon} {Longitudinal} {Study} of {Parents} and {Children} and the {General} {Practice} {Research} {Database}},
volume = {12},
issn = {1475-9276},
shorttitle = {Socio-economic position and childhood multimorbidity},
doi = {10.1186/1475-9276-12-66},
abstract = {INTRODUCTION: In adults, multimorbidity is associated with social position. Socially disadvantaged adults typically experience more chronic illness at a younger age than comparable individuals who are more advantaged. The relation between social position and multimorbidity amongst children and adolescents has not been as widely studied and is less clear.
METHODS: The NHS Information Centre (NHS IC) linked participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) to the General Practice Research Database (GPRD). Multimorbidity was measured in three different ways: using a count of the number of drugs prescribed, a count of chronic diseases, and a person's predicted resource use score; the latter two measures were derived using the Johns Hopkins ACG system. A number of different socio-economic position variables measured as part of ALSPAC during pregnancy and early childhood were considered. Ordered logistic and negative binomial regression models were used to investigate associations between socio-economic variables and multimorbidity.
RESULTS: After mutually adjusting for the different markers of socio-economic position, there was evidence, albeit weak, that chronic condition counts among children aged from 0 to 9 years were higher among those whose mothers were less well educated (OR = 0.44; 95\% confidence interval 0.18-1.10; p = 0.08). Conversely, children whose mothers were better educated had higher rates of chronic illness between 10 and 18 years (OR = 1.94; 95\% CI 1.14-3.30). However, living in a more deprived area, as indicated by the Townsend score, was associated with a higher odds of chronic illness between 10 and 18 years (OR for each increasing decile of Townsend score = 1.09; 95\% CI 1.00-1.19; p = 0.06).
CONCLUSIONS: We have found some evidence that, in younger children, multimorbidity may be higher amongst children whose parents are less well educated. In older children and adolescents this association is less clear. We have also demonstrated that linkage between prospective observational studies and electronic patient records can provide an effective way of obtaining objectively measured outcome variables.},
language = {eng},
journal = {International Journal for Equity in Health},
author = {Cornish, Rosie P. and Boyd, Andy and Van Staa, Tjeerd and Salisbury, Chris and Macleod, John},
year = {2013},
pmid = {23962118},
pmcid = {PMC3751770},
keywords = {Adolescent, Child, Child, Preschool, Chronic Disease, Comorbidity, Drug Prescriptions, Educational Status, Family Practice, Female, Great Britain, Humans, Infant, Male, Parents, Regression Analysis, Socioeconomic Factors},
pages = {66}
}Interaction between stimulus intensity and perceptual load in the attentional control of pain. Romero, Roa, Y., Straube, T., Nitsch, A., Miltner, W. H.<nbsp>R., & Weiss, T. Pain, 154(1):135--140, January, 2013.
Link abstract bibtex
Link abstract bibtex The interaction between intensity of nociceptive stimuli and cognitive load in a concomitant task is still a challenging and complex topic. Here, we investigated the interaction between top-down factors (i.e., perceptual load), induced by a visual task, and bottom-up factors (i.e., intensity of nociceptive stimuli that implicitly modifies saliency of input). Using a new experimental paradigm, in which perceptual load is varied while laser heat stimuli of different intensities are processed; we show a significant interaction between intensity of nociceptive stimuli and perceptual load on both pain ratings and task performance. High perceptual load specifically reduced intensity ratings of high intensity stimuli. However, under this condition, task performance was impaired, regardless of interindividual differences in motivation and pain catastrophizing. Thus, we showed that pain ratings can be reduced by increasing the load of attentional resources at the perceptual level of a non-pain-related task. Nevertheless, the disruptive effect of highly intensive nociceptive stimuli on the performance of the perceptual task was evident only under high load.
@article{ romero_interaction_2013,
title = {Interaction between stimulus intensity and perceptual load in the attentional control of pain},
volume = {154},
issn = {1872-6623},
url_link = {http://dx.doi.org/10.1016/j.pain.2012.10.003},
abstract = {The interaction between intensity of nociceptive stimuli and cognitive load in a concomitant task is still a challenging and complex topic. Here, we investigated the interaction between top-down factors (i.e., perceptual load), induced by a visual task, and bottom-up factors (i.e., intensity of nociceptive stimuli that implicitly modifies saliency of input). Using a new experimental paradigm, in which perceptual load is varied while laser heat stimuli of different intensities are processed; we show a significant interaction between intensity of nociceptive stimuli and perceptual load on both pain ratings and task performance. High perceptual load specifically reduced intensity ratings of high intensity stimuli. However, under this condition, task performance was impaired, regardless of interindividual differences in motivation and pain catastrophizing. Thus, we showed that pain ratings can be reduced by increasing the load of attentional resources at the perceptual level of a non-pain-related task. Nevertheless, the disruptive effect of highly intensive nociceptive stimuli on the performance of the perceptual task was evident only under high load.},
language = {eng},
number = {1},
journal = {Pain},
author = {Romero, Yadira Roa and Straube, Thomas and Nitsch, Alexander and Miltner, Wolfgang H. R. and Weiss, Thomas},
month = {January},
year = {2013},
keywords = {Adult, Attention, Catastrophization, Child, Female, Hot Temperature, Humans, Male, Nociceptors, Pain Perception, Pain Threshold, Psychomotor Performance, Reaction Time},
pages = {135--140}
}Genetic expression profiles of adult and pediatric ependymomas: molecular pathways, prognostic indicators, and therapeutic targets. Nagasawa, D., T., Trang, A., Choy, W., Spasic, M., Yew, A., Zarinkhou, G., Garcia, H., M., & Yang, I. Clinical neurology and neurosurgery, 115(4):388-99, Elsevier B.V., 4, 2013.
Paper abstract bibtex
Paper abstract bibtex Ependymomas are tumors that can present within either the intracranial or spinal regions. While 90% of all pediatric ependymomas are intracranial, spinal cord ependymomas are more commonly found in patients 20-40 years old. Treatment for spinal lesions has achieved local control rates up to 100% following gross total resection, while pediatric intracranial tumors have 40-60% mortality. Given the inability to effectively treat ependymomas with current standard practices, researchers have focused their efforts on evaluating chromosomal alterations, genetic expression profiles, epigenetic events, and molecular pathways. While these studies have provided critical insight into the potential mechanisms underlying ependymoma pathogenesis, understanding of the intricate interplay between the various pathways involved in tumor initiation, development, and progression will require deeper investigation. However, several potential prognostic markers and therapeutic targets have been identified, providing key areas of focus for future research. The utilization of unique genetic expression profiles based upon patient age, tumor location, tumor grade, and subtype has revealed a multitude of findings warranting further study. Inspection of various molecular pathways associated with ependymomas may establish the foundation for developing novel therapies capable of achieving significant clinical improvements with individualized regimens specifically designed for personalized treatment strategies.
@article{
title = {Genetic expression profiles of adult and pediatric ependymomas: molecular pathways, prognostic indicators, and therapeutic targets.},
type = {article},
year = {2013},
identifiers = {[object Object]},
keywords = {Adult,Antineoplastic Agents,Antineoplastic Agents: therapeutic use,Brain Neoplasms,Brain Neoplasms: genetics,Brain Neoplasms: therapy,Central Nervous System Neoplasms,Central Nervous System Neoplasms: genetics,Central Nervous System Neoplasms: therapy,Child,DNA Fingerprinting,Ependymoma,Ependymoma: genetics,Ependymoma: therapy,Gene Expression Regulation, Neoplastic,Gene Expression Regulation, Neoplastic: genetics,Humans,Metabolic Networks and Pathways,Prognosis,Spinal Neoplasms,Spinal Neoplasms: genetics,Spinal Neoplasms: therapy},
pages = {388-99},
volume = {115},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/23374238},
month = {4},
publisher = {Elsevier B.V.},
id = {68d355f8-8c34-333d-86b5-149babd1763d},
created = {2014-10-27T21:24:52.000Z},
accessed = {2014-10-27},
file_attached = {true},
profile_id = {d4a749e1-410f-3c2d-bb47-9216071b48a9},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-12-29T21:45:19.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {Ependymomas are tumors that can present within either the intracranial or spinal regions. While 90% of all pediatric ependymomas are intracranial, spinal cord ependymomas are more commonly found in patients 20-40 years old. Treatment for spinal lesions has achieved local control rates up to 100% following gross total resection, while pediatric intracranial tumors have 40-60% mortality. Given the inability to effectively treat ependymomas with current standard practices, researchers have focused their efforts on evaluating chromosomal alterations, genetic expression profiles, epigenetic events, and molecular pathways. While these studies have provided critical insight into the potential mechanisms underlying ependymoma pathogenesis, understanding of the intricate interplay between the various pathways involved in tumor initiation, development, and progression will require deeper investigation. However, several potential prognostic markers and therapeutic targets have been identified, providing key areas of focus for future research. The utilization of unique genetic expression profiles based upon patient age, tumor location, tumor grade, and subtype has revealed a multitude of findings warranting further study. Inspection of various molecular pathways associated with ependymomas may establish the foundation for developing novel therapies capable of achieving significant clinical improvements with individualized regimens specifically designed for personalized treatment strategies.},
bibtype = {article},
author = {Nagasawa, Daniel T and Trang, Andy and Choy, Winward and Spasic, Marko and Yew, Andrew and Zarinkhou, Golmah and Garcia, Heather M and Yang, Isaac},
journal = {Clinical neurology and neurosurgery},
number = {4}
}Myopia Stabilization and Associated Factors Among Participants in the Correction of Myopia Evaluation Trial (COMET). Investigative Opthalmology & Visual Science, 54(13):7871, December, 2013.
Paper doi bibtex
Paper doi bibtex @article{noauthor_myopia_2013,
title = {Myopia {Stabilization} and {Associated} {Factors} {Among} {Participants} in the {Correction} of {Myopia} {Evaluation} {Trial} ({COMET})},
volume = {54},
issn = {1552-5783},
url = {http://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.13-12403},
doi = {10.1167/iovs.13-12403},
language = {en},
number = {13},
urldate = {2018-03-28TZ},
journal = {Investigative Opthalmology \& Visual Science},
month = dec,
year = {2013},
keywords = {Adolescent, Aging, Child, Child, Preschool, Ethnic Groups, Eyeglasses, Female, Follow-Up Studies, Gompertz function, Humans, Male, Myopia, Prevalence, Prospective Studies, Refraction, Ocular, Treatment Outcome, United States, associated factors, myopia, myopia progression, myopia stabilization},
pages = {7871}
}An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population. Hall, G. C., Morant, S. V., Carroll, D., Gabriel, Z. L., & McQuay, H. J. BMC family practice, 14:28, 2013.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices. METHODS: Patients with a first diagnosis of post-herpetic neuralgia (PHN), painful diabetic neuropathy (PDN) or phantom limb pain (PLP) were identified from the General Practice Research Database (2006 - 2010) and incidence rates were calculated. Prescription records were searched for pain treatments from diagnosis of these conditions and the duration and daily dose estimated for first-line and subsequent treatment regimens. Recording of neuropathic back and post-operative pain was investigated. RESULTS: The study included 5,920 patients with PHN, 5,340 with PDN, and 185 with PLP. The incidence per 10,000 person-years was 3.4 (95% CI 3.4, 3.5) for PHN; and 0.11 (95% CI 0.09, 0.12) for PLP. Validation of the PDN case definition suggested that was not sensitive. Incident PHN increased over the study period. The most common first-line treatments were amitriptyline or gabapentin in the PDN and PLP cohorts, and amitriptyline or co-codamol (codeine-paracetamol) in PHN. Paracetamol, co-dydramol (paracetamol-dihydrocodeine) and capsaicin were also often prescribed in one or more condition. Most first-line treatments comprised only one therapeutic class. Use of antiepileptics licensed for neuropathic pain treatment had increased since 2002-2005. Amitriptyline was the only antidepressant prescribed commonly as a first-line treatment. CONCLUSION: The UK incidence of diagnosed PHN has increased with the incidence of back-pain and post-operative pain unclear. While use of licensed antiepileptics increased, prescribing of therapy with little evidence of efficacy in neuropathic pain is still common and consequently treatment was often not in-line with current guidance.
@article{hall_observational_2013,
title = {An observational descriptive study of the epidemiology and treatment of neuropathic pain in a {UK} general population},
volume = {14},
issn = {1471-2296},
doi = {10.1186/1471-2296-14-28},
abstract = {BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices.
METHODS: Patients with a first diagnosis of post-herpetic neuralgia (PHN), painful diabetic neuropathy (PDN) or phantom limb pain (PLP) were identified from the General Practice Research Database (2006 - 2010) and incidence rates were calculated. Prescription records were searched for pain treatments from diagnosis of these conditions and the duration and daily dose estimated for first-line and subsequent treatment regimens. Recording of neuropathic back and post-operative pain was investigated.
RESULTS: The study included 5,920 patients with PHN, 5,340 with PDN, and 185 with PLP. The incidence per 10,000 person-years was 3.4 (95\% CI 3.4, 3.5) for PHN; and 0.11 (95\% CI 0.09, 0.12) for PLP. Validation of the PDN case definition suggested that was not sensitive. Incident PHN increased over the study period. The most common first-line treatments were amitriptyline or gabapentin in the PDN and PLP cohorts, and amitriptyline or co-codamol (codeine-paracetamol) in PHN. Paracetamol, co-dydramol (paracetamol-dihydrocodeine) and capsaicin were also often prescribed in one or more condition. Most first-line treatments comprised only one therapeutic class. Use of antiepileptics licensed for neuropathic pain treatment had increased since 2002-2005. Amitriptyline was the only antidepressant prescribed commonly as a first-line treatment.
CONCLUSION: The UK incidence of diagnosed PHN has increased with the incidence of back-pain and post-operative pain unclear. While use of licensed antiepileptics increased, prescribing of therapy with little evidence of efficacy in neuropathic pain is still common and consequently treatment was often not in-line with current guidance.},
language = {eng},
journal = {BMC family practice},
author = {Hall, Gillian C. and Morant, Steve V. and Carroll, Dawn and Gabriel, Zahava L. and McQuay, Henry J.},
year = {2013},
pmid = {23442783},
pmcid = {PMC3599764},
keywords = {Acetaminophen, Adolescent, Adult, Aged, Amines, Amitriptyline, Analgesics, Non-Narcotic, Analgesics, Opioid, Anticonvulsants, Capsaicin, Child, Child, Preschool, Codeine, Cyclohexanecarboxylic Acids, Diabetic Neuropathies, Drug Combinations, Drug Prescriptions, Female, Great Britain, Humans, Hydrocodone, Infant, Male, Middle Aged, Neuralgia, Postherpetic, Phantom Limb, Physician's Practice Patterns, Primary Health Care, Sensory System Agents, Young Adult, gamma-Aminobutyric Acid, incidence},
pages = {28}
}2012 (6)
Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005-2008. Looker, A. C., Borrud, L. G., Hughes, J. P., Fan, B., Shepherd, J. A., & Melton, L. J. Vital and Health Statistics. Series 11, Data from the National Health Survey, March, 2012.
abstract bibtex
abstract bibtex
OBJECTIVE: This report presents bone measurement data from dual-energy X-ray absorptiometry scans of the lumbar spine and proximal femur for persons aged 8 years and over from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. METHODS: Means, standard deviations, and selected percentiles were calculated for the proximal femur and lumbar spine (total and subregions) by sex, race and ethnicity, and age. Smoothed mean total lumbar spine and femur neck bone mineral density (BMD) were plotted by age, sex, and race and ethnicity. Multiple regression was used to test for significant interactions and to calculate mean total lumbar spine and femur neck BMD after adjusting for age, sex, and race and ethnicity. Differences by sex, race and ethnicity, and age were summarized by calculating the percent difference in adjusted means. RESULTS: Among scanned individuals, 11% lacked total lumbar spine data due to invalid data for one or more lumbar vertebrae, and 4% had invalid data for the proximal femur. Non-Hispanic black persons had 6% higher total lumbar spine BMD and 9%-10% higher femur neck BMD than non-Hispanic white persons. Mean total lumbar spine BMD and femur neck BMD did not differ between Mexican-American and non-Hispanic white persons in those under age 20. For those aged 20 and over, Mexican-American persons had 4% lower total lumbar spine BMD but 1% higher femur neck BMD than non-Hispanic white persons. Mean total lumbar spine BMD was 8%-17% higher in females aged 8-15 compared with males of the same age. In the age group 16-49, mean total lumbar spine BMD was similar or slightly higher for females compared with males, but after age 50 it was 60%-15% lower for females compared with males. Mean femur neck BMD was 5%-13% lower for females than males in all age groups except 12-15.
@article{looker_lumbar_2012-1,
title = {Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: {United} {States}, 2005-2008},
issn = {0083-1980},
shorttitle = {Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area},
abstract = {OBJECTIVE: This report presents bone measurement data from dual-energy X-ray absorptiometry scans of the lumbar spine and proximal femur for persons aged 8 years and over from the National Health and Nutrition Examination Survey (NHANES) 2005-2008.
METHODS: Means, standard deviations, and selected percentiles were calculated for the proximal femur and lumbar spine (total and subregions) by sex, race and ethnicity, and age. Smoothed mean total lumbar spine and femur neck bone mineral density (BMD) were plotted by age, sex, and race and ethnicity. Multiple regression was used to test for significant interactions and to calculate mean total lumbar spine and femur neck BMD after adjusting for age, sex, and race and ethnicity. Differences by sex, race and ethnicity, and age were summarized by calculating the percent difference in adjusted means.
RESULTS: Among scanned individuals, 11\% lacked total lumbar spine data due to invalid data for one or more lumbar vertebrae, and 4\% had invalid data for the proximal femur. Non-Hispanic black persons had 6\% higher total lumbar spine BMD and 9\%-10\% higher femur neck BMD than non-Hispanic white persons. Mean total lumbar spine BMD and femur neck BMD did not differ between Mexican-American and non-Hispanic white persons in those under age 20. For those aged 20 and over, Mexican-American persons had 4\% lower total lumbar spine BMD but 1\% higher femur neck BMD than non-Hispanic white persons. Mean total lumbar spine BMD was 8\%-17\% higher in females aged 8-15 compared with males of the same age. In the age group 16-49, mean total lumbar spine BMD was similar or slightly higher for females compared with males, but after age 50 it was 60\%-15\% lower for females compared with males. Mean femur neck BMD was 5\%-13\% lower for females than males in all age groups except 12-15.},
language = {eng},
number = {251},
journal = {Vital and Health Statistics. Series 11, Data from the National Health Survey},
author = {Looker, Anne C. and Borrud, Lori G. and Hughes, Jeffery P. and Fan, Bo and Shepherd, John A. and Melton, L. Joseph},
month = mar,
year = {2012},
pmid = {24261130},
keywords = {Absorptiometry, Photon, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bone Density, Child, Ethnic Groups, Female, Femur, Humans, Lumbar Vertebrae, Male, Middle Aged, Nutrition Surveys, Regression Analysis, Sex Factors, United States, Young Adult},
pages = {1--132}
}A study on the epidemiology of rosacea in the U.K. Spoendlin, J., Voegel, J. J., Jick, S. S., & Meier, C. R. The British Journal of Dermatology, 167(3):598--605, September, 2012.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Rosacea is a chronic facial skin disease of unclear origin. Epidemiological data are scarce and controversial, with reported prevalences ranging from 0·09% to 22%. To our knowledge, incidence rates have not been quantified before. OBJECTIVES: In this observational study we quantified incidence rates of diagnosed rosacea in the U.K. and described demographic characteristics and the prevalence of ocular symptoms in patients with rosacea. We compared lifestyle factors such as smoking and alcohol consumption between patients with rosacea and controls. METHODS: Using the U.K.-based General Practice Research Database, we identified patients with an incident diagnosis of rosacea between 1995 and 2009 and matched them (1:1) to rosacea-free control patients. We assessed person-time of all patients at risk and assessed incidence rates of rosacea, stratified by age, sex, year of diagnosis and region. RESULTS: We identified 60,042 rosacea cases and 60,042 controls (61·5% women). The overall incidence rate for diagnosed rosacea in the U.K. was 1·65 per 1000 person-years. Rosacea was diagnosed in some 80% of cases after the age of 30 years. Ocular symptoms were recorded in 20·8% of cases at the index date. We observed a significantly reduced relative risk of developing rosacea among current smokers (odds ratio 0·64, 95% confidence interval 0·62-0·67). Alcohol consumption was associated with a marginal risk increase. CONCLUSIONS: We quantified incidence rates and characteristics of patients with rosacea diagnosed in clinical practice in a large epidemiological study using primary care data from the U.K. Smoking was associated with a substantially reduced risk of developing rosacea.
@article{spoendlin_study_2012,
title = {A study on the epidemiology of rosacea in the {U}.{K}},
volume = {167},
issn = {1365-2133},
doi = {10.1111/j.1365-2133.2012.11037.x},
abstract = {BACKGROUND: Rosacea is a chronic facial skin disease of unclear origin. Epidemiological data are scarce and controversial, with reported prevalences ranging from 0·09\% to 22\%. To our knowledge, incidence rates have not been quantified before.
OBJECTIVES: In this observational study we quantified incidence rates of diagnosed rosacea in the U.K. and described demographic characteristics and the prevalence of ocular symptoms in patients with rosacea. We compared lifestyle factors such as smoking and alcohol consumption between patients with rosacea and controls.
METHODS: Using the U.K.-based General Practice Research Database, we identified patients with an incident diagnosis of rosacea between 1995 and 2009 and matched them (1:1) to rosacea-free control patients. We assessed person-time of all patients at risk and assessed incidence rates of rosacea, stratified by age, sex, year of diagnosis and region.
RESULTS: We identified 60,042 rosacea cases and 60,042 controls (61·5\% women). The overall incidence rate for diagnosed rosacea in the U.K. was 1·65 per 1000 person-years. Rosacea was diagnosed in some 80\% of cases after the age of 30 years. Ocular symptoms were recorded in 20·8\% of cases at the index date. We observed a significantly reduced relative risk of developing rosacea among current smokers (odds ratio 0·64, 95\% confidence interval 0·62-0·67). Alcohol consumption was associated with a marginal risk increase.
CONCLUSIONS: We quantified incidence rates and characteristics of patients with rosacea diagnosed in clinical practice in a large epidemiological study using primary care data from the U.K. Smoking was associated with a substantially reduced risk of developing rosacea.},
language = {eng},
number = {3},
journal = {The British Journal of Dermatology},
author = {Spoendlin, J. and Voegel, J. J. and Jick, S. S. and Meier, C. R.},
month = sep,
year = {2012},
pmid = {22564022},
keywords = {Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Alcohol Drinking, Child, Child, Preschool, Diagnosis, Differential, Epidemiologic Methods, Female, Great Britain, Humans, Infant, Life Style, Male, Middle Aged, Rosacea, Smoking, Young Adult, incidence},
pages = {598--605}
}Proton therapy for spinal ependymomas: planning, acute toxicities, and preliminary outcomes. Amsbaugh, M., J., Grosshans, D., R., McAleer, M., F., Zhu, R., Wages, C., Crawford, C., N., Palmer, M., De Gracia, B., Woo, S., & Mahajan, A. International Journal of Radiation Oncology Biology Physics, 83(5):1419-24, Elsevier Inc, 8, 2012.
Paper abstract bibtex
Paper abstract bibtex PURPOSE: To report acute toxicities and preliminary outcomes for pediatric patients with ependymomas of the spine treated with proton beam therapy at the MD Anderson Cancer Center.
METHODS AND MATERIALS: Eight pediatric patients received proton beam irradiation between October 2006 and September 2010 for spinal ependymomas. Toxicity data were collected weekly during radiation therapy and all follow-up visits. Toxicities were graded according to the Common Terminology Criteria for Adverse Events version 3.0.
RESULTS: All patients had surgical resection of the tumor before irradiation (7 subtotal resection and 1 gross total resection). Six patients had World Health Organization Grade I ependymomas, and two had World Health Organization Grade II ependymomas. Patients had up to 3 surgical interventions before radiation therapy (range, 1-3; median, 1). Three patients received proton therapy after recurrence and five as part of their primary management. The entire vertebral body was treated in all but 2 patients. The mean radiation dose was 51.1 cobalt gray equivalents (range, 45 to 54 cobalt gray equivalents). With a mean follow-up of 26 months from the radiation therapy start date (range, 7-51 months), local control, event-free survival, and overall survival rates were all 100%. The most common toxicities during treatment were Grade 1 or 2 erythema (75%) and Grade 1 fatigue (38%). No patients had a Grade 3 or higher adverse event. Proton therapy dramatically reduced dose to all normal tissues anterior to the vertebral bodies in comparison to photon therapy.
CONCLUSION: Preliminary outcomes show the expected control rates with favorable acute toxicity profiles. Proton beam therapy offers a powerful treatment option in the pediatric population, where adverse events related to radiation exposure are of concern. Extended follow-up will be required to assess for late recurrences and long-term adverse effects.
@article{
title = {Proton therapy for spinal ependymomas: planning, acute toxicities, and preliminary outcomes.},
type = {article},
year = {2012},
identifiers = {[object Object]},
keywords = {Adolescent,Child,Child, Preschool,Disease-Free Survival,Ependymoma,Ependymoma: pathology,Ependymoma: radiotherapy,Ependymoma: surgery,Erythema,Erythema: etiology,Erythema: pathology,Fatigue,Fatigue: etiology,Female,Follow-Up Studies,Humans,Infant,Male,Neoplasm Recurrence, Local,Neoplasm Recurrence, Local: radiotherapy,Protons,Protons: adverse effects,Protons: therapeutic use,Radiation Injuries,Radiotherapy Dosage,Spinal Neoplasms,Spinal Neoplasms: pathology,Spinal Neoplasms: radiotherapy,Spinal Neoplasms: surgery,Survival Rate,Treatment Outcome,Tumor Burden},
pages = {1419-24},
volume = {83},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/22245209},
month = {8},
publisher = {Elsevier Inc},
day = {1},
id = {ba888ca5-70c7-39d5-946d-244183b6d8d3},
created = {2014-03-15T18:24:10.000Z},
accessed = {2014-03-04},
file_attached = {true},
profile_id = {8c4ca2d5-86de-3b5d-86be-8408415f34e0},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-12-29T19:36:51.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {PURPOSE: To report acute toxicities and preliminary outcomes for pediatric patients with ependymomas of the spine treated with proton beam therapy at the MD Anderson Cancer Center.
METHODS AND MATERIALS: Eight pediatric patients received proton beam irradiation between October 2006 and September 2010 for spinal ependymomas. Toxicity data were collected weekly during radiation therapy and all follow-up visits. Toxicities were graded according to the Common Terminology Criteria for Adverse Events version 3.0.
RESULTS: All patients had surgical resection of the tumor before irradiation (7 subtotal resection and 1 gross total resection). Six patients had World Health Organization Grade I ependymomas, and two had World Health Organization Grade II ependymomas. Patients had up to 3 surgical interventions before radiation therapy (range, 1-3; median, 1). Three patients received proton therapy after recurrence and five as part of their primary management. The entire vertebral body was treated in all but 2 patients. The mean radiation dose was 51.1 cobalt gray equivalents (range, 45 to 54 cobalt gray equivalents). With a mean follow-up of 26 months from the radiation therapy start date (range, 7-51 months), local control, event-free survival, and overall survival rates were all 100%. The most common toxicities during treatment were Grade 1 or 2 erythema (75%) and Grade 1 fatigue (38%). No patients had a Grade 3 or higher adverse event. Proton therapy dramatically reduced dose to all normal tissues anterior to the vertebral bodies in comparison to photon therapy.
CONCLUSION: Preliminary outcomes show the expected control rates with favorable acute toxicity profiles. Proton beam therapy offers a powerful treatment option in the pediatric population, where adverse events related to radiation exposure are of concern. Extended follow-up will be required to assess for late recurrences and long-term adverse effects.},
bibtype = {article},
author = {Amsbaugh, Mark J and Grosshans, David R and McAleer, Mary Frances and Zhu, Ron and Wages, Cody and Crawford, Cody N and Palmer, Matthew and De Gracia, Beth and Woo, Shiao and Mahajan, Anita},
journal = {International Journal of Radiation Oncology Biology Physics},
number = {5}
}Efficacy and effectiveness of influenza vaccines: A systematic review and meta-analysis. Osterholm, M., T., Kelley, N., S., Sommer, A., & Belongia, E., a. The Lancet Infectious Diseases, 12(1):36-44, 2012.
Paper abstract bibtex
Paper abstract bibtex Background: No published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza. Methods: We searched Medline for randomised controlled trials assessing a relative reduction in influenza risk of all circulating influenza viruses during individual seasons after vaccination (efficacy) and observational studies meeting inclusion criteria (effectiveness). Eligible articles were published between Jan 1, 1967, and Feb 15, 2011, and used RT-PCR or culture for confirmation of influenza. We excluded some studies on the basis of study design and vaccine characteristics. We estimated random-effects pooled efficacy for trivalent inactivated vaccine (TIV) and live attenuated influenza vaccine (LAIV) when data were available for statistical analysis (eg, at least three studies that assessed comparable age groups). Findings: We screened 5707 articles and identified 31 eligible studies (17 randomised controlled trials and 14 observational studies). Efficacy of TIV was shown in eight (67%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 59% [95% CI 51-67] in adults aged 18-65 years). No such trials met inclusion criteria for children aged 2-17 years or adults aged 65 years or older. Efficacy of LAIV was shown in nine (75%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 83% [69-91]) in children aged 6 months to 7 years. No such trials met inclusion criteria for children aged 8-17 years. Vaccine effectiveness was variable for seasonal influenza: six (35%) of 17 analyses in nine studies showed significant protection against medically attended influenza in the outpatient or inpatient setting. Median monovalent pandemic H1N1 vaccine effectiveness in five observational studies was 69% (range 60-93). Interpretation: Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality. Funding: Alfred P Sloan Foundation. © 2012 Elsevier Ltd.
@article{
title = {Efficacy and effectiveness of influenza vaccines: A systematic review and meta-analysis},
type = {article},
year = {2012},
identifiers = {[object Object]},
keywords = {Vaccine effectiveness},
pages = {36-44},
volume = {12},
id = {0f707827-12dc-3fde-a01c-bef2cbdbbf77},
created = {2015-09-09T15:56:50.000Z},
file_attached = {true},
profile_id = {7a0fec24-6ec6-312f-956e-f210abd2cdb7},
group_id = {943817ab-6073-3383-a1c5-963a6e7efbea},
last_modified = {2015-09-14T21:03:56.000Z},
tags = {VDECGA,VDECICIDFLUREV,VDECVE},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {Background: No published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza. Methods: We searched Medline for randomised controlled trials assessing a relative reduction in influenza risk of all circulating influenza viruses during individual seasons after vaccination (efficacy) and observational studies meeting inclusion criteria (effectiveness). Eligible articles were published between Jan 1, 1967, and Feb 15, 2011, and used RT-PCR or culture for confirmation of influenza. We excluded some studies on the basis of study design and vaccine characteristics. We estimated random-effects pooled efficacy for trivalent inactivated vaccine (TIV) and live attenuated influenza vaccine (LAIV) when data were available for statistical analysis (eg, at least three studies that assessed comparable age groups). Findings: We screened 5707 articles and identified 31 eligible studies (17 randomised controlled trials and 14 observational studies). Efficacy of TIV was shown in eight (67%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 59% [95% CI 51-67] in adults aged 18-65 years). No such trials met inclusion criteria for children aged 2-17 years or adults aged 65 years or older. Efficacy of LAIV was shown in nine (75%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 83% [69-91]) in children aged 6 months to 7 years. No such trials met inclusion criteria for children aged 8-17 years. Vaccine effectiveness was variable for seasonal influenza: six (35%) of 17 analyses in nine studies showed significant protection against medically attended influenza in the outpatient or inpatient setting. Median monovalent pandemic H1N1 vaccine effectiveness in five observational studies was 69% (range 60-93). Interpretation: Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality. Funding: Alfred P Sloan Foundation. © 2012 Elsevier Ltd.},
bibtype = {article},
author = {Osterholm, Michael T. and Kelley, Nicholas S. and Sommer, Alfred and Belongia, Edward a.},
journal = {The Lancet Infectious Diseases},
number = {1}
}Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., Abraham, J., Ackerman, I., Aggarwal, R., Ahn, S. Y., Ali, M. K., Alvarado, M., Anderson, H. R., Anderson, L. M., Andrews, K. G., Atkinson, C., Baddour, L. M., Bahalim, A. N., Barker-Collo, S., Barrero, L. H., Bartels, D. H., Basáñez, M., Baxter, A., Bell, M. L., Benjamin, E. J., Bennett, D., Bernabé, E., Bhalla, K., Bhandari, B., Bikbov, B., Bin Abdulhak, A., Birbeck, G., Black, J. A., Blencowe, H., Blore, J. D., Blyth, F., Bolliger, I., Bonaventure, A., Boufous, S., Bourne, R., Boussinesq, M., Braithwaite, T., Brayne, C., Bridgett, L., Brooker, S., Brooks, P., Brugha, T. S., Bryan-Hancock, C., Bucello, C., Buchbinder, R., Buckle, G., Budke, C. M., Burch, M., Burney, P., Burstein, R., Calabria, B., Campbell, B., Canter, C. E., Carabin, H., Carapetis, J., Carmona, L., Cella, C., Charlson, F., Chen, H., Cheng, A. T., Chou, D., Chugh, S. S., Coffeng, L. E., Colan, S. D., Colquhoun, S., Colson, K. E., Condon, J., Connor, M. D., Cooper, L. T., Corriere, M., Cortinovis, M., de Vaccaro, K. C., Couser, W., Cowie, B. C., Criqui, M. H., Cross, M., Dabhadkar, K. C., Dahiya, M., Dahodwala, N., Damsere-Derry, J., Danaei, G., Davis, A., De Leo, D., Degenhardt, L., Dellavalle, R., Delossantos, A., Denenberg, J., Derrett, S., Des Jarlais, D. C., Dharmaratne, S. D., Dherani, M., Diaz-Torne, C., Dolk, H., Dorsey, E. R., Driscoll, T., Duber, H., Ebel, B., Edmond, K., Elbaz, A., Ali, S. E., Erskine, H., Erwin, P. J., Espindola, P., Ewoigbokhan, S. E., Farzadfar, F., Feigin, V., Felson, D. T., Ferrari, A., Ferri, C. P., Fèvre, E. M., Finucane, M. M., Flaxman, S., Flood, L., Foreman, K., Forouzanfar, M. H., Fowkes, F. G. R., Franklin, R., Fransen, M., Freeman, M. K., Gabbe, B. J., Gabriel, S. E., Gakidou, E., Ganatra, H. A., Garcia, B., Gaspari, F., Gillum, R. F., Gmel, G., Gosselin, R., Grainger, R., Groeger, J., Guillemin, F., Gunnell, D., Gupta, R., Haagsma, J., Hagan, H., Halasa, Y. A., Hall, W., Haring, D., Haro, J. M., Harrison, J. E., Havmoeller, R., Hay, R. J., Higashi, H., Hill, C., Hoen, B., Hoffman, H., Hotez, P. J., Hoy, D., Huang, J. J., Ibeanusi, S. E., Jacobsen, K. H., James, S. L., Jarvis, D., Jasrasaria, R., Jayaraman, S., Johns, N., Jonas, J. B., Karthikeyan, G., Kassebaum, N., Kawakami, N., Keren, A., Khoo, J., King, C. H., Knowlton, L. M., Kobusingye, O., Koranteng, A., Krishnamurthi, R., Lalloo, R., Laslett, L. L., Lathlean, T., Leasher, J. L., Lee, Y. Y., Leigh, J., Lim, S. S., Limb, E., Lin, J. K., Lipnick, M., Lipshultz, S. E., Liu, W., Loane, M., Ohno, S. L., Lyons, R., Ma, J., Mabweijano, J., MacIntyre, M. F., Malekzadeh, R., Mallinger, L., Manivannan, S., Marcenes, W., March, L., Margolis, D. J., Marks, G. B., Marks, R., Matsumori, A., Matzopoulos, R., Mayosi, B. M., McAnulty, J. H., McDermott, M. M., McGill, N., McGrath, J., Medina-Mora, M. E., Meltzer, M., Mensah, G. A., Merriman, T. R., Meyer, A., Miglioli, V., Miller, M., Miller, T. R., Mitchell, P. B., Mocumbi, A. O., Moffitt, T. E., Mokdad, A. A., Monasta, L., Montico, M., Moradi-Lakeh, M., Moran, A., Morawska, L., Mori, R., Murdoch, M. E., Mwaniki, M. K., Naidoo, K., Nair, M. N., Naldi, L., Narayan, K. M. V., Nelson, P. K., Nelson, R. G., Nevitt, M. C., Newton, C. R., Nolte, S., Norman, P., Norman, R., O'Donnell, M., O'Hanlon, S., Olives, C., Omer, S. B., Ortblad, K., Osborne, R., Ozgediz, D., Page, A., Pahari, B., Pandian, J. D., Rivero, A. P., Patten, S. B., Pearce, N., Padilla, R. P., Perez-Ruiz, F., Perico, N., Pesudovs, K., Phillips, D., Phillips, M. R., Pierce, K., Pion, S., Polanczyk, G. V., Polinder, S., Pope, C. A., Popova, S., Porrini, E., Pourmalek, F., Prince, M., Pullan, R. L., Ramaiah, K. D., Ranganathan, D., Razavi, H., Regan, M., Rehm, J. T., Rein, D. B., Remuzzi, G., Richardson, K., Rivara, F. P., Roberts, T., Robinson, C., De Leòn, F. R., Ronfani, L., Room, R., Rosenfeld, L. C., Rushton, L., Sacco, R. L., Saha, S., Sampson, U., Sanchez-Riera, L., Sanman, E., Schwebel, D. C., Scott, J. G., Segui-Gomez, M., Shahraz, S., Shepard, D. S., Shin, H., Shivakoti, R., Singh, D., Singh, G. M., Singh, J. A., Singleton, J., Sleet, D. A., Sliwa, K., Smith, E., Smith, J. L., Stapelberg, N. J. C., Steer, A., Steiner, T., Stolk, W. A., Stovner, L. J., Sudfeld, C., Syed, S., Tamburlini, G., Tavakkoli, M., Taylor, H. R., Taylor, J. A., Taylor, W. J., Thomas, B., Thomson, W. M., Thurston, G. D., Tleyjeh, I. M., Tonelli, M., Towbin, J. A., Truelsen, T., Tsilimbaris, M. K., Ubeda, C., Undurraga, E. A., van der Werf, M. J., van Os, J., Vavilala, M. S., Venketasubramanian, N., Wang, M., Wang, W., Watt, K., Weatherall, D. J., Weinstock, M. A., Weintraub, R., Weisskopf, M. G., Weissman, M. M., White, R. A., Whiteford, H., Wiersma, S. T., Wilkinson, J. D., Williams, H. C., Williams, S. R. M., Witt, E., Wolfe, F., Woolf, A. D., Wulf, S., Yeh, P., Zaidi, A. K. M., Zheng, Z., Zonies, D., Lopez, A. D., Murray, C. J. L., AlMazroa, M. A., & Memish, Z. A. Lancet (London, England), 380(9859):2163–2196, December, 2012.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. FUNDING: Bill & Melinda Gates Foundation.
@article{vos_years_2012,
title = {Years lived with disability ({YLDs}) for 1160 sequelae of 289 diseases and injuries 1990-2010: {A} systematic analysis for the {Global} {Burden} of {Disease} {Study} 2010.},
volume = {380},
issn = {1474-547X},
shorttitle = {Years lived with disability ({YLDs}) for 1160 sequelae of 289 diseases and injuries 1990-2010},
doi = {10.1016/S0140-6736(12)61729-2},
abstract = {BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs).
METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis.
FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa.
INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
FUNDING: Bill \& Melinda Gates Foundation.},
language = {ENG},
number = {9859},
journal = {Lancet (London, England)},
author = {Vos, Theo and Flaxman, Abraham D. and Naghavi, Mohsen and Lozano, Rafael and Michaud, Catherine and Ezzati, Majid and Shibuya, Kenji and Salomon, Joshua A. and Abdalla, Safa and Aboyans, Victor and Abraham, Jerry and Ackerman, Ilana and Aggarwal, Rakesh and Ahn, Stephanie Y. and Ali, Mohammed K. and Alvarado, Miriam and Anderson, H. Ross and Anderson, Laurie M. and Andrews, Kathryn G. and Atkinson, Charles and Baddour, Larry M. and Bahalim, Adil N. and Barker-Collo, Suzanne and Barrero, Lope H. and Bartels, David H. and Basáñez, Maria-Gloria and Baxter, Amanda and Bell, Michelle L. and Benjamin, Emelia J. and Bennett, Derrick and Bernabé, Eduardo and Bhalla, Kavi and Bhandari, Bishal and Bikbov, Boris and Bin Abdulhak, Aref and Birbeck, Gretchen and Black, James A. and Blencowe, Hannah and Blore, Jed D. and Blyth, Fiona and Bolliger, Ian and Bonaventure, Audrey and Boufous, Soufiane and Bourne, Rupert and Boussinesq, Michel and Braithwaite, Tasanee and Brayne, Carol and Bridgett, Lisa and Brooker, Simon and Brooks, Peter and Brugha, Traolach S. and Bryan-Hancock, Claire and Bucello, Chiara and Buchbinder, Rachelle and Buckle, Geoffrey and Budke, Christine M. and Burch, Michael and Burney, Peter and Burstein, Roy and Calabria, Bianca and Campbell, Benjamin and Canter, Charles E. and Carabin, Hélène and Carapetis, Jonathan and Carmona, Loreto and Cella, Claudia and Charlson, Fiona and Chen, Honglei and Cheng, Andrew Tai-Ann and Chou, David and Chugh, Sumeet S. and Coffeng, Luc E. and Colan, Steven D. and Colquhoun, Samantha and Colson, K. Ellicott and Condon, John and Connor, Myles D. and Cooper, Leslie T. and Corriere, Matthew and Cortinovis, Monica and de Vaccaro, Karen Courville and Couser, William and Cowie, Benjamin C. and Criqui, Michael H. and Cross, Marita and Dabhadkar, Kaustubh C. and Dahiya, Manu and Dahodwala, Nabila and Damsere-Derry, James and Danaei, Goodarz and Davis, Adrian and De Leo, Diego and Degenhardt, Louisa and Dellavalle, Robert and Delossantos, Allyne and Denenberg, Julie and Derrett, Sarah and Des Jarlais, Don C. and Dharmaratne, Samath D. and Dherani, Mukesh and Diaz-Torne, Cesar and Dolk, Helen and Dorsey, E. Ray and Driscoll, Tim and Duber, Herbert and Ebel, Beth and Edmond, Karen and Elbaz, Alexis and Ali, Suad Eltahir and Erskine, Holly and Erwin, Patricia J. and Espindola, Patricia and Ewoigbokhan, Stalin E. and Farzadfar, Farshad and Feigin, Valery and Felson, David T. and Ferrari, Alize and Ferri, Cleusa P. and Fèvre, Eric M. and Finucane, Mariel M. and Flaxman, Seth and Flood, Louise and Foreman, Kyle and Forouzanfar, Mohammad H. and Fowkes, Francis Gerry R. and Franklin, Richard and Fransen, Marlene and Freeman, Michael K. and Gabbe, Belinda J. and Gabriel, Sherine E. and Gakidou, Emmanuela and Ganatra, Hammad A. and Garcia, Bianca and Gaspari, Flavio and Gillum, Richard F. and Gmel, Gerhard and Gosselin, Richard and Grainger, Rebecca and Groeger, Justina and Guillemin, Francis and Gunnell, David and Gupta, Ramyani and Haagsma, Juanita and Hagan, Holly and Halasa, Yara A. and Hall, Wayne and Haring, Diana and Haro, Josep Maria and Harrison, James E. and Havmoeller, Rasmus and Hay, Roderick J. and Higashi, Hideki and Hill, Catherine and Hoen, Bruno and Hoffman, Howard and Hotez, Peter J. and Hoy, Damian and Huang, John J. and Ibeanusi, Sydney E. and Jacobsen, Kathryn H. and James, Spencer L. and Jarvis, Deborah and Jasrasaria, Rashmi and Jayaraman, Sudha and Johns, Nicole and Jonas, Jost B. and Karthikeyan, Ganesan and Kassebaum, Nicholas and Kawakami, Norito and Keren, Andre and Khoo, Jon-Paul and King, Charles H. and Knowlton, Lisa Marie and Kobusingye, Olive and Koranteng, Adofo and Krishnamurthi, Rita and Lalloo, Ratilal and Laslett, Laura L. and Lathlean, Tim and Leasher, Janet L. and Lee, Yong Yi and Leigh, James and Lim, Stephen S. and Limb, Elizabeth and Lin, John Kent and Lipnick, Michael and Lipshultz, Steven E. and Liu, Wei and Loane, Maria and Ohno, Summer Lockett and Lyons, Ronan and Ma, Jixiang and Mabweijano, Jacqueline and MacIntyre, Michael F. and Malekzadeh, Reza and Mallinger, Leslie and Manivannan, Sivabalan and Marcenes, Wagner and March, Lyn and Margolis, David J. and Marks, Guy B. and Marks, Robin and Matsumori, Akira and Matzopoulos, Richard and Mayosi, Bongani M. and McAnulty, John H. and McDermott, Mary M. and McGill, Neil and McGrath, John and Medina-Mora, Maria Elena and Meltzer, Michele and Mensah, George A. and Merriman, Tony R. and Meyer, Ana-Claire and Miglioli, Valeria and Miller, Matthew and Miller, Ted R. and Mitchell, Philip B. and Mocumbi, Ana Olga and Moffitt, Terrie E. and Mokdad, Ali A. and Monasta, Lorenzo and Montico, Marcella and Moradi-Lakeh, Maziar and Moran, Andrew and Morawska, Lidia and Mori, Rintaro and Murdoch, Michele E. and Mwaniki, Michael K. and Naidoo, Kovin and Nair, M. Nathan and Naldi, Luigi and Narayan, K. M. Venkat and Nelson, Paul K. and Nelson, Robert G. and Nevitt, Michael C. and Newton, Charles R. and Nolte, Sandra and Norman, Paul and Norman, Rosana and O'Donnell, Martin and O'Hanlon, Simon and Olives, Casey and Omer, Saad B. and Ortblad, Katrina and Osborne, Richard and Ozgediz, Doruk and Page, Andrew and Pahari, Bishnu and Pandian, Jeyaraj Durai and Rivero, Andrea Panozo and Patten, Scott B. and Pearce, Neil and Padilla, Rogelio Perez and Perez-Ruiz, Fernando and Perico, Norberto and Pesudovs, Konrad and Phillips, David and Phillips, Michael R. and Pierce, Kelsey and Pion, Sébastien and Polanczyk, Guilherme V. and Polinder, Suzanne and Pope, C. Arden and Popova, Svetlana and Porrini, Esteban and Pourmalek, Farshad and Prince, Martin and Pullan, Rachel L. and Ramaiah, Kapa D. and Ranganathan, Dharani and Razavi, Homie and Regan, Mathilda and Rehm, Jürgen T. and Rein, David B. and Remuzzi, Guiseppe and Richardson, Kathryn and Rivara, Frederick P. and Roberts, Thomas and Robinson, Carolyn and De Leòn, Felipe Rodriguez and Ronfani, Luca and Room, Robin and Rosenfeld, Lisa C. and Rushton, Lesley and Sacco, Ralph L. and Saha, Sukanta and Sampson, Uchechukwu and Sanchez-Riera, Lidia and Sanman, Ella and Schwebel, David C. and Scott, James Graham and Segui-Gomez, Maria and Shahraz, Saeid and Shepard, Donald S. and Shin, Hwashin and Shivakoti, Rupak and Singh, David and Singh, Gitanjali M. and Singh, Jasvinder A. and Singleton, Jessica and Sleet, David A. and Sliwa, Karen and Smith, Emma and Smith, Jennifer L. and Stapelberg, Nicolas J. C. and Steer, Andrew and Steiner, Timothy and Stolk, Wilma A. and Stovner, Lars Jacob and Sudfeld, Christopher and Syed, Sana and Tamburlini, Giorgio and Tavakkoli, Mohammad and Taylor, Hugh R. and Taylor, Jennifer A. and Taylor, William J. and Thomas, Bernadette and Thomson, W. Murray and Thurston, George D. and Tleyjeh, Imad M. and Tonelli, Marcello and Towbin, Jeffrey A. and Truelsen, Thomas and Tsilimbaris, Miltiadis K. and Ubeda, Clotilde and Undurraga, Eduardo A. and van der Werf, Marieke J. and van Os, Jim and Vavilala, Monica S. and Venketasubramanian, N. and Wang, Mengru and Wang, Wenzhi and Watt, Kerrianne and Weatherall, David J. and Weinstock, Martin A. and Weintraub, Robert and Weisskopf, Marc G. and Weissman, Myrna M. and White, Richard A. and Whiteford, Harvey and Wiersma, Steven T. and Wilkinson, James D. and Williams, Hywel C. and Williams, Sean R. M. and Witt, Emma and Wolfe, Frederick and Woolf, Anthony D. and Wulf, Sarah and Yeh, Pon-Hsiu and Zaidi, Anita K. M. and Zheng, Zhi-Jie and Zonies, David and Lopez, Alan D. and Murray, Christopher J. L. and AlMazroa, Mohammad A. and Memish, Ziad A.},
month = dec,
year = {2012},
pmid = {23245607},
keywords = {Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Global Health, Health Status, Humans, Incidence, Infant, Infant, Newborn, Male, Middle Aged, Prevalence, Quality-Adjusted Life Years, Sex Factors, Wounds and Injuries, Young Adult},
pages = {2163--2196},
}Health service use in families where children enter public care: a nested case control study using the General Practice Research Database. Simkiss, D. E., Spencer, N. J., Stallard, N., & Thorogood, M. BMC health services research, 12:65, 2012.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: At least 3% of children spend some of their childhood in public care and, as a group, have poor outcomes across a range of education, employment, health and social care outcomes. Research, using social care or government datasets, has identified a number of risk factors associated with children entering public care but the utility of risk factors in clinical practice is not established. This paper uses routine primary health care data to see if risk factors for children entering public care can be identified in clinical practice. METHODS: A nested case control methodology using routine primary care data from the United Kingdom. Health service use data were extracted for the 12 months before the case child entered public care and compared with 12 months of data for four control mother child pairs per case pair, matched on the age and sex of the child and the general practice. Exposures of interest were developed from a systematic review of the literature on risk factors associated with children entering public care. RESULTS: Conditional logistic regression was used to investigate the combined effect of more than one exposure of interest. Maternal mental illness (OR 2.51, 95% CI 1.55-4.05), maternal age at birth of the child, socio-economic status (5(th) quintile vs. 1(st) quintile OR 7.14, 95% CI 2.92-17.4), maternal drug use (OR 28.8, 95% CI 2.29-363), non attendance at appointments (OR 2.42, 95% CI 1.42-4.14), child mental illness (OR 2.65, 95% CI 1.42-4.96) and child admission to hospital (OR 3.31, 95% CI 1.21-9.02) were all significantly associated with children entering public care. Maternal use of primary care contraception services was negatively associated with children entering public care (OR 0.52, 95% CI 0.31-0.87). CONCLUSIONS: Differences in health service use can be identified from routine primary care data in mother child pairs where children enter public care after controlling for maternal age and socio-economic status. The interaction between different risk factors needs testing in a cumulative risk model using longitudinal datasets.
@article{simkiss_health_2012,
title = {Health service use in families where children enter public care: a nested case control study using the {General} {Practice} {Research} {Database}},
volume = {12},
issn = {1472-6963},
shorttitle = {Health service use in families where children enter public care},
doi = {10.1186/1472-6963-12-65},
abstract = {BACKGROUND: At least 3\% of children spend some of their childhood in public care and, as a group, have poor outcomes across a range of education, employment, health and social care outcomes. Research, using social care or government datasets, has identified a number of risk factors associated with children entering public care but the utility of risk factors in clinical practice is not established. This paper uses routine primary health care data to see if risk factors for children entering public care can be identified in clinical practice.
METHODS: A nested case control methodology using routine primary care data from the United Kingdom. Health service use data were extracted for the 12 months before the case child entered public care and compared with 12 months of data for four control mother child pairs per case pair, matched on the age and sex of the child and the general practice. Exposures of interest were developed from a systematic review of the literature on risk factors associated with children entering public care.
RESULTS: Conditional logistic regression was used to investigate the combined effect of more than one exposure of interest. Maternal mental illness (OR 2.51, 95\% CI 1.55-4.05), maternal age at birth of the child, socio-economic status (5(th) quintile vs. 1(st) quintile OR 7.14, 95\% CI 2.92-17.4), maternal drug use (OR 28.8, 95\% CI 2.29-363), non attendance at appointments (OR 2.42, 95\% CI 1.42-4.14), child mental illness (OR 2.65, 95\% CI 1.42-4.96) and child admission to hospital (OR 3.31, 95\% CI 1.21-9.02) were all significantly associated with children entering public care. Maternal use of primary care contraception services was negatively associated with children entering public care (OR 0.52, 95\% CI 0.31-0.87).
CONCLUSIONS: Differences in health service use can be identified from routine primary care data in mother child pairs where children enter public care after controlling for maternal age and socio-economic status. The interaction between different risk factors needs testing in a cumulative risk model using longitudinal datasets.},
language = {eng},
journal = {BMC health services research},
author = {Simkiss, Douglas E. and Spencer, Nicholas J. and Stallard, Nigel and Thorogood, Margaret},
year = {2012},
pmid = {22424404},
pmcid = {PMC3361673},
keywords = {Adolescent, Adult, Case-Control Studies, Child, Child, Preschool, Databases, Factual, Family Health, Female, General Practice, Great Britain, Health Services Research, Hospitalization, Humans, Infant, Logistic Models, Male, Maternal Age, Maternal-Child Health Centers, Mental Disorders, Middle Aged, Mothers, Primary Health Care, Public Sector, Questionnaires, Risk Factors, Social Class, Young Adult},
pages = {65}
}2011 (6)
The London low emission zone baseline study. Kelly, F., Armstrong, B., Atkinson, R., Anderson, H. R., Barratt, B., Beevers, S., Cook, D., Green, D., Derwent, D., Mudway, I., Wilkinson, P., & HEI Health Review Committee Research Report (Health Effects Institute), November, 2011.
abstract bibtex
abstract bibtex
On February 4, 2008, the world's largest low emission zone (LEZ) was established. At 2644 km2, the zone encompasses most of Greater London. It restricts the entry of the oldest and most polluting diesel vehicles, including heavy-goods vehicles (haulage trucks), buses and coaches, larger vans, and minibuses. It does not apply to cars or motorcycles. The LEZ scheme will introduce increasingly stringent Euro emissions standards over time. The creation of this zone presented a unique opportunity to estimate the effects of a stepwise reduction in vehicle emissions on air quality and health. Before undertaking such an investigation, robust baseline data were gathered on air quality and the oxidative activity and metal content of particulate matter (PM) from air pollution monitors located in Greater London. In addition, methods were developed for using databases of electronic primary-care records in order to evaluate the zone's health effects. Our study began in 2007, using information about the planned restrictions in an agreed-upon LEZ scenario and year-on-year changes in the vehicle fleet in models to predict air pollution concentrations in London for the years 2005, 2008, and 2010. Based on this detailed emissions and air pollution modeling, the areas in London were then identified that were expected to show the greatest changes in air pollution concentrations and population exposures after the implementation of the LEZ. Using these predictions, the best placement of a pollution monitoring network was determined and the feasibility of evaluating the health effects using electronic primary-care records was assessed. To measure baseline pollutant concentrations before the implementation of the LEZ, a comprehensive monitoring network was established close to major roadways and intersections. Output-difference plots from statistical modeling for 2010 indicated seven key areas likely to experience the greatest change in concentrations of nitrogen dioxide (NO2) (at least 3 microg/m3) and of PM with an aerodynamic diameter \textless or = 10 microm (PM10) (at least 0.75 microg/m3) as a result of the LEZ; these suggested that the clearest signals of change were most likely to be measured near roadsides. The seven key areas were also likely to be of importance in carrying out a study to assess the health outcomes of an air quality intervention like the LEZ. Of the seven key areas, two already had monitoring sites with a full complement of equipment, four had monitoring sites that required upgrades of existing equipment, and one required a completely new installation. With the upgrades and new installations in place, fully ratified (verified) pollutant data (for PM10, PM with an aerodynamic diameter \textless or = 2.5 microm [PM2.5], nitrogen oxides [NOx], and ozone [O3] at all sites as well as for particle number, black smoke [BS], carbon monoxide [CO], and sulfur dioxide [SO2] at selected sites) were then collected for analysis. In addition, the seven key monitoring sites were supported by other sites in the London Air Quality Network (LAQN). From these, a robust set of baseline air quality data was produced. Data from automatic and manual traffic counters as well as automatic license-plate recognition cameras were used to compile detailed vehicle profiles. This enabled us to establish more precise associations between ambient pollutant concentrations and vehicle emissions. An additional goal of the study was to collect baseline PM data in order to test the hypothesis that changes in traffic densities and vehicle mixes caused by the LEZ would affect the oxidative potential and metal content of ambient PM10 and PM2.5. The resulting baseline PM data set was the first to describe, in detail, the oxidative potential and metal content of the PM10 and PM2.5 of a major city's airshed. PM in London has considerable oxidative potential; clear differences in this measure were found from site to site, with evidence that the oxidative potential of both PM10 and PM2.5 at roadside monitoring sites was higher than at urban background locations. In the PM10 samples this increased oxidative activity appeared to be associated with increased concentrations of copper (Cu), barium (Ba), and bathophenanthroline disulfonate-mobilized iron (BPS Fe) in the roadside samples. In the PM2.5 samples, no simple association could be seen, suggesting that other unmeasured components were driving the increased oxidative potential in this fraction of the roadside samples. These data suggest that two components were contributing to the oxidative potential of roadside PM, namely Cu and BPS Fe in the coarse fraction of PM (PM with an aerodynamic diameter of 2.5 microm to 10 microm; PM(2.5-10)) and an unidentified redox catalyst in PM2.5. The data derived for this baseline study confirmed key observations from a more limited spatial mapping exercise published in our earlier HEI report on the introduction of the London's Congestion Charging Scheme (CCS) in 2003 (Kelly et al. 2011a,b). In addition, the data set in the current report provided robust baseline information on the oxidative potential and metal content of PM found in the London airshed in the period before implementation of the LEZ; the finding that a proportion of the oxidative potential appears in the PM coarse mode and is apparently related to brake wear raises important issues regarding the nature of traffic management schemes. The final goal of this baseline study was to establish the feasibility, in ethical and operational terms, of using the U.K.'s electronic primary-care records to evaluate the effects of the LEZ on human health outcomes. Data on consultations and prescriptions were compiled from a pilot group of general practices (13 distributed across London, with 100,000 patients; 29 situated in the inner London Borough of Lambeth, with 200,000 patients). Ethics approvals were obtained to link individual primary-care records to modeled NOx concentrations by means of post-codes. (To preserve anonymity, the postcodes were removed before delivery to the research team.) A wide range of NOx exposures was found across London as well as within and between the practices examined. Although we observed little association between NOx exposure and smoking status, a positive relationship was found between exposure and increased socioeconomic deprivation. The health outcomes we chose to study were asthma, chronic obstructive pulmonary disease, wheeze, hay fever, upper and lower respiratory tract infections, ischemic heart disease, heart failure, and atrial fibrillation. These outcomes were measured as prevalence or incidence. Their distributions by age, sex, socioeconomic deprivation, ethnicity, and smoking were found to accord with those reported in the epidemiology literature. No cross-sectional positive associations were found between exposure to NOx and any of the studied health outcomes; some associations were significantly negative. After the pilot study, a suitable primary-care database of London patients was identified, the General Practice Research Database responsible for giving us access to these data agreed to collaborate in the evaluation of the LEZ, and an acceptable method of ensuring privacy of the records was agreed upon. The database included about 350,000 patients who had remained at the same address over the four-year period of the study. Power calculations for a controlled longitudinal analysis were then performed, indicating that for outcomes such as consultations for respiratory illnesses or prescriptions for asthma there was sufficient power to identify a 5% to 10% reduction in consultations for patients most exposed to the intervention compared with patients presumed to not be exposed to it. In conclusion, the work undertaken in this study provides a good foundation for future LEZ evaluations. Our extensive monitoring network, measuring a comprehensive set of pollutants (and a range of particle metrics), will continue to provide a valuable tool both for assessing the impact of LEZ regulations on air quality in London and for furthering understanding of the link between PM's composition and toxicity. Finally, we believe that in combination with our modeling of the predicted population-based changes in pollution exposure in London, the use of primary-care databases forms a sound basis and has sufficient statistical power for the evaluation of the potential impact of the LEZ on human health.
@article{kelly_london_2011,
title = {The {London} low emission zone baseline study},
issn = {1041-5505},
abstract = {On February 4, 2008, the world's largest low emission zone (LEZ) was established. At 2644 km2, the zone encompasses most of Greater London. It restricts the entry of the oldest and most polluting diesel vehicles, including heavy-goods vehicles (haulage trucks), buses and coaches, larger vans, and minibuses. It does not apply to cars or motorcycles. The LEZ scheme will introduce increasingly stringent Euro emissions standards over time. The creation of this zone presented a unique opportunity to estimate the effects of a stepwise reduction in vehicle emissions on air quality and health. Before undertaking such an investigation, robust baseline data were gathered on air quality and the oxidative activity and metal content of particulate matter (PM) from air pollution monitors located in Greater London. In addition, methods were developed for using databases of electronic primary-care records in order to evaluate the zone's health effects. Our study began in 2007, using information about the planned restrictions in an agreed-upon LEZ scenario and year-on-year changes in the vehicle fleet in models to predict air pollution concentrations in London for the years 2005, 2008, and 2010. Based on this detailed emissions and air pollution modeling, the areas in London were then identified that were expected to show the greatest changes in air pollution concentrations and population exposures after the implementation of the LEZ. Using these predictions, the best placement of a pollution monitoring network was determined and the feasibility of evaluating the health effects using electronic primary-care records was assessed. To measure baseline pollutant concentrations before the implementation of the LEZ, a comprehensive monitoring network was established close to major roadways and intersections. Output-difference plots from statistical modeling for 2010 indicated seven key areas likely to experience the greatest change in concentrations of nitrogen dioxide (NO2) (at least 3 microg/m3) and of PM with an aerodynamic diameter {\textless} or = 10 microm (PM10) (at least 0.75 microg/m3) as a result of the LEZ; these suggested that the clearest signals of change were most likely to be measured near roadsides. The seven key areas were also likely to be of importance in carrying out a study to assess the health outcomes of an air quality intervention like the LEZ. Of the seven key areas, two already had monitoring sites with a full complement of equipment, four had monitoring sites that required upgrades of existing equipment, and one required a completely new installation. With the upgrades and new installations in place, fully ratified (verified) pollutant data (for PM10, PM with an aerodynamic diameter {\textless} or = 2.5 microm [PM2.5], nitrogen oxides [NOx], and ozone [O3] at all sites as well as for particle number, black smoke [BS], carbon monoxide [CO], and sulfur dioxide [SO2] at selected sites) were then collected for analysis. In addition, the seven key monitoring sites were supported by other sites in the London Air Quality Network (LAQN). From these, a robust set of baseline air quality data was produced. Data from automatic and manual traffic counters as well as automatic license-plate recognition cameras were used to compile detailed vehicle profiles. This enabled us to establish more precise associations between ambient pollutant concentrations and vehicle emissions. An additional goal of the study was to collect baseline PM data in order to test the hypothesis that changes in traffic densities and vehicle mixes caused by the LEZ would affect the oxidative potential and metal content of ambient PM10 and PM2.5. The resulting baseline PM data set was the first to describe, in detail, the oxidative potential and metal content of the PM10 and PM2.5 of a major city's airshed. PM in London has considerable oxidative potential; clear differences in this measure were found from site to site, with evidence that the oxidative potential of both PM10 and PM2.5 at roadside monitoring sites was higher than at urban background locations. In the PM10 samples this increased oxidative activity appeared to be associated with increased concentrations of copper (Cu), barium (Ba), and bathophenanthroline disulfonate-mobilized iron (BPS Fe) in the roadside samples. In the PM2.5 samples, no simple association could be seen, suggesting that other unmeasured components were driving the increased oxidative potential in this fraction of the roadside samples. These data suggest that two components were contributing to the oxidative potential of roadside PM, namely Cu and BPS Fe in the coarse fraction of PM (PM with an aerodynamic diameter of 2.5 microm to 10 microm; PM(2.5-10)) and an unidentified redox catalyst in PM2.5. The data derived for this baseline study confirmed key observations from a more limited spatial mapping exercise published in our earlier HEI report on the introduction of the London's Congestion Charging Scheme (CCS) in 2003 (Kelly et al. 2011a,b). In addition, the data set in the current report provided robust baseline information on the oxidative potential and metal content of PM found in the London airshed in the period before implementation of the LEZ; the finding that a proportion of the oxidative potential appears in the PM coarse mode and is apparently related to brake wear raises important issues regarding the nature of traffic management schemes. The final goal of this baseline study was to establish the feasibility, in ethical and operational terms, of using the U.K.'s electronic primary-care records to evaluate the effects of the LEZ on human health outcomes. Data on consultations and prescriptions were compiled from a pilot group of general practices (13 distributed across London, with 100,000 patients; 29 situated in the inner London Borough of Lambeth, with 200,000 patients). Ethics approvals were obtained to link individual primary-care records to modeled NOx concentrations by means of post-codes. (To preserve anonymity, the postcodes were removed before delivery to the research team.) A wide range of NOx exposures was found across London as well as within and between the practices examined. Although we observed little association between NOx exposure and smoking status, a positive relationship was found between exposure and increased socioeconomic deprivation. The health outcomes we chose to study were asthma, chronic obstructive pulmonary disease, wheeze, hay fever, upper and lower respiratory tract infections, ischemic heart disease, heart failure, and atrial fibrillation. These outcomes were measured as prevalence or incidence. Their distributions by age, sex, socioeconomic deprivation, ethnicity, and smoking were found to accord with those reported in the epidemiology literature. No cross-sectional positive associations were found between exposure to NOx and any of the studied health outcomes; some associations were significantly negative. After the pilot study, a suitable primary-care database of London patients was identified, the General Practice Research Database responsible for giving us access to these data agreed to collaborate in the evaluation of the LEZ, and an acceptable method of ensuring privacy of the records was agreed upon. The database included about 350,000 patients who had remained at the same address over the four-year period of the study. Power calculations for a controlled longitudinal analysis were then performed, indicating that for outcomes such as consultations for respiratory illnesses or prescriptions for asthma there was sufficient power to identify a 5\% to 10\% reduction in consultations for patients most exposed to the intervention compared with patients presumed to not be exposed to it. In conclusion, the work undertaken in this study provides a good foundation for future LEZ evaluations. Our extensive monitoring network, measuring a comprehensive set of pollutants (and a range of particle metrics), will continue to provide a valuable tool both for assessing the impact of LEZ regulations on air quality in London and for furthering understanding of the link between PM's composition and toxicity. Finally, we believe that in combination with our modeling of the predicted population-based changes in pollution exposure in London, the use of primary-care databases forms a sound basis and has sufficient statistical power for the evaluation of the potential impact of the LEZ on human health.},
language = {eng},
number = {163},
journal = {Research Report (Health Effects Institute)},
author = {Kelly, Frank and Armstrong, Ben and Atkinson, Richard and Anderson, H. Ross and Barratt, Ben and Beevers, Sean and Cook, Derek and Green, Dave and Derwent, Dick and Mudway, Ian and Wilkinson, Paul and {HEI Health Review Committee}},
month = nov,
year = {2011},
pmid = {22315924},
keywords = {Adolescent, Adult, Aged, Air Pollutants, Air Pollution, Child, Child, Preschool, Cross-Sectional Studies, Environmental Exposure, Environmental Monitoring, Female, Health Status, Humans, Infant, London, Longitudinal Studies, Male, Metals, Middle Aged, Nitrogen Oxides, Particulate Matter, Pilot Projects, Primary Health Care, Small-Area Analysis, Smoking, Socioeconomic Factors, Vehicle Emissions, Young Adult},
pages = {3--79}
}Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in England, 2001 to 2005. Kotz, D., Simpson, C. R., & Sheikh, A. The Journal of Allergy and Clinical Immunology, 127(3):623--630.e1, March, 2011.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Previous descriptions of the epidemiology of peanut allergy have mainly been derived from small cross-sectional studies. OBJECTIVE: To interrogate a large national research database to provide estimates for the incidence, prevalence, and trends of general practitioner (GP)-recorded diagnosis of peanut allergy in the English population. METHODS: Version 10 of the QRESEARCH database was used with data from 2,958,366 patients who were registered with 422 United Kingdom general practices in the years 2001 to 2005. The primary outcome was a recording of clinician-diagnosed peanut allergy. RESULTS: The age-sex standardized incidence rate of peanut allergy in 2005 was 0.08 per 1000 person-years (95% CI, 0.07-0.08), and the prevalence rate was 0.51 per 1000 patients (95% CI, 0.49-0.54). This translated into an estimated 4000 incident cases (95% CI, 3500-4600) and 25,700 prevalent cases (95% CI, 24,400-27,100) of GP-recorded diagnosis of peanut allergy in England in 2005. During the study period, the incidence rate of peanut allergy remained fairly stable, whereas the prevalence rate doubled. In those under 18 years of age, the crude lifetime prevalence rate was higher in males than females. A significant inverse relationship between prevalence and socioeconomic status was found. CONCLUSION: These data on GP-recorded diagnosis of peanut allergy from a large general practice database suggest a much lower prevalence in peanut allergy than has hitherto been found. This difference may in part be explained by underrecording of peanut allergy in general practice. Further research is needed to assess the true frequency of peanut allergy in the population and whether there has been a true increase in recent years.
@article{kotz_incidence_2011,
title = {Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in {England}, 2001 to 2005},
volume = {127},
issn = {1097-6825},
doi = {10.1016/j.jaci.2010.11.021},
abstract = {BACKGROUND: Previous descriptions of the epidemiology of peanut allergy have mainly been derived from small cross-sectional studies.
OBJECTIVE: To interrogate a large national research database to provide estimates for the incidence, prevalence, and trends of general practitioner (GP)-recorded diagnosis of peanut allergy in the English population.
METHODS: Version 10 of the QRESEARCH database was used with data from 2,958,366 patients who were registered with 422 United Kingdom general practices in the years 2001 to 2005. The primary outcome was a recording of clinician-diagnosed peanut allergy.
RESULTS: The age-sex standardized incidence rate of peanut allergy in 2005 was 0.08 per 1000 person-years (95\% CI, 0.07-0.08), and the prevalence rate was 0.51 per 1000 patients (95\% CI, 0.49-0.54). This translated into an estimated 4000 incident cases (95\% CI, 3500-4600) and 25,700 prevalent cases (95\% CI, 24,400-27,100) of GP-recorded diagnosis of peanut allergy in England in 2005. During the study period, the incidence rate of peanut allergy remained fairly stable, whereas the prevalence rate doubled. In those under 18 years of age, the crude lifetime prevalence rate was higher in males than females. A significant inverse relationship between prevalence and socioeconomic status was found.
CONCLUSION: These data on GP-recorded diagnosis of peanut allergy from a large general practice database suggest a much lower prevalence in peanut allergy than has hitherto been found. This difference may in part be explained by underrecording of peanut allergy in general practice. Further research is needed to assess the true frequency of peanut allergy in the population and whether there has been a true increase in recent years.},
language = {eng},
number = {3},
journal = {The Journal of Allergy and Clinical Immunology},
author = {Kotz, Daniel and Simpson, Colin R. and Sheikh, Aziz},
month = mar,
year = {2011},
pmid = {21236479},
keywords = {Adolescent, Adult, Child, Child, Preschool, England, Female, General Practitioners, Great Britain, Humans, Infant, Male, Medical Records, Peanut Hypersensitivity, Prevalence, incidence},
pages = {623--630.e1}
}Helping children correctly say “I don't know” to unanswerable questions. Waterman, A., H. & Blades, M. Journal of Experimental Psychology: Applied, 17(4):396-405, 2011.
abstract bibtex
abstract bibtex
Adults ask children questions in a variety of contexts, for example, in the classroom, in the forensic context, or in experimental research. In such situations children will inevitably be asked some questions to which they do not know the answer, because they do not have the required information ("unanswerable" questions). When asked unanswerable questions, it is important that children indicate that they do not have the required information to provide an answer. These 2 studies investigated whether preinterview instructions (Experiment 1) or establishing a memory narrative (Experiment 2) helped children correctly indicate a lack of knowledge to unanswerable questions. In both studies, 6- and 8-year-olds participated in a classroom-based event about which they were subsequently interviewed. Some of the questions were answerable, and some were unanswerable. Results showed that preinterview instructions increased the number of younger children's appropriate "don't know" responses to unanswerable questions, without decreasing correct responses to answerable questions. This suggests that demand characteristics affect children's tendency correctly to say "I don't know." The opportunity to provide a narrative account increased children's appropriate "don't know" responses to unanswerable yes/no questions, and increased the number of younger children's correct responses to answerable questions. This suggests that cognitive factors also contribute to children's tendency correctly to say "I don't know." These results have implications for any context where adults need to obtain information from children through questioning, for example, a health practitioner asking about a medical condition, in classroom discourse, in the investigative interview, and in developmental psychology research.
@article{
title = {Helping children correctly say “I don't know” to unanswerable questions.},
type = {article},
year = {2011},
identifiers = {[object Object]},
keywords = {an integral part of,communication,everyday,how well children can,in,in many different settings,instructions,interview,memory narrative,questions has important implications,the question-answer exchange is,understand and respond to},
pages = {396-405},
volume = {17},
id = {d39d8ec6-2d22-372e-9172-01a2516250b3},
created = {2016-01-12T14:30:17.000Z},
file_attached = {false},
profile_id = {d5b53108-91c5-30b8-8e6c-dd027f636bcd},
last_modified = {2017-03-16T06:19:45.131Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {true},
hidden = {false},
abstract = {Adults ask children questions in a variety of contexts, for example, in the classroom, in the forensic context, or in experimental research. In such situations children will inevitably be asked some questions to which they do not know the answer, because they do not have the required information ("unanswerable" questions). When asked unanswerable questions, it is important that children indicate that they do not have the required information to provide an answer. These 2 studies investigated whether preinterview instructions (Experiment 1) or establishing a memory narrative (Experiment 2) helped children correctly indicate a lack of knowledge to unanswerable questions. In both studies, 6- and 8-year-olds participated in a classroom-based event about which they were subsequently interviewed. Some of the questions were answerable, and some were unanswerable. Results showed that preinterview instructions increased the number of younger children's appropriate "don't know" responses to unanswerable questions, without decreasing correct responses to answerable questions. This suggests that demand characteristics affect children's tendency correctly to say "I don't know." The opportunity to provide a narrative account increased children's appropriate "don't know" responses to unanswerable yes/no questions, and increased the number of younger children's correct responses to answerable questions. This suggests that cognitive factors also contribute to children's tendency correctly to say "I don't know." These results have implications for any context where adults need to obtain information from children through questioning, for example, a health practitioner asking about a medical condition, in classroom discourse, in the investigative interview, and in developmental psychology research.},
bibtype = {article},
author = {Waterman, A. H. and Blades, M},
journal = {Journal of Experimental Psychology: Applied},
number = {4}
}Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Griffin, G. & Flynn, C., A. The Cochrane database of systematic reviews, 1, 2011.
Website abstract bibtex
Website abstract bibtex BACKGROUND: This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2006.Otitis media with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. The effectiveness of antihistamines, decongestants and antihistamine/decongestant combinations in promoting the resolution of effusions has been assessed by randomized controlled trials.
OBJECTIVES: The objective of this review was to determine whether antihistamine, decongestant or combination therapy is effective in treating children who present with OME.
SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 1 February 2011, following a previous search in 2006.
SELECTION CRITERIA: Randomized controlled trials (RCTs) using antihistamines, decongestants or antihistamine/decongestant combinations as treatment for OME in children. We excluded trials that randomized on the basis of acute otitis media (AOM) even though OME was also studied in follow up.
DATA COLLECTION AND ANALYSIS: Two authors independently extracted data from the published reports using standardized data extraction forms and methods. The two authors assessed the methodological quality of the included studies independently. We expressed dichotomous results as a risk ratio with 95% confidence intervals using a fixed-effect model when homogeneous and a random-effects model when heterogeneous. Nearly all outcomes analyzed were homogeneous. We discussed continuous results qualitatively. We conducted statistical analysis using RevMan 5.1 software.
MAIN RESULTS: Sixteen studies (1880 participants) were included in the review. No statistical or clinical benefit was found for any of the interventions or outcomes studied. However, treated study subjects experienced 11% more side effects than untreated subjects (number needed to treat to harm = 9).
AUTHORS' CONCLUSIONS: The pooled data demonstrate no benefit and some harm from the use of antihistamines or decongestants alone or in combination in the management of OME, therefore we recommend against their use.
@article{
title = {Antihistamines and/or decongestants for otitis media with effusion (OME) in children.},
type = {article},
year = {2011},
identifiers = {[object Object]},
keywords = {Child,Drug Therapy, Combination,Drug Therapy, Combination: methods,Histamine H1 Antagonists,Histamine H1 Antagonists: adverse effects,Histamine H1 Antagonists: therapeutic use,Humans,Nasal Decongestants,Nasal Decongestants: adverse effects,Nasal Decongestants: therapeutic use,Otitis Media with Effusion,Otitis Media with Effusion: drug therapy,Randomized Controlled Trials as Topic},
pages = {CD003423},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/21901683},
month = {1},
id = {fb261d14-693c-34e8-abe8-2e60793c7372},
created = {2015-12-02T02:16:28.000Z},
accessed = {2015-11-10},
file_attached = {false},
profile_id = {39c52e3a-ea6a-3a4a-9394-d3b9885e79f1},
group_id = {44d55093-6ab8-35a4-bbc6-bfecee8cd020},
last_modified = {2015-12-02T02:16:28.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {BACKGROUND: This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2006.Otitis media with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. The effectiveness of antihistamines, decongestants and antihistamine/decongestant combinations in promoting the resolution of effusions has been assessed by randomized controlled trials.
OBJECTIVES: The objective of this review was to determine whether antihistamine, decongestant or combination therapy is effective in treating children who present with OME.
SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 1 February 2011, following a previous search in 2006.
SELECTION CRITERIA: Randomized controlled trials (RCTs) using antihistamines, decongestants or antihistamine/decongestant combinations as treatment for OME in children. We excluded trials that randomized on the basis of acute otitis media (AOM) even though OME was also studied in follow up.
DATA COLLECTION AND ANALYSIS: Two authors independently extracted data from the published reports using standardized data extraction forms and methods. The two authors assessed the methodological quality of the included studies independently. We expressed dichotomous results as a risk ratio with 95% confidence intervals using a fixed-effect model when homogeneous and a random-effects model when heterogeneous. Nearly all outcomes analyzed were homogeneous. We discussed continuous results qualitatively. We conducted statistical analysis using RevMan 5.1 software.
MAIN RESULTS: Sixteen studies (1880 participants) were included in the review. No statistical or clinical benefit was found for any of the interventions or outcomes studied. However, treated study subjects experienced 11% more side effects than untreated subjects (number needed to treat to harm = 9).
AUTHORS' CONCLUSIONS: The pooled data demonstrate no benefit and some harm from the use of antihistamines or decongestants alone or in combination in the management of OME, therefore we recommend against their use.},
bibtype = {article},
author = {Griffin, Glenn and Flynn, Cheryl A},
journal = {The Cochrane database of systematic reviews},
number = {9}
}Efficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials. Schnabel, A., Poepping, D. M, Pogatzki-Zahn, E. M, & Zahn, P. K Paediatric anaesthesia, 21(12):1219–1230, December, 2011.
doi abstract bibtex
doi abstract bibtex
BACKGROUND Clonidine is still the most popular additive for caudal regional anesthesia. Aim of the present quantitative systematic review was to assess the efficacy and safety of the combined use of clonidine and local anesthetics in comparison with caudal local anesthetics alone. METHODS The systematic search, data extraction, critical appraisal and pooled analysis were performed according to the PRISMA statement. The systematic search included the Central register of controlled trials of the Cochrane Library (to present), MEDLINE (1966 to present), EMBASE (1980 to present) and CINAHL (1981 to present). Relative risk (RR), mean difference (MD) and the corresponding 95% confidence intervals (CI) were calculated using the Revman(®) statistical software for dichotomous and continuous outcomes. RESULTS Twenty randomized controlled trials (published between 1994 and 2010) including 993 patients met the inclusion criteria. There was a longer duration of postoperative analgesia in children receiving clonidine in addition to local anesthetic (MD: 3.98 h; 95% CI: 2.84-5.13; P \textless 0.00001). Furthermore, there was a lower number of patients requiring rescue analgesics in the clonidine group (RR: 0.72; 95% CI: 0.57-0.90; P = 0.003). The incidence of complications (e.g., respiratory depression) remained very low and was not different to caudal local anesthetics alone. CONCLUSIONS There is considerable evidence that caudally administered clonidine in addition to local anesthetics provides extended duration of analgesia with a decreased incidence for analgesic rescue requirement and little adverse effects compared to caudal local anesthetics alone.
@article{schnabel_efficacy_2011-2,
title = {Efficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials},
volume = {21},
issn = {1460-9592},
shorttitle = {Efficacy and safety of clonidine as additive for caudal regional anesthesia},
doi = {10.1111/j.1460-9592.2011.03715.x},
abstract = {BACKGROUND
Clonidine is still the most popular additive for caudal regional anesthesia. Aim of the present quantitative systematic review was to assess the efficacy and safety of the combined use of clonidine and local anesthetics in comparison with caudal local anesthetics alone.
METHODS
The systematic search, data extraction, critical appraisal and pooled analysis were performed according to the PRISMA statement. The systematic search included the Central register of controlled trials of the Cochrane Library (to present), MEDLINE (1966 to present), EMBASE (1980 to present) and CINAHL (1981 to present). Relative risk (RR), mean difference (MD) and the corresponding 95\% confidence intervals (CI) were calculated using the Revman(®) statistical software for dichotomous and continuous outcomes.
RESULTS
Twenty randomized controlled trials (published between 1994 and 2010) including 993 patients met the inclusion criteria. There was a longer duration of postoperative analgesia in children receiving clonidine in addition to local anesthetic (MD: 3.98 h; 95\% CI: 2.84-5.13; P {\textless} 0.00001). Furthermore, there was a lower number of patients requiring rescue analgesics in the clonidine group (RR: 0.72; 95\% CI: 0.57-0.90; P = 0.003). The incidence of complications (e.g., respiratory depression) remained very low and was not different to caudal local anesthetics alone.
CONCLUSIONS
There is considerable evidence that caudally administered clonidine in addition to local anesthetics provides extended duration of analgesia with a decreased incidence for analgesic rescue requirement and little adverse effects compared to caudal local anesthetics alone.},
number = {12},
journal = {Paediatric anaesthesia},
author = {Schnabel, Alexander and Poepping, Daniel M and Pogatzki-Zahn, Esther M and Zahn, Peter K},
month = dec,
year = {2011},
pmid = {22023418},
keywords = {Analgesics, Anesthesia, Caudal, Child, Clonidine, Humans, Pain, Postoperative, Postoperative Nausea and Vomiting, Randomized Controlled Trials as Topic, Risk, Treatment Outcome},
pages = {1219--1230}
}Comprehensive comparison of drug prescribing in the United States and United Kingdom. Parkin, L., Hagberg, K. W., & Jick, H. Pharmacotherapy, 31(7):623--629, July, 2011.
doi abstract bibtex
doi abstract bibtex
STUDY OBJECTIVE: To compare the frequency of outpatient drug prescribing in the United States and United Kingdom according to individual drugs and therapeutic categories during 2004-2006. DESIGN: Retrospective prescription record review. DATA SOURCES: United Kingdom General Practice Research Database, and the MarketScan Commercial Claims and Encounters Database for U.S. data. SUBJECTS: In the U.K. database, we identified 1.6 million people younger than 65 years who were prescribed at least one prescription drug in at least one of the calendar years during the study period (2004-2006). For comparison, for each U.K. person identified, we randomly identified one person of the same sex and year of birth in the U.S. database who was also prescribed at least one drug in the same calendar year. MEASUREMENTS AND MAIN RESULTS: We compared the frequency of prescribing of individual drugs, as well as selected therapeutic categories. Substantially higher proportions of people in the United States were prescribed antibiotics, statins, and postmenopausal hormones, but asthma drugs were prescribed more frequently in the United Kingdom. In those younger than 20 years, antidepressants and antipsychotics were prescribed more than twice as frequently in the United States, and males in the United States were far more likely to be prescribed drugs for attention-deficit-hyperactivity disorder than were their counterparts in the United Kingdom. CONCLUSION: This study provides documented quantification of differing patterns of drug use in the United States and United Kingdom during 2004-2006. The higher proportionate prescribing for most indications in the United States and the greater use of drugs under patent suggest that monetary costs are likely to be considerably higher in the United States than in the United Kingdom.
@article{parkin_comprehensive_2011,
title = {Comprehensive comparison of drug prescribing in the {United} {States} and {United} {Kingdom}},
volume = {31},
issn = {1875-9114},
doi = {10.1592/phco.31.7.623},
abstract = {STUDY OBJECTIVE: To compare the frequency of outpatient drug prescribing in the United States and United Kingdom according to individual drugs and therapeutic categories during 2004-2006.
DESIGN: Retrospective prescription record review.
DATA SOURCES: United Kingdom General Practice Research Database, and the MarketScan Commercial Claims and Encounters Database for U.S. data.
SUBJECTS: In the U.K. database, we identified 1.6 million people younger than 65 years who were prescribed at least one prescription drug in at least one of the calendar years during the study period (2004-2006). For comparison, for each U.K. person identified, we randomly identified one person of the same sex and year of birth in the U.S. database who was also prescribed at least one drug in the same calendar year.
MEASUREMENTS AND MAIN RESULTS: We compared the frequency of prescribing of individual drugs, as well as selected therapeutic categories. Substantially higher proportions of people in the United States were prescribed antibiotics, statins, and postmenopausal hormones, but asthma drugs were prescribed more frequently in the United Kingdom. In those younger than 20 years, antidepressants and antipsychotics were prescribed more than twice as frequently in the United States, and males in the United States were far more likely to be prescribed drugs for attention-deficit-hyperactivity disorder than were their counterparts in the United Kingdom.
CONCLUSION: This study provides documented quantification of differing patterns of drug use in the United States and United Kingdom during 2004-2006. The higher proportionate prescribing for most indications in the United States and the greater use of drugs under patent suggest that monetary costs are likely to be considerably higher in the United States than in the United Kingdom.},
language = {eng},
number = {7},
journal = {Pharmacotherapy},
author = {Parkin, Lianne and Hagberg, Katrina Wilcox and Jick, Hershel},
month = jul,
year = {2011},
pmid = {21923448},
keywords = {Adolescent, Adult, Age Factors, Child, Databases, Factual, Female, Great Britain, Humans, Male, Middle Aged, Physician's Practice Patterns, Prescription Drugs, Retrospective Studies, Sex Factors, United States, Young Adult},
pages = {623--629}
}2010 (4)
Pyridoxal-5-phosphate plasma concentrations in children receiving tuberculosis chemotherapy including isoniazid. Cilliers, K., Labadarios, D., Schaaf, H. S., Willemse, M., Maritz, J. S., Werely, C. J., Hussey, G., & Donald, P. R. Acta Paediatrica (Oslo, Norway: 1992), 99(5):705--710, May, 2010.
doi abstract bibtex
doi abstract bibtex
AIM: Little is known about pyridoxine nutriture of children treated with isoniazid (INH) regimens. This study documents plasma pyridoxal 5'-phosphate (PLP) concentrations in children, HIV-infected and HIV-uninfected, receiving INH regimens. METHODS: Children from the Western Cape of South Africa hospitalized for tuberculosis (TB) management were studied. Plasma PLP concentrations were determined on enrolment, 1-month after commencing TB treatment, and again after 4-month's treatment. The children received a supplement meeting pyridoxine requirements. RESULTS: Nineteen HIV-infected and 33 HIV-uninfected children received INH (dosage range 4-20 mg/kg) daily. Mean PLP plasma concentrations on enrolment were 8.32 (SD 6.75) ng/mL and 11.28 (SD 3.02) ng/mL in HIV-infected and HIV-uninfected children, respectively (p = 0.11) and after 4-month's treatment 6.75 (SD 2.71) ng/mL and 14.76 (SD 7.96) ng/mL (p \textless 0.001). On enrolment 9 (50%) HIV-infected and 5 (15%) HIV-uninfected children (p = 0.016) had suboptimal PLP concentrations (\textless6 ng/mL); after 4-month's treatment 8 (42%) and 2 (6%) (p = 0.004). CONCLUSION: Plasma PLP concentrations in children treated for TB were low on enrolment in HIV-infected and HIV-uninfected children; after 4-month's treatment low values were still common in HIV-infected children. Additional pyridoxine supplementation of malnourished children treated for tuberculosis is advisable, particularly those HIV-infected.
@article{ cilliers_pyridoxal-5-phosphate_2010,
title = {Pyridoxal-5-phosphate plasma concentrations in children receiving tuberculosis chemotherapy including isoniazid},
volume = {99},
issn = {1651-2227},
doi = {10.1111/j.1651-2227.2010.01696.x},
abstract = {AIM: Little is known about pyridoxine nutriture of children treated with isoniazid (INH) regimens. This study documents plasma pyridoxal 5'-phosphate (PLP) concentrations in children, HIV-infected and HIV-uninfected, receiving INH regimens.
METHODS: Children from the Western Cape of South Africa hospitalized for tuberculosis (TB) management were studied. Plasma PLP concentrations were determined on enrolment, 1-month after commencing TB treatment, and again after 4-month's treatment. The children received a supplement meeting pyridoxine requirements.
RESULTS: Nineteen HIV-infected and 33 HIV-uninfected children received INH (dosage range 4-20 mg/kg) daily. Mean PLP plasma concentrations on enrolment were 8.32 (SD 6.75) ng/mL and 11.28 (SD 3.02) ng/mL in HIV-infected and HIV-uninfected children, respectively (p = 0.11) and after 4-month's treatment 6.75 (SD 2.71) ng/mL and 14.76 (SD 7.96) ng/mL (p {\textless} 0.001). On enrolment 9 (50%) HIV-infected and 5 (15%) HIV-uninfected children (p = 0.016) had suboptimal PLP concentrations ({\textless}6 ng/mL); after 4-month's treatment 8 (42%) and 2 (6%) (p = 0.004).
CONCLUSION: Plasma PLP concentrations in children treated for TB were low on enrolment in HIV-infected and HIV-uninfected children; after 4-month's treatment low values were still common in HIV-infected children. Additional pyridoxine supplementation of malnourished children treated for tuberculosis is advisable, particularly those HIV-infected.},
language = {eng},
number = {5},
journal = {Acta Paediatrica (Oslo, Norway: 1992)},
author = {Cilliers, K. and Labadarios, D. and Schaaf, H. S. and Willemse, M. and Maritz, J. S. and Werely, C. J. and Hussey, G. and Donald, P. R.},
month = {May},
year = {2010},
pmid = {20146723},
keywords = {AIDS-Related Opportunistic Infections, Adolescent, Antitubercular Agents, Child, Child, Preschool, Female, Genotype, HIV Infections, Humans, Infant, Isoniazid, Male, Pyridoxal Phosphate, South Africa, Tuberculosis},
pages = {705--710}
}Dissemination limits the survival of patients with anaplastic ependymoma after extensive surgical resection, meticulous follow up, and intensive treatment for recurrence. Saito, R., Kumabe, T., Kanamori, M., Sonoda, Y., & Tominaga, T. Neurosurgical Review, 33(2):185-91; discussion 191-2, 4, 2010.
Paper abstract bibtex
Paper abstract bibtex The extent of resection is the most consistent factor affecting outcome of intracranial ependymomas. The outcomes in patients with intracranial anaplastic ependymomas who underwent more than subtotal resection and intensive treatment for recurrence were reviewed retrospectively. Between 1989 and 2007, 18 patients underwent more than subtotal resection at Tohoku University Hospital. Adjuvant chemoradiation therapy was conducted in 16 patients. Meticulous follow-up was performed for early detection of recurrence. Intensive therapy including surgery and chemoradiation therapy was added for recurrence. Median survival in all 18 patients was 136 months. The 5- and 10-year survival rates were 59.1% and 50.7%, respectively. Eight patients died during the observation period, five of dissemination, but none of uncontrollable local recurrence. High resection rate, meticulous follow-up, and intensive treatment for recurrence improved the survival of patients with anaplastic ependymoma. Dissemination was the life-determining factor in this series of patients.
@article{
title = {Dissemination limits the survival of patients with anaplastic ependymoma after extensive surgical resection, meticulous follow up, and intensive treatment for recurrence.},
type = {article},
year = {2010},
identifiers = {[object Object]},
keywords = {Adjuvant,Adolescent,Adult,Brain Neoplasms,Brain Neoplasms: diagnosis,Brain Neoplasms: mortality,Brain Neoplasms: pathology,Brain Neoplasms: therapy,Chemotherapy,Child,Ependymoma,Ependymoma: diagnosis,Ependymoma: mortality,Ependymoma: pathology,Ependymoma: therapy,Female,Follow-Up Studies,Humans,Kaplan-Meier Estimate,Local,Local: therapy,Magnetic Resonance Imaging,Male,Middle Aged,Neoplasm Recurrence,Preschool,Radiotherapy,Retrospective Studies,Survival Rate},
pages = {185-91; discussion 191-2},
volume = {33},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/20186454},
month = {4},
id = {095ad00f-60e1-3a2f-8cae-2eb3aba8490a},
created = {2013-09-07T05:22:53.000Z},
accessed = {2013-09-07},
file_attached = {true},
profile_id = {8c4ca2d5-86de-3b5d-86be-8408415f34e0},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-11-22T16:36:56.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {The extent of resection is the most consistent factor affecting outcome of intracranial ependymomas. The outcomes in patients with intracranial anaplastic ependymomas who underwent more than subtotal resection and intensive treatment for recurrence were reviewed retrospectively. Between 1989 and 2007, 18 patients underwent more than subtotal resection at Tohoku University Hospital. Adjuvant chemoradiation therapy was conducted in 16 patients. Meticulous follow-up was performed for early detection of recurrence. Intensive therapy including surgery and chemoradiation therapy was added for recurrence. Median survival in all 18 patients was 136 months. The 5- and 10-year survival rates were 59.1% and 50.7%, respectively. Eight patients died during the observation period, five of dissemination, but none of uncontrollable local recurrence. High resection rate, meticulous follow-up, and intensive treatment for recurrence improved the survival of patients with anaplastic ependymoma. Dissemination was the life-determining factor in this series of patients.},
bibtype = {article},
author = {Saito, Ryuta and Kumabe, Toshihiro and Kanamori, Masayuki and Sonoda, Yukihiko and Tominaga, Teiji},
journal = {Neurosurgical Review},
number = {2}
}Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Patel, A., Davidson, M., Tran, M., C., J., Quraishi, H., Schoenberg, C., Sant, M., Lin, A., & Sun, X. Anesthesia and analgesia, 111(4):1004-10, 10, 2010.
Paper abstract bibtex
Paper abstract bibtex Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A).
@article{
id = {c38657a8-c1fa-3ef3-9bfe-a4cfa2b950b4},
title = {Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy.},
type = {article},
year = {2010},
identifiers = {[object Object]},
keywords = {Adenoidectomy,Adenoidectomy: adverse effects,Analgesia,Analgesia: methods,Analgesics,Anesthesia Recovery Period,Child,Dexmedetomidine,Dexmedetomidine: administration & dosage,Female,Fentanyl,Fentanyl: administration & dosage,Humans,Infusions,Intravenous,Male,Non-Narcotic,Non-Narcotic: administration & dosage,Obstructive,Obstructive: drug therapy,Obstructive: surgery,Postoperative Complications,Postoperative Complications: etiology,Postoperative Complications: prevention & control,Preschool,Prospective Studies,Psychomotor Agitation,Psychomotor Agitation: etiology,Psychomotor Agitation: prevention & control,Sleep Apnea,Tonsillectomy,Tonsillectomy: adverse effects},
created = {2011-06-20T05:32:43.000Z},
pages = {1004-10},
volume = {111},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/20705788},
month = {10},
accessed = {2011-06-16},
file_attached = {true},
profile_id = {fe7067eb-58b8-34c6-b8cd-6717fdf7605c},
group_id = {ba0deb47-e19a-3151-83cc-b6262d5edb6e},
last_modified = {2014-07-19T19:17:29.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
citation_key = {Patel2010},
client_data = {"desktop_id":"097be1b9-94fa-4ae9-a74d-296e7811c66d"},
abstract = {Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A).},
bibtype = {article},
author = {Patel, Anuradha and Davidson, Melissa and Tran, Minh C J and Quraishi, Huma and Schoenberg, Catherine and Sant, Manasee and Lin, Albert and Sun, Xiuru},
journal = {Anesthesia and analgesia},
number = {4}
}Muslim women and medical students in the clinical encounter. McLean, M., Ahbabi, S. A., Ameri, M. A., Mansoori, M. A., Yahyaei, F. A., & Bernsen, R. Medical education, 44(3):306--315, March, 2010.
doi abstract bibtex
doi abstract bibtex
CONTEXT: Increasingly, male medical students report being refused by female patients, particularly in obstetrics and gynaecology, which is impacting on recruitment into the discipline. However, little has been documented in terms of Muslim patients and medical students in the clinical consultation. METHODS: Female Emirati nationals (n = 218) attending out-patient clinics at a public hospital in Al Ain, United Arab Emirates (UAE), were interviewed by medical students. Participants were provided with four hypothetical clinical scenarios (three personal, one concerning a pre-pubertal child) and asked whether they would allow male and female students to be present at a consultation, take a history or perform an examination. They were also canvassed about their past experiences with medical students and their social responsibility to contribute towards the training of Emirati doctors. RESULTS: Significant differences were recorded in terms of female versus male student involvement for all activities (P \textless 0.05-0.0005). For gynaecological and abdominal problems, patients would generally refuse male students. More than 50% of interviewees would not allow a male student to examine their face. Students of either gender could, however, examine their 8-year-old child. Although 47% of the women had had previous clinical encounters with students, in only 58% of consultations had the attending doctor asked their permission. Despite this, the women had generally felt comfortable, although satisfaction decreased with increasing age (P = 0.088). Almost 90% of the women believed that Emiratis had a social responsibility to contribute towards the training of Emirati doctors, but this decreased with increasing income (P = 0.004). CONCLUSIONS: As many medical students will encounter Muslim patients during their training, they need to be sensitive to religious and cultural issues, particularly for personal examinations. In contexts where most patients are Muslim, alternative options (e.g. manikins, international rotations) may be required for male students. In the UAE, patient education may improve history-taking opportunities but will probably not transcend religious and cultural beliefs without intervention from religious leaders.
@article{ mclean_muslim_2010,
title = {Muslim women and medical students in the clinical encounter},
volume = {44},
issn = {1365-2923},
doi = {10.1111/j.1365-2923.2009.03599.x},
abstract = {{CONTEXT}: Increasingly, male medical students report being refused by female patients, particularly in obstetrics and gynaecology, which is impacting on recruitment into the discipline. However, little has been documented in terms of Muslim patients and medical students in the clinical consultation.
{METHODS}: Female Emirati nationals (n = 218) attending out-patient clinics at a public hospital in Al Ain, United Arab Emirates ({UAE}), were interviewed by medical students. Participants were provided with four hypothetical clinical scenarios (three personal, one concerning a pre-pubertal child) and asked whether they would allow male and female students to be present at a consultation, take a history or perform an examination. They were also canvassed about their past experiences with medical students and their social responsibility to contribute towards the training of Emirati doctors.
{RESULTS}: Significant differences were recorded in terms of female versus male student involvement for all activities (P {\textless} 0.05-0.0005). For gynaecological and abdominal problems, patients would generally refuse male students. More than 50% of interviewees would not allow a male student to examine their face. Students of either gender could, however, examine their 8-year-old child. Although 47% of the women had had previous clinical encounters with students, in only 58% of consultations had the attending doctor asked their permission. Despite this, the women had generally felt comfortable, although satisfaction decreased with increasing age (P = 0.088). Almost 90% of the women believed that Emiratis had a social responsibility to contribute towards the training of Emirati doctors, but this decreased with increasing income (P = 0.004).
{CONCLUSIONS}: As many medical students will encounter Muslim patients during their training, they need to be sensitive to religious and cultural issues, particularly for personal examinations. In contexts where most patients are Muslim, alternative options (e.g. manikins, international rotations) may be required for male students. In the {UAE}, patient education may improve history-taking opportunities but will probably not transcend religious and cultural beliefs without intervention from religious leaders.},
language = {eng},
number = {3},
journal = {Medical education},
author = {McLean, Michelle and Al Ahbabi, Salma and Al Ameri, Mouza and Al Mansoori, Muneera and Al Yahyaei, Fatima and Bernsen, Roos},
month = {March},
year = {2010},
pmid = {20444062},
keywords = {Abdomen, Adolescent, Adult, Aged, Child, Choice Behavior, Education, Medical, Face, Female, Gynecology, Humans, Islam, Male, Middle Aged, Outpatient Clinics, Hospital, Patient Acceptance of Health Care, Patient Satisfaction, Questionnaires, Sex Factors, Social Responsibility, Students, Medical, United Arab Emirates, Young Adult},
pages = {306--315}
}2009 (4)
A survey of pediatric caudal extradural anesthesia practice. Menzies, R., Congreve, K., Herodes, V., Berg, S., & Mason, D. G Paediatric anaesthesia, 19(9):829–836, September, 2009.
doi abstract bibtex
doi abstract bibtex
BACKGROUND Caudal extradural blockade is one of the most commonly performed procedures in pediatric anesthesia. However, there is little information available on variations in clinical practice. OBJECTIVES To perform a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland who undertake caudal anesthesia. Methods: An 'online' World Wide Web questionnaire collected information on various aspects of clinical practice. The survey ran from April to June 2008. RESULTS There were 366 questionnaires completed. The majority of respondents had \textgreater5 years of pediatric experience and performed up to ten caudal extradural procedures a month. The commonest device used was a cannula (69.7%) with 68.6% using a 22G device. There was a trend toward the use of a cannula in those anesthetists with \textless15 years experience, while those with \textgreater15 years experience tended to use a needle. Most anesthetists (91.5%) did not believe that there was a significant risk of implantation of dermoid tissue into the caudal extradural space. The majority used a combination of clinical methods to confirm correct placement. Only 27 respondents used ultrasound. The most popular local anesthetics were bupivacaine (43.4%) and levobupivacaine (41.7%). The most common additives were clonidine (42.3%) and ketamine (37.5%). The caudal catheter technique was used by 43.6%. Most anesthetists (74%) wear gloves for a single shot caudal injection. CONCLUSIONS This survey provides a snapshot of current practice and acts a useful reference for the development of enhanced techniques and new equipment in the future.
@article{menzies_survey_2009,
title = {A survey of pediatric caudal extradural anesthesia practice},
volume = {19},
issn = {1460-9592},
doi = {10.1111/j.1460-9592.2009.03116.x},
abstract = {BACKGROUND
Caudal extradural blockade is one of the most commonly performed procedures in pediatric anesthesia. However, there is little information available on variations in clinical practice.
OBJECTIVES
To perform a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland who undertake caudal anesthesia. Methods: An 'online' World Wide Web questionnaire collected information on various aspects of clinical practice. The survey ran from April to June 2008.
RESULTS
There were 366 questionnaires completed. The majority of respondents had {\textgreater}5 years of pediatric experience and performed up to ten caudal extradural procedures a month. The commonest device used was a cannula (69.7\%) with 68.6\% using a 22G device. There was a trend toward the use of a cannula in those anesthetists with {\textless}15 years experience, while those with {\textgreater}15 years experience tended to use a needle. Most anesthetists (91.5\%) did not believe that there was a significant risk of implantation of dermoid tissue into the caudal extradural space. The majority used a combination of clinical methods to confirm correct placement. Only 27 respondents used ultrasound. The most popular local anesthetics were bupivacaine (43.4\%) and levobupivacaine (41.7\%). The most common additives were clonidine (42.3\%) and ketamine (37.5\%). The caudal catheter technique was used by 43.6\%. Most anesthetists (74\%) wear gloves for a single shot caudal injection.
CONCLUSIONS
This survey provides a snapshot of current practice and acts a useful reference for the development of enhanced techniques and new equipment in the future.},
number = {9},
journal = {Paediatric anaesthesia},
author = {Menzies, Robert and Congreve, Kate and Herodes, Veiko and Berg, Simon and Mason, David G},
month = sep,
year = {2009},
pmid = {19691690},
keywords = {Adolescent, Anesthesia, Anesthesia, Caudal, Anesthesia, Epidural, Anesthetics, Local, Asepsis, Child, Child, Preschool, Gloves, Surgical, Health Care Surveys, Humans, Infection Control, Marketingaktiv, Masks, Questionnaires},
pages = {829--836}
}Imaging of ependymomas: MRI and CT. Yuh, E., L., Barkovich, A., J., & Gupta, N. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 25(10):1203-13, 10, 2009.
abstract bibtex
abstract bibtex
The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are described. Finally, salient imaging features obtained in the postoperative period to evaluate completeness of surgical resection, and thereafter for long-term surveillance for disease recurrence, are reviewed.
@article{
title = {Imaging of ependymomas: MRI and CT.},
type = {article},
year = {2009},
identifiers = {[object Object]},
keywords = {Brain Neoplasms,Brain Neoplasms: metabolism,Brain Neoplasms: pathology,Brain Neoplasms: radiography,Child, Preschool,Diffusion Magnetic Resonance Imaging,Ependymoma,Ependymoma: metabolism,Ependymoma: pathology,Ependymoma: radiography,Humans,Magnetic Resonance Imaging,Magnetic Resonance Spectroscopy,Perfusion Imaging,Protons,Spinal Cord Neoplasms,Spinal Cord Neoplasms: metabolism,Spinal Cord Neoplasms: pathology,Spinal Cord Neoplasms: radiography,Tomography, X-Ray Computed},
pages = {1203-13},
volume = {25},
websites = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2744772&tool=pmcentrez&rendertype=abstract},
month = {10},
id = {2861e18e-9fb0-3054-889f-dab7b8dba29b},
created = {2015-04-16T16:43:58.000Z},
accessed = {2015-04-16},
file_attached = {false},
profile_id = {77af58c9-50fe-33a7-884e-41c4f0059fcb},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2015-04-16T16:43:58.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are described. Finally, salient imaging features obtained in the postoperative period to evaluate completeness of surgical resection, and thereafter for long-term surveillance for disease recurrence, are reviewed.},
bibtype = {article},
author = {Yuh, E L and Barkovich, A J and Gupta, N},
journal = {Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery},
number = {10}
}Isoniazid plasma concentrations in a cohort of South African children with tuberculosis: implications for international pediatric dosing guidelines. McIlleron, H., Willemse, M., Werely, C. J., Hussey, G. D., Schaaf, Simon, H., Smith, P. J., & Donald, P. R. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 48(11):1547--1553, June, 2009.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: In most countries with a high burden of tuberculosis, children with tuberculosis are prescribed isoniazid at dosages of 4-6 mg/kg/day, as recommended by international authorities. METHODS: We studied isoniazid concentrations in 56 hospitalized children (median age, 3.22 years; interquartile range [IQR], 1.58-5.38 years) who received isoniazid daily (median dosage, 5.01 mg/kg/day; range, 2.94-15.58 mg/kg/day) as part of antituberculosis treatment. At 1 and 4 months after initiation of treatment, isoniazid concentrations were measured in plasma samples at 0.75, 1.5, 3, 4, and 6 h after a treatment dose, to describe pharmacokinetic measures by using noncompartmental analysis. The effects of dose in milogram per kilogram, acetylator genotype, age, sex, and clinical diagnosis of kwashiorkor and human immunodeficiency virus (HIV) infection on isoniazid concentrations were evaluated. RESULTS: Median peak concentrations of isoniazid in children prescribed a dose of 4-6 mg/kg were 58% lower than those in children prescribed a dose of 8-10 mg/kg (2.39 mg/L [IQR, 1.59-3.40] vs. 5.71 mg/L [IQR, 4.74-7.62]). Peak concentrations were \textless3 mg/L in 70% of children prescribed a dose of 4-6 mg/kg. In contrast, children prescribed a dose of 8-12 mg/kg achieved peak concentrations approximating those in adults treated with 300 mg of isoniazid daily. Intermediate or fast acetylator genotype independently predicted a 38% (95% confidence interval [CI], 21%-51%) reduction in peak concentrations, compared with the slow-acetylator genotype. Each 1-mg/kg increase in the dose and each year increase in age were associated with increases in peak concentrations of 21% (95% CI, 16%-25%) and 6% (95% CI, 3%-10%), respectively. CONCLUSIONS: Younger children require higher doses of isoniazid per kilogram of body weight to achieve isoniazid concentrations similar to those in adults. A daily isoniazid dose of 8-12 mg/kg should be recommended.
@article{ mcilleron_isoniazid_2009,
title = {Isoniazid plasma concentrations in a cohort of {South} {African} children with tuberculosis: implications for international pediatric dosing guidelines},
volume = {48},
issn = {1537-6591},
shorttitle = {Isoniazid plasma concentrations in a cohort of {South} {African} children with tuberculosis},
doi = {10.1086/598192},
abstract = {BACKGROUND: In most countries with a high burden of tuberculosis, children with tuberculosis are prescribed isoniazid at dosages of 4-6 mg/kg/day, as recommended by international authorities.
METHODS: We studied isoniazid concentrations in 56 hospitalized children (median age, 3.22 years; interquartile range [IQR], 1.58-5.38 years) who received isoniazid daily (median dosage, 5.01 mg/kg/day; range, 2.94-15.58 mg/kg/day) as part of antituberculosis treatment. At 1 and 4 months after initiation of treatment, isoniazid concentrations were measured in plasma samples at 0.75, 1.5, 3, 4, and 6 h after a treatment dose, to describe pharmacokinetic measures by using noncompartmental analysis. The effects of dose in milogram per kilogram, acetylator genotype, age, sex, and clinical diagnosis of kwashiorkor and human immunodeficiency virus (HIV) infection on isoniazid concentrations were evaluated.
RESULTS: Median peak concentrations of isoniazid in children prescribed a dose of 4-6 mg/kg were 58% lower than those in children prescribed a dose of 8-10 mg/kg (2.39 mg/L [IQR, 1.59-3.40] vs. 5.71 mg/L [IQR, 4.74-7.62]). Peak concentrations were {\textless}3 mg/L in 70% of children prescribed a dose of 4-6 mg/kg. In contrast, children prescribed a dose of 8-12 mg/kg achieved peak concentrations approximating those in adults treated with 300 mg of isoniazid daily. Intermediate or fast acetylator genotype independently predicted a 38% (95% confidence interval [CI], 21%-51%) reduction in peak concentrations, compared with the slow-acetylator genotype. Each 1-mg/kg increase in the dose and each year increase in age were associated with increases in peak concentrations of 21% (95% CI, 16%-25%) and 6% (95% CI, 3%-10%), respectively.
CONCLUSIONS: Younger children require higher doses of isoniazid per kilogram of body weight to achieve isoniazid concentrations similar to those in adults. A daily isoniazid dose of 8-12 mg/kg should be recommended.},
language = {eng},
number = {11},
journal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},
author = {McIlleron, Helen and Willemse, Marianne and Werely, Cedric J. and Hussey, Gregory D. and Schaaf, H. Simon and Smith, Peter J. and Donald, Peter R.},
month = {June},
year = {2009},
pmid = {19392636},
keywords = {Antitubercular Agents, Child, Preschool, Female, Humans, Infant, Isoniazid, Male, Plasma, South Africa, Tuberculosis},
pages = {1547--1553}
}The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997-2006. Dolan, J. P., Diggs, B. S., Sheppard, B. C., & Hunter, J. G. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 13(12):2292–2301, December, 2009.
doi abstract bibtex
doi abstract bibtex
INTRODUCTION: This study aims to determine the mortality rate and significant factors associated with laparoscopic (LC) and open cholecystectomies (OC) over a 10-year period. METHODS: Using the Nationwide Inpatient Sample, we analyzed data for both LC and OC between 1997 and 2006. Cholecystectomies performed as part of another primary procedure were excluded. Using procedure-specific codes, we calculated annual national volumes for both open and laparoscopic cholecystectomies for the time period under review and the associated in-hospital mortality following both of these procedures. Using logistic regression modeling, we then analyzed selected patient and institutional characteristics to determine if a significant association existed between these factors and in-hospital mortality. RESULTS: There was a 16% increase in the volume of LC and a corresponding decrease in open procedures over the 10 years under review. In 2006, 12% of cholecystectomies were still performed using an open approach and the associated mortality remained significantly higher than that seen with LC. Overall, after adjusting for patient and hospital characteristics, the mortality for OC was higher than that for LC (OR 4.57; 95% CI, 4.37-4.79, p \textless 0.001). Age (\textgreater60 years), male gender, non-elective admission, admission source, and a primary diagnosis other than cholelithiasis were all independently associated with increased mortality. The average mortality rate associated with conversion from LC to OC was found to be 0.7%. CONCLUSIONS: These data indicate an increase in the proportion LCs performed over the years under study with a decrease in the proportion of OCs. However, OCs remain associated with a significant mortality burden when compared with the laparoscopic approach.
@article{dolan_national_2009,
title = {The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997-2006},
volume = {13},
issn = {1873-4626},
shorttitle = {The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy},
doi = {10.1007/s11605-009-0988-2},
abstract = {INTRODUCTION: This study aims to determine the mortality rate and significant factors associated with laparoscopic (LC) and open cholecystectomies (OC) over a 10-year period.
METHODS: Using the Nationwide Inpatient Sample, we analyzed data for both LC and OC between 1997 and 2006. Cholecystectomies performed as part of another primary procedure were excluded. Using procedure-specific codes, we calculated annual national volumes for both open and laparoscopic cholecystectomies for the time period under review and the associated in-hospital mortality following both of these procedures. Using logistic regression modeling, we then analyzed selected patient and institutional characteristics to determine if a significant association existed between these factors and in-hospital mortality.
RESULTS: There was a 16\% increase in the volume of LC and a corresponding decrease in open procedures over the 10 years under review. In 2006, 12\% of cholecystectomies were still performed using an open approach and the associated mortality remained significantly higher than that seen with LC. Overall, after adjusting for patient and hospital characteristics, the mortality for OC was higher than that for LC (OR 4.57; 95\% CI, 4.37-4.79, p {\textless} 0.001). Age ({\textgreater}60 years), male gender, non-elective admission, admission source, and a primary diagnosis other than cholelithiasis were all independently associated with increased mortality. The average mortality rate associated with conversion from LC to OC was found to be 0.7\%.
CONCLUSIONS: These data indicate an increase in the proportion LCs performed over the years under study with a decrease in the proportion of OCs. However, OCs remain associated with a significant mortality burden when compared with the laparoscopic approach.},
language = {ENG},
number = {12},
journal = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
author = {Dolan, James P. and Diggs, Brian S. and Sheppard, Brett C. and Hunter, John G.},
month = dec,
year = {2009},
keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Child, Cholecystectomy, Cholecystectomy, Laparoscopic, Female, Humans, Inpatients, Male, Middle Aged, United States},
pages = {2292--2301}
}2008 (3)
No association between routinely recorded infections in early life and subsequent risk of childhood-onset Type 1 diabetes: a matched case-control study using the UK General Practice Research Database. Cardwell, C. R., Carson, D. J., & Patterson, C. C. Diabetic Medicine: A Journal of the British Diabetic Association, 25(3):261--267, March, 2008.
doi abstract bibtex
doi abstract bibtex
AIMS: To determine whether children with infections in early life (recorded routinely in general practice) have a reduced risk of Type 1 diabetes, as would be expected from the hygiene hypothesis. METHODS: Children with Type 1 diabetes and up to 20 matched (on year of birth, sex and region) control subjects were selected from a cohort of children born in the UK at General Practice Research Database practices. For each child, the frequency of general practitioner consultations for infections and prescriptions for antibiotics in the first year of life were determined. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using conditional logistic regression. RESULTS: The main analysis included 367 case and 4579 matched control subjects. There was no evidence of any reduction in the subsequent risk of Type 1 diabetes in children with at least one infection in the first year of life (OR = 1.03, 95%CI 0.79, 1.34) or in children prescribed antibiotics in the first year of life (OR = 1.03, 95%CI 0.82, 1.29). Further analyses also revealed little evidence of a difference in subsequent risk of Type 1 diabetes after different types of infection in the first year of life (including gastrointestinal, conjunctivitis, otitis media and upper and lower respiratory tract). Analyses of infections in the first 2 years of life reached similar conclusions. CONCLUSIONS: This study provides no evidence of an association between infections in early life and subsequent risk of childhood-onset Type 1 diabetes and therefore does not support the hygiene hypothesis.
@article{cardwell_no_2008,
title = {No association between routinely recorded infections in early life and subsequent risk of childhood-onset {Type} 1 diabetes: a matched case-control study using the {UK} {General} {Practice} {Research} {Database}},
volume = {25},
issn = {1464-5491},
shorttitle = {No association between routinely recorded infections in early life and subsequent risk of childhood-onset {Type} 1 diabetes},
doi = {10.1111/j.1464-5491.2007.02351.x},
abstract = {AIMS: To determine whether children with infections in early life (recorded routinely in general practice) have a reduced risk of Type 1 diabetes, as would be expected from the hygiene hypothesis.
METHODS: Children with Type 1 diabetes and up to 20 matched (on year of birth, sex and region) control subjects were selected from a cohort of children born in the UK at General Practice Research Database practices. For each child, the frequency of general practitioner consultations for infections and prescriptions for antibiotics in the first year of life were determined. Odds ratios (ORs) and 95\% confidence intervals (95\%CIs) were calculated using conditional logistic regression.
RESULTS: The main analysis included 367 case and 4579 matched control subjects. There was no evidence of any reduction in the subsequent risk of Type 1 diabetes in children with at least one infection in the first year of life (OR = 1.03, 95\%CI 0.79, 1.34) or in children prescribed antibiotics in the first year of life (OR = 1.03, 95\%CI 0.82, 1.29). Further analyses also revealed little evidence of a difference in subsequent risk of Type 1 diabetes after different types of infection in the first year of life (including gastrointestinal, conjunctivitis, otitis media and upper and lower respiratory tract). Analyses of infections in the first 2 years of life reached similar conclusions.
CONCLUSIONS: This study provides no evidence of an association between infections in early life and subsequent risk of childhood-onset Type 1 diabetes and therefore does not support the hygiene hypothesis.},
language = {eng},
number = {3},
journal = {Diabetic Medicine: A Journal of the British Diabetic Association},
author = {Cardwell, C. R. and Carson, D. J. and Patterson, C. C.},
month = mar,
year = {2008},
pmid = {18201209},
keywords = {Adolescent, Case-Control Studies, Child, Child, Preschool, Diabetes Mellitus, Type 1, Great Britain, Humans, Infant, databases as topic, infection},
pages = {261--267}
}Sleep hygiene for children with neurodevelopmental disabilities. Jan, J., E., Owens, J., a., Weiss, M., D., Johnson, K., P., Wasdell, M., B., Freeman, R., D., & Ipsiroglu, O., S. Pediatrics, 122(6):1343-50, 12, 2008.
Paper abstract bibtex
Paper abstract bibtex Sleep disturbances in children with neurodevelopmental disabilities are common and have a profound effect on the quality of life of the child, as well as the entire family. Although interventions for sleep problems in these children often involve a combination of behavioral and pharmacologic strategies, the first line of treatment is the promotion of improved sleep habits or "hygiene." Despite the importance of sleep-hygiene principles, defined as basic optimal environmental, scheduling, sleep-practice, and physiologic sleep-promoting factors, clinicians often lack appropriate knowledge and skills to implement them. In addition, sleep-hygiene practices may need to be modified and adapted for this population of children and are often more challenging to implement compared with their healthy counterparts. This first comprehensive, multidisciplinary review of sleep hygiene for children with disabilities presents the rationale for incorporating these measures in their treatment, outlines both general and specific sleep-promotion practices, and discusses problem-solving strategies for implementing them in a variety of clinical practice settings.
@article{
id = {d3b99cc5-13c9-3545-885b-7a4dc0d6a45b},
title = {Sleep hygiene for children with neurodevelopmental disabilities.},
type = {article},
year = {2008},
identifiers = {[object Object]},
keywords = {Caregivers,Caregivers: psychology,Child,Child Care,Child Care: methods,Child, Preschool,Developmental Disabilities,Developmental Disabilities: complications,Developmental Disabilities: diagnosis,Environment,Female,Humans,Infant,Male,Mental Disorders,Mental Disorders: complications,Mental Disorders: diagnosis,Mental Health,Parent-Child Relations,Pediatrics,Pediatrics: standards,Pediatrics: trends,Quality of Life,Risk Assessment,Severity of Illness Index,Sleep Disorders,Sleep Disorders: etiology,Sleep Disorders: rehabilitation,Stress, Psychological},
created = {2012-06-13T03:54:21.000Z},
pages = {1343-50},
volume = {122},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/19047255},
month = {12},
accessed = {2010-10-11},
file_attached = {true},
profile_id = {fe7067eb-58b8-34c6-b8cd-6717fdf7605c},
group_id = {ba0deb47-e19a-3151-83cc-b6262d5edb6e},
last_modified = {2014-07-19T19:17:22.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
citation_key = {Jan2008},
client_data = {"desktop_id":"f412cd4a-20b9-4037-8a18-be3d160659b2"},
abstract = {Sleep disturbances in children with neurodevelopmental disabilities are common and have a profound effect on the quality of life of the child, as well as the entire family. Although interventions for sleep problems in these children often involve a combination of behavioral and pharmacologic strategies, the first line of treatment is the promotion of improved sleep habits or "hygiene." Despite the importance of sleep-hygiene principles, defined as basic optimal environmental, scheduling, sleep-practice, and physiologic sleep-promoting factors, clinicians often lack appropriate knowledge and skills to implement them. In addition, sleep-hygiene practices may need to be modified and adapted for this population of children and are often more challenging to implement compared with their healthy counterparts. This first comprehensive, multidisciplinary review of sleep hygiene for children with disabilities presents the rationale for incorporating these measures in their treatment, outlines both general and specific sleep-promotion practices, and discusses problem-solving strategies for implementing them in a variety of clinical practice settings.},
bibtype = {article},
author = {Jan, James E and Owens, Judith a and Weiss, Margaret D and Johnson, Kyle P and Wasdell, Michael B and Freeman, Roger D and Ipsiroglu, Osman S},
journal = {Pediatrics},
number = {6}
}Comparison between omega-3 and omega-6 polyunsaturated fatty acid intakes as assessed by a food frequency questionnaire and erythrocyte membrane fatty acid composition in young children. Orton, H., D., Szabo, N., J., Clare-Salzler, M., & Norris, J., M. Eur J Clin Nutr, 62(6):733-738, 2008.
Website abstract bibtex
Website abstract bibtex OBJECTIVE: We conducted a dietary validation study in youth aged 1-11 years by comparing dietary intake of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) as assessed by a parent-completed semiquantitative food frequency questionnaire (FFQ) over time to erythrocyte membrane composition of the same fatty acids. DESIGN: The study population included youth aged 1-11 years who were participants in the Diabetes Autoimmunity Study in the Young (DAISY), a longitudinal study in Denver, Colorado that is following a cohort of youth at risk for developing type I diabetes. Four hundred and four children who had erythrocyte membrane fatty acid data matched to an FFQ corresponding to the same time frame for a total of 917 visits (matches) were included. PUFA intake was expressed both as g/day (adjusted for total energy) and as percent of total fat intake. We used mixed models to test the association and calculate the correlation between the erythrocyte membrane estimates and PUFA intake using all records of data for each youth. RESULTS: Intakes of total omega-3 fatty acids (beta=0.52, P<0.0001, rho=0.23) and marine PUFAs (beta=1.62, P<0.0001, rho=0.42), as a percent of total fat in the diet, were associated with percent of omega-3 and marine PUFAs in the erythrocyte membrane. Intakes of omega-6 PUFAs (beta=0.04, P=0.418, rho=0.05) and arachidonic acid (beta=0.31, P=0.774, rho=0.01) were not associated. CONCLUSIONS: In these young children, an FFQ using parental report provided estimates of average long-term intakes of marine PUFAs that correlated well with their erythrocyte cell membrane fatty acid status.
@article{
title = {Comparison between omega-3 and omega-6 polyunsaturated fatty acid intakes as assessed by a food frequency questionnaire and erythrocyte membrane fatty acid composition in young children},
type = {article},
year = {2008},
identifiers = {[object Object]},
keywords = {*Diet,Biological Markers/blood,Child,Child, Preschool,Cohort Studies,Colorado,Cross-Sectional Studies,Diet Surveys,Dietary Fats, Unsaturated/*administration & dosage,Erythrocyte Membrane/*chemistry,Fatty Acids, Omega-3/*administration & dosage/anal,Fatty Acids, Omega-6/*administration & dosage/*ana,Female,Humans,Infant,Longitudinal Studies,Male,Questionnaires/*standards,Reproducibility of Results,Seafood,Sensitivity and Specificity},
pages = {733-738},
volume = {62},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17440518},
edition = {2007/04/19},
id = {73ca6912-d3a5-3d7e-af03-263b919dd64e},
created = {2017-06-19T13:45:54.565Z},
file_attached = {false},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:45:54.690Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
language = {eng},
notes = {<m:note>Orton, H D<m:linebreak/>Szabo, N J<m:linebreak/>Clare-Salzler, M<m:linebreak/>Norris, J M<m:linebreak/>DK32493/DK/NIDDK NIH HHS/United States<m:linebreak/>P30 DK 57516/DK/NIDDK NIH HHS/United States<m:linebreak/>P30 DK057516-019004/DK/NIDDK NIH HHS/United States<m:linebreak/>R01 DK049654-06/DK/NIDDK NIH HHS/United States<m:linebreak/>R01-DK49654/DK/NIDDK NIH HHS/United States<m:linebreak/>R37 DK032493-18/DK/NIDDK NIH HHS/United States<m:linebreak/>Research Support, N.I.H., Extramural<m:linebreak/>Validation Studies<m:linebreak/>England<m:linebreak/>European journal of clinical nutrition<m:linebreak/>1602763<m:linebreak/>Eur J Clin Nutr. 2008 Jun;62(6):733-8. Epub 2007 Apr 18.</m:note>},
abstract = {OBJECTIVE: We conducted a dietary validation study in youth aged 1-11 years by comparing dietary intake of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) as assessed by a parent-completed semiquantitative food frequency questionnaire (FFQ) over time to erythrocyte membrane composition of the same fatty acids. DESIGN: The study population included youth aged 1-11 years who were participants in the Diabetes Autoimmunity Study in the Young (DAISY), a longitudinal study in Denver, Colorado that is following a cohort of youth at risk for developing type I diabetes. Four hundred and four children who had erythrocyte membrane fatty acid data matched to an FFQ corresponding to the same time frame for a total of 917 visits (matches) were included. PUFA intake was expressed both as g/day (adjusted for total energy) and as percent of total fat intake. We used mixed models to test the association and calculate the correlation between the erythrocyte membrane estimates and PUFA intake using all records of data for each youth. RESULTS: Intakes of total omega-3 fatty acids (beta=0.52, P<0.0001, rho=0.23) and marine PUFAs (beta=1.62, P<0.0001, rho=0.42), as a percent of total fat in the diet, were associated with percent of omega-3 and marine PUFAs in the erythrocyte membrane. Intakes of omega-6 PUFAs (beta=0.04, P=0.418, rho=0.05) and arachidonic acid (beta=0.31, P=0.774, rho=0.01) were not associated. CONCLUSIONS: In these young children, an FFQ using parental report provided estimates of average long-term intakes of marine PUFAs that correlated well with their erythrocyte cell membrane fatty acid status.},
bibtype = {article},
author = {Orton, H D and Szabo, N J and Clare-Salzler, M and Norris, J M},
journal = {Eur J Clin Nutr},
number = {6}
}2007 (1)
Risk of colorectal cancer in women with a prior diagnosis of gynecologic malignancy. Srinivasan, R., Yang, Y., Rubin, S. C., Morgan, M. A., & Lewis, J. D. Journal of Clinical Gastroenterology, 41(3):291--296, March, 2007.
doi abstract bibtex
doi abstract bibtex
GOALS AND BACKGROUND: Earlier studies regarding the risk of colorectal cancer (CRC) in women with a prior diagnosis of gynecologic malignancies have revealed conflicting results. We sought to further clarify this association. METHODS: A retrospective cohort study was performed using the General Practice Research Database of the United Kingdom. Patients with a prior diagnosis of ovarian, uterine, or cervical cancers were compared with control patients without a prior gynecologic malignancy. The primary outcome was a diagnosis of CRC. Poisson regression analysis was used to assess the effects of potential confounders. RESULTS: The study included 1995 ovarian, 1348 uterine, and 1101 cervical cancer patients and 7980, 5392, and 4404 matched control patients, respectively. The adjusted incidence rate ratio (IRR) of CRC among ovarian cancer patients was 2.90 [95% confidence intervals (CI) 1.45-5.82]. Five of 10 cases of CRC in ovarian cancer patients were diagnosed within 6 months of the cancer diagnosis with an adjusted IRR of 8.0 (95% CI 1.9-33.6). Excluding the initial 6 months of follow-up after the diagnosis of ovarian cancer, the adjusted IRR was 1.6 (95% CI 0.76-5.03). The adjusted IRR of CRC in patients with a prior diagnosis of uterine and cervical cancer was 0.79 (95% CI 0.24-2.61) and 1.50 (95% CI 0.43-5.21), respectively. CONCLUSIONS: Women with a prior diagnosis of ovarian cancer are at an increased risk of CRC. The risk of CRC was not increased among patients with a prior history of uterine and cervical cancer.
@article{srinivasan_risk_2007,
title = {Risk of colorectal cancer in women with a prior diagnosis of gynecologic malignancy},
volume = {41},
issn = {0192-0790},
doi = {10.1097/01.mcg.0000225587.85953.06},
abstract = {GOALS AND BACKGROUND: Earlier studies regarding the risk of colorectal cancer (CRC) in women with a prior diagnosis of gynecologic malignancies have revealed conflicting results. We sought to further clarify this association.
METHODS: A retrospective cohort study was performed using the General Practice Research Database of the United Kingdom. Patients with a prior diagnosis of ovarian, uterine, or cervical cancers were compared with control patients without a prior gynecologic malignancy. The primary outcome was a diagnosis of CRC. Poisson regression analysis was used to assess the effects of potential confounders.
RESULTS: The study included 1995 ovarian, 1348 uterine, and 1101 cervical cancer patients and 7980, 5392, and 4404 matched control patients, respectively. The adjusted incidence rate ratio (IRR) of CRC among ovarian cancer patients was 2.90 [95\% confidence intervals (CI) 1.45-5.82]. Five of 10 cases of CRC in ovarian cancer patients were diagnosed within 6 months of the cancer diagnosis with an adjusted IRR of 8.0 (95\% CI 1.9-33.6). Excluding the initial 6 months of follow-up after the diagnosis of ovarian cancer, the adjusted IRR was 1.6 (95\% CI 0.76-5.03). The adjusted IRR of CRC in patients with a prior diagnosis of uterine and cervical cancer was 0.79 (95\% CI 0.24-2.61) and 1.50 (95\% CI 0.43-5.21), respectively.
CONCLUSIONS: Women with a prior diagnosis of ovarian cancer are at an increased risk of CRC. The risk of CRC was not increased among patients with a prior history of uterine and cervical cancer.},
language = {eng},
number = {3},
journal = {Journal of Clinical Gastroenterology},
author = {Srinivasan, Radhika and Yang, Yu-Xiao and Rubin, Stephen C. and Morgan, Mark A. and Lewis, James D.},
month = mar,
year = {2007},
pmid = {17426469},
keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Child, Cohort Studies, Colorectal Neoplasms, Female, Genital Neoplasms, Female, Humans, Middle Aged, Ovarian Neoplasms, Retrospective Studies, Risk, Uterine Cervical Neoplasms, Uterine Neoplasms},
pages = {291--296}
}2006 (4)
Child passenger safety for inner-city Latinos: new approaches from the community. Martin, M., Holden, J., Chen, Z., & Quinlan, K. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 12(2):99-104, 4, 2006.
Website abstract bibtex
Website abstract bibtex Motor vehicle crashes injuries, the leading cause of death for Latino children in the United States, can be reduced by the correct use of child safety seats. This study evaluated the ability of a community health worker education program to improve proper child safety seat usage in urban low income Latino families.
@article{
title = {Child passenger safety for inner-city Latinos: new approaches from the community.},
type = {article},
year = {2006},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Attitudes,Automobiles,Child,Community Health Services,Community Health Services: organization & administ,Female,Health Education,Health Education: methods,Health Knowledge,Hispanic Americans,Humans,Infant,Infant Equipment,Infant Equipment: utilization,Male,Middle Aged,Newborn,Parents,Practice,Preschool,Program Evaluation,United States,Urban Health Services,Urban Health Services: organization & administrati,Wounds and Injuries,Wounds and Injuries: ethnology,Wounds and Injuries: prevention & control},
pages = {99-104},
volume = {12},
websites = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2577363&tool=pmcentrez&rendertype=abstract},
month = {4},
id = {87fdea4a-6f0c-3a6b-86a9-61cad4b0a1b7},
created = {2016-09-13T00:48:25.000Z},
accessed = {2016-09-05},
file_attached = {false},
profile_id = {c7856f8a-4963-3e63-90cb-57986d91c9b0},
group_id = {1fd78437-06d9-37cf-b89d-417b03940b66},
last_modified = {2016-09-13T05:55:52.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {false},
hidden = {false},
abstract = {Motor vehicle crashes injuries, the leading cause of death for Latino children in the United States, can be reduced by the correct use of child safety seats. This study evaluated the ability of a community health worker education program to improve proper child safety seat usage in urban low income Latino families.},
bibtype = {article},
author = {Martin, M. and Holden, J. and Chen, Z. and Quinlan, K.},
journal = {Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention},
number = {2}
}Translational research in child and adolescent transportation safety. Simons-Morton, B., G. & Winston, F., K. Evaluation & the health professions, 29(1):33-64, 3, 2006.
Website abstract bibtex
Website abstract bibtex Motor vehicle crash (MVC)-related injury is the leading cause of death among youths age 1 to 19 years. Advances in MVC and injury prevention depend on interrelated combinations of technology, policy, and education, and research on these topics can inform policy and lead to improvement in safety. This article presents two examples of translational research in transportation injury prevention. In the first example of child passenger protection, the authors describe a program of research designed to reduce the gap between the theoretical and practical effectiveness of safety methods. In the second example of novice teen drivers, the authors examine translational research related to two complementary approaches to reducing the exposure of novice teen drivers to high-risk driving conditions-graduated driver licensing policy and parental management of novice teen drivers. The examples suggest the utility of systematic programs of research designed to improve the translation into practice of MVC and injury prevention technology and policy.
@article{
title = {Translational research in child and adolescent transportation safety.},
type = {article},
year = {2006},
identifiers = {[object Object]},
keywords = {Accidents,Adolescent,Adult,Child,Diffusion of Innovation,Equipment Design,Humans,Infant Equipment,Information Dissemination,Licensure,Licensure: legislation & jurisprudence,Motor Vehicles,Motor Vehicles: legislation & jurisprudence,Motor Vehicles: statistics & numerical data,Postmarketing,Product Surveillance,Research Design,Safety,Safety: statistics & numerical data,Traffic,Traffic: statistics & numerical data,Wounds and Injuries,Wounds and Injuries: prevention & control},
pages = {33-64},
volume = {29},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/16510879},
month = {3},
id = {ffb0b0f9-9111-3191-afe3-fb5e79cd761a},
created = {2016-09-13T00:48:27.000Z},
accessed = {2016-09-05},
file_attached = {false},
profile_id = {c7856f8a-4963-3e63-90cb-57986d91c9b0},
group_id = {1fd78437-06d9-37cf-b89d-417b03940b66},
last_modified = {2016-09-13T05:55:54.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {false},
hidden = {false},
abstract = {Motor vehicle crash (MVC)-related injury is the leading cause of death among youths age 1 to 19 years. Advances in MVC and injury prevention depend on interrelated combinations of technology, policy, and education, and research on these topics can inform policy and lead to improvement in safety. This article presents two examples of translational research in transportation injury prevention. In the first example of child passenger protection, the authors describe a program of research designed to reduce the gap between the theoretical and practical effectiveness of safety methods. In the second example of novice teen drivers, the authors examine translational research related to two complementary approaches to reducing the exposure of novice teen drivers to high-risk driving conditions-graduated driver licensing policy and parental management of novice teen drivers. The examples suggest the utility of systematic programs of research designed to improve the translation into practice of MVC and injury prevention technology and policy.},
bibtype = {article},
author = {Simons-Morton, Bruce G. and Winston, Flaura Koplin},
journal = {Evaluation & the health professions},
number = {1}
}Chest pain in general practice: incidence, comorbidity and mortality. Ruigómez, A., Rodríguez, L. A. G., Wallander, M., Johansson, S., & Jones, R. Family Practice, 23(2):167--174, April, 2006.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Chest pain is a common symptom that presents the primary care physician with a complex diagnostic and therapeutic challenge. AIMS: To evaluate the natural history and management of patients diagnosed with chest pain of unspecified type or origin in primary care. DESIGN: Population-based case-control study. METHODS: The study included 13,740 patients with a first diagnosis of unspecified chest pain and 20,000 age- and sex-matched controls identified from the UK General Practice Research Database. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. Risk estimates were adjusted for age, sex and number of physician visits. RESULTS: The incidence of a new diagnosis of chest pain was 15.5 per 1000 person-years and increased with age, particularly in men. The risk of a chest pain diagnosis was greatest in patients with prior diagnoses of coronary heart disease (OR: 7.1; 95% CI: 6.1-8.2) and gastroesophageal reflux disease (OR: 2.0; 95% CI: 1.7-2.3). In the year after diagnosis, chest pain patients were more likely than controls to be newly diagnosed with coronary heart disease (OR: 14.9; 95% CI: 12.7-17.4) and heart failure (OR: 4.7; 95% CI: 3.6-6.1). A new diagnosis of chest pain was associated with an increased risk of death in the following year (RR: 2.3; 95% CI: 1.9-2.8). CONCLUSIONS: Some causes of chest pain are underdiagnosed in primary care. This is of particular consequence for the minority of chest pain patients with cardiac disease.
@article{ruigomez_chest_2006,
title = {Chest pain in general practice: incidence, comorbidity and mortality},
volume = {23},
issn = {0263-2136},
shorttitle = {Chest pain in general practice},
doi = {10.1093/fampra/cmi124},
abstract = {BACKGROUND: Chest pain is a common symptom that presents the primary care physician with a complex diagnostic and therapeutic challenge.
AIMS: To evaluate the natural history and management of patients diagnosed with chest pain of unspecified type or origin in primary care.
DESIGN: Population-based case-control study.
METHODS: The study included 13,740 patients with a first diagnosis of unspecified chest pain and 20,000 age- and sex-matched controls identified from the UK General Practice Research Database. Odds ratios (ORs) and 95\% confidence intervals (CIs) were computed using unconditional logistic regression. Risk estimates were adjusted for age, sex and number of physician visits.
RESULTS: The incidence of a new diagnosis of chest pain was 15.5 per 1000 person-years and increased with age, particularly in men. The risk of a chest pain diagnosis was greatest in patients with prior diagnoses of coronary heart disease (OR: 7.1; 95\% CI: 6.1-8.2) and gastroesophageal reflux disease (OR: 2.0; 95\% CI: 1.7-2.3). In the year after diagnosis, chest pain patients were more likely than controls to be newly diagnosed with coronary heart disease (OR: 14.9; 95\% CI: 12.7-17.4) and heart failure (OR: 4.7; 95\% CI: 3.6-6.1). A new diagnosis of chest pain was associated with an increased risk of death in the following year (RR: 2.3; 95\% CI: 1.9-2.8).
CONCLUSIONS: Some causes of chest pain are underdiagnosed in primary care. This is of particular consequence for the minority of chest pain patients with cardiac disease.},
language = {eng},
number = {2},
journal = {Family Practice},
author = {Ruigómez, Ana and Rodríguez, Luis Alberto García and Wallander, Mari-Ann and Johansson, Saga and Jones, Roger},
month = apr,
year = {2006},
pmid = {16461444},
keywords = {Adolescent, Adult, Aged, Case-Control Studies, Chest pain, Child, Child, Preschool, Comorbidity, Family Practice, Female, Great Britain, Humans, Longitudinal Studies, Male, Middle Aged, State Medicine, databases as topic},
pages = {167--174}
}Daughters increase longevity of fathers, but daughters and sons equally reduce longevity of mothers. Jasienska, G., Nenko, I., & Jasienski, M. Am J Hum Biol, 18(3):422-425, 2006.
Paper abstract bibtex
Paper abstract bibtex Reproduction is energetically and physiologically expensive, and an individual investing resources into producing offspring should suffer costs such as deterioration in health condition and possibly shorter life span. Since the energetic and nutritional demands of pregnancy and breastfeeding render reproductive costs much higher in women than in men, women with a large number of children should show signs of deterioration in condition, while men with large families should not. However, whether reproductive costs reduce longevity in women is still questionable, and in men this issue has not been adequately addressed. In addition, since sons are energetically more expensive to produce than daughters, having sons should have a more pronounced negative impact on maternal longevity than having daughters. Here we document a striking disparity in the impact of children on the life span of mothers and fathers in a Polish rural population. We show for the first time that number of daughters was positively related to a longer life span of their fathers, increasing their longevity on average by 74 weeks per daughter born, while number of sons did not have a significant effect on paternal longevity. In contrast, in women, the number of daughters and number of sons reduced maternal longevity and did so to the same extent, on average by 95 weeks per son or daughter, indicating that for women, the costs of having sons and daughters are similar.
@article{
title = {Daughters increase longevity of fathers, but daughters and sons equally reduce longevity of mothers},
type = {article},
year = {2006},
identifiers = {[object Object]},
keywords = {*Family Characteristics,*Nuclear Family,*Parents,Adolescent,Adult,Aged,Aged, 80 and over,Child,Child, Preschool,Female,Humans,Longevity/*physiology,Male,Middle Aged,Poland/epidemiology,Rural Population/trends,Survival Rate},
pages = {422-425},
volume = {18},
id = {0e49814c-3477-3b9f-812f-0fd600352d97},
created = {2017-06-19T13:44:32.411Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:44:32.557Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>Comparative Study<m:linebreak/>Journal Article<m:linebreak/>Research Support, Non-U.S. Gov't</m:note>},
abstract = {Reproduction is energetically and physiologically expensive, and an individual investing resources into producing offspring should suffer costs such as deterioration in health condition and possibly shorter life span. Since the energetic and nutritional demands of pregnancy and breastfeeding render reproductive costs much higher in women than in men, women with a large number of children should show signs of deterioration in condition, while men with large families should not. However, whether reproductive costs reduce longevity in women is still questionable, and in men this issue has not been adequately addressed. In addition, since sons are energetically more expensive to produce than daughters, having sons should have a more pronounced negative impact on maternal longevity than having daughters. Here we document a striking disparity in the impact of children on the life span of mothers and fathers in a Polish rural population. We show for the first time that number of daughters was positively related to a longer life span of their fathers, increasing their longevity on average by 74 weeks per daughter born, while number of sons did not have a significant effect on paternal longevity. In contrast, in women, the number of daughters and number of sons reduced maternal longevity and did so to the same extent, on average by 95 weeks per son or daughter, indicating that for women, the costs of having sons and daughters are similar.},
bibtype = {article},
author = {Jasienska, G and Nenko, I and Jasienski, M},
journal = {Am J Hum Biol},
number = {3}
}2005 (2)
Utility of routinely acquired primary care data for paediatric disease epidemiology and pharmacoepidemiology. Helms, P. J., Ekins Daukes, S., Taylor, M. W., Simpson, C. R., & McLay, J. S. British Journal of Clinical Pharmacology, 59(6):684--690, June, 2005.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: The majority of medicines prescribed for children are prescribed in primary care for common acute and chronic conditions. This is in contrast to prescribing in secondary care where the population of children admitted is small but where a large number of different medicines are prescribed to treat more serious and less common conditions. METHODS: Data on prescribing was extracted from the General Practice Administration System for Scotland (GPASS) for the year November 1999 to October 2000 and prescribing patterns for children aged 0-16 years expressed as percentages. A comparison of age specific consultations for asthma, as an example of a common paediatric condition, was also made between two separate general practice data sets, the General Practice Research Database (GRPD) and the continuous morbidity recording (CMR) subset of GPASS. RESULTS: Of 214 medicines investigated for unlicensed and off-label prescribing no unlicensed prescribing was identified. Off-label prescribing due to age was most common among younger and older children. The most common reasons for off-label prescriptions were, in order of frequency, lower than recommended dose, higher than recommended dose, below the recommended age, and unlicensed formulation. Age and gender specific consultations for asthma were similar in the two representative databases, GPRD and CMR, both showing disappearance of the male predominance in the teenage years. CONCLUSIONS: Large primary care data sets available within a unified health care system such as the UK National Health Service (NHS) are likely to be broadly compatible and produce similar results. The prescribing of off-label medicines to children is common in primary care, most commonly due to prescribing out with the recommended dosage regimen.
@article{helms_utility_2005,
title = {Utility of routinely acquired primary care data for paediatric disease epidemiology and pharmacoepidemiology},
volume = {59},
issn = {0306-5251},
doi = {10.1111/j.1365-2125.2005.02404.x},
abstract = {BACKGROUND: The majority of medicines prescribed for children are prescribed in primary care for common acute and chronic conditions. This is in contrast to prescribing in secondary care where the population of children admitted is small but where a large number of different medicines are prescribed to treat more serious and less common conditions.
METHODS: Data on prescribing was extracted from the General Practice Administration System for Scotland (GPASS) for the year November 1999 to October 2000 and prescribing patterns for children aged 0-16 years expressed as percentages. A comparison of age specific consultations for asthma, as an example of a common paediatric condition, was also made between two separate general practice data sets, the General Practice Research Database (GRPD) and the continuous morbidity recording (CMR) subset of GPASS.
RESULTS: Of 214 medicines investigated for unlicensed and off-label prescribing no unlicensed prescribing was identified. Off-label prescribing due to age was most common among younger and older children. The most common reasons for off-label prescriptions were, in order of frequency, lower than recommended dose, higher than recommended dose, below the recommended age, and unlicensed formulation. Age and gender specific consultations for asthma were similar in the two representative databases, GPRD and CMR, both showing disappearance of the male predominance in the teenage years.
CONCLUSIONS: Large primary care data sets available within a unified health care system such as the UK National Health Service (NHS) are likely to be broadly compatible and produce similar results. The prescribing of off-label medicines to children is common in primary care, most commonly due to prescribing out with the recommended dosage regimen.},
language = {eng},
number = {6},
journal = {British Journal of Clinical Pharmacology},
author = {Helms, Peter J. and Ekins Daukes, Suzie and Taylor, Michael W. and Simpson, Colin R. and McLay, James S.},
month = jun,
year = {2005},
pmid = {15948933},
pmcid = {PMC1884863},
keywords = {Adolescent, Age Distribution, Asthma, Child, Child, Preschool, Databases, Factual, Drug Approval, Drug Prescriptions, Female, Humans, Infant, Infant, Newborn, Male, Medical Records Systems, Computerized, Pediatrics, Primary Health Care, Reproducibility of Results, Scotland, State Medicine, pharmacoepidemiology},
pages = {684--690}
}The preparation of reach-to-grasp movements in adults, children, and children with movement problems. Mon-Williams, M., Tresilian, J., R., Bell, V., E., Coppard, V., L., Nixdorf, M., & Carson, R., G. The Quarterly journal of experimental psychology. A, Human experimental psychology, 58(October 2014):1249-1263, 2005.
Paper abstract bibtex
Paper abstract bibtex This study explored the use of advance information in the control of reach-to-grasp movements. The paradigm required participants to reach and grasp illuminated blocks with their right hand. Four target blocks were positioned on a table surface, two each side of the mid-saggital plane. In the complete precue condition, advance information precisely specified target location. In the partial precue condition, advance information indicated target location relative to the midsaggital plane (left or right). In the null condition, the advance information was entirely ambiguous. Participants produced fastest responses in the complete precue condition, intermediate response times in the partial condition, and the slowest responses in the null condition. This result was observed in adults and four groups of children including a group aged 4-6 years. In contrast, children with Developmental Coordination Disorder (DCD, n=11, aged 7--13 years) showed no advantage of partial precueing. Movement duration was determined by target location but was unaffected by precue condition. Movement duration was a clear function of age apart from children in the DCD group who showed equivalent movement times to those of the youngest children. These findings provide important insights into the control of reach-to-grasp movements and highlight that partial cues are exploited by children as young as 4 years but are not used in situations of abnormal development.
@article{
title = {The preparation of reach-to-grasp movements in adults, children, and children with movement problems.},
type = {article},
year = {2005},
identifiers = {[object Object]},
pages = {1249-1263},
volume = {58},
id = {6655dc6a-a75f-3c4b-9034-d2a3d072dd0b},
created = {2016-01-12T14:18:51.000Z},
file_attached = {true},
profile_id = {d5b53108-91c5-30b8-8e6c-dd027f636bcd},
last_modified = {2017-03-16T06:19:45.131Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {true},
hidden = {false},
abstract = {This study explored the use of advance information in the control of reach-to-grasp movements. The paradigm required participants to reach and grasp illuminated blocks with their right hand. Four target blocks were positioned on a table surface, two each side of the mid-saggital plane. In the complete precue condition, advance information precisely specified target location. In the partial precue condition, advance information indicated target location relative to the midsaggital plane (left or right). In the null condition, the advance information was entirely ambiguous. Participants produced fastest responses in the complete precue condition, intermediate response times in the partial condition, and the slowest responses in the null condition. This result was observed in adults and four groups of children including a group aged 4-6 years. In contrast, children with Developmental Coordination Disorder (DCD, n=11, aged 7--13 years) showed no advantage of partial precueing. Movement duration was determined by target location but was unaffected by precue condition. Movement duration was a clear function of age apart from children in the DCD group who showed equivalent movement times to those of the youngest children. These findings provide important insights into the control of reach-to-grasp movements and highlight that partial cues are exploited by children as young as 4 years but are not used in situations of abnormal development.},
bibtype = {article},
author = {Mon-Williams, M and Tresilian, J R and Bell, V E and Coppard, V L and Nixdorf, M and Carson, R G},
journal = {The Quarterly journal of experimental psychology. A, Human experimental psychology},
number = {October 2014}
}2003 (3)
Nonopioid additives to local anaesthetics for caudal blockade in children: a systematic review. Ansermino, M., Basu, R., Vandebeek, C., & Montgomery, C. Paediatric anaesthesia, 13(7):561–573, September, 2003.
abstract bibtex
abstract bibtex
BACKGROUND Caudal epidural injection with local anaesthetics is a popular regional technique used in infants and children. A disadvantage of caudal blockade is the relatively short duration of postoperative analgesia. Opioids have traditionally been added to increase the duration of analgesia but have been associated with unacceptable side-effects. A number of nonopioid additives have been suggested to increase the duration of analgesia. METHODS A systematic review was conducted to identify randomized control trials comparing the use of local anaesthetic to local anaesthetic with nonopioid additives for caudal blockade in children. The increase in duration of analgesia and side-effects were compared. RESULTS The addition of clonidine to the local anaesthetic solution produces an increase in the duration of analgesia following caudal blockade in children (pooled weighted mean difference of 145 min with 95% confidence interval of 132-157 min). Side-effects include sedation and the potential for neonatal respiratory depression. Ketamine and midazolam further increase the duration of analgesia, however, the potential for neurotoxicity remains a concern. CONCLUSION The evidence examined shows an increased duration of analgesia with clonidine, ketamine and midazolam. However, we are not convinced that the routine use of these adjuvants in the setting of elective outpatient surgery shows improved patient outcome. It is unclear if the potential for neurotoxicity is outweighed by clinical benefits. Further testing, including large clinical trials, is required before recommending routine use of nonopioid additives for caudal blockade in children.
@article{ansermino_nonopioid_2003,
title = {Nonopioid additives to local anaesthetics for caudal blockade in children: a systematic review},
volume = {13},
issn = {1155-5645},
shorttitle = {Nonopioid additives to local anaesthetics for caudal blockade in children},
abstract = {BACKGROUND
Caudal epidural injection with local anaesthetics is a popular regional technique used in infants and children. A disadvantage of caudal blockade is the relatively short duration of postoperative analgesia. Opioids have traditionally been added to increase the duration of analgesia but have been associated with unacceptable side-effects. A number of nonopioid additives have been suggested to increase the duration of analgesia.
METHODS
A systematic review was conducted to identify randomized control trials comparing the use of local anaesthetic to local anaesthetic with nonopioid additives for caudal blockade in children. The increase in duration of analgesia and side-effects were compared.
RESULTS
The addition of clonidine to the local anaesthetic solution produces an increase in the duration of analgesia following caudal blockade in children (pooled weighted mean difference of 145 min with 95\% confidence interval of 132-157 min). Side-effects include sedation and the potential for neonatal respiratory depression. Ketamine and midazolam further increase the duration of analgesia, however, the potential for neurotoxicity remains a concern.
CONCLUSION
The evidence examined shows an increased duration of analgesia with clonidine, ketamine and midazolam. However, we are not convinced that the routine use of these adjuvants in the setting of elective outpatient surgery shows improved patient outcome. It is unclear if the potential for neurotoxicity is outweighed by clinical benefits. Further testing, including large clinical trials, is required before recommending routine use of nonopioid additives for caudal blockade in children.},
number = {7},
journal = {Paediatric anaesthesia},
author = {Ansermino, Mark and Basu, Rahul and Vandebeek, Christine and Montgomery, Carolyne},
month = sep,
year = {2003},
pmid = {12950855},
keywords = {Analgesics, Non-Narcotic, Anesthesia, Caudal, Anesthetics, Local, Child, Child, Preschool, Humans, Pain, Postoperative, Randomized Controlled Trials as Topic},
pages = {561--573}
}Epidemiology and possible causes of autism. Jick, H. & Kaye, J. A. Pharmacotherapy, 23(12):1524--1530, December, 2003.
abstract bibtex
abstract bibtex
OBJECTIVES: To review the recent literature on possible causes of the increase in frequency of diagnosed autism reported from three countries, and to compare the medical diagnoses and drug therapy from a new series of autistic boys and their mothers with that of comparable nonautistic boys and their mothers. DESIGN: Case-control evaluation. PARTICIPANTS: Members of over 250 general practices in the United Kingdom. MEASUREMENTS AND MAIN RESULTS: Frequency of exposure to drugs and presence of preexisting clinical illnesses in autistic children and their mothers were compared with nonautistic children and their mothers over time. According to published studies, the incidence of boys diagnosed with autism rose dramatically in the 1990s. Numerous published studies have concluded that the measles-mumps-rubella vaccine is not responsible for the large rise in diagnosed autism. In our study, boys diagnosed with autism had medical and drug histories, such as vaccines, before diagnosis, that were closely similar to those of nonautistic boys, except that developmental and sensory disorders were far more common in autistic boys. No material differences during pregnancy were found between the mothers of autistic boys and those of nonautistic boys in relation to illness or drug therapy. In the early 1990s, boys with diagnosed developmental disorders were infrequently diagnosed with autism. In the later 1990s, such boys more often were diagnosed with autism. CONCLUSION: A major cause of the recent large increase in the number of boys diagnosed with autism probably is due to changing diagnostic practices.
@article{jick_epidemiology_2003,
title = {Epidemiology and possible causes of autism},
volume = {23},
issn = {0277-0008},
abstract = {OBJECTIVES: To review the recent literature on possible causes of the increase in frequency of diagnosed autism reported from three countries, and to compare the medical diagnoses and drug therapy from a new series of autistic boys and their mothers with that of comparable nonautistic boys and their mothers.
DESIGN: Case-control evaluation.
PARTICIPANTS: Members of over 250 general practices in the United Kingdom.
MEASUREMENTS AND MAIN RESULTS: Frequency of exposure to drugs and presence of preexisting clinical illnesses in autistic children and their mothers were compared with nonautistic children and their mothers over time. According to published studies, the incidence of boys diagnosed with autism rose dramatically in the 1990s. Numerous published studies have concluded that the measles-mumps-rubella vaccine is not responsible for the large rise in diagnosed autism. In our study, boys diagnosed with autism had medical and drug histories, such as vaccines, before diagnosis, that were closely similar to those of nonautistic boys, except that developmental and sensory disorders were far more common in autistic boys. No material differences during pregnancy were found between the mothers of autistic boys and those of nonautistic boys in relation to illness or drug therapy. In the early 1990s, boys with diagnosed developmental disorders were infrequently diagnosed with autism. In the later 1990s, such boys more often were diagnosed with autism.
CONCLUSION: A major cause of the recent large increase in the number of boys diagnosed with autism probably is due to changing diagnostic practices.},
language = {eng},
number = {12},
journal = {Pharmacotherapy},
author = {Jick, Hershel and Kaye, James A.},
month = dec,
year = {2003},
pmid = {14695031},
keywords = {Autistic Disorder, Case-Control Studies, Child, Preschool, Epidemiologic Methods, Female, Humans, Male, Measles-Mumps-Rubella Vaccine, Pregnancy Complications, Retrospective Studies, pregnancy},
pages = {1524--1530}
}Population screening in the age of genomic medicine. Khoury, M., J., McCabe, L., L., & McCabe, E., R. N Engl J Med, 348(1):50-58, 2003.
Paper bibtex
Paper bibtex @article{
title = {Population screening in the age of genomic medicine},
type = {article},
year = {2003},
keywords = {*Genetic Screening/ethics/legislation & jurisprude,*Neonatal Screening/ethics/legislation & jurisprud,Adult,Child,Cystic Fibrosis/diagnosis/genetics,Factor V/genetics,Female,Genomics,Hemochromatosis/diagnosis/genetics,Heterozygote,Human,Infant, Newborn,Point Mutation,Tay-Sachs Disease/diagnosis/genetics},
pages = {50-58},
volume = {348},
id = {4a011104-dc6c-3027-acd0-5bcf83e843dd},
created = {2017-06-19T13:44:20.292Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:44:20.533Z},
tags = {03/09/17},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>Journal Article<m:linebreak/>Review<m:linebreak/>Review, Tutorial</m:note>},
bibtype = {article},
author = {Khoury, M J and McCabe, L L and McCabe, E R},
journal = {N Engl J Med},
number = {1}
}2002 (3)
Building an Asynchronous Web-Based Tool for Machine Learning Classification. Weber, G., Vinterbo, S., & Ohno-Machado, L. JAMIA, Suppl. S:869–73, 2002.
abstract bibtex
abstract bibtex
Various unsupervised and supervised learning methods including support vector machines, classification trees, linear discriminant analysis and nearest neighbor classifiers have been used to classify high-throughput gene expression data. Simpler and more widely accepted statistical tools have not yet been used for this purpose, hence proper comparisons between classification methods have not been conducted. We developed free software that implements logistic regression with stepwise variable selection as a quick and simple method for initial exploration of important genetic markers in disease classification. To implement the algorithm and allow our collaborators in remote locations to evaluate and compare its results against those of other methods, we developed a user-friendly asynchronous web-based application with a minimal amount of programming using free, downloadable software tools. With this program, we show that classification using logistic regression can perform as well as other more sophisticated algorithms, and it has the advantages of being easy to interpret and reproduce. By making the tool freely and easily available, we hope to promote the comparison of classification methods. In addition, we believe our web application can be used as a model for other bioinformatics laboratories that need to develop web-based analysis tools in a short amount of time and on a limited budget.
@article{Weber2002,
title = {Building an Asynchronous Web-Based Tool for Machine Learning Classification.},
author = {Weber, Griffin and Vinterbo, Staal and {Ohno-Machado}, Lucila},
year = {2002},
journal = {JAMIA},
volume = {Suppl. S},
pages = {869--73},
abstract = {Various unsupervised and supervised learning methods including support vector machines, classification trees, linear discriminant analysis and nearest neighbor classifiers have been used to classify high-throughput gene expression data. Simpler and more widely accepted statistical tools have not yet been used for this purpose, hence proper comparisons between classification methods have not been conducted. We developed free software that implements logistic regression with stepwise variable selection as a quick and simple method for initial exploration of important genetic markers in disease classification. To implement the algorithm and allow our collaborators in remote locations to evaluate and compare its results against those of other methods, we developed a user-friendly asynchronous web-based application with a minimal amount of programming using free, downloadable software tools. With this program, we show that classification using logistic regression can perform as well as other more sophisticated algorithms, and it has the advantages of being easy to interpret and reproduce. By making the tool freely and easily available, we hope to promote the comparison of classification methods. In addition, we believe our web application can be used as a model for other bioinformatics laboratories that need to develop web-based analysis tools in a short amount of time and on a limited budget.},
copyright = {All rights reserved},
pii = {D020001919},
pubmedid = {12463949},
keywords = {12463949,Algorithms,Anonymous Testing,Artificial Intelligence,Carcinoma,Child,Comparative Study,Computerized,Confidentiality,Databases,Diagnosis,Differential,Disclosure,DNA,Gene Expression,Gene Expression Profiling,Gene Expression Regulation,Genetic Markers,Humans,Internet,Logistic Models,Lung Neoplasms,Medical Records Systems,Multivariate Analysis,Neoplasm,Neoplasms,Neoplastic,Neural Networks (Computer),Non-U.S. Gov't,Oligonucleotide Array Sequence Analysis,P.H.S.,Privacy,Research Support,Rhabdomyosarcoma,Sarcoma,Small Cell,Software,U.S. Gov't},
file = {/Users/staal/Documents/Zotero/storage/26TPF5RW/amia02-weber.pdf;/Users/staal/Documents/Zotero/storage/FRPABBPG/amia02-weber.pdf;/Users/staal/Documents/Zotero/storage/GME7HZA7/amia02-weber.pdf}
}Comparing Imperfect Measurements with the Bland-Altman Technique: Application in Gene Expression Analysis. Ohno-Machado, L., Vinterbo, S., Dreiseitl, S., Jenssen, T., & Kuo, W. JAMIA, Suppl. S:572–6, 2002.
abstract bibtex
abstract bibtex
Several problems in medicine and biology involve the comparison of two measurements made on the same set of cases. The problem differs from a calibration problem because no gold standard can be identified. Testing the null hypothesis of no relationship using measures of association is not optimal since the measurements are made on the same cases, and therefore correlation coefficients will tend to be significant. The descriptive Bland-Altman method can be used in exploratory analysis of this problem, allowing the visualization of gross systematic differences between the two sets of measurements. We utilize the method on three sets of matched observations and demonstrate its usefulness in detecting systematic variations between two measurement technologies to assess gene expression.
@article{Ohno-Machado2002,
title = {Comparing Imperfect Measurements with the {{Bland-Altman}} Technique: Application in Gene Expression Analysis.},
author = {{Ohno-Machado}, Lucila and Vinterbo, Staal and Dreiseitl, Stephen and Jenssen, Tor-Kristian and Kuo, Winston},
year = {2002},
journal = {JAMIA},
volume = {Suppl. S},
pages = {572--6},
abstract = {Several problems in medicine and biology involve the comparison of two measurements made on the same set of cases. The problem differs from a calibration problem because no gold standard can be identified. Testing the null hypothesis of no relationship using measures of association is not optimal since the measurements are made on the same cases, and therefore correlation coefficients will tend to be significant. The descriptive Bland-Altman method can be used in exploratory analysis of this problem, allowing the visualization of gross systematic differences between the two sets of measurements. We utilize the method on three sets of matched observations and demonstrate its usefulness in detecting systematic variations between two measurement technologies to assess gene expression.},
copyright = {All rights reserved},
pii = {1833},
pubmedid = {12463888},
keywords = {12463888,Algorithms,Anonymous Testing,Artificial Intelligence,Bias (Epidemiology),Carcinoma,Child,Comparative Study,Computational Biology,Computerized,Confidentiality,Data Interpretation,Databases,Diagnosis,Differential,Disclosure,DNA,Gene Expression,Gene Expression Profiling,Gene Expression Regulation,Genetic Markers,Humans,Internet,Logistic Models,Lung Neoplasms,Medical Records Systems,Messenger,Multivariate Analysis,Neoplasm,Neoplasms,Neoplastic,Neural Networks (Computer),Non-U.S. Gov't,Oligonucleotide Array Sequence Analysis,P.H.S.,Privacy,Research Support,Rhabdomyosarcoma,RNA,Sarcoma,Small Cell,Software,Statistical,U.S. Gov't}
}What is the Birth Defect Risk Associated With Consanguineous Marriages ?. Zlotogora, J. American journal of medical genetics, 109(1):70-71, 2002.
Paper bibtex
Paper bibtex @article{
title = {What is the Birth Defect Risk Associated With Consanguineous Marriages ?},
type = {article},
year = {2002},
identifiers = {[object Object]},
keywords = {*Consanguinity,Abnormalities/*genetics,Child,Female,Human,Infant,Male,Preschool,Risk Factors},
pages = {70-71},
volume = {109},
id = {f8021355-3e47-3c4b-b4f4-b8bb58d6fc41},
created = {2017-06-19T13:42:00.462Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:42:00.784Z},
tags = {04/11/22},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note> <m:bold>From Duplicate 1 ( </m:bold> <m:bold> </m:bold><m:bold><m:italic>What is the birth defect risk associated with consanguineous marriages?</m:italic></m:bold><m:bold> </m:bold> <m:bold> - Zlotogora, J )<m:linebreak/> </m:bold> <m:linebreak/>Case Reports<m:linebreak/>Letter<m:linebreak/> <m:linebreak/> </m:note>},
bibtype = {article},
author = {Zlotogora, Joël},
journal = {American journal of medical genetics},
number = {1}
}2001 (7)
Endemic stability--a veterinary idea applied to human public health. Coleman, P. G., Perry, B. D., & Woolhouse, M. E. Lancet (London, England), 357(9264):1284--1286, April, 2001.
abstract bibtex
abstract bibtex
Endemic stability is an epidemiological state of a population, in which clinical disease is scarce despite high level of infection. The notion was developed to describe patterns of tick-borne disease in cattle. However, we propose a general model of endemic stability that is applicable to a broader range of diseases that are important in public health, including malaria, rubella, and mumps. We postulate that endemic stability requires only that (1) the probability, or severity, of clinical disease after infection increases with age, and (2) after one infection, the probability that subsequent infections result in disease is reduced. We present these criteria in simple mathematical terms. Our hypothesis predicts that partial disease control activities might, under certain circumstances, lead to an increase in disease incidence. We discuss the implications for public health interventions.
@article{coleman_endemic_2001,
title = {Endemic stability--a veterinary idea applied to human public health.},
volume = {357},
issn = {0140-6736 0140-6736},
abstract = {Endemic stability is an epidemiological state of a population, in which clinical disease is scarce despite high level of infection. The notion was developed to describe patterns of tick-borne disease in cattle. However, we propose a general model of endemic stability that is applicable to a broader range of diseases that are important in public health, including malaria, rubella, and mumps. We postulate that endemic stability requires only that (1) the probability, or severity, of clinical disease after infection increases with age, and (2) after one infection, the probability that subsequent infections result in disease is reduced. We present these criteria in simple mathematical terms. Our hypothesis predicts that partial disease control activities might, under certain circumstances, lead to an increase in disease incidence. We discuss the implications for public health interventions.},
language = {eng},
number = {9264},
journal = {Lancet (London, England)},
author = {Coleman, P. G. and Perry, B. D. and Woolhouse, M. E.},
month = apr,
year = {2001},
pmid = {11418173},
keywords = {*Endemic Diseases, *Epidemiologic Methods, *Models, Theoretical, *Public Health, Age Distribution, Animals, Child, Preschool, Communicable Diseases/*epidemiology/etiology, Humans, Incidence, Infant, Infant, Newborn},
pages = {1284--1286}
}Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. Kaye, J. A., del Mar Melero-Montes, M., & Jick, H. BMJ (Clinical research ed.), 322(7284):460--463, February, 2001.
abstract bibtex
abstract bibtex
OBJECTIVE: To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. DESIGN: Time trend analysis of data from the UK general practice research database (GPRD). SETTING: General practices in the United Kingdom. SUBJECTS: Children aged 12 years or younger diagnosed with autism 1988-99, with further analysis of boys aged 2 to 5 years born 1988-93. MAIN OUTCOME MEASURES: Annual and age specific incidence for first recorded diagnoses of autism (that is, when the diagnosis of autism was first recorded) in the children aged 12 years or younger; annual, birth cohort specific risk of autism diagnosed in the 2 to 5 year old boys; coverage (prevalence) of MMR vaccination in the same birth cohorts. RESULTS: The incidence of newly diagnosed autism increased sevenfold, from 0.3 per 10 000 person years in 1988 to 2.1 per 10 000 person years in 1999. The peak incidence was among 3 and 4 year olds, and 83% (254/305) of cases were boys. In an annual birth cohort analysis of 114 boys born in 1988-93, the risk of autism in 2 to 5 year old boys increased nearly fourfold over time, from 8 (95% confidence interval 4 to 14) per 10 000 for boys born in 1988 to 29 (20 to 43) per 10 000 for boys born in 1993. For the same annual birth cohorts the prevalence of MMR vaccination was over 95%. CONCLUSIONS: Because the incidence of autism among 2 to 5 year olds increased markedly among boys born in each year separately from 1988 to 1993 while MMR vaccine coverage was over 95% for successive annual birth cohorts, the data provide evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time. The explanation for the marked increase in risk of the diagnosis of autism in the past decade remains uncertain.
@article{kaye_mumps_2001,
title = {Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis},
volume = {322},
issn = {0959-8138},
shorttitle = {Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners},
abstract = {OBJECTIVE: To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine.
DESIGN: Time trend analysis of data from the UK general practice research database (GPRD).
SETTING: General practices in the United Kingdom.
SUBJECTS: Children aged 12 years or younger diagnosed with autism 1988-99, with further analysis of boys aged 2 to 5 years born 1988-93.
MAIN OUTCOME MEASURES: Annual and age specific incidence for first recorded diagnoses of autism (that is, when the diagnosis of autism was first recorded) in the children aged 12 years or younger; annual, birth cohort specific risk of autism diagnosed in the 2 to 5 year old boys; coverage (prevalence) of MMR vaccination in the same birth cohorts.
RESULTS: The incidence of newly diagnosed autism increased sevenfold, from 0.3 per 10 000 person years in 1988 to 2.1 per 10 000 person years in 1999. The peak incidence was among 3 and 4 year olds, and 83\% (254/305) of cases were boys. In an annual birth cohort analysis of 114 boys born in 1988-93, the risk of autism in 2 to 5 year old boys increased nearly fourfold over time, from 8 (95\% confidence interval 4 to 14) per 10 000 for boys born in 1988 to 29 (20 to 43) per 10 000 for boys born in 1993. For the same annual birth cohorts the prevalence of MMR vaccination was over 95\%.
CONCLUSIONS: Because the incidence of autism among 2 to 5 year olds increased markedly among boys born in each year separately from 1988 to 1993 while MMR vaccine coverage was over 95\% for successive annual birth cohorts, the data provide evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time. The explanation for the marked increase in risk of the diagnosis of autism in the past decade remains uncertain.},
language = {eng},
number = {7284},
journal = {BMJ (Clinical research ed.)},
author = {Kaye, J. A. and del Mar Melero-Montes, M. and Jick, H.},
month = feb,
year = {2001},
pmid = {11222420},
pmcid = {PMC26561},
keywords = {Age Distribution, Autistic Disorder, Child, Child, Preschool, Family Practice, Female, Great Britain, Humans, Male, Measles-Mumps-Rubella Vaccine, Risk Assessment, incidence},
pages = {460--463}
}Protecting Against Bad Air. Luzzatto, L. & Notaro, R. Science, 293(July):442-443, 2001.
Paper bibtex
Paper bibtex @article{
title = {Protecting Against Bad Air},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {*Agriculture,*Glucosephosphate Dehydrogenase Deficiency/epidemi,*Variation (Genetics),Animal,Child,Erythrocytes/enzymology/parasitology,Evolution,Falciparum/*enzymology/epidemiology/*gene,Genetic,Glucosephosphate Dehydrogenase/blood/*genetics/met,Haplotypes,Human,Immunity,Malaria,Microsatellite Repeats,Models,Natural/genetics,Plasmodium falciparum/physiology,Polymorphism,Polymorphism (Genetics),Prevalence,Restriction Fragment Length,Selection (Genetics)},
pages = {442-443},
volume = {293},
id = {e244ac6a-cafa-3de1-81ae-e83092bdc695},
created = {2017-06-19T13:42:01.571Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:42:01.713Z},
tags = {03/03/18},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note> <m:bold>From Duplicate 1 ( </m:bold> <m:bold> </m:bold><m:bold><m:italic>Malaria. Protecting against bad air</m:italic></m:bold><m:bold> </m:bold> <m:bold> - Luzzatto, L; Notaro, R )<m:linebreak/> </m:bold> <m:linebreak/>eng<m:linebreak/>Comment<m:linebreak/>Journal Article<m:linebreak/> <m:linebreak/> </m:note>},
bibtype = {article},
author = {Luzzatto, Lucio and Notaro, Rosario},
journal = {Science},
number = {July}
}The local field in infratentorial ependymoma: does the entire posterior fossa need to be treated?. Paulino, A., C. International Journal of Radiation Oncology Biology Physics, 49(3):757-61, 3, 2001.
Paper abstract bibtex
Paper abstract bibtex INTRODUCTION: In the past decade, there have been multiple reports indicating that the predominant problem in the curative treatment of intracranial ependymoma is local failure. As a result, many have recommended local field radiotherapy. For infratentorial ependymoma, there is controversy regarding what constitutes the local field. Some radiation oncologists advocate coverage of the entire posterior fossa, whereas others recommend radiotherapy to the tumor bed and a safety margin. METHODS AND MATERIALS: From 1984 to 1998, 28 patients with posterior fossa ependymoma were diagnosed at our institution. There were 18 males and 10 females with a median age of 12 years (range, 2-81 years). Four patients (14%) had high-grade ependymoma and 3 (11%) had M+ disease at initial diagnosis. Gross total resection was achieved in 17 (61%) and postoperative radiotherapy (RT) was given to 22 (77%). Radiotherapy fields were craniospinal in 10, whole brain in 1, posterior fossa in 2, and tumor bed with a 2-cm. margin in 9. Median dose to the primary site was 54 Gy (range, 45-55 Gy). All 4 patients with high-grade ependymoma received craniospinal RT. Six patients did not receive RT after surgery. Magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain at initial diagnosis were compared to MRI or CT scans of patients at relapse to determine if the local relapse was in the tumor bed or nontumor bed posterior fossa. Median follow-up was 127 months (range, 14-188 months). RESULTS: Six patients have relapsed. For the 11 patients who had craniospinal or whole brain radiotherapy (RT), 3 recurred (tumor bed 1, spine 1, nontumor bed posterior fossa + spine 1). Both patients who failed in the spine had high-grade tumors. Neither of the 2 treated with posterior fossa fields relapsed. For the 9 patients who had tumor bed RT alone and the 6 who did not receive RT, there were 3 relapses; all were in the tumor bed. There were no relapses in the nontumor bed posterior fossa. CONCLUSION: For nondisseminated, low-grade infratentorial ependymoma, the radiotherapy volume does not need to include the entire posterior fossa. This information can be used to minimize late effects of RT in the era of three-dimensional (conformal) radiotherapy. No conclusion can be reached regarding the appropriate local field for high-grade infratentorial ependymoma because of the small number of patients.
@article{
title = {The local field in infratentorial ependymoma: does the entire posterior fossa need to be treated?},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {80 and over,Adolescent,Adult,Aged,Child,Cranial Fossa,Ependymoma,Ependymoma: radiotherapy,Ependymoma: surgery,Female,Humans,Infratentorial Neoplasms,Infratentorial Neoplasms: radiotherapy,Infratentorial Neoplasms: surgery,Male,Middle Aged,Posterior,Preschool,Radiotherapy Dosage,Survival Analysis,Treatment Failure},
pages = {757-61},
volume = {49},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/11172959},
month = {3},
day = {1},
id = {824b4da9-3acc-37d7-9dd5-8c30fb640a36},
created = {2014-08-02T21:56:13.000Z},
file_attached = {true},
profile_id = {be299c88-7105-3a8d-a1cd-3aa95c25e2c4},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-12-29T19:36:51.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {INTRODUCTION: In the past decade, there have been multiple reports indicating that the predominant problem in the curative treatment of intracranial ependymoma is local failure. As a result, many have recommended local field radiotherapy. For infratentorial ependymoma, there is controversy regarding what constitutes the local field. Some radiation oncologists advocate coverage of the entire posterior fossa, whereas others recommend radiotherapy to the tumor bed and a safety margin. METHODS AND MATERIALS: From 1984 to 1998, 28 patients with posterior fossa ependymoma were diagnosed at our institution. There were 18 males and 10 females with a median age of 12 years (range, 2-81 years). Four patients (14%) had high-grade ependymoma and 3 (11%) had M+ disease at initial diagnosis. Gross total resection was achieved in 17 (61%) and postoperative radiotherapy (RT) was given to 22 (77%). Radiotherapy fields were craniospinal in 10, whole brain in 1, posterior fossa in 2, and tumor bed with a 2-cm. margin in 9. Median dose to the primary site was 54 Gy (range, 45-55 Gy). All 4 patients with high-grade ependymoma received craniospinal RT. Six patients did not receive RT after surgery. Magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain at initial diagnosis were compared to MRI or CT scans of patients at relapse to determine if the local relapse was in the tumor bed or nontumor bed posterior fossa. Median follow-up was 127 months (range, 14-188 months). RESULTS: Six patients have relapsed. For the 11 patients who had craniospinal or whole brain radiotherapy (RT), 3 recurred (tumor bed 1, spine 1, nontumor bed posterior fossa + spine 1). Both patients who failed in the spine had high-grade tumors. Neither of the 2 treated with posterior fossa fields relapsed. For the 9 patients who had tumor bed RT alone and the 6 who did not receive RT, there were 3 relapses; all were in the tumor bed. There were no relapses in the nontumor bed posterior fossa. CONCLUSION: For nondisseminated, low-grade infratentorial ependymoma, the radiotherapy volume does not need to include the entire posterior fossa. This information can be used to minimize late effects of RT in the era of three-dimensional (conformal) radiotherapy. No conclusion can be reached regarding the appropriate local field for high-grade infratentorial ependymoma because of the small number of patients.},
bibtype = {article},
author = {Paulino, A C},
journal = {International Journal of Radiation Oncology Biology Physics},
number = {3}
}Objects and attention: The state of the art. Scholl, B. J. Cognition, 80(1-2):1-46, 2001.
abstract bibtex
abstract bibtex
What are the units of attention? In addition to standard models holding that attention can select spatial regions and visual features, recent work suggests that in some cases attention can directly select discrete objects. This paper reviews the state of the art with regard to such 'object-based' attention, and explores how objects of attention relate to locations, reference frames, perceptual groups, surfaces, parts, and features. Also discussed are the dynamic aspects of objecthood, including the question of how attended objects are individuated in time, and the possibility of attending to simple dynamic motions and events. The final sections of this review generalize these issues beyond vision science, to other modalities and fields such as auditory objects of attention and the infant's 'object concept'.
@Article{Scholl2001b,
author = {B. J. Scholl},
journal = {Cognition},
title = {Objects and attention: {T}he state of the art.},
year = {2001},
number = {1-2},
pages = {1-46},
volume = {80},
abstract = {What are the units of attention? In addition to standard models holding
that attention can select spatial regions and visual features, recent
work suggests that in some cases attention can directly select discrete
objects. This paper reviews the state of the art with regard to such
'object-based' attention, and explores how objects of attention relate
to locations, reference frames, perceptual groups, surfaces, parts,
and features. Also discussed are the dynamic aspects of objecthood,
including the question of how attended objects are individuated in
time, and the possibility of attending to simple dynamic motions
and events. The final sections of this review generalize these issues
beyond vision science, to other modalities and fields such as auditory
objects of attention and the infant's 'object concept'.},
keywords = {80 and over, Adenoviridae, Adolescent, Adult, Aged, Analysis of Variance, Animals, Attention, Auditory Perception, Biopsy, Bone Nails, Bone Neoplasms, Bone Screws, Bone Transplantation, Breast Neoplasms, Carcinoma, Child, Child Development, Cognition, Cohort Studies, Comparative Study, Concept Formation, Constriction, Esophageal Neoplasms, Female, Femoral Neck Fractures, Femoral Neoplasms, Femur Head, Femur Neck, Fibula, Follow-Up Studies, Fracture Fixation, Fractures, Gene Expression, Gene Transfer Techniques, Green Fluorescent Proteins, Hepatitis, Homologous, Humans, Inbred Strains, Infant, Injections, Internal, Intramedullary, Intravenous, Judgment, Knee Joint, Liver, Luminescent Proteins, Male, Meta-Analysis, Middle Aged, Models, Motion, Motion Perception, Needle, Neoplasms, Non-P.H.S., Non-U.S. Gov't, P.H.S., Perceptual Distortion, Portal Vein, Preschool, Problem Solving, Psychological, Radiation-Induced, Rats, Research Support, Retrospective Studies, Second Primary, Self Concept, Sensitivity and Specificity, Social Perception, Space Perception, Spontaneous, Squamous Cell, Students, Time Factors, Tomography, Transplantation, Treatment Outcome, U.S. Gov't, Visual Perception, X-Ray Computed, 11245838},
}Reducing everyday memory and planning problems by means of a paging system: a randomised control crossover study. Wilson, B., a., Emslie, H., C., Quirk, K., & Evans, J., J. Journal of neurology, neurosurgery, and psychiatry, 70(4):477-82, 4, 2001.
Paper Website abstract bibtex
Paper Website abstract bibtex To evaluate a paging system designed to improve independence in people with memory problems and executive deficits.
@article{
title = {Reducing everyday memory and planning problems by means of a paging system: a randomised control crossover study.},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Aged,Brain Injuries,Brain Injuries: complications,Brain Injuries: physiopathology,Brain Injuries: psychology,Child,Female,Humans,Male,Memory,Memory Disorders,Memory Disorders: etiology,Memory Disorders: physiopathology,Memory: physiology,Middle Aged,Questionnaires,Reminder Systems,Task Performance and Analysis},
pages = {477-82},
volume = {70},
websites = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1737307&tool=pmcentrez&rendertype=abstract},
month = {4},
id = {900b322d-ea43-3553-8e3e-d89f7d23728a},
created = {2017-06-01T08:23:43.336Z},
file_attached = {true},
profile_id = {b6efe121-8b29-3abc-9df5-2353a8d30e77},
group_id = {32ad6c38-dd7d-39b9-9a71-86890e245b76},
last_modified = {2017-06-01T08:23:43.469Z},
tags = {attention},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {To evaluate a paging system designed to improve independence in people with memory problems and executive deficits.},
bibtype = {article},
author = {Wilson, B a and Emslie, H C and Quirk, K and Evans, J J},
journal = {Journal of neurology, neurosurgery, and psychiatry},
number = {4}
}Molecular genetic alterations on chromosomes 11 and 22 in ependymomas. Lamszus, K., Lachenmayer, L., Heinemann, U., Kluwe, L., Finckh, U., Höppner, W., Stavrou, D., Fillbrandt, R., & Westphal, M. International journal of cancer, 91(6):803-8, 3, 2001.
Paper abstract bibtex
Paper abstract bibtex Ependymomas arise from the ependymal cells at different locations throughout the brain and spinal cord. These tumors have a broad age distribution with a range from less than 1 year to more than 80 years. In some intramedullary spinal ependymomas, mutations in the neurofibromatosis 2 (NF2) gene and loss of heterozygosity (LOH) on chromosome arm 22q have been described. Cytogenetic studies have also identified alterations involving chromosome arm 11q, including rearrangements at 11q13, in ependymomas. We analyzed 21 intramedullary spinal, 14 ventricular, 11 filum terminale and 6 intracerebral ependymomas for mutations in the MEN1 gene, which is located at 11q13, and mutations in the NF2 gene, which is located at 22q12, as well as for LOH on 11q and 22q. NF2 mutations were found in 6 tumors, all of which were intramedullary spinal and all of which displayed LOH 22q. Allelic loss on 22q was found in 20 cases and was significantly more frequent in intramedullary spinal ependymomas than in tumors in other locations. LOH 11q was found in 7 patients and exhibited a highly significant inverse association with LOH 22q (p<0.001). A hemizygous MEN1 mutation was identified in 3 tumors, all of which were recurrences from the same patient. Interestingly, the initial tumor corresponded to WHO grade II and displayed LOH 11q but not yet a MEN1 mutation. In 2 subsequent recurrences, the tumor had progressed to anaplastic ependymoma (WHO grade III) and exhibited a nonsense mutation in exon 10 of MEN1 (W471X) in conjunction with LOH 11q. This suggests that loss of wild-type MEN1 may be involved in the malignant progression of a subset of ependymomas. To conclude, our findings provide evidence for different genetic pathways involved in ependymoma formation and progression, which may allow to define genetically and clinically distinct tumor entities.
@article{
title = {Molecular genetic alterations on chromosomes 11 and 22 in ependymomas},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Aged,Alleles,Base Sequence,Brain Neoplasms,Brain Neoplasms: genetics,Child,Chromosome Deletion,Chromosomes,DNA,DNA Primers,DNA Primers: chemistry,Ependymoma,Ependymoma: genetics,Ependymoma: pathology,Female,Genes,Human,Humans,Infant,Loss of Heterozygosity,Male,Microsatellite Repeats,Middle Aged,Mutation,Neoplasm Proteins,Neoplasm Proteins: genetics,Neurofibromatosis 2,Neurofibromatosis 2: genetics,Newborn,Pair 11,Pair 11: genetics,Pair 22,Pair 22: genetics,Polymerase Chain Reaction,Preschool,Proto-Oncogene Proteins,Sequence Analysis,Spinal Cord Neoplasms,Spinal Cord Neoplasms: genetics},
pages = {803-8},
volume = {91},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/11275983},
month = {3},
day = {15},
id = {7d56c6a1-5e17-379e-ab86-667dcf2ce1cd},
created = {2013-08-05T21:04:27.000Z},
file_attached = {true},
profile_id = {8c4ca2d5-86de-3b5d-86be-8408415f34e0},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-12-29T19:36:50.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {Ependymomas arise from the ependymal cells at different locations throughout the brain and spinal cord. These tumors have a broad age distribution with a range from less than 1 year to more than 80 years. In some intramedullary spinal ependymomas, mutations in the neurofibromatosis 2 (NF2) gene and loss of heterozygosity (LOH) on chromosome arm 22q have been described. Cytogenetic studies have also identified alterations involving chromosome arm 11q, including rearrangements at 11q13, in ependymomas. We analyzed 21 intramedullary spinal, 14 ventricular, 11 filum terminale and 6 intracerebral ependymomas for mutations in the MEN1 gene, which is located at 11q13, and mutations in the NF2 gene, which is located at 22q12, as well as for LOH on 11q and 22q. NF2 mutations were found in 6 tumors, all of which were intramedullary spinal and all of which displayed LOH 22q. Allelic loss on 22q was found in 20 cases and was significantly more frequent in intramedullary spinal ependymomas than in tumors in other locations. LOH 11q was found in 7 patients and exhibited a highly significant inverse association with LOH 22q (p<0.001). A hemizygous MEN1 mutation was identified in 3 tumors, all of which were recurrences from the same patient. Interestingly, the initial tumor corresponded to WHO grade II and displayed LOH 11q but not yet a MEN1 mutation. In 2 subsequent recurrences, the tumor had progressed to anaplastic ependymoma (WHO grade III) and exhibited a nonsense mutation in exon 10 of MEN1 (W471X) in conjunction with LOH 11q. This suggests that loss of wild-type MEN1 may be involved in the malignant progression of a subset of ependymomas. To conclude, our findings provide evidence for different genetic pathways involved in ependymoma formation and progression, which may allow to define genetically and clinically distinct tumor entities.},
bibtype = {article},
author = {Lamszus, K and Lachenmayer, L and Heinemann, U and Kluwe, L and Finckh, U and Höppner, W and Stavrou, D and Fillbrandt, R and Westphal, M},
journal = {International journal of cancer},
number = {6}
}2000 (3)
Multivariate frailty model with a major gene: application to genealogical data. Begun, A., Desjardins, B., Iachine, I., & Yashin, A. Stud Health Technol Inform, 77:412-416, 2000.
Website abstract bibtex
Website abstract bibtex Multivariate survival models are shown to be appropriate for the analysis of the genetic and the environmental nature of a human life-span. Models which involve continuously distributed individual frailty, play an important role in the genetic analysis of an individual's susceptibility to disease and death. These models, however, are not appropriate for the detection of the effects of separate genes on survival. For this purpose we developed a 'major gene' frailty model of multivariate survival and applied it to simulated and real pedigree data. The analysis shows that this model can be used for the detection of the presence of major genes in the population and for the evaluation of the effects of such genes on survival.
@article{
title = {Multivariate frailty model with a major gene: application to genealogical data},
type = {article},
year = {2000},
identifiers = {[object Object]},
keywords = {*Genetic Predisposition to Disease,*Models, Genetic,Adolescent,Adult,Alleles,Child,Child, Preschool,Female,Genotype,Humans,Infant,Infant, Newborn,Longevity/*genetics,Male,Mathematical Computing,Multivariate Analysis,Quebec,Risk,Software,Survival Analysis},
pages = {412-416},
volume = {77},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11187585},
id = {23588418-0e3c-33dd-b0e4-fed475556b34},
created = {2017-06-19T13:44:21.917Z},
file_attached = {false},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:44:22.080Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>0926-9630<m:linebreak/>Journal Article</m:note>},
abstract = {Multivariate survival models are shown to be appropriate for the analysis of the genetic and the environmental nature of a human life-span. Models which involve continuously distributed individual frailty, play an important role in the genetic analysis of an individual's susceptibility to disease and death. These models, however, are not appropriate for the detection of the effects of separate genes on survival. For this purpose we developed a 'major gene' frailty model of multivariate survival and applied it to simulated and real pedigree data. The analysis shows that this model can be used for the detection of the presence of major genes in the population and for the evaluation of the effects of such genes on survival.},
bibtype = {article},
author = {Begun, A and Desjardins, B and Iachine, I and Yashin, A},
journal = {Stud Health Technol Inform}
}Combined treatment of fourth ventricle ependymomas: report of 26 cases. Spagnoli, D., Tomei, G., Ceccarelli, G., Grimoldi, N., Lanterna, A., Bello, L., Sinisi, M., M., De Santis, A., & Villani, R., M. Surgical Neurology, 54(1):19-26; discussion 26, 7, 2000.
Paper abstract bibtex
Paper abstract bibtex This study investigated the relevance of prognostic factors and the impact of histological features in posterior fossa ependymoma.
@article{
title = {Combined treatment of fourth ventricle ependymomas: report of 26 cases},
type = {article},
year = {2000},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Antineoplastic Combined Chemotherapy Protocols,Antineoplastic Combined Chemotherapy Protocols: th,Brain Neoplasms,Brain Neoplasms: mortality,Brain Neoplasms: pathology,Brain Neoplasms: therapy,Child,Combined Modality Therapy,Cranial Fossa,Ependymoma,Ependymoma: mortality,Ependymoma: pathology,Ependymoma: therapy,Female,Follow-Up Studies,Fourth Ventricle,Fourth Ventricle: radiation effects,Fourth Ventricle: surgery,Humans,Infant,Male,Middle Aged,Posterior,Posterior: radiation effects,Posterior: surgery,Preschool,Radiotherapy Dosage,Retrospective Studies,Survival Rate,Treatment Outcome},
pages = {19-26; discussion 26},
volume = {54},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/11024503},
month = {7},
id = {7cd94e64-54ff-3d5c-8cac-190b02d239a4},
created = {2013-08-05T21:04:27.000Z},
file_attached = {true},
profile_id = {8c4ca2d5-86de-3b5d-86be-8408415f34e0},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-11-22T16:36:55.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {This study investigated the relevance of prognostic factors and the impact of histological features in posterior fossa ependymoma.},
bibtype = {article},
author = {Spagnoli, D and Tomei, G and Ceccarelli, G and Grimoldi, N and Lanterna, A and Bello, L and Sinisi, M M and De Santis, A and Villani, R M},
journal = {Surgical Neurology},
number = {1}
}Familial cancer risks to offspring from mothers with 2 primary breast cancers: leads to cancer syndromes. Hemminki, K., Vaittinen, P., & Easton, D. Int J Cancer, 88(1):87-91., 2000.
abstract bibtex
abstract bibtex
The nationwide Swedish Family-Cancer Database was used to analyse the risk of cancer among the offspring of bilateral breast cancer patients. We studied 4,734 such mothers who had 9,391 offspring, of whom 328 presented with a primary cancer in the years 1958-1996. Standardised incidence ratios (SIRs) were increased for breast [SIR 3.05, 95% confidence interval (CI) 2.57-3.59], ovarian (SIR 1.84, 95% CI 1.03-3.05) and anogenital (SIR 1.75, 95% CI 1.11-2.63) cancers and childhood sarcomas (SIR 9.39, 95% CI 1.93-29.13). Additionally, squamous-cell skin cancer was increased among sons and all childhood cancers among daughters. When analysed by histological type, adenocarcinomas of the breast and ovary, all squamous-cell carcinomas and tumours at glandular epithelium (seminomas and intestinal carcinoids) were increased. Mothers with bilateral breast cancer had an excess of 2 or more children with cancer. The increased risk of ovarian cancer is consistent with germline mutations in the BRCA1 and BRCA2 genes, while the risk of soft tissue and bone sarcomas may reflect the association of these tumours with Li-Fraumeni syndrome. The increases in squamous-cell carcinomas at many sites may reflect a new susceptibility syndrome.
@article{
title = {Familial cancer risks to offspring from mothers with 2 primary breast cancers: leads to cancer syndromes},
type = {article},
year = {2000},
identifiers = {[object Object]},
keywords = {Adolescence,Adult,Breast Neoplasms/epidemiology/*genetics,Child,Child, Preschool,Databases, Factual,Family Health,Female,Human,Incidence,Infant,Infant, Newborn,Male,Middle Age,Mothers,Neoplasms, Second Primary/epidemiology/*genetics,Neoplasms/epidemiology/*genetics,Risk Factors,Socioeconomic Factors,Support, Non-U.S. Gov't,Sweden/epidemiology},
pages = {87-91.},
volume = {88},
id = {588e6ac8-7072-3509-b985-6895b25455d2},
created = {2017-06-19T13:44:44.036Z},
file_attached = {false},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:44:44.218Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>eng<m:linebreak/>Journal Article</m:note>},
abstract = {The nationwide Swedish Family-Cancer Database was used to analyse the risk of cancer among the offspring of bilateral breast cancer patients. We studied 4,734 such mothers who had 9,391 offspring, of whom 328 presented with a primary cancer in the years 1958-1996. Standardised incidence ratios (SIRs) were increased for breast [SIR 3.05, 95% confidence interval (CI) 2.57-3.59], ovarian (SIR 1.84, 95% CI 1.03-3.05) and anogenital (SIR 1.75, 95% CI 1.11-2.63) cancers and childhood sarcomas (SIR 9.39, 95% CI 1.93-29.13). Additionally, squamous-cell skin cancer was increased among sons and all childhood cancers among daughters. When analysed by histological type, adenocarcinomas of the breast and ovary, all squamous-cell carcinomas and tumours at glandular epithelium (seminomas and intestinal carcinoids) were increased. Mothers with bilateral breast cancer had an excess of 2 or more children with cancer. The increased risk of ovarian cancer is consistent with germline mutations in the BRCA1 and BRCA2 genes, while the risk of soft tissue and bone sarcomas may reflect the association of these tumours with Li-Fraumeni syndrome. The increases in squamous-cell carcinomas at many sites may reflect a new susceptibility syndrome.},
bibtype = {article},
author = {Hemminki, K and Vaittinen, P and Easton, D},
journal = {Int J Cancer},
number = {1}
}1999 (1)
Visual-proprioceptive mapping in children with developmental coordination disorder. Mon-Williams, M., A., Wann, J., P., & Pascal, E. Developmental Medicine & Child Neurology, 41(4):247-254, 1999.
abstract bibtex
abstract bibtex
Developmental coordination disorder (DCD) occurs in a small but significant proportion of children who present with impaired body-eye coordination and show poor acquisition of motor skills. This study investigated the visual-proprioceptive mapping ability of children with DCD from a small selected group, with particular reference to the use of vision in matching tasks. The children with DCD in this study were significantly poorer than control children on all matching tasks. They seemed to have particular difficulty in cross-modal judgements that required the use of visual information to guide proprioceptive judgements of limb position. A distinction is drawn between tasks that can be achieved purely through sensory matching and those that require body-centred spatial judgements, suggesting that it is the latter that posits a particular difficulty for children with DCD
@article{
title = {Visual-proprioceptive mapping in children with developmental coordination disorder},
type = {article},
year = {1999},
identifiers = {[object Object]},
keywords = {Case-Control Studies,Child,Female,Growth Disorders,Humans,Male,Motor Skills,Preschool,Proprioception,Vision,physiopathology,psychology},
pages = {247-254},
volume = {41},
id = {2a1d6312-9620-3630-b63f-f17c2d8e07ef},
created = {2016-01-12T14:17:48.000Z},
file_attached = {false},
profile_id = {d5b53108-91c5-30b8-8e6c-dd027f636bcd},
last_modified = {2017-03-16T06:19:45.131Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {true},
hidden = {false},
abstract = {Developmental coordination disorder (DCD) occurs in a small but significant proportion of children who present with impaired body-eye coordination and show poor acquisition of motor skills. This study investigated the visual-proprioceptive mapping ability of children with DCD from a small selected group, with particular reference to the use of vision in matching tasks. The children with DCD in this study were significantly poorer than control children on all matching tasks. They seemed to have particular difficulty in cross-modal judgements that required the use of visual information to guide proprioceptive judgements of limb position. A distinction is drawn between tasks that can be achieved purely through sensory matching and those that require body-centred spatial judgements, suggesting that it is the latter that posits a particular difficulty for children with DCD},
bibtype = {article},
author = {Mon-Williams, M A and Wann, J P and Pascal, E},
journal = {Developmental Medicine & Child Neurology},
number = {4}
}1998 (1)
Phenotypic variability in five cystic fibrosis patients compound heterozygous for the Y1092X mutation. De Braekeleer, M., Allard, C., Leblanc, J., P., Simard, F., & Aubin, G. Human heredity, 48(3):158-62, 1998.
Paper Website abstract bibtex
Paper Website abstract bibtex Five cystic fibrosis (CF) patients distributed in three families and compound heterozygotes for the Y1092X mutation have been followed for a period ranging from 5 to 20 years. The genealogical reconstruction identified a common ancestor couple to all 3 families at the 5th generation. All 5 patients were pancreatic insufficient. A high variability in the clinical aspects and pulmonary function was seen between the families, but not within. Based on our observations, it will be very difficult to predict the course of disease for CF patients with the Y1092X mutation, even if they are closely related (first-degree cousins).
@article{
title = {Phenotypic variability in five cystic fibrosis patients compound heterozygous for the Y1092X mutation.},
type = {article},
year = {1998},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Amino Acid Substitution,Amino Acid Substitution: genetics,Child,Child, Preschool,Cystic Fibrosis,Cystic Fibrosis: ethnology,Cystic Fibrosis: genetics,Female,Heterozygote Detection,Humans,Male,Mutation,Mutation: genetics,Pedigree,Phenotype,Quebec,Tyrosine,Tyrosine: genetics},
pages = {158-62},
volume = {48},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/9618063},
id = {9ed32f45-92a0-3822-89d1-3076c7d8e676},
created = {2017-06-19T13:41:38.972Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:41:39.171Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {Five cystic fibrosis (CF) patients distributed in three families and compound heterozygotes for the Y1092X mutation have been followed for a period ranging from 5 to 20 years. The genealogical reconstruction identified a common ancestor couple to all 3 families at the 5th generation. All 5 patients were pancreatic insufficient. A high variability in the clinical aspects and pulmonary function was seen between the families, but not within. Based on our observations, it will be very difficult to predict the course of disease for CF patients with the Y1092X mutation, even if they are closely related (first-degree cousins).},
bibtype = {article},
author = {De Braekeleer, M and Allard, C and Leblanc, J P and Simard, F and Aubin, G},
journal = {Human heredity},
number = {3}
}1996 (1)
Asthma on Tristan da Cunha: looking for the genetic link. The University of Toronto Genetics of Asthma Research Group. Zamel, N., McClean, P., A., Sandell, P., R., Siminovitch, K., A., & Slutsky, A., S. Am J Respir Crit Care Med, 153(6 Pt 1):1902-1906, 1996.
Website abstract bibtex
Website abstract bibtex Although asthma has a significant heritable component, the mode of inheritance remains controversial because of the complexity of the disease and the influence of environmental factors. Isolated, inbred populations serve to reduce variability, thus increasing the probability of gene localization. We studied the inbred population of the remote island of Tristan da Cunha to document asthma prevalence for the purpose of genetic linkage analysis. Medical histories and skin atopy were determined on 282 islanders, representing 97% of the population, and airway responsiveness was measured in 254; 226 by methacholine challenge (tidal breathing method) and 28 by bronchodilator response (400 micrograms salbutamol aerosol). Blood samples were collected from 275 islanders. Participants ranged in age from 3 to 94 yr. Asthma was defined as increased airway responsiveness (AR+: PC20 < 4 mg/ml or > or = 15% increase in FEV1 postbronchodilator) combined with a positive history (Hx+). Fifty-seven percent of the islanders had at least partial evidence of asthma (Hx+ and/or AR+) and 23% had a definitive diagnosis of asthma (AR+ with Hx+). Overall 47% of the population were atopic, atopy was proportionally higher in asthmatics (74%) than nonasthmatics (32%; p < 0.01). Analysis of the methacholine dose-response curves demonstrated that asthmatics were significantly (p < 0.01) more responsive than those with AR+ only, and nonasthmatics (AR-, Hx-) were more responsive than laboratory control subjects (p < 0.05), suggesting that these islanders may also carry an airway hyperresponsiveness gene. A frequency plot of the percent fall in FEV1 for all Hx- subjects compared with control data suggests a bimodal distribution consistent with a major gene mechanism for airway responsiveness. Genealogy mapping revealed that the islanders are direct descendants of the 15 original settlers, and historical records suggest at least two founders may have been asthmatic. The data confirm previous reports of a high asthma prevalence on Tristan and support the postulate that this prevalence is a result of gene enrichment occurring in isolated populations by virtue of extensive inbreeding and a probable founder effect.
@article{
title = {Asthma on Tristan da Cunha: looking for the genetic link. The University of Toronto Genetics of Asthma Research Group},
type = {article},
year = {1996},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Age Distribution,Aged,Aged, 80 and over,Allergens/diagnostic use,Asthma/epidemiology/*genetics,Atlantic Ocean,Bronchoconstrictor Agents/diagnostic use,Child,Child, Preschool,Consanguinity,Female,Forced Expiratory Volume,Founder Effect,Humans,Linkage (Genetics),Male,Methacholine Chloride/diagnostic use,Middle Aged,Prevalence,Research Support, Non-U.S. Gov't,Sex Distribution,Skin Tests},
pages = {1902-1906},
volume = {153},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8665053},
id = {ba377ad3-36ac-3937-b8d3-44f6b08c99e3},
created = {2017-06-19T13:44:45.103Z},
file_attached = {false},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:44:45.287Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>1073-449x<m:linebreak/>Journal Article</m:note>},
abstract = {Although asthma has a significant heritable component, the mode of inheritance remains controversial because of the complexity of the disease and the influence of environmental factors. Isolated, inbred populations serve to reduce variability, thus increasing the probability of gene localization. We studied the inbred population of the remote island of Tristan da Cunha to document asthma prevalence for the purpose of genetic linkage analysis. Medical histories and skin atopy were determined on 282 islanders, representing 97% of the population, and airway responsiveness was measured in 254; 226 by methacholine challenge (tidal breathing method) and 28 by bronchodilator response (400 micrograms salbutamol aerosol). Blood samples were collected from 275 islanders. Participants ranged in age from 3 to 94 yr. Asthma was defined as increased airway responsiveness (AR+: PC20 < 4 mg/ml or > or = 15% increase in FEV1 postbronchodilator) combined with a positive history (Hx+). Fifty-seven percent of the islanders had at least partial evidence of asthma (Hx+ and/or AR+) and 23% had a definitive diagnosis of asthma (AR+ with Hx+). Overall 47% of the population were atopic, atopy was proportionally higher in asthmatics (74%) than nonasthmatics (32%; p < 0.01). Analysis of the methacholine dose-response curves demonstrated that asthmatics were significantly (p < 0.01) more responsive than those with AR+ only, and nonasthmatics (AR-, Hx-) were more responsive than laboratory control subjects (p < 0.05), suggesting that these islanders may also carry an airway hyperresponsiveness gene. A frequency plot of the percent fall in FEV1 for all Hx- subjects compared with control data suggests a bimodal distribution consistent with a major gene mechanism for airway responsiveness. Genealogy mapping revealed that the islanders are direct descendants of the 15 original settlers, and historical records suggest at least two founders may have been asthmatic. The data confirm previous reports of a high asthma prevalence on Tristan and support the postulate that this prevalence is a result of gene enrichment occurring in isolated populations by virtue of extensive inbreeding and a probable founder effect.},
bibtype = {article},
author = {Zamel, N and McClean, P A and Sandell, P R and Siminovitch, K A and Slutsky, A S},
journal = {Am J Respir Crit Care Med},
number = {6 Pt 1}
}1995 (1)
The risk of sulfasalazine- and mesalazine-associated blood disorders. Jick, H., Myers, M. W., & Dean, A. D. Pharmacotherapy, 15(2):176--181, April, 1995.
abstract bibtex
abstract bibtex
Sulfasalazine (SASP) has often been reported to cause serious blood disorders, particularly agranulocytosis; however, little quantitative information is available to estimate the risk or to identify possible modifiers of the risk. We used comprehensive clinical information recorded on office computers by selected general practitioners in Britain to conduct a follow-up study of some 10,000 users of SASP and some 4000 users of mesalazine to estimate the risk of blood disorders associated with these drugs. Overall, the frequency of blood disorders attributable to SASP was 27/10,332 (2.6/1000 users). The risk for SASP users who were treated for arthritic disorders (6.1/1000 users) was some 10 times higher than that for users who were treated for inflammatory bowel disease (0.6/1000 users). There were no cases of blood disorders in users of mesalazine.
@article{jick_risk_1995,
title = {The risk of sulfasalazine- and mesalazine-associated blood disorders},
volume = {15},
issn = {0277-0008},
abstract = {Sulfasalazine (SASP) has often been reported to cause serious blood disorders, particularly agranulocytosis; however, little quantitative information is available to estimate the risk or to identify possible modifiers of the risk. We used comprehensive clinical information recorded on office computers by selected general practitioners in Britain to conduct a follow-up study of some 10,000 users of SASP and some 4000 users of mesalazine to estimate the risk of blood disorders associated with these drugs. Overall, the frequency of blood disorders attributable to SASP was 27/10,332 (2.6/1000 users). The risk for SASP users who were treated for arthritic disorders (6.1/1000 users) was some 10 times higher than that for users who were treated for inflammatory bowel disease (0.6/1000 users). There were no cases of blood disorders in users of mesalazine.},
language = {eng},
number = {2},
journal = {Pharmacotherapy},
author = {Jick, H. and Myers, M. W. and Dean, A. D.},
month = apr,
year = {1995},
pmid = {7624265},
keywords = {Adolescent, Adult, Aged, Agranulocytosis, Aminosalicylic Acids, Anti-Inflammatory Agents, Non-Steroidal, Arthritis, Child, Child, Preschool, Female, Follow-Up Studies, Great Britain, Hematologic Diseases, Humans, Infant, Inflammatory Bowel Diseases, Male, Mesalamine, Middle Aged, Product Surveillance, Postmarketing, Risk Factors, Sulfasalazine},
pages = {176--181}
}1993 (1)
Erythromycin-associated cholestatic hepatitis. Derby, L. E., Jick, H., Henry, D. A., & Dean, A. D. The Medical Journal of Australia, 158(9):600--602, May, 1993.
abstract bibtex
abstract bibtex
OBJECTIVE: To estimate the risk of cholestatic hepatitis of uncertain origin in patients who had recently received erythromycin, a drug which is known to cause this disorder. DESIGN: A retrospective cohort study using data automatically recorded on general practitioners' office computers. SETTING: Some 600 general practices in the United Kingdom. SUBJECTS: 366,064 people who received erythromycin. MAIN OUTCOME MEASURE: Clinically documented cholestatic hepatitis of uncertain origin diagnosed 1-45 days after a prescription for erythromycin. RESULTS: There were 13 cases of cholestatic hepatitis of uncertain origin diagnosed within 45 days of receiving erythromycin which were either characteristic of or consistent with a syndrome previously described as being associated with this drug. CONCLUSION: The risk of cholestatic jaundice associated with erythromycin is estimated to be in the range of 3.6 per 100,000 users (95% confidence interval, 1.9-6.1).
@article{derby_erythromycin-associated_1993,
title = {Erythromycin-associated cholestatic hepatitis},
volume = {158},
issn = {0025-729X},
abstract = {OBJECTIVE: To estimate the risk of cholestatic hepatitis of uncertain origin in patients who had recently received erythromycin, a drug which is known to cause this disorder.
DESIGN: A retrospective cohort study using data automatically recorded on general practitioners' office computers.
SETTING: Some 600 general practices in the United Kingdom.
SUBJECTS: 366,064 people who received erythromycin.
MAIN OUTCOME MEASURE: Clinically documented cholestatic hepatitis of uncertain origin diagnosed 1-45 days after a prescription for erythromycin.
RESULTS: There were 13 cases of cholestatic hepatitis of uncertain origin diagnosed within 45 days of receiving erythromycin which were either characteristic of or consistent with a syndrome previously described as being associated with this drug.
CONCLUSION: The risk of cholestatic jaundice associated with erythromycin is estimated to be in the range of 3.6 per 100,000 users (95\% confidence interval, 1.9-6.1).},
language = {eng},
number = {9},
journal = {The Medical Journal of Australia},
author = {Derby, L. E. and Jick, H. and Henry, D. A. and Dean, A. D.},
month = may,
year = {1993},
pmid = {8479375},
keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Child, Cholestasis, Cohort Studies, Drug-Induced Liver Injury, Erythromycin, Female, Humans, Male, Middle Aged, Retrospective Studies},
pages = {600--602}
}1992 (1)
Intramedullary spinal cord ependymomas--a study of 45 cases with long-term follow-up. Ferrante, L., Mastronardi, L., Celli, P., Lunardi, P., Acqui, M., & Fortuna, a. Acta Neurochirurgica, 119(1-4):74-9, 1, 1992.
Paper abstract bibtex
Paper abstract bibtex Of the 62 patients with intramedullary spinal cord ependymoma treated surgically at our Neurosurgery Division between January 1951 and December 1990 45 had a follow-up of at least 3 years and the longest 30 years. The 28 conus-cauda equina-filum ependymomas operated during the same period are not considered in this study. An analysis of our cases and of the larger published series shows that favourable prognostic factors, apart of course from total tumour removal, which is now usually possible, are a site below the high cervical segments and a mild pre-operative symptom pattern. Patient age at diagnosis, tumour size and "low dose" (< 40 Gy) radiotherapy seem to have no influence on the prognosis. Aggressive surgical removal is the treatment of choice and also for long-term recurrence.
@article{
title = {Intramedullary spinal cord ependymomas--a study of 45 cases with long-term follow-up.},
type = {article},
year = {1992},
identifiers = {[object Object]},
keywords = {Adolescent,Adult,Aged,Child,Child, Preschool,Combined Modality Therapy,Ependymoma,Ependymoma: diagnosis,Ependymoma: radiotherapy,Ependymoma: surgery,Female,Follow-Up Studies,Humans,Magnetic Resonance Imaging,Male,Middle Aged,Neoplasm Recurrence, Local,Neoplasm Recurrence, Local: diagnosis,Neoplasm Recurrence, Local: radiotherapy,Neoplasm Recurrence, Local: surgery,Neurologic Examination,Reoperation,Retrospective Studies,Spinal Cord Neoplasms,Spinal Cord Neoplasms: diagnosis,Spinal Cord Neoplasms: radiotherapy,Spinal Cord Neoplasms: surgery},
pages = {74-9},
volume = {119},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/1481757},
month = {1},
id = {08111960-a49a-3d5e-890c-10bb4dbadd57},
created = {2013-09-04T15:14:24.000Z},
file_attached = {true},
profile_id = {8c4ca2d5-86de-3b5d-86be-8408415f34e0},
group_id = {a484ae4c-fcac-3c7e-9ac3-3fad0df719a2},
last_modified = {2014-11-22T16:36:55.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {Of the 62 patients with intramedullary spinal cord ependymoma treated surgically at our Neurosurgery Division between January 1951 and December 1990 45 had a follow-up of at least 3 years and the longest 30 years. The 28 conus-cauda equina-filum ependymomas operated during the same period are not considered in this study. An analysis of our cases and of the larger published series shows that favourable prognostic factors, apart of course from total tumour removal, which is now usually possible, are a site below the high cervical segments and a mild pre-operative symptom pattern. Patient age at diagnosis, tumour size and "low dose" (< 40 Gy) radiotherapy seem to have no influence on the prognosis. Aggressive surgical removal is the treatment of choice and also for long-term recurrence.},
bibtype = {article},
author = {Ferrante, L and Mastronardi, L and Celli, P and Lunardi, P and Acqui, M and Fortuna, a},
journal = {Acta Neurochirurgica},
number = {1-4}
}1990 (2)
A total audit of preventive procedures in 45 practices caring for 430,000 patients. Lawrence, M., Coulter, A., & Jones, L. BMJ (Clinical research ed.), 300(6738):1501--1503, June, 1990.
abstract bibtex
abstract bibtex
OBJECTIVE: To develop and report the results of a system of audit of computer records in general practice. DESIGN: A retrospective audit of records in practices using the same computer system. Information about recorded preventive procedures was collected by sending the same audit program to each practice on floppy disk. Other characteristics of the practices were determined by postal questionnaire. SETTING: Forty five general practices, widely distributed in England and Wales. SUBJECTS: All 430,901 patients registered with the practices. MAIN OUTCOME MEASURES: Within each practice the percentage of patients in specified age groups for whom certain preventive procedures were recorded as having been carried out. These measures were analysed in relation to practice characteristics. RESULTS: Practice characteristics and recording rates for preventive procedures varied over a wide range. Recording rates were higher in practices with computer terminals on every doctor's desk. Only one practice achieved the new contract target of 90% coverage for recorded primary immunisations, and fewer than two thirds recorded 80% coverage for cervical cytology in the past five years. Practices holding clinics did no better than those without. Smaller partnerships and smaller doctors' list sizes were associated with better performance. CONCLUSIONS: Centrally programmed audit of computerised records is a feasible method of providing data on a regular basis for epidemiological purposes and for performance review. The fact that practices with smaller list sizes had higher levels of recorded preventive care suggests that the trend towards larger lists promoted by the new contract might militate against the intended effect of better preventive care.
@article{lawrence_total_1990,
title = {A total audit of preventive procedures in 45 practices caring for 430,000 patients},
volume = {300},
issn = {0959-8138},
abstract = {OBJECTIVE: To develop and report the results of a system of audit of computer records in general practice.
DESIGN: A retrospective audit of records in practices using the same computer system. Information about recorded preventive procedures was collected by sending the same audit program to each practice on floppy disk. Other characteristics of the practices were determined by postal questionnaire.
SETTING: Forty five general practices, widely distributed in England and Wales.
SUBJECTS: All 430,901 patients registered with the practices.
MAIN OUTCOME MEASURES: Within each practice the percentage of patients in specified age groups for whom certain preventive procedures were recorded as having been carried out. These measures were analysed in relation to practice characteristics.
RESULTS: Practice characteristics and recording rates for preventive procedures varied over a wide range. Recording rates were higher in practices with computer terminals on every doctor's desk. Only one practice achieved the new contract target of 90\% coverage for recorded primary immunisations, and fewer than two thirds recorded 80\% coverage for cervical cytology in the past five years. Practices holding clinics did no better than those without. Smaller partnerships and smaller doctors' list sizes were associated with better performance.
CONCLUSIONS: Centrally programmed audit of computerised records is a feasible method of providing data on a regular basis for epidemiological purposes and for performance review. The fact that practices with smaller list sizes had higher levels of recorded preventive care suggests that the trend towards larger lists promoted by the new contract might militate against the intended effect of better preventive care.},
language = {eng},
number = {6738},
journal = {BMJ (Clinical research ed.)},
author = {Lawrence, M. and Coulter, A. and Jones, L.},
month = jun,
year = {1990},
pmid = {2372603},
pmcid = {PMC1663201},
keywords = {Adolescent, Adult, Blood Pressure Determination, Child, Child, Preschool, England, Family Practice, Female, Humans, Immunization, Medical Audit, Microcomputers, Middle Aged, Patient Acceptance of Health Care, Primary Prevention, Retrospective Studies, Smoking, Vaginal Smears, Wales},
pages = {1501--1503}
}Autogenous rib graft for reconstruction of alveolar bone defects in cleft patients. Long-term follow-up results. Witsenburg, B., Peter, H., & Freihofer, M. J Craniomaxillofac Surg, 18(2):55-62, 1990.
Website abstract bibtex
Website abstract bibtex In a retrospective study (mean follow-up 76 months), the use of a free autogenous rib graft for reconstruction of anterior residual bone defects in seventeen cleft patients is evaluated on a long term basis. The results show recurrence of a palatal oronasal fistula in 2 out of 17 patients. 6 patients had acceptable results, while 9 had good to excellent scores at all sites. The costal graft material does not prevent permanent upper cuspids from erupting into this bone, after its incorporation. It is concluded that autogenous rib bone is a good material for secondary bone grafting of the residual alveolar and palatal defect in cleft patients.
@article{
title = {Autogenous rib graft for reconstruction of alveolar bone defects in cleft patients. Long-term follow-up results},
type = {article},
year = {1990},
identifiers = {[object Object]},
keywords = {*Alveoloplasty,*Bone Transplantation/methods,Alveolar Process/*abnormalities/pathology,Child,Cleft Palate/*surgery,Female,Fistula/surgery,Follow-Up Studies,Humans,Male,Mouth Diseases/surgery,Nose Diseases/surgery,Periodontium/pathology,Retrospective Studies,Ribs,Surgical Flaps,Tooth Eruption,Tooth Movement},
pages = {55-62},
volume = {18},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2312739},
edition = {1990/02/01},
id = {995f870a-fb9f-3ad7-b2b1-5d49ce70aec2},
created = {2017-06-19T13:43:58.810Z},
file_attached = {false},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
group_id = {b2078731-0913-33b9-8902-a53629a24e83},
last_modified = {2017-06-19T13:43:58.940Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
language = {eng},
notes = {<m:note>Witsenburg, B<m:linebreak/>Peter, H<m:linebreak/>Freihofer, M<m:linebreak/>Germany, west<m:linebreak/>Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery<m:linebreak/>J Craniomaxillofac Surg. 1990 Feb;18(2):55-62.</m:note>},
abstract = {In a retrospective study (mean follow-up 76 months), the use of a free autogenous rib graft for reconstruction of anterior residual bone defects in seventeen cleft patients is evaluated on a long term basis. The results show recurrence of a palatal oronasal fistula in 2 out of 17 patients. 6 patients had acceptable results, while 9 had good to excellent scores at all sites. The costal graft material does not prevent permanent upper cuspids from erupting into this bone, after its incorporation. It is concluded that autogenous rib bone is a good material for secondary bone grafting of the residual alveolar and palatal defect in cleft patients.},
bibtype = {article},
author = {Witsenburg, B and Peter, H and Freihofer, M},
journal = {J Craniomaxillofac Surg},
number = {2}
}1980 (1)
Emergency room care of the poisoned child. Greensher, J. & Mofenson, H. C. Issues in Comprehensive Pediatric Nursing, 4(3):1--21, June, 1980.
bibtex
bibtex
@article{greensher_emergency_1980,
title = {Emergency room care of the poisoned child},
volume = {4},
issn = {0146-0862},
language = {eng},
number = {3},
journal = {Issues in Comprehensive Pediatric Nursing},
author = {Greensher, J. and Mofenson, H. C.},
month = jun,
year = {1980},
pmid = {6900625},
keywords = {Antidotes, Child, Child, Preschool, Emergency Medical Services, Emergency Service, Hospital, Household Products, Humans, Infant, Plant Poisoning, Poisoning},
pages = {1--21}
}1978 (1)
The treatment of poisoning. Arena, J. M. Clinical Symposia (Summit, N.J.: 1957), 30(2):1--47, 1978.
bibtex
bibtex
@article{arena_treatment_1978,
title = {The treatment of poisoning},
volume = {30},
issn = {0009-9295},
language = {eng},
number = {2},
journal = {Clinical Symposia (Summit, N.J.: 1957)},
author = {Arena, J. M.},
year = {1978},
pmid = {753572},
keywords = {Acetaminophen, Acids, Antidotes, Aspirin, Barbiturates, Carbon Tetrachloride Poisoning, Child, Child, Preschool, Digitalis Glycosides, Emetics, Gastric Lavage, Household Products, Humans, Hypnotics and Sedatives, Infant, Insecticides, Lye, Metals, Morphine, Oxalates, Plant Poisoning, Poisoning, Renal Dialysis, Rodenticides, Tranquilizing Agents},
pages = {1--47}
}1976 (1)
Letter: First-aid treatment of poisoning. Raffle, A., Gray, J., & MacDonald, H. R. British Medical Journal, 1(6001):93, January, 1976.
bibtex
bibtex
@article{raffle_letter:_1976-1,
title = {Letter: {First}-aid treatment of poisoning},
volume = {1},
issn = {0007-1447},
shorttitle = {Letter},
language = {eng},
number = {6001},
journal = {British Medical Journal},
author = {Raffle, A. and Gray, J. and MacDonald, H. R.},
month = jan,
year = {1976},
pmid = {1136},
pmcid = {PMC1638368},
keywords = {Child, First Aid, Humans, Ipecac, Poisoning, Vomiting},
pages = {93}
}