bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing traditional healers: an observational clinical study of classical Arabic medicine in Mauritania, with comparison of prognosis and outcome
Authors: Graz Bertrand
Published: November 2005

In a classical Arabic medicine clinic near Nouakchott, Mauritania, two general practitioners observed 170 consecutive consultations. With a follow-up rate of 66%, the studied practices appeared fairly safe and, in many chronic conditions, traditional healers performed similarly to what can be expected with modern medicine. Traditional healers and professionals from the nearby primary health care centre started a weekly joint consultation.
Childhood brucellosis in Babol, Iran
Authors: Roushan Mohammad Reza Hasanjani , Ahmadi Seyed Ahmad Asgharzadeh , Gangi Seyed Mokhtar Smailnejad , Janmohammadi Nasar , Amiri Mohammad Jafar Soleimani
Published: November 2005

This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.
Complications from traditional tooth extraction in South-western Uganda
Authors: Ellis J , Arubaku W
Published: November 2005

We report on the practices of traditional tooth extraction and highlight the complications.
Does maternity care improve pregnancy outcomes in women with previous complications? A study from Zimbabwe
Authors: Majoko F , Nystrom L , Munjanja S , Mason E , Lindmark G
Published: November 2005

To determine the utilization of maternal health care services and pregnancy outcomes for women with a history of complications in previous pregnancy, we analysed the pregnancy records of multiparous women (parity - 1) who booked and completed follow-up in Gutu district, Zimbabwe between January 1995 and June 1998. Women with previous uncomplicated pregnancies ( n = 6140) were classified as low risk, whereas those with complications of previous pregnancy ( n = 1077) were classified high risk. At enrolment, there was no difference in maternal age and parity between low- and high-risk women. A higher proportion of high-risk women had more than five antenatal visits (32% versus 21%; P<0.001) and gave birth in hospital (47% versus 18%; P<0.001). The risk of antenatal (relative risk [RR] 1.57; 95% confidence interval [CI] 1.32-1.88), labour/delivery (RR 1.98; 95% CI 1.75-2.25) and neonatal (RR 1.83; 95% CI 1.44-2.34) complications was elevated in high-risk women. There was increased risk for perinatal death in high-risk women, but this did not reach statistical significance (RR 1.56; 95% CI 0.98-2.49). The recurrence ratio for most complications was low and the sensitivity of historical risk markers in predicting women likely to develop further complicated pregnancies was only 23%. Most women with previous pregnancy complications can safely give birth in the rural health centre. We concluded that high-risk women had an elevated risk of complications in the index pregnancy and that better utilization of maternal health care, especially for delivery, reduced adverse perinatal outcomes.
Sexual risk behaviour among young people in Osogbo, Osun state Nigeria
Authors: Mabayoje V O , Akinwusi P O , Fadiora S O , Adeyeba O A , Aderounmu A O , Ebgewale E B
Published: November 2005

By analysing data randomly collected via administration of questionnaire by interview of individuals on sexual risk behaviour to 628 young people living in Osogbo, Nigeria, the results of the questionnaire revealed that the mean age of first sexual encounter was 17.4 years for men and 16.5 years for women.

Men tended to have multiple sexual partners more than the women (74.4% and 25.1%, respectively), while there was a highly significant relationship between sexually transmitted disease and multiple sexual partners among singles with P<0.001 and P= 0.000.

We concluded that parents and government alike should teach sex education at home, and in schools involving intensive counselling.
Taenia-induced ileal perforation
Authors: Singh R B , Bakshi N , Pavithran Nevil M
Published: November 2005

An unusual case of taenia-induced ileal perforation is reported and the management is discussed.
Unusual sites of hydatid cysts in India
Authors: Khanna A K , Prasanna G Venkateshwar , Khanna Rahul , Khanna Anuradha
Published: November 2005

Hydatid disease usually affects liver and lungs, but may affect any organ, posing a diagnostic and therapeutic dilemma. We analysed 110 patients with hydatid cyst over 21 years in our general surgical unit, which included 24 cases in unusual sites. The spleen was the most common, followed by skin and soft tissues.
Aetioepidemiological profile of spinal injury patients in Eastern Nepal
Authors: Lakhey S , Jha N , Shrestha B P , Niraula S
Published: November 2005

This is a retrospective case series of 233 spinal injury patients admitted to the orthopaedic ward of BPKIHS from May 1997 to April 2001. The inpatient records were analysed. In all, 40.3% of spinal injuries resulted from falls from trees while cutting leaves for fodder, and 27.9% resulted from falls from first/second floors. More than 75% of total spinal injuries are largely preventable. Overall, 46.8% of our spinal injury patients had complete cord transection at the level of injury. All adolescents and adults, irrespective of age or sex, should be the target groups for community education and intervention programmes for prevention of spinal injury.
Comparison of three different combination therapies in the treatment of human brucellosis
Authors: Ersoy Yasemin , Sonmez Emine , Tevfik Mehmet R , But Aype Dinç
Published: November 2005

The efficacy and tolerability of three different combination treatment regimens in human brucellosis were compared in 118 uncomplicated patients enrolled in a prospective study between May 1997 and December 2002. Brucellosis was diagnosed using standard clinical and microbiological findings. Patients with central nervous system involvement, spondylitis, endocarditis or children under 16 years of age were excluded from the study. Patients were randomly assigned to receive 400 mg of ofloxacin plus 600 mg of rifampicin (OR, n = 41), 200 mg of doxycycline plus 600 mg of rifampicin (DR, n = 45) or 1g intramuscularly streptomycin (administered for three weeks) plus 200 mg doxycycline (DS, n = 32) daily for 6 weeks. All patients were followed up at least 6 months after cessation of therapy.

There was no statistical difference between the groups on relapse rates and clinical response to the treatment ( P>0.05). Five patients in OR (12.8%), six patients in DR (14.3%) and three patients in DS groups (9.7%) suffered relapse. The side-effects were seen in eight (19.5%), 21 (46.7%) and eight (25.0%) patients of OR, DR and DS groups, respectively.

The use of combination therapy of ofloxacin plus rifampicin for 6 weeks was found to be as effective as DR and DS. The side-effects of therapy in OR and DS groups was less severe than in the DR group.
Assessment of physical conditions and current practice in laboratories carrying out sputum smear microscopy in Northwest Ethiopia
Authors: Mulu Andargachew , Kassu Afework
Published: November 2005

A cross-sectional study was conducted in Northwestern Ethiopia involving 18 health-care institutes in August 2003 to assess the physical conditions and current laboratory practice, pertaining to handling sputum specimens in the health-care laboratories carrying out sputum smear microscopy. A structured and pre-tested questionnaire was used to collect information. The laboratories had an area of less than 25 m2. None of them had separate rooms or safety cabinets for sputum smear preparation. Only three laboratories used facemasks. QJ;Decontamination of sputum specimens prior to disposal was reported in only two. Incineration as a means of sputum specimen disposal was used in only six laboratories. The physical conditions of the laboratories were found below the standard set by the International Union Against Tuberculoses and Lung Diseases. A large number of sputum specimens continue to be handled, despite the poor conditions and procedures in all the healthcare laboratories. Laboratory safety standards need to be improved, to minimize the risk of infection. In addition, there is an urgent need for education, training and supervision of the staff involved in sputum microscopy.
Issues of measuring and improving the treatment of malaria in sub-Saharan Africa
Authors: Onwujekwe Obinna , Nigeria Enugu , Dike Nkem , Uzochukwu Benjamin
Published: November 2005

This paper, using focus group discussions and questionnaires in Enugu State, Southeast Nigeria, examines the implications of consumer malaria perceptions and behaviour for measuring the disease burden and improving its treatment. The results show that, because peoples' understanding of the disease was related to its symptoms, this could lead to overestimation of the economic burden of malaria, based only on surveys without diagnostic confirmation. Survey-based estimations of the burden of malaria should control for the different local terminologies of malaria, and health personnel should be aware of these in order to improve the appropriate use of antimalarial drugs in presumptive treatment of malaria.
Cervical spine injuries in 64 attempted suicidal hangings in India
Authors: Kumar S , Vijayan J , Jacob J , Aaron S , Joseph M , Alexander M , Gnanamuthu C
Published: November 2005

This report describes the outcome of 64 attempted suicidal hangings, 81% of whom made a full recovery.
Quadruple-2 protease inhibitors (PI)-therapy does not accelerate viral decay and suppression in PI-naive HIV-1 infected patients with severe immunosuppression and high viral load as compared with standard triple therapy
Authors: Portilla Joaquín , Boix Vicente , Garcia-Henarejos José Antonio , Llopis Coral , Martínez-Madrid Onofre , Gimeno Adelina , Sánchez-Paya José , Merino Esperanza
Published: December 2005

To analyse if a four-drug combination including two protease inhibitors (PIs) accelerates viral decay and suppression as compared with standard triple therapy in heavily immunosuppressed HIV-1 infected patients, an open label clinical trial was designed. PIs naive patients receiving their first highly active antiretroviral therapy were included if their CD4 cell count was lower than 200/mm3 and their HIV viral load (VL) >100,000 RNA copies/mL. Every patient received two analogues and was randomized in two groups receiving either one PI (saquinavir soft gel capsule) or two PIs (saquinavir + nelfinavir). Viral efficacy (VL <50), time to reach VL <50, viral clearance rate constant and plasmatic elimination half-life were determined. In all, 30 patients were enrolled. No viral variable was significatively improved by the four-drug combination in the short term. No clinical benefit should be expected with a four-drug (two PIs) regimen in patients with low CD4 + cell count and high VL.
Causes of the decline in AIDS deaths, United States, 1995–2002: prevention, treatment or both?
Authors: Holtgrave David R
Published: December 2005

The decline in AIDS deaths in the USA between 1995 and 2002 has been attributed by Centers for Disease Control (CDC) to HIV treatments advances. The purpose of the present study is to assess whether this AIDS deaths decline was due entirely to treatment advances, to earlier prevention successes, or a combination of both. Secondarily, we quantitatively estimate the number of AIDS deaths averted (or delayed) by treatment advances over and above prevention effects.

The study employed scenario analysis to address the research questions. To answer the primary research question, we examined whether three key predictions derived from the shape and peak of the HIV incidence curve in the USA (and the natural history of HIV disease in the era before highly active antiretroviral therapy [HAART]) about the shape and peak of the AIDS deaths curve were upheld (e.g., one prediction was that the peak of the AIDS deaths curve should occur 10–12 years after the peak of the HIV incidence curve). To the extent that these predictions are supported, there is evidence that earlier HIV prevention efforts impacted the number of AIDS deaths later in the epidemic. To answer the second research question, the observed annual AIDS deaths curve (1995–2002) was compared with three estimated AIDS deaths curves that may have occurred had HAART never became available. Three estimations were employed to reflect a range of assumptions about the lag between the flattening of HIV incidence in the USA and the flattening of AIDS deaths (i.e., 10, 11 or 12 years). For any one of the three-scenario analyses, the quantitative area between the 'observed' and 'estimated' AIDS deaths curves provide an estimate of the number of AIDS deaths averted by HIV/AIDS treatments.

The three predictions from the HIV incidence curve (and the pre-HAART natural history of HIV disease) for determining the shape and peak of the AIDS deaths curve were supported thereby indicating the influence of past prevention efforts on recent AIDS deaths. However, the observed decline in AIDS deaths was more precipitous than predicted (indicating the influence of treatment advances). The scenario analyses indicated that between 33,480 and 41,784 AIDS deaths were averted (or delayed) between 1995 and 2002 as a function of treatment. That is, approximately, 206,037 AIDS deaths occurred between 1995 and 2002 (in the HAART era), but between 239,517 and 247,821 likely would have occurred without the advent of HAART.

We conclude that both past prevention and current treatment services have lead to the AIDS deaths decline in the USA, and that HAART has averted between 33,480 and 41,784 AIDS deaths in the USA between 1995 and 2002 over and above the effects of early prevention efforts.
Skeletal myopathy associated with nucleoside reverse transcriptase inhibitor therapy: potential benefit of coenzyme Q10 therapy
Authors: Rosenfeldt Franklin L , Mijch Anne , McCrystal Graham , Sweeney Clare , Pepe Salvatore , Nicholls Melissa , Dennett Xenia
Published: December 2005

Zidovudine (ZDV) has been associated with 'ragged-red' fibre myopathy, due to its effects on myocyte mitochondria. Usually this is reversible with cessation of ZDV. We report a 52-year-old man, who in 1985 developed ragged-red fibre myopathy 14 years after diagnosis of HIV infection while on effective ZDV-based combination antiretroviral therapy (ART). He was treated with the mitochondrial anti-oxidant coenzyme Q10 and made an excellent recovery, without change of ARTs. This suggests a novel therapy for further investigation targeted at ZDV induced myopathy, potentially allowing continuation of antiviral treatments including ZDV.
Mid-Sequence Archaeology at the Sigatoka Sand Dunes with Interpretive Implications for Fijian and Oceanic Culture History
Authors: Burley David
Published: November 2005

Continued erosion of the Sigatoka Sand Dunes on the western coast of Viti Levu, Fiji has exposed discrete assemblages of ceramics associated with all phases of Fijian prehistory. Excavations here in 2000 investigated stratigraphically separated occupation floors associated with Fijian Plainware and Navatu phase components, respectively radiocarbon dated to between ca. 450-550 C.E. and 550-650 C.E. The excavations and analysis of recovered data allow for a clarification of previous misunderstandings of the mid-sequence occupation at the site as well as its associated uses and features. These data further bear upon the Plainware/Navatu phase transition for Fiji as a whole. In the Lau Islands of southeastern Fiji this transition is described as abrupt and attributable to influences or a population movement from Vanuatu. Mid-sequence ceramic and other data from Sigatoka illustrate a similar break that potentially represents different cultural traditions.
A 3000-Year Culture Sequence from Palau, Western Micronesia
Authors: Clark Geoffrey R. (Geoffrey Richard)
Published: November 2005

In western Micronesia archaeological sites containing material-culture remains spanning millennia are rare. This paper reports one from Ulong Island in Palau, which is radiocarbon dated to 3000 cal. B.P. The pottery sequence was divided into three assemblages, each distinguished by distinct vessel forms and by the type and proportion of nonplastic temper inclusions. An abrupt transformation of the ceramic assemblage is tentatively dated to around 2400 cal. B.P., coincident with substantial landscape alteration on the main island where pottery was manufactured, indicating that anthropogenic activity may have constrained the raw materials available to prehistoric potters. There is a discontinuity in the sequence from 2000-1000 B.P. that might represent an hiatus in site use. Critical consideration of paleoenvironmental data pointing to human arrival at 4500-4300 cal. B.P. suggests, instead, that climatic events may be responsible for the observed palaeoecological changes. If so, then sites dating to 3300-3000 cal. B.P., such as Ulong, could well be among the oldest in western Micronesia.
Chemical Identification and Cultural Implications of a Mixed Fermented Beverage from Late Prehistoric China
Authors: McGovern Patrick E , Underhill Anne P , Fang Hui , Luan Fengshi , Hall Gretchen R , Yu Haiguang , Wang Chen-shan , Cai Fengshu , Zhao Zhijun , Feinman Gary M
Published: November 2005

Humans around the world have shown a remarkable propensity to ferment available sugar sources into alcoholic beverages. These drinks have contributed significantly to cultural innovation and development, including agricultural and horticultural skills to harness natural resources; technologies to produce the beverages and to make special vessels to serve, drink, and present them ceremonially; and their incorporation into feasting and other activities. Molecular archaeological analyses of a range of pottery forms from the site of Liangchengzhen, China, illustrates how contemporaneous chemical data, in conjunction with intensive archaeological and botanical recovery methods, enables the reconstruction of prehistoric beverages and their cultural significance. During the middle Longshan period (ca. 2400-2200 B.C.), a mixed fermented beverage of rice, fruit (probably hawthorn fruit and/or grape), and possibly honey was presented as grave offerings and consumed by the residents of the regional center.
Toward an Understanding of Technological Variability in Microblade Assemblages in Hokkaido, Japan
Authors: Nakazawa Yuichi , Izuho Masami , Takakura Jun , Yamada Satoru
Published: November 2005

Five decades of research history on the late Upper Paleolithic in Hokkaido (northern Japan) shows that microblade assemblages appeared by approximately 20,000 B.P. and that various microblade technologies were developed during late Pleistocene. The empirically observed good association between the morphological features of lithic raw materials and the reduction sequences of microblade cores demonstrates that morphological features of procured lithic raw materials (i.e., size and surface condition), which were constrained by unique geological and geoarchaeological characteristics in Hokkaido, created remarkable variability in reduction methods of microblade technology. This implies that geoarchaeological perspective can contribute to understanding technological variability in microblade assemblages in northeastern Asia.
Illuminating Southeast Asian Prehistory: New Archaeological and Paleoanthropological Frontiers for Luminescence Dating
Authors: Roberts R. G. (Richard Graham) , Morwood M. J. (Mike J.) , Westaway Kira E
Published: November 2005

Since the explorations of Alfred Russel Wallace and Eug�ne Dubois in the nineteenth century, Southeast Asia has been one of the world's focal points for studies of biogeography and biodiversity, human evolution and dispersal, environmental change, and the spread of culture, farming, and language. Yet despite its prominence, reliable chronologies are not available for many of the critical archaeological, evolutionary, and environmental turning points that have taken place in the region during the last 1.5 million years. In this paper, we discuss some of these chronological problems and describe how luminescence dating may help overcome them. "Luminescence dating" is a term that embraces the techniques of thermoluminescence (TL) and optical dating, which can be used to estimate the time elapsed since ubiquitous mineral grains, such as quartz and potassium feldspar, were last heated to a high temperature or were last exposed to sunlight. Luminescence methods have been successfully deployed at late Quaternary archaeological, paleoanthropological, and geological sites around the world, but not to any great extent in Southeast Asia. Here we describe the principles of TL and optical dating and some of the difficulties that are likely to arise in dating the volcanic minerals found throughout the region. We also outline several long-standing archaeological and paleoanthropological questions that are the subject of a current program of luminescence dating in Southeast Asia, and present recent dating results from Liang Bua in Indonesia and Bukit Bunuh in Malaysia.
Certain Victims of an International Contagion: The Panic of 1797 and the Hard Times of the Late 1790s in Baltimore
Authors: Chew Richard S
Published: November 2005

In the late 1790s, three events–the Panic of 1797, the Quasi-War with France, and a yellow fever epidemic–coincided to end a decade-long export boom in the United States and usher in hard times for the republic. Focusing on Baltimore as a case study, the evidence reveals that the economic downturn was a turning point for the U.S. economy rather than a temporary setback; thereafter, the domestic economy eclipsed overseas trade as the primary engine of growth. The first event that led to the hard times, the Panic of 1797, was a financial collapse precipitated by the Bank of England's suspension of specie payments. This action unraveled the web of Atlantic credit that many merchants depended on. Those with commercial interests in the Caribbean were somewhat insulated from the effects of the Panic, but they experienced major disruptions in 1797 and 1798 thanks to the Quasi-War with France. To make matters worse, the yellow fever epidemic eliminated any chance for recovery by shutting down affected American ports. Although the hard times had largely ended by 1800, the export boom did not return. Instead, U.S. overseas trade experienced extreme volatility and stagnation between 1800 and 1807. The Embargo of 1807 and the War of 1812 accelerated the demise of the export economy as the wellspring of American prosperity, but the experience of Baltimore's business community demonstrates that the hard times of the late 1790s were the initial turning point for the shift towards the domestic economy.
The Early American Middle Class
Authors: Goloboy Jennifer L
Published: November 2005

Using the diary of Samuel Seabury, this article argues that the middle class in the early republic defined itself as the group that possessed middle-class values: a diligent work ethic, a passion for education, and a devotion to genteel self-restraint. Contemporary Americans believed that these values were more important than wealth or power in determining class status. Because anyone could believe he or she was a hard worker, loved education, and was genteel, the category "middle class" was far less restrictive than it might seem, especially in comparison to the increasingly codified categories of race and gender. The triumph of the American middle class was part of a transnational revolt against traditional authority that made a more egalitarian world possible.
Securing Human Property: Slavery, Life Insurance, and Industrialization in the Upper South
Authors: Murphy Sharon Ann
Published: November 2005

Beginning in the 1830s and continuing throughout the antebellum period, life insurance expanded rapidly among the urban middle class of the Northeast as a means of protecting families against the loss of their primary breadwinner. As life insurance spread to the South, it was most strongly embraced by slaveholders. Creative southerners of both races adopted insurance to alleviate some of the most evil consequences of the slave trade, while urbanites of the South promoted insurance as a means of mitigating the untimely loss of their slave property. By the 1850s, the industry was firmly established in Richmond–underwriting the lives of slaves engaged in dangerous occupations, valued as artisans or house slaves, or hired out for work in factories and railroads–and was expanding rapidly into the other industrialized areas of Virginia. Indeed, life insurance was fast becoming a key component of industrialization in the Upper South. With the purchase of insurance, urban slaveholders demonstrated their confidence in both the longevity of the slave system itself and the value of slavery for the future of southern industrialization.
Class and the History of Working People in the Early Republic
Authors: Rockman Seth
Published: November 2005

This essay explores the utility of class as a concept for writing the history of working people in the postrevolutionary United States. Historians have no difficulty identifying the impoverishment of female seamstresses, immigrant canal diggers, and enslaved agricultural laborers, but have few analytic categories for situating such diverse working people in an economic system that translated the physical labor of some into the wealth of others. Class has fallen out of favor in recent years–as overdetermined, as premature, or as blind to concurrent racial or gender inequality–but this essay contends that class need not rely upon the articulation of a coherent political consciousness, the emergence of factory wage labor, or the denigration of other categories of analysis. Freed from these burdens, class offers the best way to make sense of the economic power relations that structured early republic capitalism.
Thinking about Elites in the Early Republic
Authors: Schocket Andrew M
Published: November 2005

This article argues for a new model in the analysis of elites during the early nationhood of the United States. To speak of one elite class is as problematic as talking about one working class in the early republic. There was not one elite, but many elites: those that differed by economic or geographic scale, by local or regional interest, by business pursuits, by ethnicity, by religion, by race, and by gender. Elites should be examined on different scales and in different contexts, and through four disparate lenses. First, each elite should be considered through its level of access to various kinds of capital; second, through its ability to invoke or command the power and authority of the state to further its interests; third, through its degree of elite consciousness, as expressed private, publicly, and in dress, deportment, and other modes of elitist behavior; and fourth, through its patterns of public and private actions that reinforce class divisions. Using these criteria, we can better identify elites and consider the extent to which their composition and conduct changed over time. By doing so, scholars of the early American republic may draw a more accurate, complete, and nuanced picture of class, of society at large, and of social change in the early republic.
Afro-Eurasian Bronze Age Economic Expansion and Contraction Revisited
Authors: Frank Andre Gunder , Thompson William R
Published: November 2005

By developing systematic, albeit crude, information on the timing of economic fluctuations in Afro-Eurasia between 4000 and 1000 B.C.E., we seek further evidence about the scope and degree of interdependence in the world system's economic interactions. The empirical outcome suggests a variety of weak to moderate connections and waves of economic fluctuation that were especially and increasingly discernible in troughs of the contraction periods. By no means does this analysis resolve any or all questions about the antiquity or integration of the contemporary world system, but it supports the idea that world history is very much rooted in the continuity of ancient processes.
German Social Science, Meiji Conservatism, and the Peculiarities of Japanese History
Authors: Grimmer-Solem Erik
Published: November 2005

An influential strand of Japanese historiography is invested in notions of peculiarity that highlight the deviance of Meiji Japan from Western liberal-democratic patterns. This special path is associated with the rising influence of the German Historical School of Economics. By analyzing the content of that influence and by maintaining a comparative perspective with the United States, Britain, and Germany, it is possible to highlight the worldwide demise of laissez-faire liberalism and the emergence in the 1880s of an international community of social reformers influenced by the Historical School, thus affirming the intellectual plurality and multiple political valence of this tradition of economic thought.
La civilization la plus antique : Voltaire's Images of India
Authors: Mohan Jyoti
Published: November 2005

This article examines the writings of the Enlightenment philosophe Voltaire on India as he situated that land within a global context of history and cultural exchange. It examines the creation of a recognizable entity, "India," in the Western imaginary by studying selected texts and focusing on a romanticized ideal of India as an Oriental paradise. It also examines the reasons behind such creation of India, primarily the Enlightenment attack on the Roman Catholic Church and more specifically Voltaire's claim that many of the most important Christian rituals had their origin in Hindu rituals.
The HND mouse, a nonobese model of type 2 diabetes mellitus with impaired insulin secretion
Authors: Horio Fumihiko , Teradaira Shin , Imamura Tsunehiko , Anunciado Rea Victoria P , Kobayashi Misato , Namikawa Takao , Niki Ichiro
Published: December 2005

Objectives: This study aimed to develop a novel type 2 diabetes model designated the HND (Horio–Niki diabetic) mouse, by transferring diabetogenic genes from wild castaneus mice (Mus musculus castaneus) captured in the Philippines into laboratory mice (C57BL/6J:B6).

Methods: Offspring from the cross between a wild male and a B6 female were backcrossed to the sire. One male backcross which exhibited fasting hyperglycemia was crossed with a B6 female to comprise the fundamental stock (F0). Thereafter, full-sib mating was performed, and mice with impaired glucose tolerance were selected and bred from the F2 generation. Characterization of the phenotype of HND mice and insulin release from their islets was evaluated with F12 generation males.

Results: The male HND mice were lean, and spontaneously exhibited impaired glucose tolerance at a high incidence rate at 6 weeks of age. Their serum insulin levels in response to intraperitoneal glucose were markedly attenuated. However, glucose-induced insulin release from isolated HND islets was not affected. Notably, inhibition of glucose-induced insulin release by epinephrine was more pronounced in HND islets than in B6 islets. Moreover, in vivo treatment of HND mice with the α2-adrenergic receptor agonist clonidine resulted in marked hypoinsulinemic hyperglycemia.

Conclusions: We suggest the HND mouse may be a distinctive and useful model for type 2 diabetes with impaired neural control of insulin secretion.
Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome
Authors: Hahn Susanne , Janssen Onno E , Tan Susanne , Pleger Katja , Mann Klaus , Schedlowski Manfred , Kimmig Rainer , Benson Sven , Balamitsa Efthimia , Elsenbruch Sigrid
Published: December 2005

Objective: Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in quality of life. This study examines the extent of different PCOS symptoms on quality-of-life, psychosocial well-being and sexual satisfaction.

Methods: Complete metabolic, hormonal, clinical and psychosocial data were obtained from a total of 120 women with PCOS. Patients were compared with 50 healthy women to establish reductions in quality-of-life and emotional well-being. In addition, the correlation between psychosocial variables and the major clinical PCOS features obesity (body mass index (BMI)), excessive body hair (hirsutism score), acne, hyperandrogenism (serum testosterone levels), disturbed insulin regulation (area under the insulin response curve and homeostasis model assessment of insulin resistance), menstrual cycle disturbances and infertility were analyzed.

Results: PCOS patients showed significant reductions in quality-of-life, increased psychological disturbances, and decreased sexual satisfaction when compared with healthy controls. BMI and hirsutism scores, but not the presence of acne, were associated with physical aspects of quality-of-life and sexual satisfaction. No clear effect of androgens or insulin resistance on psychosocial variables was detected. Similarly, the type of menstrual cycle disturbances or infertility had no impact on psychological well-being.

Conclusion: In PCOS, changes in appearance, particularly obesity and hirsutism, reduce physical dimensions of quality-of-life and decrease sexual satisfaction. The role of biochemical, endocrine and metabolic parameters as well as menstrual irregularities and infertility appeared to be less important. Clinicians should pay attention to the psychosocial dimensions of PCOS on an individual basis, regardless of symptom severity or treatment response.
Pro- and mature IGF-II during diet-induced weight loss in obese subjects
Authors: Espelund Ulrick , Bruun Jens Meldgaard , Richelsen Bjørn , Flyvbjerg Allan , Frystyk Jan
Published: December 2005

Background: In normal subjects up to 10% of circulating insulin-like growth factor II (IGF-II) consists of pro-IGF-II. However, its regulation and biological impact remains unknown. In obese subjects, serum free and total IGF-II are increased, and we therefore investigated the impact of obesity and diet on serum pro-IGF-II.

Design: Non-diabetic, obese subjects (n = 34) with a body mass index (BMI) of 38.9 ± 0.5 kg/m2 were subjected to 8 weeks with very low calorie diet (800 kcal/day) followed by 12 weeks with a weight-stabilizing diet. Fasting serum was collected before the study, and after 8 and 20 weeks. Pro-IGF-II was determined after acid-gel chromatography using a novel, highly specific in-house assay, free and total IGFs were measured after ultrafiltration and acid-ethanol extraction, respectively, and IGF-binding proteins (IGFBPs) were measured with specific immunoassays.

Results: Diet reduced BMI and fasting levels of insulin and glucose (P < 0.001). Serum pro-IGF-II was markedly reduced in obese subjects as compared with matched normal-weight controls (means and 95% confidence intervals: 93 μg/l (82–104 μg/l) versus 171 μg/l (152–192 μg/l), respectively; P < 0.001), and levels remained unchanged after the weight loss. In contrast, during the study period total and free IGF-II decreased (P < 0.05), whereas total IGF-I, IGFBP-1 and IGFBP-2 increased (P < 0.001). Serum free IGF-I remained unaltered. Cross-sectional and longitudinal correlation analyses showed that pro-IGF-II was closer and more consistently associated with IGF-I than IGF-II.

Conclusion: This study demonstrates that pro-IGF-II is reduced in obesity, in contrast to mature IGF-II. This indicates a hitherto unrecognized link between nutrition and pro-IGF-II. In addition, our data indicate that pro-IGF-II is regulated independently of mature IGF-II.
Role of sequence variations of the GnRH receptor and G protein-coupled receptor 54 gene in male idiopathic hypogonadotropic hypogonadism
Authors: Lanfranco Fabio , Gromoll Jörg , von Eckardstein Sigrid , Herding Eva M , Nieschlag Eberhard , Simoni Manuela
Published: December 2005

Objective: To determine the frequency of mutations of the gonadotropin-releasing hormone receptor (GnRHR) and of the G protein-coupled receptor 54 (GPR54) genes in normosmic idiopathic hypogonadotropic hypogonadism (IHH).

Methods: In a retrospective study we analyzed the GnRHR and the GPR54 genes of 45 IHH patients and 50 controls. Genomic DNA was amplified by PCR to obtain partially overlapping amplicons encompassing the exon–intron boundaries of the GnRHR and GPR54 genes and analyzed by single-stranded conformation polymorphism gel electrophoresis and/or DNA sequencing.

Results: One heterozygous R262Q mutation of the GnRHR gene was identified in one patient with familial IHH. The silent single-nucleotide polymorphism (SNP) 453C > T occurred at the same frequency in patients and controls. One patient with sporadic IHH and consanguineous parents showed a novel homozygous sequence variation of the GPR54 gene (1001_1002insC) resulting in an open reading frame shift and elongation of 43 amino acids with an increased number of proline residues in the intracellular receptor domain. This patient had delayed puberty, low testosterone (3.4 nmol/l), and low-normal LH and FSH levels responsive to GnRH. Pulsatile GnRH administration normalized testosterone levels and induced spermatogenesis sufficiently to induce a pregnancy with assisted reproduction. Two common SNPs in exon 1 and exon 5 of the GPR54 gene showed similar frequency distribution and hormonal profiles in IHH and controls.

Conclusions: Mutations of the GnRHR and of the GPR54 gene are rare in IHH and should be investigated especially in cases with autosomal recessive transmission. Common SNPs of the GnRHR and GPR54 genes do not play any role in IHH.
Consensus statement: medical management of acromegaly
Authors: Melmed S , Casanueva F , Cavagnini F , Chanson P , Frohman L A , Gaillard R , Ghigo E , Ho K , Jaquet P , Kleinberg D , Lamberts S , Laws E , Lombardi G , Sheppard M C , Thorner M , Vance M L , Wass J A H , Giustina A
Published: December 2005

In November 2003, the Pituitary Society and the European Neuroendocrine Association sponsored a consensus workshop in Seville to address challenging issues in the medical management of acromegaly. Participants comprised 70 endocrinologists and neurosurgeons with international expertise in managing patients with acromegaly. All participants participated in the workshop proceedings, and the final document written by the scientific committee reflects the consensus opinion of the interactive deliberations. The meeting was supported by an unrestricted educational grant from Ipsen. No pharmaceutical representatives participated in the program planning or in the scientific deliberations.
Variability of isolated autosomal dominant GH deficiency (IGHD II): impact of the P89L GH mutation on clinical follow-up and GH secretion
Authors: Salemi Souzan , Yousefi Shida , Baltensperger Kurt , Robinson Iain C A F , Eblé Andrée , Simon Dominique , Czernichow Paul , Binder Gerhard , Sonnet Emmanuel , Mullis Primus E
Published: December 2005

Objective: Four distinct familial types of isolated GH deficiency (IGHD) are classified, of which type II, IGHD II, is the autosomal dominant inherited form. Based on clinical data, it became evident that there is a wide variability in phenotype among the various GH-1 gene alterations leading to the disorder. As subjects suffering from IGHD II caused by the specific missense mutated P89L GH (C6129T) have never been reported in detail, the aim was to analyse the impact of this mutated GH form on its clinical follow-up as well as to study its effect at the cellular level in comparison with the most common missense mutation R183H GH (G6664A).

Methods: Twelve subjects belonging to four families presenting with P89L GH were clinically compared with 17 subjects from 5 families with the R183H GH missense mutation. Further, co-localization of the wild-type (wt-type) and mutant GH forms was studied in AtT-20 cells, mouse pituitary gland, applying quantitative confocal microscopy analysis. Using immunofluorescent techniques, cells were double stained for GH and one of the following organelles: endoplasmic reticulum (anti-Grp94), Golgi (anti-βCOP) and secretory granules (anti-Rab3a). In addition, GH secretion and cell viability was analysed in detail.

Results: Importantly, as well as growth hormone deficiency, eight out of twelve subjects with the P89L mutated GH form developed other endocrine deficits and the pituitary gland became smaller over time (P < 0.05). At the cellular level, quantitative analysis of the variable mutants expressed in AtT-20 cells revealed a different extent of co-localization, different effects on GH secretion, and, therefore, a different impact on the secretory pathway which might be caused by different folding or aggregation problems necessary for sorting, packaging and/or secretion through the regulated secretory pathway.

Conclusions: Our results show that specific and detailed analyses of the different mutations identified in IGHD II may shed light on the different mechanisms of secretory pathophysiology, and may provide a better explanation of the range of clinical features associated with GH missense isoforms. Importantly, the findings in patients with P89L GH extend beyond classical IGHD and stress the need for continued clinical vigilance in IGHD II patients for the development of other hormonal deficiencies.
Effect of beta-mercaptoethanol during in vitro fertilization procedures on sperm penetration into porcine oocytes and the early development in vitro
Authors: Funahashi Hiroaki
Published: December 2005

This study was carried out to determine the effects of beta-mercaptoethanol (bME) during a transient co-culture of gametes for 10 min, and/or the following culture until 6–9 h after insemination, on sperm penetration of porcinein vitromaturation (IVM) oocytes and the early developmentin vitro. When fresh spermatozoa were cultured in various concentrations of bME for 2 h, bME neutralized the stimulatory effect of caffeine-benzoate on sperm capacitation and the spontaneous acrosome reaction at 50–250 μmol/l. When 50 μmol/l bME were added during a transient co-culture of gametes for 10 min, the sperm penetration rate was reduced 9 h after insemination (70.5–82.0% vs 90.5–94.0% in the absence of bME), but the incidence of monospermic penetration was not affected. When 50 μmol/l bME were supplemented during culture after a transient co-culture, the sperm penetration rate was not affected, but the incidence of monospermy oocytes was increased (43.9–45.8% vs 31.7–34.3% in the absence of bME). The presence of bME following a transient co-culture minimized a decrease of oocyte glutathione content at 6 h after insemination (7.9 pmol/oocyte beforein vitrofertilization (IVF), 6.7 pmol/oocyte in the presence of bME vs 5.5 pmol/oocyte in the absence of bME). When the distribution of cortical granules was evaluated 1 h after activation with calcium ionophore, mean pixel intensity of fluorescein isothiocyanate-labeled peanut agglutinin (FITC-PNA) at the cortex region was lower in the oocytes activated and cultured in the presence of 50 μmol/l bME. Although the presence of 50 μmol/l bME during a transient co-culture for 10 min and the following culture did not increased blastocyst formation (29.6–37.7%), 50 μmol/l bME during the following culture significantly increased the mean cell numbers per blastocyst (73.3–76.4 vs 51.2 in the presence and absence of bME respectively). These results demonstrate that supplementation with bME during IVF procedures, except during a transient co-culture period of gametes in the presence of caffeine, has a beneficial effect in maintaining the function of gametes, the incidence of normal fertilization and, consequently, the quality of IVF embryos.
Thirty-Six-Month Outcomes for Families of Children Who Have Disabilities and Participated in Early Intervention
Authors: Bailey Donald B. , Hebbeler Kathleen , Spiker Donna , Scarborough Anita , Mallik Sangeeta , Nelson Lauren
Published: December 2005

Objective. Infants and toddlers with disabilities in the United States and their families are eligible for early intervention services under Part C of the Individuals With Disabilities Education Act. The purpose of this study was to assess family outcomes at the end of early intervention (near the child’s third birthday).

Methods. A nationally representative sample of 2586 parents in 20 states completed a 40-minute telephone interview on or near their child’s third birthday. This article summarizes data related to perceived family outcomes at the end of early intervention.

Results. At the end of early intervention, most parents felt competent in caring for their children, advocating for services, and gaining access to formal and informal supports. They also were generally optimistic about the future. Most (82%) parents believed that their family was better off as a result of early intervention. Parents were somewhat less positive in their perceived ability to deal with their child’s behavior problems or gain access to community resources, and lower family outcome scores were found for parents of minority children, children with health problems, and children who were living with a single adult.

Conclusion. Results suggest that Part C early intervention provides important supports for families of young children with disabilities. The findings reinforce the need for experimental research to identify factors that are most likely to lead to successful outcomes for all families. In the meantime, early identification and expeditious referral are important so that maximum benefit can be realized for children with disabilities and their families.
Functional Plasticity or Vulnerability After Early Brain Injury?
Authors: Anderson Vicki , Catroppa Cathy , Morse Sue , Haritou Flora , Rosenfeld Jeffrey
Published: December 2005

Context. Traumatic brain injury (TBI) is a common, acquired, childhood disability that may be used as a model to understand more completely the impact of early brain injury on both brain structure and day-to-day function. Contrary to previously held views of the “plasticity” of the young brain, recent research suggests that such early insults may have a profound impact on development. To date, these suggestions remain largely untested.

Objectives. To plot changes in cognitive abilities after childhood TBI over the 30 months after injury and to examine the impact of age at injury on cognitive outcomes.

Design. Prospective longitudinal study.

Setting. Royal Children’s Hospital, Victoria, Australia.

Main Outcome Measures. Global intellectual ability, verbal and nonverbal skills, attention, and processing speed.

Participants. A total of 122 children admitted to the hospital with a diagnosis of TBI were divided according to injury age, ie, young (age: 3–7 years) or old (age: 8–12 years), and injury severity (mild, moderate, or severe) and were evaluated acutely and at 12 and 30 months after injury. An additional sample of children injured before 3 years of age (n = 27) was compared with these groups with respect to global intellectual ability only.

Results. A clear relationship was documented between injury severity and cognitive performance. For children who sustained severe injury, younger age at injury was associated with minimal, if any, recovery after injury, but better outcomes were observed after severe TBI among older children. Age at injury was not predictive of outcomes for children with mild or moderate TBI, although infants (age: 0–2.11 years) with moderate TBI showed poorer outcomes than did older children with injury of similar severity.

Conclusions. Findings support a “double-hazard” model for severe and early brain insults and add to the ongoing debate regarding cerebral plasticity, suggesting that, contrary to traditional views, young children who sustain severe TBI in early childhood or moderate or severe TBI in infancy may be particularly vulnerable to significant residual cognitive impairment. From a clinical perspective, results indicate that long-term follow-up monitoring and management should be targeted to this high-risk group.