bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of olive oil and its minor phenolic constituents on obesity-induced cardiac metabolic changes
Authors: Ebaid Geovana MX , Seiva Fábio RF , Rocha Katiucha KHR , Souza Gisele A , Novelli Ethel LB
Published: October 2010

Background

Olive oil and its minor constituents have been recommended as important dietary therapeutic interventions in preventive medicine. However, a question remains to be addressed: what are the effects of olive oil and its phenolic compounds on obesity-induced cardiac metabolic changes?

Methods

Male Wistar rats were divided into two groups (n = 24/group): (C) receiving standard-chow; (Ob) receiving hypercaloric-chow. After 21 days C and Ob groups were divided into four subgroups (n = 6/group):(C) standard-chow and saline; (C-Olive)standard-chow and olive-oil (3.0 g/kg.day); (C-Oleuropein)standard-chow and oleuropein (0.023 mg/kg/day); (C-Cafeic) standard-chow and cafeic-acid (2.66 mg/kg/day); (Ob)receiving hypercaloric-chow and saline;(Ob-Olive) hypercaloric-chow and olive-oil;(Ob-Oleuropein) hypercaloric-chow and oleuropein;(Ob-Cafeic) hypercaloric-chow and cafeic-acid. Treatments were given twice a week during 21 days.

Results

After 42 days, obesity was evidenced in Ob rats from enhanced body-weight, surface-area, and body-mass-index. Energy-expenditure, oxygen consumption(VO2) and fat-oxidation were lower in Ob-group than in C. Despite no morphometric changes, Ob-Olive, Ob-Oleuropein and Ob-Cafeic groups had higher VO2, fat-oxidation, myocardial beta-hydroxyacyl coenzyme-A dehydrogenase and lower respiratory-quotient than Ob. Citrate-synthase was highest in Ob-Olive group. Myocardial lipid-hydroperoxide(LH) and antioxidant enzymes were unaffected by olive-oil and its compounds in obesity condition, whereas LH was lower and total-antioxidant-substances were higher in C-Olive and C-Oleuropein than in C.

Conclusions

The present study demonstrated for the first time that olive-oil, oleuropein and cafeic-acid enhanced fat-oxidation and optimized cardiac energy metabolism in obesity conditions. Olive oil and its phenolic compounds improved myocardial oxidative stress in standard-fed conditions.
Role of LOX-1 and ROS in oxidized low-density lipoprotein induced epithelial-mesenchymal transition of NRK52E
Authors: Wang Rui , Ding Guohua , Liang Wei , Chen Cheng , Yang Hongxia
Published: October 2010

Background

To investigate the effect of oxidized low density lipoprotein receptor-1 (LOX-1) on tubular epithelial-mesenchymal transition (TEMT) induced by oxidized low-density lipoprotein (ox-LDL) and its mechanism.

Methods

NRK-52E cells were incubated with ox-LDL (0, 25, 50, and 100 μg/ml) for 24 hours or pre-treated with the chemical inhibitor of the LOX-1 receptor polyinosinic acid (poly I) and carrageenan or the antioxidant N-acetyl-L-cysteine (NAC), the cells were then exposed to 50 μg/ml of ox-LDL.The expression of LOX-I, E-cadherin, α-smooth muscle actin (α-SMA) and reactive oxygen species (ROS) were analyzed by real-time PCR, western blotting analysis, immunofluorescence and confocal laser scanning microscopy.

Results

Ox-LDL increased the expression of LOX-1 mRNA and protein in a dose-dependent manner from 0 to 100 μg/ml (P < 0.05). Following the increase in the LOX-1 protein level, the lipid intake, ROS generation and α-SMA expression increased; however, the E-cadherin level decreased. The pre-treatment with poly I or carrageenan or NAC significantly inhibited the LOX-1 expression, α-SMA expression, the lipid intake and ROS generation and reversed decrease of E-cadherin expression induced by ox-LDL. Meanwhile, the ROS generation were associated with a increase in the LOX-1 expression. The α-SMA expression was positively correlated with the ROS generation and LOX-1 expression, and the E-cadherin expression was negatively correlated with the ROS generation and LOX-1 expression.

Conclusions

LOX-1 and ROS may play a important role in epithelial-mesenchymal transition of NRK52E induced by OX-LDL.
Early combined treatment with sildenafil and adipose-derived mesenchymal stem cells preserves heart function in rat dilated cardiomyopathy
Authors: Lin Yu-Chun , Leu Steve , Sun Cheuk-Kwan , Yen Chia-Hung , Kao Ying-Hsien , Chang Li-Teh , Tsai Tzu-Hsien , Chua Sarah , Fu Morgan , Ko Sheung-Fat , Wu Chiung-Jen , Lee Fan-Yen , Yip Hon-Kan
Published: October 2010

Background

We investigated whether early combined autologous adipose-derived mesenchymal stem cell (ADMSC) and sildenafil therapy offers an additive benefit in preserving heart function in rat dilated cardiomyopathy (DCM).

Methods

Adult Lewis rats (n = 8 per group) were divided into group 1 (normal control), group 2 (saline-treated DCM rats), group 3 [2.0 × 106 ADMSC implanted into left ventricular (LV) myocardium of DCM rats], group 4 (DCM rats with sildenafil 30 mg/kg/day, orally), and group 5 (DCM rats with combined ADMSC-sildenafil). Treatment was started 1 week after DCM induction and the rats were sacrificed on day 90.

Results

The results showed that mitochondrial protein expressions of connexin43 and cytochrome-C were lowest in group 2, and lower in groups 3 and 4 than in group 5 (p < 0.002). Conversely, oxidative index was highest in group 2, and also higher in groups 3 and 4 than in group 5 (p < 0.0003). The mRNA expressions of interleukin (IL)-10, Gro/IL-8, endothelial nitric oxide synthase, and Bcl-2 were lowest in group 2, and lower in groups 3 and 4 compared with group 5 (p < 0.0001). The mRNA expressions of matrix metalloproteinase-9, Bax, caspase 3, and stromal-cell derived factor-1α were highest in group 2, and higher in groups 3 and 4 than in group 5 (p < 0.0004). Apoptosis and fibrosis in LV myocardium were most prominent in group 2 and higher in groups 3 and 4 than in group 5, whereas angiogenesis and LV ejection fraction were lowest in group 2 and lower in groups 3 and 4 than in group 5 (p < 0.003).

Conclusion

Early combined ADMSC/sildenafil is superior to either treatment alone in preserving LV function.
A structural constraint for functional interaction between N-terminal and C-terminal domains in simian immunodeficiency virus capsid proteins
Authors: Inagaki Natsuko , Takeuchi Hiroaki , Yokoyama Masaru , Sato Hironori , Ryo Akihide , Yamamoto Hiroyuki , Kawada Miki , Matano Tetsuro
Published: October 2010

Background

The Gag capsid (CA) is one of the most conserved proteins in highly-diversified human and simian immunodeficiency viruses (HIV and SIV). Understanding the limitations imposed on amino acid sequences in CA could provide valuable information for vaccine immunogen design or anti-HIV drug development. Here, by comparing two pathogenic SIV strains, SIVmac239 and SIVsmE543-3, we found critical amino acid residues for functional interaction between the N-terminal and the C-terminal domains in CA.

Results

We first examined the impact of Gag residue 205, aspartate (Gag205D) in SIVmac239 and glutamate (Gag205E) in SIVsmE543-3, on viral replication; due to this difference, Gag206-216 (IINEEAADWDL) epitope-specific cytotoxic T lymphocytes (CTLs) were previously shown to respond to SIVmac239 but not SIVsmE543-3 infection. A mutant SIVmac239, SIVmac239Gag205E, whose Gag205D is replaced with Gag205E showed lower replicative ability. Interestingly, however, SIVmac239Gag205E passaged in macaque T cell culture often resulted in selection of an additional mutation at Gag residue 340, a change from SIVmac239 valine (Gag340V) to SIVsmE543-3 methionine (Gag340M), with recovery of viral fitness. Structural modeling analysis suggested possible intermolecular interaction between the Gag205 residue in the N-terminal domain and Gag340 in the C-terminal in CA hexamers. The Gag205D-to-Gag205E substitution in SIVmac239 resulted in loss of in vitro core stability, which was recovered by additional Gag340V-to-Gag340M substitution. Finally, selection of Gag205E plus Gag340M mutations, but not Gag205E alone was observed in a chronically SIVmac239-infected rhesus macaque eliciting Gag206-216-specific CTL responses.

Conclusions

These results present in vitro and in vivo evidence implicating the interaction between Gag residues 205 in CA NTD and 340 in CA CTD in SIV replication. Thus, this study indicates a structural constraint for functional interaction between SIV CA NTD and CTD, providing insight into immunogen design to limit viral escape options.
Hypoxia-dependent sequestration of an oxygen sensor by a widespread structural motif can shape the hypoxic response - a predictive kinetic model
Authors: Schmierer Bernhard , Novák Béla , Schofield Christopher J
Published: October 2010

Background

The activity of the heterodimeric transcription factor hypoxia inducible factor (HIF) is regulated by the post-translational, oxygen-dependent hydroxylation of its α-subunit by members of the prolyl hydroxylase domain (PHD or EGLN)-family and by factor inhibiting HIF (FIH). PHD-dependent hydroxylation targets HIFα for rapid proteasomal degradation; FIH-catalysed asparaginyl-hydroxylation of the C-terminal transactivation domain (CAD) of HIFα suppresses the CAD-dependent subset of the extensive transcriptional responses induced by HIF. FIH can also hydroxylate ankyrin-repeat domain (ARD) proteins, a large group of proteins which are functionally unrelated but share common structural features. Competition by ARD proteins for FIH is hypothesised to affect FIH activity towards HIFα; however the extent of this competition and its effect on the HIF-dependent hypoxic response are unknown.

Results

To analyse if and in which way the FIH/ARD protein interaction affects HIF-activity, we created a rate equation model. Our model predicts that an oxygen-regulated sequestration of FIH by ARD proteins significantly shapes the input/output characteristics of the HIF system. The FIH/ARD protein interaction is predicted to create an oxygen threshold for HIFα CAD-hydroxylation and to significantly sharpen the signal/response curves, which not only focuses HIFα CAD-hydroxylation into a defined range of oxygen tensions, but also makes the response ultrasensitive to varying oxygen tensions. Our model further suggests that the hydroxylation status of the ARD protein pool can encode the strength and the duration of a hypoxic episode, which may allow cells to memorise these features for a certain time period after reoxygenation.

Conclusions

The FIH/ARD protein interaction has the potential to contribute to oxygen-range finding, can sensitise the response to changes in oxygen levels, and can provide a memory of the strength and the duration of a hypoxic episode. These emergent properties are predicted to significantly shape the characteristics of HIF activity in animal cells. We argue that the FIH/ARD interaction should be taken into account in studies of the effect of pharmacological inhibition of the HIF-hydroxylases and propose that the interaction of a signalling sensor with a large group of proteins might be a general mechanism for the regulation of signalling pathways.
Successful application of technetium-99m-labeled octreotide acetate scintigraphy in the detection of ectopic adrenocorticotropin-producing bronchial carcinoid lung tumor: a case report
Authors: Esfahani Armaghan Fard , Chavoshi Maryam , Noorani Mohammad Hadi , Saghari Mohsen , Eftekhari Mohammad , Beiki Davood , Fallahi Babak , Assadi Majid
Published: October 2010

Introduction

The diagnostic efficacy of somatostatin receptor scintigraphy labeling with 111 indium in the localization of tumors has been assessed in a limited number of patients with contradictory outcomes. Here, we describe the case of a patient with an ectopic adrenocorticotropic hormone-producing bronchial carcinoid tumor diagnosed preoperatively using technetium-99m-labeled octreotide acetate scintigraphy.

Case presentation

A 29-year-old Asian man presented to our hospital with the typical clinical features of Cushing's syndrome, which he had had for a duration of 18 months. The results of a biochemical evaluation revealed he had adrenocorticotropic hormone-dependent Cushing's syndrome. The results of a spiral abdominal computed tomography scan showed he had bilateral adrenal hypertrophy. A magnetic resonance image of the patient's brain showed he had a normal hypophysis. Whole body technetium-99m-labeled octreotide acetate scintigraphy was performed to check for the presence of an ectopic adrenocorticotropic hormone-producing tumor. The scan results showed a small focal increase in uptake in the lower lobe of our patient's right lung, just above his diaphragm. A spiral chest computed tomography scan also revealed a small non-specific lesion in the same region. A transthoracic biopsy was then performed. Pathological evaluation confirmed the diagnosis of a carcinoid tumor, of the adrenocorticotropic hormone-producing type. After surgical removal, the patient's symptoms resolved and significant clinical improvement was achieved.

Conclusions

This case report shows that technetium-99m-labeled octreotide acetate scintigraphy can effectively detect an ectopic adrenocorticotropic hormone-producing bronchial carcinoid.
Women's experiences of wearing therapeutic footwear in three European countries
Authors: Williams Anita E , Nester Christopher J , Ravey Michael I , Kottink Anke , Klapsing Morey‐Gaspar
Published: October 2010

Background

Therapeutic footwear is recommended for those people with severe foot problems associated with rheumatoid arthritis (RA). However, it is known that many do not wear them. Although previous European studies have recommended service and footwear design improvements, it is not known if services have improved or if this footwear meets the personal needs of people with RA. As an earlier study found that this footwear has more impact on women than males, this study explores women's experiences of the process of being provided with it and wearing it. No previous work has compared women's experiences of this footwear in different countries, therefore this study aimed to explore the potential differences between the UK, the Netherlands and Spain.

Method

Women with RA and experience of wearing therapeutic footwear were purposively recruited. Ten women with RA were interviewed in each of the three countries. An interpretive phenomenological approach (IPA) was adopted during data collection and analysis. Conversational style interviews were used to collect the data.

Results

Six themes were identified: feet being visibly different because of RA; the referring practitioners’ approach to the patient; the dispensing practitioners’ approach to the patient; the footwear being visible as different to others; footwear influencing social participation; and the women's wishes for improved footwear services. Despite their nationality, these women revealed that therapeutic footwear invokes emotions of sadness, shame and anger and that it is often the final and symbolic marker of the effects of RA on self perception and their changed lives. This results in severe restriction of important activities, particularly those involving social participation. However, where a patient focussed approach was used, particularly by the practitioners in Spain and the Netherlands, the acceptance of this footwear was much more evident and there was less wastage as a result of the footwear being prescribed and then not worn. In the UK, the women were more likely to passively accept the footwear with the only choice being to reject it once it had been provided. All the women were vocal about what would improve their experiences and this centred on the consultation with both the referring practitioner and the practitioner that provides the footwear.

Conclusion

This unique study, carried out in three countries has revealed emotive and personal accounts of what it is like to have an item of clothing replaced with an ‘intervention’. The participant's experience of their consultations with practitioners has revealed the tension between the practitioners’ requirements and the women's ‘social’ needs. Practitioners need greater understanding of the social and emotional consequences of using therapeutic footwear as an intervention.
Prognostic Factors in Patients With Metastatic Germ Cell Tumors Who Experienced Treatment Failure With Cisplatin-Based First-Line Chemotherapy
Authors:   The International Prognostic Factors Study Group
Published: October 2010

Purpose

To develop a prognostic model in patients with germ cell tumors (GCT) who experience treatment failure with cisplatin-based first-line chemotherapy.

Patients and Methods

Data from 1,984 patients with GCT who progressed after at least three cisplatin-based cycles and were treated with cisplatin-based conventional-dose or carboplatin-based high-dose salvage chemotherapy was retrospectively collected from 38 centers/groups worldwide. One thousand five hundred ninety-four (80%) of 1,984 eligible patients were randomly divided into a training set of 1,067 patients (67%) and a validation set of 527 patients (33%). Seminomas were set aside for posthoc analyses. Primary end point was the 2-year progression-free survival after salvage treatment.

Results

Overall, 990 patients (62%) relapsed and 604 patients (38%) remained relapse free. Histology, primary tumor location, response, and progression-free interval after first-line treatment, as well as levels of alpha fetoprotein, human chorionic gonadotrophin, and the presence of liver, bone, or brain metastases at salvage were identified as independent prognostic variables and used to build a prognostic model in the training set. Survival rates in the training and validation set were very similar. The estimated 2-year progression-free survival rates in patients not included in the training set was 75% in very low risk, 51% in low risk, 40% in intermediate risk, 26% in high risk, and only 6% in very high-risk patients. Due to missing values in individual variables, 69 patients could not reliably be classified into one of these categories.

Conclusion

Prognostic variables are important in patients with GCT who experienced treatment failure with cisplatin-based first-line chemotherapy and can be used to construct a prognostic model to guide salvage strategies.
Impact of Overall Treatment Time on Survival and Local Control in Patients With Anal Cancer: A Pooled Data Analysis of Radiation Therapy Oncology Group Trials 87-04 and 98-11
Authors: Ben-Josef Edgar , Moughan Jennifer , Ajani Jaffer A. , Flam Marshall , Gunderson Leonard , Pollock JonDavid , Myerson Robert , Anne Rani , Rosenthal Seth A. , Willett Christopher
Published: October 2010

Purpose

To determine whether increased duration of radiation therapy (RT) and overall treatment (RX) time has a detrimental effect in anal cancer.

Patients and Methods

Data from Radiation Therapy Oncology Group (RTOG) 87-04 and RTOG 98-11 trials were combined to form three treatment groups: RT/fluorouracil (FU)/mitomycin (n = 472), RT/FU/cisplatin (n = 320), and RT/FU (n = 145). Cox proportional hazards models were used with the following variables: RT duration, RT intensity, RX duration, treatment group, age, sex, Karnofsky performance score (KPS), T stage, N stage, and RT dose.

Results

In the univariate analysis, there was a significant association between RX duration and colostomy failure (CF; hazard ratio [HR] = 1.51; 95% CI, 1.07 to 2.14; P = .02), local failure (HR = 1.52; 95% CI, 1.14 to 2.03; P = .005), locoregional failure (HR = 1.51; 95% CI, 1.15 to 1.98; P = .003), and time to failure (HR = 1.40; 95% CI, 1.10 to 1.79; P = .007). The significance of RX duration was maintained after adjusting for treatment group. In multivariate modeling there was a trend toward an association between RX duration and CF (HR = 1.57; 95% CI, 0.98 to 2.50; P = .06) and a statistically significant association with local failure (HR = 1.96; 95% CI, 1.34 to 2.87; P = .0006). Age, sex, KPS, T stage, N stage, and RT dose, but not RT duration, RT intensity, or RX duration, were found to be statistically significant predictors of OS and colostomy-free survival.

Conclusion

Total treatment time, but not duration of radiation therapy, seems to have a detrimental effect on local failure and colostomy rate in anal cancer. Induction chemotherapy may contribute to local failure by increasing total treatment time.
Renal Impairment in Patients With Multiple Myeloma: A Consensus Statement on Behalf of the International Myeloma Working Group
Authors: Dimopoulos Meletios A. , Terpos Evangelos , Chanan-Khan Asher , Leung Nelson , Ludwig Heinz , Jagannath Sundar , Niesvizky Ruben , Giralt Sergio , Fermand Jean-Paul , Bladé Joan , Comenzo Raymond L. , Sezer Orhan , Palumbo Antonio , Harousseau Jean-Luc , Richardson Paul G. , Barlogie Bart , Anderson Kenneth C. , Sonneveld Pieter , Tosi Patrizia , Cavo Michele , Rajkumar S. Vincent , Durie Brian G.M. , San Miguel Jésus
Published: October 2010

Renal impairment is a common complication of multiple myeloma (MM). The estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula is the recommended method for the assessment of renal function in patients with MM with stabilized serum creatinine. In acute renal injury, the RIFLE (risk, injury, failure, loss and end-stage kidney disease) and Acute Renal Injury Network criteria seem to be appropriate to define the severity of renal impairment. Novel criteria based on eGFR measurements are recommended for the definition of the reversibility of renal impairment. Rapid intervention to reverse renal dysfunction is critical for the management of these patients, especially for those with light chain cast nephropathy. Bortezomib with high-dose dexamethasone is considered as the treatment of choice for such patients. There is limited experience with thalidomide in patients with myeloma with renal impairment. Thus, thalidomide can be carefully administered, mainly in the context of well-designed clinical trials, to evaluate if it can improve the rapidity and probability of response that is produced by the combination with bortezomib and high-dose dexamethasone. Lenalidomide is effective in this setting and can reverse renal insufficiency in a significant subset of patients, when it is given at reduced doses, according to renal function. The role of plasma exchange in patients with suspected light chain cast nephropathy and renal impairment is controversial. High-dose melphalan (140 mg/m2) and autologous stem-cell transplantation should be limited to younger patients with chemosensitive disease.
The Future of Radiation Oncology in the United States From 2010 to 2020: Will Supply Keep Pace With Demand?
Authors: Smith Benjamin D. , Haffty Bruce G. , Wilson Lynn D. , Smith Grace L. , Patel Akshar N. , Buchholz Thomas A.
Published: October 2010

Purpose

Prior studies forecasted an incipient shortage of medical oncologists as a result of the aging US population, but the radiation oncology workforce has not been studied. Accordingly, we projected demand for radiation therapy and supply of radiation oncologists in 2010 and 2020 to determine whether a similar shortage may exist for this specialty.

Methods

Demand for radiation therapy in 2010 and 2020 was estimated by multiplying current radiation utilization rates (as calculated with Surveillance, Epidemiology, and End Results data) by population projections from the Census Bureau. Supply of radiation oncologists was projected using data from the American Board of Radiology inclusive of current radiation oncologists and active residents, accounting for variation in full-time equivalent status and expected survival by age and sex.

Results

Between 2010 and 2020, the total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 22%, from 470,000 per year to 575,000 per year. In contrast, assuming that the current graduation rate of 140 residents per year remains constant, the number of full-time equivalent radiation oncologists is expected to increase by only 2%, from 3,943 to 4,022. The size of residency training classes for the years 2014 to 2019 would have to double to 280 residents per year in order for growth in supply of radiation oncologists to equal expected growth in demand.

Conclusion

Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020. Research is needed to explore strategies to enhance capacity to deliver quality radiation therapy despite increased patient loads.
Biochemical endocrinology of the hypogonadal male
Authors: Belchetz Paul E , Barth Julian H , Kaufman Jean-Marc
Published: October 2010

Hypogonadism in the male results from inadequate testicular function, especially defects in androgen synthesis and secretion, or action. Androgen action is important throughout normal male development: in the fetus, puberty, adult life and old age. Regulation is by variable activity of the hypothalamo-pituitary axis at different phases of the life span. Clinical aspects include: genetic aspects presenting at birth and pubertal failure/arrest. Aspects in adult life embrace sexuality, somatic symptoms and osteoporosis. Acquired causes of hypogonadism may arise from various forms of testicular damage (primary hypogonadism), pituitary and hypothalamic disorders, as well as aetiologies acting at several sites. Measurement of testosterone (T) is crucial to the diagnosis of hypogonadism and the technologies continue to develop, with recent major advances. A growing problem relates to the diagnosis and treatment of hypogonadism in the ageing male. T therapy is available in several forms, with major improvements in more newly available modalities.
Constitutive Property Behavior of Type N and Type S Mortars
Authors: Williams Erin M. , Akers Stephen A. , Berger Rebecca P. , Reed Paul A.
Published: October 2010

An extensive program of quasi-static mechanical property tests was conducted to characterize the mechanical behavior of type N and type S mortars under various stress and strain boundary conditions to decide which mortar to use in the construction of triple-brick and brick-over-block walls. The material characterization effort consisted of hydrostatic compression, unconfined compression, triaxial compression, direct pull, reduced triaxial extension, and uniaxial strain tests. The results from all of the quasi-static tests provided the mechanical properties required for determining which mortar to use in the construction of target walls for projectile perforation experiments as well as the constitutive model coefficients for numerical simulations of these experiments. This paper provides a summary of the mechanical property test results obtained for type N and type S mortars and the rational for using type S mortar in the construction of triple-brick and brick-over-block walls.
Heterogeneity in the responsiveness to long-term lifestyle intervention and predictability in obese women with polycystic ovary syndrome
Authors: Pasquali Renato , Gambineri Alessandra , Cavazza Carla , Ibarra Gasparini Daniela , Ciampaglia Walter , Cognigni Graciela Estela , Pagotto Uberto
Published: October 2010

Background

Treatment of obesity improves all features of the polycystic ovary syndrome (PCOS). There is, however, a heterogeneous response to weight loss, and predictive factors are unknown.

Objective

This follow-up study aimed to investigate obese women with PCOS treated with a long-term lifestyle program to evaluate responsiveness and predictability.

Methods

One hundred PCOS women meeting the criteria for selection were invited to participate and 65 of them agreed. Lifestyle intervention had consisted of a 1200–1400 kcal/day diet for 6 months, followed by mild calorie restriction and physical activity. The protocol, which was similar at baseline and follow-up, included anthropometry, clinical evaluation, pelvic ultrasound, and laboratory investigations. The mean follow-up period was 20.4±12.5 months.

Results

After the follow-up period, women were reclassified into three groups according to the persistence (group 1, 15.4%), partial (group 2, 47.7%), or complete (group 3, 36.9%) disappearance of the categorical features of PCOS (hyperandrogenism, menses, and ovulatory dysfunctions). Duration of the follow-up and extent of weight loss were similar among the three groups, as were fasting and glucose-stimulated insulin and indices of insulin resistance. Baseline waist circumference, waist to hip ratio (WHR), and androstenedione blood levels were negatively correlated with a better outcome in the univariate analysis. However, only basal androstenedione values persisted to a highly significant extent (P<0.001) in the multivariate analysis.

Conclusions

Responsiveness to weight loss in overweight/obese PCOS women varies considerably and more than one third of women may achieve full recovery. These findings add new perspectives to the impact of obesity on the pathophysiology of PCOS.
Natural history of the transition from euthyroidism to overt autoimmune hypo- or hyperthyroidism: a prospective study
Authors: Effraimidis Grigoris , Strieder Thea G A , Tijssen Jan G P , Wiersinga Wilmar M
Published: October 2010

Objective

To evaluate the progression in time from euthyroidism to overt autoimmune hypothyroidism or to overt autoimmune hyperthyroidism.

Subjects and methods

The design is that of a nested case–control study within the prospective Amsterdam autoimmune thyroid disease (AITD) cohort study in which 790 healthy euthyroid women with at least one first or second degree relative with documented AITD were followed for 5 years. Thyroid function tests were assessed annually. Contrast between cases (overt hypothyroidism – TSH>5.7 mU/l and free thyroxine (FT4)<9.3 pmol/l and overt hyperthyroidism – TSH<0.4 mU/l and FT4>20.1 pmol/l, also referred to as events) and controls (matched for age and duration of follow-up).

Results

At baseline, the 38 hypothyroid cases had already higher TSH and lower FT4 concentrations than their 76 controls, and the difference between both the groups persisted 1 year before occurrence of the event. In contrast, neither TSH nor FT4 values differed between the 13 hyperthyroid cases and their 26 controls at baseline or 1 year before the event. The prevalence of thyroid peroxidase-Ab was higher in both hypothyroid and hyperthyroid cases than in controls. At the time of event, hypothyroid cases were less common among current smokers (P=0.083) and more common in the postpartum period (P=0.006) than their controls, whereas hyperthyroid cases were pregnant more frequently (P=0.063).

Conclusions

The data suggest that progression toward overt autoimmune hypothyroidism is a gradual process taking several years, but in contrast overt autoimmune hyperthyroidism develops faster in terms of months.
Endocrinology of the mammalian fetal testis
Authors: O'Shaughnessy Peter J , Fowler Paul A
Published: October 2010

The testes are essential endocrine regulators of fetal masculinization and male development and are, themselves, subject to hormonal regulation during gestation. This review focuses, primarily, on this latter control of testicular function. Data available suggest that, in most mammalian species, the testis goes through a period of independent function before the fetal hypothalamic–pituitary–gonadal axis develops at around 50% of gestation. This pituitary-independent phase coincides with the most critical period of fetal masculinization. Thereafter, the fetal testes appear to become pituitary hormone-dependent, concurrent with declining Leydig cell function, but increasing Sertoli cell numbers. The two orders of mammals most commonly used for these types of studies (rodents and primates) appear to represent special cases within this general hypothesis. In terms of testicular function, rodents are born ‘early’ before the pituitary-dependent phase of fetal development, while the primate testis is dependent upon placental gonadotropin released during the pituitary-independent phase of development.
Complex Genetic Effects in Quantitative Trait Locus Identification: A Computationally Tractable Random Model for Use in F2 Populations
Authors: Zimmer Daisy , Mayer Manfred , Reinsch Norbert
Published: October 2010

Methodology for mapping quantitative trait loci (QTL) has focused primarily on treating the QTL as a fixed effect. These methods differ from the usual models of genetic variation that treat genetic effects as random. Computationally expensive methods that allow QTL to be treated as random have been explicitly developed for additive genetic and dominance effects. By extending these methods with a variance component method (VCM), multiple QTL can be mapped. We focused on an F2 crossbred population derived from inbred lines and estimated effects for each individual and their corresponding marker-derived genetic covariances. We present extensions to pairwise epistatic effects, which are computationally intensive because a great many individual effects must be estimated. But by replacing individual genetic effects with average genetic effects for each marker class, genetic covariances are approximated. This substantially reduces the computational burden by reducing the dimensions of covariance matrices of genetic effects, resulting in a remarkable gain in the speed of estimating the variance components and evaluating the residual log-likelihood. Preliminary results from simulations indicate competitiveness of the reduced model with multiple-interval mapping, regression interval mapping, and VCM with individual genetic effects in its estimated QTL positions and experimental power.
Association Between Medicaid Reimbursement and Child Influenza Vaccination Rates
Authors: Yoo Byung-Kwang , Berry Andrea , Kasajima Megumi , Szilagyi Peter G.
Published: October 2010

OBJECTIVE:

We examined associations between influenza vaccination rates and Medicaid reimbursement rates for vaccine administration among poor children who were eligible for Medicaid (<100% of the federal poverty level in all states).

METHODS:

We analyzed 3 consecutive National Immunization Surveys (NISs) to assess influenza vaccination rates among nationally representative children 6 to 23 months of age during the 2005–2006 (unweighted N = 12 885), 2006–2007 (unweighted N = 9238), and 2007–2008 (unweighted N = 11 785) influenza seasons (weighted N = 3.3–4.0 million per season). We categorized children into 3 income levels (poor, near-poor, or nonpoor). We performed analyses with full influenza vaccination as the dependent variable and state Medicaid reimbursement rates (continuous covariate ranging from $2 to $17.86 per vaccination) and terms with income levels as key covariates.

RESULTS:

In total, 21.0%, 21.3%, and 28.9% of all US children and 11.7%, 11.6%, and 18.8% of poor children were fully vaccinated in the 2006, 2007, and 2008 NISs, respectively. Multivariate analyses of all 3 seasons found positive significant (all P < .05) associations between state-level Medicaid reimbursement and influenza vaccination rates among poor children. A $10 increase, from $8 per influenza vaccination (the US average) to $18 (the highest state reimbursement), in the Medicaid reimbursement rate was associated with 6.0-, 9.2-, and 6.4-percentage point increases in full vaccination rates among poor children in the 2006, 2007, and 2008 NIS analyses, respectively.

CONCLUSION:

Medicaid reimbursement rates are strongly associated with influenza vaccination rates.
Referral to the Emergency Department by a Primary Care Provider Predicts Severity of Illness
Authors: Rinderknecht Andrea S. , Ho Mona , Matykiewicz Pawel , Grupp-Phelan Jacqueline M.
Published: October 2010

OBJECTIVE:

The purpose of this study was to assess whether referral to a pediatric emergency department (PED) by a primary care provider was associated with greater severity of illness, as determined on the basis of clinical measures and increased resource utilization.

METHODS:

A retrospective study of data for 121 088 children who presented to a PED with abdominal pain, fever, or respiratory complaints during a 5-year period was performed. Demographic data, referral status, and proxy markers of illness severity were collected from the medical records and analyzed.

RESULTS:

A total of 26.3% of all patients seen in the PED presented with these 3 complaint categories. With adjustment for age, gender, race, and insurance class, referred patients were significantly more likely to have high triage acuity designations, higher rates of very abnormal vital signs, and higher admission rates, compared with patients who were self-referred. Referred patients were more likely to undergo testing (laboratory or radiologic), to receive intravenous fluid therapy and pain medications, and to be assigned higher-severity discharge diagnoses, such as appendicitis, septic shock, or status asthmaticus.

CONCLUSIONS:

Referral by a primary care provider to a PED was significantly and independently associated with greater severity of illness and resource utilization. Referral status should be considered in algorithms used to triage cases for evaluation in the PED.
An Educated Spirit
Authors: Manthey Marie
Published: October 2010

Richard Olding Beard, founder of the University of Minnesota School of Nursing, was a passionate and eloquent champion of educating rather than simply training nurses and of the contributions professional nurses make to social justice by improving the health care of society. The issues he wrote and spoke about are the same issues raised in contemporary discussions of entry-level preparation for nursing.
Journaling: Creating Space for “I”
Authors: Charles Jennell P.
Published: October 2010

As nurses engaged in a caring profession, it is critical that we learn not only to care for others but also to care for ourselves. To care effectively for ourselves, we must create the space and time in which to do this. Journaling is one tool that scholars offer as a way to create this space. Although there is no clear consensus about the best techniques for journaling, there is evidence that journaling, as a reflective, meditative activity, can promote creativity, self-awareness, and personal development.
Death with Dignity
Authors: Mathiews Ann Kimberlin
Published: October 2010

The concept of death with dignity evolves over a nurse's career. A new nurse focuses on the patient as a person. As the nurse gains experience, she facilitates family grieving. As a seasoned professional, the nurse emphasizes the dignity that, through effective nursing, can be restored to dying. Preservation of dignity is found in the way we honor death.
New morbidity of the young
Authors: Stankovic Biljana
Published: October 2010

In the present phase of epidemiological transition, the most frequent causes of youth morbidity are disorders in reproductive health, mental disorders and injuries which are not life threatening. This, so-called new youth morbidity, is most often caused by their risky behavior, which in the field of sexuality often leads to unplanned pregnancies and abortions, as well as sexually transmitted infections. Misuse of tobacco, alcohol and narcotics, which is most commonly started in adolescence, has an unfavorable short-term and long-term influence on the psycho-physical health of the young. All research, in the world and in our country, indicate gradual yet constant growth of sexual activity of the youth and the age decrease of its starting point, especially when girls are in question. Due to insufficient maturity and inadequate knowledge and consciousness on the necessity of protecting reproductive health, sexual behavior of young people can often be characterized as insufficiently responsible and not supplemented with the usage of adequate protective measures. The result is frequently abortion, which terminates 90% of unplanned and unwanted pregnancies in this age. This creates health and psychosocial risks, as well as giving birth in adolescence which is contrary to the modern health concepts that giving birth should not be performed too early, while the young are still developing. A significant increase in the frequency of sexually transmitted diseases is also present, to which the youth are especially susceptible due to the specific development period in which they are in. A serious medical and sociopathological problem of contemporary society represents the greater and greater misuse of psychoactive substances among the young people, with a tendency of decreasing the average age they are consumed for the first time, as well as the use of drugs and alcohol. With the increase of the anti-smoking campaign and restrictive measures in highly developed countries smoking among young people is decreasing, while it is increasing in Eastern Europe and developing countries. As the health disorders of young people mentioned above, are conditioned, above all, by their risky behavior and insufficient relation towards health, the degree to which they are widespread can be influenced by prevention. Educational and health institutes represent the carriers of preventive activity, which understands health education and aid to young people in overcoming life's skills, along with the necessity to direct support to the family as well, which maintains a significant place in the life of young people and has a important influence on their behavior to risk exposure. A significant influence is also legal and provision regulations, the role of mass media, as well as the activities of political, nongovernmental, religious and other organizations which determine the environment in which young people live.
How many children does Serbia need?
Authors: Djurdjev Branislav
Published: October 2010

The work is an attempt to determine basic quantities for introducing a family planning program which will be aiming at a replacement level. In order to do that census year 2002 was taken as an example for calculation. Total fertility rate of 2.1 children per woman was considered as necessary level and that means Serbia needs 105.000 newborns each year. In accordance with that level a set of five age specific fertility rates (ASFR) were established in order to find appropriate model of reproductive behavior for Serbia. The sets are established in the following manner: multiplying ASFR by quotient between necessary and real number of newborns, by the data from the last year when fertility was large enough to provide for replacement level (with mortality level from 2002), by linear interpolation between two ASFR models and by Brass fertility polynomial. All five different models of age specific fertility rates suggest that there is no ideal distribution of ASFR. Also parity progression from zero to first, from first to second, and from second to third child is determined. The main reason for below replacement level in Serbia is small parity progression from second to third child. So, rearing the third child should be the most stimulated in every family planning program, as long as every second women have them by the end of her reproductive life span.
Development of reprogenetics and its demographic aspects
Authors: Devedzic Mirjana
Published: October 2010

The development of reprogenetics during the last two decades of the XX century has brought a new age of reproduction. The paper surveys different types of reprogenetics in a wider sense, i.e. different assisted reproductive technologies (ART) that include manipulation of female reproductive cell out of a woman's womb. Development of reprogenetics is documented by available quantitative indicators of the number and success of ART procedures in developed countries at the beginning of the XXI century. Since 1978, when the first baby was born from in vitro fertilization, the number of children born that way has reached 1% of all children, and in some countries even over 3%. Moreover, existing documentation is incomplete and does not include all forms of assisted reproduction - in reality, the importance of assisted reproduction is even higher and becomes demographically significant. Hence the paper indicates existing and potential effects of the ART development on the demographic development i.e. on specific demographic aspects of this phenomenon. It also points out the effects on the level of fertility, on the changes of direct fertility determinants, and on the levels of mortality and infant mortality, as well as a new understanding of birth control, the possibility of affecting biological structures, and the changes of the fundaments of marriage and family. Development perspectives of reprogenetics are also being raised in the context of bioethical discussions and indicate ethical dilemmas related to assisted reproduction. Solutions to the dilemmas define the scope of applying new reproductive technologies in the future.
On the problem of population projections exactness at district level: Example of population projections of Serbia 1970-2000
Authors: Nikitovic Vladimir
Published: October 2010

The quality and exactness of population projections is an important issue not only for their numerous users but for all authors of these demographic calculations who try to increase their utility value. The question of the exactness of population projections of smaller territorial entities are especially sensitive and for smaller time periods as well, because such projections are usually used as input parameters for various forms of social planning. The results of the analysis which refers to the best documented set of projections so far of this type and which includes the whole territory of Serbia have been presented in this work. The projections are on the level of municipalities made for a thirty year period, 1970-2000, as a scientific basis of the social plan of SR Serbia. Two different variants had been prepared. One understood the linear continuation of noted tendencies from the projected period, and the other is the result of the hypothesis of the so-called cohort-component method which assumed gradual equaling of fertility namely mortality level among the municipalities within each macro-entity of Serbia, with migrations abstracted. By applying several indicators, based on relative discrepancy of projected total district population from the registered values by census, the projected mistake intensity and direction has been determined. The explication of the origin and formation of measured values had been carried out by analyzing the discrepancies of projected trends of main demographic components in relation to realized demographic development. Within the analysis, the correlation dependency level was tested between the amount of mistakes and factors which were recognized as possible sources of discrepancy. The analysis results confirmed the importance of migration components in projecting populations of smaller territorial units within the country. Although prediction of future migrational balance is connected with the greatest sources of uncertainty in comparison with the other two components of population development, especially on a long-term basis, its abstraction from the projected calculations considerably influences more the exactness of projected results regarding the district level rather than macro-entirety level. The reason lays in the generally more intensive inner-state migrational trends rather than in outer migrations, as well as in the proportionally larger migration effect on small population units in comparison with macro-entireties. One of the basic results of this analysis indicates that the greatest discrepancies of projected results, in relation to realized values, are connected precisely to districts where demographic development of migrational components had their greatest influence.