bluuebunny/crossref_metadata_2025 huggingface dataset:
β-Cell Function Preservation After 3.5 Years of Intensive Diabetes Therapy
Authors: Harrison Lindsay B. , Adams-Huet Beverley , Raskin Philip , Lingvay Ildiko
Published: June 2012

OBJECTIVE

To assess β-cell function preservation after 3.5 years of intensive therapy with insulin plus metformin (INS group) versus triple oral therapy (TOT group) with metformin, glyburide, and pioglitazone.

RESEARCH DESIGN AND METHODS

This was a randomized trial of 58 patients with treatment-naïve newly diagnosed type 2 diabetes. All patients were treated with insulin and metformin for a 3-month lead-in period followed by random assignment to the INS or TOT group. β-Cell function was assessed using a mixed-meal challenge test at randomization and 6, 12, 18, 30, and 42 months. Analyses were intention to treat and performed with repeated-measures models.

RESULTS

Completion rates at 3.5 years were 83% in the insulin group and 72% in the TOT group, with good compliance in both groups (87 ± 20% in the INS group vs. 90 ± 15% in the TOT group). β-Cell function was preserved at 3.5 years after diagnosis, with no significant change from baseline or difference between the two groups as measured by area under the curve (AUC) of C-peptide (P = 0.14) or the ratio of C-peptide to glucose AUC (P = 0.7). Excellent glycemic control was maintained in both groups (end-of-study HbA1c 6.35 ± 0.84% in the INS group vs. 6.59 ± 1.94% in the TOT group). Weight increased in both groups over time (from 102.2 ± 24.9 kg to 106.2 ± 31.7 kg in the INS group and from 100.9 ± 23.0 kg to 110.5 ± 31.8 kg in the TOT group), with no significant difference between groups (P = 0.35). Hypoglycemic events decreased significantly over time (P = 0.01) but did not differ between groups (P = 0.83).

CONCLUSIONS

β-Cell function can be preserved for at least 3.5 years with early and intensive therapy for type 2 diabetes with either insulin plus metformin or triple oral therapy after an initial 3-month insulin-based treatment period.
Intensive Glycemic Control Is Not Associated With Fractures or Falls in the ACCORD Randomized Trial
Authors: Schwartz Ann V. , Margolis Karen L. , Sellmeyer Deborah E. , Vittinghoff Eric , Ambrosius Walter T. , Bonds Denise E. , Josse Robert G. , Schnall Adrian M. , Simmons Debra L. , Hue Trisha F. , Palermo Lisa , Hamilton Bruce P. , Green Jennifer B. , Atkinson Hal H. , O’Connor Patrick J. , Force Rex W. , Bauer Douglas C.
Published: June 2012

OBJECTIVE

Older adults with type 2 diabetes are at high risk of fractures and falls, but the effect of glycemic control on these outcomes is unknown. To determine the effect of intensive versus standard glycemic control, we assessed fractures and falls as outcomes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) randomized trial.

RESEARCH DESIGN AND METHODS

ACCORD participants were randomized to intensive or standard glycemia strategies, with an achieved median A1C of 6.4 and 7.5%, respectively. In the ACCORD BONE ancillary study, fractures were assessed at 54 of the 77 ACCORD clinical sites that included 7,287 of the 10,251 ACCORD participants. At annual visits, 6,782 participants were asked about falls in the previous year.

RESULTS

During an average follow-up of 3.8 (SD 1.3) years, 198 of 3,655 participants in the intensive glycemia and 189 of 3,632 participants in the standard glycemia group experienced at least one nonspine fracture. The average rate of first nonspine fracture was 13.9 and 13.3 per 1,000 person-years in the intensive and standard groups, respectively (hazard ratio 1.04 [95% CI 0.86–1.27]). During an average follow-up of 2.0 years, 1,122 of 3,364 intensive- and 1,133 of 3,418 standard-therapy participants reported at least one fall. The average rate of falls was 60.8 and 55.3 per 100 person-years in the intensive and standard glycemia groups, respectively (1.10 [0.84–1.43]).

CONCLUSIONS

Compared with standard glycemia, intensive glycemia did not increase or decrease fracture or fall risk in ACCORD.
Effects of Gastric Bypass Surgery in Patients With Type 2 Diabetes and Only Mild Obesity
Authors: Cohen Ricardo V. , Pinheiro Jose C. , Schiavon Carlos A. , Salles João E. , Wajchenberg Bernardo L. , Cummings David E.
Published: June 2012

OBJECTIVE

Roux-en-Y gastric bypass (RYGB) ameliorates type 2 diabetes in severely obese patients through mechanisms beyond just weight loss, and it may benefit less obese diabetic patients. We determined the long-term impact of RYGB on patients with diabetes and only class I obesity.

RESEARCH DESIGN AND METHODS

Sixty-six consecutively selected diabetic patients with BMI 30–35 kg/m2 underwent RYGB in a tertiary-care hospital and were prospectively studied for up to 6 years (median 5 years [range 1–6]), with 100% follow-up. Main outcome measures were safety and the percentage of patients experiencing diabetes remission (HbA1c <6.5% without diabetes medication).

RESULTS

Participants had severe, longstanding diabetes, with disease duration 12.5 ± 7.4 years and HbA1c 9.7 ± 1.5%, despite insulin and/or oral diabetes medication usage in everyone. For up to 6 years following RYGB, durable diabetes remission occurred in 88% of cases, with glycemic improvement in 11%. Mean HbA1c fell from 9.7 ± 1.5 to 5.9 ± 0.1% (P < 0.001), despite diabetes medication cessation in the majority. Weight loss failed to correlate with several measures of improved glucose homeostasis, consistent with weight-independent antidiabetes mechanisms of RYGB. C-peptide responses to glucose increased substantially, suggesting improved β-cell function. There was no mortality, major surgical morbidity, or excessive weight loss. Hypertension and dyslipidemia also improved, yielding 50–84% reductions in predicted 10-year cardiovascular disease risks of fatal and nonfatal coronary heart disease and stroke.

CONCLUSIONS

This is the largest, longest-term study examining RYGB for diabetic patients without severe obesity. RYGB safely and effectively ameliorated diabetes and associated comorbidities, reducing cardiovascular risk, in patients with a BMI of only 30–35 kg/m2.
A Critical Evaluation of Glycated Protein Parameters in Advanced Nephropathy: A Matter of Life or Death
Authors: Freedman Barry I.
Published: June 2012

Chronic kidney disease remains as one of the major complications for individuals with diabetes and contributes to considerable morbidity. Individuals subjected to dialysis therapy, half of whom are diabetic, experience a mortality of ∼20% per year. Understanding factors related to mortality remains a priority. Outside of dialysis units, A1C is unquestioned as the “gold standard” for glycemic control. In the recent past, however, there is evidence in large cohorts of diabetic dialysis patients that A1C at both the higher and lower levels was associated with mortality. Given the unique conditions associated with the metabolic dysregulation in dialysis patients, there is a critical need to identify accurate assays to monitor glycemic control to relate to cardiovascular endpoints. In this two-part point-counterpoint narrative, Drs. Freedman and Kalantar-Zadeh take opposing views on the utility of A1C in relation to cardiovascular disease and survival and as to consideration of use of other short-term markers in glycemia. In the narrative below, Dr. Freedman suggests that glycated albumin may be the preferred glycemic marker in dialysis subjects. In the counterpoint narrative following Dr. Freedman’s contribution, Dr. Kalantar-Zadeh defends the use of A1C as the unquestioned gold standard for glycemic management in dialysis subjects.

—William T. Cefalu, MD Editor in Chief, Diabetes Care
Liver Fat Is Reduced by an Isoenergetic MUFA Diet in a Controlled Randomized Study in Type 2 Diabetic Patients
Authors: Bozzetto Lutgarda , Prinster Anna , Annuzzi Giovanni , Costagliola Lucia , Mangione Anna , Vitelli Alessandra , Mazzarella Raffaella , Longobardo Margaret , Mancini Marcello , Vigorito Carlo , Riccardi Gabriele , Rivellese Angela A.
Published: June 2012

OBJECTIVE

To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

With use of a factorial 2 × 2 randomized parallel-group design, 37 men and 8 women, aged 35–70 years, with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment were assigned to one of the following groups for an 8-week period: 1) high-carbohydrate/high-fiber/low–glycemic index diet (CHO/fiber group), 2) high-MUFA diet (MUFA group), 3) high-carbohydrate/high-fiber/low–glycemic index diet plus physical activity program (CHO/fiber+Ex group), and 4) high-MUFA diet plus physical activity program (MUFA+Ex group). Before and after intervention, hepatic fat content was measured by 1H NMR.

RESULTS

Dietary compliance was optimal and body weight remained stable in all groups. Liver fat content decreased more in MUFA (−29%) and MUFA+Ex (−25%) groups than in CHO/fiber (−4%) and CHO/fiber+Ex groups (−6%). Two-way repeated-measures ANOVA, including baseline values as covariate, showed a significant effect on liver fat content for diet (P = 0.006), with no effects for exercise training (P = 0.789) or diet-exercise interaction (P = 0.712).

CONCLUSIONS

An isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinically relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes.
Professional Stress and Health among Critical Care Nurses in Serbia
Authors: Milutinović Dragana , Golubović Boris , Brkić Nina , Prokeš Bela
Published: June 2012

Professional Stress and Health among Critical Care Nurses in Serbia

The aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a cross-sectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.
Smoking among Macedonian Workers Five Years after the Anti-Smoking Campaign
Authors: Minov Jordan , Karadžinska-Bislimovska Jovanka , Vasilevska Kristin , Nelovska Zlatka , Risteska-Kuc Snežana , Stoleski Sašo , Mijakoski Dragan
Published: June 2012

Smoking among Macedonian Workers Five Years after the Anti-Smoking Campaign

To assess the efficacy of nationwide anti-smoking campaign, we compared the findings of a study on worker smoking performed in 2005 with our latest cross-sectional study completed in 2010. It included 753 randomly selected workers, of whom 126 office, 108 construction, 93 agricultural, 97 petroleum refinery, 114 textile, 117 food processing workers, and 98 cleaners. Information was collected with a self-administered questionnaire. The prevalence of current smokers among all workers was 35.4 %, ranging from 30.2 % in office workers to 43.5 % in construction workers. It did not significantly differ from the prevalence recorded in 2005 (35.4 % vs. 36.8 %, respectively; P=0.441). Mean pack-years smoked among all smokers was 12.4±2.3, ranging from 10.9 in administrative workers to 13.7 in agricultural workers. We did not find any significant difference in the prevalence of current smokers between male and female workers and between workers aged less or more than 40 years, as well as between workers of higher and lower education. The prevalence of ex-smokers was 10.5 %, ranging from 8.4 % in construction workers to 12.1 % in administrative workers, whereas the prevalence of passive smokers was 29.1 %, ranging from 26.2 % in food processing workers to 32.9 % in agricultural workers. Our findings indicate that the prevalence of current and passive smokers has remained high regardless of the anti-smoking campaign and call for stricter implementation of anti-smoking regulations.
Recovery from an Eighty-Percent Total Body Surface Area Burn Injury Sustained at Work
Authors: Hahn Helga
Published: June 2012

Recovery from an Eighty-Percent Total Body Surface Area Burn Injury Sustained at Work

This article presents a case of severe burn injury at work involving 80 % of body surface area and patient treatment and rehabilitation, which resulted in preserved working ability. The worker was injured by hot water and steam. After initial treatment in the intensive care unit, he underwent comprehensive clinical and outpatient rehabilitation that took 92 weeks, after which he returned to work. His working disability was 100 % after the initial treatment in the intensive care unit, but rehabilitation improved it to 50 %. It should always be kept in mind that even patients with serious or life-threatening injuries can be reintegrated into the workforce if patients, physicians, occupational physicians, and employers all work together.
Effects of Exposure to Mixed Organic Solvents on Blood Pressure in Non-Smoking Women Working in a Pharmaceutical Company
Authors: Mohammadi Saber , Golabadi Majid , Labbafinejad Yasser , Pishgahhadian Fatemeh , Attarchi Mirsaeed
Published: June 2012

Effects of Exposure to Mixed Organic Solvents on Blood Pressure in Non-Smoking Women Working in a Pharmaceutical Company

Some studies suggest that exposure to industrial solvents can affect blood pressure. The objective of this study was to investigate the effect of a mixture of organic solvents on blood pressure in women working in a pharmaceutical company in Iran. Four hundred and thirty-three women were included in the study. Women working in packing units (group 1) were not exposed to the mixture of organic solvents, women in new laboratory units (group 2) were exposed to the mixture within the permitted range and women working in old laboratory units (group 3) were exposed to the mixture above the permitted limit. We compared systolic and diastolic blood pressures (SBP & DBP) and prevalence of hypertension and pre-hypertension among groups. The results revealed a significant difference in SBP and pre-hypertension (p<0.001) and hypertension (p<0.05) prevalence between the exposed and the control group, but DBP did not differ significantly. Logistic regression analysis showed a significant association between hypertension and exposure to mixed solvents. Odds ratio for hypertension in the group 2 and group 3 (exposed) workers was 2.36 and 3, respectively, compared to controls. Our results suggest that exposure to a mixture of organic solvents may increase SBP and hypertension and pre-hypertension prevalence in drug manufacture workers. Therefore, more attention should be paid to workers that work in such settings by periodically measuring blood pressure and implementing accurate and comprehensive programs to reduce exposure to organic solvents.
Concentration of Lead, Cadmium, and Iron in Sediment Dust and Total Suspended Particles Before and After Initialisation of Integral Production in Iron and Steel Work Plant Zenica
Authors: Prcanović Halim , Duraković Mirnes , Beganović Sanela
Published: June 2012

Concentration of Lead, Cadmium, and Iron in Sediment Dust and Total Suspended Particles Before and After Initialisation of Integral Production in Iron and Steel Work Plant Zenica

Poor air quality is a common fact for all areas with base industry. The city of Zenica was once the metallurgical centre of Ex-Yugoslavia and is therefore highly polluted at present. Air pollution peaked in 1987 when average concentration of pollutants was extremely high (daily average concentration of SO2 was 1800 μg m-3). With the beginning of the war in 1992, integral production in the steel work plant was shut down, to be re-launched in 2008. Limit values for iron do not exist, but iron has been monitored in Zenica for the past 28 years because of the presence of steel works. Concentrations of cadmium and lead have also been measured because they are very much present in polluted areas with steel works. The concentration of mentioned elements in air deposit and total suspended particles before and after integral production in the steel work plant was re-launched is the subject of this paper. Total suspended particles were measured in two locations using German standard VDI 2463 Blatt 4. Sediment dust was measured in nine locations using Bergerhoff method. The concentration of iron, lead, and cadmium was performed in the chemical laboratory of the Metallurgical Institute "Kemal Kapetanović" Zenica using standard methods. Higher concentrations of these parameters during the period of integral production clearly point to the impact of steel works on Zenica valley.
Frequency of Musculoskeletal and Eye Symptoms among Computer Users at Work
Authors: Radulović Bojana , Huršidić-Radulović Azra
Published: June 2012

Frequency of Musculoskeletal and Eye Symptoms among Computer Users at Work

Computer users most often complain of the eye and locomotor system disorders. The goal of this paper was to find out the frequency and relation between musculoskeletal and eye symptoms among computer workers.

The data on musculoskeletal and eye symptoms were provided by two questionnaires. Forty-nine workers were included in the study. Their mean age was 41 years and average length of service 16 years. The average amount of time they spent in front of computers was 6.73 hours per day. Women spent more time working at a computer per day than men (P=0.025). The most frequent complaint in the past year referred to the upper back pain (30.6 % of the workers). Every fourth worker, i.e. 24.5 % of them experienced neck pain in the past year; women more often than men (P=0.024). A health problem which reduced the range of motion and prompted the workers to ask for sick leave was lower back pain. The relation between eye symptoms and the upper back pain experienced in the past year (P=0.004), and in the last week (P=0.031) was statistically significant.

Proper exercises for stretching musculoskeletal system, ergonomic computer equipment, and artificial tears could decrease muscular and eye problems, which in turn could enhance productivity and reduce sick leaves.
Ototoxic Substances at the Workplace: a Brief Update
Authors: Nies Eberhard
Published: June 2012

Ototoxic Substances at the Workplace: a Brief Update

Ototoxic chemicals can impair the sense of hearing and balance. Lately, efforts have been intensified to compile evidence-based lists of workplace agents with ototoxic properties. This article gives a rough overview of the latest relevant publications, which confirm that toluene, styrene, and lead should receive particular attention as ototoxic substances at the workplace. Moreover, there is sufficient evidence that occupational exposure to trichloroethylene, mercury, carbon monoxide, and carbon disulfide can affect the ear. Based on the existing information, industrial hygienists should make sure that occupational health professionals and the workforce are made aware of the risks posed by ototoxic substances; support their replacement or new technical measures to reduce exposure; make these substances a part of regular screening, develop tools that can early diagnose chemically induced hearing impairment, and investigate further into the ototoxic properties of these substances. Further research should focus on quantifying the combined effects of ototoxic substances and noise.
Worker Protection During Mercury Electrolysis Cell Plant Decommissioning
Authors: Besson Jean-Claude , Augarde Estelle , Nasterlack Michael
Published: June 2012

Worker Protection During Mercury Electrolysis Cell Plant Decommissioning

This article brings information on how to protect worker health during the decommissioning of mercury-based electrolysis facilities. It relies on the Euro Chlor document "Health 2, Code of practice, Control of worker exposure to mercury in the chlor-alkali industry" that provides protection guidelines for both normal production and decommissioning activities, and on hands-on experience gained during chlor-alkali plant decommissioning operations.

Decommissioning and dismantling of mercury-containing chlorine production plants presents challenges to industrial hygiene and health protection that are usually not present during normal operations. These involve meticulous training and enforcement of the appropriate use of personal protective equipment to prevent excessive mercury exposure.

The best practice guidelines and recommendations available from Euro Chlor can help employers and occupational physicians to manage these challenges, as they provide state-of-the-art procedures. Our experience is that rigorous implementation of these procedures and worker training ensured acceptable hygiene at the workplace and prevented mercury-related adverse health effects.
Respiratory Symptoms in Fish Processing Workers on the Adriatic Coast of Croatia
Authors: Žuškin Eugenija , Kern Josipa , Mustajbegović Jadranka , Pucarincvetković Jasna , Doko-Jelinić Jagoda , Bradić Tihomir
Published: June 2012

Respiratory Symptoms in Fish Processing Workers on the Adriatic Coast of Croatia

This article describes respiratory symptoms and lung function in 98 fish processing female workers employed in a fish processing plant located on the Croatian Adriatic coast and 95 matching controls. The study included chronic and acute respiratory symptoms which developed during the shifts. Lung function measurements included forced vital capacity (FVC), one-second forced expiratory volume (FEV1) and maximal expiratory rates at 50 % and the last 25 % (FEF50, FEF25). Chronic respiratory symptoms were significantly dominant in fish processing workers compared to controls. The most common chronic symptoms were hoarseness (57.1 %), nasal catarrh (51.0 %), chronic cough (42.9 %), chronic phlegm (34.7 %), and frequent chest cold (35.7 %). Exposed smokers and nonsmokers had a similar prevalence of chronic respiratory symptoms. Acute symptoms over the work shift were high, with headache in lead (smokers: 62.5 %; nonsmokers: 56.1 %). Most of the ventilatory capacity parameters were significantly lower than predicted, FEF25 in particular, indicating obstructive changes predominantly in the smaller airways. These findings suggest that fish processing workers are prone to developing acute and chronic respiratory symptoms as well as to lung function changes. This calls for medical and technical preventive measures to be introduced in the work environment of the fish processing plant.
Psychosocial Risks in the Workplace: An Increasing Challenge for German and International Health Protection
Authors: Portuné Roland
Published: June 2012

Psychosocial Risks in the Workplace: An Increasing Challenge for German and International Health Protection

Occupational health in a changing world has to face up to psychosocial risks to protect the health of employees now and in the future. Faster production, service and communication processes, a service- and knowledge-based society, an increasing proportion of intellectual work, growing complexity of work-related demands, new technologies and constant availability, mobility demands, and job insecurity contribute to the problem of psychosocial risks in the workplace. Psychosocial risks affect both physical and psychosocial health. There is scientific evidence of the link between psychosocial work-related stress and cardiovascular diseases, affective disorders or musculoskeletal disorders, especially chronic back pain.

The Framework Directive on Safety and Health makes it very clear that employers are obliged "to ensure the safety and health of workers in every aspect relating to work". In spite of these far reaching obligations, a kind of taboo sometimes makes it hard to focus on topics that have psychosocial implications. A large number of models, instruments and methods are now available to gauge psychosocial risks in the workplace. Given the clear contrast between knowledge and application, there is not a lack of knowledge in this regard, but rather a lack of application.

In Germany, statutory accident insurance institutions are guided by two key principles: putting prevention before rehabilitation and rehabilitation before compensation. To prevent work-related health risks the BG RCI has developed several prevention tools to help employers and employees deal with psychosocial risks in the workplace.
Selected methods of measuring workload among intensive care nursing staff
Authors: Kwiecień Katarzyna , Wujtewicz Maria , Mędrzycka-Dąbrowska Wioletta
Published: June 2012

Intensive care units and well-qualified medical staff are indispensable for the proper functioning of every hospital facility. Due to demographic changes and technological progress having extended the average life expectancy, the number of patients hospitalized in intensive care units increases every year [9,10]. Global shortages of nursing staff (including changes in their age structure) have triggered a debate on the working environment and workload the nursing staff are exposed to while performing their duties. This paper provides a critical review of selected methods for the measurement of the workload of intensive care nurses and points out their practical uses. The paper reviews Polish and foreign literature on workload and the measurement tools used to evaluate workload indicators.
Cardiotoxicity of Palladium Compounds / Kardiotoksičnost Jedinjenja Paladijuma
Authors: Perić Tanja S. , Janković Slobodan M.
Published: June 2012

Previous studies have shown that palladium has toxic effects on the kidney and liver, leads to deterioration of the general condition of animals, and could cause allergy in animals and humans. Considering the limited data about the influence of palladium on the cardiovascular system, the aim of our study was to evaluate the effects of palladium on the heart from available published data, and to compare the toxicity of inorganic and organic palladium compounds. Relevant studies for our review were identified from PubMed and Scopus databases. The search terms included »palladium «, »palladium compound«, »cardiotoxicity«, »toxicity«, »heart«, »myocardium«, »oxidative stress« and »myocardial enzyme«, as well as combinations of these terms. There were only two published studies with the primary purpose to investigate the effect of palladium on the cardiovascular system, while others registered the side-effects of palladium compounds on the heart. Palladium could cause arrhythmias, a drop in blood pressure, decrease of the heart rate, as well as death of experimental animals. Based on the presented data it seems that palladium does not express significant cardiac toxicity when it is bound in an organic compound. Further investigation of the effects of palladium on the heart is necessary for a clear picture of the nature and extent of its cardiac toxicity.
Effects of Erythropoietin on the Serum and Liver Tissue Levels of Copper and Zinc in Rats with Obstructive Jaundice / Efekti Eritropoetina Na Nivoe Bakra I Cinka U Serumu I Tkivima Jetre Kod Pacova Sa Opstruktivnom Žuticom
Authors: Aliosmanoglu Ibrahim , Kapan Murat , Gul Mesut , Arikanoglu Zulfu , Onder Akin , Taskesen Fatih , Basarili Mustafa Kemal
Published: June 2012

Background: Erythropoietin is an anti-apoptotic, anti-inflammatory, angiogenetic cytokine and has protective properties against oxidative stress. In this study we investigated the effects of erythropoietin on the levels (serum and liver tissue) of copper and zinc in cholestatic rats.

Methods: Thirty-two Wistar albino rats used in the study were divided into four groups - Group I: Sham; Group II: Erythropoietin; Group III: Obstructive Jaundice; Group IV: Obstructive Jaundice+Erythropoietin. After the first operation, rats were followed up for seven days and then operated for the second time. Rats were sacrificed by intracardiac blood taking, and the liver tissue samples were obtained immediately.

Results: Erythropoietin reduces copper, and increases zinc levels in serum and liver tissues after obstructive jaundice (p<0.05). Furthermore, it has been shown that the levels of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, alkaline phosphatase and total bilirubin/direct bilirubin were significantly lower in Obstructive Jaundice+Erythropoietin group than Obstructive Jaundice group.

Conclusions: Erythropoietin affects the changes in copper and zinc levels, thus decreasing the liver damage biochemically in rats with obstructive jaundice. However, further investigations are needed to discover how erythropoietin therapy might reduce target organ damage in cholestatic liver cases by affecting copper and zinc levels.
Editorial
Authors: Kostrzewski Andrzej , Stryjakiewicz Tadeusz
Published: June 2012

Editorial
Women's Body Consciousness and Political Ideologies in Finnish Exercise Culture
Authors: Sarje Aino
Published: June 2012

Women's Body Consciousness and Political Ideologies in Finnish Exercise Culture

For over one hundred years, women's gymnastics has been one of the most popular sports in the Nordic countries. In the article, two styles of Finnish women's gymnastics will be studied. Of them, the former one was in use from the beginning of the 1900s, and the latter one from the 1930s on. In the article, it will be analyzed, how each style of gymnastics, with the rhythm and spatiality of its movements, has created a model of how the gymnasts have been in time, and in space. In the same time, by exercising the gymnasts have generated and maintained ideas about the use of space and time in social circumstances, in their normal life. This way, gymnastics has been an institution and a form of activity, which has created and maintained values and norms concerning not only the bodies but the personalities of the gymnasts, as well.
Physical Activity and Sedentary Behaviour as Predictors of Adolescent Health in Rural and Urban Environments in Poland
Authors: Tabak Izabela , Oblacińska Anna , Jodkowska Maria
Published: June 2012

Physical Activity and Sedentary Behaviour as Predictors of Adolescent Health in Rural and Urban Environments in Poland

While numerous studies have examined correlates of physical activity, less attention has been given to identifying the rural/urban differences in the strength of the relationship between physical activity and health. The main objective of the current study was to analyze relationships between physical activity, sedentary behavior, and the health of rural and urban adolescents. Cross-sectional data on physical activity (Moderate-to-Vigorous Physical Activity, MVPA), sedentary behavior (watching TV and using a computer), self-rated general health, and mental health (General Health Questionnaire, GHQ-12) was assessed through a questionnaire in the sample of 600 Polish adolescents aged 13 years. Pearson χ2, t-Student tests and hierarchical regression analyses were used to compare differences by place of residence. No rural/urban differences in physical activity levels and self-rated health were found. Rural boys spent more time watching TV and urban adolescent males spent more time using a computer. Urban girls were more affected by stress than rural. Physical activity was an important predictor of self-assessed health (8% of variance) and mental health (4% of variance) of adolescents living in rural areas. The results show that physical activity level is an important predictor of rural adolescents’ health and particular attention must be paid to promoting physical activities in rural environments.
Philosophy of Sport in Poland: Observations
Authors: Kosiewicz Jerzy
Published: June 2012

Philosophy of Sport in Poland: Observations

The presented paper has a polemic and an explanatory nature. It refers to some of the inaccuracies contained in the text authored by Ivo Jirásek and Peter Hopsicker. The aforementioned authors presented the achievements of various prominent philosophers of sport from Slavic countries, including the achievements of some Polish thinkers. My observations are focused mainly on issues related to the birth and development of the philosophy of sport in Poland. I would like to thank Professor Ivo Jirásek and Professor Peter Hopsicker for addressing the topic of Polish philosophy and for their research efforts. I also would like to ask the authors to receive my comments with the good intentions with which I composed them, and hope my comments may enrich their cognitive project.
The effects of particulate matter air pollution on respiratory health and on the cardiovascular system
Authors: Pražnikar Zala , Pražnikar Jure
Published: June 2012

The effects of particulate matter air pollution on respiratory health and on the cardiovascular system

Particulate matter (PM) is a major component of urban air pollution and has a significant effect on human health. Natural PM sources are volcanic eruptions, dust storms, forest and grassland fires, living vegetation and sea spray. Traffic, domestic heating, power plants and various industrial processes generate significant amounts of anthropogenic PM. PM consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. The chemical composition of particles is very complex and depends on emission sources, meteorological conditions and their aerodynamic diameter. Several epidemiological studies have demonstrated that exposure to PM of varying size fractions is associated with an increased risk of respiratory and cardiovascular diseases. Adverse health effects have been documented from studies of both acute and chronic exposure. The most severe effects in terms of overall health burden include a significant reduction in life expectancy by a several months for the average population, which is linked to long-term exposure to moderate concentrations of PM. Nevertheless, numerous deaths and serious cardiovascular and respiratory problems have also been attributed to short-term exposure to peak levels of PM. Although many studies attribute greater toxicity to smaller size fractions, which are able to penetrate deeper into the lung, the molecular mechanisms and the size fractions of the PM that are responsible for the observed diseases are not completely understood.
No Dishonour to Be a Pirate: The Problem of Infinite Advantage in Defoe's Captain Singleton
Authors: Wear Jeremy
Published: June 2012

In Captain Singleton (1720), Daniel Defoe rehearses the ethical and discursive justifications of predatory capitalism. Through an examination of Defoe's economic writings, I illustrate how the author confronts readers with the moral ambiguity of legal trade by comparing the “litteral” pirate Singleton with the “allegorical” pirates of London's central economic institutions. Through this comparison, Defoe places legal trade on an uncertain continuum with piracy. By extension, he explores the problematic necessity of reconciling the hero-outlaw Singleton's piracy to conceptions of national identity predicated on economic expansionism. Defoe suggests this reconciliation is best achieved by understanding trade in terms of “infinite advantage.” This article contextualizes “infinite advantage” as an imaginative projection onto the world of the conditions necessary to sustain infinite trade, and argues that Singleton appropriates this ideology to palliate fears of Hobbesian scarcity. Thus, the novel examines the conditions of scarcity that precipitate predatory trade practices alongside the fantasy of economic infinitude that would make these practices obsolete.
Du roman au drame: Grandison et Le Fils naturel
Authors: Charles Shelly
Published: June 2012

S'appuyant sur une nouvelle chronologie des lectures richardsoniennes de Diderot, l'article fait l'hypothèse d'une influence précoce de l'Histoire de Sir Charles Grandison sur la conception du drame diderotien. Avec son rendu minutieux du dialogue rompu et de la pantomime expressive, avec sa gestion complexe des plans scéniques, Grandison, lu dans la traduction littérale complète de Gaspard-Joël Monod, fournit à Diderot le modèle d'une nouvelle esthétique dont l'adaptation servirait à régénérer un théâtre sclérosé. Avant d'examiner cette présence du modèle dramaturgique richardsonien dans l'«espèce de roman» formé par Le Fils naturel et les Entretiens, l'article propose une étude approfondie de l'intertexte du Fils naturel. La célèbre réécriture par Diderot d'Il vero amico est ainsi revisitée et expliquée à partir de la compatibilité de l'intrigue goldonienne avec celle du dernier roman de Richardson, œuvre «barbare» dont il s'agissait de retenir la leçon tout en la réduisant aux dimensions d'une pièce respectant «les lois des trois unités».
Roderick Random, Literacy, and the Appropriation of Plebeian Culture
Authors: Thorn Jennifer
Published: June 2012

This article characterizes Tobias Smollett's Roderick Random (1748) in terms of a specifically mid-eighteenth-century ambivalence about polite literacy and progress that both precludes its reading as a Bildungsroman and limits the utility of modelling the novel as an agent of empire. Though the preface and ending of the novel affirm traditional hierarchy, the digressive and peripatetic middle values such plebeian virtues in the protagonist as loyalty, righteous opposition to injustice, and manly competence, which are formal elements resembling such popular chapbook romances as Jack the Giant-Killer. Particularly significant are both the novel's portrait of Roderick's defiantly and virtuously impolite childhood and the depiction of maritime life as an alternative to the corruption and snobbishness of land-bound life, an alternate ethos that is complicated by its facilitation of the slave-trading that ultimately enables the Great House fantasy with which the novel concludes.
A Policy at the University of Adelaide for Student Objections to the Use of Animals in Teaching
Authors: Whittaker Alexandra L. , Anderson Gail I.
Published: June 2012

In veterinary medical education, the use of animals or cadaveric tissue as a component of teaching practice is common. Teachers are required, during the process of ethical review, to apply the 3 Rs principle (replacement, refinement, reduction) whenever they consider using animals during a teaching exercise. This often involves use of replacement strategies, such as utilization of video footage or simulation-based training. However, aside from legislative or ethical requirements imposed by a country's regulatory framework on the institution, students are often the key advocates for using alternative teaching practices that do not make use of animals. This has prompted many institutions with veterinary and other life sciences teaching programs to develop student-conscientious objection policies to the use of animals in teaching. In this article, we discuss the procedures implemented to make provision for student-conscientious objectors at a new Australian Veterinary School, at the University of Adelaide. We also describe the processes to provide information to students and faculty on this issue and to facilitate information gathering on alternatives.
Consensus definitions of complications for accurate recording and comparisons of surgical outcomes in pediatric neurosurgery
Authors: Drake James M. , Singhal Ash , Kulkarni Abhaya V. , DeVeber Gabrielle , Cochrane D. Douglas , _ _
Published: June 2012

Object

Monitoring and recording of complications in pediatric neurosurgery are important for quality assurance and in particular for improving outcomes. Lack of accurate or mutually agreed upon definitions hampers this process and makes comparisons between centers, which is an important method to improve outcomes, difficult. Therefore, the Canadian Pediatric Neurosurgery Study Group created definitions of complications in pediatric neurosurgery with consensus among 13 Canadian pediatric neurosurgical centers.

Methods

Definitions of complications were extracted from randomized trials, prospective data collection studies, and the medical literature. The definitions were presented at an annual meeting and were subsequently recirculated for anonymous comment and revision, assembled by a third party, and re-presented to the group for consensus.

Results

Widely used definitions of shunt failure were extracted from previous randomized trials and prospective studies. Definitions for wound infections were extracted from the definitions from the Centers for Disease Control and Prevention. Postoperative neurological deficits were based on the Pediatric Stroke Outcome Measure. Other definitions were created and modified by consensus. These definitions are now currently in use across the Canadian Pediatric Neurosurgery Study Group centers in Morbidity and Mortality data collection and for subsequent comparison studies.

Conclusions

Coming up with consensus definitions of complications in pediatric neurosurgery is a first step in improving the quality of outcomes. It is a dynamic process, and further refinements are anticipated. Center to center comparison will hopefully allow significant variations in outcomes to be identified and acted upon.
Leo Max Davidoff: his formative years and participation in the MacMillan Arctic Expedition
Authors: Wisoff Hugh S.
Published: June 2012

Leo Max Davidoff was one of the outstanding students of Harvey Cushing, who helped create the discipline of modern neurological surgery. In his own right, Dr. Davidoff was a pioneer who made significant contributions both in neurosurgery and neuroradiology. He also helped to found the Albert Einstein College of Medicine of Yeshiva University. This paper describes his early life and education, together with his participation in the MacMillan Arctic Expedition of 1925.
Limitations of fetal ultrasonography and magnetic resonance imaging in prenatal diagnosis of congenital cerebral arteriovenous malformations with hemorrhagic onset
Authors: Eguchi Seiichiro , Aihara Yasuo , Yamaguchi Kohji , Okada Yoshikazu
Published: June 2012

A fetus at 30 gestational weeks was observed on fetal ultrasonography to have a dilated right lateral ventricle. After delivery, the entity was diagnosed as a prenatal intracerebral hemorrhage (ICH) due to a ruptured arteriovenous malformation (AVM). Ultrasonography and MRI examinations performed before birth indicated a cerebral aneurysm in the territory of the right middle cerebral artery. However, digital subtraction angiography revealed an intracystic hemorrhage due to a ruptured cerebral AVM.

Arteriovenous malformations in children are rare, difficult to diagnose, and result in permanent sequelae after delayed treatment. Patient prognosis depends on early and accurate diagnosis and intervention. Outcomes can be improved if an AVM in a child is detected at the onset of ICH for young infants in the prenatal or early postnatal periods. Early AVM diagnosis is limited to fetal ultrasonography and MRI, and special consideration through invasive examination including neonatal digital subtraction angiography is urged unless a correct and clear diagnosis is made at an early stage. Prenatal ICH due to an AVM is rare. The authors discuss their observations and findings.
Surgical decompression of thoracic spinal stenosis in achondroplasia: indication and outcome
Authors: Vleggeert-Lankamp Carmen , Peul Wilco
Published: June 2012

Object

The achondroplastic spinal canal is narrow due to short pedicles and a small interpedicular distance. Compression of neural structures passing through this canal is therefore regularly encountered but rarely described. Symptomatology, radiological evaluation, and treatment of 20 patients with achondroplasia who underwent decompression of the thoracic spinal cord are described and outcome is correlated with the size of the spinal canal and the thoracolumbar kyphotic angle.

Methods

Scores from the modified Japanese Orthopaedic Association scale, Nurick scale, European Myelopathy scale, Cooper myelopathy scale for lower extremities, and Odom criteria before and after surgery were compared. Magnetic resonance imaging was evaluated to determine the size of the spinal canal, spinal cord compression, and presence of myelomalacia. The thoracolumbar kyphotic angle was measured using fluoroscopy.

Results

Patient symptomatology included deterioration of walking pattern, pain, cramps, spasms, and incontinence. Magnetic resonance images of all patients demonstrated spinal cord compression due to degenerative changes. Surgery resulted in a slight improvement on all the ranking scales. Surgery at the wrong level occurred in 15% of cases, but no serious complications occurred. The mean thoracolumbar kyphotic angle was 20°, and no correlation was established between this angle and outcome after surgery. No postoperative increase in this angle was reported. There was also no correlation between size of the spinal canal and outcome.

Conclusions

Decompressive surgery of the thoracic spinal cord in patients with achondroplasia can be performed safely if anatomical details are taken into consideration. Spondylodesis did not appear essential. Special attention should be given to the method of surgery, identification of the level of interest, and follow-up of the thoracolumbar kyphotic angle.