bluuebunny/crossref_metadata_2025_split huggingface dataset:
New-Onset Diabetes after Renal Transplantation
Authors: Mora Pablo F. 
Published: May 2016

Transplantation medicine has grown to be an important element of medical practice, and with the development of modern immunosuppression agents and protocols, the occurrence of diabetes as renal transplantation is recognized as one of the metabolic consequences of therapy with these agents. New-onset diabetes after transplantation can be defined as diabetes mellitus developing in any patient without history of diabetes before transplantation, who has sustained hyperglycemia that meets the current diagnostic criteria by the American Diabetes Association or by the World Health Organization. New-onset diabetes after transplantation has been associated with the following risk factors: age, non-white ethnicity, hepatitis C infection, glucocorticoid therapy for rejection, and chronic immunosuppression with cyclosporine and tacrolimus. The observation that current immunosuppression using tacrolimus is one of the most important single risk factor for the development of new-onset diabetes after transplantation has been made. The pathophysiology of this condition resembles that of type 2 diabetes mellitus. There is conclusive evidence that pretransplantation end-stage renal disease is an insulin-resistant state, and after transplantation, glucocorticoids induce further peripheral insulin insensitivity. The “second hit” seems to be an acquired (yet reversible) insulin secretion defect caused by the calcineurin inhibitors cyclosporine but more pronounced with tacrolimus. Future directions include pretransplantation and posttransplantation testing using glucose measurements and other techniques to identify high-risk individuals and possibly develop treatment strategies aimed to modify insulin resistance as well as to preserve beta cell function.
Carotid Intima-Media Thickness and Stiffness are Independent Risk Factors for Atherosclerotic Diseases
Authors: Tu Shih-Te , Wang I-Wen , Lin Hsiu-Fen , Liao Yi-Chu , Lin Ruey-Tay , Liu Chin-San , Juo SHH 
Published: May 2016

Objective We assessed the correlation between intima-media thickness (IMT) and stiffness and test whether they are independent risk factors for atherosclerotic diseases. Methods We enrolled 2333 participants from the general population. Among the study subjects, 197 subjects had a history of stroke or myocardial infarction (MI) and were treated as patients, and the rest were the control subjects. Intima-media thickness was measured at the common carotid artery (CCA), bifurcation, and internal carotid artery. Three parameters (arterial stiffness [β], elastic modulus, and pulse wave velocity) were measured for carotid stiffness. Correlation between IMT and stiffness was first calculated. Multivariate regression model was used to evaluate whether inclusion of both IMT and stiffness can increase the prediction of cardiovascular events. Results Only CCA and bifurcation IMTs were significantly and positively correlated with stiffness. After adjusting for age and sex, the correlations were substantially attenuated. Common carotid artery IMT was most significantly associated with stroke and MI ( P = 2.6 × 10−8) followed by bifurcation IMT ( P = 5.5 × 10−6), and internal carotid artery IMT was least significant ( P = 0.02). For stiffness, β was most significant ( P = 3.6 × 10−8) for stroke and MI, followed by elastic modulus ( P = 1.1 × 10−6) and pulse wave velocity ( P = 6.8 × 10−6). The best model for the combined effect was from β ( P < 0.03) and CCA ( P = 0.056) or bifurcation IMT ( P = 0.057). Conclusions Carotid IMT and stiffness represent different properties of atherosclerotic vessel wall. Measuring both traits provides a better characterization of atherosclerosis.
The Highs and Lows of Maternal Depression: Cluster Analysis of Depression Symptoms in a Sample of African American Women
Authors: Ronzio Cynthia R. , Mitchell Stephanie J. 
Published: May 2016

Background Maternal depression affects between 10% and 15% of US mothers. Emerging evidence suggests that variability in symptoms is linked to different risk factors and different pathological subtypes. Building on this research, this study examines manifestations of depression symptoms and risk factors associated with different manifestations among a socioeconomically heterogeneous sample of African American mothers. Methods Data were collected via telephone interviews with a community sample of 208 self-identified African American women with children 2 to 18 months old. Mothers were screened for depression symptoms using the Center for Epidemiological Studies Depression scale and reported on several psychosocial factors including social support, history of depression, and demographic characteristics. Cluster analysis was used to determine whether there were distinct subtypes of depression symptoms in this sample. Results A k-means cluster analysis of the 57 women with a positive depression symptom screen revealed 2 distinct groups characterized by higher versus lower symptom severity. A logistic regression indicated that mothers were more likely to fall into the high severity cluster if they were employed and reported lower levels of social support. Limitations Because of its cross-sectional design, this study could not explore the timing and the course of depression symptoms, which may be more closely related to risk and functional impairment than the severity distinction found in this research. Conclusions Researchers, pediatricians, and obstetricians working with African American mothers should screen for social support, with the understanding that those with low levels may be at increased risk for severe depression symptoms. Finally, the heterogeneity in symptoms suggests that clinicians should be aware of all depression symptoms among their patients rather than looking for specific, potentially stereotypical symptoms as cues.
Infliximab Reduces the Frequency of Interleukin 17-Producing Cells and the Amounts of Interleukin 17 in Patients with Rheumatoid Arthritis
Authors: Shen Hui , Xia Liping , Lu Jing , Xiao Weiguo 
Published: May 2016

Background To detect frequency changes in interleukin 17 (IL-17)+ CD4+ T cells and the amounts of IL-17 in supernatants between baseline and 30 weeks after Infliximab combined with methotrexate (MTX) or MTX-alone therapy. Methods Flow cytometry was used to analyze the frequency of IL-17+ CD4+ T cells in rheumatoid arthritis (RA) patients and control subjects at baseline and 30 weeks after therapy. Secretion of IL-17 by peripheral blood mononuclear cells was measured by enzyme-linked immunosorbent assay. Results The percentages of IL-17+ CD4+T cells were increased in the peripheral blood mononuclear cells of patients with RA compared with healthy subjects. The percentages of IL-17+ CD4+T cells were correlated with the number of swelling joints and C-reactive protein of RA patients. Likewise, concentrations of IL-17 in supernatants from patients with RA were significantly higher compared with those from control subjects. After infliximab combined with MTX or MTX-alone therapy, the number of swelling joints, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and Disease Activity Score 28 decreased significantly compared with baseline. Only in the infliximab + MTX group that the frequency of TH17 cells and concentration of IL-17 decreased. Conclusions These data support the hypothesis that infliximab therapy can have an effect on TH17 cells and decrease disease activity.
Design of a Bioartificial Pancreas
Authors: Opara Emmanuel C. , Mirmalek-Sani Sayed-Hadi , Khanna Omaditya , Moya Monica L. , Brey Eric M. 
Published: May 2016

Introduction In type 1 diabetes, the β-cells that secrete insulin have been destroyed such that daily exogenous insulin administration is required for the control of blood glucose in individuals with the disease. After the development of reliable techniques for the isolation of islets from the human pancreas, islet transplantation has emerged as a therapeutic option, albeit for only a few selected patients largely because there are not enough islets for the millions of patients requiring the treatment, and there is also the need to use immunosuppressive drugs to prevent transplant rejection. In 1980, the concept of islet immunoisolation by microencapsulation was introduced as a technique to overcome these 2 major barriers to islet transplantation. Microencapsulation of islets and transplantation in the peritoneal cavity was then described as a bioartificial pancreas. However, it is difficult to retrieve encapsulated islets transplanted in the peritoneal cavity, thus making it difficult to meet all the criteria for a bioartificial pancreas. A new design of a bioartificial pancreas comprising islets co-encapsulated with angiogenic protein in permselective multilayer alginate-poly-L-ornithine-alginate microcapsules and transplanted in an omentum pouch is described in this paper. Materials and Methods The multilayer alginate-poly-L-ornithine-alginate microcapsules are made with ultrapure alginate using poly-L-ornithine as a semipermeable membrane separating the 2 alginate layers. The inner alginate layer is used to encapsulate the islets, and the outer layer is used to encapsulate angiogenic protein, which would induce neovascularization around the graft within the omentum pouch. Results In in vitro studies, we found that both the wild-type and the heparin-binding growth-associated molecule (HBGAM)-fibroblast growth factor-1 chimera can be encapsulated and released in a controlled and sustained manner from the outer alginate layer with a mean diameter in the range of 113 to 164 µm when 1.25% high guluronic acid alginate is used to formulate this outer layer. Discussion We are currently performing in vivo experiments to determine the ability of angiogenic proteins released from this outer layer to induce neovascularization around the grafts in the omentum pouch. We will subsequently examine the effect of co-encapsulation of islets with angiogenic protein on blood glucose control in diabetic animals. It is hoped that addition of tissue engineering to encapsulated islet transplantation will result in long-term survival of the islets and their ability to control blood glucose in type 1 diabetes without the necessity to use risky immunosuppressive drugs to prevent transplant rejection.
Airway Platelet Activation is Associated with Airway Eosinophilic Inflammation in Asthma
Authors: Benton Angela S. , Kumar Nikila , Lerner Jennifer , Wiles Andrew A. , Foerster Matthew , Teach Stephen J. , Freishtat Robert J. 
Published: May 2016

Background Allergic asthma is characterized by airway inflammation associated with recruitment and activation of eosinophils. In mice, allergen exposure induces platelet migration to the airways that is necessary for eosinophil recruitment and activation. We therefore hypothesized that in the airways of human subjects with asthma, platelet activation would be positively associated with eosinophil activation and platelet and eosinophil activation would both be associated with clinical asthma characteristics. Methods Nasal wash levels of P-selectin (a measure of platelet activation) and eosinophil cationic protein (ECP) (a measure of eosinophil activation) were compared with each other and with clinical asthma characteristics in a cross-sectional study of urban children and adolescents (age range, 6-20 years) with asthma. Results Regression analysis revealed a significantly positive association between log10 P-selectin levels and log10 ECP levels (β = 0.50 ng/mL [95% confidence interval, 0.05-0.94 ng/mL]; P = 0.029). Additionally, ECP was significantly and negatively associated with 2 asthma-related quality of life measurements, and P-selectin was associated with one of these. Conclusions Our study shows the first significant association between platelet and eosinophil activation in airways of human subjects with asthma. These data provide a first step toward delineating what seems to be an important role for platelets in airway eosinophilia.
Age, Sex, and Ethnicity May Modify the Influence of Obesity on Inflammation
Authors: Laurson Kelly R. , McCann Dustin A. , Senchina David S. 
Published: May 2016

Objectives Many medical concerns associated with obesity are due to chronic inflammation, but factors underlying the development or maintenance of obesity-associated inflammation remain unclear. This study investigated how age, sex, and ethnicity may modify the interplay of subclinical inflammation and obesity in nationally representative contexts. Methods Using National Health and Nutrition Examination Survey data from 1999 to 2008, we assessed the role of these demographic factors on immunological markers of subclinical inflammation (such as total white blood cell counts, white blood cell subpopulation counts, and C-reactive protein [CRP] levels) in both obese and nonobese individuals. Approximately 9756 individuals were included in the analysis after removing individuals with confounding conditions. Results The CRP levels, total white blood cell count, and white blood cell subpopulation counts increased with increasing body mass index (BMI). After controlling for BMI, female subjects had greater levels of most inflammatory markers compared with male subjects. After controlling for age, sex, and ethnicity, the following inflammatory markers significantly increased with increasing BMI: CRP and white blood cell, lymphocyte, monocyte, and neutrophil counts. Basophil and eosinophil counts also increased with increasing BMI but not significantly. Conclusions Factors, such as age, sex, and ethnicity, may modify the influence of obesity on subclinical inflammation at the population level.
Assessment of Atrial Conduction Time in Patients with Sarcoidosis
Authors: Buyukoglan Hakan , Kaya Mehmet Gungor , Ardic Idris , Yarlioglues Mikail , Dogdu Orhan , Bol Canan , Sahin Omer , Kanbay Asiye , Koç Fatih , Ozdogru Ibrahim 
Published: May 2016

Objectives Sarcoidosis is an inflammatory granulomatous disease of unknown cause that involves multiple organ systems. Myocardial involvement is usually associated with poor prognosis, but diagnosis of cardiac sarcoidosis is frequently difficult. The aim of this study was to investigate the atrial conduction time in patients with sarcoidosis by using high-usefulness tissue Doppler echocardiography. Methods The study population included 49 patients with sarcoidosis (19 men; mean age, 40.5 ± 9.8 years; mean disease duration, 35.7 ± 15.3 months) and 45 healthy control subjects (17 men; mean age, 40.7 ± 7.2 years). From the 12-lead electrocardiogram, P wave dispersion (PWD) was calculated. The timing of atrial contractions (PA) was measured as the intervals between the onset of P wave on electrocardiogram and the beginning of A-wave on TDI, and atrial electromechanical delay (EMD) was calculated from the lateral (PA lateral) and septal (PA septal) mitral annulus and lateral tricuspid annulus (PA tricuspid). Results Both PA lateral and PA septal were significantly longer in patients with sarcoidosis than control subjects (67.9 ± 16.1 vs 56.3 ± 13.1, P < 0.001; and 54.8 ± 15.2 vs 45.1 ± 14.2 ms, P = 0.002, respectively). Intra-atrial (PA septal-PA tricuspid) and interatrial (PA lateral-PA tricuspid) EMD were significantly higher in sarcoidosis groups (12.6 ± 7.5 vs 8.0 ± 7.1, P = 0.003; and 25.7 ± 9.8 vs 19.3 ± 7.7 ms, P = 0.001, respectively). Similarly, maximum P-wave duration and PWD were significantly longer in patients with sarcoidosis than control subjects (105.2 ± 11.8 vs 96.7 ± 15.4, P = 0.004 and 24.7 ± 5.6 vs 19.7 ± 7.1 ms, P = 0.001, respectively). There were significant positive correlations between the disease duration and interatrial EMD ( r = 0.56, P < 0.001) and intra-atrial EMD ( r = 0.66, P < 0.001). Positive correlation also was present between the disease duration and PWD ( r = .62, P < 0.001). Conclusions Atrial EMD was found prolonged in patients with sarcoidosis. We also have demonstrated that PWD, interatrial and intra-atrial EMD were significantly correlated with disease duration. This study calls attention to measurement of atrial conduction time that may be clinically helpful in the recognition of cardiac involvement.
Comparison of Characteristics and Outcomes of Patients Undergoing Saphenous Vein Graft Stenting who were or were not Enrolled in the Stenting of Saphenous Vein Grafts Randomized Controlled Trial
Authors: Michael Tesfaldet T. , Badhey Neeraj , Banerjee Subhash , Brilakis Emmanouil S. 
Published: May 2016

Objective We sought to compare the characteristics and outcomes of patients who were enrolled versus those who were not enrolled in the Stenting of Saphenous Vein Grafts (SOS) randomized controlled trial. Methods and Results We identified all patients who underwent saphenous vein graft stenting during the SOS Trial enrollment period (May 2005 and October 2007) at our institution. Baseline characteristics and clinical outcomes were compared between patients who were versus those who were not enrolled in SOS. Of the 97 patients who underwent saphenous vein graft stenting during the study period, 62 patients (64%) were enrolled in SOS. In the enrolled group, 62 patients with 91 lesions were randomized to a bare metal stent (BMS) (n = 39) or paclitaxel-eluting stent (n = 41). In the nonenrolled group, 35 patients with 44 lesions received a drug-eluting stent (DES) (n = 27) or BMS (n = 8). During a median follow-up period of 2.66 years, nonenrolled patients had higher mortality (31.4% vs 14.5%, P = 0.039), but lower rates of myocardial infarction (5.7% vs 32.3%, P = 0.005) and target vessel failure (37% vs 61.3%, P = 0.023). Overall, patients who received DES had lower incidence of myocardial infarction, target lesion revascularization, target vessel failure and major adverse cardiac events, and similar mortality compared with the BMS group. Conclusions Compared with nonenrolled patients, those who were enrolled in SOS had lower mortality. Patients receiving DES had better outcomes than those receiving BMS in both groups.
Telmisartan Improves Insulin Resistance in Patients with Low Cytokine Levels
Authors: Sanchez Muñoz-Torrero Juan Francisco , Rivas Maria D. , Costo Alberto , Crespo Leandro , Fraile Juana , Doncel Carlos , Fernandez Toro Jose Maria , Zamorano Jose 
Published: May 2016

Metabolic syndrome (MS) is a disease with an inflammatory component. Telmisartan improves insulin resistance in MS, but its relationship with the inflammatory state is unknown. We investigated the effect of 3-month telmisartan therapy on homeostatic model assessment-insulin resistance (HOMA-IR) in hypertensive subjects with MS with regard to the levels of circulating plasma cytokines. Methods A total of 42 patients were included in this study; 30 were men (71%), aged 50 ± 8.2 years (mean ± SD). Cytokines and metabolic parameters were analyzed before and after treatment with telmisartan. Results Twenty-eight patients showed low plasma levels of cytokines (group 1) similar to control subjects, and 14 showed high levels (group 2). Treatment with telmisartan diminished by 35% HOMA-IR in group 1 (4.5 ± 3.1 vs 2.9 ± 2.1), without improvement in group 2. In the multivariate analysis, the predictors of improvement of HOMA-IR in response to telmisartan treatment were low levels of cytokines, whereas systolic and diastolic blood pressure and the elevation of high-sensitivity C-reactive protein had a negative effect. Conclusions Our study provides evidence of a more favorable effect of telmisartan on glucose homeostasis in patients with MS and low levels of serum cytokines.
Increased Platelet and Erythrocyte Arginase Activity in Chronic Obstructive Pulmonary Disease Associated with Tobacco or Wood Smoke Exposure
Authors: Guzmán-Grenfell Alberto , Nieto-Velázquez Nayeli , Torres-Ramos Yessica , Montoya-Estrada Araceli , Ramírez-Venegas Alejandra , Ochoa-Cautiño Leticia , Flores-Trujillo Fernando , Hicks Juan José 
Published: May 2016

Background Chronic obstructive pulmonary disease (COPD) is an inflammatory disease that is characterized by a progressive and irreversible decline in lung function and is caused primarily by chronic exposure to tobacco and to wood smoke. It is linked to oxidative stress and to an up-regulation of airway arginases and is also associated with alterations in platelets and erythrocytes. In the present study, arginase activity was studied in platelets and erythrocytes of 2 groups of COPD patients: 31 tobacco ex-smokers and 27 patients who had been exposed to wood smoke. A total of 15 healthy controls were also included. Methods Plasma, platelets, and erythrocytes were obtained from the blood samples. Levels of the oxidative stress biomarkers, carbonyls and malondialdehyde, were measured in the plasma, and arginase activity was quantified in platelets and erythrocytes. Results In both groups of COPD patients, an increase in the oxidative stress biomarkers was found. Platelet arginase activity in both COPD groups was 2-fold higher than that in the control group. In the erythrocytes, the arginase activity increased 1.7-fold over the control only in the wood smoke-induced COPD group. Discussion and Conclusions These results suggest that the increase in arginase activity in platelets and erythrocytes participates in the alteration in nitric oxide metabolism in COPD patients and that there may be some differences between the tobacco smoke- and wood smoke-induced COPD.
Relationship of the Protein Z Intron F G79A and IL6 C634G Gene Polymorphisms with the Risk of Recurrent Pregnancy Loss in Egyptian Women
Authors: El-Hamid Samah Abd , El-Khayat Waleed 
Published: May 2016

Purpose To investigate the relationship between recurrent pregnancy loss and single nucleotide polymorphisms in the protein Z (PZ) intron F G79A and the promoter region of the IL6 C634G genes in Egyptian women. Procedures Single nucleotide polymorphisms in the PZ intron F G79A gene and the promoter region of the IL6 C634G gene were studied in 70 Egyptian women; 40 patients and 30 healthy and parous volunteers using the polymerase chain reaction-restriction fragment length polymorphism technique. Results Regarding the PZ intron F G79A polymorphism; a higher prevalence of the A allele in the controls (53.3%) compared with the cases (22.5%) was found, and the difference proved to be statistically significant ( P = 0.008). As for the IL6 C634G polymorphism, the frequency of the G allele was higher in the controls (100%) than in the cases (95%), but the difference did not prove to be statistically significant ( P = 0.503). A statistically significant difference between the prevalence of the IL6 C634G (95%) and the PZ intron F G79A (22.5%) was detected ( P ≤ 0.001). Conclusion A statistically significant difference of the frequency of the A allele of the PZ intron F G79A polymorphism was found with a higher prevalence of the A allele among the controls compared with the patients, suggesting a lower risk of recurrent pregnancy loss among the studied patients, but the IL6 C634G polymorphism did not prove to have an equivalent effect.