bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired fasting pyloric compliance in gastroparesis and the therapeutic response to pyloric dilatation
Authors: Gourcerol G. , Tissier F. , Melchior C. , Touchais J. Y. , Huet E. , Prevost G. , Leroi A. M. , Ducrotte P. 
Published: December 2014

SummaryBackgroundPyloric pressure and compliance have never been investigated in health nor gastroparesis.AimWe hypothesised that pyloric pressure and/or compliance may be altered in gastroparesis.MethodsFasting pyloric pressure and compliance were investigated in 21 healthy volunteers (HV), 27 gastroparetic patients (GP) and 5 patients who had undergone oesophagectomy without pyloroplasty as positive controls. Under videofluoroscopic control, pyloric compliance and pressure were measured by the EndoFLIP technique. Gastric emptying half time (T1/2) using 13C–octanoic acid breath test, as well as symptoms and quality of life (GIQLI score) were also monitored.ResultsMean fasting pyloric compliance was measured at 25.2 ± 2.4 mm²/mmHg in HV, and was lower both in GP (16.9 ± 2.1 mm²/mmHg; P < 0.05) and patients with oesophagectomy (10.9 ± 2.9 mm²/mmHg; P < 0.05). By contrast, fasting pyloric pressure was not different among groups. Fasting pyloric compliance and pressure correlated with T1/2 in GP (R = −0.43; P = 0.04). Fasting pyloric compliance, but not pressure, correlated with symptoms and GIQLI score. Pyloric dilation in 10 GP with low fasting pyloric compliance (<10 mm²/mmHg) increased compliance from 7.4 ± 0.4 to 20.1 ± 4.9 mm²/mmHg (P < 0.01) and improved the GIQLI score from 72.5 ± 5.5 to 89.3 ± 6.1 (P = 0.04).ConclusionThis prospective study assessed pyloric compliance for the first time, and showed that fasting pyloric compliance is decreased in gastroparetic patients and is associated with T1/2, symptoms and quality of life. This suggests that pyloric compliance may be a new relevant metric in gastroparetic patients, and may be useful to target patients for pyloric dilation or botulinum toxin injection.
Comparison of systematic transrectal biopsy to transperineal magnetic resonance imaging/ultrasound‐fusion biopsy for the diagnosis of prostate cancer
Authors: Borkowetz Angelika , Platzek Ivan , Toma Marieta , Laniado Michael , Baretton Gustavo , Froehner Michael , Koch Rainer , Wirth Manfred , Zastrow Stefan 
Published: December 2014

ObjectivesTo compare targeted, transperineal magnetic resonance imaging (MRI)/ultrasound (US)‐fusion biopsy to systematic transrectal biopsy in patients with previous negative or first prostate biopsy and to evaluate the gain in diagnostic information with systematic biopsies in addition to targeted MRI/US‐fusion biopsies.Patients and MethodsIn all, 263 consecutive patients with suspicion of prostate cancer were investigated. All patients were evaluated by 3‐T multiparametric MRI (mpMRI) applying the European Society of Urogenital Radiology criteria. All patients underwent MRI/US‐fusion biopsy transperineally (mean nine cores) and additionally a systematic transrectal biopsy (mean 12 cores).ResultsIn all, 195 patients underwent repeat biopsy and 68 patients underwent first biopsy. The median age was 66 years, median PSA level was 8.3 ng/mL and median prostate volume was 50 mL. Overall, the prostate cancer detection rate was 52% (137/263). MRI/US‐fusion biopsy detected significantly more cancer than systematic prostate biopsy (44% [116/263] vs 35% [91/263]; P = 0.002). In repeat biopsy, the detection rate was 44% (85/195) in targeted and 32% (62/195) in systematic biopsy (P = 0.002). In first biopsy, the detection rate was 46% (31/68) in targeted and 43% (29/68) in systematic biopsy (P = 0.527). In all, 80% (110/137) of biopsy confirmed prostate cancers were clinically significant. For the upgrading of Gleason score, 44% (32/72) more clinically significant prostate cancer was detected by using additional targeted biopsy than by systematic biopsy alone. Conversely, 12% (10/94) more clinically significant cancer was found by systematic biopsy additionally to targeted biopsy.ConclusionsMRI/US‐fusion biopsy was associated with a higher detection rate of clinically significant prostate cancer while taking fewer cores, especially in patients with prior negative biopsy. Due to a high portion of additional tumours with Gleason score ≥7 detected in addition to targeted biopsy, systematic biopsy should still be performed additionally to targeted biopsy.
Patient experience and satisfaction with Onabotulinumtoxin A for refractory overactive bladder
Authors: Malde Sachin , Dowson Christopher , Fraser Olivia , Watkins Jane , Khan Muhammed S. , Dasgupta Prokar , Sahai Arun 
Published: December 2014

ObjectiveTo evaluate the patient experience of our dedicated botulinum toxin A (BTX‐A) service using a validated patient‐reported experience measure (PREM) and assess patient‐reported satisfaction with treatment.Materials and MethodsThe first 100 patients who underwent BTX‐A treatment for refractory idiopathic detrusor overactivity (IDO) in our institution were contacted for telephone interview. They had all been assessed, injected and followed up in a dedicated BTX‐A clinic. Patients were asked to complete a validated PREM – the Client Satisfaction Questionnaire (CSQ‐8) – as well as a questionnaire developed in our department to assess satisfaction with the results of the treatment. Most patients received 200 U OnabotulinumtoxinA (Botox®) via an outpatient local anaesthetic flexible cystoscopy technique.ResultsComplete data was available for 72 patients. In all, 49 patients were continuing to receive BTX‐A treatment while 23 had opted for no further injections. The overall mean (sd) CSQ‐8 satisfaction score was 38.3 (3.3), indicating a high level of patient satisfaction with the service offered in our institution. There was a significant difference in total satisfaction scores between those still receiving BTX‐A (mean score 29.8) and those who have discontinued treatment (mean score 25.1) (P < 0.01). Overall patient satisfaction with the result of the treatment was high with an overall mean (sd) score of 8.6 (2.0) on a visual analogue scale. Of those who had discontinued BTX‐A, most were either using conservative measures only (44%) or had recommenced anticholinergic medications.ConclusionOverall patient satisfaction with the dedicated BTX‐A service offered in our institution is high and can result in a positive patient experience. The use of PREMs are advocated in order to fully capture the patient's views of the quality of services and treatments they receive.
Pilomyxoid Astrocytoma (PMA) Shows Significant Differences in Gene Expression vs. Pilocytic Astrocytoma (PA) and Variable Tendency Toward Maturation to PA
Authors: Kleinschmidt‐DeMasters Bette K. , Donson Andrew M. , Vogel Hannes , Foreman Nicholas K. 
Published: December 2014

AbstractPilomyxoid astrocytomas (PMAs) manifest a more aggressive clinical course than pilocytic astrocytomas (PAs). Development of effective therapies demands a better biological understanding of PMA. We first conducted gene expression microarray analysis of 9 PMA and 13 PA from infra‐ and supratentorial sites. Unsupervised hierarchical clustering analysis demonstrated that tumors are grouped according to anatomic site, not diagnosis. Gene expression profiles were then contrasted between eight PMAs and six PAs, all supratentorial/hypothalamic/chiasmal. Clinical outcome of PMAs varied, with four out of four patients with diencephalic syndrome succumbing to disease, one of whom showed bulky metastatic leptomeningeal spread at autopsy, with bimodal maturation to PA in some areas and de‐differentiation to glioblastoma in others. A surviving child has undergone multiple surgical debulking, with progressive maturation to PA over time. Ontology‐enrichment analysis identified overexpression in PMAs of extracellular matrix and mitosis‐related genes. Genes overexpressed in PMA vs. PA, ranked according to fold‐change, included developmental genes H19, DACT2, extracellular matrix collagens (COL2A1; COL1A1) and IGF2BP3 (IMP3), the latter previously identified as an adverse prognostic factor in PMA and PA.
ZEB1 Promotes Invasion in Human Fetal Neural Stem Cells and Hypoxic Glioma Neurospheres
Authors: Kahlert Ulf D. , Suwala Abigail K. , Raabe Eric H. , Siebzehnrubl Florian A. , Suarez Maria J. , Orr Brent A. , Bar Eli E. , Maciaczyk Jaroslaw , Eberhart Charles G. 
Published: December 2014

AbstractDiffuse spread through brain parenchyma and the presence of hypoxic foci rimmed by neoplastic cells are two cardinal features of glioblastoma, and low oxygen is thought to drive movement of malignant gliomas in the core of the lesions. Transcription factors associated with epithelial‐to‐mesenchymal transition (EMT) have been linked to this invasion, and we found that hypoxia increased in vitro invasion up to fourfold in glioblastoma neurosphere lines and induced the expression of ZEB1. Immunohistochemical assessment of 295 surgical specimens consisting of various types of pediatric and adult brain cancers showed that ZEB1 expression was significantly higher in infiltrative lesions than less invasive tumors such as pilocytic astrocytoma and ependymoma. ZEB1 protein was also present in human fetal periventricular stem and progenitor cells and ZEB1 inhibition impaired migration of in vitro propagated human neural stem cells. The induction of ZEB1 protein in hypoxic glioblastoma neurospheres could be partially blocked by the HIF1alpha inhibitor digoxin. Targeting ZEB1 blocked hypoxia‐augmented invasion of glioblastoma cells in addition to slowing them in normoxia. These data support the role for ZEB1 in invasive and high‐grade brain tumors and suggest its key role in promoting invasion in the hypoxic tumor core as well as in the periphery.
Differential factors associated with challenge‐proven food allergy phenotypes in a population cohort of infants: a latent class analysis
Authors: Peters R. L. , Allen K. J. , Dharmage S. C. , Lodge C. J. , Koplin J. J. , Ponsonby A.‐L. , Wake M. , Lowe A. J. , Tang M. L. K. , Matheson M. C. , Gurrin L. C. ,   the HealthNuts study
Published: December 2014

SummaryBackgroundFood allergy, eczema and wheeze are early manifestations of allergic disease and commonly co‐occur in infancy although their interrelationship is not well understood. Data from population studies are essential to determine whether there are differential drivers of multi‐allergy phenotypes. We aimed to define phenotypes and risk factors of allergic disease using latent class analysis (LCA).MethodsThe HealthNuts study is a prospective, population‐based cohort of 5276 12‐month‐old infants in Melbourne, Australia. LCA was performed using the following baseline data collected at age 12 months: food sensitization (skin prick test ≥ 2 mm) and allergy (oral food challenge) to egg, peanut and sesame; early (< 4 months) and late‐onset eczema; and wheeze in the first year of life. Risk factors were modelled using multinomial logistic regression.ResultsFive distinct phenotypes were identified: no allergic disease (70%), non‐food‐sensitized eczema (16%), single egg allergy (9%), multiple food allergies (predominantly peanut) (3%) and multiple food allergies (predominantly egg) (2%). Compared to the baseline group of no allergic disease, shared risk factors for all allergic phenotypes were parents born overseas (particularly Asia), delayed introduction of egg, male gender (except for single egg allergy) and family history of allergic disease, whilst exposure to pet dogs was protective for all phenotypes. Other factors including filaggrin mutations, vitamin D and the presence of older siblings differed by phenotype.Conclusions and clinical relevanceMultiple outcomes in infancy can be used to determine five distinct allergy phenotypes at the population level, which have both shared and separate risk factors suggesting differential mechanisms of disease.
Three‐year experience with access to nationally funded growth hormone (GH) replacement for GH‐deficient adults
Authors: Holdaway I.M. , Hunt P. , Manning P. , Cutfield W. , Gamble G. , Ninow N. , Staples‐Moon D. , Moodie P. , Metcalfe S. 
Published: December 2014

SummaryObjectiveTreatment of growth hormone (GH)‐deficient adults with GH has been shown to improve a range of metabolic abnormalities and enhance quality of life. However, the results of access to nationally funded treatment have not been reported.DesignRetrospective case series auditing nationally funded treatment of defined GH‐deficient adults in New Zealand, with carefully designed entry and exit criteria overseen by a panel of endocrinologists.PatientsApplications for 201 patients were assessed and 191 approved for funded treatment over the initial 3 years since inception. The majority had GH deficiency following treatment of pituitary adenomas or tumours adjacent to the pituitary.ResultsAfter an initial 9‐month treatment period using serum IGF‐I measurements to adjust GH dosing, all patients reported a significant improvement in quality of life (QoL) score on the QoL‐AGHDA® instrument (baseline (95%CI) 19 (18–21), 9 months 6 (5–7·5)), and mean serum IGF‐I SD scores rose from ‐3 to zero. Mean waist circumference decreased significantly by 2·8 ± 0·6 cm. The mean maintenance GH dose after 9 months of treatment was 0·39 mg/day. After 3 years, 17% of patients had stopped treatment, and all of the remaining patients maintained the improvements seen at 9 months of treatment.ConclusionCarefully designed access to nationally funded GH replacement in GH‐deficient adults was associated with a significant improvement in quality of life over a 3‐year period with mean daily GH doses lower than in the majority of previously reported studies.
Cadmium delays puberty onset and testis growth in adolescents
Authors: Interdonato Monica , Pizzino Gabriele , Bitto Alessandra , Galfo Federica , Irrera Natasha , Mecchio Anna , Pallio Giovanni , Ramistella Vincenzo , Luca Filippo De , Santamaria Angelo , Minutoli Letteria , Marini Herbert , Squadrito Francesco , Altavilla Domenica 
Published: December 2014

SummaryObjectiveCadmium (Cd) has been shown to impair pubertal development in experimental animals. However, no data are available for male adolescents with increased urinary cadmium levels.DesignThe aim of this cross‐sectional study was to evaluate pubertal onset and pituitary–gonadal axis hormones in male adolescents with increased urinary levels of Cd.SubjectsWe studied 111 males, aged 12–14 years living in the Milazzo‐Valle del Mela area. A control age‐matched population (n = 60) living 28–45 km far from the industrial site was also enrolled.MeasurementsPubertal stages were assessed by clinical examination according to Tanner's score. Mean testicular volume was also investigated by ultrasound examination. Urinary Cd concentration and blood levels of FSH, LH, testosterone and inhibin B were also investigated.ResultsCd levels were significantly higher in adolescents living in the Milazzo‐Valle del Mela area, compared to both age‐matched subjects living far from the industrial plants and the reference values. Our population showed also a delayed onset of puberty, a smaller testicular volume and lower testosterone levels. An inverse correlation was found between urinary Cd and testicular volume (r = −0·25; P = 0·0008), testosterone levels (Spearman's r = −0·0·37; two‐tailed P < 0·0001) and LH levels (Spearman's r = 0·048; P < 0·05). Testosterone levels were positively correlated with testicular volume (Spearman's r = 0·48; P < 0·0001).ConclusionsThis study, for the first time, suggests that increased Cd burden is associated with delayed onset of puberty in male adolescents and impaired testicular growth.
Defining the histopathological changes induced by nonablative radiofrequency treatment of faecal incontinence – a blinded assessment in an animal model
Authors: Herman R. M. , Berho M. , Murawski M. , Nowakowski M. , Ryś J. , Schwarz T. , Wojtysiak D. , Wexner S. D. 
Published: December 2014

AbstractAimNonablative radiofrequency (RF) sphincter remodelling has been used to treat gastro‐oesophageal reflux disease (GERD) and faecal incontinence (FI). Its mechanism of action is unclear. We aimed to investigate the histomorphological and pathophysiological changes to the internal and external anal sphincter (IAS and EAS) following RF remodelling.MethodAn experimental FI model was created in 12 female pigs: eight underwent RF 6 weeks following induction of FI (FI+RF) and four were untreated (UFI). Four animals served as controls (CG). Two blinded pathologists examined all haematoxylin and eosin and trichrome stained slides.ResultsCompared with the UFI group, histological examination of the IAS in the FI+RF group demonstrated an increased smooth muscle (SM)/connective tissue ratio (77.2 vs 68.1%, P < 0.05) and increased collagen I compared with collagen III content (67.2 vs 54.9%, P < 0.001). The RF+FI group exhibited greater SM bundle thickness compared with the UFI group (SM width 486.93 vs 338.59 μm, P < 0.01; height 4384.4 vs 3321.0 μm, P < 0.05). The EAS of the FI+RF animals showed a significantly higher type I/II fibre ratio (33.5 vs 25.2%, P = 0.023) and fibre type I diameter (67.2 vs 59.7 μm, P < 0.001) compared with the UFI group. Post‐RF manometry showed higher basal (18.8 vs 0 mmHg, P < 0.001) and squeeze (76.8 vs 12.4 mmHg, P < 0.05) anal pressures. After RF treatment, the number of interstitial cells of Cajal was significantly reduced compared with the UFI and CG groups [0.9 (FI+RF) vs 6.7 (UFI) vs 0.7 (CG) per mm2, P < 0.001].ConclusionIn an animal model nonablative RF appeared to induce morphological changes in the IAS and EAS leading to an anatomical state reminiscent of normal sphincter structure.
Treatment of rectovaginal fistula after colorectal resection with endoscopic stenting: long‐term results
Authors: Lamazza A. , Fiori E. , Schillaci A. , Sterpetti A. V. , Lezoche E. 
Published: December 2014

AbstractAimTo treat patients with rectovaginal fistula after anterior resection for cancer using self‐expanding metal stents.MethodTen patients of mean age of 56.3 years with rectovaginal fistula after colorectal resection for cancer were treated with endoscopic placement of a self‐expanding metal stent. In three patients a diverting proximal stoma had been performed elsewhere. The rectal opening of the fistula was located from 3 to 10 cm from the anal verge (mean 6 cm). All patients had preoperative radiotherapy. In seven patients the stent was placed as the initial treatment while three referred patients had had multiple failed operations.ResultsThere were no complications after the procedure. At a mean follow‐up of 24 months the rectovaginal fistula has healed without major faecal incontinence in eight patients. In the remaining two the fistula has reduced significantly in size to allow a successful flap transposition.ConclusionEndoscopic placement of a self‐expanding metal stent is a valid adjunct to treat patients with rectovaginal fistula after colorectal resection for cancer.
Acute eccentric resistance exercise decreases matrix metalloproteinase activity in obese elderly women
Authors: Nascimento Dahan da Cunha , Navalta James Wilfred , Durigan João Luiz Quagliotti , Marqueti Rita de Cassia , Tibana Ramires Alsamir , Luiz Franco Octavio , de Almeida Jesser Alves , Camarço Nathalia Ferreira , Neto Ivo Vieira de Sousa , Prestes Jonato 
Published: December 2014

SummaryThe association of ageing with obesity commits elderly women and has been correlated with multiple degenerative processes, which could be occasioned by an enhancing in levels of matrix metalloproteinase‐2 and metalloproteinase‐9 (MMPs) as well by an cytokine unbalance that included an enhancing on interleukin‐6 (IL‐6). Furthermore, other factors could be also related to degenerative process, as they could be reduced by eccentric resistance exercise (ERE), which seems particularly important to initiate resistance training in obese older adults. In this view, this study aims to determinate the effects of an acute ERE session on serum MMP‐2, MMP‐9 and IL‐6 in elderly obese women. Ten elderly obese women participated in this study and completed a 10 repetitions maximum test (10 RM) utilizing leg extension exercise. Subjects then completed an acute ERE session consisting of seven sets of 10 repetitions at 110% of 10 RM with a rest of 3 min between sets. Blood samples were collected before, immediately after, 3, 24 and 48 h following the ERE session. Zymograms were utilized to measure the MMP‐2 and MMP‐9 enzymes from all individuals. Moreover, IL‐6 concentration was also determinated. After ERE session, MMP‐2 and MMP‐9 decreased, remaining significantly below baseline values after 48 h (P<0·05). Although not statistically significant, there was a tendency for IL‐6 to decrease 48 h after the ERE when compared with 3 h (P = 0·06). An acute ERE session decreases MMP‐9, MMP‐2 and IL‐6 in elderly obese women, possibly indicating a transient protection against the low grade inflammation present in this specific population.
Acute blood pressure changes are related to chronic effects of resistance exercise in medicated hypertensives elderly women
Authors: Moreira Sérgio R. , Cucato Gabriel G. , Terra Denize F. , Ritti‐Dias Raphael M. 
Published: December 2014

SummaryBackgroundA previous study observed that the chronic effects of aerobic training on blood pressure (BP) are related to acute BP responses after a single bout of aerobic exercise. However, whether similar responses are observed with resistance exercise (RE) remains obscure. Thus, this study analysed the relationship between the acute BP responses to a single bout of RE and chronic changes in resting BP after a RE training in medicated hypertensive elderly women.Methods and resultsTwenty medicated hypertensive women participated in the study. They underwent an acute RE bout where BP and heart rate (HR) were obtained at rest and for 60 min after the RE. Subsequently, the participants underwent a progressive RE training for 12 weeks at 60–80% of maximal strength test. Resting BP and HR were also obtained after the RE training. The chronic decreases in systolic and diastolic BP were significantly greater in the participants who experienced acutely decreased systolic and diastolic BP, respectively (P<0·05). The changes in systolic BP after acute RE were correlated with the chronic changes in resting systolic BP after RE training (r = 0·47; P = 0·03). Similar correlations between acute and chronic responses were also observed for diastolic BP (r = 0·70; P = 0·01), mean BP (r = 0·58; P = 0·01), HR (r = 0·73; P<0·01) and RPP (r = 0·52; P = 0·01).ConclusionSimilar to previously work involving aerobic exercise, BP responses to a single bout of RE are strongly related to chronic effects of RE training on BP in medicated hypertensive elderly women.
Acute and training effects of resistance exercise on heart rate variability
Authors: Kingsley J. Derek , Figueroa Arturo 
Published: December 2014

SummaryHeart rate variability (HRV) has been used as a non‐invasive method to evaluate heart rate (HR) regulation by the parasympathetic and sympathetic divisions of the autonomic nervous system. In this review, we discuss the effect of resistance exercise both acutely and after training on HRV in healthy individuals and in those with diseases characterized by autonomic dysfunction, such as hypertension and fibromyalgia. HR recovery after exercise is influenced by parasympathetic reactivation and sympathetic recovery to resting levels. Therefore, examination of HRV in response to acute exercise yields valuable insight into autonomic cardiovascular modulation and possible underlying risk for disease. Acute resistance exercise has shown to decrease cardiac parasympathetic modulation more than aerobic exercise in young healthy adults suggesting an increased risk for cardiovascular dysfunction after resistance exercise. Resistance exercise training appears to have no effect on resting HRV in healthy young adults, while it may improve parasympathetic modulation in middle‐aged adults with autonomic dysfunction. Acute resistance exercise appears to decrease parasympathetic activity regardless of age. This review examines the acute and chronic effects of resistance exercise on HRV in young and older adults.