bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited response to CRH stimulation tests at 2 weeks of age in preterm infants born at less than 30 weeks of gestational age
Authors: Niwa Fusako , Kawai Masahiko , Kanazawa Hoshinori , Iwanaga Kougorou , Matsukura Takashi , Shibata Minoru , Hasegawa Takeshi , Heike Toshio 
Published: September 2012

SummaryBackgroundThe high incidence of glucocorticoid‐responsive complications in extremely preterm infants suggests the immaturity of their adrenal function; however, knowledge of the hypothalamus–pituitary–adrenal (HPA) axis in extremely preterm infants is limited.MethodsTo clarify the characteristics of the HPA axis in preterm very low birthweight (VLBW) infants, we performed CRH tests repeatedly: at about 2 weeks of age and at term (37–41 weeks of postmenstrual age) for 21 VLBW infants with a gestational age (GA) <30 weeks at birth.ResultsBasal cortisol values at 2 weeks of age were significantly higher than those at term in VLBW infants < 30 weeks of gestation at birth (304·1 ± 146·3 nmol/l vs 184·7 ± 108·2 nmol/l). Response to corticotropin‐releasing hormone (CRH) stimulation tests at 2 weeks of age was significantly lower than at term (delta cortisol 148·3 ± 90·7 nmol/l vs 271·8 ± 167·0 nmol/l, delta ACTH 3·9 ± 3·2 pmol/l vs 12·3 ± 9·2 pmol/l, respectively). We found that earlier GA contributed to the higher basal cortisol values, and antenatal glucocorticoid (AG) contributed to the lower response of cortisol to CRH tests at 2 weeks of age.ConclusionsVLBW infants showed a characteristic pattern in the HPA axis at 2 weeks of age: higher basal cortisol values and lower response to CRH tests. This study suggested that AG was related to the lower response to CRH tests, at least partly.
Osteoporosis and metabolic syndrome according to socio‐economic status, contribution of PTH, vitamin D and body weight: The Canarian Osteoporosis Poverty Study (COPS)
Authors: Navarro María del Carmen , Saavedra Pedro , Jódar Esteban , Gómez de Tejada Mª Jesús , Mirallave Ana , Sosa Manuel 
Published: September 2012

SummaryBackgroundPoverty is associated with a great number of diseases, but the prevalence of vitamin D deficiency, secondary hyperparathyroidism and the potential association of osteoporosis, osteoporotic fractures and metabolic syndrome in this situation are less well known.ObjectiveTo evaluate the associations between poverty, bone density, fragility fractures and metabolic syndrome in a population of southern European postmenopausal women. Also, to assess the potential role of vitamin D and parathyroid hormone (PTH) levels in these associations.MethodCross‐sectional study was carried out in 1 250 postmenopausal Caucasian Spanish women. The socio‐economic status of the participants was determined after a personal interview, according to the criteria of the Spanish Institute of Statistics. Participants were divided into two socio‐economic levels: low (poverty) and medium or high socioeconomic level. The study protocol included a health questionnaire, a complete physical examination, lateral radiograph of the dorsal and lumbar spine and measurement of bone mineral density (BMD) at the lumbar spine (L2‐L4) and proximal femur. Fasting blood was obtained to measure 25‐hydroxy‐vitamin D (25‐OHD), intact PTH and selected biochemical variables.ResultsLow socio‐economic status was associated with 25‐OHD insufficiency, higher values of PTH, higher body weight and body mass index (BMI), lower values of BMD at the lumbar spine and a higher prevalence of fragility fractures, both vertebral and nonvertebral. Poverty was also associated with higher prevalence of metabolic syndrome, but this association was driven mainly by the higher BMI and not by poverty itself. Both vitamin D insufficiency and elevated PTH were consistently related to poverty and osteoporotic fractures.ConclusionsPoor postmenopausal women in southern Europe have a high prevalence of metabolic syndrome and osteoporotic fractures. Poverty was associated with higher BMI and metabolic syndrome on the one hand and, on the other, with 25OHD insufficiency, higher PTH levels and osteoporosis. 25OHD insufficiency and/or secondary hyperparathyroidism do not have a significant influence on the presence of metabolic syndrome in this population.
Associations of insulin‐like growth factor‐I and its binding proteins and testosterone with frailty in older men
Authors: Yeap B. B. , Paul Chubb S. A. , Lopez Derrick , Ho K. K. Y. , Hankey Graeme J. , Flicker Leon 
Published: September 2012

SummaryObjectiveAgeing is associated with frailty and decreased anabolic hormones, insulin‐like growth factor‐I (IGF‐I) and testo;?>sterone. We hypothesized that components of the IGF‐I system, in conjunction with testosterone, modulate frailty risk in the elderly. We examined associations between IGF‐I, its binding proteins IGFBP1 and IGFBP3 and testosterone with frailty in men.DesignObservational study of 3 447 community‐dwelling men aged 70–89 years assessed in 2001–04, with 1 654 reassessed in 2008–09.MethodsBaseline total IGF‐I, IGFBP1, IGFBP3 and testosterone were assayed. Frailty was assessed using the FRAIL scale, comprising 5 domains: fatigue; difficulty climbing stairs; difficulty walking >100 m; >5 illnesses; weight loss >5%. Men with ≥ 3 domains were considered frail.ResultsAt baseline, 527 men (15·3%) were frail. Frail men had lower IGFBP3 (3 630 ng/ml vs not frail: 3 800 ng/ml, P < 0·001) and comparable IGFBP1 (23·5 vs 21·5 ng/ml, P = 0·09). In multivariate analyses, higher IGFBP1 was associated with increased prevalence of frailty (highest vs lowest quartile Q4:Q1, adjusted odds ratio [OR] = 1·39, 95% CI = 1·03–1·88). New‐onset frailty arose in 260 (17·5%) of 1 484 men. Lower baseline IGF‐I predicted new‐onset frailty (Q1:Q4 OR = 1·48, 95% CI = 1·00–2·20) as did higher IGFBP1 (Q4:Q1 OR = 1·59, 95% CI = 1·01–2·50). Men with both IGF‐I and free testosterone in Q1 had greater odds of prevalent frailty (OR = 2·13, 95% CI = 1·54–2·95).ConclusionsOlder men with higher IGFBP1 level, or both lower IGF‐I and testosterone, are more likely to be frail, while those with lower IGF‐I and higher IGFBP1 are more likely to become frail. Components of the IGF‐I system may be biomarkers or independent predictors of frailty.
The risk of maternal obesity to the long‐term health of the offspring
Authors: O'Reilly James R. , Reynolds Rebecca M. 
Published: September 2012

SummaryThe prevalence of maternal obesity has risen dramatically in recent years, with approximately one in five pregnant women in the UK now classed as obese (body mass index ≥ 30 kg/m2) at antenatal booking. Obesity during pregnancy has been hypothesized to exert long‐term health effects on the developing child through ‘early life programming’. While this phenomenon has been well studied in a maternal undernutrition paradigm, the processes by which the programming effects of maternal obesity are mediated are less well understood. In humans, maternal obesity has been associated with a number of long‐term adverse health outcomes in the offspring, including lifelong risk of obesity and metabolic dysregulation with increased insulin resistance, hypertension and dyslipidaemia, as well as behavioural problems and risk of asthma. The complex relationships between the maternal metabolic milieu and the developing foetus, as well as the potential influence of postnatal lifestyle and environment, have complicated efforts to study the programming effects of maternal overnutrition in humans. This review will examine the emerging evidence from human studies linking maternal obesity to adverse offspring outcomes.
Identification and characterization of D410E, a novel mutation in the loop 3 domain of CASR, in autosomal dominant hypocalcemia and a therapeutic approach using a novel calcilytic, AXT914
Authors: Park So Young , Mun Hee‐Chang , Eom Young Sil , Baek Hae Lim , Jung Tae Sik , Kim Chul Hoon , Hong Suntaek , Lee Sihoon 
Published: September 2012

SummaryObjectiveActivating mutations of the calcium‐sensing receptor (CASR) gene are associated with autosomal dominant hypocalcemia (ADH) characterized by benign hypocalcemia, inappropriately low (PTH) levels and mostly hypercalciuria. Herein, we report a novel activating mutation in the CASR gene in a Korean family with ADH.MethodThe CASR gene was sequenced in the patient with ADH. The identified mutations were also evaluated in the patient's family members by PCR‐based sequencing. For functional studies, we examined phosphorylation of ERK1/2. In addition, intracellular Ca2+ mobilization and the effects of the calcilytic, AXT914 were measured using fluorophore Fura‐2 dye.ResultDirect sequencing analysis of the CASR gene showed that the proband and her daughter possess a novel mutation c.1230T>A, resulting in a D410E missense mutation on exon 4 of the CASR gene. Escalation of the extracellular Ca2+ concentration resulted in stronger phosphorylation of ERK1/2 and higher levels of intracellular Ca2+ in HEK293 cells expressing mutant CASR, compared with wild‐type CASR. The increase in intracellular Ca2+ signalling via CASR was successively blunted by treatment with AXT914.ConclusionsOver 60 activating mutations in the CASR gene have been identified to cause ADH so far. Here, we add one more activating mutation that causes ADH. The novel activating mutation (D410E) occurred in the loop 3 region of CASR, where its function was believed to be of little importance; therefore, this mutation may be of interest. Further clinical study will be needed to validate the effectiveness of calcilytics in treatment of ADH in vivo.
A lower value for quantitative ultrasound at radius is an additional indicator of metabolic syndrome and cardiovascular disease risk
Authors: Tao Bei , Li Zhen , Zhao Hong‐Yan , Sun Li‐Hao , Zhao Lin , Li Xiao‐Ying , Wang Wei‐Qing , Ning Guang , Liu Jian‐Min 
Published: September 2012

SummaryBackgroundThe relationships between quantitative ultrasound (QUS) values, metabolic syndrome (MetS) and cardiovascular disease (CVD) risk are unclear.Objective The objective was to determine the relationships between QUS and MetS as well as CVD risk.DesignThis was a cross‐sectional study conducted in Shanghai, China.PatientsOne‐thousand four hundred and thirty‐nine Chinese women and men with or without MetS were studied.MeasurementsSpeed of sound (SOS) at radius, phalanx and tibia and their relationships with MetS and Framingham's 10‐year cardiovascular disease risk scores were investigated.ResultsPremenopausal women with MetS had significant lower SOS at radius than those without MetS after adjusting for age, BMI and fat mass percentage (P = 0·02). The radius SOS was negatively associated with waist circumference (r = −0·109, P = 0·025), waist‐to‐hip ratio (r = −0·124, P = 0·01) and 2 h postprandial glucose level (r = −0·125, P = 0·012) in premenopausal women. Waist circumference, waist‐to‐hip ratio and 2 h postprandial glucose level increased with the decreasing tertiles of radius SOS after adjustment of age (P = 0·003, 0·002 and 0·008, respectively). The CVD risk increased with decreasing tertiles of radius SOS in postmenopausal women even after the adjustment of age, years since menopause, MetS components, smoking and alcohol habits (P < 0·001), but not in premenopausal women and men.ConclusionsLower radius SOS is associated with greater risks of MetS and CVD in premenopausal and postmenopausal women, respectively. The QUS value derived from non‐weight‐bearing site, such as radius, may represent an additional indicator of MetS and CVD risk in women.
Efficacy of confocal laser endomicroscopy for discriminating colorectal neoplasms from non‐neoplasms: a systematic review and meta‐analysis
Authors: Su P. , Liu Y. , Lin S. , Xiao K. , Chen P. , An S. , He J. , Bai Y. 
Published: September 2012

AbstractAim  Confocal laser endomicroscopy (CLE) has evolved to allow in vivo real‐time biopsy for the classification of colorectal lesions.The primary aim of this study was to assess the effectiveness of CLE for discriminating colorectal neoplasms from non‐neoplasms and its contributing factors. The secondary aim was to compare the efficacy of endomicroscopy and chromoendoscopy for diagnosing colorectal neoplasms.Method  A systematic review of the literature published between 2000 and 2012 was conducted. Pooled sensitivity and specificity were compared using univariate regression analysis according to prespecified subgroups. Pooled relative risk was computed to compare the accuracy of endomicroscopy and chromoendoscopy.Results  Fifteen studies involving 719 patients and 2290 specimens were analysed. The pooled sensitivity of all studies was 0.94 [95% confidence intervals (CI): 0.88–0.97], and pooled specificity was 0.95 (95% CI: 0.89–0.97). Real‐time CLE yielded higher sensitivity (0.96 vs 0.85, P < 0.001) and specificity (0.97 vs 0.82, P < 0.001) than blinded CLE. For real‐time CLE, endoscopy‐based systems had better sensitivity (0.96 vs 0.89, P < 0.001) and specificity (0.99 vs 0.82, P < 0.0001) than probe‐based systems. CLE yielded equivalent accuracy compared with magnifying virtual chromoendoscopy and magnifying pigment chromoendoscopy (P > 0.05).Conclusion  CLE is comparable to colonoscopic histopathology in diagnosing colorectal neoplasms, and is better in conjunction with conventional endoscopy. An endoscopy‐based rather than a probe‐based modality would be optimal in the application of CLE.
Sucralfate or placebo following argon plasma coagulation for chronic radiation proctitis: a randomized double blind trial
Authors: Chruscielewska‐Kiliszek M. R. , Regula J. , Polkowski M. , Rupinski M. , Kraszewska E. , Pachlewski J. , Czaczkowska‐Kurek E. , Butruk E. 
Published: September 2012

AbstractAim  Chronic radiation proctitis is a long‐term complication of radiation therapy for pelvic malignancy. The aim of this study was to compare the efficacy and safety of two treatment regimens, sucralfate or placebo, following argon plasma coagulation (APC) for chronic haemorrhagic radiation proctitis.Method  A single‐centre, randomized, placebo‐controlled, double‐blind study was performed on patients with haemorrhagic chronic radiation proctitis after irradiation for prostate, uterine, cervical, rectal or vaginal cancer. All patients received APC, and were then randomized to oral sucralfate (6 g twice a day) or placebo treatment for 4 weeks. APC was repeated every 8 weeks if necessary after the first session. Patients were graded clinically and endoscopically according to the Chutkan and Gilinski scales before and at 8 and 16 weeks after initial APC treatment (1.5–2 l/min, 25–40 W) and after 52 weeks (clinical only).Results  Of 122 patients, 117 completed the entire protocol, with 57/60 in the sucralfate group and 60/62 in the placebo group. At baseline there were no significant differences between the sucralfate and placebo groups. At 1 year, a significant improvement in the clinical scale in both groups occurred compared with baseline. After 16 weeks, the median overall clinical severity scores fell from 4 to 2 points and the median bleeding score from 2 to 0 in both groups.Conclusion  APC is safe and effective for the management of chronic radiation proctitis. Additional sucralfate treatment did not influence the clinical or endoscopic outcome.
Reduction of lipid‐laden macrophage index after laparoscopic Nissen fundoplication in cystic fibrosis patients after lung transplantation
Authors: Hayes Don , Kirkby Stephen , S. McCoy Karen , Mansour Heidi M. , Khosravi Medhi , Strawbridge Heather , Tobias Joseph D. 
Published: September 2012

AbstractBackgroundLipid‐laden macrophage (LLM) index could be potentially useful in assessing gastroesophageal (GE) reflux and aspiration after lung transplantation (LT) in patients with cystic fibrosis (CF).MethodsA retrospective review of CF patients undergoing LT and/or laparoscopic Nissen fundoplication (LNF) from January 1, 2009, to December 31, 2011, was performed.ResultsSeventeen CF patients (nine women), mean (±SD) age 27.9 ± 7.5 yr, underwent LT with mean (±SD) pre‐transplant FEV1 of 20.9 ± 5.0% predicted. Seventy percentage (12/17) of patients underwent LNF without complications within 1–2 wk of LT. After LT, but prior to antireflux surgery, there was no significant difference in the mean (±SD) baseline LLM index (154 ± 41 vs. 146 ± 51, p = NS) between patients who were to undergo LNF and patients who did not. After LNF, a significant reduction in the mean (±SD) LLM index occurred following the procedure (154 ± 41–74 ± 54, p < 0.0001) while each patient reported resolution of symptoms of GE reflux, whereas 40% (2/5) undergoing only medical treatment reported resolution of symptoms.ConclusionsSignificant reduction in the LLM index occurred after LNF in CF patients after LT that correlated with resolution of clinical symptoms of GE reflux.
Potential risk map for avian influenza A virus invading Japan
Authors: Moriguchi Sachiko , Onuma Manabu , Goka Koichi 
Published: September 2012

AbstractAimOur goal was to use the occurrence of the influenza A virus in wild birds in Japan to create a potential risk map for the spread of avian influenza by migratory birds. Our modelling included a consideration of the multicollinearity and spatial autocorrelation of environmental variables and an examination of the reproducibility of the model results.LocationJapan.MethodsWe used the maximum entropy approach to generate potential distribution models from presence‐only data. Independent variables in the model included environmental factors such as winter temperature and precipitation, host factors such as duck population size and habitat abundance and artificial factors such as size of urban areas and poultry density. We used eigenvector‐based spatial filters to alleviate spatial autocorrelation. To explore the reliability of the model, we compared the risk indices of localities positive in past winters for the influenza A virus in wild birds with those of all localities.ResultsThe model alleviated spatial autocorrelation with a high degree of accuracy. Dabbling duck population, size of urban area, diving duck population and altitude were the variables that were most strongly correlated with the potential distribution of avian influenza. We used the frequency of occurrence of the influenza A virus in five recent years in localities where wild birds were infected to estimate the repeatability of the high‐risk indices; the potential risk indices for avian influenza in wild birds were high in localities where wild birds were infected in past.Main conclusionsThe dabbling duck population in an area appeared to be the best indicator of high risk for the introduction of avian influenza from abroad. Priority monitoring localities for avian influenza carried by wild birds should be designated in western Japan and along the Pacific coast, which we estimated to be high‐risk areas. Poultry farms in these areas should increase their biosecurity to prevent vectors from introducing avian influenza.
Identifying risk and preventing progression to Type 2 diabetes in vulnerable and disadvantaged adults: a pragmatic review
Authors: Taylor J. , Cottrell C. , Chatterton H. , Hill J. , Hughes R. , Wohlgemuth C. , Holt R. I. G. 
Published: September 2012

AbstractAimTo identify effective approaches to recognize diabetes risk and prevent progression to Type 2 diabetes in vulnerable groups, whose diabetes risk may be difficult to identify or manage.MethodsUK‐based interventions that assess diabetes risk and/or target known risk factors were identified through four main sources: submissions to two calls for evidence by the National Institute for Health and Clinical Excellence; local practice examples collected via a targeted email questionnaire; selected electronic databases; and a focused search of relevant websites. No restriction was placed on the study type or evaluation methods used. Key themes and sub‐themes on outcomes, as well as facilitators and barriers to successful delivery, are reported.ResultsTwenty‐four interventions met all inclusion criteria: 15 included a risk identification element and 14 included preventative activities. A range of risk identification tools were used to improve diagnosis of unmet diabetes‐related health needs and raise awareness of diabetes risk factors. All preventative interventions focused on lifestyle change. No interventions monitored blood glucose as an outcome and only one reported improvements in baseline risk scores. Facilitators included tailored and flexible programme design, outreach delivery in familiar locations and effective inter‐agency working. Barriers included literacy and language difficulties, transient participant populations, low prioritization of diabetes prevention and cost.ConclusionsIt is possible to engage successfully with high‐risk adults in vulnerable groups to achieve positive health outcomes relevant to the prevention of diabetes. However, more robust evidence on longer‐term outcomes is required to ensure that programmes are targeted and delivered appropriately.
The impact of calcineurin inhibitors on insulin sensitivity and insulin secretion: a randomized crossover trial in uraemic patients
Authors: Øzbay L. A. , Møller N. , Juhl C. , Bjerre M. , Carstens J. , Rungby J. , Jørgensen K. A. 
Published: September 2012

AbstractAimsThe calcineurin inhibitors cyclosporine and tacrolimus are implicated in post‐transplant complications such as new‐onset diabetes after transplantation. The relative contribution of each calcineurin inhibitor to new‐onset diabetes after transplantation remains unclear. We sought to compare the impact of cyclosporine and tacrolimus on glucose metabolism in humans.MethodsEight haemodialysis patients received 8–10 days of oral treatment followed by 5‐h infusions with cyclosporine, tacrolimus and saline in a randomized, investigator‐blind, crossover study. Glucose metabolism and β‐cell function was investigated through: a hyperinsulinaemic–euglycaemic clamp, an intravenous glucose tolerance test and insulin concentration time series.ResultsCyclosporine and tacrolimus decreased insulin sensitivity by 22% (P = 0.02) and 13% (P = 0.048), respectively. The acute insulin response and pulsatile insulin secretion were not significantly affected by the drugs.ConclusionIn conclusion, 8–10 days of treatment with cyclosporine and tacrolimus impairs insulin sensitivity to a similar degree in haemodialysis patients, while acute insulin responses and pulsatile insulin secretion remain unaffected.
Comorbidities and survival in obstructive sleep apnoea beyond the age of 50
Authors: Marrone Oreste , Lo Bue Anna , Salvaggio Adriana , Dardanoni Gabriella , Insalaco Giuseppe 
Published: September 2012

Eur J Clin Invest 2012AbstractBackground  Although mortality risk associated with obstructive sleep apnoea (OSA) tends to disappear from the age of 50, it has been suggested that OSA treatment by continuous positive airway pressure (CPAP) improves survival even in older subjects. Life expectancy of subjects with several diseases is worse if OSA coexists. The objectives of this study were to evaluate the relevance of comorbidities in the relationship between OSA and mortality, and in the effect of CPAP on survival, in subjects ≥ 50 years old.Methods  Data from 810 patients studied by polysomnography for suspected OSA between 1991 and 2000 were retrospectively evaluated. In 2009, state of survival and use of CPAP were enquired. Three hundred and thirteen subjects were < 50 and 497 were ≥ 50 years at diagnosis.Results  Age and comorbidities, but not apnoea/hypopnoea index (AHI) or lowest nocturnal arterial oxygen saturation (Nadir SaO2), predicted mortality in the whole sample. Nadir SaO2 was related to mortality among the younger subjects without comorbidities (P = 0·01), but not among the older subjects. In the older patients with an AHI > 30 CPAP treatment was associated with a better survival only if comorbidities coexisted.Conclusions  Unlike in younger subjects, in subjects ≥ 50 years old, comorbidities do not mask an effect of OSA on mortality. Among OSA subjects ≥ 50 years old, comorbidities could separate those who may expect an improvement in survival with CPAP treatment from those who may not. Possibly, after the age of 50, OSA per se does not affect survival, but worsens prognosis of subjects with coexisting diseases.