bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months
Authors: Meyrat P. , Safroneeva E. , Schoepfer A. M. 
Published: October 2012

SummaryBackgroundWhile rifaximin was able to improve symptoms in patients with irritable bowel syndrome (IBS) in phase III trials, these results are yet to be repeated in phase IV studies.AimTo evaluate the treatment response to rifaximin in IBS patients in a phase IV trial.MethodsIBS patients underwent lactulose hydrogen breath testing (LHBT). LHBT‐positive patients were treated with rifaximin for 14 days. Prior to treatment as well as at week 4 and 14 following the start of rifaximin treatment, patients completed a questionnaire assessing symptom severity on a Likert scale from 0 to 10.ResultsOne hundred and six of 150 IBS patients (71%) were LHBT‐positive and treated with rifaximin. As assessed at week 4 following commencement of the therapy, rifaximin provided significant improvement of the following IBS‐associated symptoms: bloating (5.5±2.6 before the start of the treatment vs. 3.6±2.7 at week 4, P<0.001), flatulence (5.0±2.7 vs. 4.0±2.7, P=0.015), diarrhoea (2.9±2.4 vs. 2.0±2.4, P=0.005) and abdominal pain (4.8±2.7 vs. 3.3±2.5, P<0.001). Overall well‐being also significantly improved (3.9 ± 2.4 vs. 2.7 ± 2.3, P < 0.001). Similar improvements in IBS symptoms were obtained at week 14. Eighty‐six per cent of patients undergoing repetitive LHBT (55/64) tested negative at week 4.ConclusionsWe found a high percentage of LHBT‐positive IBS patients. IBS‐associated symptoms (bloating, flatulence, diarrhoea, pain) were improved for a period of 3 months following 2 weeks of treatment with rifaximin. We conclude that rifaximin treatment alleviates symptoms in LHBT‐positive IBS patients.
Assessment of non‐alcoholic fatty liver disease using serum total cell death and apoptosis markers
Authors: Shen J. , Chan H. L.‐Y. , Wong G. L.‐H. , Chan A. W.‐H. , Choi P. C.‐L. , Chan H.‐Y. , Chim A. M.‐L. , Yeung D. K.‐W. , Yu J. , Chu W. C.‐W. , Wong V. W.‐S. 
Published: October 2012

SummaryBackgroundThe diagnosis of non‐alcoholic fatty liver disease (NAFLD), non‐alcoholic steatohepatitis (NASH) and fibrosis relies on liver biopsy. Non‐invasive assessments are urgently needed.AimTo evaluate cell apoptotic marker cytokeratin‐18 M30 and total cell death markers cytokeratin‐18 M65/M65ED for the assessment and monitoring of NAFLD.MethodsA cohort of 147 patients with biopsy‐proven NAFLD and 73 controls were enroled, including 51 patients who received paired liver biopsies 36 months apart. Biomarkers were determined by enzyme‐linked immunosorbent assay.ResultsM30, M65 and M65ED increased in a stepwise fashion in control subjects, patients with non‐NASH, NAFLD and NASH (all P < 0.001). All biomarkers had similarly high accuracy over 0.9 in predicting NAFLD and moderate accuracy around 0.7 in predicting NASH. Among patients with paired liver biopsies, changes in M30, M65 and M65ED positively correlated with disease progression (rho = 0.42, 0.32 and 0.39; P = 0.002, 0.023 and 0.005 respectively), and only changes in M65 and M65ED correlated with fibrosis progression (rho = 0.29, 0.34; P = 0.038, 0.015 respectively). Both M30 and M65 had area under receiver‐operating characteristics curve above 0.8 in predicting disease progression. At cut‐off of 236 U/L, changes of M65ED had 88% NPV and 59% PPV to exclude and predict fibrosis progression.ConclusionsCytokeratin‐18 M30 and M65/M65ED have moderate accuracy in detecting non‐alcoholic steatohepatitis. Changes in the biomarkers also correlate with histological progression. However, development of new biomarkers is still required to improve the diagnostic accuracy.
IDH1 Mutations in Oligodendroglial Tumors: Comparative Analysis of Direct Sequencing, Pyrosequencing, Immunohistochemistry, Nested PCR and PNA‐Mediated Clamping PCR
Authors: Lee Dakeun , Suh Yeon‐Lim , Kang So Young , Park Tae‐In , Jeong Ji Yun , Kim Se‐Hoon 
Published: October 2012

AbstractMutations in isocitrate dehydrogenase 1 (IDH1) are found in a high proportion of glial tumors and have a significant prognostic impact. Although direct sequencing has been considered to be the gold‐standard method to detect this mutation, the sensitivity of this technique has been questioned especially because specimens from glial tumors may contain large numbers of non‐tumor cells. We screened 141 cases of oligodendroglial tumors for IDH1 mutations using peptide nucleic acid (PNA)‐mediated clamping polymerase chain reaction (PCR) and compared the results with the results of direct sequencing, pyrosequencing, and immunohistochemistry (IHC). Nested PCR was only performed in cases having mutant IDH1 only discovered by clamping PCR. Using dilution experiments mixing IDH1 wild‐type and mutant DNA samples, clamping PCR detected mutations in samples with a 1% tumor DNA composition. Using PNA clamping PCR, we detected 138 of 141 (97.9%) cases with mutant IDH1 in our series, which is significantly higher (P = 0.016; PNA clamping vs. direct sequencing) than those of direct sequencing (74.5%), pyrosequencing (75.2%) and IHC (75.9%). From our results, almost all oligodendroglial tumors have IDH1 mutations, and this suggests that IDH1 mutation is an early and common event especially in the development of oligodendroglial tumors.
Insomnia in adolescents: prevalence, help‐seeking behaviors, and types of interventions
Authors: Chung Ka‐Fai , Kan Katherine Ka‐Ki , Yeung Wing‐Fai 
Published: October 2012

BackgroundLittle is known about the DSM‐IV diagnosis of insomnia among adolescents. Their help‐seeking behaviors and self‐help strategies for insomnia remain largely unclear.MethodA cross‐sectional, interview‐based study of 290 Chinese adolescents.ResultsThe prevalence of insomnia symptoms was 40%, among which 9.3% had DSM‐IV insomnia. Primary insomnia accounted for 7.9%, whereas insomnia associated with psychiatric disorders constituted 1.4%. Adolescents with DSM‐IV insomnia had more severe and frequent insomnia, higher GHQ scores, and were more likely to have a history of sleep paralysis than those with insomnia symptoms alone. About 22% of adolescents with insomnia symptoms sought help and 32% attempted various strategies to improve sleep.ConclusionsMany adolescents were troubled by insomnia, but they seldom sought help from healthcare professionals or received proper treatments.
The oncological outcome after right hemicolectomy and accuracy of CT scan as a preoperative tool for staging in right sided colonic cancers
Authors: Lim M. , Hussain Z. , Howe A. , Storey R. , Petty D. , Haselden J. , Sebag‐Montefiore D. , Alexander D. 
Published: October 2012

AbstractAimNeoadjuvant chemotherapy may have a role in the management of colonic carcinoma but clinical trials are required to determine whether this approach is superior to the standard policy of radical surgery, high‐quality histopathology and selective postoperative chemotherapy. The selection of appropriate patients for such trials will depend on accurate locoregional staging of disease by preoperative CT scanning. We studied the outcome after radical right hemicolectomy and assessed the accuracy of preoperative CT scans in the prediction of postoperative pathology.MethodA retrospective analysis of right hemicolectomies performed with curative intent for colon cancer under the care of a single colorectal surgeon (D.J.A.) was performed. Preoperative CT‐proven Dukes D patients were excluded. Patient demographics, postoperative histology, use of adjuvant chemotherapy and survival data were collected. Kaplan–Meier curves were constructed and log‐rank testing was performed to compare cancer‐specific survival. Fifty patients had their preoperative CT scan images reviewed by two radiologists both blinded to the results of the postoperative histology. The accuracy of preoperative CT for T and N staging was studied. A P‐value of < 0.05 was significant.ResultsThere were 136 patients (79 women). Median age was 76 (interquartile ratio 67–82) years. Median period of follow‐up was 72 (interquartile ratio 39–92) months. There were 56 deaths (39 medical, 16 oncological and 1 postoperative). There were three groups of patients: node negative (n = 84), node positive with postoperative adjuvant chemotherapy (n = 30) and node positive without chemotherapy (n = 22). Five‐year cancer‐specific survival for node negative disease was 84% and was poorer for node positive patients who received adjuvant chemotherapy when compared with those who did not (62 vs 72%, P‐value = 0.046 on log‐rank testing). Sensitivity, specificity, positive and negative predictive value of CT scan for tumour (T) stage were 90, 33, 86 and 43% respectively, while that for nodal (N) stage was 83, 38, 57 and 69%, respectively.ConclusionCT scan has limited accuracy in predicting those patients with advanced locoregional disease who might benefit from neoadjuvant treatment. When this finding is combined with relatively high cancer‐specific survival with surgery alone the impact of adjuvant chemotherapy on survival after radical surgery for right colon carcinoma may be marginal.
Distensibility of the anal canal in patients with systemic sclerosis: a study with the functional lumen imaging probe
Authors: Fynne L. , Luft F. , Gregersen H. , Buntzen S. , Lundby L. , Lundager F. , Laurberg S. , Krogh K. 
Published: October 2012

AbstractAimSystemic sclerosis (SSc) is a generalized connective tissue disease that affects smooth muscle cells. Patients with SSc often have faecal incontinence caused by fibrotic degeneration of the internal anal sphincter (IAS). The functional lumen imaging probe (FLIP) is a novel method that allows the segmental biomechanical properties of the anal canal to be dynamically evaluated. The aim of the present study was to compare the segmental biomechanical properties of the anal canal in incontinent SSc patients and healthy controls. We hypothesized that the FLIP would reveal weaknesses of the IAS in the SSc patients.MethodWe performed FLIP distensions, endoanal ultrasonography and standard anal manometry on 14 incontinent SSc patients [11 women, median age 60 years (range 35–80)] and 15 healthy volunteers [12 women, median age 54 years (range 33–67)]. The anal canal was divided into three parts for the biomechanical analysis: upper (surrounded by the IAS and the puborectalis), middle (IAS and external anal sphincter) and lower (external sphincter only).ResultsThe middle anal canal was the segment most resistant to distension in all of the subjects, but it was less resistant in the SSc patients than in the controls (P < 0.01). Correspondingly, the endoanal ultrasonography showed that the IAS of the SSc patients was thinner than normal (P < 0.05), and the anal resting and squeeze pressures were lower (P < 0.05). Only minor distensibility differences were found in the upper anal canal. No changes were found in the lower anal canal.ConclusionFaecal incontinence in SSc patients is associated with poor IAS function, causing increased distensibility of the middle anal canal.
Acute effects of resistance training on cytokines and osteoprotegerin in women with metabolic syndrome
Authors: Pereira Guilherme B. , Tibana Ramires A. , Navalta James , Sousa Nuno M. F. , Córdova Claudio , Souza Vinícius C. , Nóbrega Otávio T. , Prestes Jonato , Perez Sergio E. A. 
Published: October 2012

SummaryChronic inflammation has been identified as an important component of metabolic syndrome (MetS). Inhibition of the inflammatory mediator signals is a promising strategy against insulin resistance, atherosclerosis and other problems associated with MetS. Regular exercise decreases the components associated with MetS, including inflammatory cytokines. However, the relationship between an acute resistance training (RT) session, cytokine levels and MetS is unclear. Therefore, the aim was to evaluate the effects of a single bout of acute RT on tumour necrosis factor (TNF‐α), interleukins (IL) IL‐1a, IL‐1β, IL‐12, IL‐6, IL‐10 and osteoprotegerin (OPG) in women with MetS. Twenty‐four women were divided into 2 groups: metabolic syndrome (MetS) and non‐metabolic syndrome (Non‐MetS). After the familiarization and testing for 1 repetition maximum (1RM), participants completed 3 sets of 10 repetitions in the following exercises: machine leg press, leg extension, leg curl, chest press, lat front pull‐down and machine shoulder press with 60% of 1RM followed by 15 repetitions of abdominal crunches. A rest interval of 1 min was allowed between sets and exercises. Plasma TNF‐α, IL‐1a, IL‐1β, IL‐12, IL‐6, IL‐10 and OPG were measured before, immediately post and 60 min after RT. MetS group showed significantly higher concentrations of IL‐1β (P = 0·024) and IL‐6 (P = 0·049) and a trend for higher TNF‐α values (P = 0·092) compared with Non‐MetS. There was no group × time interactions after the RT session on the measured cytokines and osteoprotegerin. In conclusion, acute RT session induced no additional increase in pro‐inflammatory cytokines nor a decrease in anti‐inflammatory cytokines and OPG in women with MetS.
Stability of the Gross Motor Function Classification System after single‐event multilevel surgery in children with cerebral palsy
Authors: RUTZ ERICH , TIROSH OREN , THOMASON PAM , BARG ALEXEJ , GRAHAM H KERR 
Published: October 2012

Aim  There are conflicting reports about the stability of the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP) after orthopaedic surgery. We studied the stability of the GMFCS in children with bilateral spastic CP after single‐event multilevel surgery, using the Gait Profile Score (GPS) as the primary outcome measure.Method  This was a retrospective cohort study of 107 children (46 females, 61 males) with bilateral spastic CP, classified as GMFCS level II or III, who underwent surgery at a single tertiary institution between 1997 and 2008. The mean age at surgery was 10 years 7 months (SD 2y 8mo). The primary outcome measure was the GPS. Changes in GMFCS level were studied at multiple time points before and after intervention.Results  Gait dysfunction was partially corrected, with a mean improvement of 28% in the GPS. The GMFCS remained stable and unchanged in 95% of children and improved by one level in 5% of children. The improvement in GPS was three times the minimal clinically important difference. The mean age at final postoperative GPS assessment was 11 years 10 months (SD 2y 10mo) and at final GMFCS assessment was 15 years 7 months (SD 3y 9mo).Interpretation  Stability of the GMFCS was confirmed in the majority of children with bilateral spastic CP after single‐event multilevel surgery, despite statistically and clinically significant improvements in gait dysfunction and functional mobility. This information is important in realistic goal‐setting and in counselling families.
Ethnic aspects of emotional distress in patients with diabetes – the Amsterdam Health Monitor Study
Authors: Pouwer F. , Wijnhoven H. A. H. , Ujcic‐Voortman J. K. , de Wit M. , Schram M. T. , Baan C. A. , Snoek F. J. 
Published: October 2012

AbstractAimsDepression and anxiety are relatively common in patients with diabetes, but it is unclear whether migrant patients with diabetes are at increased risk for emotional distress. We determined levels of emotional distress in patients with diabetes with a Turkish, Moroccan or Dutch ethnic background and compare distress levels with healthy control subjects. Among patients with diabetes, we examined demographic and clinical correlates of higher levels of emotional distress.MethodsCross‐sectional data were collected within the framework of the population‐based Amsterdam Health Monitor Survey. Adult participants were interviewed to assess demographics, presence of chronic disease(s) and ethnic background. Emotional distress was determined with the Kessler psychological distress scale. Blood was drawn to determine HbA1c, glucose, HDL and total cholesterol. Anthropometrics and blood pressure were assessed during a medical examination.ResultsThe total sample comprised of 1736 participants. The prevalence of emotional distress was significantly higher in participants with diabetes (31%) compared with healthy participants (19%). Increased levels of emotional distress were reported by 38% of the Turkish, 35% of the native Dutch and 29% of the Moroccan patients with diabetes. Among patients with diabetes, the presence of two or more co‐morbid chronic diseases was most strongly associated with higher levels of emotional distress, whereas glycaemic control, cholesterol, blood pressure or waist circumference were not.ConclusionsEmotional distress affects approximately one third of adult patients with diabetes living in Amsterdam. Having multiple co‐morbid diseases seems related to more emotional distress among these patients, while ethnicity and diabetes‐related characteristics are not.
External validity of randomized controlled trials of glycaemic control and vascular disease: how representative are participants?
Authors: Saunders C. , Byrne C. D. , Guthrie B. , Lindsay R. S. , McKnight J. A. , Philip S. , Sattar N. , Walker J. J. , Wild S. H. ,   on behalf of the Scottish Diabetes Research Network Epidemiology Group
Published: October 2012

AbstractAimsTo describe the proportion of people with Type 2 diabetes living in Scotland who meet eligibility criteria for inclusion in several large randomized controlled trials of glycaemic control to inform physicians and guideline developers about the generalizibility of trial results.MethodsA literature review was performed to identify large trials assessing the impact of glycaemic control on risk of macrovascular disease. Inclusion and exclusion criteria from each trial were applied to data on the population of people with a diagnosis of Type 2 diabetes living in Scotland in 2008 (n = 180 590) in a population‐based cross‐sectional study and the number and proportion of people eligible for each trial was determined.ResultsSeven trials were identified. The proportion of people with Type 2 diabetes who met the eligibility criteria for the trials ranged from 3.5 to 50.7%. Trial participants were younger at age of diagnosis of diabetes and at time of trial recruitment than in the Scottish study population. The application of upper age criteria excluded the largest proportion of patients, with up to 39% of people with Type 2 diabetes ineligible for a trial with the most stringent criteria based on age alone.ConclusionsWe found that many of the large trials of glycaemic control among people with Type 2 diabetes have limited external validity when applied to a population‐based cohort of people with Type 2 diabetes. In particular, the age distribution of trial participants often does not reflect that of people with Type 2 diabetes in a contemporary British population.
NMDA receptor blockade by memantine does not prevent adaptation to recurrent hypoglycaemia in healthy men
Authors: Klement J. , Pais I. , Strube J. , Lehnert H. , Peters A. , Hallschmid M. , Born J. 
Published: October 2012

AbstractAimsRecurrent hypoglycaemia leads to an attenuation of hypoglycaemic symptoms and hormonal counterregulatory responses. This phenomenon poses a severe problem in the treatment of patients with diabetes mellitus, but the underlying neuroendocrine mechanisms are unclear. On the basis of animal experimental findings, we hypothesized that counterregulatory attenuation represents a basic adaptive learning process relying on synaptic long‐term potentiation or depression. If so, attenuation should be prevented by blocking glutamatergic N‐methyl‐d‐aspartate (NMDA) receptors.MethodsSixteen healthy young men participated in two conditions, separated by 4 weeks. Participants received the NMDA antagonist memantine over 5 days (15 mg/day) in one condition and placebo in the other one. After 3 days of drug administration, participants underwent two hypoglycaemic clamps on day 4 and another one on day 5. We assessed blood concentrations of counterregulatory hormones (cortisol, ACTH, epinephrine, norepinephrine, growth hormone and glucagon) as well as subjective symptoms of hypoglycaemia and word‐list recall as an indicator of short‐term memory.ResultsCounterregulatory responses of all hormones as well as neuroglycopenic and autonomic symptom ratings showed robust attenuation following the third as compared to the first hypoglycaemia (p < 0.05). NMDA receptor antagonization by memantine impaired memory function but did not alter any neuroendocrine measure of counterregulatory attenuation (p > 0.17).ConclusionsAttenuation of the endocrine as well as symptomatic counterregulatory response to recurrent hypoglycaemia is not prevented by the NMDA receptor blocker memantine. Our results do not support the view that adaptation to repeated hypoglycaemia relies on NMDA receptor‐mediated plastic processes involving long‐term potentiation or depression.
Clinical indicators of midface fracture in patients with trauma
Authors: Smith Hayden L. , Chrischilles Elizabeth , Janus Todd J. , Sidwell Richard A. , Ramirez Marizen , Peek‐Asa Corinne , Sahr Sheryl M. 
Published: October 2012

AbstractBackground/AimMidface fractures are commonly present and difficult to diagnose in trauma patients. The objective of this study was to determine clinically accessible indicators of midface fracture.Material and MethodsA case‐control study design was used to determine clinical indicators of midface fracture. Population source was a level I trauma center registry for years 2007–2009. Cases had a documented midface fracture. Patient and trauma characteristics were compared between cases and controls. Multivariate logistic regression analysis determined significant indicators of midface fracture.ResultsStudy sample included 83 cases and 83 frequency‐matched controls. Cases had a total of 211 fractures with a median of two midface fractures per person. Common fractures were orbital (41%), malar and maxillary (28%), and nasal bones (19%). Patients with midface fracture were significantly different than patients without midface fracture in severity of injury and were more likely to have a traumatic brain injury. Significant clinical indicators of fracture were maxillary sinus opacification, ethmoid sinus opacification, forehead laceration, periorbital contusion, epistaxis, and injury mechanism (P < 0.05). Patients with midface fracture had a 63 times greater odds for maxillary sinus opacification. The multivariable model correctly classified the presence and absence of midface fracture in 95% of study sample.ConclusionsDetermined indicators of midface fracture provided a high level of discrimination in fracture status. Indicators can be used by clinicians to help detect possible midface fractures. Future prospective research on midface fracture indicators can assist in establishing their generalizability and impact on fracture detection, care, and outcomes.
Effect of skimmed pasteurized milk and Hank's balanced salt solution on viability and osteogenic differentiation of human periodontal ligament stem cells
Authors: Wang Wen‐Jun , Zhao Yu‐Ming , Feng Xiao‐Yu , Jia Wei‐Qian , Ge Li‐Hong 
Published: October 2012

AbstractBackground/AimThe purpose of this study was to compare the effect of skimmed pasteurized milk and Hank's balanced salt solution on the viability and osteogenic differentiation potential of the human periodontal ligament stem cells at room temperature in vitro.Material and methodsHuman periodontal ligament stem cells were obtained from extracted healthy third molars and conserved in skimmed pasteurized milk and Hank's balanced salt solution for 1, 2, and 4 h at room temperature to detect the viability of the cells and their osteogenic differentiation potential.ResultsThe efficacy of skimmed pasteurized milk on cell viability at 4 h was significantly higher than that of HBSS (P < 0.05), and cells stored in skimmed pasteurized milk showed significantly higher levels of mineralization than those in HBSS at 2 and 4 h (P < 0.05).ConclusionsSkimmed pasteurized milk was more effective than Hank's balanced salt solution in maintaining the viability and osteogenic differentiation potential of PDLSCs at room temperature in vitro.