bluuebunny/crossref_metadata_2025_split huggingface dataset:
Larger biopsies evaluation of transient elastography for detecting advanced fibrosis in patients with compensated chronic hepatitis B
Authors: Chen Yong Peng , Liang Xie Er , Zhang Qi , Peng Jie , Zhu You Fu , Wen Wei Qun , Hou Jin Lin 
Published: March 2012

AbstractBackground and Aim:  Although larger biopsies sample had been recommended for the study of non‐invasive liver fibrosis assessment, few studies with larger biopsies for transient elastography (TE) detecting liver fibrosis had been reported. The present study tries to re‐evaluate the performance of TE for detecting advanced fibrosis (≥F3) with larger biopsies in patients with compensated chronic hepatitis B.Methods:  A total of 375 compensated patients were analyzed, who had undergone liver biopsy, reliable TE and routine blood tests.Results:  The area under the receiver operating characteristic curve (AUC) was influenced by liver biopsy sample: 0.873 (95% confidence interval 0.838–0.909) in total patients, 0.880 (0.844–0.917) in length ≥ 15 mm, 0.897 (0.863–0.932) in length ≥ 20 mm and 0.911 (0.874–0.949) in length ≥ 25 mm. In patients with sample length ≥ 20 mm, the cutoffs to exclude and confirm advanced fibrosis were 7.1 kPa and 12.7 kPa, respectively. Stratified by alanine aminotransferase of two times the upper limit of normal (ALT 2 × ULN), transient elastography detecting advanced fibrosis with the most efficiency by 72.5% of patients obviated from liver biopsy. In patients with normal bilirubin and ALT < 2 × ULN, the area was 0.921 (0.860–0.982), and cutoffs for excluding and confirming diagnosis were 7.4 kPa and 10.6 kPa, respectively; 80% of patients could be classified with or without advanced fibrosis (AF). In patients with normal bilirubin and ALT ≥ 2 × ULN, the corresponding numbers were 0.885 (0.824–0.947), 7.5 kPa, 12.7 kPa and 79.2%, respectively.Conclusions:  Inadequate sample study would underestimate the efficiency of TE on detecting advanced fibrosis. With ALT 2 × ULN stratified cutoffs, TE determined nearly 80% of patients with normal bilirubin as AF or non‐AF and obviated them from liver biopsies.
Is myomectomy always the best choice for infertile women with symptomatic uterine fibroids?
Authors: Tropeano Giovanna , Romano Domenico , Mascilini Floriana , Gaglione Raffaele , Amoroso Sonia , Scambia Giovanni 
Published: March 2012

AbstractUterine artery embolization (UAE) is still regarded by most gynaecologists as contraindicated for women with symptomatic fibroids and otherwise unexplained infertility. For such patients, myomectomy is the usual option. We performed UAE as treatment of menorrhagia in an infertile woman with multiple subserosal and intramural fibroids who had previously failed multiple myomectomy. UAE resulted in durable symptom relief and substantial reduction of the uterine and fibroid size. The patient conceived spontaneously 20 months after UAE and progressed through pregnancy uneventfully. At 38 weeks of gestation, she underwent elective cesarean section and delivered a normal, healthy, 3180‐g fetus without complications. The present case demonstrates that in symptomatic women with multiple subserosal and intramural fibroids and otherwise unexplained infertility, UAE may have symptomatic and reproductive outcomes superior to those of myomectomy.
Preoperative plasma fibrinogen, platelet count and prognosis in epithelial ovarian cancer
Authors: Qiu Jian , Yu Yanping , Fu Yunfeng , Ye Feng , Xie Xing , Lu Weiguo 
Published: March 2012

AbstractAim:  The aim of the present study was to investigate the correlation between fibrinogen level, platelet count and prognosis in patients with epithelial ovarian cancer (EOC).Material and Methods:  Preoperative fibrinogen level and platelet count in 136 EOC patients and 146 patients with benign ovarian tumor, and their associations with clinicopathologic parameters and survival in EOC patients, were retrospectively analyzed.Results:  The fibrinogen level in EOC was higher than that in benign patients (3.95 ± 1.37 g/L versus 2.88 ± 0.6 g/L, P < 0.001), and 36.0% (49/136) of EOC patients had hyperfibrinogenemia (fibrinogen >4.0 g/L). The platelet count in EOC was higher than that in benign patients (251.5 ± 89.4 × 109/L versus 206.7 ± 49.0 × 109/L P < 0.001), and 7.4% (10/136) of EOC patients had thrombocytosis (platelet count >400 × 109/L). Hyperfibrinogenemia was associated with International Federation of Gynecologists and Obstetricians (FIGO) stage, non‐optimal cytoreduction and poor chemo‐response, but not with histologic type and grade, CA‐125 level, chemotherapy method, and age. EOC patients with advanced disease showed higher rate of elevated thrombocyte count than patients with early disease (30.7% versus 8.3%, P = 0.002). The rate of thrombocytosis was higher in patients with hyperfibrinogenemia than in those with normal fibrinogen (9/10 versus 1/10, P < 0.001). A significant correlation between platelet count and fibrinogen level was observed in EOC patients (P < 0.001). In multivariate analysis, overall survival was influenced by tumor stage (P < 0.001), chemotherapy with taxane (P < 0.001) and fibrinogen level (P = 0.004), and disease‐free survival was only influenced by tumor stage (P < 0.001).Conclusion:  Our findings suggest that hyperfibrinogenemia may be a predictor for poor chemo‐response and have a potential role as independent prognostic factors in EOC patients.
Large parasitic myomas in abdominal subcutaneous adipose tissue along a previous myomectomy scar
Authors: Yanazume Shintaro , Tsuji Takahiro , Yoshioka Takako , Yamasaki Hideki , Yoshinaga Mitsuhiro , Douchi Tsutomu 
Published: March 2012

AbstractThe incidence of iatrogenic parasitic uterine myomas associated with the use of a laparoscopic morcellator has been increasing over the past decade. Recently, we encountered a very rare case with a large parasitic myoma measuring 12 cm in diameter in the abdominal subcutaneous adipose tissue along an abdominal longitudinal surgical scar. The patient had twice undergone abdominal myomectomy for multiple fundal myomas. This is the first report describing a case with as large a parasitic myoma presenting in the suprafascial adipose tissue under the surgical scar after laparotomy. In such a case demonstrating a solid tumor of unknown cause after a gynecologic surgical procedure, a parasitic myoma must be included in the differential diagnosis.
Value of three‐dimensional contrast‐enhanced power Doppler ultrasound for characterizing adnexal masses
Authors: Huchon Cyrille , Metzger Ulrike , Bats Anne‐Sophie , Bensaid Cherazade , Chatellier Gilles , Azizi Michel , Lefrère‐Belda Marie‐Aude , Dujardin Arnaud , Bernard Jean‐Pierre , Lécuru Fabrice 
Published: March 2012

AbstractAims:  The aim of this study was to assess the diagnostic performance of 3‐D contrast‐enhanced power Doppler ultrasonography (3‐D CEPDUS) for differentiating benign and malignant adnexal masses.Material and Methods:  Consecutive patients with adnexal masses were included prospectively and underwent 2‐D ultrasonography and 3‐D CEPDUS in a tertiary centre in Paris, France. The main outcome measure was the diagnostic accuracy of 3‐D CEPDUS to diagnose malignant and borderline adnexal masses. The reference standard was the final histological examination. Two‐dimensional ultrasonography and 3‐D CEPDUS were compared using semiquantitative scores. Three‐dimensional CEPDUS assessed vessel density, vessel pattern, and three vascular indexes in a 5‐mL region of interest (vascularization index [VI], flow index [FI], and vascularization flow index [VFI]). The 2‐D and 3‐D examinations were done by different sonographers who were blinded to the other test. The pathologist was blinded to ultrasonography findings.Results:  Of 99 patients, 88 had benign tumors and were compared to the 11 patients with borderline (n = 5) or malignant (n = 6) tumors. The sensitivity of the subjective 2‐D score was 55% (95% confidence interval [CI], 25–84) and specificity 94% (95%CI, 89–99). The sensitivity of the subjective 3‐D score was 82% (95%CI, 58–100) and specificity 90% (95%CI, 83–96). Improvement of detection of malignant or borderline tumors by subjective 3‐D score was 150%. Vessel density and patterns were not more efficient than the subjective 3‐D score. The mean vascular index values were significantly different between benign and borderline/malignant groups: VI, 7.2 versus 35.5 (P < 0.0001); FI, 37.0 versus 48.2 (P = 0.003); and VFI, 2.9 versus 17.6 (P < 0.0001), respectively.Conclusions:  3‐D CEPDUS improves detection of malignant and borderline adnexal masses.
External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: Case report and review of the literature
Authors: Vizzielli Giuseppe , Fanfani Francesco , Costantini Barbara , Gallotta Valerio , Scambia Giovanni , Fagotti Anna 
Published: March 2012

AbstractThe best treatment for bone metastasis from endometrial cancer as a presenting feature is unclear. We report the first case in the literature of coxofemoral metastases from endometrial cancer treated by surgical approach. Then, after a careful review of the literature, we discuss the best therapeutic option for this subset of patients. A 62‐year‐old woman with pain, erythema and swelling of the left leg and no history of postmenopausal bleeding underwent biopsy of the leg, which revealed a moderately differentiated endometrial carcinoma, infiltrating muscle and adipose tissues. There were no other sites of distal spread. A literature review was conducted by searching the items ‘endometrial cancer’ and ‘bone metastasis’ in MEDLINE and EnBase up to September 2010. The patient was treated with neoadjuvant chemotherapy, but she did not show a clinical response. By considering her prognosis and quality of life, we decided to perform for the first time a total abdominal hysterectomy with bilateral salpingo‐oophorectomy in addition to an external hemipelvectomy with a limb amputation and partial ilium and pubic preservation. Thirty months after the procedure the patient is still alive. No other similar results are present in the literature. Patients in good clinical condition with a single bone metastasis of endometrial cancer should be treated aggressively with surgery, as survival can be extended with an acceptable quality of life.
Long‐term follow‐up after anterior sphincter repair: influence of age on functional outcome
Authors: Warner M. W. , Jones O. M. , Lindsey I. , Cunningham C. , Mortensen N. J. 
Published: March 2012

AbstractAim  Anterior sphincter repair has been advocated for women with anterior sphincter defects and faecal incontinence. There have been a number of reports of deterioration in functional outcome from anal sphincter repair over the long‐term and of inferior outcomes in older patients. This study set out to examine these issues in a specialist tertiary referral unit.Method  Patients having a sphincter repair were identified from a prospectively collected database. The information within the database was expanded by the use of a postal questionnaire and structured review of the case notes. The questionnaire incorporated commonly used validated scoring systems as well as subjective questions.Results  One hundred and thirteen patients were identified, of whom 66 (58%) responded. Of these patients, four had incomplete medical notes, leaving 62 (55%) with both returned questionnaires and complete medical notes. Forty‐eight (72%) patients reported subjective initial improvement in their symptoms, though only 37 (56%) believed themselves improved at long‐term follow‐up (median 8.8 years; range 1.1–13.6 years). Incontinence and quality of life scores mirrored these patients’ subjective responses. The median age of those patients reporting a subjective improvement at long‐term follow‐up was 38, compared with 56 in those who thought they were not improved (P < 0.001).Conclusions  Outcome from anal sphincter repair deteriorates with time. Subjective outcome is worse in older patients who additionally tend to have worse incontinence scores and quality of life measures.
Functional analyses of the mutation nt‐128 T→G in the hepatocyte nuclear factor‐1α promoter region in Chinese diabetes pedigrees
Authors: Fang Q. , Chen S. , Wang Y. , Jiang S. , Zhang R. , Hu C. , Wang C. , Liu F. , Xiang K. , Jia W. 
Published: March 2012

AbstractAims  Hepatocyte nuclear factor‐1α (HNF‐1α) regulates the expression of genes encoding proteins involved in glucose metabolism and insulin secretion. Mutations in the HNF‐1α gene cause maturity‐onset diabetes of the young Type 3. However, the mechanism leading to this disease has not been completely ascertained. Previously, we found a novel mutation in the regulatory element of the human HNF‐1α gene in two Chinese diabetes pedigrees. The nucleotide at position ‐128 T was substituted by G (nt‐128 T→G). In this study, we analysed the functional defect of nt‐128 T→G in HNF‐1α transcription activity.Methods  Luciferase reporter gene assays were carried out to examine the functional characteristics of this mutant. Electrophoretic mobility shift assays and chromatin immunoprecipitation were performed to confirm the binding of nuclear proteins to oligonucleotides.Results  The variant construct (nt‐128 T→G) had a 1.65‐fold increase in promoter activity compared with that of the wild‐type construct in HepG2 cells and a 1.33‐fold increase in MIN6 cells, respectively. The variant resided at a FOXA/HNF‐3 binding site identified by a series of competitive electrophoretic mobility shift assays and antibody supershift analyses. The assays showed a differential binding affinity in the wild‐type and the nt‐128 T→G mutant fragments by FOXA/HNF‐3. Chromatin immunoprecipitation indicated that FOXA/HNF‐3 bound to this region in vivo. One nucleotide substitution in the FOXA/HNF‐3 site in the human HNF‐1α regulatory element caused an increase of HNF‐1α transcriptional activity.Conclusions  Our data suggested that this substitution in the promoter region affects DNA–protein interaction and HNF‐1α gene transcription. The mutant may contribute to the development of diabetes in these two nt‐128 T→G pedigrees of Chinese.
Effectiveness of peer‐led self‐management coaching for patients recently diagnosed with Type 2 diabetes mellitus in primary care: a randomized controlled trial
Authors: van der Wulp I. , de Leeuw J. R. J. , Gorter K. J. , Rutten G. E. H. M. 
Published: March 2012

Diabet. Med. 29, e390–e397 (2012)SummaryAims  To study the effectiveness of a peer‐led self‐management coaching intervention in recently diagnosed patients with Type 2 diabetes.Methods  Randomized controlled trial of recently diagnosed patients with Type 2 diabetes from 54 participating general practices. The intervention group received three home visits by an experienced peer (expert patient) who adhered to the recommended treatment and lifestyle guidelines. Together with their expert patient, participants set feasible goals and these were evaluated in the next visit. Participants in the control group received care as usual. At baseline, 3 months and 6 months post‐intervention, participants completed a questionnaire measuring changes in self‐efficacy, coping, physical activity, dietary habits, psychological well‐being, depressive symptoms and diabetes related distress.Results  In total, 327 patients were eligible for inclusion in the study of which 133 consented to participate. In participating patients, self‐efficacy, coping and saturated fat intake improved significantly over time. Analyses of participants with low self‐efficacy at baseline (25th percentile: 44) revealed a significant time × group difference, F = 3.71; P = 0.03. Participants who reported low psychological well‐being at baseline increased substantially throughout the study (F = 23.84; P < 0.01) but no significant time × group differences were found.Conclusions  A peer‐led self‐management coaching programme for recently diagnosed patients with Type 2 diabetes improved self‐efficacy of patients experiencing low self‐efficacy shortly after diagnosis.
Diabetic retinopathy screening: perspectives of people with diabetes, screening intervals and costs of attending screening
Authors: Yeo S. T. , Edwards R. T. , Luzio S. D. , Charles J. M. , Thomas R. L. , Peters J. M. , Owens D. R. 
Published: March 2012

Diabet. Med. 29, 878–885 (2012)AbstractAims  To obtain the views of people with diabetes about the provision of diabetic retinopathy screening services; and the interval of screening.Methods  Between October 2009 and January 2010, people with diabetes attending diabetic retinopathy screening clinics across Wales were asked to complete a questionnaire comprising of two parts: the first asking about their health, diabetes history, demographic characteristics and views about the diabetic retinopathy screening service, and the second asking about the costs of attending the screening.Results  The response rate was 40% (n = 621) from 1550 questionnaires distributed at diabetic retinopathy clinics, with 600 complete responses analysed. Respondents had a mean known duration of diabetes of 8.5 years (sd 7.8) and had attended for screening on average 3.2 times (sd 1.6) in the last 5 years. Sixty‐eight per cent (n = 408) of respondents reported having their eyes screened approximately once a year. Eighty‐five per cent (n = 507) felt that they should have their eyes screened every year. However, 65% (n = 390) of respondents would accept screening at 2‐ or 3‐year intervals if medical evidence showed that it was safe. The reported personal costs incurred by respondents attending diabetic retinopathy screening were low.Conclusion  Our study suggests that people with diabetes undergoing diabetic retinopathy screening would accept a greater screening interval, provided that adequate clinical evidence and medical reassurance were given.
Prevalence of ketoacidosis at diagnosis of childhood onset Type 1 diabetes in Wales from 1991 to 2009 and effect of a publicity campaign
Authors: Lansdown A. J. , Barton J. , Warner J. , Williams D. , Gregory J. W. , Harvey J. N. , Lowes L. ,   on behalf of the Brecon Group
Published: March 2012

Diabet. Med. 29, 1506–1509 (2012)AbstractAims  To determine the proportion of cases of childhood Type 1 diabetes that present with ketoacidosis and any temporal trend. To assess the impact of a publicity campaign promoting earlier diagnosis.Methods  We used an all‐Wales register of incident cases with data on 2046 children from 1991 to 2009. The proportion with ketoacidosis at diagnosis was compared with the Yorkshire Childhood Diabetes Register. On World Diabetes Day posters were sent to every pharmacy, school and general practitioner surgery across Wales and radio interviews given. A questionnaire survey was conducted in Gwent to assess penetrance of the campaign.Results  Annually, in 1991–2009 the proportion presenting with ketoacidosis varied between 20% and 33% (mean 25%) with no change over time. Similar proportions occurred in Yorkshire. Ketoacidosis was more common before age 5 years (37% of cases) than at age 5–9 years (20%) or 10–14 years (23%) (P < 0.001). From November 2006–2007 30% of cases presented with ketoacidosis and from November 2007–2008 25% cases presented with ketoacidosis. After the campaign (November 2008–2009) 26% presented with ketoacidosis (P = 0.72). The information had reached a low proportion of families. General practitioners referred immediately cases that presented to them.Conclusions  Over 20 years in Wales there has been no change in the proportion of children with Type 1 diabetes initially presenting with ketoacidosis. This presentation occurs in a higher proportion of new cases aged under 5 years. Publicity to increase awareness did not reduce the proportion with ketoacidosis at diagnosis in Wales. We need to get the educational message through to parents to reduce ketoacidosis at presentation.
Fasting plasma glucose 6–12 weeks after starting insulin glargine predicts likelihood of treatment success: a pooled analysis
Authors: Karl D. , Zhou R. , Vlajnic A. , Riddle M. 
Published: March 2012

Diabet. Med. 29, 933–936 (2012)AbstractAims  To evaluate whether fasting plasma glucose values measured early during insulin therapy can identify patients with Type 2 diabetes who may not achieve adequate glycaemic control after 6 months and will require additional treatment.Methods  Patient‐level data from seven prospective, randomized, controlled studies using treat‐to‐target methods were pooled to evaluate the efficacy of insulin glargine. Fasting plasma glucose was measured at baseline, week 6 or 8 (6/8) and week 12. HbA1c was measured at week 24 to assess glycaemic control.Results  One thousand and thirty‐six patients (56% male, 81% white) were included in the analysis (mean age 56.3 years; duration of diabetes 8.4 years). Baseline mean fasting plasma glucose was 11.2 mmol/l and mean HbA1c was 73 mmol/mol (8.8%). After 24 weeks of treatment, mean HbA1c decreased to 53 mmol/mol (7.0%); 56% of patients reached a target HbA1c≤ 53 mmol/mol (7.0%). Significant correlations with week 24 HbA1c were obtained for fasting plasma glucose measured at week 6/8 and week 12 (r = 0.32; P < 0.0001 for both). Patients with fasting plasma glucose > 10 mmol/l at week 6/8 or week 12 were significantly less likely to achieve the HbA1c target at the end of treatment than patients with fasting plasma glucose < 8.9 mmol/l (P < 0.0001 for both). If fasting plasma glucose was > 10 mmol/l at week 6/8 or week 12, patients had only a 27% chance of reaching the HbA1c goal.Conclusions  Fasting plasma glucose remaining > 10 mmol/l after 6–12 weeks of glargine therapy indicates that reaching target HbA1c≤ 53 mmol/mol (7.0%) is unlikely and calls for individualized attention to consider further therapeutic options.
The First Quarter Century of the GASB (1984–2009): A Perspective on Standard Setting (Part One)
Authors: ROYBARK HELEN M. , COFFMAN EDWARD N. , PREVITS GARY J. 
Published: March 2012

The Governmental Accounting Standards Board (hereafter GASB or Board) was established in April 1984 as the authoritative accounting standard‐setting body for United States state and local governmental entities. There are over 87,000 state and local entities in the country, and for the most part these entities are required to comply with the generally accepted accounting principles established by the GASB; hence, the work of the GASB is significant.On 30 June 2009, the GASB completed its twenty‐fifth year of standard setting. Because of the Board's influence and the importance of its mission, an increased understanding of the GASB and its accomplishments during its first 25 years of existence is important.This is the first of two papers which together provide a complete sequential treatment of the GASB's operational history through the end of its first quarter century. This first paper begins with an historical perspective about municipal accounting issues from colonial times to 1934. The origin of professional self‐determining standards is the feature of the next section, identifying standard‐setting bodies that contributed to municipal accounting from 1934 to 1984. The early activities of the Board are then reviewed. Two appendices are provided to detail the composition of the Board during its first quarter century, along with biographical information about the early Board members and later Chair and Vice Chair personnel. This segment concludes with a review of the relationship of other governmental standard setting bodies at the federal level and the international level.