bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study
Authors: Matsushita Kunihiro , Blecker Saul , Pazin-Filho Antonio , Bertoni Alain , Chang Patricia P. , Coresh Josef , Selvin Elizabeth 
Published: May 2010

OBJECTIVE
This study sought to investigate an association of HbA1c (A1C) with incident heart failure among individuals without diabetes and compare it to fasting glucose.

RESEARCH DESIGN AND METHODS
We studied 11,057 participants of the Atherosclerosis Risk in Communities (ARIC) Study without heart failure or diabetes at baseline and estimated hazard ratios of incident heart failure by categories of A1C (&lt;5.0, 5.0–5.4 [reference], 5.5–5.9, and 6.0–6.4%) and fasting glucose (&lt;90, 90–99 [reference], 100–109, and 110–125 mg/dl) using Cox proportional hazards models.

RESULTS
A total of 841 cases of incident heart failure hospitalization or deaths (International Classification of Disease, 9th/10th Revision, 428/I50) occurred during a median follow-up of 14.1 years (incidence rate 5.7 per 1,000 person-years). After the adjustment for covariates including fasting glucose, the hazard ratio of incident heart failure was higher in individuals with A1C 6.0–6.4% (1.40 [95% CI, 1.09–1.79]) and 5.5–6.0% (1.16 [0.98–1.37]) as compared with the reference group. Similar results were observed when adjusting for insulin level or limiting to heart failure cases without preceding coronary events or developed diabetes during follow-up. In contrast, elevated fasting glucose was not associated with heart failure after adjustment for covariates and A1C. Similar findings were observed when the top quartile (A1C, 5.7–6.4%, and fasting glucose, 108–125 mg/dl) was compared with the lowest quartile (&lt;5.2% and &lt;95 mg/dl, respectively).

CONCLUSIONS
Elevated A1C (≥5.5–6.0%) was associated with incident heart failure in a middle-aged population without diabetes, suggesting that chronic hyperglycemia prior to the development of diabetes contributes to development of heart failure.
Roles of the Metabolic Syndrome, HDL Cholesterol, and Coronary Atherosclerosis in Subclinical Inflammation
Authors: Rein Philipp , Saely Christoph H. , Beer Stefan , Vonbank Alexander , Drexel Heinz 
Published: May 2010

OBJECTIVE
The metabolic syndrome (MetS) and coronary artery disease (CAD) frequently coincide; their individual contribution to inflammation is unknown.

RESEARCH DESIGN AND METHODS
We enrolled 1,010 patients undergoing coronary angiography. Coronary stenoses ≥50% were considered significant. The MetS was defined according to American Heart Association–revised National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS
C-reactive protein (CRP) did not differ between patients with significant CAD and subjects without significant CAD (P = 0.706) but was significantly higher in MetS patients than in those without MetS (P &lt; 0.001). The MetS criteria low HDL cholesterol (P &lt; 0.001), large waist (P &lt; 0.001), high glucose (P &lt; 0.001), and high blood pressure (P = 0.016), but not high triglycerides (P = 0.352), proved associated with CRP. When all MetS traits were considered simultaneously, only low HDL cholesterol proved independently associated with CRP (F = 44.19; P &lt; 0.001).

CONCLUSIONS
CRP is strongly associated with the MetS but not with coronary atherosclerosis. The association of the MetS with subclinical inflammation is driven by the low HDL cholesterol feature.
Acidosis: The Prime Determinant of Depressed Sensorium in Diabetic Ketoacidosis
Authors: Nyenwe Ebenezer A. , Razavi Laleh N. , Kitabchi Abbas E. , Khan Amna N. , Wan Jim Y. 
Published: May 2010

OBJECTIVE
The etiology of altered sensorium in diabetic ketoacidosis (DKA) remains unclear. Therefore, we sought to determine the origin of depressed consciousness in DKA.

RESEARCH DESIGN AND METHODS
We analyzed retrospectively clinical and biochemical data of DKA patients admitted in a community teaching hospital.

RESULTS
We recorded 216 cases, 21% of which occurred in subjects with type 2 diabetes. Mean serum osmolality and pH were 304 ± 31.6 mOsm/kg and 7.14 ± 0.15, respectively. Acidosis emerged as the prime determinant of altered sensorium, but hyperosmolarity played a synergistic role in patients with severe acidosis to precipitate depressed sensorium (odds ratio 2.87). Combination of severe acidosis and hyperosmolarity predicted altered consciousness with 61% sensitivity and 87% specificity. Mortality occurred in 0.9% of the cases.

CONCLUSIONS
Acidosis was independently associated with altered sensorium, but hyperosmolarity and serum “ketone” levels were not. Combination of hyperosmolarity and acidosis predicted altered sensorium with good sensitivity and specificity.
Glycemic Control Influences Serum Angiogenin Concentrations in Patients With Type 2 Diabetes
Authors: Siebert Janusz , Reiwer-Gostomska Magdalena , Mysliwska Jolanta , Marek Natalia , Raczynska Krystyna , Glasner Leopold 
Published: May 2010

OBJECTIVE
Because diabetes is the most frequent factor responsible for microvascular and macrovascular disease, we investigated angiogenin serum levels within the diabetic patient group.

RESEARCH DESIGN AND METHODS
We investigated 49 patients who met the criteria to be in the diabetic group. Forty nondiabetic patients were included in the control group. We set A1C &lt;7% as well-controlled diabetes. Serum angiogenin level was measured using the enzyme-linked immunosorbent assay method.

RESULTS
Serum angiogenin levels of poorly controlled patients with type 2 diabetes were significantly lower than those of group with well-controlled diabetes (361.23 ± 126.03 ng/ml vs. 446.37 ± 134.10 ng/ml; P = 0.001). Moreover, they were characterized by a significantly longer duration of the disease (P = 0.006), higher BMI (P = 0.0003), and higher systolic blood pressure (P = 0.01). Levels of total cholesterol, triglycerides, LDL, and HDL were not significantly different in both groups.

CONCLUSIONS
Patients with poorly controlled type 2 diabetes (A1C &gt;7%) have lower angiogenin levels than patients with well-controlled diabetes.
Dialysis Treatment Is an Independent Risk Factor for Foot Ulceration in Patients With Diabetes and Stage 4 or 5 Chronic Kidney Disease
Authors: Ndip Agbor , Rutter Martin K. , Vileikyte Loretta , Vardhan Anand , Asari Ashwinbhai , Jameel Mehreen , Tahir Hassan A. , Lavery Lawrence A. , Boulton Andrew J.M. 
Published: May 2010

OBJECTIVE
To determine whether dialysis treatment is an independent risk factor for foot ulceration in patients with diabetes and renal impairment.

RESEARCH DESIGN AND METHODS
We performed a cross-sectional study of consecutive patients with diabetes and stage 4 or 5 chronic kidney disease (CKD) attending clinics in Manchester (U.K.). Patients were classified as either receiving dialysis therapy (dialysis) or not (no dialysis). Foot assessment included diabetic peripheral neuropathy (DPN), peripheral arterial disease (PAD), prior foot ulceration and amputation, and foot self-care. Risk factors for prevalent foot ulceration were assessed by logistic regression.

RESULTS
We studied 326 patients with diabetes and CKD (mean age 64 years; 61% male; 78% type 2 diabetes; 11% prevalent foot ulceration). Compared with no dialysis patients, dialysis patients had a higher prevalence of DPN (79 vs. 65%), PAD (64 vs. 43%), prior amputations (15 vs. 6.4%), prior foot ulceration (32 vs. 20%), and prevalent foot ulceration (21 vs. 5%, all P &lt; 0.05). In univariate analyses, foot ulceration was related to wearing bespoke footwear (odds ratio 5.6 [95% CI 2.5–13]) dialysis treatment (5.1 [2.3–11]), prior foot ulceration (4.8 [2.3–9.8], PAD (2.8 [1.3–6.0], and years of diabetes (1.0 [1.0–1.1], all P &lt; 0.01). In multivariate logistic regression, only dialysis treatment (4.2 [1.7–10], P = 0.002) and prior foot ulceration (3.1 [1.3–7.1], P = 0.008) were associated with prevalent foot ulceration.

CONCLUSIONS
Dialysis treatment was independently associated with foot ulceration. Guidelines should highlight dialysis as an important risk factor for foot ulceration requiring intensive foot care.
Sex Steroids Affect Triglyceride Handling, Glucose-Dependent Insulinotropic Polypeptide, and Insulin Sensitivity
Authors: Lapauw Bruno , Ouwens Margriet , ′t Hart Leen M. , Wuyts Birgitte , Holst Jens J. , T'Sjoen Guy , Kaufman Jean-Marc , Ruige Johannes B. 
Published: May 2010

OBJECTIVE
To evaluate metabolic effects of sex steroids in nonfasting and fasting conditions, independent from changes in body composition.

RESEARCH DESIGN AND METHODS
A randomized clinical trial was performed to create contrasting sex steroid levels in healthy young men: by letrozole (aromatase inhibitor) to lower estradiol (E2) and increase testosterone (group T, n = 10) versus letrozole plus E2 patches to lower T and raise E2 (group E, n = 10). Mixed meals and hyperinsulinemic-euglycemic clamps were performed before and after a 1-week treatment period.

RESULTS
Following intervention, the postprandial triglyceride response displayed a diverging response with a decline in group T and an increase in group E; the postprandial glucose-dependent insulinotropic polypeptide (GIP) response increased in group T. Insulin sensitivity increased in group T but remained unaltered in group E.

CONCLUSIONS
In healthy young men, short-term changes in sex steroids affect postprandial triglyceride and GIP response and insulin sensitivity.
Measurement of response of pulmonal tumors in 64-slice MDCT
Authors: Sohns Christian , Mangelsdorf Johanna , Sossalla Samuel , Konietschke Frank , Obenauer Silvia 
Published: May 2010

Background: Advances in CT technology from single to multi-detector row CT (MDCT) permit a high resolution and volumetric presentation of pulmonary lesions. This implicates emerging measurement techniques that need to be contrasted with established methods. Purpose: To compare bidimensional, unidimensional, and volumetric methods for evaluation of treatment response in patients with lung lesions. Material and Methods: This study comprised 68 patients with pulmonary lesions who underwent a total of 276 64-MDCTs of chest at baseline and follow-up. RECIST and WHO criteria were used for unidimensional and bidimensional methods and region growing (RG) for volumetry. Patients were classified into four response categories. Respectively, two measurement techniques were contrasted and the κ index was calculated. For intra-observer reproducibility the relative measurement error (RME) and κ index with regard to agreement of response categories were evaluated. Results: Comparison of WHO und RECIST criteria achieves high correlation with κ indices of 0.76 and 0.82. In particular, lesions with moderate increase of size in the range of 25–44% for bidimensional and 12–29% for unidimensional measurement result in different response categories when applying WHO and RECIST criteria. WHO criteria delivered PD more often than RECIST. κ indices of 0.79 and 0.87 were attained in comparison of RECIST and RG, and 0.83 and 0.84 for WHO and RG. RME was 2.82% for RECIST, 7.53% for WHO, and 8.97% for RG. Intra-observer reproducibility was 95% for RECIST, 95% for WHO, and 96% for RG. Conclusion: The comparison of all methods resulted in no statistically significant differences. WHO criteria seemed to diverge the most, they declared several lesions prematurely as progression, and showed no benefit in comparison to RECIST. RG showed the best reproducibility, considered irregular lesions, was slightly superior to RECIST, and could be applied uniformly. Unidimensional measurement represents an adequate alternative with the advantage of better clinical work flow.
Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program
Authors: Lipasti Seppo , Anttila Ahti , Pamilo Martti 
Published: May 2010

Background: Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening. Purpose: To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program. Material and Methods: The material consisted of women, 50–59 years of age, who were invited for screening: 30 153 women with DM in 2007–2008 and 32 939 women with SFM in 1999–2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared. Results: Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for cancer of all recalls for diagnostic work-up were significantly higher in DM (36%) than in SFM (26%). Conclusion: In DM women were recalled for diagnostic work-up more often for calcifications, parenchymal distortions, and asymmetries than in SFM. In the case of tumor-like masses, more women were recalled in SFM. DM detected more cancers than SFM, and the PPVs for cancer were higher in DM than in SFM in all subgroups of radiological findings.
Dual-energy digital radiography for the assessment of bone mineral density
Authors: Tahvanainen Päivi S. , Lammentausta Eveliina , Pulkkinen Pasi , Tervonen Osmo , Jämsä Timo , Nieminen Miika T. 
Published: May 2010

Background: Bone mineral density (BMD) is usually determined by dual-energy X-ray absorptiometry (DXA). Digital radiography (DR) has enabled the application of dual-energy techniques for separating bone and soft tissue, but it is not clear yet whether BMD information can reliably be obtained using DR. Purpose: To determine the ability of dual-energy digital radiography (DEDR) to predict BMD as determined by DXA. Material and Methods: Reindeer femora ( n=15) were imaged in a water bath at a typical clinical imaging voltage of 79 kVp and additionally at 100 kVp on a DR system. BMD was determined in four segmented regions (femoral neck, trochanter, inter-trochanter, Ward's triangle) from these images using the DXA calculation principle. BMD results as determined by DEDR were compared with BMD values as determined by DXA. Results: Significant moderate to high linear correlations (0.66–0.76) were observed at the femoral neck, Ward's triangle, and trochanter between BMD values as determined by the two techniques. The coefficient of variation (CVRMS) ranged between 2.2 and 4.7% and 0.2 and 1.8% for DEDR and DXA analyses, respectively. Conclusion: DXA-based BMD information can be obtained with moderate precision and accuracy using DEDR. In future, combining BMD measurements using DEDR with structural and geometrical information available on digital radiographs could enable a more comprehensive assessment of bone.
Comparison of two software versions of a commercially available computer-aided detection (CAD) system for detecting breast cancer
Authors: Kim Seung Ja , Moon Woo Kyung , Kim Soo-Yeon , Chang Jung Min , Kim Sun Mi , Cho Nariya 
Published: May 2010

Background: The performance of the computer-aided detection (CAD) system can be determined by the sensitivity and false-positive marks rate, therefore these factors should be improved by upgrading the software version of the CAD system. Purpose: To compare retrospectively the performances of two software versions of a commercially available CAD system when applied to full-field digital mammograms for the detection of breast cancers in a screening group. Material and Methods: Versions 3.1 and 8.3 of a CAD software system (ImageChecker, R2 Technology) were applied to the full-field digital mammograms of 130 women (age range 36–80, mean age 53 years) with 130 breast cancers detected by screening. Results: The overall sensitivities of the version 3.1 and 8.3 CAD systems were 92.3% (120 of 130) and 96.2% (125 of 130) ( P=0.025), respectively, and sensitivities for masses were 78.3% (36 of 46) and 89.1% (41 of 46) ( P=0.024) and for microcalcifications 100% (84 of 84) and 100% (84 of 84), respectively. Version 8.3 correctly marked five lesions of invasive ductal carcinoma that were missed by version 3.1. Average numbers of false-positive marks per image were 0.38 (0.15 for calcifications, 0.23 for masses) for version 3.1 and 0.46 (0.13 for calcifications, 0.33 for masses) for version 8.3 ( P=0.1420). Conclusion: The newer version 8.3 of the CAD system showed better overall sensitivity for the detection of breast cancer than version 3.1 due to its improved sensitivity for masses when applied to full-field digital mammograms.
Le corps aux limites de la pensée
Authors: Brun Danièle 
Published: May 2010

Que veut le corps ? Que me veut-il ? Que veulent les médecins ? Autant de questions qui se rapportent à l’énigme et qui relancent l’énigme à l’instar de la fameuse question freudienne : Was will das Weib? Que veut la femme? Ces questions sont aussi l’effet de l’incertitude quant au sens du désir de l’autre qui se trouve être tantôt le médecin, tantôt le parent, tantôt l’un et l’autre. Quand le corps est aux limites de la pensée, l’espace psychique est envahi et le sentiment d’identité mis en péril. Quelques exemples issus de la pratique de la cure illustrent cette situation à l’appui de lectures et de références à la psychanalyse.
La fabrication du corps, un pluriel singulier
Authors: Lazali Karima 
Published: May 2010

Le texte Histoire de l’œil de George Bataille est orienté par le projet d’extraire dans un arrêt sur image l’insaisissable du corps. Pour cela, l’auteur a recours à une destruction organisée de l’unité corporelle. Le statut du corps dans ce texte est utilisé pour illustrer qu’il n’y a de corps, qu’à partir d’un certain renoncement à la « chair », soit à l’en-corps. En cela le registre de la perversion est un modèle paradigmatique pour penser cette fabrication et ses éventuels ratages. À ce propos, les cures analytiques des enfants sont d’un apport fondamental quant au trajet effectué pour accéder à la position d’avoir un corps.
D'un aucun autre endroit
Authors: de Rivoyre Frédéric 
Published: May 2010

Cette réflexion explore le champ sémantique et les implications cliniques de la notion de « l’ailleurs ». « Construire l’ailleurs » y apparaît comme une version de l’élaboration de la métaphore du Nom-du-père, acte auquel est convié le psychanalyste qui s’aventure dans le champ de la psychose infantile.
L'enfant objet de soin. De quelle guérison s'agit-il ?
Authors: Mathelin Catherine 
Published: May 2010

Aujourd’hui, les progrès de la médecine amènent de plus en plus souvent les enfants à naître dans des conditions particulières. Quelquefois même « hors sexe et hors filiation ». Quel rôle peut-être celui du psychanalyste, dans des services de médecine de pointe, PMA ou grande prématurité ? Comment parler de guérison dans ce domaine et si oui, de quelle guérison s’agit-il ?
Réminiscences du professeur Sigmund Freud
Authors: Graf Max 
Published: May 2010

Max Graf, musicologue viennois et père du « petit Hans », rappelle ses souvenirs de Freud et des premiers temps de la psychanalyse. Il a fait partie des premiers disciples et rend hommage à la façon dont Freud a défriché de nouveaux continents et fait face aux critiques et railleries, à son esprit brillant et à sa vaste culture.
Du bon usage de l'objet chez Winnicott
Authors: Sédat Jacques 
Published: May 2010

Les observations cliniques de Winnicott, écrites en 1941, sur le rapport de l’enfant à l’objet font apparaître chez l’enfant le passage d’une pulsion de destruction de l’objet fantasmé à l’appropriation de l’objet réel, condition d’accès à son autonomie de sujet, tout comme le relevait déjà Freud, à propos du Fort-Da . Dans son dernier texte, en 1968, Winnicott prolonge sa recherche en rapprochant la situation de l’enfant et celle de l’analysant dans le rapport à l’objet : l’analyste doit accepter d’être « utilisé » pour que son patient puisse accéder à sa propre subjectivité et s’approprier son histoire.
Lacan et Mai 68
Authors: Sédat Jacques 
Published: May 2010

Jacques Lacan a suivi de très près tout ce qui a éclaté au printemps 68, partagé entre une curiosité sympathisante et une irritation devant les aspirations maoïstes. Avec quelques mois de recul, il fait un bilan plus mitigé et sévère, voyant moins dans ce mouvement un « événement » qu’un « émoi », une forme de désarroi qui a abouti au triomphe de dérives idéologiques et du discours universitaire, où la vanité, selon lui, l’emporte sur la vérité.
Les objectifs français à la conférence navale de Londres (21 janvier - 22 avril 1930)
Authors: Laberge Martin 
Published: May 2010

Les objectifs français à la conférence navale de Londres (21 janvier - 22 avril 1930) Cet article examine les deux dimensions des objectifs français à la conférence navale de Londres : protéger les intérêts stratégiques de la France en préservant sa supériorité navale en Méditerranée et construire un accord politique garantissant le statu quo dans la région. À Londres, la Marine et les Affaires étrangères ont défendu une politique et une stratégie globales, autonomes et capables de répondre à leurs besoins sécuritaires. En maintenant l’indépendance stratégique et politique du pays en Méditerranée, les décideurs français avaient pour dessein, en fonction des travaux de la conférence sur le désarmement de Genève, d’ « assurer l’avenir » de la sécurité et de la puissance de la France face à l’adversaire le plus menaçant : l’Allemagne.
Jean Tannery (1878-1939) à l'origine de la guerre économique
Authors: Bourlet Michaël 
Published: May 2010

Jean Tannery (1878-1939) à l’origine de la guerre économique Dès l’entrée en guerre de la France en août 1914, le conflit n’est pas envisagé autrement que par le feu. Pourtant, le concept de guerre économique, imaginé par quelques hommes en 1914, est progressivement une réalité à l’état-major de l’armée pendant la Première Guerre mondiale. Parmi eux, Jean Tannery joue un rôle essentiel dans la création de la section de contrôle du cabinet du ministre de la Guerre, devenue section économique de l’état-major de l’armée et dans l’organisation du blocus. Issu d’un milieu d’intellectuels, fonctionnaire des finances de la III e République, Tannery devient le « général » de la guerre économique en France de 1914 à mai 1918 en pensant, créant et organisant une lutte totale que le temps de paix n’avait pas prévu.