bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of diabetes in family members of probands with non‐insulin‐dependent diabetes mellitus
Authors: SIMMONS D. , GATLAND B. A. , LEAKEHE L. , FLEMING C. 
Published: August 2009

Abstract. Objectives. To describe the prevalence of known diabetes in a multi‐ethnic community in South Auckland, New Zealand, in relation to family history of diabetes and past history of diabetes in pregnancy.Design. A cross‐sectional, household survey comparing ascertainment with local general practice diabetes registers where they existed.Setting. An inner‐city community with a high proportion of Maori, Pacific Islands people and Europeans.Subjects. A total of 55518 residents (91% response). Comparison with diabetes registers showed 91% ascertainment of known diabetic residents. More detailed interviews with 176/214 (82%) Europeans, 286/336 (85%) Maori and 495/585 (85%) Pacific Islands people with known diabetes. Fifty subjects had insulin‐dependent diabetes mellitus on clinical criteria and were excluded from analyses.Main outcome measures. Prevalence of diabetes.Results. Those with non‐insulin‐dependent diabetes mellitus were more likely to have a diabetic mother than father (Europeans, 21.7% vs. 9.9%; Maori, 17.6 vs. 11.4%; Pacific Islands, 15.7 vs. 5.3%). Diabetic women had a similar likelihood of having a diabetic father as diabetic men but were 1.84 times as likely to have a diabetic mother (95% CI, 1.27–2.69). Diabetic women with past diabetes in pregnancy had 2.05 (95% CI, 1.01–4.15) times the chance of a diabetic offspring as women who had not had past diabetes in pregnancy, who in turn had 2.69 (95% CI, 1.17–6.18) times the likelihood of having a diabetic offspring as diabetic men.Conclusions. The mother is a more important conduit for inheritance of diabetes than the father in these three ethnic groups. A history of diabetes in pregnancy confers an extra risk to the offspring above this usual maternal excess.
Long‐term anticoagulant therapy in cerebrovascular disease: does bleeding outweigh the benefit?
Authors: DAHL T. , ABILDGAARD U. , SANDSET P. M. 
Published: August 2009

Abstract. Objective. The aim of the present study was to determine the risk of major haemorrhagic complications, stroke and other cardiovascular events, and mortality during long‐term anticoagulant therapy (ACT) in patients with cerebrovascular disease not included in any prospective trials.Design. The data were collected retrospectively.Setting. All patients with symptomatic cerebrovascular disease discharged from the Stroke Unit, Aker University Hospital, Oslo, with ACT (warfarin) during 1983 through to 1986 were included.Subjects. The material consists of 161 patients with a mean age of 67.8 (range 40–90) years. The reason for initiating ACT was frequent transient ischaemic attacks (TIAs) in 52 patients, stroke in progression (SIP) in 33 patients, and probable embolic stroke in 76 patients. International normalized ratio (INR) of 4.2–2.8 was aimed at.Main outcome measures. Major haemorrhagic complications, recurrent stroke and survival was determined for the total material, and in the subgroups non‐valvular atrial fibrillation (NVAF, n = 49), TIAs, and SIP.Results. The mean duration of ACT was 21.1 (range 0.5–60.2) months with a total of 282.9 patient‐years. The rate of major (including fatal) haemorrhagic complications was 4.6% per year, and the rate of fatal haemorrhagic complications was 1.4% per year. The complication rates in the subgroups of patients did not differ significantly from that in the total material. Only two out of the 13 major haemorrhagic complications occurred during the initial 6 months of ACT. No strokes occurred in the TIA subgroup. The rate of recurrent stroke (excluding intracranial haemorrhage) was 3.9% per year for all patients, 4.7% per year for the patients with NVAF, and 4.2% per year for the patients with SIP.Conclusions. The total results suggest a positive net effect of ACT in patients with NVAF and TIAs. Without comparable data, no definite conclusions concerning the effect of ACT on patients with SIP can be drawn. The rate of bleeding complications was similar to that in other studied materials and is not negligible. In patients with SIP and TIAs, ACT beyond 6 months should probably only be continued if aspirin is not tolerated or has proven ineffective in the particular patient.
Albumin excretion rate and its relation to kidney disease in non‐insulin‐dependent diabetes mellitus
Authors: WIRTA O. , PASTERNACK A. , MUSTONEN J. , OKSA H. , KOIVULA T. , HELIN H. 
Published: August 2009

Abstract. Objective. To estimate the occurrence of increased albumin excretion rate (AER) and its significance as a marker of diabetic kidney disease in non‐insulin‐dependent diabetic subjects.Design. Population‐based, controlled cross‐sectional study.Setting. A primary health care centre in the city of Tampere, south‐west Finland.Subjects. Consecutive, recently diagnosed (n = 150) and long‐term (n = 146) middle‐aged non‐insulin‐dependent diabetic subjects. Matched non‐diabetic control subjects (n = 150).Main outcome measures. Albumin excretion rate, fractional AER, microalbuminuria (AER 30–300 mg 24 h−1), clinical nephropathy (AER exceeding 300 mg 24 h−1) and kidney biopsy in diabetic subjects with an AER exceeding 100 mg 24 h−1.Results. Mean (± standard deviation [SD]) 24‐h AER was increased in recently diagnosed diabetic subjects, 54 (111) mg, and long‐term diabetic subjects, 134 (479) mg, compared to non‐diabetic control subjects, 16 (19) mg. The fractional AER was 7.5 (18.3) × 10−6 in recent diabetic subjects, 53.1 (306.9) × 10−6 in long‐term diabetic subjects and 2.8 (3.7) × 10−6 in non‐diabetic control subjects. Microalbuminuria was found in 8% of non‐diabetic subjects, in 29% of recent and in 27% of long‐term diabetic subjects. The prevalence of clinical nephropathy was 7% in long‐term and 4% in recent diabetic subjects, whilst no non‐diabetic subject had nephropathy. In 12 of 16 eligible kidney biopsies, diabetic glomerulosclerosis was found, in four subjects the finding was normal.Conclusions. The AER is clearly increased in recent non‐insulin‐dependent diabetic subjects and further increased in diabetic subjects with a mean disease duration of 10 years. An increased AER in non‐insulin‐dependent diabetic subjects suggests diabetic kidney disease.
Plasma homocysteine in acute myocardial infarction: homocysteine‐lowering effect of folic acid
Authors: LANDGREN F. , ISRAELSSON B. , LINDGREN A. , HULTBERG B. , ANDERSSON A. , Brattström Lars 
Published: August 2009

Abstract. Objectives. Moderate hyperhomocysteinaemia is an independent risk factor for cardiovascular disease which may be causal. We investigated whether the concentration of plasma homocysteine changes between the acute phase of myocardial infarction and follow‐up, and whether treatment with oral folic acid was effective in lowering homocysteine levels in patients with myocardial infarction.Design and subjects. Plasma total homocysteine levels 24–36 h (baseline) after onset of acute myocardial infarction were compared with the levels obtained at 6 weeks' follow‐up and with the levels in the controls. In the same patients, we studied the effect on plasma homocysteine of 6 weeks' treatment with daily oral folic acid doses of 2.5 or 10 mg compared to no treatment.Results. At baseline, 12 of 68 patients (18%) had moderate hyperhomocysteinaemia (>17.3 μmol L−1; P < 0.05). Between baseline and follow‐up, plasma homocysteine levels increased from 13.1 ± 4.6 to 14.8 ± 4.8 μmol L−1 (mean ± SD; P < 0.001). Treatment with nitroglycerin, streptokinase, beta blockers, or acetylsalicylic acid seemed not to have caused this change. Folic acid lowered plasma homocysteine in all but two of 33 treated patients with a mean decrease of 4.4 μmol L−1 (–27%; P < 0.001). There was no difference between the effect of 2.5 and 10 mg of folic acid. In the untreated group (n = 20), plasma homocysteine increased with a mean increase of 0.6 μmol L−1 (+ 4%; P < 0.05).Conclusions. Plasma homocysteine seems to increase in the post myocardial infarction period, the cause of which warrants further study. Folic acid appears to be an effective treatment for the reduction of both normal and increased plasma homocysteine concentrations in patients with myocardial infarction. This suggests that folic acid should be used for intervention when studying the effect of homocysteine‐lowering therapy on the risk on myocardial infarction.
Positive and negative feedback regulatory loops of thiol‐oxidative stress response mediated by an unstable isoform of σRin actinomycetes
Authors: Kim Min‐Sik , Hahn Mi‐Young , Cho Yoobok , Cho Sang‐Nae , Roe Jung‐Hye 
Published: August 2009

SummaryAlternate sigma factors provide an effective way of diversifying bacterial gene expression in response to environmental changes. InStreptomyces coelicolorwhere more than 65 sigma factors are predicted, σRis the major regulator for response to thiol‐oxidative stresses. σRbecomes available when its bound anti‐sigma factor RsrA is oxidized at sensitive cysteine thiols to form disulphide bonds. σRregulon includes genes for itself and multiple thiol‐reducing systems, which constitute positive and negative feedback loops respectively. We found that the positive amplification loop involves an isoform of σR(σR′) with an N‐terminal extension of 55 amino acids, produced from an upstream start codon. A major difference between constitutive σRand inducible σR′is that the latter is markedly unstable (t1/2 ∼ 10 min) compared with the former (> 70 min). The rapid turnover of σR′is partly due to induced ClpP1/P2 proteases from the σRregulon. This represents a novel way of elaborating positive and negative feedback loops in a control circuit. Similar phenomenon may occur in other actinomycetes that harbour multiple start codons in thesigRhomologous gene. We observed thatsigHgene, thesigRorthologue inMycobacterium smegmatis, produces an unstable larger isoform of σHupon induction by thiol‐oxidative stress.
The transcriptionally active regions in the genome of Bacillus subtilis
Authors: Rasmussen Simon , Nielsen Henrik Bjørn , Jarmer Hanne 
Published: August 2009

SummaryThe majority of all genes have so far been identified and annotated systematically through in silico gene finding. Here we report the finding of 3662 strand‐specific transcriptionally active regions (TARs) in the genome of Bacillus subtilis by the use of tiling arrays. We have measured the genome‐wide expression during mid‐exponential growth on rich (LB) and minimal (M9) medium. The identified TARs account for 77.3% of the genes as they are currently annotated and additionally we find 84 putative non‐coding RNAs (ncRNAs) and 127 antisense transcripts. One ncRNA, ncr22, is predicted to act as a translational control on cstA and an antisense transcript was observed opposite the housekeeping sigma factor sigA. Through this work we have discovered a long conserved 3′ untranslated region (UTR) in a group of membrane‐associated genes that is predicted to fold into a large and highly stable secondary structure. One of the genes having this tail is efeN, which encodes a target of the twin‐arginine translocase (Tat) protein translocation system.
A mechanism of transposon‐mediated directed mutation
Authors: Zhang Zhongge , Saier Milton H. 
Published: August 2009

SummaryDirected mutation is a proposed process that allows mutations to occur at higher frequencies when they are beneficial. Until now, the existence of such a process has been controversial. Here we describe a novel mechanism of directed mutation mediated by the transposon, IS5 in Escherichia coli. crp deletion mutants mutate specifically to glycerol utilization (Glp+) at rates that are enhanced by glycerol or the loss of the glycerol repressor (GlpR), depressed by glucose or glpR overexpression, and RecA‐independent. Of the four tandem GlpR binding sites (O1–O4) upstream of the glpFK operon, O4 specifically controls glpFK expression while O1 primarily controls mutation rate in a process mediated by IS5 hopping to a specific site on the E. coli chromosome upstream of the glpFK promoter. IS5 insertion into other gene activation sites is unaffected by the presence of glycerol or the loss of GlpR. The results establish an example of transposon‐mediated directed mutation, identify the protein responsible and define the mechanism involved.
Co‐ordinated regulation of two divergent promoters through higher‐order complex formation by the LysR‐type regulator ThnR
Authors: López‐Sánchez Aroa , Rivas‐Marín Elena , Martínez‐Pérez Olga , Floriano Belén , Santero Eduardo 
Published: August 2009

SummaryThe genes required for tetralin biodegradation by Sphingomonas macrogolitabida strain TFA are clustered in two divergent and closely linked operons. ThnR, a LysR‐type regulator, activates transcription from each operon in response to tetralin. The regulatory thnR gene is co‐transcribed with the catabolic genes thnC, thnA3 and thnA4, resulting in positive autoregulation. ThnR binds with different affinity to two primary binding sites, designated B and C, in the intervening region between the two operons and makes additional contact with secondary sites that extend towards the promoters. In addition, ThnR may interact with itself when bound to each site via the formation of a DNA loop, as evidenced by the distortion of the DNA between the primary binding sites and the elimination of the higher‐order complexes following the introduction of a half‐turn of the DNA helix between the primary binding sites. Transcription from each promoter is not fully independent since mutations in each binding site affected transcription from both promoters. Based on these results, we propose a model of transcription activation that involves the formation of a complex structure by interactions between ThnR molecules bound to distant binding sites and favours transcription from one promoter to the detriment of the other.
An alternative to the glyoxylate shunt
Authors: Schink Bernhard 
Published: August 2009

SummaryA cycle remains a cycle only as long as the spokes of the wheel are not stolen. To keep the citric acid cycle going requires anaplerotic reactions such as the glyoxylate shunt to restore the cycle intermediates that are withdrawn for the biosynthesis of cell constituents, e.g. amino acids and haemin precursors. The article by Erb et al. in this issue of Molecular Microbiology documents an alternative path that replenishes four‐carbon intermediates during growth on acetate in the absence of the glyoxylate shunt. The reaction sequence forms malate and succinyl‐CoA from three acetyl‐CoA, one CO2 and one HCO3 in a linear pathway. This new pathway was discovered in phototrophic anoxygenic bacteria and in few aerobic bacteria, but it is probably widespread among many metabolic groups of bacteria.
Microbiology, time course and clinical characteristics of infection in critically ill patients receiving packed red blood cell transfusion
Authors: Rachoin J.‐S. , Daher R. , Schorr C. , Milcarek B. , Parrillo J. E. , Gerber D. R. 
Published: August 2009

Background and Objectives  Packed red blood cell transfusion has been associated with increased infection in a variety of critically ill patient populations. We evaluated the microbiology and time course of infection in transfused patients in the intensive care unit (ICU) as no data exist on these parameters.Materials and Methods  We performed a retrospective review of data for all patients admitted to a 24‐bed medical‐surgical ICU at Cooper University Hospital from July 2003 to September 2006 and entered in the Project Impact database.Results  A total of 2432 patients were admitted during the study period, of which 609 underwent transfusion. Transfused patients were more likely to develop a nosocomial infection (10·5% vs. 4·9%, P < 0·001). ICU and hospital length of stay were longer in the transfused group (P < 0·001 for both). Mortality was also greater (13·1% vs. 8·7%, P = 0·001). Transfused patients had a shorter time from hospital admission to first infection (P < 0·001) and ICU admission to first infection (P < 0·001). Multivariate analysis confirmed transfusion as an independent risk factor for infection, mortality, hospital and ICU length of stay. Methicillin‐resistant Staphylococcus aureus, vancomycin‐resistant enterococcus and Acinetobacter occurred more often in transfused patients. Acinetobacter accounted for a disproportionate share of infections among transfused patients (P < 0·001).Conclusions  Transfused ICU patients have a higher incidence of nosocomial infection and worse outcomes. Transfused patients had a shorter onset of infection. Acinetobacter infection appears to be particularly common among these patients. Further investigation is merited to better elucidate the mechanism for these findings and their therapeutic and clinical implications.
Non‐alcoholic fatty liver disease: An expanding problem with low levels of awareness in Hong Kong
Authors: Leung Chi Man , Lai Lawrence Siu Wing , Wong Wing Hang , Chan Kam Hoi , Luk Yiu Wing , Lai Jak Yiu , Yeung Yat Wah , Hui Wai Mo 
Published: August 2009

AbstractBackground and Aim:  With the Westernization of the lifestyle and the rising prevalence of obesity and diabetes mellitus, non‐alcoholic fatty liver disease (NAFLD) is an emerging health problem in the Asia–Pacific region. The purpose of this study was to determine the awareness of NAFLD among the general population in Hong Kong.Methods:  A random telephone survey was conducted from September 2007 to January 2008 using a structured multiple‐choice questionnaire. Subjects were Hong Kong residents aged 18 or above who spoke Cantonese.Results:  In the first phase of the telephone survey, 521 subjects were interviewed and the results showed that as high as 83% of respondents had never come across the term ‘NAFLD’. Upon completion of the second phase telephone survey, a total of 508 respondents who had heard of NAFLD were successfully interviewed. Of the 508 respondents, nearly half of them (42%) expressed no idea about the prevalence of NAFLD in Hong Kong. About half of respondents (47%) knew nothing about the clinical presentation of NAFLD. The majority of them (78%) had a misconception that blood tests could provide a definite diagnosis of NAFLD. Smoking, hepatitis B carriage and a past history of hepatitis A infection were cited as risk factors of NAFLD by 52%, 57% and 42% of respondents, respectively. Of the 508 respondents who had heard of NAFLD, most of them perceived that their knowledge of NAFLD was either inadequate (46%) or highly inadequate (35%).Conclusion:  This survey revealed an inadequate knowledge of NAFLD among the general population in Hong Kong.
Protein C and D‐dimer are related to portal vein thrombosis in patients with liver cirrhosis
Authors: Zhang Donglei , Hao Jianyu , Yang Ning 
Published: August 2009

AbstractBackground and Aim:  To profile changes of coagulation, anticoagulation and fibrolytic factors associated with liver function failure and portal vein thrombosis (PVT) formation in chronic liver cirrhosis patients.Methods:  A total of 116 cirrhotic patients admitted to our hospital from June 2006 to October 2008 were included in our study. All patients were classified into two groups: PVT group (31 patients), composed of patients with PVT and a control group (85 patients), including patients without PVT. Platelet, prothrombin time (PT), activated partial prothrombin time (APTT) and fibrinogen were measured. Also, plasma samples from the patients were analyzed for the levels of antithrombin III (AT‐III), protein C (PC), protein S (PS), D‐dimer, tissue‐type plasminogen activator as well as plasminogen activator inhibitor‐1. Statistical analyses were carried out to evaluate the correlation of specific variations with the disease status.Results:  In general, the higher Child‐Pugh scores, indicating the aggravation of hepatic impairment of the patients, correlated well with the prolonged PT/APTT and increased D‐dimer, as well as decreased platelet, fibrinogen, PC and AT‐III levels in the serum. Furthermore, we found that the PC, PS and D‐dimer levels in PVT patients were 2.32 ± 0.72 mg/L, 17.14 ± 3.62 mg/L and 0.99 ± 0.36 mg/L, respectively, both representing a significant difference compared with those in the control group without PVT. Logistic regression model shows that the odds ratio value of one unit of increase of PC and D‐dimer were 0.48 and 15.57.Conclusions:  Cirrhotic patients displayed dysfunctions in the coagulation, anti‐coagulation and fibrolytic systems. The development of PVT in these patients may be independently associated with the decrease of PC, PS and D‐dimer. Furthermore, decreasing PC and increasing D‐dimer may be risk factors inducing PVT in cirrhotic patients.
Impact of the Tokyo guidelines on the management of patients with acute calculous cholecystitis
Authors: Lee Shou‐Wu , Yang Sheng‐Shun , Chang Chi‐Sen , Yeh Hong‐Jeh 
Published: August 2009

AbstractBackground and Aim:  Prompt treatments for acute calculous cholecystitis can reduce both mortality and morbidity. The aim of this retrospective study was to assess the impact of the Tokyo guidelines on management of patients with acute cholecystitis.Methods:  The records of patients admitted due to acute calculous cholecystitis were collected between January 2007 and June 2008. Exclusion criteria included acalculous, hepatobiliary malignancy, younger than 18 years old and mortality unrelated to cholecystitis. These 235 patients were classified into three groups; grade I, grade II and grade III, according to the severity grading in the Tokyo guidelines for acute cholecystitis. They were further classified into two subgroups; those compatible with and incompatible with managements suggested in the Tokyo guidelines, for comparison.Results:  Lower levels of platelets, lower blood pressure, higher levels of C‐reactive protein, blood urine nitrogen, prothrombin time, bilirubin, alkaline phosphatase, and more incidences of positive microorganisms cultured in bile or blood, were found in patients as the severity of disease progressed. Shorter mean length of hospital stay was compatible with the Tokyo guidelines, but no significant differences in outcomes, including incidences of survival, post‐surgery complications and mortality, were found between the two subgroups.Conclusion:  No significant benefit of the application of the Tokyo guidelines in the management of patients was found between the two subgroups except for reduced mean length of hospital stay. The application of the Tokyo guidelines for improving the outcomes of patients with acute cholecystitis needs further investigation and evaluation.