bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of budesonide therapy in the early phase of treatment of adult coeliac disease patients with malabsorption: An in vivo/in vitro pilot study
Authors: Ciacci C , Maiuri L , Russo I , Tortora R , Bucci C , Cappello C , Santonicola A , Luciani A , Passananti V , Iovino P 
Published: May 2009

Summary

Budesonide is a glucocorticosteroid with a local anti‐inflammatory effect. Coeliac disease is an immune‐mediated disease caused by gluten ingestion in intolerant patients. The aim of the present study was to investigate the efficacy of budesonide in malabsorptive coeliac patients and its effect in an in vitro gliadin challenge.
Twenty coeliac patients with malabsorption were enrolled in the present study and were randomly assigned to one of two 4 week treatments: (i) a gluten‐free diet alone; or (ii) a gluten‐free diet plus 6 mg budesonide daily. At the end of 4 weeks treatment, all patients underwent clinical evaluation, laboratory tests and self‐evaluation of well‐being using a visual analogue scale. Intestinal biopsies from five coeliac patients (selected randomly) and four non‐coeliac disease controls who underwent upper endoscopy for intestinal bleeding were challenged with gliadin (0.5 mg/mL) and budesonide (10–30 µg/mL) for 3 and 24 h. Biopsies were tested by immunohistochemistry and immunofluorescence for known markers of inflammation.
Treatment of patients with 6 mg budesonide daily for 4 weeks resulted in increased bodyweight, a decreased number of evacuations and decreased stool weight compared with patients on a gluten‐free diet alone for 4 weeks. Well‐being scores were higher in patients treated with both a gluten‐free diet and budesonide compared with those receiving a gluten‐free diet alone.
In vitro studies showed that budesonide reduced epithelial tyrosine phosphorylation and expression of histocompatibility leucocyte antigen complex DR (HLA‐DR) elicited by gliadin‐derived peptides. In addition, the expression of cyclo‐oxygenase (COX)‐2 and intercellular adhesion molecule (ICAM)‐1 in the lamina propria was reduced in patients treated with both gliadin and budesonide compared with patients treated with gliadin alone. Budesonide alone decreased HLA‐DR in crypt enterocytes, as well as ICAM‐1 and COX‐2 expression in the lamina propria of biopsy specimen of coeliac patients. Budesonide had no effect in control samples.
In conclusion, the results of the present study indicate that budesonide shows efficacy in the treatment of symptoms in adult coeliac patients with overt malabsorption. The mechanism underlying the effects of budesonide in reducing symptoms was elucidated by in vitro studies involving a gliadin challenge.
Carotid body potentiation induced by intermittent hypoxia: Implications for cardiorespiratory changes induced by sleep apnoea
Authors: Iturriaga Rodrigo , Moya Esteban A , Del Rio Rodrigo 
Published: May 2009

Summary

The most usual form of chronic hypoxia in humans is the intermittent hypoxia resulting from obstructive sleep apnoea (OSA). The OSA syndrome is a highly prevalent sleep breathing disorder that is considered an independent risk factor for hypertension and cardiovascular diseases. Endothelial dysfunction, oxidative stress, inflammation and sympathetic activation have been proposed as potential mechanisms involved in the onset of the hypertension. However, evidence for a unique pathogenic mechanism has been difficult to establish in OSA patients because of concomitant comorbidities. Thus, animal models have been developed to study the pathological consequences of exposure to chronic intermittent hypoxia (CIH).
Because OSA patients and animals exposed to CIH show augmented ventilatory, sympathetic and cardiovascular responses to acute hypoxia, it has been proposed that enhanced carotid body responsiveness to hypoxia is involved in the autonomic changes induced by OSA and in the development of the hypertension. Recently, this proposal has received further support from recordings of carotid body chemosensory neural discharges in situ and in vitro showing that exposure of animals to CIH increases basal carotid body chemosensory discharges and enhances the chemosensory response to hypoxia.
In the present brief review, we discuss the evidence supporting an important role for the carotid body in the progression of cardiorespiratory changes induced by OSA and the contribution of oxidative stress, endothelin‐1 and pro‐inflammatory molecules in the potentiation of the carotid body chemosensory function induced by CIH.
Gastroscopy in immigrants of Turkish descent
Authors: Wegman Anna‐Isthar , Loffeld Ruud JLF 
Published: May 2009

AbstractBackground and Aim:  Little data is known on morbidity and Helicobacter pylori in the upper part of the gastrointestinal tract in male and female patients of Turkish descent. A study was done in order to assess the presence of H. pylori in Turkish men and women in relation to the diagnostic yield of the endoscopy.Methods:  All consecutive patients of Turkish descent were included in the present study. Detection of H. pylori was done with hematoxylin–eosin stain, an immunoperoxidase and Gram stain and culture.Results:  In 16 years, 2427 procedures (10.4%) were done in Turkish patients. After exclusions, 842 endoscopies in Turkish women and 827 procedures in Turkish men remained. Peptic ulcer disease was diagnosed in 101 (6%) patients and reflux esophagitis in 97 patients (5.8%). Seven patients had cancer. In 749 patients (64%), no macroscopic abnormalities were seen. Turkish men suffered more often from reflux esophagitis (81% vs 19%, P < 0.0001), hiatus hernia (58% vs 42%, P < 0.0001) and peptic ulcer disease (74% vs 26%, P < 0.0001). Women more often showed no abnormalities (P < 0.0001). There was no change in the yearly prevalence of reflux esophagitis and peptic ulcer disease in women, while the peptic ulcers decreased, and reflux esophagitis increased in men. Men were significantly more often H. pylori‐positive (P = 0.03). There was a clear trend towards a decrease in H. pylori‐positives.Conclusion:  There are differences in the presence of ulcer disease and reflux esophagitis between Turkish men and women. Men are significantly more often H. pylori‐positive. Prevalence of H. pylori infection in Turkish patients slowly decreases in the consecutive years in both men and women.
Prevalence and risk factors for non‐alcoholic fatty liver disease among adults in an urban Sri Lankan population
Authors: Dassanayake Anuradha S , Kasturiratne Anuradhani , Rajindrajith Shaman , Kalubowila Udaya , Chakrawarthi Sureka , De Silva Arjuna P , Makaya Miyuki , Mizoue Tetsuya , Kato Norihiro , Wickremasinghe A. Rajitha , De Silva H. Janaka 
Published: May 2009

AbstractBackground and Aims:  Non‐alcoholic fatty liver disease (NAFLD) is an emerging problem in the Asia–Pacific region. However, its prevalence and risk factors in Asian (especially South Asian) communities is poorly studied. In this study, the aim was to determine the community prevalence and risk factors for NAFLD among adults in an urban Sri Lankan population.Methods:  The study population consisted of 35–64‐year‐old adults, selected by stratified random sampling. NAFLD was diagnosed on established ultrasound criteria for fatty liver, safe alcohol consumption (< 14 units/week for men, < 7 units/week for females) and absence of hepatitis B and C markers. Blood pressure (BP) and anthropometric measurements were made, and fasting glucose, glycosylated hemoglobin, serum lipids, fasting serum insulin and serum alanine aminotransferase (ALT) were determined.Results:  Of the 2985 study participants, 974 (32.6%) had NAFLD (605 [62.1%] women, mean age 52.8 years [standard deviation, 7.3]). On multivariate analysis, obesity, acanthosis nigricans, insulin resistance, elevated diastolic BP, fasting plasma glucose, plasma triglycerides, and ALT twice the upper limit of the reference range or more were independently associated with NAFLD.Conclusion:  The prevalence of NAFLD among adults in this urban Sri Lankan community is high and is strongly associated with constituent features of the metabolic syndrome.
Osteopontin is upregulated in malignant and inflammatory pleural effusions
Authors: MOSCHOS Charalampos , PORFIRIDIS Ilias , PSALLIDAS Ioannis , KOLLINTZA Androniki , STATHOPOULOS Georgios T. , PAPIRIS Spyros A. , ROUSSOS Charis , KALOMENIDIS Ioannis 
Published: May 2009

ABSTRACTBackground and objective:  Osteopontin (OPN) is an important mediator of inflammation and cancer progression. In the present study, we asked whether pleural fluid (PF) and serum OPN concentrations differed between patients with pleural effusions of different aetiologies, and whether assessment of OPN levels was useful for diagnostic purposes.Methods:  One hundred and nine consecutive patients with pleural effusions of different aetiologies were recruited prospectively during daily clinics. OPN levels were measured by ELISA.Results:  PF OPN levels were 10‐fold higher in exudates than in transudates and were significantly correlated with markers of pleural inflammation and vascular hyper‐permeability, such as PF/serum LDH or protein ratios, PF protein and PF vascular endothelial growth factor levels. Patients with malignant pleural effusions had higher PF and lower serum OPN concentrations than those with benign disease. The diagnostic accuracies of PF and PF/serum OPN for malignancy were 71.5% (95% CI: 64–80) and 70.6% (95% CI: 62–80), respectively.Conclusions:  OPN levels were elevated in exudative pleural effusions, as compared with the levels in blood or transudative pleural effusions. While PF and PF/serum OPN were higher in patients with malignancies, the diagnostic accuracy of the tests was not sufficient to permit routine use in clinical practice.
Electrical impedance tomography is able to track changes in respiratory function in endotoxin‐challenged rodents
Authors: HERBER‐JONAT Susanne , HAJEK Kerstin , MITTAL Rashmi , JUST Anita , HAHN Günter , SCHULZE Andreas , FLEMMER Andreas W. 
Published: May 2009

ABSTRACTBackground and objective:  In order to assess and optimize the effect of new therapies for acute lung injury (ALI) in rodent models, a monitoring technique that continuously assesses the functional state of the lung is mandatory. Electrical impedance tomography (EIT) has been suggested as a technique for quantifying lung inflammation in ALI. However, EIT has not been evaluated in a rodent model of ALI.Methods:  EIT measurements were compared in ventilated Sprague–Dawley rats (n = 14), randomly subjected to intratracheal administration of endotoxin (LPS) or saline (control). Lung mechanics, lung weight wet/dry ratio and inflammatory markers in bronchoalveolar lavage fluid were also evaluated.Results:  LPS caused a significant decrease in lung compliance and TLC as compared with control (−42.0%, P = 0.04, and −27.9%, P = 0.02, respectively). These changes were paralleled by differences in mean impedance changes as detected by EIT (Spearman's rank correlation coefficient: ρ = 0.66 and 0.73, respectively, P < 0.01). LPS increased the lung weight wet/dry ratio (6.35 ± 0.42 vs 5.15 ± 0.07, P = 0.003), and the bronchoalveolar lavage total WCC (8.96 ± 1.87 vs 1.16 ± 0.10 × 109/L, P = 0.002) as compared with control. The lung weight wet/dry ratio was inversely related to the mean impedance change (ρ = −0.76, P < 0.01).Conclusions:  This study has demonstrated for the first time that eight‐electrode EIT readily tracks the inflammatory response of lung tissue in a rodent model of ALI. EIT may thus provide a promising, non‐invasive technique for monitoring the time‐course of ALI in rodent models, and for testing novel pharmacological strategies to counter it.
Association of impaired respiratory function with urinary incontinence
Authors: HIRAYAMA Fumi , LEE Andy H. , BINNS Colin W. , NISHIMURA Koichi , TANIGUCHI Hiroyuki 
Published: May 2009

ABSTRACTBackground and objective:  This study investigated the relationship between urinary incontinence and respiratory function in middle‐aged and older Japanese men.Methods:  Seven hundred community‐dwelling men aged 40 years or above were recruited from community centres and hospital outpatient clinics. The International Consultation on Incontinence Questionnaire‐Short Form was administered to ascertain their urinary incontinence status. Standardized spirometric measurements of respiratory function were performed.Results:  The prevalence of urinary incontinence was 7.6% among the 668 eligible participants (mean age 62.7 years). The 51 men who leaked urine had significantly lower FEV1 and FVC than those who were continent (P < 0.01). The adjusted risks of urinary incontinence were 0.67 (95% CI: 0.43–1.04) and 0.63 (95% CI: 0.40–0.98) for the two continuous respiratory function variables (L), respectively.Conclusion:  The findings indicate an inverse association between urinary incontinence and respiratory function and an additional health burden in lung diseases.
Pulmonary alveolar proteinosis in China: A systematic review of 241 cases
Authors: XU Zhihao , JING Jiyong , WANG Huiying , XU Feng , WANG Jiaoli 
Published: May 2009

ABSTRACTBackground and objective:  Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease. It was first described in China in 1965, and more cases have been reported subsequently. A systematic review was performed on 241 cases of PAP in China and progress in the diagnosis and treatment of this disease is discussed.Methods:  The Chinese biological and medical databases from 1965 to 2006 were searched and 241 cases with complete clinical and pathological data were identified. The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time.Results:  The morbidity associated with PAP has increased in recent years. The clinical manifestations were non‐specific. Progressive dyspnoea, cough and sputum were the most common symptoms. The percentage of patients undergoing CT examination has increased over the years. The combination of bronchoscopic biopsy and bronchoalveolar lavage (BAL) was usually sufficient to establish the diagnosis. Treatment was reported for a total of 142 cases. BAL and whole lung lavage were both effective and were only required once by most patients.Conclusions:  The demographic characteristics and clinical manifestations of PAP patients in China are largely consistent with previous reports. Morbidity has increased dramatically in recent years, mainly due to the broad application of bronchoscopy since 1995. CT is very important for diagnosis of the disease. The long‐term effects of treatment by whole lung lavage and BAL are similar.
Nocturnal hypoxic stress activates invasive ability of monocytes in patients with obstructive sleep apnoea syndrome
Authors: TAMAKI Shinji , YAMAUCHI Motoo , FUKUOKA Atsuhiko , MAKINODAN Kiyoshi , KOYAMA Noriko , TOMODA Koichi , YOSHIKAWA Masanori , KIMURA Hiroshi 
Published: May 2009

ABSTRACTBackground and objective:  Obstructive sleep apnoea syndrome (OSAS) is known to be a risk factor for cardiovascular events. However, the precise mechanism has not been fully elucidated. OSAS‐induced hypoxic stress may promote the production of inflammatory cytokines and chemokines by monocytes, which has a crucial role in the development of atherosclerosis. In addition, adhesion to the vascular endothelium and transendothelial migration of monocytes are considered to induce atherosclerosis. The aim of this study was to investigate the effects of hypoxic stress on the invasive ability of monocytes in OSAS.Methods:  Twenty‐one male patients with OSAS and 17 healthy male control subjects, who were matched for age and BMI, were enrolled. Venous blood samples were collected before and after sleep, and also after CPAP titration, for the purpose of monocyte isolation. The invasive ability of monocytes was evaluated by counting the number of invading cells using a BD BioCoat Matrigel Invasion Chamber.Results:  The number of cells, which represents the invasive ability of monocytes, was significantly higher in patients with OSAS compared with control subjects, in the early morning (P < 0.001). In patients with OSAS, invasive ability in the early morning after sleep was significantly elevated as compared with that before sleep (P < 0.001), and was positively correlated with the oxygen desaturation index (P < 0.05). CPAP titration led to a decrease in the invasive ability (P < 0.001).Conclusions:  These results indicate that OSAS‐induced hypoxic stress activates the invasive ability of monocytes, and that the occurrence of this phenomenon during sleep may contribute to the development of atherosclerosis in OSAS.
Transpleural perfusion with oxygenated perfluorocarbon increases systemic oxygenation
Authors: LEE Sungsoo , CHO Sukki , PARK Kay‐Hyun , SUNG Sook Whan , JHEON Sanghoon 
Published: May 2009

ABSTRACTBackground and objective:  There is a need for new methods of increasing systemic oxygenation in patients with hypoxia due to potentially reversible pulmonary failure. The goal of this study was to determine if it is possible to increase systemic oxygenation by perfusing the thoracic cavity with oxygenated perfluorocarbon in animals with induced hypoxia.Methods:  Fifteen Sprague–Dawley rats were intubated, and hypoxia was induced by hypoventilation (room air, respiratory rate <30/min). Inflow and outflow tubes were placed in the thoracic cavity and connected to a perfusion circuit containing a roller pump, warmer and oxygenator. Rats in Group I were not treated during hypoventilation, those in Group II were perfused with oxygenated saline, and those in Group III were perfused with oxygenated perfluorocarbon. Arterial blood gases were collected every 30 min for 180 min. At the conclusion of the experiments, pathological examination of the lungs and parietal pleura was performed.Results:  PaO2 in Group III was significantly higher than that in Group I or Group II. PaCO2 in Group III was significantly lower than that in the other two groups. Histological examination showed no damage to the lungs and parietal pleura in Group III.Conclusions:  Perfusion of the thoracic cavity with oxygenated perfluorocarbon in an animal model of induced hypoxia resulted in a significant increase in systemic oxygenation without lung damage and might be a useful method for improving systemic oxygenation.
Acute retinal necrosis: a case series with clinical features and treatment outcomes
Authors: Sims Joanne L , Yeoh Jonathan , Stawell Richard J 
Published: May 2009

AbstractPurpose:  To determine clinical features, viral aetiology and treatment outcomes of eyes with acute retinal necrosis (ARN).Methods:  Retrospective, interventional, non‐comparative case series.Results:  Twenty‐two patients (23 eyes) were identified between 1996 and 2007. Varicella zoster virus was the causative agent in 12 patients (nine confirmed by polymerase chain reaction), herpes simplex virus type 1 in six (five polymerase chain reaction‐confirmed) and unknown in three patients. Five patients had documented herpes zoster infection in the month prior to the onset of ARN. Twelve patients (55%) had identifiable (clinical or subclinical) immune dysfunction. At 6 months, 3 out of 15 eyes (20%) maintained vision 6/12 or better and 7 (47%) were 6/60 or worse. Median final VA was 6/60. Nine eyes developed retinal detachment and two‐thirds of these had received prior barrier laser. Poor prognostic factors for severe visual loss by univariate analysis were male gender (P = 0.019), and the development of retinal detachment (P = 0.05). Delay between onset of symptoms and diagnosis was associated with moderate visual loss (P = 0.018). Barrier laser did not reduce the risk of retinal detachment.Conclusions:  Acute retinal necrosis still has poor visual prognosis. Early diagnosis and initiation of treatment may improve outcome.
PR01 A 5 YEAR PROGRAM OF SURGICAL TREATMENT OF ENCEPHALOCOELES IN VIETNAM BY OPERATION SMILE AUSTRALIA
Authors: Breidahl A. F. , Lewandowski R. 
Published: May 2009

Operation Smile Australia (OSA) was founded by Richard Lewandowski and is a not for profit volunteer organisation, associated with Operation Smile International.OSA's mission is to bring modern craniofacial and plastic surgery techniques to developing countries. To this end, a five year plan is developed for each location, with the aim that by the end of the program the local medical teams are self sufficient and able to continue the surgical treatment of patients in their own countries without outside assistance.We report on a five year program to Cho Ray Hospital in Ho Chi Minh City, Vietnam, where the local team has been successfully taught how to manage encephalocoeles. During this time 19 patients with encephalocoeles were surgically treated by the Operation Smile Team, with increasing responsibility assumed by the local medical team. Three patients with very large encephalocoeles were brought to Australia for treatment, and two Vietnamese Neurosurgeons were brought to Australia for further education and experience. Complications were minimal, and consist of a false passage created by urethral catheterisation and a CSF leak from a lumbar drain, both of which recovered completely with conservative management.
VS08 ENDOVASCULAR VENOUS LASER VS OESCH PIN STRIPPER IN MANAGEMENT OF PRIMARY VARICOSITIES OF THE GREAT SAPHENOUS VEIN: A RANDOMIZED CONTROL TRIAL
Authors: Desai D. J. , Pedgoankar P. , Sekhar R. 
Published: May 2009

Aim:   Varicosities of the lower limb are a major economic and medical burden. Various modalities of treatment have been proposed. This study aims to compare minimally invasive Endovenous Laser Ablation (EVLA) with conventional High ligation and stripping using Oesch Pin stripper (HLS) in the management of primary varicosities of the Great Saphenous vein (GSV). Principal outcomes were abolition of GSV reflux and comparison of postoperative morbidity and mortality.Material and Methods:  This trial was prospectively conducted over 2 years and comprised to a total of 60 consecutive consenting patients randomized (randomized by a random number assigned by a blinded person) equally between the EVLA and Surgery groups. The inclusion criteria were patients with symptomatic primary GSV reflux and varicosities suitable for both modalities of treatment. Exclusion criteria were secondary GSV varicosities and recurrent varicosities. All patients were followed up at regular interval for a period of 3 months.Results:   GSV reflux was abolished in all patients in both groups. Patients with EVLA had a shorter length of stay (LOS) of 0.47 compared to 2.6 with HSL. One patient had minor burns with EVLA and in one venotomy had to be done due to slippage of guide wire. All other post‐operative complications such as haematoma, ecchymosis, and pain were significantly lower in the EVLA group. There was no mortality in either group.Conclusion:   EVLA being an outpatient procedure resulted in a safer and quicker recovery and less socioeconomic burden with a shorter LOS, however the early peri‐operative pain was higher in the EVLA group. The long term results of recurrence have not been studied in this study and warrants further investigation.
Enameloid microstructure in the oldest known chondrichthyan teeth
Authors: Botella H. , Donoghue P. C. J. , Martínez‐Pérez C. 
Published: May 2009

AbstractPrevious studies on tooth enameloid microstructure in several chondrichthyan taxa spanning the phylogeny of the group provided support for the homology of chondrichthyan tooth enameloid. This hypothesis requires that a single crystallite enameloid (SCE) monolayer must be present in the teeth of the most primitive chondrichthyan. However, the dental microstructure of the earliest sharks has yet to be investigated. We have studied the tooth enameloid microstructure of the two oldest tooth‐bearing shark species currently known, Leonodus carlsi Mader (1986) and Celtiberina maderi Wang (1993), from the lowermost Lochkovian (Lower Devonian) of Spain. Our study demonstrates the presence of a SCE monolayer in the teeth of both species. These results show that a superficial cap of SCE is present in the oldest shark teeth known, which suggest its presence in the most basal chondrichthyans.