bluuebunny/crossref_metadata_2025_split huggingface dataset:
TOLERABILITY AND USEFULNESS OF MERCAPTOPURINE IN AZATHIOPRINE‐INTOLERANT JAPANESE PATIENTS WITH ULCERATIVE COLITIS
Authors: Kuriyama Motoaki , Kato Jun , Suzuki Hideyuki , Akita Mitsuhiro , Hiraoka Sakiko , Okada Hiroyuki , Yamamoto Kazuhide 
Published: July 2010

Background and Aim:  Azathioprine (AZA) and mercaptopurine (6‐MP) are established as effective therapeutic drugs for the induction and maintenance of remission in patients with ulcerative colitis (UC). However, AZA is often intolerable due to adverse effects. Evidence regarding the approach of switching from AZA to 6‐MP in patients of Asian ethnicity is lacking. We assessed the tolerability and usefulness of 6‐MP in Japanese UC patients who had shown intolerance to AZA.Methods:  One‐hundred and ten UC patients who had been treated with AZA and/or 6‐MP from January 1985 to October 2008 were examined retrospectively.Results:  Among 110 patients, 107 were treated first with AZA; only three were treated first with 6‐MP. Thirty‐five (33%) of the 107 patients were intolerant of AZA, with adverse effects including myelosuppression (8/35, 23%), hepatotoxicity (8/35, 23%), and abdominal symptoms (6/35, 17%). Among 35 AZA‐intolerant patients, 23 were switched to 6‐MP treatment. The cumulative probability of colectomy was significantly higher in patients not treated with 6‐MP than in patients treated with 6‐MP (log–rank test, P = 0.0002). Among the 26 patients (23 AZA‐intolerant and three AZA‐untreated) treated with 6‐MP, 22 (85%) could tolerate the therapy. Adverse effects due to 6‐MP were abdominal symptoms (2/4), myelosuppression (1/4), and rash (1/4). The median initial dose of 6‐MP was 20 mg/day, and the median final dose was 30 mg/day.Conclusions:  6‐MP was tolerated in 83% of AZA‐intolerant patients, and it was effective for maintenance therapy of UC patients. 6‐MP treatment should be considered in AZA‐intolerant patients.
Cervical endometriosis: Case series and review of literature
Authors: Wong Felix Wu Shun , Lim Chi Eung Danforn , Karia Sonal , Santos Leonardo 
Published: July 2010

AbstractCervical endometriosis is uncommon and usually an incidental or retrospective finding on histopathology reports. It can be asymptomatic or present with a diverse range of persistent symptoms and even life‐threatening hemorrhage. The condition can be managed expectantly in asymptomatic patients, however persistent symptoms may warrant surgery. We encountered four cases of histologically proven cervical endometriosis at our tertiary hospital in New South Wales, Australia. All our patients had different symptoms, presentations and indications for their surgery leading to their diagnosis. This review is to report these cases followed by discussion with a review of the literature.
Combination chemotherapy for Hodgkin's lymphoma during pregnancy: Favorable outcome for mother and child
Authors: Sagan Dariusz , Semczuk Andrzej , Lampka Elżbieta 
Published: July 2010

AbstractThe incidence of malignant neoplasms in pregnant women is rising dramatically. The management of such cases poses unusual medical and ethical challenges, particularly in hematological malignancies, when potentially teratogenic chemotherapy is indicated. We report a case of stage IIA nodular sclerosis Hodgkin's lymphoma (HL), diagnosed in a 24‐year‐old woman at 18 weeks of gestation. Individualized combination chemotherapy according to etoposide‐vinblastine‐doxorubicin (EVA) regimen was administered, resulting in effective local control of the disease and improvement in the patient's general condition. At the 36th week of pregnancy, the patient delivered a healthy female infant by elective cesarian section. Four weeks later, bleomycin‐dacarbazine‐doxorubicin‐vinblastine (ABVD) chemotherapy was commenced, which provided complete remission after five cycles. Individualized chemotherapy for HL according to EVA regimen during the second and third trimesters of pregnancy, with early cesarian delivery, followed by ABVD regimen, provided a positive outcome both for the mother and her child. This strategy may be considered as an alternative for the treatment of HL in pregnancy, and deserves further clinical assessment.
Levonorgestrel‐intrauterine system effects on hemostasis and menstrual blood loss in women seeking contraception
Authors: Koh Stephen C. L. , Singh Kuldip 
Published: July 2010

AbstractAim:  The purpose of the study is to determine the effects of levonorgestrel use on hemostasis, and menstrual blood loss over 24 months in a cohort of women seeking contraception.Methods:  Data from 30 women (median age 36 years) were analyzed. Samplings at pre‐insertion, 1 and 3 months for blood and additional endometrial aspirates at 2 and 6 months were performed. Systemic determination for hemoglobin, hematocrit, computerized thromboelastography, tissue‐type plasminogen activator, urokinase‐like plasminogen activator and receptor, plasminogen activator inhibitor‐1/2, D‐dimer and von Willebrand Factor was performed. In endometrial extracts, tissue‐type plasminogen activator, urokinase‐like plasminogen activator and receptor and plasminogen activator inhibitor‐1/2 were assayed. The Menstrual Blood Loss Pictorial Chart Score for measurement of menstrual blood loss was carried out for 24 months.Results:  There were no significant changes in systemic hemostasis within 3 months of device use. In the endometrium, there was a significant increase in tissue‐type plasminogen activator antigen, plasminogen activator inhibitor‐1/2 and urokinase‐like plasminogen activator receptor levels from pre‐insertion state, with the highest level seen by 6 months. Amenorrhea was seen in 20% of women by 6 months and 50% by 24 months.Conclusions:  Enhanced expression of plasminogen activator inhibitor‐1/2 in the presence of increased urokinase‐like plasminogen activator receptor and tissue‐type plasminogen activator antigen was seen in the endometrium. The effects on hemostasis appear to be localized in the endometrium. Systemic hemostasis was not duly affected and menstrual blood loss was reduced. No women in the study had a pregnancy or expulsion of the levonorgestrel‐intrauterine system device in the 24 months of the study period.
High prevalence of diabetes mellitus in patients with liver cirrhosis
Authors: Wlazlo N. , Beijers H. J. B. H. , Schoon E. J. , Sauerwein H. P. , Stehouwer C. D. A. , Bravenboer B. 
Published: July 2010

Diabet. Med. 27, 1308–1311 (2010)AbstractAims  The reported prevalence of Type 2 diabetes mellitus in patients with liver cirrhosis is five times higher than in the general population. However, these data were never adjusted for classical risk factors for Type 2 diabetes. We therefore investigated the association between cirrhosis and Type 2 diabetes and adjusted for known risk factors for Type 2 diabetes.Methods  We reviewed medical files for presence of Type 2 diabetes and potential confounders in 94 patients with cirrhosis (cases) and compared these with a control group of 107 patients with non‐ulcer dyspepsia. Multiple logistic regression analysis was used to adjust for potential confounders.Results  The aetiology of our cirrhosis population was alcohol (59%), viral hepatitis (10%), biliary cirrhosis (3%) or cryptogenic (28%). Prevalence of Type 2 diabetes was significantly higher in patients with cirrhosis than in control subjects: 35/94 (37%) vs. 7/107 (7%) (OR 8.5, 95% CI 3.5–20.2, P < 0.001). After adjustment for age, sex, family history of Type 2 diabetes, alcohol use and BMI, cirrhosis remained significantly associated with Type 2 diabetes (OR 13.6, 95% CI 4.3–42.9, P < 0.001). Most cases of Type 2 diabetes were already diagnosed before diagnosis of cirrhosis (21/35, 60%) or were incidentally found together with cirrhosis (5/35, 14%).Conclusions  Liver cirrhosis had a strong, independent association with Type 2 diabetes. Classical risk factors such as family history and BMI could not explain the high Type 2 diabetes prevalence in cirrhosis. Therefore, a liver‐derived factor might aggravate glucose intolerance and cause Type 2 diabetes in cirrhosis. In addition, Type 2 diabetes might also cause cirrhosis through liver steatosis and fibrosis.
Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumption
Authors: Clerc O. , Nanchen D. , Cornuz J. , Marques‐Vidal P. , Gmel G. , Daeppen J.‐B. , Paccaud F. , Mooser V. , Waeber G. , Vollenweider P. , Rodondi N. 
Published: July 2010

Diabet. Med. 27, 1241–1249 (2010)AbstractAims  To investigate the relationship of alcohol consumption with the metabolic syndrome and diabetes in a population‐based study with high mean alcohol consumption. Few data exist on these conditions in high‐risk drinkers.Methods  In 6172 adults aged 35–75 years, alcohol consumption was categorized as 0, 1–6, 7–13, 14–20, 21–27, 28–34 and ≥ 35 drinks/week or as non‐drinkers (0), low‐risk (1–13), medium‐to‐high‐risk (14–34) and very‐high‐risk (≥ 35) drinkers. Alcohol consumption was objectively confirmed by biochemical tests. In multivariate analysis, we assessed the relationship of alcohol consumption with adjusted prevalence of the metabolic syndrome, diabetes and insulin resistance, determined with the homeostasis model assessment of insulin resistance (HOMA‐IR).Results  Seventy‐three per cent of participants consumed alcohol, 16% were medium‐to‐high‐risk drinkers and 2% very‐high‐risk drinkers. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA‐IR decreased with low‐risk drinking and increased with high‐risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non‐drinkers, 19% in low‐risk (P < 0.001 vs. non‐drinkers), 20% in medium‐to‐high‐risk and 29% in very‐high‐risk drinkers (P = 0.005 vs. low‐risk). Adjusted prevalence of diabetes was 6.0% in non‐drinkers, 3.6% in low‐risk (P < 0.001 vs. non‐drinkers), 3.8% in medium‐to‐high‐risk and 6.7% in very‐high‐risk drinkers (P = 0.046 vs. low‐risk). Adjusted HOMA‐IR was 2.47 in non‐drinkers, 2.14 in low‐risk (P < 0.001 vs. non‐drinkers), 2.27 in medium‐to‐high‐risk and 2.53 in very‐high‐risk drinkers (P = 0.04 vs. low‐risk). These relationships did not differ according to beverage types.Conclusions  Alcohol has a U‐shaped relationship with the metabolic syndrome, diabetes and HOMA‐IR, without differences between beverage types.
Gleaner, fisher, trader, processor: understanding gendered employment in fisheries and aquaculture
Authors: Weeratunge Nireka , Snyder Katherine A , Sze Choo Poh 
Published: July 2010

AbstractMost research on gender difference or inequities in capture fisheries and aquaculture in Africa and the Asia‐Pacific focuses on the gender division of labour. Emerging research on globalization, market changes, poverty and trends in gendered employment within this sector reveals the need to move beyond this narrow perspective. If gleaning and post‐harvesting activities were enumerated, the fisheries and aquaculture sector might well turn out to be female sphere. A livelihoods approach better enables an understanding of how employment in this sector is embedded in other social, cultural, economic, political and ecological structures and processes that shape gender inequities and how these might be reduced. We focus on four thematic areas – markets and migration, capabilities and well‐being, networks and identities, governance and rights – as analytical entry points. These also provide a framework to identify research gaps and generate a comparative understanding of the impact of development processes and socioecological changes, including issues of climate change, adaptation and resilience, on gendered employment. Without an adequate analysis of gender, fisheries management and development policies may have negative effects on people’s livelihoods, well‐being and the environment they depend on, or fail altogether to achieve intended outcomes.
Role of low‐glycemic index diet in management of childhood obesity
Authors: Kong A. P. S. , Chan R. S. M. , Nelson E. A. S. , Chan J. C. N. 
Published: July 2010

SummaryConventional dietary recommendation for obesity management is a low‐fat energy‐restricted diet, which however, only have modest and non‐sustained effects on weight reduction. Alternative dietary interventions, including low‐glycemic index (GI) diet, have been proposed.Glycemic index is a measure of blood glucose excursion per unit of carbohydrate. Foods with high GI are rapidly digested, absorbed and transformed into glucose. These processes cause accelerated and transient surges in blood glucose and insulin, earlier return of hunger sensation and excessive caloric intake. Conversely, low‐GI diet decreases blood glucose and insulin excursion, promotes greater fat oxidation, decreases lipogenesis and increases satiety. Modern food‐processing technology has produced many food products with high GI which may contribute to the burgeoning epidemic of obesity especially in children/adolescents.Epidemiological and clinical trials suggest a role for low‐GI diet in the management of childhood obesity and associated cardio‐metabolic risks although results are not always consistent. In this article, we shall review the physiological basis and current evidence for and against low‐GI diet in obesity management, with particular focus in children and adolescents.
Voting Power and Shareholder Activism: A Study of Swedish Shareholder Meetings
Authors: Poulsen Thomas , Strand Therese , Thomsen Steen 
Published: July 2010

ABSTRACTManuscript Type: EmpiricalResearch Question/Issue: This paper analyses the impact of voting power on shareholder activism using unique data on activism at Swedish shareholder meetings. We hypothesize that there is a positive relationship between shareholder activism and a measure of the largest shareholder's sensitivity to increased participation by small shareholders.Research Findings/Insights: We find that firms' amenability to small shareholder influence leads to more proposals by the nomination committee, but fewer proposals by other shareholders and fewer proposals voted against. We interpret this as evidence that the shareholder elected nomination committees effectively channel shareholder concerns and preempt other kinds of activism. In addition, we find more shareholder activity in large firms and less activity in leveraged firms.Theoretical/Academic Implications: This paper offers a new voting power approach to the study of shareholder activism. We show the empirical implications of this approach, but also the importance of local institutions such as nomination committees in shaping the nature of shareholder activism.Practitioner/Policy Implications: Politicians and companies that desire active shareholders could improve the amenability of firms to shareholder influence by ownership transparency, shareholder committees, contacts with shareholder associations and other vehicles for collective action.
The Spatial Mobility of the ‘Creative Class’: A European Perspective
Authors: MARTIN‐BRELOT HELENE , GROSSETTI MICHEL , ECKERT DENIS , GRITSAI OLGA , KOVÁCS ZOLTÁN 
Published: July 2010

AbstractThe main aim of this article is to test Richard Florida's hypothesis regarding the spatial mobility of the ‘creative class’ and the role of soft factors in their decisions concerning their place of residence. Empirical data from 11 European cities suggest that the European ‘creative class’ is not as mobile as Florida suggests. Cultural and institutional constraints contribute to lower mobility rates in Europe. In the article the role of ‘personal trajectories’, completely disregarded until now, is highlighted. On the basis of empirical research data, the role of soft location factors in the decisions of creative workers does not seem to be as relevant as has been implied by Florida and others. These factors play only a marginal role in attracting members of the creative class to a city. On the other hand, they do indeed play an important role in retaining them once they have relocated. This provides some support for policies aimed at bringing about the type of conditions characteristic of creative cities.Résumé L'article met à l'épreuve l'hypothèse de Richard Florida concernant la mobilité spatiale de la ‘classe créative’ et le rôle des facteurs intangibles (soft factors) dans le choix du lieu de résidence de ses membres. Des données empiriques collectées dans onze grandes villes d'Europe indiquent que la classe créative européenne n'est pas aussi mobile que Florida le suggère. Des contraintes culturelles et institutionnelles contribuent notamment à y abaisser les taux de mobilité. L'article souligne l'importance des ‘trajectoires personnelles’ jusqu'à présent totalement négligées. D'après les données de l'étude empirique, les facteurs d'implantation intangibles qui entrent dans les décisions des travailleurs créatifs ne sont apparemment pas aussi importants que ce que Florida et d'autres ont donnéà entendre. Ces facteurs ne jouent qu'un rôle marginal pour attirer les membres de la classe créative vers une ville. En revanche, ils présentent effectivement un grand intérêt dans la mesure où ils aident à les retenir une fois sur place. Cet aspect vient appuyer les politiques qui cherchent à réunir les conditions caractéristiques des villes créatives.
An INSIG2 Polymorphism Affects Glucose Homeostasis in Sardinian Obese Children and Adolescents
Authors: Zavattari Patrizia , Loche Alberto , Civolani Patrizia , Pilia Sabrina , Moi Loredana , Casini Maria Rosaria , Minerba Luigi , Loche Sandro 
Published: July 2010

SummaryAllelic variants of a single nucleotide polymorphism (SNP), rs7566605, located approximately 10 kb upstream of the INSIG2 gene have been found in association with body weight and with other clinical features related to obesity in some populations but not in others. Our objective was to test the association of this SNP in obese children and adolescents from the genetically isolated population of Sardinia. We tested the association of rs7566605 with body mass index (BMI) and with serum glucose and insulin concentrations and a surrogate measure of insulin resistance (HOMA‐IR) in a cohort of 747 Sardinian obese children and adolescents. A case control analysis was performed using 548 ethnically‐matched healthy controls. Allelic frequencies of the SNP were similar between patients and controls. Mean glucose and insulin concentration and mean HOMA‐IR values were significantly higher in patients carrying the CC genotype than in the CG and GG carriers. In the patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), allele C was significantly more frequent than in controls. Although INSIG2 polymorphisms do not consistently associate with BMI, the observation of an association with glucose concentration would support a role for this gene in the metabolic complications of obesity.
Power of Genetic Association Studies with Fixed and Random Genotype Frequencies
Authors: Kozlitina Julia , Xing Chao , Pertsemlidis Alexander , Schucany William R. 
Published: July 2010

SummaryWhen estimating the power of genetic association studies, the allele and genotype frequencies are often assumed to be known, and the numbers of individuals with each genotype are set equal to their expectations under Hardy‐Weinberg equilibrium. In fact, both allele and genotype frequencies are unknown and thus random. It has previously been suggested that ignoring uncertainty in these parameters could lead to inflated power expectations. To overcome the problem, one can average power estimates over the distributions of unknown frequencies. We investigate the power‐averaging method and find that, despite the intuitive appeal, it may not improve accuracy in practice, while significantly increasing computational time. For a fixed allele frequency, we show that the amount of overestimation diminishes rapidly with sample size and is completely negligible for N > 200. For an unknown frequency, the result of averaging depends on the genetic model, and may not always provide a more conservative estimate of power. We explore the effect of uncertainty in the factors that determine statistical power of association studies and propose a more economical approach to the power analysis.
Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH
Authors: Costa A , Santos C , Ayres‐de‐Campos D , Costa C , Bernardes J 
Published: July 2010

Please cite this paper as: Costa A, Santos C, DAyres‐, de‐Campos, Costa C, Bernardes J. Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH. BJOG 2010;117:1288–1293.Objective  To evaluate the impact of access to computerised cardiotocograph (CTG) analysis on reproducibility and accuracy of clinicians’ predictions of umbilical artery blood pH (UAB pH) and 5‐minute Apgar score.Design  Prospective evaluation of pre‐recorded cases.Setting  A tertiary‐care university hospital.Population  From databases of intrapartum CTGs acquired in singleton term pregnancies, 204 tracings with low signal loss and short time interval to delivery were consecutively selected.Methods  Tracings were randomly assigned to computer analysis by the Omniview‐SisPorto 3.5® system (study group n = 104) or to no analysis (control group n = 100). Three experienced clinicians evaluated all tracing printouts independently and were asked to predict the newborns’ UAB pH and 5‐minute Apgar scores from them.Main outcome measures  Interobserver agreement (measured by the intraclass correlation coefficient [ICC]) and accuracy in prediction of neonatal outcomes with 95% CI.Results  Agreement on prediction of UAB pH was significantly higher in the study group (ICC = 0.70; 95% CI 0.61–0.77) than in the control group (ICC = 0.43; 95% CI 0.21–0.60), and a trend towards better agreement was also seen in estimation of 5‐minute Apgar scores (ICC = 0.55; 95% CI 0.38–0.68 versus ICC = 0.43; 95% CI 0.25–0.57). Observers predicted UAB pH values correctly within a 0.10 margin in 70% of cases in the study group (95% CI 0.61–0.79) versus 46% in the control group (95% CI 0.35–0.56). They predicted 5‐minute Apgar scores within a margin of one in 81% of cases in the study group (95% CI 0.73–0.88) and in 70% of cases in the control group (95% CI 0.61–0.79).Conclusions  Prediction of UAB pH is more reproducible and accurate when clinicians have access to computerised analysis of CTGs.