bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron stores, liver transaminase levels and metabolic risk in healthy teenagers
Authors: Aigner E. , Hinz C. , Steiner K. , Rossmann B. , Pfleger J. , Hohla F. , Steger B. , Stadlmayr A. , Patsch W. , Datz C. 
Published: December 2009

Eur J Clin Invest 2010; 40 (2): 155–163AbstractBackground  Iron overload may contribute to the pathogenesis of insulin resistance. We aimed to investigate the relationship among iron stores, liver transaminases and components of the metabolic syndrome in healthy teenagers in a cross‐sectional study.Material and methods  We determined body mass index (BMI), waist‐to‐hip‐ratio (WHR), blood pressure, liver ultrasound, serum lipids, insulin, fasting glucose, liver transaminase levels, hsCRP, iron parameters in 325 of 341 (95·3%) students (234 men, 16·7 ± 1·7 years; 91 women, 16·5 ± 1·7 years) of one single high school. Male and female study participants were allocated to increasing quartiles of body iron stores as assessed by sTfr/ferritin and alanine aminotranspeptidase (ALT) levels, and the distribution of cardiometabolic risk factors along quartiles was analysed. Regression analysis was performed to confirm the independent relationship between parameters.Results  In male students, BMI, WHR, systolic and diastolic blood pressure, serum triglyceride levels and hsCRP were higher in the top sTfR/ferritin and ALT quartiles compared with the lowest quartiles (P < 0·01 for all parameters). In female students, sTfR/ferritin were not associated with antropomorphic cardiometabolic risk factors but with insulin resistance (HOMA‐IR, P = 0·046). Moreover, ALT levels were independently related to BMI, waist and hip circumference, systolic blood pressure, serum triglyceride and insulin concentrations (P < 0·05 for all parameters) in female students.Conclusion  These results provide evidence for linkage among body iron stores, transaminase activity and the prevalence of cardiometabolic risk factors in apparently healthy, non‐obese adolescents even within the range of normal laboratory and anthropomorphic values and suggest that iron stores should be investigated as a potentially modifiable risk factor in healthy teenagers.
Industry sponsorship and selection of comparators in randomized clinical trials
Authors: Lathyris D. N. , Patsopoulos N. A. , Salanti G. , Ioannidis J. P. A. 
Published: December 2009

Eur J Clin Invest 2010; 40 (2): 172–182AbstractBackground  Most clinical trials on medical interventions are sponsored by the industry. The choice of comparators shapes the accumulated evidence. We aimed to assess how often major companies sponsor trials that involve only their own products.Methods  Studies were identified by searching ClinicalTrials.gov for trials registered in 2006. We focused on randomized trials involving the 15 companies that had sponsored the largest number of registered trials in ClinicalTrials.gov in that period.Results  Overall, 577 randomized trials were eligible for analysis and 82% had a single industry sponsor [89% (166/187) of the placebo‐control trials, 87% (91/105) of trials comparing different doses or ways of administration of the same intervention, and 78% (221/285) of other active control trials]. The compared intervention(s) belonged to a single company in 67% of the trials (89%, 81% and 47% in the three categories respectively). All 15 companies strongly preferred to run trials where they were the only industry sponsor or even the only owner of the assessed interventions. Co‐sponsorship typically reflected co‐ownership of the same intervention by both companies. Head‐to‐head comparison of different active interventions developed by different companies occurred in only 18 trials with two or more industry sponsors.Conclusions  Each company generates a clinical research agenda that is strongly focused on its own products, while comparisons involving different interventions from different companies are uncommon. This diminishes the ability to understand the relative merits of different interventions for the same condition.
Plant traits, leaf palatability and litter decomposability for co‐occurring woody species differing in invasion status and nitrogen fixation ability
Authors: Kurokawa Hiroko , Peltzer Duane A. , Wardle David A. 
Published: December 2009

Summary1. Non‐native invasive and nitrogen (N)‐fixing plant species can cause large ecosystem‐level impacts, particularly when they differ in functionally important plant traits from native and non N‐fixing species. However, it remains unclear as to whether and how plant invasion status and N fixation ability consistently influence key plant leaf and litter traits, and trait‐driven processes like herbivory and decomposition.2. We compared leaf and litter traits, leaf palatability and litter decomposability for 41 co‐occurring woody species, including native N‐fixers, native non N‐fixers, invasive N‐fixers and invasive non N‐fixers, from a New Zealand floodplain. We tested the hypotheses that: (i) invasive and N‐fixing species have higher foliar N and specific leaf area, and lower concentrations of defensive phenolics and structural compounds than do native and non N‐fixing species, and (ii) invasive and N‐fixing species generally produce more decomposable litter and palatable foliage than do native and non N‐fixing species.3. Consistent with our hypotheses, invaders had higher foliar N and N : P ratio, and lower C : N ratio, than did native species. However, in contrast to our hypotheses, foliar phenolics were higher for the invaders while other leaf and litter traits were unaffected by invasion status. Further, N‐fixers had higher N and N : P ratios, and lower C : N ratios than did non N‐fixers, but other leaf and litter traits were unaffected by N fixation ability.4. Leaf palatability was unaffected by invasion status but was higher for N‐fixers than for non N‐fixers. Litter decomposability was unaffected both by invasion status and N fixation ability. We found a significant positive relationship between leaf palatability and litter decomposability across all species, because similar traits, particularly the C : P ratio and total phenolic concentrations of plant tissues, were correlated with both processes.5. Our results demonstrate that a small number of key traits, such as C : P ratio and total phenolic concentrations, drive both herbivory and decomposition irrespective of plant invasion status or N fixation ability. As such, they highlight that interspecific differences in particular plant traits, rather than plant functional group memberships based on invasion status and N fixation ability, are more effective in predicting palatability and decomposability.
Ecophysiological significance of leaf size variation in Proteaceae from the Cape Floristic Region
Authors: Yates Megan J. , Anthony Verboom G. , Rebelo Anthony G. , Cramer Michael D. 
Published: December 2009

Summary 1. Small leaves of species endemic to Mediterranean‐type climate areas have been associated with both low rainfall and nutrient availability, but the physiological reasons for this association remain unknown. 2. We postulated that small leaves have thin boundary layers that facilitate transpiration in winter and sensible heat loss in summer. High transpiration rates when water is available may facilitate nutrient acquisition in winter, whereas efficient sensible heat loss reduces the requirement for transpirational leaf cooling in summer. 3. The consequences of varying leaf sizes for water and heat loss in Cape Proteaceae were examined at two scales. At the leaf level, gas exchange and thermoregulatory capacities of 15 Proteaceae species with varying leaf size were assessed under controlled conditions using phylogenetically independent contrasts. At an environmental level, leaf attributes of Proteaceae occurring in the winter‐rainfall area of the Cape Floristic Region were correlated with climatic environments derived from distribution data for each species. 4. Leaf temperature was positively correlated with leaf size when wind speed was negligible. However, transpiration decreased significantly with increasing leaf size when measured on individual leaves, detached branches and when expressed on a per stoma basis. 5. From multiple stepwise regression analysis of climatic variables obtained from distribution data, leaf size was negatively correlated with A‐Pan evaporation, mean annual temperatures and water stress in January. We conclude that leaf size is conservative for survival over relatively rare periods of hot dry conditions with low wind speeds. 6. Narrow leaves enable plants to shed heat through sensible heat loss during summer droughts, without the need for transpirational cooling. Additionally, small leaf dimensions confer a capacity for high transpiration when evaporative demand is low and water is abundant (i.e. winter). This may be a particularly important strategy for driving nutrient mass‐flow to the roots of plants that take up most of their nutrients in the wet winter/spring months from nutrient‐poor soils.
Significance of patient self‐monitoring for long‐term outcomes after lung transplantation
Authors: Kugler Christiane , Gottlieb Jens , Dierich Martin , Haverich Axel , Strueber Martin , Welte Tobias , Simon Andre 
Published: December 2009

Kugler C, Gottlieb J, Dierich M, Haverich A, Strueber M, Welte T, Simon A. Significance of patient self‐monitoring for long‐term outcomes after lung transplantation. Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01197.x © 2009 John Wiley & Sons A/S.Abstract:  Background:  Lung transplant (LTx) recipients’ adherence to regular self‐monitoring of lung function (SMLF) is important in maintaining health. This study investigated patients’ behavior based on electronic monitoring (EM) and compared these findings with self‐reported data.Methods:  This single‐center study included 269 patients following LTx. Patients reported on adherence regarding SMLF, and data were compared to electronically stored measurements for the last three months prior to self‐reporting.Results:  Non‐adherence was 59.4% based on EM for a total of 22 052 measurements performed. Main reported reasons for non‐adherence were forgetfulness (22%), lack of time (19%), and good self‐perception of health status (19%). Determinants for non‐adherence were patients constraining beliefs (p ≤ 0.0001), low perceived support from the transplant center (p ≤ 0.008), a history of infections (p ≤ 0.014) and rejections (p ≤ 0.043), and bronchiolitis obliterans (p ≤ 0.006). Multiple logistic regression revealed low‐perceived support from the transplant center (OR 3.22; 95% CI 1.32–7.83; p < 0.01), and lack of support from patient organizations (OR 2.19; 95% CI 1.02–4.72; p < 0.04) as independent predictors for non‐adherence.Conclusions:  LTx recipients had some difficulties maintaining SMLF on a daily basis. Non‐adherence regarding lung function monitoring may provide a clinically relevant estimate of suspect cases for critical events impacting outcomes after LTx.
Unilateral Beau's lines associated with a fractured olecranon
Authors: Avery Helen , Cooper Hywel L , Karim Amin 
Published: December 2009

ABSTRACTWe report a case of unilateral Beau's lines developing after an olecranon fracture of the right elbow. Unilateral Beau's lines are an uncommon phenomenon but have been previously reported after trauma to the wrist, hands, forearm and elbow.
Population‐based study of cystic fibrosis disease severity and haemochromatosis gene mutations
Authors: PRATAP Upasna , QUINN Stephen , BLIZZARD Leigh B. , REID David W. 
Published: December 2009

ABSTRACTBackground and objective:  Haemochromatosis (HFE) mutations increase the risk of bowel obstruction in cystic fibrosis (CF), but the impact on other disease manifestations is unknown.Methods:  We determined the prevalence of HFE mutations (C282Y and H63D) in the Tasmanian CF population and assessed the relationship to systemic iron stores, Pseudomonas aeruginosa infection, lung disease severity and prevalence of diabetes.Results:  DNA was obtained from 82 individuals (96% of the entire CF population); 19 (23.2%) were H63D heterozygotes, three (3.7%) were H63D homozygotes and two patients were compound C282Y/H63D (2.4%). Seven (8.5%) patients were heterozygous for the C282Y mutation. Overall, 31 (37.8%) patients carried a HFE mutation. CF patients possessing HFE mutations had significantly better iron stores than non‐carriers (P < 0.05). The mean slopes of annual decline in FEV1 and FVC % predicted were significantly steeper in HFE carriers compared with non‐carriers (P < 0.01). Patients with HFE mutations were more likely to have had childhood bowel obstruction (RR 2.44, 95% CI: 1.04–5.74, P < 0.05). Diabetes was more common in HFE carriers (RR 2.96, 95% CI: 0.99–8.8, P = 0.05), but this effect attenuated when corrected for age (RR 2.89, 95% CI: 0.91–9.21, P = 0.07).Conclusions:  HFE gene mutations modify disease severity in CF, through probable effects on iron homeostasis.
Stopping tuberculosis in the 21st century: Goals and strategies
Authors: ONOZAKI Ikushi , RAVIGLIONE Mario 
Published: December 2009

ABSTRACTThe Stop TB Strategy and the Global Plan to Stop TB were launched in 2006 to achieve the tuberculosis (TB)‐related Millennium Development Goals and the Stop TB Partnership targets, and to address new challenges such as that of HIV‐associated TB and multi‐drug‐resistant TB. This paper reviews the historical and recent progress in TB control to show what has changed since the introduction of directly observed therapy (DOTS) in the mid‐1990s, why we needed the new strategy and what the global agenda is today. Major progress was seen in most countries in the last two decades. Globally, the estimated rates of TB prevalence and mortality are declining, but not quickly enough to reach the 2015 Stop TB Partnership targets of halving TB prevalence and death rates compared with 1990. In 2007, it was estimated that more than one‐third of TB patients were not detected or properly treated under proper conditions. Enhancing case detection, while maintaining high treatment success rates, is essential to achieve the 2015 targets. The ultimate goal of TB control is the elimination of the disease as a public health problem. The Stop TB Partnership aims at eliminating TB by 2050 by reaching a global incidence of disease of less than one case per million population. This target will not be achieved unless TB control efforts are further intensified and effective and affordable new technologies to prevent both disease and infection are developed and rapidly introduced in all countries worldwide.
Lung cancer: Progress in diagnosis, staging and therapy
Authors: SPIRO Stephen G. , TANNER Nichole T. , SILVESTRI Gerard A. , JANES Sam M. , LIM Eric , VANSTEENKISTE Johan F. , PIRKER Robert 
Published: December 2009

ABSTRACTLung cancer remains one of the greatest medical challenges with nearly 1.5 million new cases worldwide each year and a growing tobacco epidemic in the developing world. This review summarizes briefly the current status in growing areas of clinical research. The value of screening for early disease is not yet established and trials to see if mortality can be improved as a result are in progress. Better and more accurate staging will both streamline investigation and prove cost‐effective once ultrasound‐guided biopsy and aspiration of mediastinal nodes become universally accepted. This, allied to the new staging classification, will improve selection of cases for surgery, intensive multimodality therapy and for adjuvant treatment postoperatively. Much still needs to be done to refine staging as within a particular stage group, the outcome shows great variation. More information is needed on the genetic make‐up in some groups of tumours and not just their size; that is, more biological data on tumour growth patterns are likely to be at least as discriminating. The place of the stem cell theory of tumorigenesis is also explored in this paper. Finally, targeted therapy for advanced non‐small‐cell lung cancer is highlighted as a development with early promise, but still much clarification is required, before it can be considered as a universal approach in late disease.
Clinical characteristics of combined pulmonary fibrosis and emphysema
Authors: KITAGUCHI Yoshiaki , FUJIMOTO Keisaku , HANAOKA Masayuki , KAWAKAMI Satoshi , HONDA Takayuki , KUBO Keishi 
Published: December 2009

ABSTRACTBackground and objective:  Patients with combined pulmonary fibrosis and emphysema (CPFE) are sometimes seen, and we speculate that these patients have some different clinical characteristics from COPD patients. This study clarifies the clinical characteristics of CPFE patients.Methods:  This was a retrospective study of 47 stable patients with concurrent emphysema and diffuse parenchymal lung disease with fibrosis, based on the findings of chest CT (CPFE patients). The clinical characteristics of CPFE patients were compared with those of emphysema‐dominant COPD patients without parenchymal lung disease (COPD patients).Results:  Forty‐six of the 47 CPFE patients were male. Paraseptal emphysema was particularly common in the CPFE group. Honeycombing, ground‐glass opacities and reticular opacities were present in 75.6%, 62.2% and 84.4% of CPFE patients, respectively. Twenty‐two of the 47 CPFE patients (46.8%) had lung cancer. Pulmonary function tests showed that the CPFE group had milder airflow limitation and lower diffusing capacity than the COPD group. Desaturation during 6‐min walking test in CPFE patients tended to be more severe than in COPD patients, if the level of FEV1 or 6MWD was equal.Conclusions:  CPFE patients had some different clinical characteristics in comparison with COPD patients and may also have a high prevalence of lung cancer.
Surgery should be the first line of treatment for empyema
Authors: PETRAKIS Ioannis E. , HEFFNER John E. , KLEIN Jeffrey S. 
Published: December 2009

ABSTRACTFew thoracic conditions present such considerable challenges as pleural space infections, herein termed ‘empyema’ as a general term. Patients may present with free‐flowing infected pleural effusions that readily drain by catheter or, at the other extreme, with organized intrapleural collections of pus with thick pleural peels that require open decortication. In the transition from a simple to complex empyema, patients pass through the intermediary, or ‘fibrinopurulent’ stage. Such patients require careful assessment to determine the ideal management approach. Although existing trials provide insufficient evidence to standardize drainage approaches, an accepted principle directs clinicians to drain empyemas promptly and completely. In this pro‐con presentation, two recognized experts on empyema––a thoracic surgeon and an interventional radiologist—approach management from decidedly opposite perspectives. The surgeon prefers video‐assisted thoracoscopic surgery as primary therapy for fibrinopurulent empyemas. The radiologist counters that imaging‐guided, small‐bore catheters, sometimes with adjunctive fibrinolytic drugs, provide effective therapy for select patients. In the absence of high‐quality data to settle this debate, both experts present reasoned and thoughtful approaches, which produce superior clinical outcomes in their own institutions. So readers should recognize that controversy exists in empyema management and carefully review each expert's comments. Within each are essential elements of care that can be integrated into a multidisciplinary approach. Readers may conclude from this debate that each institution should develop a collaborative model for managing empyemas that integrates differing expertise to customize care for individual patients and continuously measure and improve their patients' outcomes.
Non‐invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation
Authors: JOHNSON Pamela L. , POPA Daniel A. , PRISK G. Kim , EDWARDS Natalie , SULLIVAN Colin E. 
Published: December 2009

ABSTRACTBackground and objective:  Ascent to high altitude results in hypobaric hypoxia and some individuals will develop acute mountain sickness (AMS), which has been shown to be associated with low oxyhaemoglobin saturation during sleep. Previous research has shown that positive end‐expiratory pressure by use of expiratory valves in a face mask while awake results in a reduction in AMS symptoms and higher oxyhaemoglobin saturation. We aimed to determine whether positive pressure ventilation would prevent AMS by increasing oxygenation during sleep.Methods:  We compared sleeping oxyhaemoglobin saturation and the incidence and severity of AMS in seven subjects sleeping for two consecutive nights at 3800 m above sea level using either non‐invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of AMS were assessed by administration of the Lake Louise questionnaire.Results:  We found significant increases in the mean and minimum sleeping oxyhaemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation.Conclusions:  The use of positive pressure ventilation during sleep at 3800 m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation.
Comparison of pulmonary diseases in common variable immunodeficiency and X‐linked agammaglobulinaemia
Authors: AGHAMOHAMMADI Asghar , ALLAHVERDI Abdolreza , ABOLHASSANI Hassan , MOAZZAMI Kasra , ALIZADEH Hooman , GHARAGOZLOU Mohammad , KALANTARI Najmoddin , SAJEDI Vahid , SHAFIEI Alireza , PARVANEH Nima , MOHAMMADPOUR Masoud , KARIMI Nasser , SADAGHIANI Mohammad Salehi , REZAEI Nima 
Published: December 2009

ABSTRACTBackground and objective:  Pulmonary disease is the most common complication in patients with common variable immunodeficiency (CVID) or X‐linked agammaglobulinaemia (XLA). Pulmonary disease may progress despite immunoglobulin replacement therapy. In this study pulmonary complications were compared in patients with CVID or XLA.Methods:  Pulmonary complications were evaluated in 115 patients (76 with CVID and 39 with XLA) by reviewing hospital records of chest infections, pulmonary function tests and high‐resolution CT scans.Results:  Thirty‐two patients with XLA (82%) presented with 59 episodes of pneumonia before diagnosis, whereas 15 patients (38.4%) experienced pneumonia after immunoglobulin replacement therapy (1.67 vs 0.45 episodes per patient per year). Among the CVID patients, 196 episodes of pneumonia were documented in 59 patients (77.6%) before diagnosis, while 36 patients (47.3%) experienced pneumonia after therapy (1.11 vs 0.58 episodes of pneumonia per patient per year). Forty‐seven (41%) patients (38 with CVID and 9 with XLA) developed chronic lung disease. The CVID patients developed more complications, including bronchiectasis and lymphoid interstitial pneumonitis, than the XLA patients.Conclusions:  Patients with CVID had a greater likelihood of developing lung disease, possibly due to delayed diagnosis and immune dysregulation, as compared with XLA patients. Early diagnosis of patients with primary antibody deficiencies and adequate i.v. immunoglobulin replacement therapy substantially reduces the number of pulmonary infections. However, CVID patients are prone to progression of lung disease despite optimal immunoglobulin therapy because of the nature of the disease. This important issue should be addressed in further studies.