bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight maintenance after a very low calorie diet (VLCD) weight reduction period and the effects of VLCD supplementation: A prospective, randomized, comparative, controlled long‐term trial
Authors: RYTTIG KJELD R. , RÖSSNER STEPHAN 
Published: August 2009

Abstract. Objectives. To evaluate the efficacy of a structured very low calorie diet (VLCD) weight reduction/weight maintenance behaviour programme on weight maintenance in obese patients (BMI ≥ 30 kg/m2).Design. Prospective, randomized, controlled intervention trial.Setting. University out‐patient obesity clinic.Subjects. A total of 114 obese patients from the waiting list were invited to participate in the structured weight reduction/weight maintenance programme lasting for 64 weeks. Sixty patients agreed to participate.Intervention. All 60 patients were placed on a Cambridge 330 kcal day‐1diet during the first 12 weeks. Fifty‐two were subsequently randomized to either a well balanced hypocaloric diet (1600 kcal day‐1), of which 220 kcal were provided by two sachets of Cambridge diet (group 1), or the same energy provided by the same principal diet (group 2) during the following 52‐week weight maintenance period.Main outcome measures. During the VLCD period, the mean body weight decreased significantly from 112.4 ± 19.8 to 91.6 ± 17.7 kg (P < 0.0001). Seventy‐one per cent of the weight loss was fat. During the weight maintenance period the average body weight increased significantly in group 1: 8.0 ± 8.2 vs. 12.3 ± 9.7 kg in group 2 (P < 0.0001). After the 64‐week treatment period the mean body weight in group 1 was 93.7 ± 18.1 kg and significantly lower compared to 109.9 ± 23.8 kg in group 2 (P = 0.008). Compliance was high: 87% completed the VLCD period and 75% completed the whole 64‐week treatment programme.Conclusion. Very low calorie diet as part of the dietary allowance during the weight maintenance programme partly prevents weight regain. This finding can be translated into practical treatment recommendations.
Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint
Authors: LIP GREGORY Y. H. , BEEVERS GARETH , ZARIFIS JOHN 
Published: August 2009

Abstract. Sufficient evidence has accumulated showing that hormone replacement therapy (HRT) does protect against cardiovascular disease in women, although data regarding the true magnitude of that protection remains incomplete. There is no evidence that HRT increases the risk of hypertension or thromboembolism, and beneficial effects have been found for plasma lipids, clotting factors and cardiovascular haemodynamics. However, the evidence is not convincing of any beneficial effect of HRT in preventing strokes, and concerns about the risk of cancer with HRT remain.Despite this, considerable uncertainty continues to exist amongst clinicians as to the balance of beneficial and harmful effects from administering HRT. Overall, HRT seems to do no harm and may be protective. A much greater awareness of the long‐term consequences of the menopause and the potential benefits of HRT should be encouraged so that women (and their doctors) can make informed decisions about their requirements.
The dissemination of false data through inadequate citation
Authors: Larsson K. Sune 
Published: August 2009

Abstract. Objectives. That occupational exposure to mercury causes reproductive failure in dental personnel has been propagated by repeated reference to a single epidemiological study in Poland, published in 1987. The present paper scrutinizes the results of this study, and monitors its subsequent citation in the literature.Method. Articles referring to the study were located in the Science Citation Index. From references in these papers and through other references, further articles were found. These papers were reviewed, and their content organized in relation to the way in which the Polish study was cited.Result. Most authors referred to the findings in the Polish study without critical evaluation of the data presented.Conclusions. Citation of irrelevant or misleading scientific data in the literature raises unfounded concerns in nonscientific circles and may lead to unwarranted regulations. It is therefore essential that editors and reviewers of scientific articles also scrutinize the literature quoted.
The prevalence of peripheral vascular disease in familial hypercholesterolaemia
Authors: KROON A. A. , AJUBI N. , VAN ASTEN W. N. J. C. , STALENHOEF A. F. H. 
Published: August 2009

Abstract. Objectives. In patients with familial hypercholesterolaemia (FH), the prevalence of haemodynamically significant peripheral vascular disease (PVD) was measured in relation to lipoproteins, general risk factors and the presence of coronary artery disease (CAD).Design. A case control study.Setting. The outpatient lipid clinic of a university hospital (tertiary referral centre).Subjects. Patients with heterozygous FH [n = 68; age 45.8 ± 11.6 years; untreated LDL‐cholesterol 9.2 ± 2.0 mmol L‐1] were compared with control subjects matched for gender, age, weight, smoking and presence of hypertension [n = 27; age 44.0 years; LDL‐cholesterol 3.8 ± 1.3 mmol L‐1].Main outcome measures. PVD was assessed during cholesterol‐lowering treatment using ankle/arm blood pressure ratios and analyses of Doppler‐derived blood flow velocities in the femoral artery at rest and during reactive hyperaemia. The diagnosis of CAD was assessed clinically.Results. Haemodynamically significant PVD was found in 21 (31%) FH patients and in one (3.7%) control subject, predominantly localized in the femoro‐popliteal vessels. CAD was present in 30 (44.1%) FH patients and in one (3.7%) control subject. PVD could be demonstrated in 50% of FH patients with CAD [relative risk 3.2 (95% CI 1.4–7.2)] and in 19% as the first manifestation of vascular disease. Males and females were equally affected. Mean arterial blood pressure of FH patients with PVD was higher compared to FH patients without PVD.Conclusions. Haemodynamically significant PVD appears to be more prevalent in FH patients than is generally assumed, especially in those with CAD. A relation with lipoprotein levels could not be demonstrated.
Causal link between neonatal hydronephrosis and later development of hypertension
Authors: Carlström Mattias 
Published: August 2009

Summary1. Although congenital ureteral obstruction is a common disorder in infants, its pathophysiology remains poorly understood and its clinical management continues to be debated. During the past decade, the surgical management of non‐symptomatic hydronephrosis in children has become more conservative, but the long‐term physiological consequences of this new policy are unclear.2. In experimental models with complete ureteral obstruction, tubular atrophy and interstitial inflammation occur rapidly. Although this type of obstruction is very rare in clinical practice, it is often referred to in clinical discussions. New studies, using a model with chronic partial ureteral obstruction, have demonstrated that hydronephrosis is associated with renal injuries and is causally related to hypertension.3. The mechanisms underlying the development of hypertension in experimental hydronephrosis are complex and involve changes in both the renin–angiotensin system and renal sympathetic nerve activity. Furthermore, oxidative stress and nitric oxide deficiency in the diseased kidney, with consequent resetting of the tubuloglomerular feedback mechanism, appear to play a pivotal role in the development and maintenance of hyper‐tension.4. In view of the new knowledge regarding the long‐term effects of partial ureteral obstruction, today’s non‐operative management of hydronephrosis should be reconsidered to prevent obstructive nephropathy and hypertension in later life.
Effect of age on cardiac excitation–contraction coupling
Authors: Fares Elias , Howlett Susan E 
Published: August 2009

Summary1. Cardiovascular diseases most commonly occur in the elderly and are a frequent cause of disability or death. However, the effect of age itself on cardiac function is not well understood.2. Studies in both human and animal hearts indicate that contractile function is unaffected by age while at rest. However, the ability to increase cardiac contractile force during strenuous activities, such as exercise, declines with age.3. Similar findings have been observed in individual ventricular myocytes isolated from aged hearts. When myocytes are stimulated with β‐adrenoceptor agonists or rapid pacing frequencies, aged cells show a much smaller increase in peak contractions and Ca2+ transients than young adult cells. In addition, contractions and Ca2+ transients are prolonged in aged cells compared with younger cells under these conditions.4. These observations suggest that the age‐related decline in cardiac contractile function originates at the cellular level and may reflect modifications in processes involved in excitation–contraction (EC) coupling.5. Biochemical studies have shown that there are age‐related modifications in the expression, regulation and function of a number of proteins essential to EC coupling in the heart.6. Functional studies indicate that these changes in EC coupling proteins disrupt Ca2+ homeostasis and contribute to decrease in peak contraction and prolongation of contraction duration observed in myocytes from aged hearts.7. The present review describes modifications in cardiac contractile function that occur in the ageing heart and evaluates underlying alterations in the EC coupling pathway that may be responsible for this decline in contractile function in ageing.
Efficacy and safety of dutasteride in Japanese men with benign prostatic hyperplasia
Authors: Tsukamoto Taiji , Endo Yukihiro , Narita Michiro 
Published: August 2009

Objectives: To assess the efficacy and safety of dutasteride in Japanese men with benign prostatic hyperplasia (BPH).Methods: This was a randomized, double‐blind, placebo‐controlled, parallel‐group study. A total of 378 subjects with clinical BPH having an International Prostate Symptom Score (IPSS) of 8 points or greater, a prostate volume of 30 mL or greater, and a maximal urinary flow rate (Qmax) of 15 mL/s or less were randomized to receive placebo or dutasteride once daily for 52 weeks. Subjects were stratified according to tamsulosin use at baseline. The numbers of subjects with and without tamsulosin use were 242 and 136, respectively. IPSS, Qmax, prostate volume and drug safety were evaluated.Results: Continued improvement in IPSS was noted in the dutasteride group, and dutasteride significantly decreased IPSS compared with placebo. At week 52, dutasteride significantly improved Qmax and prostate volume compared with placebo. Drug‐related sexual function events in the dutasteride group were infrequent and generally were not treatment limiting.Conclusions: Dutasteride improves urinary symptoms and flow rate and reduces prostate volume. In Japanese men with BPH, it is effective and generally well tolerated during the one‐year treatment period.
Near Infrared Spectroscopy study of the central nervous activity during artificial changes in bladder sensation in men
Authors: Matsumoto Shinya , Ishikawa Akira , Kume Haruki , Takeuchi Takumi , Homma Yukio 
Published: August 2009

Objectives:  To investigate the regional specificity of multi‐channel near infrared spectroscopy (NIRS) on the detection of urination‐related cortical activation in healthy men.Methods:  Frontal lobe blood flow was measured non‐invasively in 20 resting subjects using NIRS before and after micturition. The relative concentrations of oxyhemoglobin were recorded over the frontal lobe during artificial changes in bladder sensation with a 52‐channel NIRS machine. An increase in oxyhemoglobin represented locally increased blood flow. In artificially induced bladder sensation (desire to void), the lower abdomen of each participant was pressed by the examiner's hand to keep each participant feeling the desire to void for 5 s. Each participant received this series of tasks three times before and after urination. Activated concentrations calculated by contrast of subtracting the two different conditions were designed to disclose the brain areas that are involved during artificial changes in bladder sensation. The measurements were repeatedly carried out for each subject on different days to reveal the reproducibility and intra‐individual variability of the results.Results:  Cerebral responses during artificial changes in bladder sensation were bilaterally associated with increased levels of oxyhemoglobin in the frontal area. Oxyhemoglobin increases during the compression maneuver were significantly larger than those during an empty bladder in several bilateral frontal channels (P < 0.05).Conclusions:  Frontal regions were activated during artificial changes in bladder sensation before micturition using a 52‐channel NIRS machine.
Effect of bevacizumab on corneal neovascularization in experimental rabbit model
Authors: Ahmed Abdulgani , Berati Hasanreisoglu , Nalan Akyurek , Aylin Sepici 
Published: August 2009

AbstractPurpose:  To investigate the effect of bevacizumab in an experimental rabbit model of corneal neovascularization.Methods:  The right eyes of 24 white New Zealand rabbits were included in a corneal neovascularization model using alkaline burn. They were divided into four groups. Topical bevacizumab was installed three times daily in group 1, 5 mg bevacizumab subconjunctivally every 2 days in group 2, 10 mg bevacizumab subconjunctivally every 2 days in group 3 and 0.2 cc of normal saline in the same way in group 4 (control group). All eyes were treated for 7 days. Then the animals were killed and corneal specimens sent for histopathological analysis. Tear film and aqueous humour samples were obtained to assess vascular endothelial growth factor (VEGF) levels.Results:  Seven days after topical bevacizumab treatment the neovascular index in group 1 was lower than that in the control group (P = 0.028). In groups 2 and 3 the neovascular index was lower 2 days after subconjunctival bevacizumab treatment than that in control group (P = 0.009 and P = 0.009, respectively). In the control group the VEGF level in aqueous humour increased by 66% from day 7 to 14. In groups 1–3 it decreased by 49.80%, 70.20% and 76.44%, respectively (P = 0.043). The VEGF level in tear film of the control group increased by 35.23% from day 7 to 14, which was not significant (P = 0.893), while in groups 1–3 it decreased by 57.26%, 34.59% and 67.97%, respectively, which was only significant in groups 1 and 3 (P = 0.043).Conclusions:  Subconjunctival 5 mg/mL bevacizumab is effective in reducing corneal neovascularization in animal models and in reducing VEGF levels. Further research is needed to assess the potential side effects and minimal effective dose.
Optic perineuritis secondary to Wegener's granulomatosis
Authors: Purvin Valerie , Kawasaki Aki 
Published: August 2009

AbstractBackground:  Optic perineuritis (OPN) is an inflammatory condition involving the optic nerve sheath because of a variety of causes. We describe three patients in whom OPN was secondary to Wegener's granulomatosis (WG) and compare the clinical findings in these cases with those of idiopathic OPN.Methods:  This is a retrospective small case series derived from patients with OPN seen in an outpatient neuro‐ophthalmology clinic. Medical records and imaging studies of these patients were reviewed.Results:  These patients shared clinical similarities with idiopathic OPN including age, sex, symptoms, radiographic findings and steroid responsiveness. However, recurrence of symptoms on lowering the prednisone dose below 40 mg distinguished these patients from those with idiopathic OPN.Conclusions:  Steroid dependency in idiopathic OPN should raise suspicion of WG. Patients with OPN should be specifically questioned regarding pre‐existing upper respiratory tract disorders and rheumatic symptoms and laboratory testing should include acute phase reactants, anti‐neutrophil cytoplasmic antibodies and tests of renal function.
Training in pediatric anesthesia for registrars – UK National survey
Authors: MELARKODE KRISHNAN , ABDELAAL AMR , BASS SAM 
Published: August 2009

SummaryBackground:  The aim of this National survey was to review the training provided in pediatric anesthesia to all registrars across all deaneries in the United Kingdom. The Royal College of Anaesthetists (RCA) recognizes training in pediatric anesthesia as an important training module for specialist registrars in years 1 and 2 of their training and recommends that this training should be delivered in 1–3‐month blocks.Methods:  This was a simple online survey (http://www.esurveyspro.com). We aimed to contact all registrars via the Association of Paediatric Anaesthetists of Great Britain and Ireland and the RCA.Results:  Our survey indicated that there is wide variation in the duration of modular training across all deaneries. Three hundred and sixty‐two registrars (65.5%) thought that the implementation of the European working time directives (EWTD) would hamper training in this specialty. One hundred and sixty‐seven trainees (42.7%) spent more than 75% of their time doing pediatric anesthesia during their training module. Only 34 trainees (6.4%) had the opportunity to anesthetize children every week in District General Hospitals (DGHs), while 280 trainees (53.03%) said they did not have regular pediatric lists in DGHs.Conclusions:  It will be necessary to increase the duration of modular training with the implementation of EWTD. Modular training in pediatric anesthesia should be provided as a dedicated and protected module. Training opportunities in DGHs are limited. There is also a need for new guidelines, as current guidelines regarding pediatric anesthesia training will be outdated with the implementation of EWTD.
Enterocoele is a marker of severe pelvic floor weakness
Authors: Jarrett M. E. D. , Wijffels N. A. T. , Slater A. , Cunningham C. , Lindsey I. 
Published: August 2009

AbstractObjective  The aim was to evaluate the relationship between the presence of an enterocoele and grade of rectal prolapse (RP).Method  Defaecating proctograms of consecutive patients presenting to the Oxford Pelvic Floor Clinic between January 2004 and November 2008 were analysed. Patients were included if they had full thickness internal (grades 1–4 prolapse) or external RP (grade 5 prolapse). All those included were analysed with regards to the presence of an enterocoele.Results  Three hundred and seventy‐one patients [322 (87%) women and 49 (23%) men] were found to have a degree of RP. One out of eight (12.5%) patients with grade 1 RP, 10/42 (18.5%) with grade 2 RP, 34/125 (27%) with grade 3 RP, 62/135 (46%) with grade 4 RP and 23/49 (47%) with grade 5 full thickness external RP had an enterocoele present. This was a statistically significant trend (Pearson χ2 test P < 0.0002). There was a significantly higher proportion of enterocoeles in women [125/322 (39%) than in men (5/49 (10%)] (P < 0.0001) and a higher likelihood of having an enterocoele with advancing age (P < 0.0001). Within the study, there was no significant difference in the proportion of nulliparous and parous women with enterocoeles (P = 0.8); there were a significantly higher proportion of enterocoeles in hysterectomized women (P = 0.015).Conclusions  Enterocoele is increasingly seen with advancing RP severity. This suggests that the two findings are part of the same pelvic floor process. These data support the hypothesis that enterocoele is a marker of severe pelvic floor weakness. Enterocoele is seen more frequently in females particularly after hysterectomy.
Evidence‐based prescription of antibiotics in urology: a 5‐year review of microbiology
Authors: DasGupta Ranan , Sullivan Rebecca , French Gary , O’Brien Timothy 
Published: July 2009

OBJECTIVETo analyse the results of positive urine cultures over a 5‐year period in a large hospital and urology department (amongst both inpatients and outpatients), assess the prevalence of different organisms and the resistance profiles of a range of antibiotics, and thus provide information on which organisms are likely to cause urosepsis.METHODSThe use of antibiotics should be based on knowledge of which pathogens are present and what resistance patterns are emerging, particularly relevant in surgical disciplines like urology, as antibiotics are now routinely administered peri‐operatively, whereby evidence‐based prescription is preferable to generic guidelines. We therefore examined almost 25 000 positive urine cultures in our hospital over a 5‐year period, and focused on the infections encountered amongst urology patients during this time.RESULTSA significant proportion of inpatient urinary infection (40%) is caused by Gram‐positive bacteria such as Streptococcus faecalis, underlining the need for including Gram‐positive cover during urological prophylaxis. The commonest pathogen remains Escherichia coli among both inpatients and outpatients. The ineffectiveness of common antibiotics such as ciprofloxacin and trimethoprim was identified, as was the increase in gentamicin resistance.CONCLUSIONWe propose using an aminoglycoside with a penicillin for high‐risk cases (e.g. endoscopic stone surgery) while low‐risk cases (e.g. flexible cystoscopy with no risk factors) might be managed without such prophylaxis. Pathogenic patterns and resistance rates should be monitored regularly.
Erythrocytosis in offspring of mothers with Type 1 diabetes—are factors other than insulin critical determinants?
Authors: Nelson S. M. , Freeman D. J. , Sattar N. , Lindsay R. S. 
Published: July 2009

AbstractAim  Maternal diabetes is associated with polycythaemia and thrombocytopaenia in the offspring; however, the relationship with fetal hormones is unknown. We assessed the association of maternal glycaemic control, birthweight and fetal hormones with haematological indices in pregnancies complicated by maternal diabetes.Methods  Prospective study using cord blood samples from 89 offspring of mothers with Type 1 diabetes (OT1DM) and 34 control offspring. Full blood count, insulin, leptin, adiponectin, cortisol, insulin‐like growth factor 1 (IGF‐1), insulin‐like growth factor binding protein 3, intercellular adhesion molecule 1 and C‐reactive protein were measured in the umbilical vein at birth.Results  Haematocrit was higher in OT1DM (OT1DM 0.55 ± 0.17%, control offspring 0.51 ± 0.06%; P = 0.02). The difference in platelets count was not statistically significant [OT1DM 214 × 109/l (173–259); control offspring 253 × 109/l (180–310), P = 0.06]. Maternal glycated haemoglobin (HbA1c) showed a moderate positive correlation with fetal haematocrit (r = 0.30, P = 0.02). Cord platelet counts were negatively associated with birthweight in OT1DM (r = −0.27, P = 0.01). In multivariate models, cord insulin was not associated with haematocrit, but cord leptin was negatively associated with platelets in control offspring (P < 0.001) and OT1DM (P = 0.046), with additional contributions from male sex (P = 0.08) in OT1DM, and IGF‐1 (P = 0.04) and insulin (P = 0.04) in control offspring.Conclusions  Fetal haematocrit is increased in response to diabetes in pregnancy and is related to maternal glycaemic control. Fetal hyperinsulinism, hyperleptinaemia or macrosomia, although readily demonstrable in this cohort, do not emerge as determinants of raised fetal haematocrit in OT1DM. Both increased birthweight and fetal leptin are negatively associated with platelet count.