bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subclinical coeliac disease: an anthropometric assessment
Authors: CORAZZA G. R. , DI SARIO A. , SACCO G. , ZOLI G. , TREGGIARI E. A. , BRUSCO G. , GASBARRINI G. 
Published: August 2009

Abstract. Objectives. To evaluate the prevalence of malnutrition in patients with untreated coeliac disease (CD) according to their pattern of presentation, and the effect of gluten‐free diet (GFD) upon nutritional status.Design. Cohort prospective study.Setting. All subjects were seen at the outpatient ‘malabsorption’ clinic of the Department of Medical Pathology I, University of Bologna (referral centre), Bologna.Subjects. Eighty consecutive patients with CD (48 with classical and 32 with subclinical presentation), 15 patients with dermatitis herpetiformis (DH) and 40 healthy volunteers (members of the hospital staff).Main outcome measures. The nutritional status was evaluated by anthropometric measurements (percentage of ideal body weight for height and sex, percentage of standard triceps skinfold thickness and percentage of ideal arm‐muscle circumference).Results. The overall prevalence of malnutrition in our series of CD patients was 53%. Prevalence of malnutrition (actual body weight less than 90% of the ideal) was significantly higher in classical coeliacs (67%) than in subclinical ones (31 %, P < 0.002), in patients with DH (13%, P < 0.0003) and in healthy volunteers (13%, P < 0.0001). At diagnosis, percentage values of ideal body weight, triceps skinfold thickness and arm‐muscle circumference were significantly lower (P < 0.0001, P < 0.0002 and P < 0.003, respectively) in classical coeliacs (84.5 ± 10.6, 71.2±28.1 and 87.1±10.8, respectively) than in subclinical coeliacs (95.5±9.1, 105.6±41.0 and 94.8±10.6, respectively). After GFD, 33% of classical and only 3% of subclinical coeliacs were still malnourished.Conclusions. Prevalence of malnutrition in CD is lower than was previously thought. CD patients with classical presentation may require a longer period of GFD to achieve a significant improvement of their nutritional status, with respect to those with subclinical presentation, probably because of a greater extent of intestinal damage. Finally, a careful evaluation of dietary habits is usually sufficient to identify incomplete adherence to GFD as the reason for nonimprovement of the nutritional status in patients with CD.
Hip and distal arm fracture rates in peri‐ and postmenopausal insulin‐treated diabetic females
Authors: MELCHIOR T. M. , SØRENSEN H. , TORP‐PEDERSEN C. 
Published: August 2009

Abstract. Objectives. Hip and distal arm fractures are associated with osteoporosis in the postmenopausal female. In diabetic patients, bone mass has been found to be reduced leading to the hypothesis that diabetes is a risk factor for osteoporosis. Whether this has any clinical implication has only been sparsely elucidated.Design. A cross‐sectional case‐control study.Setting. All insulin‐treated diabetic females above the age of 40 years who regularly visited the Steno Memorial Hospital out‐patient clinic in 1989. Periand postmenopausal females from the general population living in a similar suburban region of Copenhagen admitted to Glostrup University Hospital because of a hip or Colles' fracture between 1 January 1989 and 31 October 1990.Subjects. The study comprised 748 insulin‐treated diabetic females. Thirty hip fractures and 82 Colles' fractures were reported after the age of 40 years. Out of 26 564 females from the general population, 622 were admitted to Glostrup hospital because of a hip or Colles' fracture.Methods/intervention. Answers based on questionnaires sent to all diabetic females, and the use of hospital files and hospital registers.Results. In diabetic females aged 40–49 years, Colles' fracture rate was 2/1000 years and hip fracture rate 0.43/1000 years. Fracture rate increased with age and, amongst 80–89‐year‐old diabetic females, the frequency of both fracture rates was 31/1000 years. These rates were slightly lower than the rates in the general female population. The relative risk of Colles' fracture in diabetic females aged 40–49 years was 0.3±0.2 (95% confidence limits) and that of hip fracture 1.O±1.1. In diabetic females aged 80–89 years, the risk of Colles' fracture and hip fracture were 1.3±1.1 and 1.0±0.9. Fracture rate was not associated with the development of diabetic complications, long‐term metabolic control, or age at diagnosis.Conclusion. Our results suggest that diabetic osteopenia does not have any clinical impact on fracture risk.
Limited joint mobility in type 1 diabetic patients: correlation to other diabetic complications
Authors: ARKKILA P. E. T. , MD I. M. KANTOL , VIIKARI J. S. A. 
Published: August 2009

Abstract. Objectives. To examine the association between limited joint mobility (LJM) and complications of diabetes in adult patients with type 1 diabetes.Design. Cross‐sectional study in diabetic patients and healthy controls.Setting. The study was performed at the department of medicine in Turku University Hospital (n = 103), a private diabetes outpatient clinic (n = 153) and the municipal health centre of Turku (n = 29), Finland.Subjects. We studied 285 diabetic patients [age (mean ± SD): 33.4 ± 10.0 years] and 288 healthy nondiabetic controls [age (mean ± SD): 32.3 ± 9.2].Main outcome measures. The limitations of several joints were examined with a goniometer. The diabetic patients were assessed in terms of the following complications: background and proliferative retinopathy, peripheral symmetrical polyneuropathy, autonomic neuropathy, impotence as well as clinical and incipient nephropathy; serum lipid values were also measured.Results. The prevalences of LJM were 58% and 14% in diabetic patients and in healthy controls, respectively. The diabetic patients with LJM had a 2.8‐fold risk of proliferative retinopathy [95% confidence interval (CI): 1.1–7.3] and a 3.6‐fold risk of nephropathy (95% CI: 1.4–9.3) compared to patients without LJM, when the confounding effect of the duration of diabetes was excluded. LJM was not related to metabolic control of diabetes, microalbuminuria, autonomic neuropathy or impotence. The association between LJM and peripheral symmetrical polyneuropathy was exclusively explained by the duration of diabetes. The correlation between LJM and serum total and low‐density lipoprotein cholesterol was dependent on the association between LJM and nephropathy. LJM did not relate to serum high‐density lipoprotein cholesterol or triglyceride values.Conclusions. The diabetic patients with LJM had an increased risk of proliferative retinopathy and nephropathy compared to patients without LJM.
Results of a prospective allocation policy of expanded criteria donors kidneys based on clinical parameters
Authors: Re L , Curcio D , Rial M , Goldberg J , Casadei D 
Published: August 2009

Re L, Curcio D, Rial M, Goldberg J, Casadei D. Results of a prospective allocation policy of expanded criteria donors kidneys based on clinical parameters. Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01053.x © 2009 John Wiley & Sons A/S.Abstract:  The ideal system to allocate expanded criteria donors (ECD) kidneys has not been fully elucidated. In a previous retrospective study, we reported that donor clinical characteristics were more predictive of transplant outcome than biopsy findings. Subsequently, we decided to use ECD kidneys solely based on a clinical scoring system. To elucidate the value of the pre‐transplant biopsy, the patients were divided in two groups according to the suitability of the kidney they received for single or double transplantation as determined by a histological scoring system (HS). All kidneys were transplanted as a single (vs. dual) transplant. We studied whether a HS of the pre‐transplant biopsy was predictive of outcome of single transplant ECD kidneys. Recipients (n = 48) were divided into two groups by whether the histologic system suggested single or double transplants be done. There were no differences between groups in two‐yr outcomes. We conclude that a clinical scoring system can predict which ECD kidney donors can be safely used as single transplants in a cohort of low immunological risk de novo kidney transplant recipients. Use of the clinical scoring system maximizes organ use.
Pure and mixed manic subtypes: a review of diagnostic classification and validation
Authors: Cassidy Frederick , Yatham Lakshmi N , Berk Michael , Grof Paul 
Published: August 2009

Objective:  To review issues surrounding the diagnosis and validity of bipolar manic states.Methods:  Studies of the manic syndrome and its diagnostic subtypes were reviewed emphasizing historical development, conceptualizations, formal diagnostic proposals, and validation.Results:  Definitions delineating mixed and pure manic states derive some validity from external measures. DSM‐IV and ICD‐10 diagnosis of bipolar mixed states are too rigid and less restrictive definitions can be validated. Anxiety is a symptom often overlooked in diagnosis of manic subtypes and may be relevant to the mixed manic state. The boundary for separation of mixed mania and depression remains unclear. A ‘pure’ non‐psychotic manic state similar to Kraepelin’s ‘hypomania’ has been observed in several independent studies.Conclusions:  Issues surrounding diagnostic subtyping of manic states remain complex and the debates surrounding categorical versus dimensional approaches continue. To the extent that categorical approaches for mixed mania diagnosis are adopted, both DSM‐IV and ICD‐10 are too rigid. Inclusion of non‐specific symptoms in definitions of mixed mania, such as psychomotor agitation, does not facilitate and may hinder the diagnostic separation of pure and mixed mania. The inclusion of a diagnostic seasonal specifier for DSM‐IV, which is currently based on seasonal patterns for depression might be expanded to include seasonal patterns for mania. Boundaries between subtypes may be ‘fuzzy’ rather than crisp, and graded approaches could be considered. With the continued development of new tools, such as imaging and genetics, alternative approaches to diagnosis other than the purely symptom‐centric paradigms might be considered.
Pediatric bipolar disorder: validity, phenomenology, and recommendations for diagnosis
Authors: Youngstrom Eric A , Birmaher Boris , Findling Robert L 
Published: August 2009

Objective:  To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis.Methods:  The present qualitative review summarizes and synthesizes available evidence about the phenomenology of bipolar disorder (BD) in youths, including description of the diagnostic sensitivity and specificity of symptoms, clarification about rates of cycling and mixed states, and discussion about chronic versus episodic presentations of mood dysregulation. The validity of the diagnosis of BD in youths is also evaluated based on traditional criteria including associated demographic characteristics, family environmental features, genetic bases, longitudinal studies of youths at risk of developing BD as well as youths already manifesting symptoms on the bipolar spectrum, treatment studies and pharmacologic dissection, neurobiological findings (including morphological and functional data), and other related laboratory findings. Additional sections review impairment and quality of life, personality and temperamental correlates, the clinical utility of a bipolar diagnosis in youths, and the dimensional versus categorical distinction as it applies to mood disorder in youths.Results:  A schema for diagnosis of BD in youths is developed, including a review of different operational definitions of ‘bipolar not otherwise specified.’ Principal areas of disagreement appear to include the relative role of elated versus irritable mood in assessment, and also the limits of the extent of the bipolar spectrum – when do definitions become so broad that they are no longer describing ‘bipolar’ cases?Conclusions:  In spite of these areas of disagreement, considerable evidence has amassed supporting the validity of the bipolar diagnosis in children and adolescents.
Phylogenetic and biological species diversity within the Neurospora tetrasperma complex
Authors: MENKIS A. , BASTIAANS E. , JACOBSON D. J. , JOHANNESSON H. 
Published: August 2009

AbstractThe objective of this study was to explore the evolutionary history of the morphologically recognized filamentous ascomycete Neurospora tetrasperma, and to reveal the genetic and reproductive relationships among its individuals and populations. We applied both phylogenetic and biological species recognition to a collection of strains representing the geographic and genetic diversity of N. tetrasperma. First, we were able to confirm a monophyletic origin of N. tetrasperma. Furthermore, we found nine phylogenetic species within the morphospecies. When using the traditional broad biological species recognition all investigated strains of N. tetrasperma constituted a single biological species. In contrast, when using a quantitative measurement of the reproductive success, incorporating characters such as viability and fertility of offspring, we found a high congruence between the phylogenetic and biological species recognition. Taken together, phylogenetically and biologically defined groups of individuals exist in N. tetrasperma, and these should be taken into account in future studies of its life history traits.
Multicentre experience with a simple blood salvage technique in patients with ruptured ectopic pregnancy in sub‐Sahelian West Africa
Authors: Priuli G. , Darate R. , Perrin R. X. , Lankoande J. , Drouet N. 
Published: August 2009

Background and Objective  Haemorrhage from ruptured ectopic pregnancy is a major cause of maternal death in Africa. The experience in three hospitals in salvaging intraperitoneal blood with a perforated metallic conical funnel is reported.Method  The blood was transfused back to the patient immediately after salvaging. Data were collected concerning the patient, her clinical state and haemoglobin levels throughout her stay in hospital, the diagnosis, the transfusion, and the complications encountered.Results  Two hundred and twelve patients were reported prospectively. The preoperative haemoglobin level was 70·6 ± 18·7 g/l (n = 132). After transfusion of 681 ± 389 ml (n = 212) of salvaged blood, haemoglobin levels reached 84·7 ± 10·5 g/l (n = 23) 6 days postoperatively. Twenty‐two patients, half of whom had a life‐threatening haemodynamic state, were also given donor blood. Twenty patients still had severe anaemia on leaving hospital (blood haemoglobin < 70 g/l). No untoward outcomes attributable to the reinfusion were seen.Conclusion  The surgical treatment of ruptured ectopic pregnancy with intraperitoneal haemorrhage was rendered safe and efficient with this new salvaging equipment.
Bone development of suckling piglets after prenatal, neonatal or perinatal treatment with dexamethasone
Authors: Śliwa E. , Dobrowolski P. , Piersiak T. 
Published: August 2009

SummaryIn mammals, the release from growth‐inhibiting conditions results in catch‐up growth. To investigate animal evidence for whether prenatal dexamethasone (DEX) treatment leads to the development of growth restriction especially reduced mineralization of skeleton, and release from it leads to the phenomenon of catch‐up, piglets were prenatally exposed to DEX (3.0 mg/sow per day−2) during the last 24 days of prenatal life and tested further in two different ways: discontinued at birth and continued administration of DEX (0.5 mg/kg day−2) to piglets through 30 days of neonatal life. Using dual energy X‐ray absorptiometry methods, bone mineral density (BMD) and bone mineral content (BMC) were measured. The three‐point bending test was applied to determine the mechanical properties of the bones. Furthermore, geometric properties of the bones were assessed. Serum concentration of osteocalcin (OC) was determined. Histomorphological analysis of the ribs was also performed. The consequences of neonate DEX treatment and in utero DEX exposure were reflected in a dramatic decrease of BMD, BMC and blood serum OC concentration and geometric parameters of piglets’ bones. Prenatal action of DEX during the last 24 days of pregnancy resulted in continued neonatal modification of bone tissues, thus diminishing bone quality, and negatively influenced structural development and mechanical properties, finally increasing the risk of fractures of ribs and limb bones. Prenatal DEX treatment limited to the last 24 days of foetal life did not reduce the term birth weight and the growth of suckling piglets followed up to 30 days of neonatal life, and catch‐up in bone mineralization did not occur.
Effect of maize starch concentration in the diet on starch and cell wall digestion in the dairy cow
Authors: Van Vuuren A. M. , Hindle V. A. , Klop A. , Cone J. W. 
Published: August 2009

SummaryAn in vivo experiment was performed to determine the effect of level of maize starch in the diet on digestion and site of digestion of organic matter, starch and neutral detergent fibre (NDF). In a repeated change‐over design experiment, three cows fitted with a rumen cannula and T‐piece cannulae in duodenum and ileum received a low‐starch (12% of ration dry matter) and a high‐starch (33% of ration dry matter) diet. Starch level was increased by exchanging dried sugar beet pulp by ground maize. After a 2‐week adaptation period, feed intake, rumen fermentation parameters (in vivo and in situ), intestinal flows, faecal excretion of organic matter, starch and NDF were estimated. When the high‐starch diet was fed, dry matter intake was higher (19.0 kg/day vs. 17.8 kg/day), and total tract digestibility of organic matter, starch and NDF was lower when the low‐starch diet was fed. Maize starch concentration had no significant effect on rumen pH and volatile fatty acid concentration nor on the site of digestion of organic matter and starch and rate of passage of ytterbium‐labelled forage. On the high‐starch diet, an extra 1.3 kg of maize starch was supplied at the duodenum in relation to the low‐starch diet, but only an extra 0.3 kg of starch was digested in the small intestine. Digestion of NDF was only apparent in the rumen and was lower on the high‐starch diet than on the low‐starch diet, mainly attributed to the reduction in sugar beet pulp in the high‐starch diet. It was concluded that without the correction for the reduction in NDF digestion in the rumen, the extra supply of glucogenic (glucose and propionic acid) and ketogenic nutrients (acetic and butyric acid) by supplemented starch will be overestimated. The mechanisms responsible for these effects need to be addressed in feed evaluation.
Metabolic and luteal function in winter‐calving Spanish beef cows as affected by calf management and breed
Authors: Álvarez‐Rodríguez J. , Palacio J. , Sanz A. 
Published: August 2009

SummaryThis experiment aimed at evaluating the effect of calf management and breed on the metabolic and luteal function of post‐partum beef cows fed at maintenance. Fifty multiparous cows, 22 Parda de Montaña (PA) and 28 Pirenaica (PI), were assigned to either suckling once‐daily for 30 min (RESTR) or ad libitum (ADLIB) from the day after calving. Blood samples were collected to analyse metabolites [non‐esterified fatty acids (NEFA), β‐hydroxybutyrate, total protein and urea)], insulin‐like growth factor‐I (IGF‐I) and progesterone (P4) at different intervals. Cows from RESTR maintained their live‐weight (LW) over the first 3 months post‐partum, whereas ADLIB cows lost nearly 4% LW. Both genotypes showed similar LW gains during this period (p > 0.10). Calf daily gains were lower in RESTR than in ADLIB treatment (p < 0.05), but similar across breeds (p > 0.10). Milk and lactose production were lower in RESTR cows than in ADLIB (p < 0.05). Milk and protein yield were greater in PA than in PI breed (p < 0.05). Serum NEFA, total protein and urea were higher in PI cows suckling ADLIB than in the rest (p < 0.05). Cows from PI breed had greater NEFA values than PA ones on the first week post‐partum (p < 0.001). Circulating IGF‐I was not affected by suckling frequency, breed nor their interaction (p > 0.10). Suckling frequency, but not breed, affected the interval from calving to first ovulation (p < 0.001), being shorter in RESTR than in ADLIB cows. In conclusion, the ad libitum suckling practice improved cow milk yield and offspring gain compared to once‐daily suckling for 30 min from the day after calving, at the expense of impairing the onset of cyclicity. The effect of calf management was confounded with breed on the studied blood biochemical constituents, but any of these metabolites influenced the role of endocrine IGF‐I in these genotypes.
Dose–response relationship of inhaled corticosteroids and cataracts: A systematic review and meta‐analysis
Authors: WEATHERALL Mark , CLAY Jennifer , JAMES Kate , PERRIN Kyle , SHIRTCLIFFE Philippa , BEASLEY Richard 
Published: August 2009

ABSTRACTBackground and objective:  The risk of cataracts associated with the long‐term use of inhaled corticosteroids (ICS) is poorly recognized, yet may be of major public health importance. The aim of this study was to determine the dose–response relationship of ICS use and risk of cataracts in adults.Methods:  A systematic review and meta‐analysis was performed of case–control studies of cataracts and ICS use, which included at least two doses of ICS and in which the number of cases and controls using each dose of ICS was reported. The primary outcome variable was risk of cataracts.Results:  Four case–control studies were identified, with a total of 46 638 cases and 146 378 controls. There was a significant relationship between the risk of cataracts and ICS dose, with a random effects pooled odds ratio for risk of cataracts per 1000 µg increase in daily beclomethasone dipropionate dose of 1.25 (95% CI: 1.14–1.37).Conclusions:  The risk of cataracts was increased by approximately 25% for each 1000 µg per day increase in the dose of beclomethasone dipropionate or equivalent. These findings reinforce the importance of prescribing within the therapeutic dose–response range for ICS in asthma and the need to determine the dose–response relationship for the efficacy of ICS in COPD. Screening for the presence of cataracts could usefully be undertaken in older subjects with asthma and COPD, particularly current or ex‐smokers.
Congenital lung malformation: Evaluation of prenatal and postnatal radiological findings
Authors: ZEIDAN Smart , GORINCOUR Guillaume , POTIER Alain , UGHETTO Fabrice , DUBUS Jean C. , CHRESTIAN Marie‐Anne , GROSSE Camille , GAMERRE Marc , GUYS Jean‐Michel , De LAGAUSIE Pascal 
Published: August 2009

ABSTRACTBackground and objective:  This study evaluated the accuracy of prenatal MRI and postnatal CT imaging in the identification of congenital cystic adenomatoid malformation and bronchopulmonary sequestration by comparison with histological analysis.Methods:  Over a 3‐year period, 15 patients with lung malformations diagnosed prenatally by ultrasound were referred for prenatal MRI, and all were investigated postnatally by chest CT. All asymptomatic newborns with unresolved lesions underwent elective surgery by thoracoscopy. All surgical specimens were analysed histologically.Results:  Among the 15 patients with an abnormality diagnosed by ultrasound, prenatal MRI findings differed from the final histological diagnosis with respect to extent (n = 3), type of lesion (n = 1) and aberrant vessel identification (n = 4). Postnatal chest CT failed to visualize the aberrant vessel in one patient. Complete regression of the lesion was noted in two patients with bronchopulmonary sequestration, and in one patient with congenital cystic adenomatoid malformation and was confirmed by CT. Elective thoracoscopic lobectomy of the affected lobe was performed for 12 patients. Two conversions to thoracotomy were required. All operated patients had an uneventful hospital course.Conclusions:  Prenatal MRI is less accurate than postnatal CT scan, which remains the most reliable diagnostic modality to specify the location and extent and kind of lesions.