bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and utilisation of critical care resources amongst high‐risk surgical patients in a large NHS trust*
Authors: Jhanji S. , Thomas B. , Ely A. , Watson D. , Hinds C. J. , Pearse R. M. 
Published: May 2008

SummaryPrevious reports describe a population of non‐cardiac surgical patients at high risk of complications and death. Outcomes are sub‐optimal for such patients, perhaps in part related to inadequate provision or ineffective utilisation of critical care resources. In this study, data describing 26 051 in‐patient non‐cardiac surgical procedures performed in a large NHS Trust between April 2002 and March 2005 were extracted from local databases. Of these procedures, 2 414 (9.3%) were high risk with an overall mortality rate of 12.2% and a prolonged hospital stay (high‐risk population median (IQR) 16 (9–30) days vs standard risk 3 (2–6) days). Mortality rates for specific procedures were consistent with UK averages. However, only 852 (35.3%) high‐risk patients were admitted to a critical care unit at any stage after surgery. Of 294 high‐risk patients who died, only 144 (49.0%) were admitted to a critical care unit at any time and only 75 (25.6%) of these deaths occurred within a critical care area. Mortality rates were high amongst patients discharged and readmitted to critical care (37.7%) and amongst those admitted to critical care following initial postoperative care on a standard ward (29.9%). These data suggest that the outcome of high‐risk general surgical patients could be improved by adequate provision and more effective utilisation of critical care resources.
Serum IGF‐I measured by four different immunoassays in patients with adult GH deficiency or acromegaly and in a control population
Authors: Granada Maria Luisa , Ulied Angels , Casanueva Felipe F. , Pico Antonio , Lucas Tomas , Torres Elena , Sanmartí Anna 
Published: May 2008

SummaryBackground  IGF‐I is a useful tool in GH disorders diagnosis, however, the use of commercially available kits needs to be validated.Objective  To validate the use of serum IGF‐I concentrations measured by four immunoassays in the diagnosis of adult GH deficiency and acromegaly.Design  Cross‐sectional study.Patients  Fifty GH‐deficient (GHD) patients, 41 acromegaly patients and 405 controls.Measurements  Serum IGF‐I concentrations were measured by four commercial immunoassays: (1) RIA‐NICHOLS; (2) ICMA‐IMMULITE; (3) IRMA‐IMMUNOTECH; and (4) non‐extraction‐IRMA‐DSL. Reference values were established from the control population in six age groups. Individual results were transformed to standard deviation score (SD score) from the age‐related reference population and reference data provided by each assay manufacturer. Diagnostic sensitivity for GH deficiency was calculated.Results  IGF‐I measured by the four assays differed significantly. In controls, assay 2 yielded the lowest results, followed by assays 1, 3 and 4 (P < 0·0001 for all comparisons). IGF‐I declined with age, but no sex‐related differences were observed. When IGF‐I was standardized with respect to reference data obtained from the manufacturers, it showed better sensitivity in assays 1 and 2, than with our controls (65%vs. 77·5% and 58%vs. 70%, respectively) for GHD diagnosis. With assays 3 and 4, higher sensitivity was obtained when standardized with our controls (62%vs. 52% and 56%vs. 36%, respectively). In acromegaly, IGF‐I was > 2 SD score with all assays.Conclusions  IGF‐I SD score for GHD diagnosis differed according to the normative data used. All assays proved to be useful for active acromegaly diagnosis.
Effects of light to moderate alcohol consumption on thyroid volume and thyroid function
Authors: Valeix Pierre , Faure Patrice , Bertrais Sandrine , Vergnaud Anne‐Claire , Dauchet Luc , Hercberg Serge 
Published: May 2008

SummaryObjective  To examine a possible relationship between alcohol consumption and thyroid volume and function.Subjects  A total of 1493 subjects (599 males aged 45–60 years and 894 females aged 35–60 years) with no known thyroid disorders who were participating in the SUpplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) study.Measures  Daily dietary intakes and alcohol consumption in grams per day were based on five 24‐h dietary records. Thyroid volume and structure were measured by ultrasonography. At baseline, TSH and free T4 (FT4) were measured.Results  Male and female drinkers consumed (mean ± SD), respectively, 30·6 ± 23·3 and 14·2 ± 13·4 g of ethanol per day. There was a decrease in carbohydrate intake with higher alcohol consumption among both male (P = 0·0001) and female drinkers (P = 0·06). Alcohol intake was associated with higher thyroid volume in males and females independently of iodine status. Multivariate odds ratios (ORs, with 95% confidence intervals) of thyroid enlargement (sex‐specific 85th percentile values of ≥ 20 ml for males, ≥ 14 ml for females) in males and females who drank ≥ 45 and ≥ 20 g/day, respectively, were 2·22 (1·10–4·47) and 2·11 (1·15–3·90) compared with low drinkers, and 11·75 (2·15–64·12) and 2·03 (1·04–3·96) compared with abstainers. ORs were slightly increased when smokers were excluded. Alcohol intake was associated with low FT4 levels in male drinkers independently of TSH.Conclusions  An increasing dose–response relationship was found between alcohol intake levels and ORs for thyroid enlargement in both males and females. Alcohol consumption was strongly associated with a higher risk in females.
Induction of hepatic 11β‐hydroxysteroid dehydrogenase type 1 in patients with alcoholic liver disease
Authors: Ahmed Adeeba , Saksena Sushma , Sherlock Mark , Olliff Simon P. , Elias Elwyn , Stewart Paul M. 
Published: May 2008

SummaryBackground and aim  The alcohol‐induced pseudo‐Cushing's syndrome is an important differential diagnosis of hypercortisolism that is poorly understood. Two isozymes of 11β‐hydroxysteroid dehydrogenase (11β‐HSD) interconvert hormonally active cortisol (F) and inactive cortisone (E). Previously we have shown higher urinary F : E metabolite ratios (a reflection of global 11β‐HSD activity) in patients with alcoholic liver disease (ALD) compared to patients with chronic liver disease (CLD) of other aetiologies, suggesting that the phenotype of alcoholic pseudo‐Cushing's may relate to altered metabolism of F.Subjects and methods  We performed selective venous sampling of the hepatic, renal and peripheral veins measuring F and E concentrations (using in‐house radioimmunoassay) in 20 patients with histologically confirmed ALD and 19 patients with CLD. Six patients who also had selective venous sampling for investigation of suspected hyperaldosteronism were used as ‘normal’ controls.Results  There was a significant difference in the hepatic F gradient (mean ± SEM) between groups, indicating increased F production in the liver in patients with ALD (34·5 ± 21·7 nmol/l) compared to those with CLD (–21·0 ± 18·5 nmol/l) (P < 0·05) and normals (–19·7 ± 17·2 nmol/l) (P < 0·05). 11β‐HSD1 mRNA expression was increased fivefold in the ALD group compared with normal controls (P < 0·01).Conclusions  These results indicate significant induction of HSD11B1 gene expression and activity in patients with ALD during short‐ and long‐term abstinence from alcohol. The mechanism is unknown but might be explained on the basis of alcohol‐induced changes in intracellular redox potential or as a protective mechanism to limit liver inflammation and injury. Selective 11β‐HSD1 inhibitors may offer a novel therapeutic approach to treat alcoholic pseudo‐Cushing's.
Mental and motor development before and during growth hormone treatment in infants and toddlers with Prader–Willi syndrome
Authors: Festen D. A. M. , Wevers M. , Lindgren A. C. , Böhm B. , Otten B. J. , Wit J. M. , Duivenvoorden H. J. , Hokken‐Koelega A. C. S. 
Published: May 2008

SummaryBackground  Prader–Willi syndrome (PWS) is a neurogenetic disorder characterized by muscular hypotonia, psychomotor delay, feeding difficulties and failure to thrive in infancy. GH treatment improves growth velocity and body composition. Research on the effects of GH on psychomotor development in infants with PWS is limited.Objective  To evaluate psychomotor development in PWS infants and toddlers during GH treatment compared to randomized controls.Design/patients  Forty‐three PWS infants were evaluated at baseline. Twenty‐nine of them were randomized into a GH group (n = 15) receiving 1 mg/m2/day GH or a non‐GH‐treated control group (n = 14). At baseline and after 12 months of follow‐up, analysis with Bayley Scales of Infant Development II (BSID‐II) was performed. Data were converted to percentage of expected development for age (%ed), and changes during follow‐up were calculated.Results  Infants in the GH group had a median age of 2·3 years [interquartile range (IQR) 1·7–3·0] and in the control group of 1·5 years (IQR 1·2–2·7) (P = 0·17). Both mental and motor development improved significantly during the first year of study in the GH group vs. the control group: median (IQR) change was +9·3% (–5·3 to 13·3) vs.–2·9% (–8·1 to 4·9) (P < 0·05) in mental development and +11·2% (–4·9 to 22·5) vs.–18·5% (–27·9 to 1·8) (P < 0·05) in motor development, respectively.Conclusion  One year of GH treatment significantly improved mental and motor development in PWS infants compared to randomized controls.
Oestrogen treatment for tall stature in girls: estimating the effect on height and the error in height prediction
Authors: Venn Alison , Hosmer Trina , Hosmer David , Bruinsma Fiona , Jones Penelope , Lumley Judith , Pyett Priscilla , Rayner Jo‐Anne , Werther George 
Published: May 2008

SummaryObjective  To determine the effect of oestrogen treatment on attenuating the growth of tall girls after adjusting for error in height prediction.Design  Retrospective cohort study.Patients  Tall girls assessed by Australian paediatric endocrinologists between 1959 and 1993. A total of 279 girls received oestrogen treatment (diethylstilboestrol or ethinyl oestradiol) and 367 girls were assessed but not treated.Measurements  Estimated mature height (EMH) was calculated using radiographic assessment of bone age in adolescence. Final adult height was self‐reported at follow‐up. To control for error in the EMH predictions and their different distributions by treatment status, pairs of treated and untreated girls, matched on EMH within 1 cm, were selected for analysis. Covariate adjusted estimates of treatment effect (final height – EMH) were calculated.Results  In the sample of 108 matched pairs, the mean difference between the final height and EMH was –1·4 cm (SE 0·29) in the treated group and 1·1 cm (SE 0·23) in the untreated group, giving an unadjusted treatment effect of –2·5 cm (95% CI –3·2 to 1·8). A regression model based on 107 pairs of treated and untreated girls contained a significant interaction between bone age at treatment initiation and treatment, which estimated an approximately 1 cm per year decrease in treatment effect. The treatment effect was greatest in those commencing treatment at an early bone age and was significant if initiated before a bone age of 15 years.Conclusions  On average, oestrogen treatment resulted in an adult height that was less than predicted. Although treatment was more effective in the least mature girls, the mean height difference was relatively modest for most treated girls.
Hypothalamus–pituitary–adrenal axis evaluation in patients with hypothalamo–pituitary disorders: comparison of different provocative tests
Authors: Giordano R. , Picu A. , Bonelli L. , Balbo M. , Berardelli R. , Marinazzo E. , Corneli G. , Ghigo E. , Arvat E. 
Published: May 2008

SummaryBackground  The insulin tolerance test (ITT) is the gold standard test to evaluate hypothalamic–pituitary–adrenal (HPA) axis in suspected ACTH insufficiency. When contraindicated, alternative tests have been proposed such as metyrapone and ACTH stimulation test. 250 µg ACTH is a supramaximal dose and unreliable in this setting. The diagnostic reliability of 1·0 µg ACTH test is controversial and very low doses have been proposed.Design  In 31 patients with hypothalamo–pituitary disorders and normal basal cortisol, we compared the diagnostic sensitivity, specificity and accuracy of metyrapone [metyrapone test (MET) 30 mg/kg p.o.], high (HDT, 250 µg i.v.), low (LDT, 1·0 µg i.v.) and very‐low (VLDT, 0·06 µg i.v.) dose ACTH tests. Receiver operator curve (ROC) analysis was applied with ITT as reference test.Results  MET approached the best pairs of values for highest sensitivity (71·4% and 64·3%) and highest specificity (100% and 82·4%) using ACTH and 11‐deoxycortisol (11‐DOC) cut‐off of 17·3 pmol/l and 144·3 nmol/l. Either HDT or LDT sensitivity approached 71·4% with a specificity of 82·4% or 73·3% with a specificity of 80% for cortisol cut‐off of 582·1 or 477·3 nmol/l. VLDT approached the highest sensitivity (57·1%) and highest specificity (88·2%) for a cortisol cut‐off of 364·2 nmol/l.Conclusion  Neither MET nor ACTH test can be considered completely reliable for the diagnosis of secondary hypoadrenalism, when compared with ITT that remains the best test. Either MET or ACTH stimulation test, at both high and low dose, show an overall similar reliability, provided that appropriated cut‐off values were considered; testing with very low ACTH doses seems to be misleading.
A common intron 2 polymorphism of the glucocorticoid receptor gene is associated with insulin resistance in men
Authors: Syed Akheel A. , Halpin Christina G. , Irving Julie A. E. , Unwin Nigel C. , White Martin , Bhopal Raj S. , Redfern Christopher P. F. , Weaver Jolanta U. 
Published: May 2008

SummaryObjective  Clinical similarities between the metabolic syndrome and Cushing's syndrome have led to speculation of genetic association between them. The Bcl1 polymorphism in intron 2 of the glucocorticoid receptor (GR) gene has been associated with insulin resistance/hyperinsulinaemia. Our objective was to test the association of rs2918419, a T→C single nucleotide change in intron 2 downstream of the Bcl1 locus, with components of the metabolic syndrome and its interaction with the Bcl1 locus.Design and methods  We genotyped a subsample of 325 White subjects (116 men) in the Newcastle Heart Project (NHP), a population‐based study in north‐east England. Gender‐specific statistical analysis by stepwise backward multiple regression was performed to test the association of allele status with adiposity, glucose and insulin responses to oral glucose tolerance test (OGTT), fasting lipids and blood pressure.Results  Minor allele frequency was 0·14 for rs2918419 and 0·39 for the Bcl1 polymorphism. rs2918419 was associated with higher fasting insulin concentration and insulin resistance in men but not in women. Contrary to earlier studies, the Bcl1 polymorphism on its own was not associated with insulin resistance/hyperinsulinaemia in either gender. Subjects carrying variant rs2918419 alleles also had variant alleles at the Bcl1 locus. In men, but not women, Bcl1 variant alleles on a background of rs2918419 wild‐type alleles associated with lower fasting insulin compared to wild‐type alleles at both loci or variant alleles at both loci.Conclusions  We report that rs2918419 was linked with hyperinsulinaemia and insulin resistance in men. Carrying Bcl1 variant alleles without rs2918419 was not associated with hyperinsulinaemia/insulin resistance. Previous reports of the association of Bcl1 polymorphism with obesity‐related characteristics may reflect linkage disequilibrium with rs2918419.
Bisphosphonate‐associated osteonecrosis of the jaw: does it occur in children?
Authors: Brown J. J. , Ramalingam L. , Zacharin M. R. 
Published: May 2008

SummaryBackground  Bisphosphonate use in adult patients has been linked to osteonecrosis of the jaw (ONJ). This complication has not been systematically assessed in a paediatric population receiving bisphosphonates.Objective  To assess our cohort of paediatric patients treated with intravenous bisphosphonate for occurrence of ONJ.Design  Observational study at a tertiary children's hospital.Patients  A total of 42 paediatric patients with osteoporosis who received bisphosphonate infusions for a mean of 6·5 years (SD 2·7 years) were assessed clinically and radiographically for possible ONJ. Among 42, 37 patients had received disodium pamidronate 1 mg/kg/dose at a mean cumulative dose of 19·8 mg/kg and zoledronic acid (ZA) 0·05 mg/kg/dose at a mean cumulative dose of 0·49 mg/kg; four had received ZA and one received pamidronate alone. Invasive dental treatment during bisphosphonate treatment, a known risk factor for osteonecrosis, was specifically assessed.Results  In all patients assessed, including 11 who had invasive dental treatment, there were no cases of osteonecrosis.Conclusion  ONJ has so far not been demonstrated in this patient group.
A meta‐analysis of ant social parasitism: host characteristics of different parasitism types and a test of Emery’s rule
Authors: HUANG MING H. , DORNHAUS ANNA 
Published: May 2008

Abstract 1. In ant social parasitism, the process by which parasite–host systems evolved and the types of invasion mechanisms parasites use are being debated. Emery’s rule, for example, states that social parasites are the closest relatives to their hosts. The present study uses previously published data to test whether Emery’s rule applies equally to all parasitism types (i.e. xenobiosis, temporary, dulosis, and inquilinism). In addition, this study also investigates other links between parasite–host relatedness and host biology, which has implications for understanding the invasion mechanisms used by certain parasites.2. We find that xenobiotic parasites typically use distantly‐related host species that are of at least medium colony size. Temporary parasites often have multiple host species that are very closely related to the parasite and hosts with medium‐size colonies. Dulotic parasites frequently have multiple host species that are slightly less related and of any size. Lastly, inquiline parasites tend to have a single, very closely related, host species with medium‐size colonies.3. Parasites tend to be more closely related to host species if they have a single host species or when the host has a large colony size. In contrast, parasites with multiple host species or hosts of small colony size tend to be less related to their hosts.4. This study is the first to examine trends in ant social parasitism across all known parasite species. Our meta‐analysis shows that Emery’s rule applies to inquilinism and temporary parasitism, but not to dulosis and xenobiosis. Our results also suggest that both parasitism type and parasite–host relatedness predict the number of hosts and host colony size. It may be that a chemical mimicry mechanism allows invasion of large host colonies, but requires close relatedness of parasite and host, and concentration on a single host species.
Detecting prostate cancer by intracellular macrophage prostate‐specific antigen (PSA): a more specific and sensitive marker than conventional serum total PSA
Authors: Herwig R. , Mitteregger D. , Djavan B. , Kramer G. , Margreiter M. , Leers M. P. , Glodny B. , Haider D. G. , Hörl W. H. , Marberger M. 
Published: May 2008

AbstractBackground  Serum prostate‐specific antigen (PSA) is a standard method and a widely used marker for prostate cancer, but it has a poor specificity for early detection. Herein we demonstrate that intracellular macrophage PSA (imPSA) enables screening and differentiation between benign and malignant prostate disease.Materials and Methods  The efficacy of intracellular macrophage PSA in circulating and tissue macrophages was therefore investigated in a double‐centre study of 38 prostate cancer patients and 36 healthy controls by fluorescent‐activated cell sorting analysis and immunohistology.Results  Both methods uncovered the existence of PSA‐positive macrophages specific for patients with prostate cancer. In addition, we demonstrate the superiority of our new test over standard serum total PSA in a blinded double‐centre trial. ImPSA had a marked higher sensitivity and specificity than serum total PSA (imPSA: sensitivity 92%, specificity 92%, positive predictive value 92%; serum total PSA: sensitivity 79·5%, specificity 87·5%, positive predictive value 26·8%).Conclusion  In this study, we demonstrate that imPSA is a new prostate cancer screening method that is highly sensitive and more specific than standard PSA testing.
Increased infiltration of Chlamydophila pneumoniae in the vessel wall of human veins after perfusion
Authors: Kupreishvili K. , Ter Weeme M. , Morré S. A. , Van Den Brule A. J. C. , Huybregts M. A. J. M. , Quax P. H. A. , Ten Velden J. , Van Hinsbergh V. W. M. , Stooker W. , Eijsman L. , Niessen H. W. M. 
Published: May 2008

ABSTRACTBackground  Several studies have suggested an association between Chlamydophila pneumoniae (Cp) infection and atherosclerosis. A recent study detected Cp DNA in the saphenous vein of 12% of all patients before bypass grafting and in 38% of failed grafts. We used a system in which human veins were perfused with autologous blood under arterial pressure.Materials and methods   Veins were surplus segments of saphenous veins of coronary artery bypass grafting (CABG) patients. Vein grafts were perfused with the blood of the same patient after CABG procedures. Veins were analysed for Cp‐specific membrane protein using immunohistochemical and PCR analysis. Veins were analysed before and after perfusion (up to 4 h). The number of Cp positive cells was then quantified in the vein layers.Results  Cp protein was detected within macrophages only. In non‐perfused veins, Cp was present in the adventitia in 91% of all patients, in the circular (64%) and longitudinal (23%) layer of the media. No positivity was found in the intima. Perfusion subsequently resulted in a significant increase of Cp positive cells within the circular layer of the media that, however, differed strongly between different patients. Cp DNA was not detected by PCR in those specimens.Conclusion  Cp protein was present in 91% of veins, but the number of positive cells differed remarkably between patients. Perfusion of veins resulted in increased infiltration of Cp into the circular layer. These results may point to a putative discriminating role of Cp with respect to graft failure between different patients.
Some Comments on the Use of Antiandrogens for Male Contraception
Authors: Schenck B. , Neumann F. 
Published: May 2008

“Pure” antiandrogens of the cyproterone or flutamide type have no or only a transient effect on testes function and spermatogenesis. They are not useful for male contraception. Only antiandrogens with antigonadotrophic (progestational) activity or combinations of “pure” antiandrogens with a central inhibitory steroid inhibit spermatogenesis and fertility. The inhibitory effect of cyproterone acetate on spermatogenesis is a direct one as has been shown in animal experiments (rats).Most susceptible to cyproterone acetate are the accessory sexual glands, followed by the epididymis, the Sertoli cell and testes function.Concerning the use of cyproterone acetate as a male contraceptive it seems to be very difficult to find a dose sufficient to inhibit fertility without influencing libido.