bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous positive airway pressure in heart failure patients with obstructive sleep apnoea
Authors: Ferrier K. A. , Neill A. M. , O’Meeghan T. , Richards M. , Campbell A. J. 
Published: February 2008

AbstractBackground:  The aim of the study was to study the effect of 6 months of continuous positive airway pressure (CPAP) in community heart failure (HF) patients with obstructive sleep apnoea (OSA).Methods:  Clinically stable outpatients with HF and OSA (left ventricular ejection fraction (LVEF) <45%, apnoea/hypopnoea index >15/h, n = 19) treated with CPAP and a control group (LVEF <45%, apnoea/hypopnoea index <10/h, n = 7) were compared at baseline and at 6 months by Minnesota heart failure score, Epworth sleepiness score, shuttle walk distance, brain natriuretic peptide, urinary catecholamines and echocardiographic indices using paired t‐test, McNemar’s tests and effect sizes.Results:  In HF patients with OSA, CPAP improved LVEF (35.9 ± 6.1% to 40.6 ± 8.0%, P = 0.015), decreased LV end‐systolic volume (152 ± 74 to 135 ± 62 cm3, P = 0.03), systolic blood pressure (P = 0.04) and sleepiness (Epworth sleepiness score 8.8 ± 4.8 to 6.3 ± 3.2, P = 0.01), whereas walk distance, catecholamines, brain natriuretic peptide levels and symptoms were unchanged. These outcomes did not change in the HF control group.Conclusion:  In community HF patients with OSA, CPAP therapy over 6 months improved LVEF, systolic blood pressure and sleepiness, but not sympathetic activation, brain natriuretic peptide or exercise levels. Acceptance was relatively low, potentially limiting therapeutic effectiveness.
Is there any role for computed tomography measurements of medial temporal lobe atrophy in dementia? A review of the literature and case series from a memory clinic
Authors: Rose M. , Scharf S. 
Published: February 2008

AbstractNeuroimaging in dementia has focused on documenting any burden of vascular disease or excluding any reversible intracranial pathology. We review the use of computed tomography to examine for medial temporal lobe atrophy in dementia and compare this with a case series of such measurements from our memory clinic. Measures of medial temporal lobe atrophy were used to separate patients with Alzheimer’s disease from those with normal cognition, mood disorders or other forms of early dementia.
Management of distal ulcerative colitis: frequently asked questions analysis
Authors: James S. L. , Irving P. M. , Gearry R. B. , Gibson P. R. 
Published: February 2008

AbstractThe majority of patients with ulcerative colitis have disease involving only the distal colon. Although 5‐aminosalicylic acid (5‐ASA, mesalazine) and corticosteroids remain the important drugs used in the management of distal colitis and proctitis, recent expansion of delivery options of 5‐ASA and high level evidence regarding efficacy have led to a shift in treatment strategies. The availability of 5‐ASA in enema, foam and suppository formulations has enabled optimization of delivery of 5‐ASA to the affected mucosa. Such therapy has superior efficacy and fewer adverse effects compared with those of topical corticosteroids. Furthermore, rectal delivery is effective in the maintenance of remission. Consequently, new guidelines for the management of distal colitis have focussed more on rectal delivery and on optimizing 5‐ASA dosage than previously. However, corticosteroids remain an important remission‐inducing agent, and immune‐modulating drugs play a clear role in prevention of relapse and in managing chronically active disease. The changes in guidelines have raised several management questions, many of which are addressed in this review.
Type 1 fimbriae of insecticidal bacterium Xenorhabdus nematophila is necessary for growth and colonization of its symbiotic host nematode Steinernema carpocapsiae
Authors: Chandra Harish , Khandelwal Puneet , Khattri Arun , Banerjee Nirupama 
Published: February 2008

Summary Xenorhabdus nematophila produces type 1 fimbriae on the surface of Phase I cells. Fimbriae mediate recognition and adhesion of the bacteria to its target cell. To investigate the role of fimbriae in the biology of X. nematophila, we have produced a fimbrial mutant strain by insertional inactivation of the mrxA gene, encoding the structural subunit of type 1 fimbriae. Phenotypic characterization of the mutant revealed loss of fimbriae on the cell surface. Cell surface characteristics like dye absorption, biofilm formation, red blood cell agglutination remained unaltered. The mrxA mutant was defective in swarming on soft agar, although swimming motility was not affected. Flagellar expression was suppressed in the mrxA strain under swarming conditions, but not swimming conditions. Agglutination and cytotoxicity of the mutant to larval haemocytes was also reduced. When the mutant cells were injected in the haemocoel of the fourth instar larvae of Helicoverpa armigera, an increase in the LT50 of 9–12 h was observed relative to the wild‐type strain. The nematode growth was slow on the lawn of the fimbrial mutant. The mrxA negative strain was unable to colonize the nematode gut efficiently. This study demonstrates importance of type 1 fimbriae in establishment of bacteria‐nematode symbiosis, a key to successful pest management program.
The value of an additional hypoechoic lesion‐directed biopsy core for detecting prostate cancer
Authors: Gosselaar Claartje , Roobol Monique J. , Roemeling Stijn , Wolters Tineke , Van Leenders Geert J.L.H. , Schröder Fritz H. 
Published: February 2008

OBJECTIVETo determine the value of a hypoechoic lesion (HL)‐directed biopsy in addition to a systematic sextant biopsy for detecting prostate cancer.SUBJECTS AND METHODSWithin the European Randomized study of Screening for Prostate Cancer, 37 627 assays for prostate‐specific antigen (PSA) were done in men aged 55–75 years (screening round 1–3, interval 4 years). A PSA level of ≥3.0 ng/mL prompted a systematic transrectal ultrasonography (TRUS)‐guided lateralized sextant biopsy (4986 biopsy sessions were evaluated). If there was a HL, an additional lesion‐directed biopsy was taken.RESULTSAt the initial screening, 1840 men were biopsied and 532 cancers were detected (28.9%). Of the men biopsied, 436 had a HL and an additional biopsy (23.7%). In these men, 230 cancers were detected (52.8%). In 3.5% (eight of 230) only the HL‐directed core showed malignancy. At the repeat and third screening, respectively, 19.3% and 18.9% of the men biopsied had prostate cancer, 16.8% and 9.3% had an HL and the additional core detected two (2.2%) and one (5.9%) cancers. At the first screen most cancers found by the additional core were clinically relevant. In later screens these cancers seemed to be minimal.CONCLUSIONThe performance of TRUS as a screening tool is poor. The value of the additional core was limited as only 3.5% of the visible cancers were detected solely by the additional biopsy (round 1). However, a substantial part of these cancers were clinically relevant and would have been missed without the additional biopsy. This finding was less clear in screening round 2 and 3, even in men who were not previously biopsied.
Assessment of the intratesticular resistive index by colour Doppler ultrasonography measurements as a predictor of spermatogenesis
Authors: Pinggera Germar‐Michael , Mitterberger Michael , Bartsch Georg , Strasser Hannes , Gradl Johannes , Aigner Friedrich , Pallwein Leo , Frauscher Ferdinand 
Published: February 2008

OBJECTIVETo investigate the value of the resistive index (RI) of intratesticular arteries, and to establish diagnostic criteria for normal and pathological sperm counts on the basis of quantitative colour Doppler ultrasonography (CDUS), as the assessment of the testicular RI is widely used to measure intratesticular blood flow.PATIENTS AND METHODSIn all, 160 men (aged 22–43 years, 320 testicles) were prospectively investigated; 80 had a normal and 80 a pathological sperm count, the latter having mild oligoasthenozoospermia. The RI was measured using a high‐frequency Doppler ultrasound probe (14 MHz), three times on each testicle at an intratesticular artery in the upper, middle and lower testicular pole. The testicular volume was also measured by US. The RI values were compared between patients with normal and pathological sperm counts, and were compared statistically with testicular volumes. In addition, blood samples were obtained for DNA extraction, chromosome analysis and hormonal evaluations.RESULTSPatients with normal sperm counts had a mean (sd) RI of 0.54 (0.05) and a mean testicular volume of 18.7 (5.2) mL, the respective values in those with pathological sperm counts were 0.68 (0.06) and 16.8 (6.0) mL, with a significantly greater RI in the latter (P < 0.001), but with no statistically significant difference in testicular volume between the groups (P > 0.05).CONCLUSIONThese preliminary data suggest that an RI of >0.6 might be suggestive of a pathological sperm count in andrological patients. The intratesticular RI as measured by CDUS seems to be a reliable indicator for routine clinical use to identify subfertile men.
Establishing the role of cytokine therapy in advanced renal cell carcinoma
Authors: Gore Martin E. , De Mulder Pieter 
Published: February 2008

Tribute to Professor Pieter De Mulder, from Martin Gore Pieter and I were often pitted against each other in debates at international meetings on the role of cytokine therapy. The truth is that there was little disagreement between us, but we both thought such set pieces were a good way to highlight the issues surrounding the use of cytokines. He wanted our true joint view to be put on record, and the result is this article. Pieter himself suffered from kidney cancer for many years and he died in April as we were putting the finishing touches to this manuscript. Pieter was a remarkable man in so many ways. He was a physician of great compassion, immense intellect, utter integrity and unshakeable scientific rigor. These qualities meant that his perspective on many clinical controversies was in great demand internationally. The European oncology community has lost one of its giants and I, a dear friend. This manuscript is dedicated to the memory of Professor Pieter de Mulder.
A proposed guideline for the urological management of patients with spinal cord injury
Authors: Abrams Paul , Agarwal Meena , Drake Marcus , El‐Masri Waghi , Fulford Simon , Reid Sheilagh , Singh Gurpreet , Tophill Paul 
Published: February 2008

OBJECTIVETo develop a guideline for the urological management of patients with spinal cord injury (SCI).METHODSThe existing practice in the UK was evaluated by a series of expert meetings. Previous publications on the subject were evaluated, and the information synthesized to produce a proposed guideline.RESULTSThe literature review showed limited good‐quality data. As a result of the process a series of research questions was produced, the answers to which would allow a guideline to be established based on good‐quality evidence. In the absence of high‐quality evidence, the guideline was constructed using expert opinion. Urological care is described in the immediate, intermediate and long‐term phases after SCI.CONCLUSIONThe urological consequences of SCI can be devastating. Urological care is an important part of the holistic care of these patients, and should be delivered from SCI centres through a network of qualified clinicians.
Leptin and adiponectin interact in the regulation of prostate cancer cell growth via modulation of p53 and bcl‐2 expression
Authors: Mistry Tina , Digby Janet E. , Desai Ken M. , Randeva Harpal S. 
Published: February 2008

OBJECTIVETo investigate the effects of leptin, full‐length adiponectin (fAd) and globular adiponectin (gAd), alone and in combination, on LNCaP and PC3 prostate cancer cell proliferation, and on the expression of p53 and bcl‐2 gene expression.MATERIALS AND METHODSLNCaP and PC3 prostate cancer cells were cultured and treated with the following: 0–100 nm leptin; 0–100 nm fAd ± 100 nm leptin; 0–100 nm gAd ± 100 nm leptin. Proliferation assays and quantitative reverse transcriptase‐polymerase chain reaction for p53 tumour‐suppressor gene and bcl‐2 oncogene expression were performed on treated samples.RESULTSCo‐incubation of PC3 cells with 100 nm leptin and 1 or 100 nm fAd significantly decreased cell proliferation to approximately half of basal (P < 0.001); there was no significant effect in LNCaP cells. Leptin‐induced inhibition of p53 expression in LNCaP cells was rescued by fAd. Leptin and fAd dose‐dependently potentiated p53 expression in PC3 cells (P < 0.001); leptin and gAd also increased p53 expression (P < 0.05 and P < 0.001). fAd and gAd had no effect on bcl‐2 expression in the presence of leptin in LNCaP cells. In PC3 cells, bcl‐2 expression was inhibited to negligible levels in the presence of leptin.CONCLUSIONSLeptin and adiponectin interact, resulting in the inhibition of prostate cancer cell proliferation, particularly in PC3 cells, via modulation of p53 and bcl‐2 expression. Our findings support the notion that high leptin and low adiponectin levels may be important in driving obesity‐related prostate cancer progression.
Paraoxonase 1 phenotype distribution and activity differs in subjects with newly diagnosed Type 2 diabetes (the CODAM Study)
Authors: Van Den Berg S. W. , Jansen E. H. J. , Kruijshoop M. , Beekhof P. K. , Blaak E. , Van Der Kallen C. J. , Van Greevenbroek M. M. , Feskens E. J. M. 
Published: February 2008

AbstractAims  Paraoxonase 1 (PON1) is an antioxidant high‐density lipoprotein‐bound enzyme, which was recently found to be expressed in the islets of Langerhans. A substitution (Q/R) at position 192 results in enzymes with different activity. Oxidation has been implicated in the onset of diabetes, and it can be hypothesized that PON1 may have a protective effect on diabetes. Our aim was to compare PON1 activities and PON1 Q/R phenotypes in subjects with different degrees of glucose intolerance.Methods  We examined 566 members of the Cohort study of Diabetes and Atherosclerosis Maastricht (CoDAM), including subjects with normal glucose tolerance (NGT, n = 298), impaired glucose regulation (IGR, n = 128), newly diagnosed Type 2 diabetes (nDM, n = 78) and treated, that is to say known, Type 2 diabetes (kDM, n = 64). PON1 activity was measured in serum using paraoxon and diazoxon as substrates. The PON1 phenotype was determined using two‐dimensional enzyme analysis.Results  The RR‐phenotype was significantly more frequent in nDM compared with NGT subjects (14.1 vs. 6.0%, P = 0.05). Adjusted for the PON1 phenotype, subjects with nDM had significant lower PON1 activity towards paraoxon and diazoxon than subjects with NGT. Adjusted odds ratios comparing the RR‐variant with the QQ‐variant were 2.17 [95% confidence interval (CI): 0.90–5.24] for impaired glucose tolerance, 2.84 (95% CI: 1.03–7.83) for nDM, 2.13 (95% CI; 0.61–7.42) for kDM and 2.65 (95% CI: 1.10–6.40) for total diabetes mellitus.Conclusions  An aberrant PON1 phenotype distribution and PON1 activity were observed in early diabetes. In addition, the higher state of oxidative stress may affect the future development of complications.
Macular oedema is not predicted by perifoveal single blot haemorrhages
Authors: Schofield C. J. , Ellis J. D. , Ellingford A. , Morris A. D. , Leese G. P. 
Published: February 2008

AbstractAims  To ascertain which perifoveal changes on digital retinal screening in diabetes predict the need for subsequent macular grid or focal laser therapy.Methods  Between 1 January 2004 and 31 December 2005, all consecutive retinal images where any lesion was within one disc diameter of the fovea were reviewed. Patients were categorized by lesion at screening as having microaneurysm, single blot haemorrhage, multiple blot haemorrhages and exudates or circinate exudates within one disc diameter of the fovea. We compared these retinal images with the findings on slit lamp examination and the related decision for laser photocoagulation.Results  Four hundred and twenty‐four retinal images were identified. Of these, 52 were excluded, principally because of an interval between photography and clinic attendance of greater than 120 days, leaving 372 retinal images in the study group (313 patients). No patients with a single blot haemorrhage required immediate laser therapy at ophthalmology review compared with 13 (23%) of those with multiple blot haemorrhages and 36 (16%) of those with exudates or circinate lesions (P < 0.001). Thirty‐nine patients with a single blot haemorrhage who did not require laser therapy underwent ongoing follow‐up. None of these underwent laser therapy for maculopathy within the study time frame (9 months from initial screening event).Conclusions  In this study, no patients with a single blot haemorrhage within one disc diameter of the fovea on digital retinal screening required laser treatment.
Efficacy of tadalafil once daily in men with diabetes mellitus and erectile dysfunction
Authors: Hatzichristou D. , Gambla M. , Rubio‐Aurioles E. , Buvat J. , Brock G. B. , Spera G. , Rose L. , Lording D. , Liang S. 
Published: February 2008

AbstractAims  Erectile dysfunction (ED) is a common comorbidity in men with diabetes mellitus. Tadalafil 10 or 20 mg taken on demand is efficacious and safe for men with diabetes and ED. Recently, continuous treatment with tadalafil has been proposed, addressing ED management as any other chronic condition. This study examined whether once‐daily tadalafil 2.5 and 5 mg is efficacious for men with diabetes and ED.Methods  This randomized, double‐blind, placebo‐controlled, multicentre, 12‐week study enrolled 298 men with diabetes and ED to once‐daily treatment with placebo, tadalafil 2.5 mg or tadalafil 5 mg. Primary efficacy measures were International Index of Erectile Function Erectile Function (IIEF EF) Domain score, and patient success rates for vaginal penetration and completion of intercourse. Patient satisfaction, endothelial function biomarkers, and safety were also assessed.Results  Patients receiving either dose of tadalafil had clinically and statistically significant improvements in IIEF EF and statistically significant improvements in mean success rates for vaginal penetration, completion of intercourse, and overall treatment satisfaction (P ≤ 0.005 tadalafil vs. placebo, all measures). Endothelial dysfunction biomarkers were unchanged. The most common adverse events were headache, back pain and dyspepsia.Conclusions  In this first study of men with diabetes and ED, once‐daily tadalafil 2.5 and 5 mg was efficacious and well tolerated, suggesting this may be an alternative to on‐demand treatment for some men, eliminating the need to plan sex within a limited timeframe.
Survey of glargine use in 115 pregnant women with Type 1 diabetes
Authors: Gallen I. W. , Jaap A. , Roland J. M. , Chirayath H. H. 
Published: February 2008

AbstractAim  To examine pregnancy outcome in women with Type 1 diabetes treated with glargine.Methods  Glargine use in pregnancy was surveyed over 2 years in 20 UK obstetric‐diabetes centres. Outcomes, including maternal complications, miscarriage, congenital abnormalities, perinatal morbidity and mortality, were recorded in a standardized format.Results  Outcomes on 109 babies from 115 women with Type 1 diabetes were collected. Insulin glargine was used prior to pregnancy in 69% of women, started during pregnancy in 30%, and stopped at booking in one patient. Insulin aspart was the bolus insulin in 45%, lispro in 42% and human soluble in 8% of women. HbA1c fell from 8.1 ± 0.2% at booking to 6.8 ± 0.1% during the third trimester. Background retinopathy developed in one patient, worsened in seven and laser photocoagulation was required in three women. Preeclampsia occurred in 12%, and 14% of women had more than one episode of severe hypoglycaemia. One hundred and nine babies were live born, with six miscarriages and no neonatal deaths. The mean gestational age was 37.5 weeks, and mean birth weight was 3500 g. Three babies had congenital abnormalities (malformation rate = 28/1000). Neonatal hypoglycaemia was seen in 46% and hyperbilirubinaemia in 22% of babies. No major adverse outcome was noted in a smaller subset of five Type 2 and seven gestational diabetes patients on glargine.Conclusions  The use of glargine in Type 1 diabetes during pregnancy was not associated with any unexpected adverse maternal or fetal outcome in this study.
Reduced frequency of blood group Lewis a−b− in female Type 1 diabetes patients
Authors: Kharagjitsingh A. V. , Prinsen K. , Lemkes H. H. P. J. , De Vries R. R. P. , Roep B. O. , Buschard K. 
Published: February 2008

AbstractAims  To examine a disputed association between the Lewis(a−b−) phenotype and Type 1 diabetes (T1D).Methods  Lewis red blood cell phenotyping was performed for 97 T1D White patients and 100 control subjects using monoclonal antibodies. Two historical cohorts were also included as a control population.Results  T1D patients had a lower frequency (4.1%) of Lewis(a−b−) blood group compared with simultaneously tested healthy control subjects (10.0%) and the historical control group (11.1%, P = 0.02). Male T1D patients showed a Lewis(a−b−) frequency of 8.0%, which was similar to both matched healthy male donors (9.8%) and historical (9.5%) male control subjects. Unexpectedly, none of the female T1D patients displayed Lewis(a−b−) phenotype, vs. 10.3% and 10.8% of female control subjects (P = 0.039 and 0.017).Conclusions  The Lewis(a−b−) phenotype occurs less frequently in T1D compared with healthy control subjects with a strong female gender bias.
Organization of a quality‐assurance project in all Belgian multidisciplinary diabetes centres treating insulin‐treated diabetes patients: 5 years’ experience
Authors: Debacker N. , Nobels F. , Vandenberghe H. , Van Crombrugge P. , Scheen A. , Van Casteren V. 
Published: February 2008

AbstractAims  To describe the IQED, a quality‐assurance system started in 2001 in Belgian hospital‐based multidisciplinary diabetes centres, and its effects on the quality of care.Methods  The study was conducted through four data collections (in 2001, 2002, 2004 and 2006). Approximately 120 diabetes centres provided data on a systematic random sample of 10% of their adult diabetic patients on at least two daily insulin injections. Data on patient characteristics, glycaemic control, cardiovascular risk, diabetes complications, follow‐up procedures and treatment were obtained. Local quality promotion was encouraged by returning comprehensive feedback (benchmarks) and during information meetings.Results  Nearly all diabetes centres (98–100%) participated. The pooled sample consisted of 9194 (32%) Type 1 and 19 828 (68%) Type 2 diabetes patients, with mean diabetes duration of 17 years and 14 years, prevalence of microvascular complications of 23% and 38% and prevalence of macrovascular complications of 9% and 26%, respectively. At the start, the quality of care was good in terms of risk‐factor testing rates and moderate in terms of patients meeting goals for risk‐factor management. At least 50% of the centres initiated quality‐promoting initiatives. After 5 years, significant improvements were seen in risk‐factor testing rates, apart from renal screening. Improvements in intermediate outcomes were less obvious, apart from an increase in patients reaching the targets for blood pressure and LDL cholesterol.Conclusions  It is feasible to implement a continuous quality‐improvement project on a nationwide scale, with improvements particularly in process indicators.