bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of haemodialysis on early markers of atherosclerosis
Authors: KOVACIC VEDRAN , LJUTIC DRAGAN , DODIG JOSIPA , RADIC MISLAV , DUPLANCIC DARKO 
Published: June 2008

SUMMARY:Introduction: End‐stage renal disease (ESRD) patients treated by haemodialysis (HD) have impaired endothelium‐dependent vasodilatation and increased intima‐media thickness (IMT) of the carotid artery The aim of the study was to analyse the relationships between parameters of chronic HD treatment and non‐invasive assessments of preclinical atherosclerosis (endothelial dysfunction and carotid IMT) in ESRD patients on HD.Methods: Fifty‐two (19 females, 33 males) adult patients on chronic maintenance (4.65 ± 3.29 years) HD aged 59.88 ± 15.49 years were investigated. Ultrasonographic studies were performed with a 7.5 MHz high‐resolution probe. The common carotid artery IMT was measured. Brachial artery diameter was analysed to the rest. In order to assess flow‐mediated dilatation (FMD), hyperaemia was induced by a pneumatic cuff, and an analysis of the diameter was performed 1, 2, 3 and 4 min after cuff deflation.Results: Significant differences were found in the average carotid IMT value between subjects with delivered dialysis dose (Kt/V) ≥1.2 and <1.2 (0.89 ± 0.21 vs 1.04 ± 0.11,P = 0.0045). A correlation between Kt/V and IMT (r = 0.366,P = 0.004) was demonstrated. FMD values of the brachial artery did not correlate with Kt/V. A correlation between low molecular weight heparin per kg of body mass and maximal percent of FMD was demonstrated (r = −0.242,P = 0.049). The maximal percent of brachial FMD was correlated with absolute difference between pre‐ and postdialysis pulse pressure values (r = −0.265,P = 0.033). In a partial correlation with haemoglobin as control, a variable significant correlation between total erythropoietin dose and maximal carotid IMT (r = −0.262,P = 0.036) was found. In a multiple linear regression model, Kt/V was independently correlated with carotid IMT values (β = −0.227,P = 0.0335).Conclusion: This study has demonstrated the association between HD procedure and early atherosclerosis markers. HD treatment has to be considered as potential modifying factor in atherosclerosis development.
Evaluation of the prognostic value of the risk, injury, failure, loss and end‐stage renal failure (RIFLE) criteria for acute kidney injury
Authors: PEREZ VALDIVIESO JOSE R , BES‐RASTROLLO MAIRA , MONEDERO PABLO , DE IRALA JOKIN , LAVILLA FRANCISCO J 
Published: June 2008

SUMMARY:Aim:  The experts have argued about the use of the risk, injury, failure, loss and end‐stage renal failure (RIFLE) criteria as a prognosis scoring system. We examined the association between in‐hospital mortality and the RIFLE criteria, and discussed its accuracy as a prognosis factor.Methods:  In this prospective study, we analysed the data gathered from a cohort of 956 patients admitted in a Spanish tertiary hospital between January 1998 and April 2006. Hazard ratios for mortality, and survival curves within 60 days were calculated. Discrimination and calibration of the model were also assessed.Results:  Excluding 53 patients, 903 patients were finally analysed. We classified them into groups according to the maximum RIFLE class reached during their admission. The RIFLE class was assessed by the glomerular filtration rate criterion. We found an increase in the in‐hospital mortality risk. Cox proportional hazard models showed that RIFLE classes risk, injury, and failure were significant predictive factors (hazard ratios were 2.77, 3.23 and 3.52, respectively; P for trend was 0.005). The multivariate analyses from the cross‐classification of the participants according to Liano score values (severity of illness) and RIFLE classes showed additive effects of the exposures on in‐hospital mortality.Conclusion:  In this population, the risk of in‐hospital mortality during the acute kidney injury (AKI) episode was positively associated with RIFLE classes. We showed that the RIFLE classification system had discriminative power in predicting hospital mortality within 60 days in AKI patients, but not better than a specific AKI predictive model. However, a combined use of both may give a more robust prognosis system.
Effect of levamisole supplementation on hepatitis B virus vaccination response in hemodialysis patients
Authors: SALI SHAHNAZ , ALAVIAN SEYED M , HAJARIZADEH BEHZAD 
Published: June 2008

SUMMARY:Aim:  As an immune‐modulating agent, levamisole has been reported to stimulate depressed T‐cell activity, enhance B lymphocyte function and restore delayed hypersensitivity reactions in immune‐depressed patients. There are a number of recent studies claiming that levamisole can improve response rate to hepatitis B virus (HBV) vaccination in haemodialysis patients. The present study has examined this hypothesis amongst some Iranian patients, using double‐blind randomized clinical trial.Methods:  During a 12 month period, 70 patients on maintenance haemodialysis with negative anti‐hepatitis B surface antibody (HBsAb) and HBV core antibody (HBcAb), from four different dialysis centres were enrolled into the study. The patients were randomized to two groups. The first group (levamisole group) received 40 μg doses of recombinant HBV vaccine i.m. at 0, 1 and 6 months, plus 100 mg levamisole p.o., after each haemodialysis session. The second group (placebo group) received the same vaccination protocol, except for the placebo instead of levamisole. The patients were followed on serum HBsAb level. Those with an HBsAb level of above 10 mIU/mL, 1 month after the third dose of vaccination, were considered as responders.Results:  The levamisole group was comprised of 38 patients and the placebo group of 32 patients. Thirty‐one patients (81.6%) of levamisole group and 26 patients (81.3%) of placebo group responded to vaccination. The difference between two groups was not significant.Conclusion:  This study indicated that in a haemodialysis population with high response to HBV vaccination, levamisole might have no significant effect in enhancing the response. Further studies with higher power can give more accurate results.
Overexpression of decorin induces apoptosis and cell growth arrest in cultured rat mesangial cells in vitro
Authors: WU HUIJUAN , WANG SUXIA , XUE AIMIN , LIU YUAN , LIU YE , WANG HUIJUN , CHEN QI , GUO MUYI , ZHANG ZHIGANG 
Published: June 2008

SUMMARY:Background:  Decorin (DCN) is a small leucine‐rich proteoglycan that plays an important role in the regulation of intercellular contact, cell migration and proliferation. DCN suppresses cell growth and induces apoptosis in various tumour cells. The aim of this study was to investigate whether overexpression of DCN could induce apoptosis and cell growth arrest in mesangial cells (MsCs) in vitro.Methods:  PcDNA3.1A‐DCN plasmid was transfected into cultured rat MsCs, and positive clones stably expressing DCN (MsC/DCN) were selected. SiRNA was used for blocking DCN expression in MsC/DCN. Apoptosis and cell growth of MsCs were assayed by flow cytometry. Hoechst staining was used for observing apoptotic cells. Expressions of active Caspase‐3, epidermal growth factor receptor (EGFR), P21 and transforming growth factor‐β (TGF‐β1) were analyzed using Western blot.Results:  Overexpression of DCN in MsCs induced apoptosis and arrested cells in the G0/G1 phase. The protein level of active Caspase‐3 was significantly elevated in MsC/DCN (P < 0.01). DCN transfection induced downregulation of EGFR and up‐expression of P21. In addition, the expression of TGF‐β1 was significantly inhibited. DCN‐siRNA transfection remarkably blocked the expression of DCN and reversed the downregulatory effects of DCN on MsC's proliferation.Conclusion:  Overexpression of DCN could inhibit MsCs proliferation by inducing apoptosis and cell growth arrest in vitro and it also downregulates expression of TGF‐β1. These results suggest novel strategies for regulating the proliferation of MsC in glomerular diseases.
Hypothesis: A simple algorithm to distinguish between hypoaldosteronism and renal aldosterone resistance in patients with persistent hyperkalemia
Authors: ADAM WILLIAM R 
Published: June 2008

SUMMARY:Aim:  Many patients with hyperkalemia have a readily identifiable cause, which leads to appropriate management. In others, particularly those with a reduced glomerular filtration rate, differentiating between (relative) hypoaldosteronism (HA) and renal aldosterone resistance (RAR) can be problematic. The aim of this study was to see if a plasma aldosterone to potassium algorithm could be defined which would help identify patients with hyperkalemia owing to suboptimal levels of aldosterone, thereby validating treatment with 9‐alpha‐fluhydrocortisone, instead of cation exchange resins, if more conservative treatment fails.Methods:  A literature search for, and analysis of, studies providing details of plasma aldosterone and plasma potassium in normals (made hyperkalemic)and patients with a plasma potassium >5.3 mmol/L, and a contemporaneous plasma aldosterone.Results:  One study was found in which normals were made significantly hyperkalemic (to 6.3 mmol/L). These subjects, while on a high sodium, low potassium (western) diet (n = 5), provided an arbitrary definition of a simple aldosterone to potassium algorithm for diagnosis (factored aldosterone (FAldo) = plasma aldosterone/(plasma K – 4.2)). The limit for FAldo is set at 280(pmol/L) or 10(ng/dL): results below the limit suggest HA; above the limit, RAR. This algorithm was then tested against, and, when plasma potassium was greater than 5.3, found to be consistent with, reported patients with confirmed HA (n = 33) and pseudohypoaldosteronism (n = 23). The ratios in reported patients with renal failure (n = 43) were consistent with either HA (n = 30) or RAR(n = 13).Hypothesis:  In hyperkalemic patients a plasma aldosterone to potassium algorithm may help distinguish HA from RAR, thereby guiding therapy.
Parathyroid hormone is inversely related to endothelin‐1 in patients on haemodialysis
Authors: PALERMO ALESSANDRO , MULÈ GIUSEPPE , GUARNERI MARCO , ARSENA ROSALIA , RICCOBENE RAFFAELLA , LORITO MARIA CARMELA , VACCARO FRANCESCO , CERASOLA GIOVANNI , COTTONE SANTINA 
Published: June 2008

SUMMARY:Aim:  Parathyroid hormone secretion is mainly influenced by hypocalcaemia, hyperphosphataemia and vitamin D deficiency. However, previous in vitro and in vivo studies showed that endothelin‐1 can influence parathyroid hormone secretion. This study was aimed at evaluating this relationship in vivo in uraemic patients.Methods:  Parathyroid hormone and endothelin‐1 plasma concentrations were measured in 67 haemodialysed patients. Patients with history of cardiovascular diseases and those with parathyroid adenoma were excluded.Results:  Plasma levels of endothelin‐1 were found to be inversely related to those of parathyroid hormone (P < 0.04) The multiple regression analysis, carried out considering parathyroid hormone as a dependent variable, and including age, sex, blood pressure, calcium × phosphorus product, and endothelin‐1, demonstrated that the independent correlates of parathyroid hormone were endothelin‐1 (β = −0.276; P = 0.015), and calcium × phosphorus product (β = 0.417; P < 0.0001).Conclusion:  For the first time in vivo, we demonstrated an inverse independent relationship between endothelin‐1 and parathyroid hormone in haemodialysed patients. Because both endothelin‐1 and parathyroid hormone are endowed with well‐known harmful actions on cardiovascular apparatus, whether such inverse relation may really influence the natural history of cardiovascular damage due to secondary hyperparathyroidism remains to be elucidated.
Assigning Escherichia coli strains to phylogenetic groups: multi‐locus sequence typing versus the PCR triplex method
Authors: Gordon David M. , Clermont Olivier , Tolley Heather , Denamur Erick 
Published: June 2008

SummaryIt is well recognized that Escherichia coli consists of a number of distinct phylo‐groups and that strains of the different phylo‐groups vary in their ecological niches, life‐history characteristics and propensity to cause disease. Consequently, much can be learnt by assigning a strain of E. coli to one of the recognized phylo‐groups. A triplex PCR‐based method that enables strains of E. coli to be assigned to a phylo‐group using a dichotomous key approach based on the presence or absence of two genes (chuA and yjaA) and an anonymous DNA fragment (TSPE4.C2) has been developed. However, the accuracy with which this method assigns strains to their correct phylo‐group has not been adequately evaluated. Consequently, 662 strains of E. coli were characterized using a multi‐locus sequence typing approach. Unsupervised population assignment algorithms were used to assign strains to phylo‐groups based on the multi‐locus sequence typing data. The analyses revealed that 85–90% of E. coli strains can be assigned to a phylo‐group and that 80–85% of the phylo‐group memberships assigned using the Clermont method are correct. However, the accuracy with which strains are assigned to the correct phylo‐group depends on their Clermont genotype. For example, strains yielding a Clermont genotype consistent with phylo‐groups B1 and B2 are assigned correctly 95% of the time. Strains failing to yield any PCR products using the Clermont method are seldom members of phylo‐group A and strains with such a genotype should not be assigned to a phylo‐group.
The management and outcome of anastomotic leaks in colorectal surgery
Authors: Khan A. A. , Wheeler J. M. D. , Cunningham C. , George B. , Kettlewell M. , Mortensen N. J. McC. 
Published: June 2008

AbstractPurpose  Anastomotic leaks in colorectal surgery are associated with significant morbidity and mortality and may result in poor functional and oncological outcomes. Diagnostic difficulties may delay identification and appropriate management of leaks. The aim of this study was to look at the diagnosis, clinical management and outcomes of anastamotic leaks in our department.Method  A retrospective audit and case note review of all patients who underwent the formation of a colorectal anastomosis between January 1996 and December 2002 (n = 1421) was performed. An anastomotic leak was defined as sepsis identified to have arisen from an anastomosis that subsequently required surgery, radiological drainage or intravenous antibiotics. Forty‐one patients (25 male, 16 female) with a median age of 60 years (range 7–89 years) were identified as having suffered an anastomotic leak.Results  The median time to diagnosis of an anastomotic leak following surgery was 7 days (range 3–29). At re‐operation, 21 patients (51%) underwent formation of a stoma, and any who required the anastomosis to be formally taken down have been left with a ‘permanent’ stoma. Currently only four of 12 patients (33%) who required a stoma for an anastomotic leak following anterior resection have undergone stoma reversal. Eleven of 16 patients (69%) who had received a stoma following another colorectal procedure had undergone stoma reversal. The mortality associated with an anastamotic leak in this series was 5% (n = 2).Conclusion  Although anastomotic leaks following colorectal surgery are associated with significant morbidity and stoma formation, early and aggressive management should result in a low overall mortality. If an anastomosis is taken down following an anastomotic leak after anterior resection, this will usually result in a ‘permanent’ stoma.
Pathologic response assessed by Mandard grade is a better prognostic factor than down staging for disease‐free survival after preoperative radiochemotherapy for advanced rectal cancer
Authors: Suárez J. , Vera R. , Balén E. , Gómez M. , Arias F. , Lera J. M. , Herrera J. , Zazpe C. 
Published: June 2008

AbstractObjective  The reduction in tumour stage induced by full course radiotherapy plus chemotherapy is apparent from histological changes. The purpose of this study was to determine the rate of complete pathological response and to evaluate the prognostic value for disease free survival (DFS) and disease specific survival (DSS) of the response. The relation between pretreatment variables (age, gender, stage, tumour height and [carcinoembryogenic antigen (CEA)] and postsurgical variables was compared to the pathological response.Method  A total of 119 patients with stage II or III rectal cancer underwent surgery 6 weeks after neoadjuvant treatment. Group A included patients with a complete or good pathological response (Mandard grade I–II) and group B patients with a poor response (Mandard grade III–IV–V).The pretreatment endo‐rectal ultrasound scan stage was compared with histopathology stage of the resected specimen. DFS and DSS were compared using the log‐rank test.Results  All 119 patients (mean age 67.9 years, 83 males) underwent resection. The tumour was located in the upper, middle and lower third of the rectum in 11, 51 and 57 patients. 88 patients had a low anterior resection, 28 patients abdomino‐perineal resection and three a Hartmann’s operation. There was no postoperative death. The circumferential margin (CM) was involved in 10%. A complete pathological response was observed in 17 (14.2%) patients. Thirty‐six (30.2%) patients had a group A and 83 a group B response. Group A showed DFS to be significantly higher than group B (log rank: P = 0.007). The DSS rate was not significantly different between the two groups (log rank P = 0.113). Down‐staging was not related with DFS. No relation was found between pretreatment variables and response. A good pathological response was related to a lower rate of permanent colostomy but not with CM involvement or the number of lymph nodes.Conclusion  Tumour regression of grades I or II was a good indicator of DFS in locally advanced rectal cancer, treated by neoadjuvant chemotherapy and radiotherapy. Patients with a high regression grade were associated with a lower incidence of definitive stoma formation. The regression grade was shown to be a better prognostic factor than down‐staging.
Fibre supplementation in addition to loperamide for faecal incontinence in adults: a randomized trial
Authors: Lauti M. , Scott D. , Thompson‐Fawcett M. W. 
Published: June 2008

AbstractBackground and aims  Many patients with faecal incontinence (FI) are prescribed a constipating agent concurrently with either fibre supplementation or a low‐residue diet. Clinician opinion varies as to which initial approach is best. This study compared these treatments in routine clinical practice.Method  Design: Double‐blind randomized cross‐over trial. Participants: Patients referred for FI. Intervention: Six weeks of low‐residue diet, placebo fibre supplement and loperamide followed by 6 weeks of fibre supplement, neutral diet and loperamide or the reverse order.Results  Sixty‐three patients were randomized. At baseline the mean Faecal Incontinence Severity Index (FISI) was 31. After low‐residue diet, placebo fibre supplement and loperamide the FISI was 18.4 (standard deviation, SD 13.2). After fibre supplementation and loperamide the FISI was 18.8 (SD 14.1). The mean difference between the treatment arms was not significant (−0.8; 95% CI: −4.9 to 3.3). There was also no difference between the treatments for the SF‐36 and the Faecal Incontinence Quality of Life scale. There was marked variability in individual responses, some favouring more fibre and some less.Conclusions  This study provides evidence that treatment with more or less fibre in addition to loperamide has similar clinical effectiveness overall, however individual tailoring of treatment seems important to achieve the best outcome.
Relationships between insulin secretion after intravenous and oral glucose administration in subjects with glucose tolerance ranging from normal to overt diabetes
Authors: Mari A. , Tura A. , Pacini G. , Kautzky‐Willer A. , Ferrannini E. 
Published: June 2008

AbstractAims  Acute insulin release (AIR) in response to intravenous glucose injection (IVGTT) can be abolished in diabetic subjects when their response to oral glucose is maintained. To elucidate this phenomenon, we examined the relationships between fasting plasma glucose (FPG) and the secretory responses to an IVGTT and an oral glucose test (OGTT).Methods  We measured AIR and secretion after a 75‐g OGTT in 221 subjects [age 37 ± 11 years, body mass index (BMI) 28 ± 5 kg/m2; mean ± sd] with normal glucose tolerance (NGT, n = 147), impaired FPG/impaired glucose tolerance (IFG/IGT, n = 28) and Type 2 diabetes (n = 46). Insulin secretion was calculated by C‐peptide deconvolution; pancreatic B‐cell glucose sensitivity was obtained by OGTT modelling.Results  Both AIR [186 (185), 142 (164) and 10 (16) pmol/l, median (interquartile range)] and B‐cell glucose sensitivity [98 (64), 66 (53) and 16 (20) pmol min−1 m−2 l mmol−1] decreased across glucose tolerance category (P < 0.0001). However, AIR became ~0 at ~7 mmol/l FPG, whereas B‐cell glucose sensitivity declined gradually throughout the FPG range. In addition, for FPG > 7 mmol/l, AIR was no longer related to FPG, whereas a strong relationship between FPG and B‐cell glucose sensitivity was preserved (ρ = −0.71, P < 0.0001). In a multivariate regression model, adjusting for sex, age and BMI, glucose sensitivity [standardized regression coefficient (std.r.) = −0.67, P < 0.0001], but not AIR (std.r. = 0.03, P = 0.55), was an independent predictor of FPG.Conclusions  AIR vanishes at fasting or 2‐h glucose levels, at which levels some B‐cell glucose sensitivity is retained; therefore, AIR has a limited ability to quantify B‐cell function in hyperglycaemic states.
Variable phenotypic spectrum of diabetes mellitus in a family carrying a novel KCNJ11 gene mutation
Authors: D’Amato E. , Tammaro P. , Craig T. J. , Tosi A. , Giorgetti R. , Lorini R. , Ashcroft F. M. 
Published: June 2008

AbstractAims  Heterozygous activating mutations in KCNJ11, which encodes the Kir6.2 subunit of the pancreatic ATP‐sensitive potassium (KATP) channel, cause both permanent and transient neonatal diabetes. Identification of KCNJ11 mutations has important therapeutic implications, as many patients can replace insulin injections with sulphonylurea tablets. The aim was to determine if a KCNJ11 mutation was responsible for a dominantly inherited form of diabetes mellitus, showing variability in age at diagnosis, in an Italian family.Methods  We sequenced KCNJ11 in members of a three‐generation family with variable phenotypes of dominantly inherited diabetes mellitus. One had transient early‐onset diabetes, one had impaired glucose tolerance during the second pregnancy, and two had young‐onset diabetes. None of the subjects showed permanent neonatal diabetes or neurological symptoms.Results  A novel heterozygous mutation (c. 679C→G and c. 680A→T) was identified, resulting in a GAG→CTG (E227L) substitution in KCNJ11. Functional studies of recombinant heterozygous KATP channels revealed a small reduction in channel inhibition by ATP (IC50 of 15 µmol/l and 38 µmol/l for wild‐type and heterozygous channels, respectively) and an increase in the resting KATP current. This would be expected to impair insulin secretion. The results are in agreement with the mild phenotype of the patients.Conclusions  Our results broaden the spectrum of diabetes phenotypes resulting from KCNJ11 mutations. They indicate testing for KCNJ11 mutations should be considered not only for neonatal diabetes but also for other forms of dominantly inherited diabetes with later onset, especially where these are associated with a low body mass index and low birth weight.