bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stability of irritable bowel syndrome using a Rome II‐based classification
Authors: WILLIAMS R. E. , BLACK C. L. , KIM H.‐Y. , ANDREWS E. B. , MANGEL A. W. , BUDA J. J. , COOK S. F. 
Published: December 2005

SummaryBackgroundAs there is no biological marker for irritable bowel syndrome, a diagnosis is made using symptom‐based criteria.AimTo evaluate the stability of self‐reported symptoms consistent with Rome II‐based irritable bowel syndrome classification.MethodsIrritable bowel syndrome subjects identified in a 2001 population‐based study by modified Rome II criteria were re‐contacted 2 years later. Data were collected via a web‐based questionnaire.ResultsOf the 697 subjects, 30% remained in the same irritable bowel syndrome subtype in both surveys, 18.4% changed irritable bowel syndrome subtype and 52% no longer met the irritable bowel syndrome criteria at follow‐up. Subjects continuing to meet the irritable bowel syndrome criteria were more likely to have been initially classified in the alternating irritable bowel syndrome subtype and had more psychological impairment and lower irritable bowel syndrome‐related quality of life than subjects not fulfilling the irritable bowel syndrome criteria at follow‐up. Lack of pain caused more subjects to fall out of the irritable bowel syndrome criteria than the absence of non‐painful bowel symptoms. However, the majority of subjects that did not fulfill the pain component of the irritable bowel syndrome criteria continued to report abdominal pain of at least moderate severity.ConclusionIn a US population‐based follow‐up study using modified Rome II criteria, we found irritable bowel syndrome is episodic in nature and current classification is limited in capturing fluctuation of disease over time.
Lifestyle factors and symptoms of gastro‐oesophageal reflux – a population‐based study
Authors: NOCON M. , LABENZ J. , WILLICH S. N. 
Published: December 2005

SummaryBackgroundAlthough the symptoms of gastro‐oesophageal reflux disease are common in the general adult population, the aetiology of gastro‐oesophageal reflux disease is still largely unknown. Lifestyle factors such as diet, body mass index, and smoking have been frequently suggested as possible risk factors.AimIn the present study, we investigated the relationship between various lifestyle factors and gastro‐oesophageal reflux disease symptoms.MethodsA total of 7124 subjects were interviewed as part of the German National Health Interview and Examination Survey, a representative sample of the general adult population. We examined a variety of possible risk factors, including age, gender, body mass index, smoking, alcohol consumption, sports and different foods. To investigate the association between lifestyle and symptoms, we used a multiple logistic regression model, including various gastro‐oesophageal reflux disease patient characteristics.ResultsWe found an association among those with reflux symptoms who were overweight and obese (odds ratio: 1.8, 95% confidence interval: 1.5–2.2; odds ratio: 2.6, 95% confidence interval: 2.2–3.2), respectively. Further risk factors included smoking and the frequent consumption of spirits, sweets, or white bread. Physical activity and the consumption of fruits seemed to have some protective effect.ConclusionsLifestyle factors – in particular overweight, obesity and smoking – were associated with increased reflux symptoms.
The efficacy and safety of ɛ‐aminocaproic acid treatment in patients with cirrhosis and hyperfibrinolysis
Authors: GUNAWAN B. , RUNYON B. 
Published: December 2005

SummaryBackgroundPatients with decompensated cirrhosis are at risk for hyperfibrinolysis; this is potentially fatal. ɛ‐aminocaproic acid has been used to treat patients with hyperfibrinolysis; however, the data about its benefit in the setting of cirrhosis are minimal.AimTo analyse the efficacy of ɛ‐aminocaproic acid and its safety in cirrhotic patients with hyperfibrinolysis.MethodsAll patients with an abnormal euglobin lysis time who were admitted to Rancho Los Amigos Medical Center from 1 January 2001 to 31 December 2002 were included in the study. Their medical records were reviewed and analysed.ResultsThere were 60 cirrhotic patients with shortened euglobin lysis time. Fifty‐two patients received ɛ‐aminocaproic acid. Of the 52 patients, seven had one or more bleeding episodes with the subcutaneous or soft tissue bleeding as the most common indication for ɛ‐aminocaproic acid use. Of the 37 patients, 34 (92%) had improvement or resolution of their bleeding. Only two (3%) patients had ɛ‐aminocaproic acid treatment discontinued because of minor side effects, rash and lightheadedness. There were no thromboembolic complications of treatment.Conclusions ɛ‐aminocaproic acid was found to be effective and safe for treatment of hyperfibrinolysis in patients with cirrhosis.
Prevalence of gastro‐oesophageal reflux disease in Spain and associated factors
Authors: PONCE J. , VEGAZO O. , BELTRÁN B. , JIMÉNEZ J. , ZAPARDIEL J. , CALLE D. , PIQUÉ J. M. ,   MEMBERS OF THE IBERGE STUDY GROUP
Published: December 2005

SummaryBackgroundThe prevalence of gastro‐oesophageal reflux disease (GERD), has not been characterized in Spain.AimTo measure the prevalence of GERD in Spain, and the factors associated with it, by means of a primary care‐based study.MethodsAn epidemiological, multicentre, cross‐sectional, population‐based study. A self‐administered questionnaire was sent out to randomly selected patients. Data were statistically analysed to provide the prevalence of GERD and to compare it with that of gastro‐oesophageal reflux symptoms. Factors associated with GERD were studied using logistic regression models.ResultsThe response rate was 45%. The prevalence of GERD was 15% (95% CI: 13.2–16.2). When compared with gastro‐oesophageal reflux symptoms patients, those with GERD experienced more intense symptoms (moderate–severe: 35% vs. 8%, P < 0.001) and suffered heartburn more frequently both at day and night (48% vs. 25%, P < 0.001) and for longer period of times (69% vs. 62%, P = 0.057). A body mass index of >25% (odds ratio: 1.07; 95% CI: 1.03–1.11) was the only independent variable associated with GERD. The risk of suffering GERD increases by 7% for each kg/m2 that the body mass index increases.ConclusionsThe prevalence of GERD among the Spanish population is 15%. Body mass index is the only risk factor significantly associated with GERD.
Systematic review and meta‐analysis: levofloxacin‐based rescue regimens after Helicobacter pylori treatment failure
Authors: GISBERT J. P. , DE LA MORENA F. 
Published: December 2005

SummaryBackgroundA quadruple therapy has been generally recommended as rescue regimen for Helicobacter pylori eradication failures.AimsTo systematically review the efficacy and tolerance of levofloxacin‐based rescue regimens, and to conduct a meta‐analysis of studies comparing these regimens with quadruple therapy for H. pylori eradication failures.MethodsSelection of studies – levofloxacin‐based rescue regimens. For the meta‐analysis, randomized‐controlled trials comparing levofloxacin‐based and quadruple regimens. Search strategy – electronic and manual. Assessment of study quality – independently by two reviewers. Data synthesis –‘intention‐to‐treat’ eradication rate.ResultsMean eradication rate with levofloxacin‐based regimens was 80%. Ten‐day regimens were more effective than 7‐day combinations (81% vs. 73%; P < 0.01). The meta‐analysis showed better results with levofloxacin than with the quadruple combination (81% vs. 70%; OR = 1.80; 95% CI = 0.94–3.46). This difference reached statistical significance and heterogeneity markedly decreased when a single outlier study was excluded or when only high‐quality studies were considered. Meta‐analysis showed less adverse effects with levofloxacin than with quadruple regimen, both overall (19% vs. 44%; OR = 0.27; 95% CI = 0.16–0.46) and regarding severe adverse effects (0.8% vs. 8.4%; OR = 0.20; 95% CI =0.06–0.67).ConclusionsAfter H. pylori eradication failure, levofloxacin‐based rescue regimen is more effective and better tolerated than the generally recommended quadruple therapy. A 10‐day combination of levofloxacin–amoxicillin–proton pump inhibitor constitutes an encouraging second‐line alternative.
Disposition and pharmacodynamics of propofol during isovolaemic haemorrhage followed by crystalloid resuscitation in humans
Authors: Takizawa Eri , Takizawa Daisuke , Hiraoka Haruhiko , Saito Shigeru , Goto Fumio 
Published: December 2005

AimsThe purpose of this study was to estimate the changes in unbound propofol concentration and pharmacodynamics of propofol during isovolaemic haemorrhage followed by crystalloid resuscitation.MethodsTen patients undergoing measure elective surgery were enrolled in this study. Anaesthesia was maintained by 60% nitrous oxide in oxygen, fentanyl 10–20 µg kg−1 and an infusion of propofol at 8 mg kg−1 h−1 until the end of the operation. Radial arterial samples were collected for measurement of propofol concentration just before the start of the operation, and at the point when blood loss was > 10 ml kg−1, 20 ml kg−1 and 30 ml kg−1. Cardiac output (CO), haemoglobin values and plasma concentrations of albumin were also determined. Patients were resuscitated with lactated Ringer's solution to maintain a mean arterial blood pressure (± 20% of prehaemorrhage). Bispectral index (BIS) was measured continuously.ResultsMean blood pressure, heart rate and CO were well maintained during the operation in all patients. Haemoglobin values and plasma albumin concentrations decreased significantly during surgery. There were no significant differences in total propofol concentrations across the time points. The unbound propofol concentration was increased from 0.10 ± 0.040 µg ml−1 to 0.17 ± 0.041 µg ml−1 after the haemorrhage of 30 ml kg−1 (P < 0.05). BIS was significantly decreased from 47 ± 5.9 to 39 ± 3.7 (P < 0.05) after the haemorrhage of 30 ml kg−1.ConclusionsThe hypnotic potency of propofol is increased during isovolaemic haemorrhage in crystalloid resuscitated patients even if CO is maintained.
Influence of gender and pubertal stage at diagnosis on growth outcome in childhood thyrotoxicosis: results of a collaborative study
Authors: Cassio A. , Corrias A. , Gualandi S. , Tato’ L. , Cesaretti G. , Volta C. , Weber G. , Bona G. , Cappa M. , Bal M. , Bellone J. , Cicognani A. 
Published: December 2005

SummaryObjective   To evaluate the influence of sex as well as pubertal stage at diagnosis on the growth outcome of childhood thyrotoxicosis.Design  Retrospective, collaborative study.Patients and methods   Longitudinal auxological evaluation in 101 patients (M/F 23/78) for 4·7 ± 3·1 years subdivided according to pubertal stage at diagnosis into prepubertal (group I) and pubertal (group II).Results   At diagnosis height and bone age (BA) standard deviation score (SDS) were positive both in girls and boys of groups I and II. In boys of group II, height SDS was significantly higher than in girls of the same group (P = 0·007) and in boys of group I (P = 0·026). During the follow‐up, in group I, height SDS remained positive without significant differences between boys and girls, and in group II, height SDS remained significantly lower in girls than in boys. The age at onset of puberty and the age at menarche were within the normal range. Final height (FH) was within target height (TH) range in all groups The FH SDS and the height gain (FH–TH) were similar in girls and in boys in group I and significantly higher in boys than in girls (P < 0·05) in group II. The boys of group II showed a mean height gain significantly greater than that found in all the other groups.Conclusions   Despite the advancement of BA at presentation, there were no adverse effects on subsequent growth and FH; the growth outcome seems to be better in boys than in girls in group II.
Identification of wild type and variants of oestrogen receptors in polymorphonuclear and mononuclear leucocytes
Authors: Stygar Denis , Westlund Pär , Eriksson Håkan , Sahlin Lena 
Published: December 2005

SummaryObjective   Leucocytes play an important role in the pathogenesis of autoimmune and cardiovascular diseases. Clinical and epidemiological observations indicate that the sex steroid hormones, particularly oestrogens, may regulate leucocyte functions. The assumption that oestrogens have a direct effect on leucocytes has to be supported by identification of functional oestrogen receptors (ER) in leucocytes. This study aimed at investigating the presence of ER subtypes in different types of leucocytes isolated from peripheral blood of female and male donors.Design and patients   A total of nine men (age range 18–43 years) and nine women (age range 19–42 years) all healthy blood donors, were recruited for the study. The donors did not receive any medication or hormonal contraceptives for the last three months. Ten millilitres of peripheral blood was collected from each donor. Polymorphonuclear leucocytes (PMN) and peripheral blood mononuclear cells (PBMC) were purified by density gradient centrifugation.Measurements   ERα and ERβ mRNA expression was measured by real‐time reverse transcriptase–polymerase chain reaction (RT‐PCR), and ER proteins were analysed by Western blot in the PBMC and PMN leucocyte populations. In addition, expression profiles of ER variant isoforms were characterized by conventional PCR using the splice‐targeted primer approach.Results   Although we detected wild‐type ERα and ERβ mRNAs in PBMC but not in PMN cells, the ERα and ERβ proteins were found in both cell types using Western blot. We observed that both ERα and ERβ proteins differ in size between PMN and PBMC, suggesting that the two leucocyte populations contain diverse variant isoforms of ERα and ERβ. RT‐PCR analysis of exon‐deleted ER splice variants revealed that PBMC express several exon‐deleted variants of ERα and ERβ, along with wild‐type receptor, whereas the PMN cells only express exon‐deleted variant isoforms and no wild‐type ERα or ERβ.Conclusions   Our study demonstrates the presence of ERα and ERβ in PBMC and PMN cells from female and male donors. The ERα and ERβ genes have complex transcriptional profiles, with many receptor variant isoforms being expressed. Considering the diversity of ER isoforms in leucocyte subtypes, we conclude that the expected effect of oestrogen would be highly cell type‐specific. Further studies are needed to test the functional activity of ER isoforms and their relation to disease.
Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study
Authors: O'Leary Peter C. , Feddema Peter H. , Michelangeli Valdo P. , Leedman Peter J. , Chew Gerard T. , Knuiman Matthew , Kaye Joey , Walsh John P. 
Published: December 2005

SummaryObjective  Overt or subclinical thyroid dysfunction is common within the community, yet the significance of subtle anomalies in thyroid function tests remains contentious. The aims of this study were to: (a) establish reference intervals for serum‐free thyroxine (FT4), thyroid‐stimulating hormone (TSH) and thyroid antibodies (antithyroperoxidase, TPOAb and antithyroglobulin, TgAb) in the Busselton community of south‐western Western Australia; and (b) determine the prevalence of thyroid hormone anomalies in this community.Subjects and design  In 1981, 2115 adults residing in Busselton participated in a cross‐sectional health survey that involved blood collection and a questionnaire on lifestyle and general health history.Measurements  Serum samples were analysed for FT4, TSH, TPOAb and TgAb by immunochemiluminescent assays.Results  Based on standard statistical approaches and using guidelines recommended by the National Academy of Clinical Biochemistry (NACB), reference intervals were derived for each analyte: 9–23 pmol/l for FT4, 0·4–4·0 mIU/l (TSH), < 35 KIU/l (TPOAb) and < 55 KIU/l (TgAb). The prevalence of elevated thyroid antibodies was 12·4% among subjects without a history of thyroid disease and is more common in women than in men. Elevated thyroid antibody levels were observed at both extremes of TSH abnormality, but were more commonly increased when TSH levels were above 4·0 mIU/l (63% subjects) than for those with TSH levels 0·4–4·0mIU/l (7·8% subjects).Conclusions  This study establishes the prevalence of antibodies to thyroperoxidase and thyroglobulin in a community‐based sample and reference intervals for free T4 and TSH. When the NACB decision limits are applied to older men or women, there is a markedly increased number with ‘elevated’ autoantibody levels compared to sex‐ and age‐specific reference intervals.
Discordant twin growth in utero and differences in blood pressure and endothelial function at 8 years of age
Authors: HALVORSEN C. P. , ANDOLF E. , HU J. , PILO C. , WINBLADH B. , NORMAN M. 
Published: December 2005

Abstract.Objective.  Low birth weight is associated with increased prevalence of hypertension and cardiovascular disease in adults. The aim of this study was to evaluate genetic and intrauterine environmental contributions to blood pressure (BP) and vascular functions in twins with discordant growth in utero.Subjects.  We studied 31 twin pairs (21 monozygous and nine dizygous), mean age 8 years) with large within‐pair differences in birth weight. Among the monozygous pairs, nine had suffered from twin‐to‐twin‐transfusion syndrome (TTTS).Methods.  Apart from BP, we determined diameters and elasticity of the carotid artery and abdominal aorta with ultrasonography, and endothelial function in skin vessels with a laser Doppler technique, before and after transdermal delivery of acetylcholine and nitroglycerin.Results.  Eight of 62 twin subjects had a systolic BP above the 90th percentile in a North‐American reference population. Among these, seven/eight were monozygous with a history of poor fetal growth and/or TTTS. In monozygous twin pairs without TTTS, systolic BP and pulse pressure were higher and vascular endothelial function was impaired in the lower birth weight twin. In the TTTS group, the lighter twin had a narrower carotid artery but there was no within‐pair difference in arterial elasticity. Pre‐eclampsia during the index pregnancy enhanced within‐pair differences in BP but abolished within‐pair differences in endothelial function.Conclusions.  Severe fetal growth retardation contributes to higher BP, arterial narrowing and endothelial dysfunction in childhood. Pre‐eclampsia may act both as an effect modifier and confounder of these associations.
Survival rate 28 days after hospital admission with first myocardial infarction. Inverse relationship with socio‐economic circumstances
Authors: GERWARD S. , TYDÉN P. , HANSEN O. , ENGSTRÖM G. , JANZON L. , HEDBLAD B. 
Published: December 2005

Abstract.Objective.  To study to what extent geographical differences of the mortality from ischaemic heart disease (IHD) can be accounted for by the 28‐day case fatality rate (CFR) following first hospital admittance for acute myocardial infarction (MI) and whether the geographical pattern of survival has any relationship with socio‐economic circumstances.Design.  Register‐based surveillance study.Setting.  Seventeen residential areas in Malmö, Sweden.Subjects.  All 5533 patients were admitted during 1986–1995 for a first acute MI at Malmö University Hospital.Main outcome measures.  CFR is based on record linkage with national registers. Area‐specific cardiovascular and socio‐economic scores (SES) are based on previous cross‐sectional studies.Results.  In patients below 75 years of age, differences of the 28‐day CFR accounted for 20–30% of the geographical variance in mortality from IHD. No corresponding association was found in older age groups. Patients from areas with low SES had the highest CFR, 23.8%. The odds ratios of fatal outcome for patients from areas with median and low SES (versus high SES) were 1.23 (95% CI: 1.01–1.50) and 1.25 (95% CI: 1.03–1.52), respectively (P for trend: 0.060). The strongest correlation was observed in men below 75 years of age (P for trend: 0.007). During the study period there was an improvement of the survival rate for patients from high and medium SES areas but no corresponding change for patients coming from areas having a low SES.Conclusions.  In patients below 75 years, geographical differences of the mortality from IHD were related to differences of the 28‐day CFR following hospital admittance for a first MI. Rates of survival were inversely related to socio‐economic circumstances in the patient's residential area.
Temporal trends in the prescription of vitamin K antagonists in patients with atrial fibrillation
Authors: FRIBERG J. , GISLASON G. H. , GADSBOELL N. , RASMUSSEN J. N. , RASMUSSEN S. , ABILDSTROM S. Z. , KØBER L. , MADSEN M. , TORP‐PEDERSEN C. 
Published: December 2005

Abstract.Objectives.  Anticoagulation therapy is recommended in patients with atrial fibrillation (AF) and risk factors for stroke. We studied the temporal trends in the prescription of vitamin K antagonists (VKA) in patients with a first hospital diagnosis of AF in Denmark, 1995–2002.Design.  The Danish National Hospital Registry was used to identify subjects with a first hospital diagnosis of AF and the Danish Register of Medical Products Statistics to determine the proportion of these patients who claimed a prescription of VKA within 3 months from discharge.Results.  Amongst 68 546 patients aged 50–99 years with a diagnosis of AF who survived 3 months following discharge, 24 991 (36%) patients claimed a prescription of VKA within 3 months. In both men and women a gradual increase in the use of VKA with time was observed, the relative increase being largest amongst the 80‐ to 99‐year olds. In all age groups, the prescription of VKA was lower in women than in men, including patients with a prior or concurrent stroke.Conclusions.  From 1995 to 2002 the proportion of AF patients receiving VKA therapy increased significantly but the use of VKA therapy amongst women was lagging behind that of men. Even in patients with AF and prior stroke, the use of VKA seems to be less than optimal.
Three‐Dimensional Representation of the Neurotransmitter Systems of the Human Hypothalamus: Inputs of the Gonadotrophin Hormone‐Releasing Hormone Neuronal System
Authors: Dudas B. , Merchenthaler I. 
Published: December 2005

AbstractThe gonadotrophin‐releasing hormone (GnRH) represents the final common pathway of a neuronal network that integrates multiple external and internal factors to control fertility. Among the many inputs GnRH neurones receive, oestrogens play the most important role. In females, oestrogen, in addition to the negative feedback, also exhibits a positive feedback influence upon the activity and output of GnRH neurones to generate the preovulatory luteinising hormone surge and ovulation. Until recently, the belief has been that the GnRH neurones do not contain oestrogen receptors and that the action of oestrogen upon GnRH neurones is indirect, involving several, oestrogen‐sensitive neurotransmitter and neuromodulator systems thattrans‐synaptically regulate the activity of the GnRH neurones. Although this concept still holds for humans, recent studies indicate that oestrogen receptor‐beta is expressed in GnRH neurones of the rat. This review provides three dimensional stereoscopic images of GnRH‐immunoreactive (IR) and some peptidergic (neuropeptide Y‐, substance P‐, β‐endorphin‐, leu‐enkaphalin‐, corticotrophin hormone‐releasing‐ and galanin‐IR) and catecholaminergic neurones and the communication of these potential oestrogen‐sensitive neuronal systems with GnRH neurones in the human hypothalamus. Because the post‐mortem human tissue does not allow the electron microscopic identification of synapses on GnRH neurones, the data presented here are based on light microscopic immunocytochemical experiments using high magnification with oil immersion, semithin sections or confocal microscopy.