bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review of local practice regarding investigations in children attending obesity clinics and a comparison of the results with other studies
Authors: Leigh‐Hunt N. , Rudolf M. 
Published: September 2007

AbstractBackground  Obese children are at high risk of developing co‐morbidities, with a prevalence of abnormal tests ranging from 30 to 58%. Recent guidance recommends that all children with a body mass index (BMI) above the 95th centile be investigated. This study aimed to determine the prevalence of abnormal results in an urban paediatric population and to compare local practice against these recommendations.Methods  Patient records of children attending either a community or hospital‐based obesity clinic were analysed retrospectively to obtain anthropometric data and laboratory results; from this, the frequency of investigation and the prevalence of abnormal results were calculated. Investigations considered were alanine aminotransferase, thyroid‐stimulating hormone (TSH), and fasting glucose, insulin and lipid profiles.Results  One hundred thirty‐six children (75 girls, 61 boys) were identified, with mean BMI z‐score of 3.27 and mean age of 11.4 years (range 1.4–20.4). Children with BMI z‐score >3 were more likely to be investigated, but otherwise, the frequency was similar for both sex and age. The prevalence of abnormal results was liver function tests, 14.3%; TSH, 0.0%; glucose, 0.0%; insulin, 31.6%; triglycerides, 10.0%; cholesterol, 15.6%. The sample size was small, but there did not appear to be a significant difference in the percentage abnormal results found for sex, age, or BMI z‐score.Conclusion  The prevalence of abnormal results was less than that identified in another UK study carried out in a tertiary centre, suggesting that the true population‐based prevalence is lower than believed. This might be especially so because fewer tests were performed in these clinics than currently recommended and children at highest risk were more likely to be investigated. Therefore, further research is indicated to determine the true figure as well as to identify risk factors for co‐morbidity, before costly recommendations to test all children with a BMI above the 95th centile are implemented.
An exploration of children's views of bed‐wetting at 9 years
Authors: Butler R. , Heron J. 
Published: September 2007

AbstractBackground  Although some empirical investigations have explored the impact of nocturnal enuresis for sufferers, little is known about how children in general understand nocturnal enuresis. This study employed a large cohort of children at 9 years, asking directly about the perceived difficulty of bed‐wetting in relation to an extensive range of life events.Method  The sample comprised 8209 children, 4012 (48.9%) male and 4197 (51.1%) female who, as part of the Avon Longitudinal Study of Parents and Children survey, completed a booklet called ‘My World’ which included a section of 21 items concerned with childhood difficulties.Results  Bed‐wetting was highly endorsed as a difficulty for children, and factor analysis revealed it to be construed as a social problem. Girls were more likely to consider events of a social and emotional nature to be difficult, whereas boys rated antisocial events as more problematic. Boys and those who suffer from nocturnal enuresis were significantly more likely to view bed‐wetting as more difficult for children.Conclusion  Bed‐wetting, which is construed as a social issue, tends to be rated as a major difficulty for children, increasingly so for boys and those who suffer from nocturnal enuresis.
Children's understanding of mental illness: an exploratory study
Authors: Fox C. , Buchanan‐Barrow E. , Barrett M. 
Published: September 2007

AbstractBackground  This study aimed to investigate children's thinking about mental illness by employing a well‐established framework of adult illness understanding.Methods  The study adopted a semistructured interview technique and a card selection task to assess children's responses to causes, consequences, timeline and curability of the different types of mental illness. The children were aged between 5 and 11 years.Results  Results indicated a developmental trend in the children's thinking about mental illness; there was an increase in the children's understanding of the causes, consequences, curability and timeline of mental illness with age. The older children demonstrated a more sophisticated and accurate thinking about mental illness compared with the younger children, who tended to rely on a medical model in order to comprehend novel mental illnesses. Furthermore, the girls exhibited more compassion, showing greater social acceptance compared with the boys.Conclusions  The Leventhal model provides a useful framework within which to investigate children's knowledge and understanding of mental illness. Limitations of the study and implications for future research are discussed.
Variation in the IGF1 gene and growth in foetal life and infancy. The Generation R Study
Authors: Geelhoed J. J. Miranda , Mook‐Kanamori Dennis O. , Witteman Jacqueline C. M. , Hofman Albert , Van Duijn Cornelia M. , Moll Henriëtte A. , Steegers Eric A. P. , Hokken‐Koelega Anita C. S. , Jaddoe Vincent W. V. 
Published: September 2007

SummaryObjective  The objective of this study was to examine whether variants of the IGF1 gene are associated with growth patterns from foetal life until infancy.Study design and measurements  This study was embedded in the Generation R Study, a population‐based prospective cohort study of foetal life. Foetal growth (head circumference, abdominal circumference, femur length, estimated foetal weight) was assessed by ultrasound in early, mid‐ and late pregnancy. Growth in infancy was assessed at birth (weight) and at the ages of 6 weeks, 6 months and 14 months (head circumference, length, weight). The IGF1 promoter region genotype was determined in 738 children.Results  Eight alleles of the IGF1 promoter region were identified. In total, 43% of the subjects were homozygous for the most common 192‐bp allele (wild‐type), 45% were heterozygous, and 12% were noncarriers of the 192‐bp allele. No differences were found in birthweight between the three groups. However, noncarriers had a lower estimated foetal weight in mid‐pregnancy (P = 0·040), followed by an increased growth rate until 6 months (P < 0·005) in comparison to the 192‐bp homozygotes. A similar difference in growth rate was found for length (P < 0·001).Conclusions  Variants of the IGF1 promoter region are not associated with birthweight. However, noncarriers of the 192‐bp allele tend to have a smaller foetal size, followed by an increased growth rate from mid‐pregnancy to early infancy. Studies in larger cohorts are necessary to replicate our findings and to examine whether these effects persist throughout childhood.
Biological variation of total testosterone, free androgen index and bioavailable testosterone in polycystic ovarian syndrome: implications for identifying hyperandrogenaemia
Authors: Cho L. W. , Kilpatrick E. S. , Jayagopal V. , Diver M. J. , Atkin S. L. 
Published: September 2007

SummaryObjective  Hyperandrogenaemia is one of the three Rotterdam consensus diagnostic criteria for polycystic ovarian syndrome (PCOS) and may be measured by estimation of total testosterone, free androgen index (FAI) or bioavailable testosterone (BioT). The aim of this study was to compare the biological variability of total testosterone with that of the biological variability of both the FAI and BioT, to determine the least variable measurement for clinical practice.Design  Comparative study.Patients  Blood samples were collected after an overnight fast at 4‐day intervals on 10 consecutive occasions from 12 PCOS patients and 11 weight‐ and age‐matched control women.Measurements  Duplicate samples of stored serum were analysed for total testosterone, SHBG and BioT in a single batch.Results  The PCOS group had a significantly higher median BioT, FAI and total testosterone than controls. In both the PCOS and control groups, the intraindividual variance was small and similar for BioT and FAI. There was no significant difference between the within‐subject biological coefficient of variation (CVI) for BioT, FAI and total testosterone. The maximum and minimum critical differences were +58% and –37% for BioT and +70% and –40% for FAI, respectively.Conclusion  FAI appears to be the better diagnostic marker to distinguish hyperandrogenism in patients with PCOS, but once diagnosis has been made, all three methods should be equally good in monitoring further changes in the androgen status.
Higher serum free testosterone is associated with better cognitive function in older men, while total testosterone is not. The Health In Men Study
Authors: Yeap Bu B. , Almeida Osvaldo P. , Hyde Zoë , Chubb S. A. Paul , Hankey Graeme J. , Jamrozik Konrad , Flicker Leon 
Published: September 2007

SummaryObjective  To determine the relationship of total and free serum testosterone to cognitive performance in older men.Design  Cross‐sectional study of a population‐based sample.Participants  A total of 2932 men aged 70–89 years.Measurements  Cognitive function was assessed using the Standardized Mini‐Mental State Examination (SMMSE). Early morning sera were assayed for total testosterone, SHBG and LH. Free testosterone was calculated using the Vermeulen method.Results  There were weak positive correlations between SMMSE score and serum free testosterone (Spearman's rho = 0·06, P = 0·001) and total testosterone (r = 0·04, P = 0·027), and a weak negative correlation with LH (r = −0·07, P < 0·001). Men with SMMSE scores in the top quintile had higher serum free testosterone compared with those in the lowest quintile [median (interquartile range, IQR): 278 (228–335) vs. 262 (212–320) pmol/l, P = 0·003], but similar total testosterone [15·2 (11·9–18·8) vs. 14·8 (11·6–18·3) nmol/l, P = 0·118]. Increasing age, non‐English‐speaking background, lower educational attainment, presence of clinically significant depressive symptoms, and cardiovascular morbidity were associated with the lowest cognitive performance quintile. After their effects were taken into account in a multivariate analysis, serum free testosterone ≥ 210 pmol/l was associated with reduced likelihood of poor cognitive performance on the SMMSE [odds ratio (OR) 0·71, 95% confidence interval (CI) 0·52–0·97].Conclusions  In community‐dwelling older men, serum free testosterone ≥ 210 pmol/l is associated with better cognitive performance. In this context, calculated free testosterone seems to be a more informative measure of androgen status than total testosterone. Studies examining the contribution of androgens to age‐related cognitive decline should incorporate an assessment of free testosterone concentration.
Effects of exercise‐induced weight loss on acylated and unacylated ghrelin in overweight children
Authors: Kim Hyun Jun , Lee Sangyeoup , Kim Tae Wun , Kim Hyoung Hoi , Jeon Tae Yong , Yoon Yeong Sook , Oh Sang Woo , Kwak Hyun , Lee Jae Gue 
Published: September 2007

SummaryObjective  Controversial data on ghrelin concentration during exercise in human subjects have been published. We tested the hypothesis that exercise could affect acylated ghrelin (AG) and unacylated ghrelin (UAG), which could partly explain the previously reported inconsistent findings on the association of exercise with changes in ghrelin.Design   A prospective randomized study.Patients and measurements  We randomized 17 overweight volunteers (11‐year‐old boys) to a 12‐week combined exercise group (EG, n = 8) or control group (CG, n = 9). At baseline, 1, 4 and 12 weeks, we measured body weight and composition, insulin, leptin, total ghrelin and acylated ghrelin.Results  Compared with the CG, body weight, percentage body fat and homeostatic model assessment (HOMA) indices were significantly lower throughout the 12 weeks in the EG. Total ghrelin and UAG levels gradually increased to 131·9 ± 5·2% and 130·4 ± 5·2% of baseline, respectively, at week 12 in the EG, whereas AG concentration remained unchanged throughout the 12 weeks both within each group and between the groups. At week 12, there were differences in the total ghrelin level and UAG level between the groups.Conclusions  This study shows an increase in unacylated acylated ghrelin and unchanged acylated ghrelin after a 12‐week combined exercise programme in overweight children. These findings provide evidence of favourable effects of exercise on improving energy metabolism.
Heritability of serum TSH, free T4 and free T3 concentrations: a study of a large UK twin cohort
Authors: Panicker V. , Wilson S. G. , Spector T. D. , Brown S. J. , Falchi M. , Richards J. B. , Surdulescu G. L. , Lim E. M. , Fletcher S. J. , Walsh J. P. 
Published: September 2007

SummaryObjective  Thyroid hormone action influences many metabolic and synthetic processes, but the degree of regulation attributed to genes and environmental factors affecting normal variation remains controversial.Design  We investigated the magnitude of the genetic and environmental determination of serum concentrations of free (f) T3, fT4, TSH and the fT4 × TSH product and their variation, in a large cohort of twin pairs. Female dizygous and monozygous twins (849 and 213 pairs, respectively) from the TwinsUK registry (mean age 45·5, range 18–80 years) were studied.Results  Comparison of thyroid parameters within various groups showed no differences between smoking categories, and higher serum TSH and lower fT3 in subjects with positive thyroid antibodies. Using structural equation modelling, we estimated the heritable contribution to serum thyroid parameters (with 95% confidence intervals) to be 65% (58%–71%) for TSH, 65% (58%–71%) for the fT4 × TSH product, 39% (20%–55%) for fT4 and 23% (3%–41%) for fT3.Conclusions  We conclude that genetic regulation is a particularly important determinant of TSH and the fT4 × TSH product, and is a less important determinant of fT4 and fT3 concentrations in Caucasian women. These data from a large well‐characterized cohort suggest that while there is a strong heritable contribution to serum TSH, variation in fT4 and fT3 concentrations may be less explained by genetic factors and more driven by environmental effects than previously thought.
Short‐term treatment with ezetimibe, simvastatin or their combination does not alter circulating adiponectin, resistin or leptin levels in healthy men
Authors: Gouni‐Berthold Ioanna , Berthold Heiner K. , Chamberland John P. , Krone Wilhelm , Mantzoros Christos S. 
Published: September 2007

SummaryObjective  Statin therapy decreases cardiovascular morbidity and mortality, and ezetimibe, a novel cholesterol absorption inhibitor has both lipid‐lowering and anti‐atherosclerotic effects in animal models. As several adipokines, that is, adiponectin, high molecular weight (HMW) adiponectin, leptin and/or possibly resistin are involved in the pathogenesis of insulin resistance (IR), dyslipidaemia and atherosclerosis, we investigated whether ezetimibe and/or statin treatment may modulate serum concentrations of these four major adipokines.Research design and methods  One‐centre, randomized, parallel three‐group study in 72 healthy men [mean age 32 ± 9 years, mean body mass index (BMI) 25·7 ± 3·2 kg/m2].Patients  Seventy‐two healthy men. Each group of 24 subjects received a 14‐day treatment with either ezetimibe (10 mg/day), simvastatin (40 mg/day) or their combination. Blood was drawn before and after the 14‐day treatment period.Measurements  Lipid levels, IR indices, serum leptin, adiponectin, HMW adiponectin and resistin concentrations.Results  Neither ezetimibe nor simvastatin or their combination had any effect on serum leptin, adiponectin, HMW adiponectin and resistin concentrations. Baseline leptin levels correlated positively, while adiponectin and HMW adiponectin negatively, with BMI. Leptin concentrations correlated negatively while adiponectin and HMW adiponectin positively with plasma high‐density lipoprotein‐cholesterol concentrations. Resistin concentrations were not associated with BMI, lipid levels or indicators of IR.Conclusions  Treatment with ezetimibe, simvastatin or their combination does not alter circulating levels of adiponectin, leptin or resistin in adult healthy men.
A systematic review of the gonadal effects of therapeutic radioactive iodine in male thyroid cancer survivors
Authors: Sawka Anna M. , Lea Jane , Alshehri Bandar , Straus Sharon , Tsang Richard W. , Brierley James D. , Thabane Lehana , Rotstein Lorne , Gafni Amiram , Ezzat Shereen , Goldstein David P. 
Published: September 2007

SummaryBackground  For patients with well‐differentiated thyroid carcinoma (WDTC), the gonadal effects of radioactive iodine (RAI) therapy is an important consideration.Objective and methods  We systematically reviewed the controlled studies examining the gonadal effects of RAI therapy in male WDTC survivors. We searched in nine electronic databases. All abstracts and papers were independently reviewed by two reviewers.Results  After reviewing 334 abstracts and 59 full‐text papers, seven papers were included. In longitudinal studies examining the effect of single primary RAI dose activities of ≤ 150 mCi, serum FSH and LH rose between months 2 and 6, with normalization by 18 months; serum testosterone did not significantly decrease. In one study, 18 months after RAI, the rates of elevated serum FSH were: 27% for 351–594 mCi and 81% for > 594 mCi. Cumulative RAI dose correlated with FSH measurements at long‐term follow‐up. In one study, approximately one in eight men experienced oligospermia 1 year after RAI therapy. Rates of infertility, pregnancy loss and offspring congenital malformation were not elevated, but studies were limited by small size and self‐reported outcomes.Conclusions  Abnormalities in testicular function are common within several months of a single therapeutic dose of RAI for WDTC. Biochemical abnormalities usually resolve within 18 months after administration of a single activity of < 150 mCi of RAI. The risk of persistent gonadal dysfunction is increased after repeated or high cumulative RAI activities. Controlled, prospective studies, with long‐term follow‐up, examining male gonadal and offspring effects of RAI therapy are needed.
Bilateral laparoscopic adrenalectomy for corticotrophin–dependent Cushing's syndrome: a review of the Mayo Clinic experience
Authors: Chow John T. , Thompson Geoffrey B. , Grant Clive S. , Farley David R. , Richards Melanie L. , Young William F. 
Published: September 2007

SummaryBackground  There has been a rapid shift from open to laparoscopic approaches in adrenal surgery, but the safety and efficacy of bilateral laparoscopic adrenalectomy (BLA) in patients with corticotrophin (ACTH)‐dependent Cushing's syndrome continues to be defined.Objective  Review outcomes in the largest series of patients reported to date undergoing BLA for ACTH‐dependent Cushing's syndrome.Design  Retrospective review study.Patients  Between January of 1995 and October of 2006, BLA was attempted in 68 patients with ACTH‐dependent Cushing's syndrome (26 ectopic ACTH syndrome; 42 persistent pituitary‐dependent Cushing's syndrome following pituitary surgery).Measurements  Review of peri‐operative morbidity and mortality, biochemical parameters and patient‐reported symptom response from chart review and mailed questionnaire.Results  BLA was successfully completed in 59 of 68 patients (87%); nine (13%) required conversion to open adrenalectomy (OA). Intra‐operative complications occurred in three patients (4·4%) (two BLA, one OA), and non‐operative complications occurred in 11 (16%) patients (eight BLA, three OA). There were no peri‐operative deaths. Median hospitalization was 5·5 days (range, 3–28) and 11·9 days (range, 4–29) for the BLA and OA groups, respectively. In patients with follow‐up data available, all achieved biochemical resolution and at least partial clinical resolution of signs and symptoms associated with hypercortisolism. Resolution of hypertension, diabetes and obesity was achieved in 64%, 29% and 35% of patients carrying those diagnoses prior to surgery, respectively.Conclusions  This study further supports the role of BLA as an effective treatment option for patients with ACTH‐dependent Cushing's syndrome.
Association of genetic variants in GABRA3 gene and thyrotoxic hypokalaemic periodic paralysis in Thai population
Authors: Jongjaroenprasert Wallaya , Chanprasertyotin Suwannee , Butadej Siriwan , Nakasatien Soontaree , Charatcharoenwitthaya Natthinee , Himathongkam Thep , Ongphiphadhanakul Boonsong 
Published: September 2007

SummaryBackground  Genetic predisposition has been suggested to play role in the pathogenesis of thyrotoxic hypokalaemic periodic paralysis (THPP).Objectives  In this study, we assessed the differences of single‐nucleotide polymorphisms (SNP) allelic frequency between THPP patients and well‐characterized controls in order to find the susceptibility genetic variants related to THPP using microarray‐based assessments on pooled DNA.Methods  Fifty cases of THPP and 50 male hyperthyroid patients without hypokalaemia as controls were recruited. Equal amounts of individual genomic DNA were pooled from each group. Estimated allele frequencies of SNPs were derived by averaging relative allele signal score obtained by Affymetrix GeneChip® Mapping 10K Arrays.Results  Sixty‐nine loci that display robust allele frequency differences between THPP and controls were identified. SNP rs750841 (A > T) in intron 3 of the gamma‐aminobutyric acid (GABA) receptor α3 subunit (GABRA3) gene possessed the most significant difference in allele frequency (27% in THPP case and 5% in controls, P = 0·007). Actual allele frequencies obtained from genotyping in each individual were very similar to the estimated frequency from the pools (28% in THPP and 2% in controls, and P = 0·0002). Nearby DNA sequences of GABRA3 were sequenced and an additional two SNPs were found (A > C at exon 1 and G > T of rs12688128). Allele A of rs750841 and allele G of rs12688128 in intron 3 were predominantly found in THPP with significant genetic relative risk of 19 (P < 0·0002; 95%CI 2·4–151·6).Conclusions  Whole‐genome scanning on pooled DNA provides an accurate, useful screening tool for elucidating genetic underpinnings of THPP. SNPs at intron 3 of GABRA3 are found to be associated with THPP.
Prediction of aggressiveness of gastrointestinal stromal tumours based on immunostaining with bcl‐2, Ki‐67 and p53
Authors: Meara R. S. , Cangiarella J. , Simsir A. , Horton D. , Eltoum I. , Chhieng D. C. 
Published: September 2007

Objective:  While the use of fine needle aspiration (FNA) in the diagnosis of gastrointestinal stromal tumours (GISTs) is well‐established, it can be difficult to predict the prognosis of GIST based on morphology alone. The objective of the current study was to determine if expression of bcl‐2, Ki‐67 and p53 correlated with the outcome of GISTs based on cytological material.Methods:  Cell‐blocks from 14 GISTs diagnosed by FNA were retrieved. Immunostaining was performed with antibodies against bcl‐2, Ki‐67 and p53. All cytological diagnoses were confirmed by positive immunostaining with c‐kit and/or subsequent histological evaluation. Positivity for bcl‐2, Ki‐67 and p53 was defined as the presence of ≥10% cytoplasmic staining, ≥5% nuclear staining and ≥5% nuclear staining respectively.Results:  The 14 patients consisted of seven males and seven females with a mean age of 58 years. The average follow‐up interval was 46 months. Six had a benign course and eight developed recurrences/metastases. Thirteen (93%) cases showed positive staining for bcl‐2. Positive Ki‐67 and p53 staining was noted in one (7%) and seven (50%) cases respectively. The difference in staining for p53 between aggressive and non‐aggressive GISTs was statistically significant. No statistically significant difference was noted for bcl‐2 staining or Ki‐67 labelling index between the two groups.Conclusions:  According to our observations, p53 immunostaining may be useful in predicting the outcome of GIST diagnosed by FNA; Ki‐67 and bcl‐2 are not useful as prognostic markers for GIST in FNA specimens.